~.$$-#T @ Co++

U. S. DEPARTMENT OF COMMERCE $ +%!%?’ * BUREAU OF THE CENSUS

JESSE H. JONES ; * WILLIAM LANE AUSTIN ‘

SECRETARY ~ % :.,>

“* ,,*: $?:L,

& DIRECTOR

@ @o *$$ *?4TES or

VITAL STATISTICS OF THE

UNITED STATES

1938

PART I

NATALITY AND MORTALITY DATA FOR -THE

UNITED STATES TABULATED BY PLACE OF OCCURRENCE

WITH SUPPLEMENTAL TABLES FOR HAWAII

PUERTO RICO, AND THE VIRGIN ISLANDS

PREPARED UNDER TIIE SUPERVISION OF .

HALBERT L. DUNN, M. D.

Chief Statistician for Yital StatMc5

UNITED STATES GOVERNMENT. PRINTING OFFICE

WASHINGTON :1940

For 8ale by the Superintendent of Documents, Washingtcm, D. C. . . - - - . - - _ . - - - - - - - - - Price $1.75

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. CONTENTS

INTRODUCTION

Page Reylslon 02 annual vital statistics volumes 1 Comparability of olaasification 1

Chsnges in the registration areas 1 GeOgxaphlo classiflOatiOn 2 Clsssifioationby raoe--------------------------------------- 3 InternationalList of Causes of Death------------------------ 3 Nativity ol=sMioation 3

Quelif@ng faotors in interpretation and use oi?data------------- 3 Age, sex, raOe---------------------------------------------- 3 Population e8timstes 4 Plaoe OS residence 4 Completeness of registration 4

Interpretationof oause-of-deathtables 4 NatalitJ-stat18ti0D 5

Birth-rate treti 5 Crude birth ratee by State----------------------------------- 6 Age of ~onts 6 Plural births 6

Page€Natfd.itystatistics—continued

Average number of otiltien 7 Birth rates by month----------------------------------------- 7 Illegitimatebirths-----— 7 RePortins of sti~bi~s 9 Illegitimate stillbirths------------------------------------- ?

Mortality statistics 9 Death-rate tzend 10 Crude death rates by State-----------------------------------10 Deaths by ~e----------------------------------------------- 10 Death rates by month-------------— 11 Deaths by raae--------------------------------------------- 11 Death rates for seleotea oe.usesof death--------------—----- 11

Infant morttilty statistics 13 Trend of infant mortality 13 Infant mertslltyby State------------------------------------13 Infant death rates by age------------------------------------13 Snfant mcmtalityby month------------------------------------14 Infsnt death rates by oause of death------------------------- 14

SUMMARYAND RATE TABLES

?khle I.—Populationj number of births and deaths, and orude rates: the registration areas, Unitei States, 1900-193S 16

Table 11.-Enumerated population by oltieS and rural sreas, and by raoe: United States t?adeeoh State, April 1, 1930------------------- 16

Tsbla III.-Enumerated population by ege, raae, cmd sax: United States, APrll 1, 1930---------------------------------------------------17

Table IT.-Estimated mldyearpopulatlon: United States and eaoh State, L93O.l937-------------------------------------------------------la

Table V .—Population, number of births and deaths, aad orude rates: speoified foreign oountries, 1936---------------------------------ls

Table VI.-Population, ntuiberof births and deaths, and orude rates: speoifiecloountrles and seleoted yema ----------------------------19

Table VII.4rude birth rates (number of live births per 1,000 estimated midyear population): United States, eaoh division end State, 1915-19m 20

Table VIII.-Crude stillbirth rates (number of stillbirthsper 1,000 live births): United States, each division ana State, 1922-193S 21 -

Table ZC.—Crude death rates (number or aeaths per 1,000 estimatedmidyear population): United 3tates,eaoh division and State,1915-19S8 22

Table X.—Infnnt mortality rates (number of deaths under 1 year of age per 1,000 live births): United States, each division,and State, 1915-19=----------------------------------------------------------------------------------------------------------------- 23

Table XI.-Deaths frameaoh oause and orude death rates: United Statae, 1937 ad19w 24’

Table XII.-Orude death rates (number of deaths per 100,000 estimated midyear population) for selected oauses of aeath: Unltea States, eaoh di~ision and State, l9=-------------------------.--.-----------------------------------1J--------------------------­ zs

Table XIII.-Blrth8, deaths, infant mortality, and stillbirths:United Stetes, l9~-.------------------------,-------1-------------------- ’30

Seotion A.-OZties havi~ populations of 10,000 or more in 1930, oities hating populations UC 2,500 to 10,000 In 1930; and rural Mstriots, in the United States and each State--------------------T----------------------------- 30

Seotion B.-Eaoh oounty (tioludingcities hating populations of 10,000 or more in 1930]----------------------------1----33

GENERAL TABLES

LiveBirths

Table l.-Live births by month eml by population @oups: United States and eaoh state, 193S---------------------------------------------S5

Table 8.-IAve blrtihsbyraoe, parent nativity of white, andpopulation groups: United States and eaoh state, 19w---------------------- as

Table S.-Live births by sex of ohild, age of mother, raoe, and paremt nativity of white: United States and eaoh State, 193S------------ 91

Teble 4.-Live births by sex or ohil~ and by age of parents: United States and eaoh State, 1936----------------------------------------- 104

Table 5.-Live births by numbar of ohild, ase of mother, and raoe, end for white by nativity of mether: United States, 193S-------------116

Table 6.-Live births, by number of ohild and by raoe, and for white by nativity of mother: United States and eaah Stet.s,193S---------- Ml

Table 7.-Cases of plurel births classified by number of ohildren bora alive and stil.lborm,and by race and sex: Onltei States aud eaoh State, l9w----------------------------------------------------------------------------------------------------------------- 1z7 ,.

III

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Iv coNI!Em’s

GENERAL TASLES-Contlnuecl

StlllblFthB F.ne

Table 8.-Stillblrthe by month and by population groups: United States and eaoh State, 1930--------------------------------------------­ 131

Table 9.-Stillbfrths by raoe, parent natirlty of white, and population ~oups: United States and eaoh State, 193S----------------------134

Table 10.-Stillbirths by number of ohlld, age of mother, and raoe, and ror white by nativity of mother: United States, 3.932------------- 137

Total Deaths

139 Table il.-Deaths by month and by poptlatlon groups: United States and each State, l9W--------------------------------------------------

Table 12.—Deaths by raoe and by population groups: United States and eaoh State, l9W--------------------------------------------------142

144 Table 13.-DmN,ha by ase, raoe, sex, aad population &?oups: United States and ea.ohState, 193S------------------------------------------­

17e Table 14.-Death8 frmn eaoh oause by ega, raoe, and sax: United 3tates, l9W-------------------------------------------------------------

Table 15.-Deaths by age, raoe, and sex: eaoh Oity hating a population of 100,000 or more, 193S------------------------------------------ 224

Table 16.-Deaths by apeoified raoes, sax, age, and population groupe: United States and eaoh State, 193S 233

247 Table 17.-Demthe from aeleoted oauses, by ege, raoe, and sex: eaoh State, l9=---------------------------------------------------------­ 3 394 Teble lS.TDeaths from eaoh oause, by raoe and sex: united States and eaeh State, l9W---------------------------------------------------

Table 19.-Deaths from seleoted muses, by raoe, sex, c!M population groups: united Statea and moh State, 193S--------------------------458

Table 20.—Deatha from eaoh oause, by detailed raoe and sex: United States, l9~--------------------------------------------------------486

-Deaths from seleoted oausea, by month: United States, l9W------------------------------------------------------------------- Table .21. 490

Infant Deaths

491 Table 22,-Deaths under 1 year from seleoted otumes, by age, month, and sex: United Statea, 1928 -----------------------------------------

Table 23.-Deaths under 1 year from seleoted causes, by age, raoe, and sex: United Statea and eaOh State, 193S---------------------------502

Table %. —Doath8 under 1 year of age from seleoted muses, by raoe, sac, and population groups: Unl.tedStates cmd eaoh State, 1936------ 541

suPPIEWI?l?

Em&t 553, 554

Pm@rto Rioo------------------------------------------------------------------------------------------------------------------------­ 553, 567

Virgin IBlada 553, 576

OF THE UNITED STATES VITAL STATISTICS PART L GEOGRAPHIC CLASSIFICATION BY PLACE OF OCCURRENCE

Introduction

Thisvolume-VitalStatisticsof theUnitedStates,Part I —contains ofrloial statisticaltabulationsor natalltyend mortality dataror the oaLendar year 1938. Tablesare pre­sentedgivingdetailedetatistlosor livebirths,stillbirths, totaLdeaths,and infantdeathsin continentalunitedStates. SupplementarytSWLatlons for Hawaii, PuertoRico, and the VirginIslandsare also Included.The natalltydataare clas­sifiedby geographicarea,raceand sexor child,age Snd na­tlvltyor parents,month,orderof birth,et cetera. Mortall­ty data are classlriedby geographicarea,sex, age,race, month,causeor death,et cetera. The geographicclasslrloa­ tlonrefers to theplace of’birth or death,irreapectlve or the usualplace or residenceor themother of the child,or the usualplaceor rasidsnceor thedecedent. The tabulations

rromtranscriptsare d$t’lved or orlglnal birthand deathcer­ tlricates thatare receivedrrcm registrationorflclalsor States,cltles,and outlylngpossessions or theUnitedStat,es.

Thisvolumewas preparedunderthe dlreotlon or Dr. Halbert L. Dunn,ChlerStatistician and Dr. John for VitalStatistics, Collinson, Assistantchiefstatisticianror Vitalstatistics. Tabulations and Intrmiuctorymaterialwerepreparedunderthe

or Dr. ForrestE. Linder,SOCISJ. Immediateenpervlsion Science Analyst .

REVISION OF ANNUAL VITAL

STATISTICS VOLUMES The presentvolumecontinuesthe new seriesor annualpub­

lleatlonsbegun lastyear. Priorto 1937, Vital-statistics datacompiledby theBureauor the Censuswerepublishedemnu­ ally In twovolumes,W.r’th,Stillbirth, and InfantMortality

and ‘Mortalitystatistics.’1 Statisticstt The gaographlcclas­ slrloatlons used in thesevolumes rererredto placeor birth or death. From the beglnnlng,the principal compilations of birthand death statistics had beenon a de ractogeographic baele-thatis,birthsand deaths weretabulatedaccordingto the placein whichthe birthor deathoccurred,withoutregard to the usual.placeor residence.The alternative1s to tabu­ lateon a de juregeographicbasis,allocatingeachbirthand deathto the State,city,and countyor residence,or usoal placeor abode. ‘ The dirrerencebetween thesetwo methodsor tabulation

should be emphasized.Manybirthsand deathsoccurIn cities or countiesor whicheitherthe motheror the childor the de­cedentIs not a usualresident. Thesebirthsand deatheare nonresident-aresultor temporarymovementsor the residents or one geographicarea to another. This continuousshirting or the populationoccursror a numberor reasons,one of which is the desireror hospital racilltlesnot availablein the cityor countyor uso.alresidence.Inasmuchas the population censusIs compiledaccordingto the usual placeor abode,the tabulationor vital statistics on a de ractobasishas there­ rore seriouslyrestrictedthe use or thesedata ror certain Purposes.

Importantas It is to tabulate birthsand deathsby place or residence,It was not desirable to make a decided break thatwoulddestroycomparability withthe series or statistics previouslypublished.The national totalsderived rrom the

two typesor tabulations are identical.sincean international birthsor deathsie nelthe,r exch&e or nonresident feasible

nor necessary. The dirrerences ror State totalsare also,in most oases,negligible.Furthermore, tabulationsby placeor occurrenceare requiredror certain admlnlstratlvepurposes. The rr+tellty and mortelltydata includedIn part I are there­ rorea continuationor the rlgWeS publishedfor prioryears in the annualvolumesWairth,stillbirth, and InfantMortality Statistics’! Statistics.*? and ‘%!ortallty Data compiledon a de jureor residencebasisare publishedin a secondvolumeenti­ tledWltal Statistics or theUnitedStates,Part II.’~

The tablesin the volumesfor 193Scorrespond, witha rew to thosepublishedror 1937. The tabulations exceptions, pre-

sentedIII1937were extensively revisedso t~t the dam mf~t be more relevantto modernsocial,medloal,and public-health problems. The revlslonswere basedon the resultsor a survey of the needsor many important socialagenciesand Individual usersor vital statistics. Msny of the valuable suggestions and comments havebeen Incorporated In the volumesror 1937 and 193S;others will contributeto tutureImprovementsend axtenslonsor vital-statistics tabulations.

COMPARABILITY OF CLASS1FICATION

CSANSNS AaxAS.-The INlWWRWISITMTION firstvitalstatistics€

publishedby the FederalGovernment relatedto 1850and were ror the entireUnitedStates. Thesestatisticswerebasedon Information collectedduringthe decennialcensusor thatyear. Slmllardecennialcollections weremade by censusenumerators at each censusUP to and Includlngthe censusor 1900. The intervalbetweenthe occurrenceof a birth or a death~d the censusenumerationresultedin Inaccurate and incompletere­ portson birthsand deaths. Sinceseveral Stateshad devel- oped efficient systemsror the registration or vitalstatis­ tics,the Sureauof the Census,In 18S0,established a nation­ al Weglstration areat~ ror deaths. Thisoriginal area con­ sistedor only two States-Massachusettsand New Jersey—the Districtor Columbia,and several largecities, but by 1900 eight otherstates had been adndtted.For the years 1880, 1890,and 1900,mortallty datawere receivedrrom the States and citiesIncludedin this expendingarea,and bothBirthand deathrlgures ror the entire countrywere compiled rromthe reportsof census enumerator.

