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DIVISION OF SANITARY REPORTS AND STATISTICS.
This division has prepared weekly the Public Health Reports, issued by the Bureau under the quarantine act of 1893. This publication is divided into two parts, one containing sanitary information relating to the United States and the other similar information concerning foreign countries. The first part is made up of circulars issued by the Department or the Bureau relating to quarantine subjects, information as to the existence of contagious disease in the United States, letters or reports from State and local health officers or from officers of the Service on sanitary subjects, special reports of investigation in the hygienic laboratory or elsewhere, reports from quarantine stations, both national and local; statements of the prevalence of smallpox or yellow fever in the United States, arranged in tabular form; reports of inspection of immigrants; reports of the mortality in States and cities, arranged both by the month and by the week, and a weekly table of temperature and rainfall in the United States, transmitted to this Bureau from the Weather Bureau. .
The second portion of the publication consists of foreign sanitary information. The first division of it is a statement in tabular form of cases and deaths occurring throughout the world, excluding the United States, from the following diseases: Cholera, smallpox, yellow fever, and plague. These tables are arranged from reports obtained through American consuls at foreign ports, and from foreign sanitary publications and from sanitary inspectors of this Service on duty at foreign ports. This is followed by translations concerning sanitary affairs, etc., from foreign journals. Then follow reports from consuls, sanitary inspectors, and others concerning the sanitary condition of their respective districts. The report ends with statistical information concerning mortality in foreign cities, both monthly and weekly. The publication is a unique one, there being nothing of exactly the same character published elsewhere. It is distributed to sanitarians in this and other countries, and to United States consuls, and to collectors of customs on the coasts. The volume for 1897, consisting of 53 numbers, comprised 1,441 pages, and is a valuable record of sanitary statistical information. The current volume is the thirteenth, and will be about as large a volume when completed as the last.
In order to obtain much of the information published in the Public Health Reports it is necessary to write to the various localities where, in the columns of the daily press, infectious disease is reported as existent, and this is especially true of smallpox, the occurrence of which is usually reported by the various State boards of health in accordance with resolutions agreed upon by themselves in conference. The progress of an outbreak, however, is rarely reported, unless at the special request of the Bureau. These letters are all prepared in this division, and the information obtained from the replies is edited and inserted in the Public Health Reports.
The correspondence connected with this division is consequently increasing, showing a growing interest in it on the part of those interested in sanitary matters.
REPORTS OF TRANSACTIONS OF LOCAL QUARANTINES.
It has been impossible to obtain reports of quarantine transactions from the State of Louisiana and from the port of New York, although repeated efforts have been made to secure them. This fact is mentioned because in my estimation the omission of statistical information concerning the arrival and inspection and other quarantine treatment of vessels at the ports of New York and New Orleans, two of the largest in the United States, is a matter seriously affecting the completeness of the quarantine statistics.
In the absence of any law, however, compelling local quarantines to make reports to this Bureau, it is impossible to obtain such reports except through the courtesy of the State or local officers, but it is a source of gratification to be able to say that at this date local officers, with the exceptions named, do make reports to the Bureau, and all receive this publication.
MORTALITY STATISTICS.–CALENDAR YEAR 1897.
In order to obtain as accurate an estimate as possible of the mortality—and morbidity where reported—throughout the United States during the calendar year 1897, I caused the same letter as in former years (see annual reports of 1896 and 1897) to be sent to all health authorities in the United States of towns having a population of 1,000 or more. Over 3,700 such letters were sent out from this office, and 1,597 replies were received which were available for use in the compilation of the statistical table.
From these replies the table of mortality statistics of 1,597 cities and towns in the United States for the twelve months ended December 31, 1897, was prepared and is here published.
This table shows the total mortality of each city and town, the mortality rate per 1,000 of estimated population, as reported during 1897, by the one to whom the letter was addressed asking for the statistics in question, and the mortality from phthisis pulmonalis, smallpox, enteric fever, typhus fever, measles, scarlet fever, diphtheria (including membranous croup), and whooping cough.
This table is the third one published by this Bureau, and in this one a radical departure has been made from former custom. Heretofore it has been the rule to calculate and insert in the table—in addition to the mortality rate per 1,000 of the estimated population-the death rate per 1,000 of the population reported according to the census of 1890. This calculation has been omitted this year, and anyone wishing to find out the rate according to that population can easily do so, using the total number of deaths and the population of the town according to the census of 1890, which is published as heretofore in one of the columns of the table. The calculation is omitted as being entirely misleading. This is especially true of the larger cities where, as in the case of New York, the population is much greater than in 1890. The estimated populations are reported by those who send in the mortality returns, and while it is not possible to regard them as absolutely correct, they are at all events far more correct than a population which might have been correct—or nearly so—nine years ago, but which in the very nature of things could not possibly be so now, except in a very few instances. As long ago as 1896 I stated in my annual report to you in this connection that “the first (Population, Census of 1890), being now six years old, is manifestly an underestimate, and as such is not capable of being used alone with any degree of accuracy in the compilation of the mortality rates, and the second, the estimated, while in the majority of cases probably an approximately correct estimate, leaves much to be desired. It must therefore be taken merely for what it is stated to be, an estimate, the liability of which to error (and error usually in excess) is manifest and natural.”
This statement is even more true to-day than it was when written, as the error of using the 1890 population as a basis for computing death rates, in a town to which in reality an eight years' increment of inhabitants has been added—the number of those dying increasing correspondingly, while the population remains theoretically stationary—is larger than it could possibly have been two years ago.
For this reason, as I have said above, it has seemed best to omit the death rate computed on the 1890 census altogether, as it would hardly be practicable to use it in some cases and not in all.
TABLE OF ANNUAL MORTALITY STATISTICS IN 1,597 CITIES AND Towxs IX TEZ
UNITED STATES FOR THE TWELVE MONTHS ENDED DECEMBER 31, 1897.