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cases occurring in the interval. The notification rate for all forms
of tuberculosis in the standard million (1901) in 1931 was 1,672;
this compares with a rate of 1,406 for the administrative County
of Essex and 2,165 for a large nearby County Borough. An analysis
of the notifications by age-groups shows that lor both sexes there
was a high rate at ages 0-4, and a low rate at 5-9. Roth sexes had
a high incidence in age-groups 15-19, but whereas males showed
a high figure for group 20-24, the female figure was low. 1 he rates
for males were fairly high at ages 25-34 and tor females 35-54.
The only conclusion which can be drawn from these notification
figures is that they are high—particularly so, considering the
facts—firstlv, that the period of 6 months, coupled with the large
transference of population, reduces the volume of population on
which the figures are based and secondly, that no allowance can
be made for those who might have contracted the disease here,
but who have removed from and are not notified in the district.
The high figure occurring at age group 0-4, although few of them
were amongst family contacts, suggests that improved housing
conditions did not materially reduce the infection at this age,
whereas on general grounds one would have expected an improvement
to be demonstrable. The high rate is not to be explained on
the grounds of excessive incidence of tuberculosis giving increased
opportunities for infection at these ages, as comparison of the number
of cases on the register shows that there is no greater proportion
of houses containing a t uberculous patient than ordinarily obtains.
The actual value of these notification figures however lies not so
much in their indicating a certain incidence lor any particular
year, but over a term of years they should become of real importance.
Death Rates.—The standardized death rates (taking the
Census figures as the population for each year) were, for males, in
the years 1930 and 1931, 920 and 1,1.33 and for females 956 and
1,142, compared with the standardized rates for England and
Wales in 1929 of 1,097 and 932. Analysis of tuberculosis deaths
for the years 1927 to 1931 shows that approximately the same
number of deaths occur each year amongst persons who contracted
the disease outside the district. The numbers of deaths amongst
Persons who are supposed to have contracted the disease locally
ner these years are erratic from year to year and show little trend,
apart from a rise which is probably due to the increase in population
over this period of time. For these four years, deaths occurring in
children up to 10 vears of age were all due to disease contracted
while resident in this district. From ages 10-20, part of the disease
Was contracted while resident outside the area, but rather more and
an increasing proportion is locally contracted. Of deaths of males
20-34, the disease was either original or contracted elsewhere in
about equal proportions but tending more to be locally contracted.
whereas to start with, deaths of males 35-54 were due to disease