The annualcollectionof mortalitystatisticsror the reg­istrationareabegan with the calender year 1900. In 1902, the Sureauor the Census,whichhad previouslyfunctionedonly In censusyears,was madea permanentagencyby an act of Con­gress. This act authorizedthe Directorof the Eureauor the Censusto obtain,annually, copiesor recordsriled in the vital-statisticsoffices of those Statesand citieshaving adequate death-registration systems. At that time,not all the States had enacted laws requiringthe registration of birthsand deaths,and In many States the existing lawswere poorlyenforced. Importantdatesin the historicaldevelop- mentof vitalstatisticsIn the variousStatesand the year in whicheach statewas admittedto the national registration areas,are givenIn tableA.

1

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2 VITAL STATISTICS OF THE UNITED STATES€

TAME A .—IMPORTANT DATES IiiTRE HISTORYOF BETS ANIkDPA’l!d REGISTRATION:UNITED STATES

FIRST sIA’I!E 2WISW.ATION

STATB I IAw2NAcrEo

m.acamllt Oi

present law (model or

COnfolming

REOOSDS ON F122 FOR

mm -

AnmTrED’TQ F.ZGISEWTION

4RR4

Birth8-----E= ;0 model law] births and

deatha bathe Birth, Births

Alabnum--.---—----J 1919 1902 190s 1925 1927 Arizm2------------ 1909 1909 1909 1909 1909 1926 1926 Arkansas----------- 1ss1 leal 1913 1914 1914 1927 192? oalifOmia 1s5s 1877 1915 1905 1905 1906 1919 Cc.lomdo----— 1907 1907 1907 1906 192e c03mcticut 1852 1s52 1905 1’29? 1897 1s90 1915 Del.g-.----—-- 1861 1861 1913 leal 1231 1919 192L

Dietrict or 2ulumbi. 1874 1871 1907 1s35 1871 laao 1915 FlorLda--—---—— m99 1899 1915 1s77 1865 1919 1924 OeOrgia-------—— 1875 1823 19s7 1919 1919 1928 192e Idaho----------- 1907 1911 1911 1911 1922 1926 IllinoiB——-—-- 1s77 12.77 1915 1916 1916 19173 1922 ImdiaM-— lea 1907 1913 1900 1907 1900 1917 ~----——-----. 12s0 1ss0 1921 1ss0 1ss0 1922 1924

Knnmn----— lea5 1s25 1911 1911 1911 1914 1917 Kmtuohy --------- 1s31 1s51 1911 1911 1911 1911 1917 Louisirma--— 1s55 191s 10s9 1s70 191s 1927 Maine-------------- 1821 1821 189P. 1892 1892 1900 1915 14aryland 1ss0 1ss0 1912 1898 1s9s 1906 1916 L&smchuset ta--”---- 1s40 1s40 1902 1s50 1s50 1ss0 1915 Michigen 1S67 1S67 19.25 1867 1S67 1900 1915

MlnLm80ta— 1670 1907 1920 1900 1910 1915 6uBaiw3ippi------—— la7e ls?a 1912 1912 1912 1919 1921 Mismvri ----------- le91 1891 1909 1910 1910 1911 1927 Mxmna------------ 1s95 1s95 1907 M07 1907 1910 1922 Nebmm— 1905 1905 1927 1905 1905 1920 1920 Nmmdm------------- 1.6’11 1911. 1929 1911 1911 1929 1929 New Sampahire------- M20 1891 1s81 1ss1 le90 1915

Now Jor8ey---— 184S 184s 1920 1842 ls4e 1ss0 1921 Now L!8x200-------—- 1907 1907 1929 1919 1919 1929 1929 New York-------- 1s47 1847 1913 1820 1s90 1915 North OarcO.ina---- 1s77 1913 1914 1914 1916 1917 North Daknta-------- 1s99 1899 1907 19ffl 1908 1924 1924 Ohio—-—--— 1.S67 1867 1908 1909 1909 1909 1917 OkItOimm 1907 1907 1917 1917 1917 1928 192s

0reg0n—-7------———— 1903 1903 1915 1903 1918 1919 Pennsylvani 1851 1s51 1905 1906 1906 1915 Whode I.lBnd 1850 1850 1911 1852 1852 1890 1921 S3uth Carolina-----y 1s72 187s 1914 1915 1915 1916 1926 south LkkOta-------- 1905 1905 1931 1905 1905 1930 1932 Tannemee 18s1 12s1 1913 1914 1914 1917 1927 Te~a -------- 1s73 1673 1927 1903 1903 1922 1933

ut8h--------------- 1898 1905 1905 1905 1910 1917 Temnt 1S56 1856 1906 le5T 1857 1890 1915 virgtnia---— 1s53 1853 1912 1912 1912 1913 1917 Washi@on 1891 1891 1907 1907 1907 1908 1917 Wast Virginlm------- 1s66 1s66 192.1 1917 1917 1925 1925 wisaOnBin 1852 1052 1907 1850 1s40 190s 1917 Wymdng------------ - 1907 1907 1907 1909 1909 1922 1922

The death-registration area ror 1900 consisted jr 10 States, the Dlst~lct of Columbla, and a number or qualified cities In nonregistratlon States. The gradual growth of this area by the addition of more states Is shown In table B, which gives for each year the estimated midyear population of the whole United States arc the number of States end the estimated population Included h the registration area.

Inasmuch as It is more dlf~icult to obtain accurate end complete registration of births than of deaths, the national birth-registration area was not established until 1915. For thle reason no birth statistics were published by the Eureau of the Ceneus from 1900 to 1914. The orlglnal birth-reglstra­tlon area of 1915 consisted of 10 States and the District of’

Columbia, but other States were gradually added in the years following. The growth of this area Is indicated also in tables A and B.

In 1933, for the first time, both the birth- and death­

regletratlon areas included all States, and since that year the annual publications have Included data for the entire United States.

The change in areas for which data have been collected and tabulated makes it impossible to obtain a national series of geographically comparable data Prior to 1933. However, rates for the expanding registration areas are an approximation to complete national rates, and general comparisons over a long period of years can be made. More e=ct trends for parts of

of the United States can be secured by use of some constant area, such as the original registration areas or the registra­ tion areas of 1920. Crude birth, stlllblrth, and death rates for the registration areas of each year are given In table I,

TABLE B. —GROWTE OF TRE VITAL STATISTICSFCdGEYPRATION A51W : ONITEDSTATE3

D3A13PRKXST2ATION A2ZA BlR5i-kUMISISATION A2E4 Eatiumted midyear

population Sntlmnted midyear hatlmntedmidyear

Y2m of population population

timber Wmber

States state.

cent or

stat*S Number

oent of

r ,Otal total

19sa-------- 130,215,0W @ 130,215,0W lW.O 4e .s0,215,WC 100.0 1937--------- 129,257,(XKI de L29,257,0W 103.0 4s ..99,257,

oontinental of Per- of Per-

United

Wc 100.0. 1936--------- 128,429,000 42 ES,429,WJ lCO.O 4s .2a,429,000 100.0 19ss WO 1s0.0 1934-----—— 126,626,000 64 L26,6Z6,000 100.0 46 .$36,626*CM2 lW. o L93s-----——— 12S),770,000 42 L25,770,W0 100.0 4s .25,770,mx 100.0

1932-------— 124,974,0S0 47 L20,291,02+Y 96.3 47 .19;027,VX 95.2 1921--------- 124,113,0W 47 L19,479,0W 96.3 46 .17,5%2,000 94.7. 1930----—--- 123,091,000 47 .18,472,0W 96.2 46 16,556,000 24.7 1929-------- U?J,526,429 46 116,317,515 95.7 46 15,097,972 94.7 192s------—- 119,861,607 44 L14,252,516 95.3 44 13,030,663 94.3 1927------—- 110,196,7S5 42 10s,177,56a 91.5 40 .03,575,656 SV.6

479 77.0

--------- 127,521,000 43 L27,521,000 100.0 40 .27,52L,

1926--------- 116,531,96S 41 .04,93a,301 90.1 35 S9,6S7?, 1923------- 114,S27,141 40 .02,951;999 89.6 33 87,4s6,096 76.2 1924-—-—-- 11s,202,319 39 ,00,0$2,062 aa.4 23 86,256,025 76.2 1922----------Ill,537,497 3s 97,816,104 S7.T 30 S0,664,406 72.3 192$2---------109,072;675 37 93,666,240 23.4 so 79,415,s41 72.3 1921-------- 10s,207,852 34 89,102,434’ E2.3 67 ‘)0,7ss,177 65.4

1920--------- 106,543,031 24 S7,632,592 2s.3 2s 6S,740,6S9 59.s 1919-------- 103,002,065 33 2s,166,043 81.1 22 61,423,422 3S.6 191e—-—--- 103,569,955 30 81,333;675 78.5 20 55,513,241 5S.6 1917--------- 102,172,S45 27 74,9s4,49s 73.4 20 54,771,416 53.6 1916--------- 100,737,735 36 71,349,162 70.8 11 32,723,670 32,,5 1915--------- 99,342,625 25 67,095,681 67.5 10 30,936,179 31.1

1914--------- 97,927,516 25 65,813,315 67.2 ~9~3__--—--- 96,512,407 24 63,200,625 65.5 1913_--—---- 95,097,298 23 60,.359,974 63.5 1911--------- 93,682,189 23 59,123,071 63.2 1910---—---- 92,267,0S0 21 53,s51,742 5s.3 1909--------- 90,691,354 18 50,870,518 56.1

,360 17 46,7S9,913 52.5190e--------- .99,073 1907--------- 87,455,366 15 43,016,990 49.2 1906--------- @5,S37,372 15 41.983,419 4s.9 1905-------- 24,219,378 10 24;052;201 40.4 1904--—---— S2,601,3S4 10 33,343,163 40.4 1903--------- E0,9U,390 10 32,701,0S3 40.4

1902--------- 79,365,396 10 32,029,.915 40.4 1901--------- 77,747,402 10 31,370,952 40.3 19w--------- g75 ,994,575 10 S0.765.61S 40.5 1890 y 62,947,714 8 31.2 leao g------ 50,155,7S2 .2 17.0

~Fi6ure8 are for oe.eua year endiag14ay 31.

NOr2.-For every year the Dlatriot of ColUmbi. was in both a.e.a, but is not included in the ‘number of 2t.tee”; Pre+ibue to 1933, the death area also inoluded

n =wi= n~er Of T.@8t~ti0a cities 1. nonrwintration 9tato9.

and crude rates for the individual States are shown In tables VII, VIII, IX, and X.

Gm2E&Wc cIASSIEYcAT1oN. -The geographic code used In @bu­latlng the data published In thi$ report gives a separate identifying number to each city having a population of 10,000 or more In 1930, and to certain towns and townships each hav­ing a population of 10,000 or more and a population density of 1,000 or more per square mile. The code also gives a separate number to each county, excluslve of theee cltles. Although

villages and cities having populations of less than 10,000 are not individually identified, each county Is dlvlded Into two

parts, one consisting Of WIcorporated places’?Of 2,500 to 10,000, end another consisting of the remainder of the county.

In this report most of the tables containing Classlrlcations by size-or-population groups show cltles of 10,000 or m@’e, cities or 2,500 to 10,000, end rural. Certain tables glVe a more detailed five-group ClaSSlflCatlOn, namely, cities having populations of lCO,@O or omre; cltles of 25,000 to 100,OOO:

cities of 10,000 to 25,000: cltles of 2,500 to 10,000; and rural. ThlS rlner classlrlcation Is given where feasible in order to break the heterogeneity of large populationgroupings.

Prior to 1930 the amual vital-statistics data were tabu­lated In two general groups—urban and rural. In this classi­rlcatlon the urban group included all cltles of 10,0~ inhabi­tants or more and a few densely populated townS and townships. The rural group included all remaining areas. These defini­

tions were consistent with those ueed in the 1920 population census. The definitions used for the 1930 population census were changed so that “urban’!Included all cities with popula­tions in excess of 2,500, and Wural” included the remalnlng

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INTRODUCTION 3 areas. To giveannual vital-statd stlcs datawhich couldbe relatedto the populatl on census,It was necessary,therefore, to divide intotwo groups the group previouslydefinedas ruralin vital statistics. Thus,by combiningthe areasof 2,5C0 to 10,000with the urbsn,fl~OS couldbe obtalnsdthat were comparablewith thoseof the 1930 census. AISO, by COLIL­ blnlngthe areasof 2,500 to 10,000with the rural,fIgures couldlikewisebe obtainedthatwere comparablewith the rural as givenin thevital-statistics reportspriorto 1930.

Most natality and mortality tablespublished since1930 showthe three-my populationclasslflcatlon: Citiesin excess or 10,OCO, citiesof 2,500to 10,000,and rural;but In some

‘ku%en!~ tablesthe simpleC3asslrlcations and WuralU are used. In these instances, is wherethe dfchotomoueclasslf’ication shown, the ruralincludesall areasexceptthe cltlesor 10,000 or more. In the precentvolume the embiguous termsWrban!? and fhu?alrf are avoided,and the table headingsindicate the composition of eachpopulationgroup.

CLASSIFICATIONBY 2AOE.—The detailedracial classification givenin thisvo~ume showsbirths and deaths classifiedby White, Negro,Indlad,Chinese,Japanese,and a residual group of numericallyminorraces. In most tables suchan extended classificationis not justi~ledand the racial divisionsare !?white ,w $~egro,nand f~other races~l; in tableswhere the nRin PurposeIS to isolatethemajorgroup;the classificationsare simply!twhltet! and ‘tallother.~!In anY case wherethe racial

on the birthor deathcertirtcate designation is Mexicen,the

of the total. Accordingly, tablesshowingparentnativityfor birthshavebeen eliminatedor revisedIn the reportefor 1937 and 1938. A continueddecreasein the proportionof birthsto foreign-born parents will justifydecreased emphasison thie

. cl.assiflcation in futurevolumes. TableC givesthe totalnumberof birthsof whitechildren

In the increasing areafor eachyearbegin­ birth-registration ningwith 1915,and the percentof thesehaving one or both parentsor rorelgnbirth. The samedataare givenfor the 10 originalbirth-registration States. For this originalregis­ trationarea,white birthsor foreignor mixedparentagewere 53.0percentof all birthsIn 1915,whereasin 1938thisgrouF comprleedonly19.2percentof the total.For the wholeUnited States, in 1938,births of foreign or mixed parentagewere only 11.0percentof the total.

