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below the normal, the death-rate of the male population being
23.3 per 1000, whilst of the female population it is only 21.5 per 1000.
Hence the mining countries, having an excess of males, owing to the
demands of trade, have a death-rate above the average, whilst towns
devoted to woollen manufactures, where the demand for female
labour is greater than for male, have a death-rate below the average.
I will not follow this subject further. Admitting the accuracy of
Registration and of the Census Returns (and he would not be a bold
doubter who questioned their absolute accuracy even if he admitted
their general accuracy), I have said enough to show that some care
is needful in estimating your sanitary progress and the efficiency of
your sanitary work by a death-rate, pure and simple. If the deathrate
is to be, well I will not say the sole, but at any rate the
great index of work done, the tell-tale of progress and of health,
I should not have the conscience year after year to issue Sanitary
Reports and to tell you every year that the death-rate is the same
or nearly the same as it was last year, or the year before, or as it
was 5, 10, or 20 years ago. We should tire of saying we hope for
better days, and you would tire of hearing us express our hopes
when they are hopes which are never realized.
Local authorities must not, therefore I contend, be continually
expecting their death-rate will be decreased, or regard their Medical
Officer as an unnecessary official, and their Sanitary Department as
a useless burden on the ratepayers, because their death-rate year after
year remains the same. Give the death-rate its proper value, but
remember it would never do if our Sanitary Report was merely a
history of births. And remember too an excessive death-rate does
not necessarily imply failure; sometimes (strange it may seem) it
means success. For a large death-rate means a large birth-rate,
and a large birth-rate means a large marriage-rate, and a large
marriage-rate means prosperity, unless we are prepared to admit
that the majority of Englishmen do not look before they leap.
Again, I acknowledge the debt we owe the Registrar-General,
for his returns without doubt are of incalculable value; but I cannot
feel that with this table before me, detailing the sanitary statistics
of our own parish for the past 20 years, a parish fortunate in early
days in having secured the services and labours of a master hand
and the energy of a master mind, can yet show little or no difference
between the death-rate of to-day, and the death-rate of the day on
which he first commenced his work.