H.—3l

8

The principal causes of death in 1920 are set out below in detail :

It will be seen that the more common infectious diseases (Nos. 1-8 on the above list) were responsible in 1920 for 1,710 deaths, or some 14 per cent, of the total mortality for the year. Scarlet fever and enteric, which are regarded by the public generally as formidable diseases, accounted for only 110 deaths, while whooping-cough and measles, which make no similar appeal to the imagination, caused double the number of fatalities. The table shows clearly that there is still in New Zealand scope for a more earnest application of the principles of preventive medicine. Infant Mortality. —The infant-mortality rate for 1920 was 50-57, as compared with the rate of 45-26 for the preceding year. SECTION 2.—NOTIFIABLE INFECTIOUS DISEASES. The outstanding features of the year under review were widespread epidemics of influenza, measles, and whooping-cough, an increased prevalence of poliomyelitis, and an outbreak of smallpox in the Otago Health District. The following table is submitted as enabling a rapid comparison to be made of the incidence of the more important infectious diseases in the Dominion during the past five years : —

Cases of Principal Infectious Diseases notified during Past Five Years.

An examination of the table discloses the following points of interest : Scarlet Fever. Scarlet fever is at a lower level than in any other year of the quinquennium. The disease, moreover, is characterized by its mildness ; only fifteen deaths, representing a ease mortality of 1-2 per cent., were attributable to this cause in 1920. Diphtheria. Diphtheria again shows a substantial decline in comparison with recent years. The disease, however, still remains all too J prevalent, the cases occurring in 1920 being more than double the number notified in 1914. The disease, fortunately, is relatively mild in type, and only ninety-five deaths were due to this cause in 1920. The same undue prevalence of diphtheria, it may be added, has been experienced in other parts of the world. The following table, giving the inciderce rate of

Disease. Number of Deaths. Proportion of 1,000 Deaths from all Causes. 1. Measles 2. Whooping-cough 3. Scarlet fever 4. Diphtheria ; croup 5. Enteric fever 6. Influenza 7. Phthisis (pulmonary tuberculosis) 8. Other forms of tuberculosis 9. Cancer 10. Diseases of nervous system and special senses.. 11. Organic heart-disease 12. Other diseases of circulatory system 13. Bronchitis .. .. .. 14. Pneumonia 15. Other diseases of respiratory system .. 16. Diarrhoea and enteritis 17. Other diseases of digestive system 18. Diseases of geni to-urinary system 19. Premature birth and diseases of early infancy 20. Old age .. 21. Injuries and accidents (violence) 22. Other causes 122 107 15 95 40 480 695 156 1,029 !, 153 1,703 323 389 528 437 188 526 504 815 1,017 696 1,091 10-08 8-84 1 -24 7-84 3-30 39-61 57-39 12-88 84-98 95-22 140-64 26-67 32-12 43-60 36-09 15-52 43-44 41-63 67-31 83-99 57-48 90-10 12,109 1,000

Disease. 1916. 1917. 1918. 1919. 1920. icarlet fever )iphtheria Cnteric fever .. .. Jerebro-spinal meningitis 'oliomyelitis 4,278 2,376 806 950 135 1,018 2,755 5,458 653 1,521 42 54 1,654 5,539 423 1,072 159 6 1,521 3,499 477 984 96 11 1,248 2,442 389 1,305 79 46 Totals 9,563 10,483 8,853 6,588 5,509