TAETJZC.—WHITE LIVE BIRTHS OF FOREIFN PASENTAGE: EXPANDING AND 0RIG2T?ALBIRTEI-REGISTW!LTON AR12AS,UNITED STATES

BISm-mcJsm4- OIW21NAL EIRANCINU BI~-SEGETSA- TIoxArm TIoiv ARw.lf

I

Z3As Oneor bothparents Oneor bathpu.enta

m’t-11 forcdsn-berm Total. foroiml-bom

mhi.te live birth.q

of total

‘~white.tt birthor deathis tabulated.with Thisallocationof 162e———————— 2,035,955 220,2ee I.1.o 61.L,915 11.7,4u 19.2 19s7---———. 1,92s,4s7 230,3SL 11.9 S95,2Z5 M, 447 20.9

with thatusedprior 192e--—--- l,eal,Se3 s41,647 12.e s? ,359 131,5e: 22.4 Mexicanbirths and deathsis consistent 16w5———— 1.ESS0012 329,6L5 ls.a 5a9,4c9 Ml,957 24.1to 1930 and for.the yearsefter1934. In the annualreports lv24-— 1,s66,S31 235,643 13.7 5s7,024 152,717 26.0

werenot classified 1622---------- 1.7s4,946 267,426 14.9 3va,24L 161,375 27.9 for the years1930to 1934,the Mexl.cems but were tabulatedwith ~!other with the ‘~whltel! races.~~ LV22-——— 1,E05,M5 296,124 16.4 616,299 16s,264 29.7

RWERWCICFIAL OF CAUSESOFDEATE. IX31! -The data in the mor- L931-——-- 1,S4S,2V3 230,772 17.9 641,625 204,2~ zl.s L6zc—-————— 1,946,S4L *,9e2 19.8 67e,3s7 229,4S2 23.8 talityreportspubllshedby the 2ureauof the Ceneuaare tabu- L92?I——--- 1,924,475 407,02?. 21..1 678,4S2 S41,cvo 25.5

lated according to the numbersand titlesof the detailed L92S--— 1,9s2,246 424,7s9 21.9 705,201 260,067 96.9

InternationalListof Causesof Death. Completetitlesof 192v--—--—— 1,925,5s3 *e,osa 23.8 726,S31 .277.949 55.2

are 1926 1,707,024 465,7% 27.S 723,449 2s5,047 99.4 this list,with the official numbersand subdlvlslons, 1925----------- 1,721,669 4s7,7C7 2s.2 746,06s 30!3,025 40.6 givenIn the stubof tableXI. In sometablesIt Is necessary, 19aL---————— 1,762,872 514,4c2 29.2 76s,964 321,777 4L.9

to abbreviatecause-of-death 1923——— 1,6-44,0s4 e21,L24 30.5 752,S60 32S,U70 42.9on accountof space llmltations, L922-—--------- 1,629,5S7 5L0,167 31.3 750,S06 329,572 43.9 titlesor to indicatethe crxnposltlon of groupsor causesby

glvlngthe listnumbers. In suchcases,referencemay be made to tableXI or to theManual of the InternationalList of Causesof Deathfor the completetitles.The nwnualindicates, also,the maindiseasesincludedIn eachtitle.

The InternationalList is revised decenniallyin order thatthe terminology by whichdeaths are classifiedcay be consistentwithadvancesIn medical scienceand changesIn diagnosticpractice.The llstused In thisvolumewas adopted

Commissionon the International by the International Listof Causesof’Death,whichmet in Parisin 1929.

specialattention Is directedto one featureof the 1929 listae used in thesetables. Sincethe Officialllstdid not Includetitles for certainkinds of accidents,suchas acci­ dentsin minesand quarriesor motorvehicleaccidents,a sup- plementalllstor 14 Importantclassesof accidentshas adopt- ed. DeathstabulatedIn this supplementalclassification are also included underthe proper officiallist titles. For example,If therewas an accidentin whichen automobilewas drivenfrom the road Intoa riverand the driverwas drowned, the deathwouldbe ClasSltledunder International Listnumber 183,whichsl.@fles drowning. In the supplemental tabulation this samedeathwouldbe reclassified undersymbol210 (auto­ mobileaccident).

WITVYYYCIASSIFIC~ON.-ESI”lY mortalityreports published by the Bureauof the Censuscontainedextensivetablesshowing parentnativity as wellas natlvlty of the decedent. Tables classifying deathsby the birthplaceof the decedentend the natlvltyof parentswerediscontinued In 1933.

In precedingreports more emphasishas been placedupon countryor birthor parentsIn the birthstatletlcs.Detailed tablesehowlngspecificcountryof birthof motherand specif­ ic covntryof birthor rather,as wellae moreabridgedclas­ sifications, havebeen publlshedfor each year through1936. The hlstorioalimportanceof these data In tracingthe chang­ ing composition or the populationof the UnitedStatesmustbe recognized.However,In recentyears the numberof birthsto foreign-born pments has beccmea relativelysmallproportion

1917- 1,230,Z8S 51.2 L916--- 76?J,SL7 52.2 L9L5—---

192k———— 1,545,446 496,813 m..? 7s9,173 552,443 44.?

L92C—--—— 1,395,522 45.1 L919——-——- 1,269,363 4s.4 19Ls--------- 1,SSS,7LL 49.0

723.8s9 m 52.0

~ Ewluoim of Sk& IoLan6.

QUALIFYING FACTORS IN INTERPRETATION

AND USE OF DATA While the datain thisvolume are availablefor a variety

of administrative purposes,theycannotbe cor­and scientific rectlyinterpreted unlesscognlsanceie takenof VSrlOUSqual- ifyingfactors. Obvlouelythe factorsto be considered depend lponthe specificpurposesfor whichthe dataare to be used. [t is not feasibleto catalogall of the pertinentfactorsin

tabulations, theuse or vi’tal.-etatistics but a few Qf the more Lmportantshouldbe mentioned.

Most of the factors llmltingthe use of vital-statistics rataarisefrom imperfections In the originalmaterialor from theimpracticabilityor tabulatingor usingthesedata In very ietailedcategories.Thesedefectsshouldnot be ignored,yet theirexistence doesnot destroythevalue oI’the tablesfor mostgeneralpurposes. Analyslsor smalldifferences or e=ct jvaluatlon or vitalstatistics and interpretation my require Xu’erulstudyof many relatedelements.However,the trendof n’udebirthand deathrates,the Increaseor decreae,e in the umber of deathefrom selectedcauses,and the majordlffer­ mces In rates amongStates,are all factsthatwill not be wteriallychangedby finerenalysis.

ME, SEX,2AGE.-Ifcrude deathratesare usedas en Index ]rthe health conditions@ a conmmnity,Comparisons of rates rordlrrerentStates or cltlesare not strictlyvalidunless theage, sex,and racialcomposition or the populationof each Lreale considered.It Is obviousthat,If the populationin me StateIs generallyolderthan that in another,the crude ieathLatewillbe higher,eventhough thereIs no essential ilrrerence deathrates. In the age-specific

4 VITAL STATISTICS OF THE UNITED STATES -€Similar considerations apply also to crude birth rates,

For example, comparison or birth rates or one area hating 8 certain proportion of women or child-bearing age with the rates of another community or a dlfrerent population composi­tion Is erroneous Ir the rates are ueed as a measure or rer­tlllty.

Various methode have been devised to compensate ror dlr­rerences in the population mmposltion or the areas to be com­pared. A necessary element or all such methods is the compu­tation or spOClrlC birth or death rates for each or the fac­

tors to be considered. While the natallty and mortality tables In this volume are stirlclently detailed ror the most impor­

tant or these computations, it 1s also essentIal to have popu­lLitiOnrigures ror each eeparate age, sex, and racial group. Since detailed population data for 1938 are not yat available, It is not poeslble, at this time, to present these speclric

rates. The crude rates given in the su!mnaryand rate tables are therefore subject to some limitations when used to compare health cr rertillty conditions in dirrerent areas.

POPULATIONESTJMTES.— Since birth and death rates are ratios or the number or births and deaths to population rlgures, accurate rates are partially dependent upon accurate popula­tion rigures. Tabulations showing the number and composition or the population for various areas are available only for the years when regular decennial population censuses are taken.

For intervening years population estimates must be used. Recent estimates for the uopulation or the United States

ae a whole are t!aeedon the number or births and deaths that have occurred since the laet censue date and on the net immi­

gration and emigration. Certain corrections havs been made in the birth end death data ror underregietration. The allow­ances for underregietrstion of births are baeed, in part, on rOCOnt tests conducted by the Eureau or tb3 Ceneus and on ratios computed from the 1930 ceneus returns in comparison with the number or births registered during the year preceding

the census,, The net immigration rigure represents, as nearly as it is possible to ascertain, the dlfYerence between the

total number or persons, both citlzene and aliens, who arrived in continental United States either from rorelgn countries or IYom outlying possessions and the nusber of persons who lef% the United Statee ror rorsign countriss or outlylng posses­sions.

Inasmuch as there is no record or the movement of popula­tion rran one State or city to another, it is not possible to employ i?or theee smaller areas the method used in estimating the population or the United States. Population estlmatee for Individual cities or counties, population groups, separate races, or ror speciric age groups, have not been mde by the

Bureau or ‘theCensue since 1933, because it is believed that unavoidable errors in these estimates would be so great as to intrcduce serious errors into rates computed rrom them. Popu­lation estimates ror States @ thO Dletrlct or Columbia given

in table IV are tased on growth trends indicated by rormer censuses, as well as on local census data, school enrollment

figures, directmy counts, and other sourcee or information. pua oF 288mrixcE.—orricial mmOnal vital statistics and

thoee published by most state and city egencles Ewe, ror the most part, been compiled according to the place of birth or

death. Under this system or tabulation, the data are tabu­lated by the city, county, or State in which the birth or

death occurred, Irrespective or the usual place or residence or the mother of the child, or the usual place or residence or the decedent.

The eignlllcance or this c+ethcdor tabulation can be seen by considering the errect of popu:.ationmweurant on dsath rates.

For example, the hospital racilitles In a city may attract

patients from surrounding areas end. as a result, many or the deaths occurring in thls clty wI1l not be deaths or residents or this city. The enumerated population of the city dces not, under such conditions, repreeent the number or persons exposed

to the risk of death: and the death rate dcms not accurately describe the mortality or this particular city. A more cor­rect rigure is obtained by reallooatlng all deaths to the

place oi’residence. Sinee there are menY causes contributing

to the movement or patients to some area other thfmtheir ueual place or residence, it cannot be assumed that the direc­ticn or the movement Is alwaye frmm rural to urtan areas.

Similar nonresident ractors affeotthe interpretation or birth statistice based upon place of occurrence. In order to deter-mine the direction or the magnitude of the dii’rerencesbetween rates compiled according to place or occurrence and those ccm­plled accotiing to place or residence, it is necessary to examine tabulations compiled on both bases.

Since the data given in thie vo lwne are compiled according to place or occurrence, flgUrOS ror individual cities Snd counties or ror population grcupe do not always give an accu­rate indication of relative health end rertility conditione.

Tabulations ror States as a whole compiled on either basis are essentially the same. Detailed tabulations by place oi’resi­dence we gi~n in ttvi~lstatisticsof the unitedfj~tes, Part II.’1

COMPM!PENESS0FI@iIS15WION .—Altbugh every State has adopt­ed a vital-statistics law requiring the registration or all births and deaths, these laws are not unlrormly enforced. In most States where the registration organization is well estab­lished and where the pereons responsible for riling certifi­cates appreciate the value of registration to the individual as well as Its value ror etatlstical purposes, practically all births and deaths are registered. In other Statee, however, the underregistration is enough to affect the use or the tabu­lated data ror certain purposes.

Accurate ini?orn?a.tionon the completeness of registration in each State is not available. One condition required for admission to the national registration areas was that there exist a demonstrated completeness or registration or at least 90 percent. Using this as a criterion, all of the States were admitted to the registration areas by 1933, end although reg­istration has become more coispletein most States, it 1s like­

ly that there has been regression in some S&tee. Estirates or the ccmpletenees of registration in States, based on the comparleon or vital-statistics reports and enumerated census da=, have been publlshed by several writere.

There is considerable evidence to show that birth regis­tration is more incomplete thendeath registration. Especial­ly incciupleteis the registration of Negro birthe in isolated rural areas.

INTERPRETATION OF MUSE-OF-DEATH TAIBLES

cause-of-death data given in this volume are classi.fled by the rourth revision or the International List or Causes or

Death. The use or this list in the tabulation or data by all States, ~d by various countrlee, results in similar =use-or­ieath titles ror the various tables. IIUWtunately, this use or a standard classirlcation Iist, although essential ror regional compariscne, does net assure strict comparability or

the tabulated ri@res. At the present time, the type of st$3t0-nent given ror the cause of death varies widely acca’ding to the care and consideration given to the COrtlfi@tiOn Of cause. 4 high degree or comparability could be attained only Ir the iata on cause or death were reported with equal completeness” ind accuracy ror every area. Table D gives, ror 1938, the

rrequency distribution or States (including the DIStriCt or :olvmbia) showing the parcent or deathe coded International Liet numbers 199 and 200, namely, 111-derined causes or death. rhe variation in the accuracy or reporting throughout the

:ountry in 1938 is indicated by the fact that in 29 StatOS Lees than 1 percent or all deaths were classlrled in this ill­iefined group, while in 6 States over 5 percent, and in 2

Statss over 10 percent wwre so classified. obviously, ir a

ligh proportion or deaths are included In this poorly defined :ause-of-death class, it means that there is an unknown deri­:Iency in the number or deaths claesiried in the more precise-Ly derined groups.

