KING OF ALL DISEASES.

Press, Volume LVIII, Issue 17645, 23 December 1922, Page 3

KING OF ALL DISEASES.

RISING DEATH-RATE FROM HEART AFFECTIONS. SEX, AGE, AND OCCUPATION FACTOBS. . The chief cause of death among humans is heart disease. We hear so much about other diseases, especially such infectious ones as tuberculosis and smallpox, or such mysterious ones as cancer, that this statement may cause surprise (says the "Literary Digest"). It is made by Dr. Louis I. Dublin, statistician of the Metropolitan Life Insurance Company of New York, in an article contributed to "The Nation's Health" (Chicago). Although particularly fatal in middle life and later, heart disease is important even m childhood, being responsible for more deaths than measles -and whooj>ingcough together. More than two and a-half million persons are affected with it in some degree in the United States alone. Dr. Dublin writes:— Since November, 1921, the death-rate from heart (liseaso has been appreciably higher than it was during the corresponding months of the previous year. The same has been truo for the associated organic diseases. The heart disease death-rate increased sharply month by month until in March the rate reached tho maximum of 165.2 deaths per 100,000 living, one of the highest figures in recent years. Obviously some of this increase of heart disease is the direct result of the influenza epidemic which broke out in the early months of this year. But this cannot be the whole cause, because heart diseases death-rates that were higher than normal prevailed for several months before the influenza epidemic and have continued for several months after its close. Experience would seem to indicate that the serious increase in heart disease deaths is quite apart from the effect of influenza and pneumonia. This disease is to-day the chief cause of death. There lias been virtually no gain in its control; the campaign against heart disease is very much in the same position as that against tuberculosis fifteen or twenty years ago. The incidence of any disease may be studied from two anglos: (1) as a cause of sickness and (2) as a cause of death. In respect to sickness, we have very few facts indeed. Proportionate to Age. The statistics of heart disease mortality are more satisfactory, both in point of areas covered, of detail as to colour, sex and. age, and of diagnostic accuracy. • The first point that comes j to viow is that the incidence of heart disease as a cause of death increases consistently with age. At the age period of 35 to 44, when persons should be at height of their productivity, one white person dies .from heart disease in every thousand living and two coloured persons out of each thousand. At the age poriod 65 to 74 the number of deaths from heart disease has increased to about 15 in each 1000 living. The rates are also very much higher for coloured persons than for whites. The sex ratios of heart-disease mortality are also rather interesting. The rates are usually higher for females than for males, up to the age of thirty. From that age onward the rates for males are higher, the difference becoming regularly greater with advancing years. But if heart disease is particularly important in middle life and at older ages, it is _already an important condition in childhood and early adlult life. Thus, the number of deaths between the ages of five and nine are as many as from two such important infectious diseases of' childhood as measles and whooping-cough. Between 15 and 24 years the death from heart disease are more numerous than from typhoid fever. Between the ages of 25 and 34 heart disease caused each year almost as many deaths as lobar pneumonia. . Dangerous Occupations. Some relations_ have been discovered between heart disease and occupation. While the figures are not 1 entirely trustworthy, it would appear that of all occupations those which arp earned on upon the water have',the highest heart disease rates. It is possible that this relationship is in some way related to exposure to greater dampness and cold. Next to these occupations are those exposed to alcoholism, including brewers, and those exposed! to lead poisoning. There are high rates f6r metalworkers, blacksmiths, cutlers, and toolmakers. All sedentary occupations hare favourable death-rateis 'from heart disease. To summarise the facts, then, we may say that, according to our best knowledge, there are about 2,500,000 persons in the United States who on examination would 'show some type of organic heart lesion. These persons are not all ill. Many of them are engaged in their ordinary pursuits and have no idea of their impairment. It is the business of American physicians to discover for each community those who are in any way suffering from one type or another of heart defect. No one knows the amount of loss sustained annually through the disability for work which results from the ..varying incapacity among these two and a half million people. : In addition, there are each year in the "United States about 150,000 deaths from, heart disease, and the number is not declining. Even under the 'age of 45 there are each year over 22,000 deaths. Each one of these deaths represents a distinct loss to the community, since these persons are presumably at an age where production may be -expected to be at its highest. They leave good-sized families of minor children who suffer from the loss of a parent, and, more usually, the father. This is the extent of the community problem which is brought about each year by heart disease.