Morton L. Levin, M.D.
JAMA. 1941;117(2):136. doi:10.1001/jama.1941.02820280058020.
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To the Editor:—  An editorial (Mortality of Husbands and Wives) in The Journal, March 8, discussing Antonio Ciocco's (Human Biol.12:508 [Dec.] 1940) finding of marital association in deaths from tuberculosis, influenza and pneumonia, heart disease and cancer remarks on the difficulty of explaining such association (except in the case of tuberculosis). It should be pointed out that the observed relationship is possibly linked with increased mortality from these diseases in certain social-occupational groups.Perhaps the most striking evidence of such selective mortality is found in the reports on occupational mortality in England and Wales. In the latest of these reports (The Registrar General's Decennial Supplement: England & Wales 1931, Part IIa. Occupational Mortality, London, His Majesty's Stationery Office, 1938) comparative mortalities are calculated for males by occupation and for married women according to the husband's occupation. Occupations are grouped into five large classes, namely:Class I. Professional workers


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