The interpretation of data on cause or death is further ~us.llried by the ract that, althOUgh in many instemces the

ieath is the result or a combination or eequence of causes, it 1s practicable to tabulate the death under one’rubric Only.

L’hisneceesitatas a choice or the Prinary cause rrom those given on the certirlcate. This eelectlon of a priSELrYcause

1s made according to rules given in the hlanualor Joint Cauees

or Death. 1t is evident, however, that the effect of ?UW such rulee on the classification or deaths ror spOCiflc causes will WY according to the completeness with which all the factors

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INTRODUCTION 5€contrlb~tory to the death are reported. If a death is the result of several causes but only a single cause “or death Is given on the certirlcate, the Manual of Joint Causes or Death

cannot, or couree, be ueed. For this reason the omieslon or pertinent complicating factors or oondltions adding to the risk or death may result in an incorrect assignment or cause. Table E gives the rrequency distribution or States (Including the District or Columbla) showing the percent of death certif­icates on which only a single cause of death was stated In 1936, the latest year for which such data are available.

In 12 States more than 50 percent or all certirlcates had Only a single cause or death. In contrast, it can be noted IYom table E, there were 5 States with less than 30 percent or the certificates reporting only a single cause. This wide variation in the amcmnt ol’Information given on the”death cer­tlrlcates must have en appreciable effect on the exact meaning of death rates ror epeclrlc causes.

Table D.—Frequency distribution of States shovtlng the peroent

or deaths ooded International

List numbers 199 end 200: 193S

POrcent ooi.d Numter

199 and zoo or

fhWitOB

0.0 - o.9-— 29 1.0 - 1.9----. —------------ 9 2.0 - 2.9---— 3.0 - 3.9-------------—--- : 4.0 - 4.9------------------- 1 5.0 - 5.9------------------ 2 6.0 - 6.9-—---— 1 7.0 -7 .9------------------- o S.o - S.9------------------ 1 9.0 - 9.9----------------- o

10.C +J- z

Table E. -Freqmno y distribution

Or States ehOwlnS percent Or

all death oa?tirioates having a single oauee of deatlu 1936

FerOOnt hmins Wumbor OrImlgle mum Statem

25 .C - Z9.9---------------Zc.c - 34.9-------------- E 35.0 - 59.9-------------- 12 40.0 - 44.9.-------——---- 7 45.0- 49.9 c 50.0- 54.9---------------- 4 55.0 - 59,9-----------.-..———— :

60.0 - 64.9----------------- :*

Apart rrom the question or comparability between areas, there is the additional problem of comparability for a given area from year to year. To a certain extent, time-trend stud-1E6 wcm.ldbe facilitated ir the InternatlonslList were main­tained without change over a long period or years. However, If the list were rigidly rixed it would soon be inconsistent

tith current medical terminology. To obtain the advantages or frequent revision, and yet to retain ‘a rlxed list ror a number or years, revisions or the list are made at an International conference every 10 years. In the process of revlslon, some causes or death Included under one title may be transferred to

other titles. Since it is dlfllcult to evaluate the numerical

importance of all such rearm.ngements, derinite dlsconttnu-Itles are introduced Into the time trends or death rates for speclrlc causes or death.

Improvement or diagnostic procedure and development or medical IuIowledgeand racillties are other Important factors not to be overlooked In the study or chenges in death rates for certain causes. For example, additional diagnostic cancer clinics located throughout the country may correctly diagnose many cancer deaths which might otherwise be classirled in an uuknovm or Ill-clefined cause-group. Another exemple tight be found In the case or syphilitic deaths. Deaths from syphilis are not always correctly reported, but the recent campaign to promote the treatment of thls disease NZIy Influence the accu­

rac,yor the reporting of syphills on the death certfricates.

NATALITY ST.4TW’l’l?03

Detailed tabulations or the live births registered In the

united States in 1938 are given in general natality tables,

numbers 1 to 7, inclusive. In these tables the reported births are clasSllled by place or birth, sex end race or child, age and natlvlty or parents, order or birth, and other subjects. Additional Information on birth statletics Is Included In the section containing summary end rate tables. The rollovfing

paragraphs point out some of the more important racts ror 1938 and give comparable rigures ror past years.

BllU!E-FWCETIUZfd.-In1938 there were 2,286,962 registered

lIVS ,births in the United Smtes. With an estimated Popula­tion or 130,215,CO0, the crude birth rate Is 17.6 per 1,000 estimated population. The number of births reported ror the

United States birth-registration area and the crude birth rates for each year since 1915 are give~ In table F. This table also gives the estimated midyear population or the

United States and the estimated midyear population and percent of total included In the increasing birth-registration area.

An inspection of table F shows a rapid downward *rend in the crude birth rate for more than 20 years. The rate ror 1938, as In 1937, is higher than the rates for 1936 and 1935, end Ie the hlgheet since 1931, but the increase IS SO slight that It csnnot be taken as an assurance that the direction of the trend has materially changed. .

TABLE F .—CSUDZ BISTS S45?S : BISTH ~GISTR4TION MM, UNITED STATES

BIRTI-SWB7W3TCNASEA

imnted midyaer pOpu-

Imthatea raidymr population

Iim births

2WAS mien or

continental Per- late per Unite.i Stet88 cent mar 1,000

Or 10pula-

totsl tion

Eat

1915—-—-—

192e---— 120,31e,ooo 10Q.O 2,3S6,962 17.6 1937— 129,257,coo 100.0 Z,2Q3,33? 17.0 1936——--—--—-- 12e,#29,wo 100.0 2,144,764 16.? 1925-—------—--- 127,5Bl,000 100.0 Z,I55,105 16.9 1934--------.-————— 126,623,0x 100.0 Z,167,636 17.1 1932-—--— 1Z3,770,000 100.0 2,0Sl,Z32 3,6.5 1932—------------ 124,974,002 95.2 2,074,042 17.4 1931------------ 124,U.3,0C0 94.7 2,U2,760 18.0 193c-—----—-—————— 123,091,CO0 V4.7 Z,203,95S 1s.9 1929-—---------— 121,526,4z9 S4.7 2,169,920 ls.9 19zs--------—-- l19,s61,647 64.3 2,232,149 19.3 1927-------------- 118,196,7S5 8’7.6 2,237,e36 20.6 1926--------------- 116,531,963 77.0 1,s56,06s 20.7 19z5-------------- 114,667,141 76.2 l,87e,ssc .%5 1924----—--------- l12,Z02,319 76.2 1,930,614 22.4 192s-—-—-—-- lU,537 ,497 72.3 1,79Z,646 22.2 19zz-------— 109,E72,675 72.3 1.774,911 22.3 1921-----— los,2c7,253 65.4 1,714,Z61 24.Z 1930-------------- M6,543,031 59.8 1,508,W4 23.7 1919-----------—- 105,00S,065 5e.6 1,373,43s ZZ.3 191e---—-— 103,587,955 53.6 1,SS3,649 24.6 19L7-—------—--- 102,172,S45 53.6 1,353,79Z 34.7 1916-—------— 100*757,7Z6 3s.5 81e,9s3 25.C

/ 99.243.6SS 31.1 776,304 25.1

The “trend or the birth rate, as shown in table F, is ef­rected somewhat by the ract that the registration area in­cluded additional. StEtes from year’ to year, end the more re­cently added States have, In general, higher birth rates than the orlglnal States. The additions to the area In various years are shown in table G. The er?%ct Or these newly added States on the rate for the area can be seen by corpparlngthe trend of the rate rOr the original birth-registration area

with the trend or the rate for the increasing area. The data ror the original birth-registration area are given in table H. For this orlglnal area the rate decreased from 25.1 in 1915 to 16.1 in 1938, a decline or 35.9 percent. In the came period

the rate for the whole area decreased rrom 25.1 to 17.6, a de-cline of 29.9 percent. The time trend of the Iate ror indi­

vidual States is given in table’VII in the section containrrtg summary and rate tables.

TABLS 13.-I3IAR IN WEICB E40H STATS We ADMITPBD TO TaS BISTH-BSGISTSATIONABEIL

i Wan 3ara*y 1939 Colorado

1916- Wrylm5 Georgia! 1932 Illinois OklnbmnalaL917- mdinris want

sand= 1Wyaning 1929 Nevada KOntuaky N(IWMaxioo North OdrolinS

193z- S.mth Dakota€Ohio€Utah 1932- *€

YaAs ST.4m T4#.s Swis

1 II 1

1916- C’brulaotiout 1917- Virginia Uaim ?mllungt.on M0m3aohumtt m

?4i0higau

Mimm3aota

New SEupshiro

N4W York

Willconsini

1919- cdirO*a Oregon1south Carolina q

19Z6 Asiwnn1Idaho

19z7- Alabama A$kanms

P8nu831valua Sh060 Mf.n6 Y

1930~ Nebraska LOuisir.na Nise0ur4

VOnuOnt 19zh D.31amar0 Tmneaaee Dint . or Columbia Miasisaippi L

lf Drappndframthe birth-mgi-tion arm in 1919; raatitt.d i. 1931.€q Indluded ID Staten.€3J Dropped fraa tha€birth-r.glstxati.n am. in 1935; madmitt.d in 196S.

i

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6 VITAL STATISTICS OF THE UNITED STATES€TABLB H .—CRUDE BISTH€ AND DEATHHATES: ORZGINALBIRTH-S3ZGISTSATION

AREA,lf UNITED8TATES

RATE Pm 1,000

Live Total POPOIATIOil

birth8 Ieaths g�

+’193S-------------------— 3 S9,160,OOC 629,903 427,902 16.1 10.9

1937---------------------------- 39,160,000 612,423 450,939 15.6 11.5 1936---------------------------- 39,00S,COC 602,931 451,391 15.5 11.6 1935---------------------------- 28.725.030 605,062 423,026 15.6 11.2 1934------------------— 60.2,101 434,205 15.7 11.3

1935-----------------------—— 594,117 426,747 15.5 11.2 1922---------——-------—--- 631,427 42s,300 16.6 11.2 1931----------—--— 657,W74 4x3,069 17.3 11.3

1930--------------------------- 694,433 432,479 le.4 11.5 1929--------------— 693,545 453,976 18.6 12.2 192s--------------------------- 719,569 450,524 19.6 12.3 1927------------------------- 741,102 422,679 20.5 11.7 1926------------------------- 735,7e2 4s3,3e6 20.6 12.7 1923---------------------------- 757,0s2 432,Oce 21.5 12.3 19?+----------------— 770,523 420,3W 22.5 12.1 1923------------—-- 760,120 427,157 22.2 12.e 192s--------------------------- 755,s0s 414,932 22.5 12.3 19SI 794,229 399,176 e4.o 12.0 1920----------------------—--- 773,646 44s,7eo 23.7 13.7 1919--------------— 730,752 42e,7e2 22.7 13.3 1918------------------— 783,997 607,605 24.7 19.2 1917--------------— 7S6,890 461,647 25.2 14.e 1914---------------------------- 770,71s 454,669 25.0 14.s 191s-----------.----— 76.?,399 427,6’/1 25.1 14.11

~ExClusive of Rhode Ialard. ~Ex.lu8ive of stillbirths, gPopul.MO. estimmted for 1937; no estimate mad. for 193S.�

In spite of the decllning birth rate as indicated In table�F, there was still en excess of more than 905,000 births over�deathe In the United States In 1938. Even in the original�

birth-registration area, where the death rate Is higher and�the birth rate is lower than for the whole United States,�there are 629,900 blrthe compared with 427’,902deaths. Data�on deaths in the original birth-registration area are Included�In table H in order to facilitate the comparison of rate�

trends. As Indicated In table J, each State also has a higher�birth rate than death rate In 1938.�

TABL2 J.—CRUDE BIRTR AND DEATR RATES:UNITEDSTATES�AND EACH sTATE,19S8�

I II 1�

Fwl’Eml, ooo RATE FEW 1,033 ETmdmED mDYE4R E9TIMATMI MICY2kR

FomLATmN l/ I FCF+JLATION~

of the populat1on, as well as in other conditions affecting

fertility, contrltdte to these differences in the crude birth�rates.�

AOE OF PARKWPS.— Careful analysls of the trend of birth�

rates or the comparison of rates between areas necesearlly in­�volves the consideration of age-specific birth rates. Such�rates are not included in this volume, since accurate estl.�mates of population by age, sex, and marital condition are not�available for recent years. Certain detailed tabulations of�births by age of father or age of mother are given In tables�3, 4, end 5.�

Proportionate distributionsof live blrthe by age of mother�fOr the years 1934 to 1938 are given in table K, and similar�dlstrlbutlons by age of father are given in table L. Table M�gives, for 1938, the proportionate distributions by age of�father for each age-of-mother group. It is evident from each�of these tables that there Is an Increasing tendency for a�

greater proportion of blrthe to occur to parents in younger-�age groups. Such changes could arise from differences in the�rate of change of age-speclflc birth rates, from gradual�changes in the age distribution of the population in the re-�productive period of life, or from changes in the groes mar­�riage rate of the distribution of age at marriage.�

It Is un~ortunate that there are no national statistics on�marriage and divorce to which birth statistics could be re­�lated.�

