[14] An address to the Alpha-Kappa-Kappa Club, Johns Hopkins University, Wednesday, December 10, 1919.
CHAPTER VII
The Obstacles to and Ideals of Health Progress [15]
There are two ways in which Health Problems can be approached: what may be called the microscopic method, which examines in minute detail each individual problem; and the conspective method, in which an attempt is made to obtain an unbiased and comparative view of the chief problems concerned, in order that their relative importance may be assessed, and the possibilities of improvement may be gauged. In proposing to myself the latter and more difficult task, I appreciate the impossibility of discussing all the items which emerge.
I would not have us forget what has already been achieved. Taking the national figures for England and Wales as an illustration, it is noteworthy that the death-rate from all causes fell from 22.4 per 1,000 of population in 1846-50 to 13.8 in 1911-15, a reduction of nearly 40 per cent. Comparing the decennium 1871-80 with the quinquennium 1911-15, the incidence of reduction of death-rate at different ages was as follows:
Percentage reduction in death-rate
| Age | Age | ||
| 0-5 | 42 | 35-45 | 42 |
| 5-10 | 48 | 45-55 | 25 |
| 10-15 | 43 | 55-65 | 15 |
| 15-20 | 46 | 65-75 | 10 |
| 20-25 | 51 | 75-85 | 7 |
| 25-35 | 50 | 85 and upwards | 15 |
The survey is saddened by the terrible losses of War, and the even more devastating ravages of influenza; and we realize our inadequacy to prevent catarrhal infections, until further research into preventive possibilities proves successful, and until the standard of universal conduct for catarrhal affections becomes much higher than at present. We realize furthermore that probably at least half the deaths from all causes which occur could be postponed until old age. But the standard of health of the general population has greatly improved; typhus has practically disappeared under peace conditions; yellow fever approaches its demise; malaria and typhoid are controllable; tuberculosis and venereal diseases are only waiting for systematic, complete, and continuous measures to secure their rapid decline or actual disappearance; the mortality from childbearing and of young children has greatly declined; and this is an incomplete statement of what has already been done.
Obstacles
This improvement is all the more remarkable in view of the additional obstacles imposed to health improvement by modern conditions of urban and industrial life.