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1943 NEW ZEALAND

DEPARTMENT OF HEALTH ANNUAL REPORT OF THE DIRECTOR-GENERAL OF HEALTH HON. A. H. NORDMEYER, MINISTER OF HEALTH REPORT The Director-General of Health to the Hon. the Minister of Health, Wellington. I have the honour to lay before you the annual report of the Department for the year 1942-43.

Introduction The outstanding features of 1942 were a widespread outbreak of cerebro-spinal fever, a marked rise in the death-rate, and a record low level of maternal and infant mortality. Vital Statistics (Exclusive of Maoris) Population. —The mean population of the Dominion was estimated to be 1,545,112 in 1942, an increase of 6,492 over the corresponding figure for 1941. Birth-rate. —The total births in 1942 were 33,574, representing a rate of 21-73 per 1,000 mean population. This is the second highest birth-rate recorded since 1923 and was beaten only by the rate of 22-81 in 1941. Death-rate. —The death-rate in 1942 was 10-60 per 1,000 mean population, as compared with a rate of 9-84 in the preceding year. This rate, which was the highest experienced in New Zealand since the influenza pandemic year of 1918, was not altogether unexpected by reason of our ageing population. The Government Statistician had this to say in the " New Zealand Official Year-Book, 1942," on the influence of the age-constitution of the population on the death-rate " The increase in the crude death-rate since .1933 is an indication that the age-constitution of the population has passed the optimum distribution from the viewpoint of maintaining a very low level of death-rates. This trend must continue for some years to come, since the present death-rate of 9-24 (1940) per 1,000 is still much lower than could be regarded as possible in a population stable in respect of age-constitution, and it is reasonable to expect further increases in death-rates." Infant Mortality. —The infant-mortality rate was 28-71 per 1,000 live births, and, as already stated, is a new low record. In 1941 the rate was 29-77. Still-births. —The still-birth rate was 26-54 per 1,000 live births, as compared with 27-66 in 1941. The rate for 1942 is the lowest on record. Maternal Mortality. —The maternal-mortality rate, including deaths from septic abortion, was 2-53 per 1,000 live births, as compared with 3-36 in 1941. When deaths from septic abortion are deducted, the maternal-mortality rate was ] -73 (2-68 in 1941). Infectious and other Diseases (Exclusive of Maori, unless otherwise stated) Four thousand three hundred and seventy-two cases of notifiable diseases were reported in all in 1942, as compared with 3,623 in 1941. The outbreak of cerebro-spinal fever, already mentioned, accounted for 852 of these cases. Scarlet Fever. —Four hundred and fifty-seven cases of scarlet fever were reported with one death. The corresponding figures for the previous year were 338 cases and 1 death. Diphtheria. —Diphtheria showed an increase, 542 cases being notified in 1942, as compared with 383 in 1941. There were 24 deaths giving a death-rate of 0-16 per 10,000 of mean population. In 1941 the corresponding figures were 17 deaths and a death-rate of 0-1 i. Diphtheria took a heavy toll of young life in the period 1872-1892. With a population of 273,000 in 1872, increasing to 642,000 in 1892, there was only one year (1878) when deaths dropped below 100, and on five occasions they rose above 200, the highest figures being 270 in 1874 and 281 in 1892. From 1892 there was a decrease in the incidence or in the severity of the disease until 1904, when only 4-0 deaths were recorded. (The introduction of anti-diphtheritic serum in March, 1895, no doubt had a marked influence on the death-rate.) Deaths then gradually increased until 1915, when a rapid increase occurred, culminating in 240 deaths in 1917 and 195 in 1918. Since then deaths have declined, until during the past ten years there have been less than 50 per annum, and during the three years ended 1941 less than 20 per annum. As the population has been increasing during this period, the numbers of deaths do not give a true indication of the reduction in incidence which has occurred. In 1874 there were 8-47 deaths from diphtheria per 10,000 of mean population ; in 1892, 4-38 ; in 1917, 2-18 ; and in 1941, 0-11 per 10,000 of population. Notifications for calendar years are available since 1910. In that year 838 were received. In J914 notifications increased to 1,094, and then rapidly increased each year, culminating in the epidemic