PLURALBIIiWS.�-The great majority of birthe reglstel”edeach�year are single birthe. Of the total of 2,286,962 live blrthe�in 1938, there were 2,236,863 single births. In addition to�

these there were 25,644 caees of twins, 262 cases of triplets,�and 1 case or quadruplets, In each of which there was at least�one live birth.�

The proportion of plural-birth cases to the total number�of cases of birth remains fairly constant frOm year to year.�

In 1938 there were 11.4 cases of plural blrthe per 1,000 total�cases. The highest proportion of plural births was recorded�

in 1919 when the ratio was 12.2 casee per 1,000. Since 1920�

the ratio has fluctuated between 11.2 and 11.9.�The total number of cases of live births; the cases of�

single births; and the cases of twins, triplets, and quadru­�

plets, are given for the birth-registration area in table N.�An authentic case of quintuplets In the United States hae�

never been reported during the time that the Bureau of the�Live )La.ths Census has been compiling annual birth data.�

birth, g�

TABLEK.—DISTRIROTIONOF LfvE BIRTBB,PER 1,000,BY AGE�

11 10.6 Mia*ou?i------------- 14.7 10.7 OF MOTB3R:DNITEDSTATES

mm,talla------------ 19.8 10.5 Iiebra.lm 16.4 8.s

Alabama--------------- 21.4 10.2 Nava&-------.-. -—-- 18.7 12.6 AGEOFAQm 1938 1937 1996 1935 1934 Arizona--------------- 26.4 14.6 New Hampshire-------- 15.4 12.3 Arkarman le.E S.3 California 16.5 12.4 New Jermy ----------- 18.9 10.1 All0s------------------------ l,oeo.o 1,020.0 1,020.0 l,COOLO l,OQO.O mlorado 19.2 11.8 New MSXLOO---.------ 23.9 14.1

Cormocticut 13.7 10.1 New York-------—-North Camlirm----—-

14.6 22.9

11.4 9.6

10 to 14 your. ------— 1,4 1.4 1.4 1.5 1.3

Dalawam------------- 17.0 1.?.5 Wmth tbkota 16.5 7.4 Distriot of Columbia-- 20.6 12.7 Florid---------------- le.6 12.6 Ohio----------------- 16.7 11.1 GOorgia 21.0 11.0 Oklcho,m,------------- 17.3 7.8

OrwgOn------------ 15.e 11.5 Idaho 22.9 9.2 PeDr,@Talli.3--— 16.3 10.5

o-------------- 15.6 10.8 Shod. Iolrm6-------- 15.5 12..2 hai~.-----------—--- 17.3 11.1 Iom------------------ 16.9 10.0 South 2arolim 21.9 11.0 Knnsao---------------- 15.9 10.0 couth D9kotll 17.1 7.9 i= !! !!! --! --!!

Kentuaky------------- 21.2 10.0 Tmmemwe TaxF.#-------------

12.s 19.6

10.1 $.e

~ lam than .ne-t.ath or 1 per 1,000 live births.

LOuloiun.1-----.-----.- 22.9 11.6 Ut.sh---—-----.-— 25.3 9.4 14P.lno---------— 17.8 12.3 TABIX L .—DISTRIBUTIONOF LIvE BIRTEM, PER 1,000,BY AGE mwland -------------- 17.3 12.4 vermOnt—----------- 16.3 12.0 OF FATE12R:UNITEDSTAT&

-firgir,i 19.e 10.9 lla.e.chueett.s--------- 13.8 11.2 !7LlElhirigton 16.1 11.2 Michigml------” 20.1 10.5 wont T1l.ginia .W.8 9.5 ACEOFFATKER 1922 1937 1936 1935 1934

Illlr.oi�

Wlrme.ota----— 18.9 9.9 Wiamnmiri I le.s 10.5�Mia8is8iPDi-—---.----7 26.5 11.3 IIWyoming-------------+ E1.o 9.5�

All llgea 1,030.0 1,002.0 1,000.0 l,coo.o 1,C04.O�IJ Ratm for United Stmta,qbared on 192S mtimate.d popuhtim. Eat.. for St.te.

b.iwd gopul.tion; no .Stiumte. made for 1933. ~ ~QIU.iV. of .stillbitihs. 10 to 14 y.mrs------------------- Y A/ u g

15 tO 19 y.or.n----— 15.9 15.0 14.4 14.e 14.6 .30to 24 yoe.ro----------------——— 194.6 193.6 190.1 lS5.6 1s4.9

CRUDE BIRTN RAl%S BY SPA!PE.-TableJ gives the 1938 crude 25 to 29 YOU--------------------- 2s2.4 279.4 276.6 271.0 266.6

birth and death mtes for each State. The reported rates m to 34 yam-------------------35 to 39 y-o--------------------

316.2 135.7

212.2 1%.2

209.9 142.8

207.9 146.3

213.5 144.4

rsnge from 12.9 for New Jersey to 33.9 ror New Mexico. With a 40 to 44 demo -------------------- 72.3 76.6 20.3 22.4 86.1 few exceptions, the crude birth rate is highest In the South-ern, Southwestern, and Rocky Mountain States and lowest in the

45 to 49 year---------------------50 to 54 ye-c -------------------65 years and aver

33.4 12.4 7.3

35.0 12.5 7.4

36.3 13.1 7.s

3B.2 13.9 8.0

39.2 14.5 7.9

New England, Middle Atlentlc, Midwestern, and far western Eot stated-------— 29.9 30.2 2s.8 Ce.e 29.4

on 1937 eetime.tefi

States. Varlatlons in the age, racial, end marital composition &/ ban than ona-te.thor lper 1,000 live births.�

---------------------------------------------

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--- ---- ---

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INTRODUCTION 7 TABEE M.-DISTRZWJTION OF LIVE BIRTHS,PER 1,000, BY ACE OF FATBERFOR E4CEAGE-OF-MOTSER GROUP: UN7TED STATES, 19’+

I A030F~

AX OF FWE28 1 10 to 14 .5to 19 2ot024 25 to 29 sot034 35 to 39 4ot044 L5to 49 Not

ymra yeSrB yeara yearn 78E7JX pal% mars 34== stated

Au asaa----------------—-—----—-----------------——— 1,024).01,002.0 1,000.0 l,ti.o l,COO.O 1,000.0 1,000.G 1,000.O 1,000.01,000.0

I I I I I 10 to 14 wwB----------------------------------------------15 to 19 yeuw

2.1 195.9

4/100.0

- —.- -.——2/7.5 0.6 0.2 0.1

.------0.1 .——-

0.3 7.6

30 to 24 yullra----------—-—----------—-----—-—------- 214.8 545.7 249.1 44.1 6.5 1.9 0.8 2.L 17.0 100.4 2s to 2,9yau.w-------------—----—-----------—.---—---- 66.0 191.0 429.9 404.4 ?4.7 13.6 3.8 2.9 22.7 142.4 20 to % YOara-----------—------------------—------------ 16.1 4)..5 129.7 259.8 420.0 80.1 16.0 %4 90.9 105.6 35 to 39 mm 11.3 13.0 36.9 222.2 326.5 374.8 87.0 23.7 108.0 82.6 40 to 44 Yema 7.3 4.3 11.4 34.7 3.19.o 317.2 333.5 107.1 102.3 43.2 45 to 49 mua---------------------------------------------- 3.3 1.9 4.4 13.1 39.4 131.4 316.2 425.7 56.s 26.3 30 to 34 mmc----------------------------------------------- 2.1 0.9 1.9 4.8 14.6 42.9 123.1 270.8 346.6 10.8 55yams ad omr ...----. —----- —--. ----. -—--— —___ 4.0 0.9 1.4 3.6 8.9 25.8 57;7 3.36.3 2s7.3 10.2 Not 8tat0&----------------------------------------------- 4Tr.o 100.8 27.8 12.8 1o.2 1.2.s 11.7 16.9 28.4 4m.7

thanone-tenth birkhs. lf I.oao of 1 per1,02011-

TABLS N.-OASFS OF LIVS BIRTES: BIRTH-=GISTRATION AR&i, births. Thisrate is one of the highest illegitimacy rates UNY.TECST- recordedfor the registration area sincethesedatawere IWst

availableIn 1917. In thatfirst yearthe ratewas 20.2,and thereWQS a steadyIncreaseIn the yearsfollowing.The trend of thisrate Is somewhat Influenced by the changingcharacter

! of the registrationareafrom year to year. The ratefor racesother thanwhite1s very high,end the additionto the

1928---- 2,262,770 2,226,863 23,907 193’?-----2,179,823 2,154,719 25,104

25,644 24,881,

262 219

1 4

ar8a of Stateswitha high proportionof Negroes11.4

registration the upwardtrendof the totalrate. However,XL.5 has accelerated

1936--- 2,121,519 3,C96,667 24,e5z 1935---- 2,132,Z02 z,lo7,

“ 1924---- 2,144,1u Z,l18,997 25,214

24,569

24,t166

277

242

6

6

11.7 for the whitegroupalone,therehas beena markedIncreaseIn 11.7 the proportionof recorded Illeglt

1933-:---2,0ES,6S6 2,0S4,466 24,220 1932---- 2,0=,396 2,027,134 24,26z 1931--- 2,09C,086 2,C65,S03 24,283

33,995 84,C20 24,C49

32C 8% 232

5 6 2

I.1.a rate for ths whitegroup In the registrationareawas 13.0,11.a 11.6 and in 1938the ratewas 20.5:

19w----- 2,1s),312 2,155,094 25,ae 1929---- 2,146,016 2,120,412 25,501 192s---- 2,20e,7e4 3,u32,e79 25,905 1927--- 2,1J.4,4052,C89,50S 34,e97 192’3--- 1,8W,1S8 1,825,1C8 21,083 1923---- 1,859,174 1,S28,296 20,878 19w---- 1,3C9,S69 1,SS7,776 28,023 192s---- 1,773,106 1,752,331.20,77511922---- 1,755,561 1,735,C74 20,4e7

24,963 25,35S 25,619 24.35s 20,ss5 2Q,645 21,264 20,534

20,284

249

285 233 192 220 226 179

199

6 3 1 6 3 3 3 2

4

11.6 11.9 TABLEO.—AVERAGE NOMBZR OF CSIIDSRi ETER BOFW K) WOMEN WHO BOSS?. 11o7 CSILDREN IN SPECIFZEDYEARS:BIRTd-F3GISTMTIONARM, y UNITfKJSTATES I.1.e 21.5 I Il..? A7ESAGE NUbf83S OF CSU.DSEN LN-11.6

A&Z OFMmU.7 122s 1937 L9261933 !9s4 19s3 .9321931 1923 1929

11.7 tl-

s03 24,399 24,167 -—- 11.4 Imte births. In 1917the

1931---- 1,695,127 1,674,e75 20,252 20,021 2m 1 31.9 1920-- 1,492,533 1,475,113 17,419 17,229 1s4 6 11.7 All a@n-----—— 2.e 2.8 2.9 3.0 3.1 3.1 $,1 3.1 3.1 3.2 1919—-- 1,337,737 1,242.234 16,333 16,316 1s6 1 12.2 191s--- 1,349,015 1,322,526 15,4s9 15,342 147 --—- 11.5 191’i--- 1,229,975 1,325,426 14,349 14,394 15s ---— lC.9 UnderZ)years——— 1.2 1.3 1.3 1.2 1.2 1.3 1.3 1.3 3..3 1.3 1916—- sll,l19 m2,892 8,s37 S,139 2$ z 10.1 60 to 84 marS—— 1.s 1.9 1.9 1.9 1.9 2.0 1.9 1.9 1.9 2,C 1915—- \ 768,887 761,150 7,737 ‘?,673 54 —--- 10.1 2S tO 29Y7wuB 2.6 2.7 2.8 2.e 2.9 2.9 2.9 2.9 .%9 3.0

I II I II I so to 34 yOars 3.s’ 3.9 3.9 4.0 4.1 4.2 4.2 4.3 4.2 4.2 85 to 39 wars------- 5.5 5.6 5.6 5.7 5.7 5.8 5.8 5.8 6.8 5.s

lf &eludesOtiYthan.anmoa inwhiohat leastone m a Mm birth. 40 to 44 y0ar8-——— 7.2 7.3 7.4 7.4 7.6 7.4 7.4 7.4 7.5 7.5 45 tO 49 p-n-—— e.9 e.9 e.9 8.9 9.0 9.0 e.9 9.0 9.0 8.9 30 to 54 ymrs---- 7.6 7.2 7.1 7.7 9.4 8.C 7.4 7.3 7.5 7.5

AWE NUMBEROF ~ .-TableO Is a tabulationor the 55 yearsandmr— 9.0 9.0 7.7 ..- —- ..- -.. 2.8 2.6averagenumber of childrenever born to womenwho bore chil- Not mtata.i 3.3 . 3.3 3.3 3.3 I t2.4 2.5 2.8flT 2.6 T

dren,in eachspecifiedyear. Theseaverages are givenror the years1929to 1938. In 1929 the averagenumber of chil- fr-aM-1929 ti Nsw&shirn in 1933;to 1932;0XC1W170‘ofC&?ado, Y&@saobai.tts,dreneverbornwas 3.2. Thisfigurehas graduallydeclinedto 13x0M10iTa d Nowmnlpnhira 1924to 192s.of Kaswdnlsotts *

2.8 in 1937 and 1938. The decreasein the averagenumberof children is probablyan indicationor declining rertlllty. TABu P .-ANNUAL CRODE BISTB RATES ~ PER 1,000 E3TRdATED MIPYEAS

by the faot thatthere. This interpretation1s strengthened Is POPULATION, BY MONTE: UNITED STATES

a decreaseIn the averagenumber of childrenfor almostevery age-of-mother group. The rlguresgivencannotbe directlyin- 1937 1936 1925 1924

timethatthe reproductive rateof certainage groupswouldbe 18.4 17.5 17.e le.2 IS.2 17.5 17.7 1.S.5 Increasing. X.8 16.4 16.3 17.5

BIWS RATESBYEONl!2.-The fluctuationsof the crudebirth rate

terpretedas theaveragesizeof family In thewholepopula-tion,inasmuchas onlythosenqtherswho gavebirthduringthe 17.0 16.7 16.9 17.1

currentyearare included.Moreover,the averagefor all ages 1s efrectedby changesin the marriagerate or In theaverage Je.maly

Februw--------— 17.6 le.o

16.6 17.2

16.7 17.3

17.2 17.4

17.0 17.1

age at marriage,as wellas by otherfactors. Thus,Ir a raP- Mu’ah---—------------------ 17.? 17.3 17.3 17.2 16.7

Id increaseIn themarriage rate Increasedthe proportionof April—----------—------------..-.—-.--------- —------

17.2 17.0

16.6 16.5

16.2 15.7

16.5 16:2

16.3 16.7

first births,the average numberof childrenwould be de-creased. This decrease wouldthenbe occurringat the same

July------------— i 17.2 16.8

17.8

16.8

17.5

17.1

17.e

16.9

17.5

frommonth to monthare shownIn tableP for the years m 16.S 15.s 16.0 16.9

1934tO 1938. In 1938 thehighest rate,18.6, occurredIn yor stillbirth. 16.5 15.6 15.9 16.6

8mlwiv0 Augustend the lowest,16.5,In December.

