PROCEEDINGS, MAY, xiii 



MR. Johnston's paper. 



The discussion, adjourned from last meeting, was resumed on the 

 paper by Mr. R. M. Johnston, F.L.S., on " How far the general 

 death-rate for all ages can be relied upon as a comparative index of 

 the health or sanitary condition of any community," 



Mr. Johnston said before the discussion was commenced he wished 

 to correct an error that had occurred in his paper. On page 8 they 

 would iind the statement, " Where, as in Tasmania, 36*74 per cent, of 

 the deaths exceed the allotted span," etc. The words, "the mean 

 age of," should have preceded the figures 36"74. Several other errors 

 of a less important character had occurred in the paper. 



Dr. C. J. Parkinson then opened the discussion, and said : — In the 

 few remarks I have to make on the very interesting and instructive 

 paper of Mr. Johnston, I am sorry I have not had the material or 

 the time to go into the question so thoroughly as I should like to 

 have done. The two points I wish to deal with are the age limits of 

 his health standard, and the conclusion he draws on pp. 10 and 11, 

 with regard to the health of Hobart. Speaking of the influence of 

 migration on the total death-rate on p. 11, what Mr, Johnston points 

 out constitutes an argument against including the deaths between 

 and 5 in the health standard. The reason is manifest : the bulk of 

 immigrants consists of persons between 5 and 50, The proportion of 

 children under 5 is thus reduced in a colony, and, therefore, for 

 comparison with England or any old country, deaths at this age should 

 be omitted. Also, on p. 12, Mr. Johnston points out the effect of 

 the birth-rate disturbance, showing that an increase in the marriage 

 and birth rates arising from a general improvement in the material 

 welfare of a country may considerably increase the total death-rate 

 without implying a deterioration in the general health and sanitary 

 condition. This further suggests the desirability of omitting deaths at 

 this age. To illustrate this, let us assume that the births in Tasmania 

 in 1885 had been 20 per cent, larger, while the death-rate for all ages 

 remained the same. The effect would have been to add 927 to the 

 population and 104 to the deaths, and the general effect on the health 

 standard used by Mr. Johnston would be to raise the death-rate from 

 10 "5 to 11 "2; thus, in Mr. Johnston's words, increasing the total death- 

 rate without any disturbance of matters affecting the local health and 

 sanitary condition. With regard, now, to the upper limit of the health 

 standard, I venture to think that 60 is too low an age to take. We are 

 not in the habit of considering deaths at that time of life as due to 

 " extreme old age," and since Mr. Johnston, on p. 8, speaks merely of 

 the desirability of excluding deaths from " extreme old age" in his 

 health standard, I think he ought to have fixed the upper limit rather 

 higher— perhaps 65 or 68 would be a better limit. (Hear, hear.) In 

 England about 25 per cent, of the population die between the ages of 

 0—5, and 25 per cent, at 69 and upwards, the middle 50 per cent. , that 

 is those from 5 — 68 would probably afford a more desirable index for 

 the purpose in view. It would also be desirable for greater accuracy 

 to omib deaths from violence. This may seem an unnecessary refine- 

 ment, but, bearing in mind the frightful losses of life in adjoining 

 colonies from the recent shipping and colliery disasters, the result of 

 including such deaths may occasionally be very great on the general 

 death-rate ; though suggesting these alterations in Mr, Johnston's present 

 health standard I still think it a far more reliable test than any other 

 in use. The next point I should like to touch upon is that of the 

 health of Hobart compared with other towns. See pp. 10 and 11, As 

 indicating the great utility of the health standard, the comparision 

 made is most useful, but as proving the superior " health and sanitary 

 condition " of Hobart, it is hardly so satisfactory, and for this 



