ÆäÀÌÁö À̹ÌÁö
PDF
ePub

REPORT OF THE HEALTH OFFICER.

HEALTH DEPARTMENT, DISTRICT OF COLUMBIA,

Washington, June 30, 1906. GENTLEMEN: In compliance with the requirements of the act of June 11, 1878, and in obedience to your instructions of July 5, 1906, I submit the following statement of the operations of the health department during the year ended June 30, 1906, and an analysis of the data relative to deaths, births, and diseases filed by physicians and midwives in conformity with law.

So much space in this report is given to the analysis of the vital statistics of the District of Columbia that it may not be amiss to explain the purpose of such statistics and their relation to the aspirations and hopes of the health department. The collection, compilation, and analysis of vital statistics represent a very considerable burden imposed by law upon the medical profession of the community, for which in theory at least the public pays when it pays for professional services. They represent, too, the expenditure of much time on the part of officers and employees in the service of the health department, for which the public pays directly. Unless such statistics have a more or less definite value the collection and study of them should be discontinued.

Vital statistics are the index to the state of the public health, and form or should form reliable guides to the directions in which action can most advantageously be taken to improve the physical well-being of the community to which they relate. The comparison of the general death rate of one community with the general death rates of other communities affords the grossest means for determining whether the sanitary condition of the one compares favorably with the sanitary condition of the others; but so many factors influence general death rates that no well-informed statistician ever thinks of accepting the results of such a comparison as conclusive. The figures that go to make up the general death rates must be carefully analyzed and compared before results can be obtained that will accurately show the probable relation between the relative sanitary condition of the places under consideration.

But even when it is known that one community is probably in a less satisfactory sanitary condition than other communities similarly situated, or in a less satisfactory sanitary condition than the same community was at some previous time, no proper basis for sanitary effort has yet been established. The particular nature of the sanitary defect must be ascertained and localized, so that the proper remedial measures can be adopted and so that they can be applied at the proper place. The nature of the diseases that contribute unduly to the death

rate must be ascertained; the particular class or classes of the population among which disease is unduly prevalent must be discovered; and the extent to which disease and death prevail in different portions of the territorial extent of the jurisdiction must be located.

When the data described in the preceding paragraph have been collated, then and then only can rational action be taken to remove the conditions upon which the undue prevalence of disease and death depend. If it is found that a particular disease is overcommon in any one portion of the population, then competent investigators must study the causes for such prevalence. If one section of the territory which the community occupies is unduly affected then a similar investigation must be undertaken. If the entire community is affected by some one malady more than are other similar communities, or more than the same community has been at other times, then the reason should be searched for until definite results are obtained. It may be, and often will be, that the statistics for one year, or for two, or for three, or even for longer periods yield no results; but figures that to-day seem worthless to-morrow will come into the light from some new standpoint and point the way to the desired end. And when the cause of the undue prevalence of disease has been established then the physiologist and the pathologist and the bacteriologist and the sanitary engineer can intelligently enter upon the task of discovering and applying proper preventive measures.

Such is rational public sanitation, and in such a manner should the work of the health department be performed. How poorly equipped the department is for doing such work can be ascertained without difficulty by examining its scant laboratory facilities, and by looking into the daily routine of the officers and employees in its service. Salaries are so small, certainty of tenure so ill-defined, chance of promotion so nearly absent, and hope of achieving results so barren, that but few of the most desirable class of men can be induced to enter the service of the health department. And those that do enter upon it find their time frittered away in the exhausting daily grind of trivial matters that if a sufficient working force were provided could readily be attended to by nontechnical clerks or inspectors. A more liberal policy toward the health department in the matter of salaries, of tenure of office, of working force, and of laboratory equipment must be adopted if it is to do in a proper manner the work that should be done and that is necessary if it is to take its place, as it undoubtedly should, among the effective and productive health departments of the world.

VITAL STATISTICS, CALENDAR YEAR, 1905.

(For an outline of the mortality record for the first six months of 1906, see page 25.)

POPULATION.

The following statistics, in so far as they are based on the population of the District of Columbia, are computed on the returns of police census of April 12, 1905. A summary of such returns appears on page 24.

GENERAL MORTALITY.

The general death rate for the District of Columbia during 1905 was 19.20. This is somewhat better than the corresponding figure for

« ÀÌÀü°è¼Ó »