BlE3!2S.-The llvebirths Data on illegitimate and 1938 ILIJXWFIMAT2 numberof illegitimate live birthsfor 1936,193’7, and the rateper 1,000totallivebirthsare givenin tableQ. Cor individualStatesare givenin tableR. This tablegives In 1938.. birthsend the rateror each State, therewere 74,462birthsin theunitedStates(exclu- thenumberof Illegitimate

Massachusetts,New York, end TeXae)re- Cor %hite” and “allotherraces. Massachusetts, siveof ‘Callromila, ‘t California, end the ratewas 41.1.per 1,000live andNew York are not Includedfor any year,and Texashas also portedas illegitimate,

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8 VITAL STATISTICS OF THE UNITED STATES been excluded ror 1938. The birth certirlcatee for these TABLE R. —IIJXGITIMMI’ELIVE BIRTRSBY RACE: ONITED eTATES lf

States do not require a statement concerning legitimacy. It AND EACH STATE-Continued

must be recognized that the reporting or the ract or lllegltl-IU.EOITM47!E LIVE B=€macy in other States Is probably Incomplete and Inaccurate.€

I

‘TABLE Q. —ILLEGITIMATELIVE BIRTHSBY RACE: B~-F&3GISTRATION AmAmo R4cE lhmber Per 1,000 total

STATX3 I I lireAREA,~ UNI’1723 births

ILL2GITIMAT3 LIVE BIF3112 r1038 1937 1936 I Mea 1327 I 16S6

E3AR All otharraoem 1,029 76.9 1 163.4 1s0.0 119.e

IlmAlwL-----— 1,049 9s4 1,043 17.8 17.5 19.s

Total Whit@ All Auother Total 2hite other

mite Au Otbr moon 206

772 212 209

14.8 109.3

14.2 116.3

I-5.9 127.9

Mcoa mom IOWA---— 794 505 767 le.4 19.1 le.o 1 Uh2te------------------------ 767 769 739 17.9 18.4 17.4

193+------------------ 74,452 32,043 42,0.9 41.1 20.5 169.1 All othor raOee------------ 27 36 2e 94.4 ne.4 107.7

1937----—-------— 1936----------------

74,93s 72,23S

32,231 31,s30

42,707 40.2 20.1 163.9 40,KS 39.8 20.3 162.4

ImMa6s White------—------------------

6s1 376

5W7 5s3.

463 376

I.&s UN.

17.s 12.4

16.1 L2.9

Rd.opm 1,000 ILLINOIS-—------—--———

I 3,270 2,236 2,676 26.7 24.e 23.e

mmhr I totalMm births mite-------—----—-— 2,241 2,094 2,CQ5 19.3 19.1 18. B

670

I1933----------------—— 75,1U 33,6S5 1ti,456 41.1 21.4 143.6 All other rrLme-------------- 125 IZ6 107 LI.2.2 126.6 116.1€~93.+------------ 75,s62 32,6s2 43,670 a.o 20.9 L54.0 { 1s33-----------— 73,2s9 31,742 41,647 4L.8 21.3 lea.9 Ztmmm3Y

11,242 1,414 1,501 26.5 23.2 26.9

1932---------—---—---- 70,811 31,m7 39,204 42,.0 Z1.s 160.9 mite---------------------- 1,125 920 1,047 19.2 1s.s 19.81931—-------— 65,952 30,137 95,615 37.5 19.8 130.5 All othermoon 617 434 404 161.9 139.5 2s1.2

1930--—------------- 62,667 29,490 34,277 34.7 le.6 141.1 LOOL9L4U4---------------------- 4,066 3,92s 3,699 82.2 .s3.4 84.41929------------------- 60,921 27,7F?0 W.,1.11 23.9 17.7 143.5 white-------------------—-—-- 529 497 443 1s.4 1.S.7 18.4192s—-—----—------—-- 60,661 27,746 32,916 32.S 17.2 139.5 All othermOetI------—--——5,537 3,431 3,251 175.2 176.2 175.1 1927---——-------——--- 52,022 26,134 25.s9s 2%0 2.2.9 131.6 1924--------------—--- 37,576 21,316 16;260 25.6 16.0 121.3 M41x2---—---—

!510 510 4691 23.s X3.5 31.s

192s-----—--------—-- eJt,4L4 21,564 io,ew 35.3 16.0 120.6 Uh2te---—-—-—----—— 025 SW 4M BEez 33.s 31.71924------------——---- 39,292 20,532 1s,209 35.9 3.5.0 123.8 All otherzmOs-----— 5 3 3 172.4 76.9 69.e

lg~------------------- 35,040 le,139 16,901 25.2 14.4 126.2 2,328 Z,lEO 1,978 76.s 78.6 74.4€1922--------------------- 35,605 18,471 17,124 25a 14.s 130.0 Whlto 546 037 540 24.0 34.7 23.7 1921--------------------- 34,s24 17,440 17,324 26.6 14.s 12s.5 All otherraae.------— 1,682 1,242 1,493 269.0 274.e 256.4 1920-------------— 27,749 15,170 12,579 24.9 15.0 125.0 1919---_--_---_---------- 23,660 12,260 11,200 23.6 13.6 121.9 MmsmAu----------------— 2,329 2,X% 2,144 W.o 2-4J 24.21915-----—----------—-

1917-------------------- 20,444 12,23s a,226 20.2 13.o 120.1 All other mOsLT----------—-- P37 L19.4 115.6 107.3 I

IJ I!xolusi.eof Oelifomla, Mas.achusatt., end !hw York for e.cb y9ar,ami ‘Mm. tor 1938. These states do not zwquire a statement .admemin.g legitday or cblld.

MIamscm-----------------------whito white-----------------------Allother raam---—-----——

1,133 1,040

93

1,0+!4 1,010

74

l,04a23.1 965 21.6 83 M2.2

23.6 2L?I

12L.3

22.0 20.6

132.4

NOTE.—rota mot available for the gmra 1913 and 1916. MIS913SIPPI------—--— 4,397 4*3M 4,?21 31..9 62.2 65.4

White---— -------------------- 243 10.9 12.2 n. o

TABLE R. —.ULEGITIb6A!i!i LIVE BIRTHS BY RACE: UNITED STATXS ~ All other mOnS-— 4,134 3,937 9,97s 139.7 132.6 144.3

19,906 12,000 7,906 19.4 12.5 113.8 mite—--------------------—- 11,903 1,221 l,sfn 20*4 20.6 21.2

AND EACH STATE IGssOmu-------------—

11,932 l,MS 1,762 33.3 31.9 31.5

mite------------—-— ------- 1,237 1,223 1,221 24.4 22.9 2.3.3

ILL3W3T4ATE LIVE BIRWS Allother rflOes 1615 595 Ml 165.7 14% 4 153.6

!213 199 20-2 20.0 19.2 19.6€

Onto MC 151 160 14.0 13.7 15.4€

AzvA Arm 2ACE Inmber Pm 1,020 total

All othmmoos 73 44 34 113.o 70.8 24.6€live birtim€

r€—---—-------—-------—- 210 2Z9 3C5 9.4 10.0 las

mnhita----—---——------—-- 213 2s9 9.1 9.7 12.5r1938 1337 \ 19S6 193s 1937 19S6 411 otherraOaB------— 10 10 16 31.3 34.4 67.3

S2mD4-----------—------— 33 23 17 le. s 13.2 12.0United StfJte6~----------

1=74,462 ‘4,936172,3SE 4J.1 #..9 39.8 mite----— 19 14 11 10.9 e.9 e.3

Whltm 32,042 12,2s1 31,330 20.5 20.1 20.3 AllOtimr raooa-------—-——--i

16 9 6 115.1 52.9 67.4All other lueeo-—--—— 42,419 ,2,707 40,4s9 169.1 162.9 162.4

m a41.m21s2------— 1s3 166 164 23.4. 33.0 21.4 lawhite-----------------— 167 161 23.1 22..9 21.0

5,178 5,01s 5,012 23.5 al.4 E%4 All OtharUhita-------------------------- 702 649 S93 18.1 17.0 16.1

mean-----------—--- 1 2 1 9 250.0 2JXL0 300.O

A8rK3iA 255 274 Unto------------------------- lm 167 AU other mobs 72 57

270 130 24

33.4 19.1 55.2

26.1 20.4 66.0

2a.3 .92.5 66.5

Rh2te-----------—--------——— E06 Ul othermaO.s-— 1sea

791 ?J09

773 470

16.2 133.6

13.7 119.5

16.6 ML 9

1,476 1,33s 449 45.0mite-----—-------------——-

KLlothor xuoe.---------— 1,037 1,123

1,564 369

101E3

39.7 15.8 118,0

44.1 16.2 130.9

46.4 14.5

146.5

m ?12XIco-----------------———— 566Hh2te------------------——— 499Allether rm.8------------- 67

595 427 2s

504 4ss 51

39.6 36.5

106.5

32.7 25.4 10B.6

39.0 36.S 35.1

ooIo8Am-— 035 498 mite---—---—--— 514 476Allo%her raOea--— 1 $!1 22

414 397 17

26.0 25.3 70.0

35.4 24.6 76.9

33.6 33.0 70.a

2iOREi0.4R3LIN4------------------- 6,590 mite----—------------------ 1,445 All other rnOea--— 4,245

6,166 1,602 4.6S7

5,74s 1,362 4,%

76.2 Z6.5

132.3

78.3 3s.0

1s4.4

77.6 26.1

1ss.s

co3mEcTlom---------------—------- 479 409 423 20.1 le.o 19.1 Nosr2 114Km4---—--------— z% 293 2/2 22.s 23.!2 20.0

W6iite 433 357 36e le.3 16.1 17.0 3bSte--------—-------------- 247 242 253 19.6 L9.9 17.6

ALl other mma------------- 36 52; 67 90.B 24.3 9s.8 NJ other raom----------— 47 ?

51 40 103.9 loa.1 95.8

All othor m.oea--------------- 1 4,476 4,366 4,a9 192.2 1S3.6 189.1 Mm! .T2R32Y----—-----------——————— 1,419 1,300 1,.240 35.3 23.s 32.1

11 Wi12te-----------------— 95 All othor raOeB-------—--

{ 222 212

al 179

37.2 310.2

22.0 3W..V

24.9 266.0

Whit.s---------------——---M.1 Other lmOen-—-—--- 4 730 Wl 430 125.6

z 1.22.6 lls.1

DIBTRIOY OF 00LM481A—------ L,106 l,OW 973 25.4 S&l 23.1 l,zra 1,129 1,006 20.0 %?ez 34.0 Wblt’a----------------------- 175 19.? All othor m3e8-------------— 1 9E9 353

179 794

20.2 224.5

23.2 210.9

22.7 228.7

619 Allothar re.oe#------------ z 510

416 3s8

16.s 13s.8

16.5 232.s

16.0 115.0

1 FLORIDA 2,119 2,036 1.s96 6s.1 69.7 67.4 0820m?-----------------— 227 Z12W 163 14.0 15.5 14.2

392

--------------------—--- 369 507 %30 83.s 70.5 66.3 Oslo----------------——-— 2,63S 2,m.. 2,44a 23.5 23.5 23.6 127 1,s78 1,252 l,a13 17.6 1’s, 18.4

mite------—-------------— 21.9 1s.0 15.5 18.0 ‘ihlte------—-—---— 222 329 195 13.8 ls.o 14.1 421 othermOm&——--------—- 1,727 1,737 1*3G M4.9 194.2 1S4.6 All other rmea ------------- 4 1% 10 3 6s.2 3L.S 1s.s

momma----------—

4 1

4,s92 4,s85 4,s22 75.7 73.9 72.2 PmwsYLv4N14--------------------- 3,619 6,4s6 5,333 28.9 $4.0 39.0

White----------—---— 602 5425s7 20.7 14.2 16.1 White-------------------—---- 4,092 4,031 4,049 26.0 26.7 ,96.7 All othermces—— 4,304 4,s23 4,=5 166.5 167.1 167.4 Au otherIWI.sw 1,5-W 1,404 1,.204 173.0 162.2 16440

/ Idaho lw 1.I.4 I-29 13.3 11.o 11.6 SBoDx IBIABn 1 296 276 Wa 2s.1 27.0 2e.3

mhite------------—--—---- 140 10s lJ.o 12.5 10.s 1.L.4 To12te--—----------— 266 226 256 25.9 23.7 28.7 All otherraaes—-----—----—- / 10 6 4 100.0 69.0 39.6 Allotherrnaea--——-— 30 do 32 120.5 3.39.9 1s6.2

see rOOtnOtea at and Ortable.

