H.— 31.

The Dominion is now unfortunately experiencing a period of want and poverty, and, pending necessary adjustments, there will be some overcrowding of persons in dwellings. Doubtless this will in some measure mar our vital statistics, but such effect is not vet noticeable. It is to be hoped that restoration of the economic balance can be achieved in order that the beneficieni influence over many years of steady improvement in the nutrition and the hygienic environment of the poorer people will not be greatly lessened.

The Principal Causes of Death itemized.

It is again noteworthy that these diseases of the heart and arteries accounted for 3,990 deaths— i.e., 34 per cent, of the total deaths during the year. In L 928 they accounted for 28 per cent., in 1929 29 per cent., and in 1930 and 193] 32 per cent, of the total. This, by reason of its magnitude and increasing tendency, appears to present a field worthy of special investigation by the Department and the medical profession. Certain infectious and other diseases such as scarlet fever, diphtheria, and acute rheumatism, and syphilis are known to sometimes affect the heart and blood-vessels, lint their potency and influence has definitely waned. Again, some may regard deaths from these diseases as the inevitable results of fair wear-aiul-tea r. lint analysis shows that, during the three years ending L 930, of an approximate total of 11,000 deaths in New Zealand from those causes 2,50 I occurred before the age of sixty had been reached, 1,100 before age fifty, and 500 before age fori ; - These diseases, then, not only shorten life, bul stand out as the main blot on a clearing horizon. Medical attention to individual patients (usually middle-aged or older persons) does l>v means of detect ion of arterio-selerosis. nigh blood pressure, or heart incompetence and the alteration of habits, including dietary, lengthen their lives, Imi by co-operative effori in a wider lield. commencing at an earlier age, and an endeavour to ascertain the fundamental causes of these very common diseases of the heart and blood-vessels it seems possible lli.it longevity could be increased. Cancer, another important cause of death, is regarded by many as a disease of civilization. If this be true, then the necessary correction of the human errors which predispose to cancer will probably prove to be neither-a short nor a simple task. There are, in fact, very few examples in medical bistorj of any disease having been eradicated by rapid cure, anil in respect of these diseases of the heart and blood-vessels it may be said with greater force than is true of cancer that the results of early diagnosis and medical attention bo individual cases appear to justify a wider and earlier application of the process. Moreover, the very fact that our knowledge of the causes of a rterio-sclerosis and of many forms of heart-disease is scanty itself points to the need of special investigation. The number of annual deaths involved is such as to offer a margin of gain wort h the effort. Cancer, 1,472. The following table, taken from the " New Zealand Official sTear-Book," shows the cancer deathrate in the Dominion for the last five fears: —

Number of Persons who died from Cancer, the Proportion per 10,000 Persons living, and the Percentage of all Deaths, 1928-32.

We know not the cause of cancel , . Ii is increasing in prevalence at a slow, nol rapid, rate. Being a disease of late life and having in the pasi often missed detection or registration, its appareni increase is in considerable measure accounted for by our longer span of life and greater skill in diagnosis. The real increase is slight.

2—H. 31.

9

Year. Cause. 1928. 1929. 1930. 1931. L932. Heart-disease (all forms) .. .. 2,315 2,533 2,897 2,817 2,935 Apoplexy or cerebral hemorrhage .. 643 634 659 634 611 Diseases of the arteries .. .. 394 428 432 420 444 Totals .. .. .. 3,352 3,595 3,988 3,871 3,990

n .it, t t t l r> n. Deaths from Deaths from Year. cite Cancer per 10,000 Cancer per !<»> Cancer. all Causee. o f L i vin g Arsons. of all Deaths. 1928 .. .. .. .. 1,374 11,81] 9-87 Ll-63 1929 .. .. .. .. 1,467 12,314 10-43 11-91 1930 .. .. .. .. 1,452 12,199 10-19 11.90 1931 .. .. .. .. 1,493 12,017 10-33 12-39 1932 .. .. .. .. 1.172 11,683 10-11 12-60