According to statistics, the death-rate of children is almost 50 per cent higher in cities than in rural districts, and it is a general impression that most deaths in the country are from old age. English statistics show, however, and those of the United States would probably show the same thing, that while a baby born in the city is more likely to die before its first birthday than a baby born in the country, they have equal chances to finish a month of life and that the city child has better chances to live out the first week. The advantages of the country, therefore, do not begin to operate until after the first month of the baby's life, and there is a decidedly greater chance of the child's living in the city the first week on account, probably, of better and quicker medical attendance.
Typhoid fever and the death-rate.
Turning now to special diseases and comparing the number of deaths caused by special diseases in the country and in the city, it is to be noted, first of all, that a greater difference exists in the case of certain special diseases in the country and in the city than was found in the general death-rate. In the case of typhoid fever, basing the comparison on the statistics of the Census Office of the United States, we find, first, that, at present, the difference in the death-rates from typhoid fever in cities and in rural districts is very small. It is also to be seen (from the following table) that in both city and in rural districts, the rate is steadily decreasing, although in neither has the rate yet fallen to what would, in other countries, be considered a reasonable and proper death-rate. The first line of the table is the actual death-rate from typhoid fever per 100,000 population, based on the total population resident in all the United States where vital statistics are kept; the second line gives the same data for cities not included in registration states;[1] the third line is based on figures for cities in registration states;[**] and the fourth line is based on the statistics for rural districts and villages of less than 8000 population:—
Table VI. Showing Death-rates per 100,000 Population from Typhoid Fever in Places Indicated
| Year | 1900 | 1901 | 1902 | 1903 | 1904 | 1905 | 1906 | 1907 | 1908 |
| The registration area | 35.9 | 32.4 | 34.5 | 34.4 | 32.0 | 28.1 | 32.1 | 30.3 | 25.3 |
| Registration cities | 36.5 | 33.9 | 37.5 | 38.2 | 35.2 | 30.1 | 34.2 | 32.9 | 25.8 |
| Cities in registration states | 28.5 | 26.5 | 25.9 | 24.6 | 24.0 | 22.0 | 34.2 | 31.7 | 24.5 |
| Rural part of registration states | 34.6 | 28.8 | 27.0 | 24.7 | 23.8 | 23.0 | 28.6 | 26.0 | 24.3 |
This table shows that, taking the United States as a whole, the typhoid-rate in rural districts is generally less than in cities and that in cities the rate is excessively high.
When it is remembered that by filtration of public water-supplies the typhoid-rate may be brought down to about 15 per 100,000, and that cities with pure water-supplies will not exceed that rate, it is plain how serious is the danger from typhoid in such cities as Cohoes or Oswego. The following table from statistics taken in New York State shows the same conditions as Table VI.—
Table VII. Showing Death-rates from Typhoid Fever per 100,000 Population in New York State as Indicated
| Year | 1900 | 1901 | 1902 | 1903 | 1904 | 1905 | 1906 | 1907 | 1908 |
| Cities average | 25.4 | 23.9 | 23.4 | 22.6 | 21.6 | 19.1 | 19.0 | 20.7 | 20.1 |
| Rural districts | 32.0 | 27.3 | 23.4 | 22.1 | 21.8 | 21.8 | 20.2 | 19.3 | 20.8 |
| Average of city population | — | 38.9 | 33.9 | 43.0 | 40.3 | 32.2 | 30.5 | 32.1 | 32.4 |
| Average of rural population | — | 20.3 | 24.1 | 23.2 | 21.3 | 22.3 | 21.3 | 19.9 | 20.8 |
The first line is the death-rate in cities, found by taking the ratio of all the deaths from typhoid in cities to the population in those cities, and the second line is a similar ratio for rural districts. If the actual rates of the several cities be averaged, a method which has the effect of giving the rate found for a city of 10,000 equal value in the average with one of 1,000,000, the third line of the table is obtained; and in the same way, by averaging the death-rates of the counties of the state, excluding cities, the fourth line is obtained. These last two lines show that the average of the city rates is noticeably higher than the average of the rural rates, and that, while since 1900 the average of the rural districts has remained uniform, the death-rate in cities has been continually decreasing.