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* INTRODUCTION 9

TAsLE R.—IIU3GIlItMATELIVZ BIRTHS BY RACE: ~ STATI?S~ AND BACH STATE-Coutinued

I RL03221LW72 SJTS BIN2X3

Per 1,003 total lim birtb6

I 192e 1937 1936 19m ‘193’7 1936

1922 to 1930 the ratio variedaround 38, 39, and 40, without demonstrateIng any appreciabletrend. However,since1930 the

has been consistentlydecreasing;L’at’io for 1938 it is 32.1, whichIs 18.1percentbelowthe ratiofor 1930. This decrease . In recent yearsmustbe due to factorsotherthen changesin the registrationarea becausethe area has includedthe whole UnitedStatessince1933.

. TABLE S.-RATIO OF STILLBIRTHS TO LI’TEBIRTHS: BIRTR-FEGLSTRATIOli

H, DNITSD STAT2S’ SOIRS fCmcLllm 4,537 4,23[ 3,992 11o.1 107.2 101.

mat----------------——504 47C 4CE 24.e 24.1 al.] AU other rmes--------——— 4,023 3,55: 3,584 193.7 185.s 1?9.E 2L’ILm122ss 2TILmmm3

5303s rAKo?&-.-—-———__— 206 206 2m 17.4 17.3 17.$ Y24R LiTe Live

Nbite-———— 161 167 186 14.5 14.8 3.3 births Zatapsr Y2A16

blrtb8 sate pmA

ALl other raaez--—-—————— 43 3s 44 60.5 66.1 64.1 Lfumbc.r l;% Number l;:

2,361 2,1* 2,166 .44.0 40.9 42.e births births

L3blte---—-------—— 928 e35 926 20.s 19.1 22.7 All otherrams------.— 1,433 1,286 1,232 17e.o 159.2 158.9 193?3----2,226,962 73,467 22.1 S3,67S 39.5

192%--- 2,202,227 73,609 33.4 S9,’765 40.2 ti 3,14’7 3,269 ~ 27.1 29.3 1936--- 2,144,790 ‘?3,733 24.4 82,931 38.e

Nhito----------—---— $ 1,52L 1,595 14.9 16.s 1935- 2,L55,105 77,119 3s.8 70,716 38.1 Al-1othermoes—-.--——— 1,626 1,674 2/ 116.7 121.5 1934- 2,167,636 78,503 36.2 71,519 2s.1

1932-- 2,0s1,232 77,059 37.0 75,e17 39.3 ——----. -— lse MC 140 9.? 11.o I-1.z 19S?- .9,074,042 78,3= 37.e 69,757 5S.9Nhite-----.---—----——___ 121 1.20 131 9.22 10.4 10.5 1931-- 3,1L2,760 20,616 32.2 70,010 39.4 All otheramen-----.---—---- 7 10 9 61.4 4s.5 70.3 l.93c- 2,203,95S 86,466 39.2 42,634 y 40.1

1 4

I I I! .-.—-----_-_-- 198 194 209 31.4 30.7 22.4

Zl!itc 19e 193 209 31.4 30.5 33.4 &/ ExclusiTe .X Lfmsacb.setts, Fdmde Island,wa8hin@on,and Baltimr$ kkryl­; AU otherrnoea ~ . 1 332.3 No transcripts of stillbirths frm theseareas,warereceived

V~GIN14----------—----------23,997 3,923 3,71L. 74.7 75.5 72.4 NOTB.-Iata zelat werenot collected for the yeas 1919tomite------—--—---———1,072 995 997 27.9 .97.0 27.3 1921,Inclusive

ing to stillbirths .

All otherrawa--— 2,92S 2,9Z8 2,714 194.6 193.7 1s4.5

WASHINGTON———.—.————— --l532 ‘m? 462 19.9 2.0.7 19.e IILECITIMATE numberof stillbirths91ZLLSllWRS.-The reportedWhite---——--—---————— 466 433 432 17.9 10.6 le.6

is shownin tableT. As may beAll other mcaa-.-—-—------ 66 54 40 9s.5 96.1 63.4 as legitimateor Illegitimate

-1l,ess 1,s07 1,7s5 44.5 42.e 43.7 expected,the stillbirthratefor illegitimatebirths,“70.6,

NEW VIRGINIA-—-———————————— mitO---———-———— 1,6CQ 1,529 1,545 39.9 Za.s 39.9 k higher thanthe stillbirthrate~or legitimatebirths, All other raoes——~ 27e 240 X44.9 L21.1 114.8 30.6. Eta in tableT are for the years 1933 to 1938 for

smcmfem---—-—.— 4 1, oeo 1,131 1,117 19.6 2L.1 2L.2 White~tand ‘fall ‘f California, andotherraces. Massachusetts, Rhite All otherlmM,——----

1,024 1,067 1,057 Ls.s 20.1 20.3 NewYork are not included in this tablefor any year,and56 54 60 93.0 U9.4 106.4 Texashas also been excludedin 1938.

uYcLmm————————————— 4 72 24 14.6 le.s 12.swhite.—----.—— 55 67 ;: 1.L.5 le.z lo.e All otherracea--.———— 17 17 13 114.1 149.1 25.9 TASLE T.-STH,I.BISTSS BY LEGITD44cYAND FU.CB: ONITBIL STATSS ti

andTexaLI I 2TILmIsm2~ Ikludv. of Callfmni?+,. bknsmbusetts, andNewYorkforeachyear,for192S. IIw20Stntesdo notrmu2re a stateuant l@@tmacy of child.a.nocmning

~ !hxaadidnotmquim a atatnmntin 1938concerningMgitlmg of child. per 1,000

m6a AND RAo2 I Number Rata livebirths

I@WIINi OF 8TILLBIB1’RS.-Infonnationon stillbirthswas firstcollectedby the Bureauof the Censusin 1918. No data I Total L3uitl. nlegw TotfLl Leziti­were collected or publishedfor the years 1919 to 1921, in- tit e imate lmte

clusive,but since 1922 stillbirthtableshave been compiled 193e

snnuallyfor the birth-registrationarea. Total------—— 5s,3s! 5B,127 5,26( 32.2 30.6 70.6 In some Statesstillbirthsare reportedon a singlestill- White-—-———————— 42,02s 41,434 1,65: 27.6 27.1 51.6

birth certificate,wherea$in others,Statelaws requirethe All othermom--------415,29: 11,69~ 3,6iX 61.0 56.1 B5.o

1937physicianor ,attendamtat a stillbirthto rile both a birth TotaL—-—__——— 62.,7LX 57,357 5,346 33.7 32.1 71.4and a deathoertiricate.Suchbasicdifferencesin reporting mltO-——————..—.———— 46,164 4.4*4SI 1,68L? 2e.8 2s.3 52.2

or reg- All otherraces----.———— 16,54 12,e76 3,6= 63.5 59.1 S&eprocedureintrcducesomevariationin the’completeness istrationand in the informationreported.More important, 1936 from a statisticalstandpoint,are differencesin the legal

of a stillbirthdefinitions used in the states. Variationsin the definitionmake it impossibleto compilestrictlycompara­ble data for all States,and confuse the interpretationof consolidatednational rigures. A 11st showing the various definitionsused in reportingstillbirthshas been published eachyear before1937in the volume entitled?8irth,Still-birth,and Infant Mortalitystatisties.fiMore recentdata on

definitionsstillbirth for the Statesare givenin VitalSta­tistics—SpecialReports,vol. 3, No. 2, table13. Neitherof these sourcesof definitionscan be consideredup-to-datesince changesmay occasionallybe made in Stateprocedures.It iS expectedthat the adoptionor a standsrd stillbirthcertifi­cate in 1940willmake thesedatamore completeand uniform.

Detailedtablesclassifying by area,race,agestillbirths of mother,nativityor parents,end other subjects,are given in tables8, 9, and 10 in the eection containinggeneralna­talitytables.

The total numberor stillbirthsend the ratio or still­birthsto each 1,000live birthsare given in tableS for the birth-registrationarea for a seriesof years.

The ratioof stillbirthsto live birthsfor the rirstyear that these data are available(1918)is 40.1. For the years

20ta-————————— 62,694 57,22JI 5,364 24.5 32.9 74.2nhlte-— 43,964 44,227 .1,637 29.3 2s,9 51.4AU etherra.a.s 16,730 13,W3 3,727 67.1 62.3 92.1

J 1925

rOtu----—--—————.—— 65,936 60,182 5,734 36.1 34.3 76.6 ●

other raue6------- 17,525i

L2.3SL 3,954 69.2 64.1 95.4

1934 I 66,996 60,e96 6,1W 36.4 34.5 a.o ~ ~ a

?/ % 3 I/2/

--——---- 42,401 46,601 I,eoo 20.7 30,3 53.4milt A6.1

1923M.aL———-—--------4 79.964,913 59,052 5,861 37.0 35.1Nbite--—— 46,755 44,901 l,e54 31..3 20.7 3s.4 All otherraoes-_————— le,15s 14,151 4.Occ 69.3 64.2 96.2

~ I&cluaimI of California, Ma.mch.s.tt., and New York for ●ob year,mid TOXIM ‘or lW. Z!mm 3tat.s do not require a atatemnt Connmnlng legltimuy of child.

SJ Cat. not mailable.

MORTALITY STATISTICS

Detailedtables classifyingdeathsin the UnitedStates for1938,by placeof death,age, race,sex,cause of death, md othersubjects,are givenin the sectioncontzlminggeneral nortalitystatistics, iontables11 to 21, inclusive. In add,it to thesedetailedtables,selecteddata ror deathsare included

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10 VITAL STATISTICS OF THE UNITED S!I’ATES€in the summary and rate tables. Special tables for deaths of TABIJS W .—m m WHICH SACS STA~ WAS Azmm TO TEE

infants are given in the section containing general int%nt- DEATH-SSGLSTSATIONASEA

sxn’talltytables.

DEATE-BM!ETIWiD.-In 1938 there were 1,381,391 registered Yzds mm YEAS SrAm

deaths In the United States. Using an estImated midyear Popu­s ­lation of 130,215,000, the crude death rate Is 10.6 per 1,000. 12ao-- !&3Sacilumtt 19.30 Nebraeka

New JerseyThis rate is 5.4 percent lower than the rate of 11.2 for 1937 Difit.of c.aluu6aia

FMinnesota 1922- COorgia gA 1910

and is the 10VF3st rate recorded for the United States death- Montam Idaho le90-- Cmnect.icut North CamlinaY Wyoming

reglstration area since 1900. In 1900, the first year for Delanare w Utah

which annual mortality statistics were compiled, the crude New Smpshire 1 1933- Iowa New YOrk 1911- Kentu.aky

death rate was 17.6. The trend of the rate since that ysar Shode Inland Missouri 1924-- North Dakota

has been generally downward, although 1918 was a year of high Vazmont 1913- Virgitia

192s-- A.labmamortality and other yearshavs shownsmallIncreases. lWo- Maine 1914- Kansas ?iostVirginia

Table U, giving the number of’ deaths end the death rate Miohlgml 1Indiana 1916- South Carolina 1926— Arizona

for each ysar, shows also the eetlmated population of the i United States end the proportion of it that is included In the 19Q6- Cclliromlia 1917-; ‘Mlne88ee 1927-- Arkansas

Coloradodeath-registration area. The States which ware added in varl- Mu-ylmd 192&- dklahauz.€

ous years are indicated in table W. Even though the succes- Rlnmylvada€

sion of rates In table U does not rerer to a strictly compara-SmthDakotaq 1929- Nemda€

New bferi.w ble geogmphlc area, the consistent downward trend or the rate 190s-- Wa.eMngton

Wiacellain 1932-- Twxasis not misleading. Essent Ially the seinetrend is evident in table H for a constant geographic area. Although there Ls� 1/ Inaludad in States.

~Dropped from the r.@atration@ .reain16CO; readmitted in 1919.conelderable variation In the level of the zate,similar trends ~Emopp.d fmm the ragistratlonare. in 1910; readmitted in 1930.

for individual States are shown In table IX. 4fIncl.dcd only mmicipalities with powtionsof l,COCor!nora in 1900 (about 16 peruent of the total population]; tbn rmzinder or the State was added to ths ama in 1916.

TASIJ+U.-CSUDE DSATH SATES: DEATs-l?EGISTMIItON AFC3A, UNITED STATSS 5JDroppc.d ~ttimgiatmtion ~ain19~; readmitted in192S.

