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different medical men. Some doctors rarely, if ever, give old age
as the cause of death. They always name a certain disease, though
this disease (if it can be called a disease) is only a part and parcel
of the process of growing old. Some of the deaths of persons over
90 years of age have been certified as myocardial degeneration.
These are placed under Heart disease together with other conditions
such as Myocarditis following Rheumatic Infection or Valvular
Disease of the heart. But there is no analogy between the two
conditions. In the former the degeneration of the heart was merely
part of a general degeneration; there was a general break-up of the
mechanism and death was inevitable. Death could not have
been avoided, and methods of preventure could not avail. When
the Myocarditis follows Rheumatic Infection the conditions are
entirely different. The infection may have been an avoidable one,
and the life could have been prolonged. The death has usually
occurred before the other parts of the body have worn out, and the
unfortunate sufferer had died in the prime of life. Heart disease
looms larger in our returns than any condition, but it does not mean
that preventable heart disease is more prevalent. Most of the deaths
from heart disease are of persons over 65 years of age; out of the 71
deaths classified in Table 1, as due to heart disease 47 were in persons
over 65 years of age. In the number returned by the Registrar
General the percentage of those over 65 years of age is much higher.
These deaths are certified as fatty degeneration of the heart, myocardial
degeneration, &c. At the other end of life we have the
congenital deformities of the heart and these deaths again are not
preventable.
Heart disease may or may not be on the increase, but until
the returns show us how many of the deaths are due to a degeneration
which is inevitable and those due to post infective heart disease
which may be preventable, our information is not sufficient to form
an opinion.
On Table 3 are given the rates for 1931 and previous years.
Based upon the revised estimates the death rate is higher than that
of 1390 but lower than that of 1929. A comparison with 1929
is not quite a fair one as there was an extensive outbreak of Influenza
in the early part of that year.
It will be observed that recently the death rate has been
stationary or has even shown a tendency to rise. This does not
mean that the general health of the community has in any way
suffered a set back. It probably means that, the age distribution
of the population is altering. We have a larger proportion of inhabitants
who have passed the prime of life and amongst whom
the death rate is naturally high. The continued drop in the birth
rate is making itself felt in the age distribution of the population.