Different proportions of the Expenses of Burials to the Community in healthy and unhealthy Districts.
§ 75. It is a prevalent popular error, not unsanctioned by doctrines held by several eminent public writers, that “as one disease disappears so another springs up,” that the positive “amount of mortality, the common lot,” is the same to all classes. But death, besides differing in the period to different individuals, differs widely in the numbers of burials, and in the consequent expenses to different families, classes, and districts. It is the number as well as the separate expense of each of the funerals which occur during the year to each class of persons, or to different districts, which determines the total expense of burial to the class or district. Thus, to the poorer classes, living in wretched habitations, as those comprised in Bethnal Green and Whitechapel, there is one burial to every 31 of the inhabitants, whilst in the contiguous district of Hackney there is only one burial to every 56 of the inhabitants yearly. In Liverpool there is one burial per annum to every 30 of the inhabitants, whilst in the county of Hereford there is one burial only to every 55 of the inhabitants. If the existing charge of burial, at the above rates of expense to each class of individuals, were commuted for an annual payment, commencing at birth, as a premium for the payment of 100l., 50l., and 5l., payable at the undermentioned periods respectively, it would in the metropolis and the county of Hereford be nearly as follows:—
| CLASS. | METROPOLIS. | HEREFORDSHIRE. | ||||||
|---|---|---|---|---|---|---|---|---|
| Average Age at Death. | Annual Payment for Burial to every Individual. | Average Age at Death. | Annual Payment for Burial to every Individual. | |||||
| Years. | £. | s. | d. | Years. | £. | s. | d. | |
| Gentry | 44 | 1 | 1 | 10 | 45 | 1 | 1 | 0 |
| Tradesmen or Farmers | 25 | 1 | 6 | 8 | 47 | 0 | 9 | 9 |
| Labourers | 22 | 0 | 3 | 2 | 39 | 0 | 2 | 9 |
| Average of all Classes | 27 | 39 | ||||||
Supposing each member of the family to have been assured at birth, a labourer’s family in Herefordshire consisting of five persons would have to pay yearly 13s. 9d., and there a farmer’s family of the same number would have to pay 2l. 8s. 9d. yearly; whilst in London for an artisan’s family of five, the yearly payment would be 15s. 10d. and for a tradesman’s family it would be 6l. 13s. 4d. per annum. To insure the payment of the average cost of funerals, 14l. 7s. 5d. at the end of 27 years, on the metropolitan chances of life, the annual payment would be 7s., whilst on the Herefordshire chances of life of 39 years to all born high or low the sum would be only 4s. Or to take another form of displaying the comparative burthen; the general average cost of each burial being 14l. 7s. 5d., and the annual proportions of deaths being different from the average duration of life—being 1 of every 40 in the metropolis, a poll-tax to defray the burial expenses must there be 7s. 2¼d.; whilst in Hereford the proportions of deaths being one in every 55, the poll-tax on all of the inhabitants to meet the charge would be 5s. 3d. per head.
§ 76. It appears, therefore, that in considering the means of relief from the evils connected with the number and expenses of burial, it should at the same time be borne in mind that the primary means of abatement and relief of the misery of frequent funerals will be found in the means of the removal of the developed and removable causes of premature mortality. Had the annual mortality amongst the population in the high, open, and naturally-drained district of Hackney been the same proportionate amount of mortality as that in the contiguous, but low, ill-drained, ill-cleansed, and ill-ventilated district of Bethnal Green and Whitechapel, instead of 759 deaths per annum, Hackney would have upwards of 1138 deaths, and an expense of 5448l. more for funerals during the year than it has. So the county of Hereford, if it were afflicted with the same amount of mortality as that which prevails in Liverpool, would have 1488 more deaths annually and an additional expenditure of 21,390l. per annum in burials. How directly, certainly, and powerfully, defective sanitary measures in respect of drainage and cleansing, bear upon health and life, and, by consequence, on the frequency of burials, will be seen in the latter portions of the examination of Mr. Blencarne, surgeon, one of the medical officers of the City of London Union, and of Mr. Abraham, surgeon, one of the Registrars of Deaths in the same Union; which I select as an instance, because the City stands high in wealth, in endowed charities, and in supposed immunity from the removable or preventible causes of disease.[[17]]
§ 77. Two individual cases which were narrated by the physician who attended them, will serve to convey a conception of a large proportion of the common cases denoted by the units of the statistical evidence derived from towns, and will illustrate more clearly the economy of the prevention of sickness and death, as a superior economy of the incidents of sickness as well as of funerals.
One case was that of an intelligent industrious man who had been foreman to a tradesman, and having married and established himself as a master tradesman, had a family of children. To diminish the expense of his family he took a house which he let off to lodgers, retaining to himself only the garrets and the underground or kitchen floor. He had five children who became unhealthy and were attacked with cachectic diseases and scald head; and the expense of an apothecary to the family during one year was 59l.: but still more serious disease afterwards appearing, a physician was called in, who perceiving the impure air of the apartments, pointed out the causes of the varied illness which had prevailed, and the remedy—removal from the house.
In another case the foreman of a brewery married a healthy wife, who gave birth to seven children, of whom six died at various ages, while young, from diseases evidently springing from impure air. The source of this impure air was an ill-constructed cesspool in the lower part of the house, the stench of which was pointed out by the physician, who happened to have a perception of such causes, and advised the immediate removal of the family. Since that time they have had two other children, who with the third which escaped, are now living in their better lodging in the enjoyment of good health; the last of the children who died, when “ailing,” was sent to the purer atmosphere of a rural district, and returned in robust health, but soon after his exposure to the impure atmosphere was attacked with fever, of which he died within a fortnight.
It was in the power of neither of these persons to obtain an amendment of the general system of drainage, which occasioned the atmospheric impurity under which they suffered; but the actual expenses of structural measures of prevention would not, as an entire outlay, have amounted to half the apothecary’s bill for drugs in the first case, or of the expenses of the funerals (superadded to the expenses of drugs) in the second case; but if the expenses of those structural arrangements were defrayed by an annual payment of instalments of principal and interest, spread over a period of 30 years, or a period coincident with the benefit, the expense of the extended or combined measure of prevention would not be more than 1l. 5s. 10d. per tenement, or perhaps a small proportion of that sum, to the individual family.[[18]]
§ 78. But to return to collective examples. Mr. Blencarne, on a view of the sanitary condition of the population, and the causes of mortality within his district, expresses a confident opinion that in that district the average amount of mortality might be reduced one-third by efficient sanitary measures. The saving by a reduction of 71 funerals yearly, or one-third of the burials in that district, at the average expense of funerals for the metropolis, would amount to nearly 1020l. per annum. If, as appears to be practicable, there were a reduction of one-half of the expenses of the other two-thirds of the average number of funerals, the total saving from this source would be 2040l. per annum to the population inhabiting, according to the last census, 1416 houses. Now the annual share of the expense of the chief structural sanitary arrangements, supposing every house in the district to be deficient, would, on the proximate estimate, amount to a sum of 1829l., or less than the amount saved by the reduction of the funeral expenditure, giving the health and longevity, and all the moral and social savings, plus the mere pecuniary saving; these remoter savings being in themselves unquestionably far greater than can be represented by the pecuniary items directly economised.