SEASONAL VARIATIONS IN DEATH RATES.

Reference to deaths from diarrheal diseases of infancy leads logically to the consideration of the effect of season on mortality. The following statement shows the variations that occurred from month to month during 1905 in the average number of deaths per day within certain specified age periods. Information as to seasonal variations in the death rate from any particular disease may be obtained by consulting Table 1b in the Appendix.

Average daily mortality, by months, arranged with reference to race and to ages of decedents, during the calendar year 1905.

MORTALITY WITH REFERENCE TO NATIVITY AND MARITAL STATUS.

Figures showing the distribution of decedents during 1905, with respect to birthplace and with respect to marital status, are published in the Appendix. As the corresponding distribution of the population is not known it is impossible to calculate the death rates for the single, married, and widowed, or for natives of the District of Columbia and of other places.

MORTALITY WITH RESPECT TO LOCATION.

The police census of April 12, 1905, furnished the data upon which to base a study of death rates as related to location, and particularly as related to alleys as distinguished from streets. It is apparent, however, from what has been said before that the general death rate in any part of the District is influenced largely by the number of colored persons living in it-the larger the proportion of colored people the higher the death rate. If a study of the distribution of deaths with respect to locality is ever to afford any clue to the unwholesome parts of the District, this fact must be taken into consideration, and death rates for whites compared with other death rates for the same class and death rates for colored people be used in a similar manner. method will be adhered to in the following discussion of mortality with reference to locality.

This

The map accompanying this report shows death rates for certain more or less arbitrarily selected vital-statistics districts into which this jurisdiction has been divided. In determining the significance of any given death rate it is necessary to know the figures upon which

it is based, the number of deaths, and the population. It has not been found possible to incorporate such data into this map, but they are set forth in full in Table 75 in the Appendix. Other tables in the Appendix show the number of deaths in each district from certain of the more important diseases, and from such tables and the table referred to above it is possible to determine the death rate for each such disease in each vital-statistics district.

It is impossible here intelligently to point out those parts of the District in which the death rates have been above the average or to explain the reason therefor. For information as to the places in which the higher death rates occurred it is necessary merely to refer to the map appended to this report. It is as yet impossible to understand why these death rates vary as they do, and before the health department can express an opinion relative thereto it will be necessary for it to make a much more extended study of the situation than has yet been possible. In certain districts, however, the presence of large institutions having more or less the nature of asylums seems to be the controlling factor in making the death rate inordinately high. Such, for instance, are the districts in which are located the Government Hospital for the Insane, the Washington Asylum, the Soldiers' Home, and the Freedmen's Hospital. In other districts the fact that the recorded death rate is unusually high or unusually low is apparently the result merely of chance, the number of people living within the district being so small as to render of doubtful value annual death rates computed thereon. Throughout the city proper, including West Washington, the death rate for colored people is in each district in excess of the death rate for whites. In several of the suburban districts the reverse is true, but there is nothing to indicate the reason for the variation.

ALLEY DEATH RATES.

What has already been said with respect to the effect of the racial distribution of the population of any particular locality in determining its death rate applies with peculiar force to the determination of the death rate of dwellers in alleys for purpose of comparison with the death rate of that portion of the community dwelling on streets and other similar thoroughfares. Of the entire alley population 90.54 per cent is colored, and therefore the alley death rate approximates the colored death rate and is high, 26.96 per 1,000 per annum. On the other hand, of the street population 74.03 per cent is white, and therefore the street death rate approaches more closely the white death rate and is relatively low, 18.73 per thousand per annum. But when the death rate for colored people living in alleys is compared with the death rate for colored people living on streets a different result is obtained. Among colored people living in alleys the death rate during 1905 was 28.39; among those living on streets it was 28.89. And among white alley dwellers the death rate was 13.23, while among persons of the same race residing on streets the death rate was 15.17. The figures just given effectually dispose of the possible objection that the colored death rate is high because of the effect of alley life on the large number of colored people living in such places.

If those parts of the District in which alleys do not exist be disregarded, and this will result in the exclusion of the greater part of the suburban and all of the rural districts, the relation between street and

alley death rates is somewhat changed. Among white people the street death rate is then 14.62 and the alley death rate 13.23. Among colored the street death rate is 27.54 and the death rate in alleys 28.39.

And the showing in the two preceding paragraphs is altogether too favorable to the alley death rates, since all of the hospitals and asylums of the District are located on streets, and those deaths which occurred in such institutions have been charged to the institution when the decedent had no other residence within this jurisdiction. The extent to which this circumstance has come into play can not now be determined accurately without an excessive amount of labor, but a few samples will illustrate the point. The section in which the Government Hospital for the Insane is located shows street death rates of 50.85 for whites and 115.97 for colored, and the Freedmen's Hospital section shows a street death rate for colored people of 63.83. The Soldiers' Home section shows a white death rate of 39.79 and a colored death rate of 54.54, both being street death rates. In none of these sections are alleys found. In the Washington Asylum section the street death rate for whites was 33.51, with no white alley population, and the colored death rates were for streets 71.48, and for alleys 15.38. And in the section in which the Central Dispensary and Emergency Hospital and the George Washington University Hospital are located the death rate for streets was for whites 21 and for colored 57.44. The alley population in this section is very small, and among the whites no deaths were recorded; two deaths were entered against colored alley dwellers, with a resultant alley death rate of 13.89.

An effort has been made to determine in what parts of the District there was the greatest difference between alley and street death rates, but the results were unsatisfactory. In too many sections the number of persons dwelling in the alleys was so small as to render death rates. covering but one year of no practical value.

The following statement shows the death rates for 1905 of persons of various ages dwelling in streets and in alleys:

Death rates for streets and for alleys, arranged by age periods and by race, during the calendar year 1905.

Death rates for dwellers in alleys are in six out of the eight classes better than the corresponding death rates for persons living on streets. This is notably the case with respect to children under 1 year of age, but figures relating to this age group must be interpreted with great caution, as has already been pointed out. Unfortunately, the figures in the preceding statement can not now be conveniently corrected so as to show what would be the result if the suburban and rural sections in which there are no alleys were omitted, but the correction of the general street and alley death rates in that manner can not be regarded

as having materially affected the result with respect to such death rates, and there is no reason for believing that different conditions exist with respect to the death rates for any particular age period.

Classifying the deaths that occurred on streets and those that occurred in alleys, with reference to certain specified diseases, results are obtained that are of little or no value, in view of the smallness of factors upon which they are based. These results are embodied in the following statement and are so erratic as to defy interpretation:

Death rates for streets and for alleys, arranged with reference to certain specified diseases, during the calendar year 1905.

MORTALITY IN ITS RELATION TO PARTICULAR DISEASES.

The following tables show the results of classifying the decedents who died during 1905, according to certain more or less clearly defined groups of diseases. No analysis of these tables have been undertaken as the ground is fully covered by the next following statement relative to individual diseases. For detailed information concerning deaths and death rates from each disease reference should be made to the tables printed as a part of the Appendix.

Relative mortality in 1904 and 1905 with reference to certain groups of diseases.

Deaths during the calendar year 1905, arranged by classes of diseases and by sex and race.

Deaths and death rates from certain specified diseases during 1904 and 1905, with corresponding average annual deaths and death rates during the past ten years.

Table 16, in the Appendix, shows the fluctuations in the mortality from certain of the more important diseases during the past ten years. It is sufficient here, therefore, to call attention only to the status of several of the chief factors in our death rate.

Pulmonary tuberculosis. The death rate from pulmonary tuberculosis fell from 2.623 per 1,000 to 2.556. There was a decline in the