Senescence, the Last Half of Life

by G. Stanley Hall

A. Newsholme[119] presents a table giving the annual death rate, per million persons living, from a few prominent diseases, showing that there is a falling off in the death rate from old age. The author adds: “If this were a real falling off, it would not be an indisputable advantage as most people would prefer to die of old age. The decline under this head, however, is chiefly due to an improved specification of the causes of which the old die.” He gives copious statistics on the causes of death. He also gives an interesting table (p. 237) on the basis of 100,000 of each sex, showing graphically the steady decline in death liability and that the percentage of death is least at 12 and the early teens and soon after begins slightly to increase, falling somewhat more rapidly after 40 and then becoming a little less rapid after 70; while at 90, only 2,000 of the original 100,000 remain alive.

Director Sam L. Rogers of the Bureau of the Census published tables of vitality statistics[120] to show expectation of life at all ages for the population of New England, New York, New Jersey, Indiana, Michigan, and the District of Columbia (these being the mortality death registration states) on the basis of the population in 1910 and the mortality for three years. They are like life tables of insurance companies with the exception that they are based on the whole population. According to these tables the average expectation of life for males at birth is 49.9 years; for females, 52.2. Expectation of white males reaches its maximum at the age of 2 (57.7 years). At the age of 12, it is 59.2 years; at 25, 39.4; at 40, 28.3; at 50, 21.2; at 60, 14.6; at 70, 9.1; at 80, 5.2 years. During the first month of life the death rate of native white boys is nearly 28 per cent higher than that for girls. The twelfth year seems to be the healthiest for the native whites and thereafter there is continuous increase in the death rate. Expectation of life is not the same as saying that a man has an even chance of living that number of years, because expectation represents the average remaining length of life at any given age in a stationary population. A native white male child at birth has one chance in two of reaching sixty. At the end of his first year he has more than an even chance of reaching sixty-four. At forty-two he has an even chance of attaining seventy. At all ages women live longer than men and expectation in the country at all ages is distinctly greater than in the city.

R. Henderson’s work[121] sets forth the theoretical relations with reference to the duration of human life, describing those mortality tables that have had the greatest influence on the development of the science of life contingency and its applications in this country. The author establishes a connection between mortality tables and mortality statistics and tells how to interpret the latter. The methods of constructing mortality tables from census and death returns and from insurance experience are then taken up. The writer deals only with life contingencies and not at all with monetary applications and gives us a new table. “The present value of a sum of money payable at death cannot be properly calculated in assuming it to be payable at the end of a definite period equal to the expectation of life.” Nor can the present value of a life annuity be calculated by assuming it to be certainly payable for that period.

W. S. Rankin[122] tells how he applies vital statistics to sick towns or cities in a way to first restore consciousness by telling them just where they stand relatively with regard to death rates and second to bring about reforms. He has various charts and diagrams. The opinion of prominent people in every community is, in general, that their health conditions are good, but when asked what the death rate is they can give no answer. One community compelled a railroad to build and maintain an expensive overhead bridge at a cost of $1,500 a year to prevent one death and the aldermen appropriated only $150 to prevent fifty deaths. The first thing in treating sick social organisms is to restore consciousness.

Alexander Graham Bell[123] in the study of a family which is almost classic found that the average duration of life was 34.6 years; 35.2 per cent of these persons died before they were 20 years of age, and 7.3 per cent lived to be 80 or older. A second danger period was found in adolescence, ending at 23. Both sexes showed an increase of deaths during adolescence. More females than males lived to be 95. But the fathers, on the average, lived longer than the mothers and the children born between four and eight years after the marriage of their parents lived longer than those born later. Those who live to be old come from long-lived parents. The long-lived seem to inherit disease-resisting qualities and also are more fecund than the short-lived. He says[124] that in this family mothers who lived to extreme old age had, on the average, larger families than those who died earlier in life, for example, those who died before forty had, on the average, only three to four children apiece. The long-lived proportion is practically doubled when one parent lives to be old and quadrupled when both parents do so. The people who lived to be old represented the disease-resistant strain of their generation and on account of their superior fecundity this quality is distributed largely throughout the population. “A very large proportion of each generation is sprung from a very small proportion of the preceding generation; namely, from the people who lived to old age. The members of the short-lived group come from the short-lived parents. The children of the long-lived parents are on the average stronger, more vigorous, and longer-lived than the children of others, and there were more of them per family.”

