H.—3l

12

It will be seen from this that New Zealand's puerperal death-rate, unlike lier general death-rate, is relatively high, due less to puerperal-septicaemia deaths than to deaths from other puerperal causes, such as puerperal albuminuria and convulsions, puerperal haemorrhage, and other accidents of labour. It will be seen also that several other countries believed to possess skilled midwifery service, which show a relatively high puerperal death-rate, also owe their relatively high rate more to these other puerperal causes than to puerperal septicaemia. I instance Northern Ireland, Australia, Canada, Scotland, and the United States of America. In previous reports, by graphs and tables, I have demonstrated that in New Zealand these other puerperal causes are less fatal to women residing in the fourteen principal urban areas than to women in the rural areas and the smaller towns. It is probable that not only in New Zealand, but also in the several other countries to which I have referred, this higher death-rate is in some measure attributable to the scattered distribution of population rendering antenatal care and the procurement of skilled midwifery service more difficult of attainment. Another factor which should be taken into account is that we have reason to believe that the collection of statistics is more accurately performed in New Zealand than in many European countries. The notification of puerperal septicaemia in New Zealand is so thorough as to have occasioned comment overseas, and the questionnaire of medical practitioners by the New Zealand Government Statistician regarding female deaths is searching. SECTION 2.—THE COMMON INFECTIOUS DISEASES. Influenza (all Fobms), 242. Number of Deaths from, Influenza in New Zealand, 1923-28. Year. Number. Year. Number. 1923 .. .. 403 1926 .. .. 288 1924 .. .. 90 [ 1927 .. .. 131 1925 .. .. 86 i 1928 .. .. 242 Pneumonic Influenza. Pneumonic influenza, the deaths from which are included in influenza (all forms), is a form of influenza which is compulsorily notifiable.

Pneumonic Influenza in New Zealand, 1923-28.

Diphtheria, 72. Diphtheria in New Zealand, 1924-28.

Notifications. Deaths. Year. Number Rate per 10,000 of Number Rate per 10,000 of Mean Population. ' Mean Population. 1923 .. .. .. 1,144 8-98 223 1-75 1924 .. .. .. 180 1-39 32 0-25 1925 .. .. .. 69 0'52 23 0-17 1926 .. 641 4-73 132 0-98 1927 .. . . ., 176 1-28 43 0-31 1928 .. .. .. 354 2-55 100 , 0-72 I I

Notifications. Deaths.* Year. ; ; Number. Rate per 10 000 Number . | Rate per 10,000 of Mean Population. I of Mean Population. 1924 .. .. .. 2,717 20-84 82 0-63 1925 . .. 1,518 11-42 52 0-40 1926 . .. .. 1,975 14-59 66 0-49 1927 ., .. j 1,446 10-52 58 0-42 1928 . , .. .. | 1,600 11-51 72 0-52 * Figures include deaths from croup.