H.-31

6

THE PRINCIPAL CAUSES OP DEATH. The following table gives the main causes of deaths last year in their order of magnitude, and the actual number of deaths therefrom. Total Deaths in New Zealand in 1929, 12,314. Causos. Actual Deaths. Heart-disease (all forms) .. .. .. •• 2,533 Cancer .. .. . . .. .. • • • • 1 > 467 Chest-diseases — Pneumonia .. .. . . .. • • • ■ 464 Pneumonia secondary to influenza, whooping-cough, and measles 177 Broncho-pneumonia .. .. .. .. • • 251 Bronchitis .. .. .. .. . • • • 314 1,206 Violence .. .. .. .. .. • • • • • • 955 Tuberculosis (all forms) .. .. .. . • • • • • 642 Apoplexy or cerebral haemorrhage .. .. .. ■ • • ■ 634 Kidney or Bright's disease .. .. .. .. . • • ■ 537 Senility . . . . .. .. . • • • ■ • • • 518 Disease of the arteries .. . . .. . . ■ • • • 428 Diabetes .. .. .. .. ■ • • • • • • • 201 Diseases and accidents of childbirth (i.e., maternal mortality) . . . . 129 Hernia and intestinal obstruction .. .. . . • • ■ • 107 Appendicitis . . .. .. .. ■ ■ • • • • 100 Diarrhoea and enteritis .. .. . . .. .. ■ • 82 Epilepsy .. .. .. .. .. .. • • • • 46 Common Infectious Diseases. Influenza (all forms, including pneumonic) .. .. .. .. 297 Diphtheria . . . . .. .. . . . • • • 92 Scarlet fever . . . . .. .. . . . . . • 27 Typhoid fever . . .. .. .. . . . . .. 22 Whooping-cough .. .. .. . . . . . . . . 17 Measles .. .. .. .. . . .. . . • • 1 Infant Mortality. Infant deaths (under one year), all causes .. .. .. ~ 912 The first six causes in the above list account for 7,437 deaths, or approximately two-thirds of the total. Obviously, with some of them —e.g., tuberculosis, the common chest-diseases, some forms of heart-disease, and apoplexy —habits of life and environment are important factors. The correction of faulty habits, where applicable, and the improvement of the environment of an unfortunate or careless minority of the New Zealand public would reduce these deaths, and the numbers are such as to offer a margin of gain worth the effort. It is only by the active co-operation of the public, the local authorities, the medical and nursing professions, and the Department of Health in definite diseaseprevention in the home, school, and workplace environment of the people that great reduction in our death-rate will be made. New Zealand has a low general death-rate —the lowest in the world —but its reduction has been far less rapid than that of the birth-rate. Consideration of the above table indicates that there are prospects of considerable reduction in the number of deaths, provided the efforts of central and local governing authorities, including the Hospital Boards, the medical and nursing professions, and the general public, are united, and also that they are well directed. Concentration upon further reduction of the already low infant-death rate, the still-birth rate, or the maternal deaths (129) will reduce deaths under these three headings, but the numbers are such that thereby no great reduction can be made in the general death-rate. Of the grand total of 12,314 deaths, 11,402 apply to persons over one year of age, and, of these, 11,273 were not associated with maternity. Pregnancy and birth are events dangerous to both mother and child, and our intended efforts to reduce this danger cannot affect the general death-rate to any considerable degree. It is obvious that we must widen our preventive effort to include persons of both sexes and all ages. It is particularly necessary to correct bad living-habits, to treat disease in its early stages, and, wherever possible, to prevent the spread of any infectious illness. A definite alliance rather than a " cordiale entente " with the army of general medical practitioners is advisable, and it is equally important that they should be definitely engaged in the prevention of disease. The ideal to strive for is that the local authorities and their Medical Officers of Health should be aiding the medical practitioners in disease-prevention by measures intended to improve the environment of the general public. For several years past graduates from the Otago Medical School have received special training in preventive medicine.