PUBLIC HEALTH

Evening Post, Volume CIV, Issue 73, 23 September 1927, Page 8

PUBLIC HEALTH

BENEFITS CONFERRED

NOVEL BALANCE-SHEET

REDUCED DEATH RATES

The Director of the Public Hygiene j Department of .Health (Dr. T. M'Kibbin) delivered an intersting address at a meeting of the Sanitary Inspectors 1 Association at the Town Hall last evening. Dr. M'Kibbin said he proposed in a general talk on health work to count some of the blessings that modern sanitation and preventive medicine had conferred on mankind, and endeavour to count the cost insofar as Now Zealand was concerned. "I propose," ho said, "to submit for your audit a novel type of balancesheet. On the ono hand I shall endeavour to show some of the benefits conferred by our sanitary law and practice and on the other I shall state the debt that has been incurred thereby. It can be said that in the past fifty years there has been a steady and great reduction in the death rates from infectious diseases in New Zealand, "I submit for your inspection a graph which has been prepared by tho Census and Statistics officer, basod upon five-year periods since 1876, and giving the deat]i rates per 100,000 of moan population. Prom this you will see that the. death rate from typhoid fever, which is often takeu as a sanitary index of a country, has fallen from 30 to 25 per 100,000 of mean population. Those of diphtheria and scarlet fever have also fallen greatly. In the same period, namely, since 1576, the death rate from tuberculosis (all forms) has dropped from 160 per 100,----000 of mean population to 50, and that reduction has been gradual and consistent. Thus, though we still have the unsolved problems of cancer which attacks persons late in life, the degenerative diseases such as heart disease, disease of the arteries, cerebral hemorrhage, and kidney disease, which are- important causes of death, mainly again in late life, it may be said as a general statement .that the death-deal-ing effects of all the principal infectious diseases upon persons from infancy to adult life have been steadily and very greatly reduced. "A high death rate from typhoid fever usually indicates bad sanitation. A high death rate from tuborculosis may mean in addition a bad environment, such as slum houses or bad nutrition. New Zealand's tuberculosis death rate, though it still admits of groat reduction, is a clear indication" of comparatively healthy conditions. THE PAST TEN YEARS. "Turning now to a more recent period, viz>, the past ton years, tho crude general death rate in Now Zealand in 1916 was 9.64 per 1000 of population. It has gradually fallen to 8.74 in 1926. Tho expectation of life, or the average after lifetime of a person at birth was, for females in 1016, 61.7 years. In 1926 it had risen to C 3.5 years. That is to say, the span of life was increased by about two yoars in a short ten-year period. In 1896 tho expectation of life for females iv Now Zealand was 58 years. It haa thus boon extended by 5J yoars in tho 30 years from 1896 to 1926. England has shown a gain of fifteen years in, roughly, half a century.- Now Zealand's gain in that period has not been definitoly ascertained, but is considerably loss, since tho conditions of living in New Zealand half a century ago, though primitive, were far moro healthy than in the older countrios. I have taken females as an example because the war yoars disturbed tho male population, though for males tho statistics aro similarly favourable Thus ono of tho many solid benofits conferred by improvement in the public health' is that it is steadily becoming more economical to insure a life in New Zealand. EXPECTATION OF LIFE. "For purposes of comparison' I now give you the expectation of life, or average after lifotimo at birth, for females in soveral countrios:—Now Zealand, C 3.5 years; Australia, 63.3; South Africa, 59.2; England and Wales, 55.4; United States, 53.2; Japan, 44.8. "Tho expectation of lifo then of a New Zealand woman is eight yoars longer than that of hor English sister and i over eighteen yoars longer than that of a Japaneae. And what may bo said of tho general bonefitsf If we take typhoid fever and tuberculosis and compare 1876 with 1926 wo have soon that of every 100,000 persons formerly, thirty died annually from typhoid fever and 160 from tuberculosis. In 1926, taking the same number of persons, only 2.5 died from typhoid and fifty 'from tuberculosis. Theso are the deaths only. Many moro people who recovered from these diseases experienced weeks of suffering, and during that period lost their livelihood. The economic gain from improvement of the public health has been enormous. THE DEBIT SIDE. "The debit side of New Zealand's balance-sheet is that tho Public Debt, as tho result of borrowing by tho General Government, is to-day about 248 million pounds, and there is a further sixty million pounds due by local governing bodies. Moroovor, tis regards the local government debt in the tenyear period I have quoted by from 1916 to 1926, during which the expectation of life at birth has increased by roughly two years, the local governmont debt has risen from twenty-six millions to over sixty millions sterling, and the annual interest and sinking fund charges to pay for these loans now amount to £2 13s Id for each man, woman, and ohild in the Dominion, or over £13 annually for a family of five. It is true that more than half this amount has been expended in reproductive undertakings such as hydroelectricity, harbour works, and tramways. Nevertheless, the development of sanitary works and hospitals has been rapid, and the times we live in aro such that even a sanitarian should pause before committing either a local authority or a private individual to expense' that is not fully justified."