FIFTH ANNUAL REPORT OF THE BUREAU OF VITAL AND SANITARY STATISTICS, FOR THE YEAR ENDING SEPTEMBER 30, 1886. By C. N. METCALF, M. D., Secretary of the Board. Under the law, as it now is, there are several obstacles in the way of collecting statistics, which must be removed before the desired result can be accomplished. The reports of births are not so difficult to procure as are reports of deaths. Some physicians, from the fact that they are so loath to report deaths, seem to feel as though possibly they have in some manner been instrumental in bringing it about. They feel, and in some instances have so stated, that a report of a death is regarded as evidence against the skill of the physician making it, forgetting that "it is appointed unto man once to die." Others excuse themselves because they are not paid for the labor required to make the report. The Attorney General, in an opinion published elsewhere in this volume, says: "A physician should honestly endeavor to obtain and report all information required by the regulations of the statutes and the Board of Health. This is his duty as a surgeon, and is im posed as an obligation by the ethics of the useful and honorable profession of which he is a member. The statute confers on a physician certain privileges, and may impose corresponding duties." The Secretary of the Board has conferred with many county health officers, and various methods looking to an improvement in the law, as now constituted, have been discussed. That method which is least inconvenient to the physician and the people will be most popular, and hence, more readily enforced. A majority of those who have expressed opinions upon this subject seem to agree that in all cases of death burial permits should be required based upon a report of death. The number of deaths reported to us indicate a very light mortality, and while this is true, comparatively (as, upon the whole, the health of our people was never better), it is much too small. In New Hampshire, prior to the enactment of a law requiring burial permits, the deaths reported showed a death rate of eight to the thousand, while, after the law went into effect, the rate was increased to eighteen to the thousand. Insurance companies, who have selected risks requiring a medical examination of applicants, report a death rate of eight to ten to the thousand. So that it is safe to conclude that our death rate, taken as a whole, is in fact about eighteen to the thousand. Of course, in cities the mortality is somewhat in excess of what it is in the country. I wish to urge the importance of keeping the death record, and, in fact, other records, accurately. There are frequent calls at county health offices by pension examiners as to causes of death in certain cases. So also in regard to the settlement of estates, proving that as time progresses these records become more and more valuable. Whose duty it should be made to issue this burial permit, without causing unnecessary inconvenience, is rather a perplexing question, but the weight of opinion seems to be that the Township Trustee is the proper officer in whom this authority should be vested. In cities the Secretary of the Board of Health or the City Clerk might be required to perform this work. Certain it is that under the present law, and the unwillingness on the part of physicians, and even health officers, to assist in its enforcement, our statistics will be far from complete, and in the matter of reliable information upon these subjects we can not keep pace with other States which take a deeper interest in such matters. In the matter of births, the number reported is more nearly correct, because physicians make such reports much more readily. They seem to take more pleasure in officiating at the beginning than at the end of one's career. The birth record of the county health officer is, however, deficient in one important matter, viz.: that of the christian name of the child. In a majority of cases the infant is not named at birth, because a name selected in advance might not be appropriate, and the physician is compelled to leave it blank, and no effort is made afterward to to supply the omission. We again urge the necessity of proper amendments to the law, which will measurably remedy the present defects. |