Scott Nearing[125] says that the years from 45 to 60 or 65 should be the most valuable ones from the social point of view. He reminds us that if the average length of life were doubled the population would in a generation double without any increase in the birth rate. The average length of life in the leading countries of the world varies much. In Sweden, for males it is 53.9; France, 45.7; England and Wales, 44.1; Massachusetts, 44.1; India, 23.0. Men born in America of native white parents live on the average only 31 years; those born of foreign white parents, 29.1 years. Men in the modern cities die when they are one score and ten. There is a great difference in occupations: for shoemakers the death rate per thousand is 8.7; farmers, 11.02; tailors, 13.65; cigar and tobacco makers, 21.67; servants, 21.78; and laborers, 22.3. Such figures suggest the dangerous occupations. As to the length of the working life, from 15 to 65, out of every one thousand males living at the age of 15, 440 will survive to the age of 65, while the rest will have fallen out for some cause. So society has lost more than half its working force at the end of the working period. In the 16th century the average length of life he estimates at 21.2 years; in the 17th, 25.7; in the 18th, 33.6; and in the 19th, nearly 40 years. Finkenberg thinks that in the 16th century it was between 18 and 20 years; at the close of the 18th, over 30; while to-day it is from 38 to 40. We have no data for the United States as a whole that are of any value. Among males in England the average length of life is increasing at the rate of 14 years per century; France, 10; Denmark, 25; Massachusetts, 14. Although these figures are only approximations, Nearing thinks life is probably twice as long as it was a few centuries ago.

Irving Fisher[126] says in Europe the span of life is double that in India. The death rate in Dublin is twice that of Amsterdam and three times that of rural Michigan. Life is probably twice as long as it was three or four centuries ago and is increasing more rapidly now than ever. The rate of progress is very variable in different countries, the maximum being in Prussia. Improvement is most in females and the rate of increase is accelerated perhaps four years a century on the whole, although during the last three-quarters of the nineteenth century Fisher thinks it has increased nine years. At least fourteen years could be added to human life by eliminating preventable diseases, which would be the equivalent of reducing the death rate about 23 per cent. In a table he shows that seven of the ninety causes of death are responsible for over one-half of the shortening of life. He gives us a diagram that shows where the saving of life has been and might be greatest. The area between the curves shows that from 1855 to 1897, 550,000 years were saved for a supposed group of 100,000 persons, or 5.5 years per person. The addition of 12.8 years to the lifetime of each of 100,000 persons might be divided into three groups, namely, that of preparation, the working period, and the decline. The chief cause of prolongation is found in new hygienic ideals.

Metchnikoff thought that the lengthening of human life would at once decrease the burden on the productive period, which is some 55 per cent of the total years lived—assuming the working period to be from 17 to 60—and that the latter limit would shift forward. As life becomes complex and as knowledge increases the period of preparation should be prolonged. Men should graduate later. Life should be lived on a larger scale, with more utilization of accumulated experience and less disastrous immaturity. Now we have to force young men into positions prematurely because of their vitality. Metchnikoff says “Old age, at present practically a useless burden on the community, will become a period of work valuable to it.” Human life will become much longer and the par value of old people will become much more important than it is to-day.

Willcox thinks the death rate in the United States is at least eighteen per thousand. Moreover, we have some three million persons always on the sick list, more among the old than the young since morbidity increases in age. But at least one-third are in the working period. The loss by consumptives alone is figured at sixty million dollars. Now, it costs no more to raise a man capable of living eighty years than it does to grow one who has the capacity of living only forty. Health means increased vitality and makes life, in Mallock’s phrase, better worth the living, for health is the first wealth. We can do much to raise American vitality.

Fisher adds[127] that in the United States the general death rate has steadily fallen for several decades, as is common in all civilized countries. Many think this means a gain in national vitality. This may be true for the younger age but the “gain has served to mask a loss of vitality at the older age periods. This latter phenomenon, a rising mortality in elderly life, is something almost peculiar to the United States.” In other lands this fall in death rate has been due not solely to the reduction of mortality in infancy and adult life, for most countries have improved their mortality at every age period. Probably this is due to “some unknown biologic influence or to the amalgamation of the various races that constitute our population. It must be ascribed in a broad sense to lack of adaptation to our rapidly developing civilization.” The American decreases in younger ages are not as great as in England and Wales and they change into increase at about the age of forty-five and continue to increase thereafter, while in England and Wales the decline occurs at all ages. In 1900 or thereabouts the death rates in the middle ages of life were heavier in the United States than in Prussia, France, Italy, and Sweden. Since then death rates in the United States at these ages have grown even greater.