The ordinary barometers of ill health—death rates and reports of communicable diseases—do not indicate that harmful effects of the depression upon the health of the population as a whole have taken place. The comfortable conclusion is drawn by many that the physical well-being of the American people not only has not suffered but, in view of the continued decline in mortality, may have been benefited, by the economic catastrophe. Such a conclusion, based upon mortality statistics alone, obviously is open to question. Death rates are not sensitive indices of the immediate effects of deleterious conditions. Even if they were, existing mortality and population records are not available in such form as to yield the very essential information as to whether any economic group has experienced a higher mortality than other groups. What we need, in appraising the depression’s cost in ill health, are more efficient indices of physical and mental impairment in order to determine whether or not population groups whose economic status was most severely affected are suffering damages to health and what the nature and extent of these damages are. Only in this way can reasonably accurate appraisal be made. Among the now well recognized indices of ill health are records of sickness. When properly obtained and analyzed, they reveal some of the reactions of human beings to immediate environmental factors in a far

5T HE morbidity study, conducted from June, 1938 to May, 1943, in the original Eastern Health District of Baltimore, is the first investigation of illness where, due in large part to the method of sampling, families with relatively short periods of observation constitute an important part of the total observed population of families. Preliminary analysis of the morbidity experience of the first year of the study indicated that about one-third of the total families either moved out of or into the study area during that period (1). Movement of families continued throughout the five-year period. This paper presents a study of some of the socio-economic characteristics of the moving and non-moving families-characteristics which form a background for forthcoming analyses of illness. Reed, et al. have presented some general characteristics of the population in the Eastern Health District (Wards 6 and 7) from which the morbidity study population was drawn (2). They found that in 1939, 56 per cent of the white families in the district were home owners. They concluded also that The population is essentially in the lower middle economic class with a greater proportion of skilled and semi-skilled workers 'relatively' than in the rest of the city.

Monthly influenza-pneumonia death rates in Massachusetts (14) show a series of moderate-sized epidemics of those diseases from 1890 to 1900, followed by several smaller outbreaks from 1901 to 1907. Then came almost a decade in which there was practically no excess mortality over the usual seasonal expectancy, but minor epidemics occurred in the early months of 1916, 1917, and 1918. Since September of 1918 weekly mortality from influenza and pneumonia in groups of cities is available (3, 4, 6, 15). Counting minor and major epidemics, the current influenza outbreak of December-January 194344 was the twentieth period since the begilning of 1916 in which influenza and pneumonia mortality was above the usual seasonal expectancy in nearly all geographic sections of the United States. In practically every instance the excess in mortality extended over a period of 2 to 4 months, with a mortality peak which marked the phenomenon with the usual characteristics of an influenza outbreak. The recent accelerated decrease in the mortality from pneumonia and influenza which began about 1938 (15) is presumably due to newer methods of treatment. Improved treatment would reduce the mortality but would affect the number of cases of pneumonia only insofar as these drugs are used in influenza to prevent the occurrence of complications and presumably would have no effect upon the number of influenza cases. The mortality from influenza and pneumonia in excess of the usual seasonal expectancy has been used as a measure of the extent and severity of influenza epidemics because the reporting of cases is so incomplete; however, in the last few years of greatly

Vital and Health Statistics in the Federal Government Selwyn D. Collins CopyRight*Presented before the American Association of Registration Executives and the Vital Statistics Section of the American Public Health Association at the Seventy-second Annual Meeting in New York, N. Y., October 13, 1943. https://doi.org/10.2105/AJPH.34.3.219 Published Online: August 29, 2011

The use of all available measures to prevent the spread of infectious disease is an obligation of peace that is increased during war. The increase of sickness during such emergencies has in the past been widespread and has appeared to be inevitable. It is only within the present century that attempts at prevention and control show encouraging evidence that morbidity and mortality among soldiers and civilians can be curbed by the application of increasing knowledge about sanitation, personal hygiene, and immunization. For only a few of the many infectious diseases is active artificial immulnization available and commonly used (8,5, £6, 27, 34). Venereal diseases and tuberculosis, which are among the greatest wartime problems, are at present entirely outside of the purview of immunization. The control of meningitis, poliomyelitis, encephalitis, and influenza with its complicating pneumonia, now rests largely upon therapeutics. Mumps and chickenpox which are of low fatality but high incidence are subject only to quarantine and isolation. The prevention of malaria is almost entirely a matter of environmental sanita-

SOME years ago the small town physician was frequently the pharmacist also. Thus the writing and compounding of prescriptions were functions of the same individual, so there was little difference between direct dispensing by the physician and the writing of a prescription. Moreover, the purchase of medicine on the recommendation of the druggist was practically equivalent to procuring it on a doctor's prescription. Even medicine purchased over the counter was not entirely without the sanction of a physician since the doctor-proprietor of the small drug store handled most of the sales of medicines.

Previous articleNext article No AccessBook ReviewsHealth and Unemployment. Leonard C. Marsh , A. Grant Fleming , C. F. Blackler Selwyn D. CollinsSelwyn D. Collins Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmailPrint SectionsMoreDetailsFiguresReferencesCited by American Journal of Sociology Volume 45, Number 6May, 1940 Article DOIhttps://doi.org/10.1086/218510 Views: 1Total views on this site PDF download Crossref reports no articles citing this article.

Trend and Geographic Variation in Cancer Mortality and Prevalence, With Special Reference to Gastric Cancer Get access Selwyn D. Collins, Selwyn D. Collins principal statistician Public Health Methods, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Mary Gover, Mary Gover associate statistician Public Health Methods, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar Harold F. Dorn Harold F. Dorn senior statistician Public Health Methods, National Institute of Health, United States Public Health Service Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 1, Issue 4, February 1941, Pages 425–450, https://doi.org/10.1093/jnci/1.4.425 Published: 01 February 1941