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open to the same criticisms as are similar
comparisons between death rates from particular
diseases where diagnostic interpretations may
vary between one country and another.
The following tables and extracts are taken
from a stimulating paper given by Dr R Logan,
Director of the Medical Care and Research Unit
at Manchester University—
Health Hazards in Middle Age
'Although the leading causes of death hold the
same rank across all developed countries,-the
middle aged die at different rates from the same
diseases in each country and these add up to
considerable differences in risk of death. Middle
aged men in Sweden die at almost half the rate
of those in Scotland. Britain is far from the top
in the world league of a score of developed
countries and, in the European competition,
is nearer to the bottom. Neither do the chances
improve for those who reach retirement. Indeed,
by the time men and women have passed their
prime of life, their chances of survival from 65 to
85 for men in Norway are double those in
England, and the gap has not narrowed in recent
years, and France is improving in its lead on us.
Amongst women, the Norwegians again have the
brightest prospects of survival, but the differences
internationally are less for women than men,
and indeed the English woman is catching up with
brighter prospects of her overseas sisters.
However, this enhancement of her survival makes
her even more likely to be a widow as her English
husband is marking time. Indeed, it is men in late
middle age who are the only male group to mark
time in risk of dying, whilst their women folk
continue to improve so that the gap has widened
and for the past decade men aged 55-64 have
been dying at twice the rate of their female peers.
The reasons for this, of course, lie in the nature
of the killing diseases with the men succumbing
to ischaemic heart diseases and lung cancer at
over five times the rate of women and from road
accidents, suicides and other violent deaths at
twice the female rate, whilst bronchitis is
essentially a working man's killer (and his
personal air pollution from cigarette smoking is
the common and dominant factor in this self
destruction, from coronary catastrophy, lung
cancer and bronchitis, at least)'. (1)

Bronchitis, well known as the English disease
accounts for part of these differences in that it
kills seven in every hundred of us even in middle
age ie between the ages of 45 and 65 at a time of
great responsibilities to work and family alike.
It is also interesting that a glance at the last table
clearly shows that there would be few widows in
this country if Englishmen and Welshmen had
the same survival rates as their near neighbours
the Norwegian men just across the North Sea.
What tragedies and unhappiness this would
prevent to say nothing of the economic loss
caused to individuals, to families and to the
country as a whole!
Nobody, however, questions the durability of
our individual constitutions nor the standards of
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