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and the report concludes with, a review of the deaths from cancer over the past fifty years. Cancer is essentially a disease of the later decades of life, and there is little doubt that the increase in the crude (or actual) death-rate from cancer is due in large part to the increased proportion of older people in our population. It is interesting to compare the fifty-year review of the death-rate from cancer with a similar review of the deathrate from tuberculosis which appeared in the last annual report. Both tables refer to Europeans only. Over the fifty years the crude. death-rate from tuberculosis (which, in general, is responsible for deaths at an earlier age than cancer) has decreased from 9-87 per 10,000 of mean population to 2-46, while over the same period the death-rate from cancer has increased from 5*63 to 13-98. The number of live births registered and the birth-rate per 1,000 of mean population remain at a high level. The year 1947 saw the greatest number of live births (49,804) thus far recorded in this country • the birth-rate was 27-63, and the European birth-rate was the highest recorded since 1912. The figures for 1949 (European, 43,999 ; Maori, 4,888 ; total 48,887) show some reduction on the figures for 1948, but this reduction is less than as between 1947 and 1948. The birth-rate for 1949 was European, 24-89 ; Maori, 43-09 ; combined, 25-99 ; compared with 25-52, 45-09, and 26-69 respectively in the previous year. In 1947 the maternal-mortality rate (European and Maori combined) reached the remarkably low figure of 1-18 per 1,000 live births. In 1948 the rate was 1-30, while for 1949 it is 1-23. The European rate for 1949 (1-02) is even lower than the corresponding rate for 1947, and is, in fact, the lowest ever recorded in this country. The actual figures for maternal deaths, excluding septic abortion, for 1949 are : European, 45 ; Maori, 15. Deaths from septic abortion numbered only 3, all European. The position with regard to puerperal sepsis is worthy of comment. During 1949 the number of cases notified was 52, and there were no deaths. It is not so very long ago that puerperal sepsis was one of the dreaded complications of childbirth, with a considerable mortality. In this country, for example, over the five years from 1920 to 1924 the average number of cases notified per year was 210 and the average number of deaths per year was 54. A number of factors have contributed to the improvement, the most recent being the introduction of the sulphonamide drugs and penicillin. I believe, however, that the present position constitutes a high tribute to the standard of care afforded by the medical and nursing professions, and, speaking as one who has watched the position as an observer outside the Department, I feel that considerable credit is due to past and present officers of this Department, both medical and nursing, for their sustained efforts over the years. •The problem of reducing the number of still-births and neo-natal deaths —i.e., deaths during the first month after birth —is one which is receiving considerable attention in various countries. While certain of these deaths are due to causes, such as congenital malformation, which cannot be prevented, the question does arise as to " the contribution which medicine can make to the prevention of human wastage by slaving the potential lives which are lost at or before birth, and children who die during the first month of life . . . It is clear that the widest scope for the saving of the youngest life is care of the pregnant woman, skilful midwifery, prevention of prematurity, and protection of the new-born from infection " (Bourne and Williams, 1948), In New Zealand the still-birth rate for Europeans (statistics of Maori still-births are not available) has shown a steady decline over the last ten years, and in 1949 reached 17-66 per 1,000 total births, which is the lowest on record for this country. The infant-mortality rate (deaths under one year of age) for Europeans for 1949 was 23-73 per 1,000 live births ; this is the second lowest rate recorded in New Zealand, the lowest being 21*93 in 1948. Of the total rate of 23-73, neo-natal deaths (under one month) account for 17-00, while the remaining 6-73 represent deaths between one month and twelve months. The marked reduction in the infant-mortality rate for Europeans over

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