The truth is that as yet we have only made a feeble beginning in public health work, especially in this country. We need first of all to do what Sweden has done for a hundred and fifty years—namely, to keep proper vital statistics. Vital statistics are the bookkeeping of health, and we cannot economize health any more successfully than we can economize money unless we keep books. At present only a little over half of the population of the United States has statistics of its deaths, while the statistics of the births are as yet nowhere sufficiently accurate to be called real statistics.
Our National Statistician, Dr. Wilbur, illustrates by a story how much better we keep our commercial books than our books of vital statistics. In a Western State a girl was entitled to a fortune when she became twenty-one. Reaching, as she supposed, her twenty-first birthday, she laid claim to the fortune. Much to her surprise, her father said, “But you are only nineteen;” and then the two tried to look up the records. They had no family Bible, they had no public record office to go to, and they were at sea as to how to discover exactly the date when she was born. However it suddenly occurred to her father, who was a farmer, that the very day his daughter was born a calf was born on his farm and the birth of the calf had been recorded. In that way he established the date of the birth of his daughter.
In view of the great slack of our vital statistics, therefore, we cannot measure even the death rate, much less the number of preventable deaths in the United States. All that we can do is to study carefully the registration area and on this basis to work out certain minimum figures.
Four years ago, as a member of President Roosevelt’s Conservation Commission, I endeavored to do this and to report on the condition of our “National Vitality.” I found, after getting together all the statistics available and taking account of the degree of preventability of different diseases as estimated by experts that, out of some 1,500,000 deaths annually in the United States, at least 630,000 are preventable. Of these preventable deaths, the greater number are from seven causes. These seven causes include three great diseases of infancy, then typhoid fever, which usually makes its attack in the twenties, then tuberculosis, accidents in industry, and pneumonia which come in the thirties.
Now 630,000 unnecessary deaths per year mean over 1,700 unnecessary deaths per day or more than the lives lost on the Titanic disaster. The nation cannot continue indifferent to hygiene as it gradually dawns on the public that for lack of hygiene we suffer a Titanic disaster every day of the year. The popular imagination was deeply stirred by the image of 1,600 helpless human beings suddenly engulfed in mid-ocean. That was a vivid dramatic picture which the blindest of men could see and understand. It led to immediate official action on both sides of the Atlantic to safeguard human life at sea. Yet on land we lose three hundred and sixty-five times as many lives as this every year and never stop to add it up. They are scattered and diffused throughout the land—a Wilbur Wright lost from typhoid, a handful of miners in an explosion, some railway employes in an accident, some victims of lead poisoning, a little army of infants, here a few and there a few. Yet these deaths are just as real and mean an infinitely more serious loss than were the deaths from the Titanic disaster. Moreover, they could be as easily prevented.
And concomitant with this unnecessarily great death rate, there is, of course, a colossal aggregate of needless sickness. We have no real statistics, but by analogy with English statistics we may assume that, on the average, for every death per annum there are two persons sick during the year. This makes about three million people constantly lying on sick beds in the United States, of which, on the most conservative estimate, at least half do not need to have been there.
If, now, on the basis of these figures, we try to compute how much human life is needlessly shortened in the United States, we find that it is shortened at least fifteen years. Again, if we translate these preventable losses into commercial terms, we find that, even by the most conservative reckoning, this country is losing over $1,500,000,000 worth of wealth producing power every year.
What does this mean? To us individually, it means that we are losing a large part of our rightful life not only by death itself which cuts off many years we might have lived, but also from diseases and disabilities which are not fatal but cripple the power to work and mar the joy of living. I believe I am far within the facts when I venture the opinion that the average man or woman in the United States is not doing half of the work nor having half of the joy of work of which the human being is capable.
With all this room for improvement before our eyes, it is not surprising that the zeal of the health movement is growing fast. Each success serves as justification for further effort.
One of the most encouraging symptoms of progress is the great attention which is being paid to public health in the present political campaign. All three of the party platforms included planks in behalf of public health. The Democratic and Progressive platforms were particularly explicit and emphatic and all the candidates have emphasized health in speeches and in their record in public life. The Democratic campaign managers are carrying out plans to make progressive health legislation prominent in the campaign.