PREVENTABLE WASTE OF LIFE

Especially significant as an indication of the progress for better health conditions is a pamphlet recently issued by the Provident Savings Life Assurance Society of New York, entitled “The State and the Death-Roll,” and designed to show the increased waste of life from kidney, heart, brain and other non-communicable maladies in the past thirty years, in contrast to the reduction in the death-rate from contagious diseases. The author, Mr. E. E. Rittenhouse, president of the society, refers to the report of Professor Irving Fisher on national vitality, showing that over six hundred thousand human lives are needlessly sacrificed in the United States every year, and that about three million persons are constantly seriously ill in the United States, more than one-half of these illnesses being preventable. The financial importance of these statements to life insurance companies is evident.

While the general death-rate and especially the death-rate from communicable diseases has been reduced, the rate from non-communicable diseases due primarily to personal habits, overwork, etc., has been largely increased. In proof of this, the following facts are cited: The death-rate for consumptives in the registration area in the United States has decreased 49 per cent. since 1880, while the death-rate from diseases of the kidneys has increased 131 per cent. in the same time. The death-rate from heart disease has increased 57 per cent., from apoplexy 84 per cent., and from all three 83 per cent. At the same time, the death-rate from heart, apoplexy and blood-vessel diseases in England and Wales has decreased 7 per cent. Particularly illuminating is the table showing the death-rate for different ages by decades from 1880 to 1907, that of Massachusetts and that of England and Wales being contrasted. Between the ages of twenty and thirty, the death-rate in Massachusetts has decreased 41 per cent., while between the ages of twenty-five and thirty-five it has decreased in England and Wales 34 per cent. Between the ages of thirty and forty, the death-rate in Massachusetts has decreased 15 per cent. and in England and Wales 25 per cent., but between the ages of forty and fifty the death-rate in Massachusetts has increased 35 per cent., while in England and Wales the rate from forty-five to fifty-five has decreased 11 per cent., making a total difference of forty-six lives per hundred between the ages of forty and fifty-five, the most valuable years of a man's life, in which England and Wales have gained while Massachusetts has lost. Mr. Rittenhouse concludes that this abnormal increase in the death-rate from non-communicable diseases is due to the early wearing out of vital organs due to excesses in eating, drinking, working and playing—in short, intemperate living and the strenuous life. He says: “The science of sanitation and disease prevention has steadily advanced and yet the death-rate from these degenerative maladies has increased by leaps and bounds. The fact that the mortality in the younger lives is decreasing is very gratifying, but it offers no excuse for ignoring the extraordinary increase in mortality in middle life and old age. We try to protect a man from a disease which another might give him, but, without the slightest help, permit him to die of a disease which he may unknowingly give himself.”

As a remedy for existing conditions, Mr. Rittenhouse urges that the state inaugurate a systematic and permanent campaign of education for the prevention of diseases of all kinds by the distribution of health bulletins, the liberal use of health and medical inspectors and by other methods. He also suggests that the state provide free medical examinations, periodically, for any who may desire them, for the purpose of detecting disease in time to check and cure it. This plan, he says, would enlarge the work of the health departments and would require an increased staff of inspectors and medical examiners, but this would be well within the bounds of reason and would be amply justified by the results.

Mr. Rittenhouse's pamphlet is a most significant and encouraging evidence of the rapid growth of public opinion in favor of the prevention of disease and the conservation of life. When it is once thoroughly realized by business organizations and by commercial interests that the present waste of life means an enormous loss not only to the country at large, but also to the business interests themselves, steps will be taken to prevent the waste of life and energy which has been going on unchecked. This subject is of interest not only to capital as represented by the life-insurance companies and invested interests, but also to organized labor, since a large share of the preventable loss through sickness and death falls on the laboring man and his family.

JAMA. 1910;54(4):294-295