We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA 100 Years Ago |


JAMA. 2008;299(18):2220. doi:10.1001/jama.299.18.2220.
Text Size: A A A
Published online


Of all the advances made in medicine during recent decades, no step has been more fraught with benefit to the common weal than the birth of a science of public health. The first step in this direction, and one that was absolutely essential to its development, was the institution of what is known as vital statistics, i. e., an efficient official registration of births and deaths, with the causes of the latter, and of infectious diseases. The science of epidemiology, also, itself a subordinate part of the science of public health, took its rise with that of vital statistics. In this country, until recently, very little effort was made, save in large cities, to establish an official statistical record. By the growth since 1895 of what is known as the registration area of the United States, the vital statistics now cover a total of 48.7 per cent. of the entire population, so far as mortality returns are concerned. But in the “Report of Mortality Statistics,” for 1906, of the Departments of Commerce and Labor, Bureau of the Census, there is to be noted an inquiry as to why there is no registration area for births. The bureau, with a view to answering this question, sent out an inquiry to all states and to all cities of 50,000 population or over in 1900, concerning the status of the registration of births therein. After eliminating replies which for one reason or another were inadequate, the reasons for the inadequacy of birth returns assigned by registration officials in 64 state or city areas show, on analysis, that in no less than 41 the inadequacy is attributed to the “negligence,” “unwillingness,” “failure,” “indifference,” etc., of physicians. In one case this attitude of the physicians is emphasized by the statement, “no difficulty from midwives, but considerable from physicians.” Occasionally a reason is given for the laxity of the physicians, such as an objection to do clerical work for nothing, or the fact that the physician witholds the report in order to obtain the name, and ultimately forgets it altogether.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.