KING OF DISEASES

Evening Post, Volume CIV, Issue 150, 22 December 1922, Page 24

KING OF DISEASES

DEATHS FROM HEART. AFFECTIONS. SEX, AGE. AND OCCUPATION ' FACTORS. ■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 i'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 oven in childhood, being responsible for more deaths than measlco and whooping-cough together. More than two and a half mirUod persona are afi'acted with it in some i degree in.,the United Stales alone. Dr. Dublin, writes: —• ' ". _ ' . Since November-, 1921, the "death, rate i from heart disease- has been appreciably higher than it was during the corresponding months of the previous year. : The samo hr.a been true for the associated organic 'diseases. The heart d.i»easo death, rate increased sharply month- by month until in March the rate Cached the maximum of 168.2 deaths per IOO.CQO living, one of the highest figures in recent yeare. 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 h-sart disease death rates that were higher than normal prevailed for several months before the influenza epidemic, and have continued for ssversl 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 has been virtually no gain, in its control; the campaign against heart disease is very, much in the same position as that, against tuber- | culosis fifteen or twenty years ago. The incidence of any disease may be studied from two angles :. (1) as a cause of sickness and (2) as a cause of death. In respect to sicluiess, we.have very few facts indeed. : , PROPORTIONATE TO AGS The statistics of heart disease mortal-, ity 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 to, view 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 the 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 period 65 to 74 the number of deaths irom 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 Tates 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 adult 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 whoopingcough. Between -fifteen and twenty-four years the deaths from heart disease are more numerous than from typhoid fever. Between the ages tiwenty-fiye and thirtyfour 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 entirely trustworthy, ifj would appear that of all occupations those which are carried, on upon the water have the highest heartdisease 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 brew-.! ers, and those exposed to lead poisonings There are high' rates for metalworkers, blacksmiths, cutlors,'and toolmakers. All sedentary .occupations have, favourable, death rates... 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 examinatioD would show some type of organic heart lesion. These persons, are not all, ill.. Many of them are engaged.m 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 thece 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-forTy-five there are each year over 22,000 deaths. Each one of these deaths 1 represents a distinct loss to, the community, since' these persons are presumably at an ago 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 fathef. This is the extent of the community problem which is" brought about each year by heart disease. v,.■■..•'■■ ■ '.-: