PUBLIC HEALTH

Evening Post, Volume CVII, Issue 16, 19 January 1924, Page 7

PUBLIC HEALTH

NEW ZEALAND'S PREMIER POSITION

INFECTIOUS DISEASES

CONTINUED REDUCTIONS NOTED.

The proud position occupied by New Zealand in regard to its low death rate compared with other countries and to its low percentage of infectious diseases ii acknowledged by national health organisations in Great Britain and the United States. The official figures with respect to infectious diseases in the Dominion for! the past year are now available. Interviewed by a "Post" representative, the Deputy Director-General of Health, Dr. J. P. Frengley, drew attention to New Zealand's enviable position in respect to public health, and made some interesting comments on the continued improvement shown by the figures as to infectious diseases for last year as compared with previous years. • "A highly complimentary reference to the health of New Zealanders," statea Dr. Frengley, "appears in an article m Current -History,' by James A. lobey, Washington representative of tKe National Health Council. Mr. Tobey writes: 'To imrpove the health of the world isa big task. That it can be done has been shown by results in single nations. One ..of the healthiest countries is New Zealand. There the expectancy of life is about 60.years, whereas in Uermany m 1910 it was about 45 years. In the United States and in England it is about the same as in Germany, while ny India it is less than 25 years. As the, death-rate decreases the expectancy of life increases. It has been estimated that at least 15 years could be added to the average length of life by means of sanitary measures scientifically applied. Public health has been defined by Professor C. E. A. Winslow, of Yale, as 'The science and the art of preventing disease, prolonging life and promoting physical lisalth and efficiency through^ organised community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, .the organisation of medical _ and nursing service for the early diagnosis and preventive treatment of disease and- the development of tiie social machinery which will insure to every individual 'in the community a standard of Jiving adequate for the maintenance of health.' " MARKED IMPROVEMENT SHOWN. Looking a little more closely at the death-rate figures of New Zealand that ale available, it is found that there has been a gradual improvement every year, execept in .special circumstances. For instance, in 1903 the rate per thousand of population was 10.40; ten years later this was clown to 9.47 iv 1913. In 1918 the influenza epidemic increased the rate to 14.84, but in 1922 the steady normal decrease was again in evidence at 8.77. For the same year in the Commonwealth of Australia the rate was 9.-21. Comparing the New Zealand rate of 8.77 with" certain other countries a very satisfactory advantage is noticed as regards England and Wales (13 7) United Statas (14.5), Scotland (14 8) Ireland (16.2), France (19.8); Germany (20.2), Italy (22.1), Japan (22.5), Ceylon (31.0). The nearest approaches, with the exception of the Commonwealth of Australia, ai'e Union of South Africa (12.0) and Denmark (12.6). It must be remembered that throughout 'the World there are many powerful-and varied organisations striving for improvements in all conditions relative to public health, and the fact that New Zealand is to a great extent independent or such organisations is no small tribute to the value of the measures that have been in vogue for a number of years past. The infantile mortality rate for children under one year in New Zealand in 1872 wa s 35.29 per cent, of population. Twenty years later it was 24.70. Another ten years brought the parcentage in 1902 to 20.44, while the last ten years to 1922 saw the striking reduction to 11.07 per cent. Persons between the ages of 60 and 65 years made up 2.50 per cent, of the deaths i.i 1872; 5.69 per cent, in 1892; and 6.65 per cent, in 1922. For still older persons 70-75 years, the percentage has improved in. forty years from 2.05 in 1882 to 8.24 "in 1922. NOT ALL OWING TO NATURAL ADVANTAGES; In considering the many natural advantages of New Zealand, such as the great open 6paces and ' forests; the mountains and plains; the ever-abun-dant rivers and streams; the remarkable length of coast line: and the coolness and equability of the climate, there may be a tendency to infer that the country derives through these factors an unusual degree of immunity against many diseases whicli handicap other countries. But statistics show that this is iiot so. lii the case of infantile mortality, for instance, although the rate is now reduced to a figure that sets a standard for the world, the comparisons were not always so favourable. Apart from social and economic factors, it is not unreasonable to assume thai the high expectancy of life noticed by Mr. Tobey is due in no small measure to the efforts that have been made to disseminute a greater knowledge of the essential requirements of child-rearing aild1 Of maintaining the health of the adult, together with the widespread adoption of j advanced ideas in sanitation and other aspects of public hygiene^ PEAK NOT YET BEACHED. That good" progress continues to.be made from year to year, and that the "peak" has not yet been reached, is indicated in a comparison of the infectious diseases returns for 1923 with the figures for the previous year. Puerperal septicaemia, so much discussed" in connection with the maternal mortality rate, shows a noticeable decrease of 32:4 per cent, in the number of cases notified, and this is the first time since before 1918 that there has not been an annual increase. The figures are : 1922, notifications 252, deaths 52; 1923, notifications 177, deaths 39, Poliomyelitis (infantile paralysis) reached a high figure iv 1921 with 267 notifications. In 1922 this was reduced to 98, but last year only 17 cases were recorded. Enteric fever, with 276 cases, has only half the number as for 1922, and, indeed, in comparison with other countries it might almost be said that now there is no enteric fever problem in this country. Enteric fever has well been referred to as a "filth disease, and the sanitary measures effected in New Zealand during the past twenty years make it almost possible to say that it is only Where there is some untoward breakdown in these precautions that we have to consider enteric fever as a serious factor. For diphtheria the figures are • 1923, 1951 cases; 1922, 4.989 cases. Though it is yet early to make a definite | pronouncement, the Department of L Health has gre.a£ hopes pf still further;

reducing the diphtheria incidence by the toxin-antitoxin method of prophylaxis. i bcarlet fever shows-a better reduction from 1449 to 1201—the lowest. recorded formany years. Cerebrb-spinal meningitis, which was highest in 1918, with 159 cases, has continued with a steady decrease to 36 cases last year, against 42 cases for 1922. Tuberculosis has 127 cases less, and pneumonia has a decrease of 158, while influenza last year nad a very noticeable total of 1144 cases, as compared with 216 cases for the previous year. In fact, this is the only instance where it can be said that ground was lost, and that, of course, was only temporary. " . ■"■ Cancer may be mentioned in passing, since it is being brought prominently be--lore the public at present. Not being an infectious disease, it is not included in the return discussed above, but is definitely known.to be on the increase year" by year. It is interesting to near" this in mind in connection with the increasing expectation of life in New Zealand and in other progressive civilised'cbi}n-, tries. .Cancer is largely\ a disease of later life, and it may be speculated'-thaV Its apparent increase is not so rcal".ae"i!> may seem, since more people are living w a greater age., and hence thenf are." more opportunities for- theTdisease to impress itself, on statistical returns.