DIWTS-W13TMTION AS2.4 D- n ME.-A.gedistributions bY sex, race, and cause of’

death, are Included in several of the general mortality tables. I

I midvanr popillatmidyear4/

A brier sunm!aryof these dlstrlbutlons is given In table Y, RMMatoo. I mtlmatd

ion I Total dea%ha which shows the total nmnber or deaths in the United Statee In€

23AS Pocat ion I 1938, classified by age and sex. This table includes also the€of eontiwntal I

Sats proportionate age distribution of deatha by sex. Slmllar dis-€Un.itadState. Pm.-

I I ‘r per tributions for total deaths are given in table Z for the years

Eu!rJml’ Qant

Wumber 1,000or pOpl- 1934 to 1938. It can be observed that a emaller proportion or

total latian deaths are occurring at younger ages. In each of ‘theage

1 1 I I groups under 45 years there was a smaller proportion of the 19ss--------------------- 13c,215,c00 lW3,215,W0 102.0 l,Ya.1,391 10.6 total deaths In 1938 than in 1934, whereas in meet of the1937—--—---—--— 129,257,000 129,2.57,2C0 10C.O 1,450,427 11.2 1936-------------------— 12s,439,m 12a,429,coc 100.0 1,479,22E 11.5 groups over 45, the proportion Increased. While, to a certain 193s------------------ 127,521,000 ls7,521,CCf) 100.0 1,392,732 10.9 extent, thle Is an Indication or changing age-specific death1934----------— 126,636,W0 126,626,000 100.0 1,396,603 11.0

i rates, such as the decrease In infant mortality, It Is prM-1933------------------- 125,770,MO 125,770,000 120.0 1,342,106 10.7 rily a result of the gradual”agelng of the population exposed€1932------— 124,974,030 120,291,200 96.3 l,m3,3s9 10.9€1931-------------------- 134,113,m l19,479,cco 96.3 1,32S,5S7 I.1.l to the risk or death. Inasmuch ae accurate population esti-€1920-------------------- 129,091,CXJJ 118,472,CW 96.2 1,3-43,356 11.3 mates by age are not available, age-specific death rates have€1929—------------------- 121,52S,429 116,317,53.3 95.7 1,386,363 11.9€

1 not been computed. 192s—------------------ l19,861,6C7 114,S5S,616 95.3 1,378,673 12.1 1927--------------------- 113,1%,765 10s,177,568 91.5 1,236,949 11.4 1926--------------------- 116,531,963 M4,9WJ,2C1 6Q.1 1,2S5,927 13.3 TABLEY.—DISTSIBUTION OF DEATSS, ~ FES 1,000, BY AGE AND SEX: 1925---------------- l14,e47,1u 102,931,999 S9.6 1,219,019 11.s UNITED STATES, 19S8 1924---------------- i 113,202,319 100,032,062 2s.4 1,173,930 11.7

1923--— Ill ,537,497 1922 ---— 109,S72,673 1921----------------- 108,207,233 1920----------------- 106,343,031 1919-----—---------—— 1106,OJ3,O65

97,3Z2.,104 9s ,s66,YAo 89,102,4Z4 87,632,592 33,166,043

57.7 23.4 S2.3 22.3 S1.1

1,193,017 1,101,s63 1,022,,009 1,142,55S 1,096,4?5

1%2 11.7 11.6 13.0 12.9

Aa2 Wumbor

I=4T=Y

Distribution pr 1,000

1918—------------—--- 103,587,9ss Sl,3iV5,675 78.5 1,471,2+37 1s.1 ‘rWal we mzals mlalo 1917-----— 102,172,S45 74,9s4,49s 73.4 1,062,932 14.3 1916-------------------- 12+3,757,735 71,249,162 m.0 l,col,931 14.0 1913-------------------- 60,242,625 67,095,6Sl 67.5 909,155 13.6 All ageB--------- 1,2W,391 734,902 616,4s9 ., COO.O 1914— i 97,927,516 65,S13,315 67.2 S9S,059 13.6

I€

1913—--— 96,513,407 63,203,625 65.5 890,s43 14.1 Under 1 yenr---------- 116,702 66,462 50,240 24.5 26.9 S1.5

191f?--------------------- 95,097,89s m ,359,974 63.5 S?4,251 13.9� 1 9ear--------------- 15,303 s,166 7,137 11.1 10.7 11.6 ~ -a------------ 7,467 4,043 3,444 5.4 5.3 6.6

1911-------------------- 93,6S2,1S9 59 ,la3,071 63.2 259,254 14.2 3 y*ara—------------ 5,134 2,S2A 2,314 2.7 3.7 3,e

19Lo---—--—— 92,267,0S0 53,231,T42 5s.3 MJ5 ,41.3 15.0 4 pma------------ 3,896 2,114 1,782 2.8 2.8 2.91!W9—-----— I 60,691,s54 50,870,51s 56.1 732,53S 14.4

me-— 89,073,3W 46,7s9,913 52.5 691,574 14.e Under 5 ymr8-------- 142,522 S3,605 64,917 107.5 109.3 105.3€

5 to 9 YearlJ--—----- 14,4’?4 e,091 6 ,SSS 10.5 10.6 10.4€1907——--------—-- S7,455,366 43,016,990 49.2 6S7,034 16.0 7.0to 14 pars----—— 13,542 7,759 5,722 9.s 10.1 9.4€

1606—---------------- e5,s37,37z 41,993,U9 42.9 65S,105 15.7 15 to 19 Jealm————— 33,590 lz,ozc lo,5eo 17.1 17.0 17.2€

lm5-— 124,219,378 34,052,201 40.4 345,533 16.0 2U to 24 3WU’8-------- 30,52s 16,2SS 14,25a 2s.1 21..4 23.1€

25 to 29 Pmra 23,624 17,779 M, 915 24.4 2s.2 S3.s€s2,601,.SS4 33,345,163 40.4 551,354 16.5

w to 34 yae.l’s 36,359 19,679 16,SS0 2s.3 23.7 27.1€1902-— m,96s,3so 32,701,022 40.4 m?4,413 16.0 3s to 39 yW+2’s------ 45,031 24,240 2s,191 32.6 92.5 32.e

1902--—--------—---1901—---------------- 40.3 51S,207 16.5 lqj&----------- 3 ti ;!::5 :5;% 40.5

1 539,939

1 17.6

45 to 49 p@.m 50 to 54 y.ars--------

72,526 m,7m

43,022 E4,629

29,524 36,091

40.s 52.S 6s.7

42.4 56.2 71.4

3a.7 47.9 3B.5

~2sdusi.e of atil.lbitiha. ~Populaticut onwmrated for .enm. ymmendlngMay31.

55 to 59 pars-—---60 to 64 yaarEi 65 to 69 yaars-—----

lcz,Wo lm ,356 141,664

61 ,Zm 70,230 20,322

41,275 30,106 61,342

74,2 S7.1 102.6

w .1 91.8

105.0

67.0 S1.3 99.5

CRUDEDEATHMTES BY SMTE.-The crude death rate for each 70 to 74 ym.m-—---75 to 79 para

141,901 126,252

77,614 71,395

w,2S7 64,S67

102.7 9S.6

101.5 93.3

104.3 105.s

30 to e4 yWlr#------ 97,s90 4s,7s1 49,109 70.9 63.8 79.7

i 40.4 52s,640 15.9 40 to 44 ye?.ra 56,307 32,469 23,sss :1

State Is glvsn in table J. The reported rates range from 7.4 35 to 89 y8ars------- 51,702 24,002 S7,7W 37.4 31.4 44.9

for North Dakota to 14.6 I%r Arizona. This VSYlatlOn reSUltS 92 to 94 year8-------- 17,4s3 7,374 10,114 12.7 9.6 16.4€

95 to 59 wam------- 4,063 1,594 2,469 3.9 2.1 4.0€In part from differences in age, sex, and race composition of

100 YU=8 Snd mar---- 1,1s4 409 725 o.e 0.5 1.2€

the population, and from vsrlation in public-health and medi- Nat .tatul----------- 1,02s 665 363 0.7 0.9 0.6

cal racillties. lf Sxoluslm of stillbirtbn.

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INTRODUCTION 11 TABLE z .—DISTFZSUTIONOF DEATES,~ PER 1,000,BY AGE: UNiTED SKITES high rates Lor the winter months, results for the most part€

from an inorease in the number of’deaths from respiratory€.4cs 1938 1937 1936 1935 1924 causes. A tabulation of deaths rrom selected causes,by month,€

is given in table 21.

~ =S-------------------1,000.0 1,000.0 1,000.0 1,000.0 1,000.0 ‘MBLEAS.—ANNUAL CRUDE DEATE RATES U PSR 1,000 ESKUJ4TXD hWDYW4R

Un6er 1 year----------— ---------- 84.5 23.7 32.8 86.3 93.2 PoPULATION, BY MON’IW UNITED STATES€

1 Year------—----— ------- Ill 11.2 11.6 12.o 14.6€2 Zee.ml------------------- 5.4 5.7 5.7 6.1 ?.3 MoNlli 193s 1637 1936 1935 1924 MONTR 193a 1937 1936 1935 1924€3 ye-a-----------—--—---- 3.7 3.8 4.0 4.5 5.1€4 yeu-a----------—-----—-- 2.8 3.0 3.3 3.8 3.9€

10.6 11.z 1.1.510.9 ‘11.o Ju3e--- - 10.0 10.2 10.7 10.3 10.65 to 9 Del-a--—-— 10.5 1.1.3 12.3 12.9 14.3 Tutfil--JuQ--—-- 9.8 10.3 11.6 9.9 10.810 to 14Ym?ss 9.8 10.6 11.4 1.2.4 12.2 Jammry--- 11.9 13.6 lZ.6 lZ.6 1.1.9 Augwt----- 9.6 9.’/ 9.8 9.5 9.615 to 19 yews 17.1 1.S.4 le.9 19.3 19.2 I%bmary--- 11.6 13.e 13.5 12.4 12.5 S0pt3mbar- 9.6 9.7 9.6 9.7 9.s20 to 24 ymra----------— ----- 23.1 24.4 25.3 26.,2 26.6 Mazwh-- - 11.4 1.2.61.2.9U. 9 1.2.3 October-- 10.2 10.4 10.6 10.Z 10.135 to 29YOWLI--------------------24.4 26.4 27.5 23.3 2s.0 April—--- 11.o 1.1.7‘12.5IJ..511.6 Nommb%r — 10.5 10.6 11.Z 10.5 lo.e

30 to M deem------------—---- 26.3 2s.5 22.9 Z9.7 29.9 ~Y-—--- 1.O.510.9 I.1.o11.o 11.1 Decemkw--- 11.4 11.5 laz 11.9 lJ.7

35 to 39 years.------— --------- 32.6 34.8 35.9 36.7 36.0 of stillbirths.44 to 44 years 40.8 43.1 42.7 43.8 43.7 ~ Exclusive

45 to 49 Yem?s 52.5 54.0 53.7 34.2 53.6 w to 54 years— 65.7 65.8 64.6 64.5 64.6 DEATHS BY lMCE.-Table AC ie a Classirioation of deathe by~ 55 to 59yeare 74.7, 73.8 72.5 7Z.6 70.9 race and sex. out of the total or 1,381,391 deathe in 1938, 60to64years 87.1 86.4 85.1 24.5 84.6 1,195,431 or 86.5 percent were classified as white. Negro65to 69 ye~a ----------------- 102.6 99.2 97,1 95.2 91.1 70to 74yOars----------—--- 10Z.7 96.1 97.8 97.6 9s.1 deaths numbered 178,5’Y3or 12.9 percent. The number of deaths 75 to 79 years

1 98.6 96.4 25.6 91.a 8s.7 reported fOr Indian, Chinese, Japanese, and other nmnerically

80 to 84 years 70.9 68.5 67.5 64.2 63.4 13iIIOr races, totaled 7,387 or less than 1 percent of all 25 to 89yams--------------- 37.4 36.6 36.6 35.1 33.7 deaths. 80 to 94 ymra----------------- 12.7 lZ.7 13.1 lZ.5 12.3 95 to 99yearn------—--------- Z.9 3.0 3.1 Z.8 2.8 TABLE AC.—DISTR’WJTCON OF DEATSS, ~ PER 1,000, BY RACE AND SEX:100yeerB and Omr--— 0.8 0.8 0.9 0.9 0.9 UNITED STATIS, 19ssNot statcd-------------—----I 0.7 0.8 0.9 0.9 1.Z

lJ Exolusiwof ntillblrthn. nE.4TE6Y

Table AA gives the total number of deaths In the United States and the proportionate age dLstrlMtion of deaths by

m Number I Distributionper,,000

race for 1938. It is apparent that the proportion . of deaths Total J531e Female lbt31 We me that occur at early ages Is much higher for Negroes and other

races than for the white race. Part of this difference is due Allracas—— 1,2s1,391 764,9Q2 616,489 1,000.Q 1,000.01,020.0 to the relatively high proportion of the nonwhite population in the ywnger age groups, but it also reflects the higher mte-—-——- l,195,4zl 665,559 SZ9,8?2 265.4 e70.1 259.5 age-specific mortality rates amng norIwhiterices.� ~w---------— 17e,573 94,659 33,914 129.3 u23.e lz6.1

mdi.wP--------- 5,07e 2,722 2,356 3.7 3,6 3.e

TABLEA4.-DIsTRIBuTIONOF DICATRS, ~m~e-_-.-.-- 1,119 1,009 I.lo o.e 1.3 0.2

~ PSR 1,000, BY AGE AND R60E: Jap9ne.w Sla 614 224 0.6 0.8 0.3 UNITKDSTATES,193s AJl otherraoe3---- 37Z 339 33 0.3 0.4 0.1

~ 2XChlSiW of stlllbirtbs.

DEATH BATES EOR SEIWIED CAUSES OF DEATH.—Tabulations. orAm Disttibutio] 1,000por

deaths by cause and other classiricatione are given in genePalother mortality tables, rnmbers 14 and 17 to 21, inclusive. TheZbtnl. Ilhlte Negro ~eea

number of deaths in the United Statee in 1938 and the crude 7e,573 7,3s7LGZO.O WCO.C @IOA l@J.o death rate for each International List title and subdivision~ w-—-- 1,2s1,391 .,195.421

are given in table XI. Death rates ‘forselected causes are U36er1 yOm----- lZ.6,702 94,425 20,s551,262 S&!) 79.0 U6.8 1s4.4 tabulated in table XII for each State.1 ymr-----—— 13,303 11,934 3,059 310 Z.1..l10.0 17.1 4Z.O z yOara 7 t37 6,02z 1,3ZZ 133 5.4 5.0 7.4 18.0 The trend in death rates for epecific oauses, over the 3 yOars-— 5,136 4,182 S56 96 3.7 3.5 4.8 13.0 past ~ or 30 years, may be characterized by two general4 p3rB--— 3,896 3,144 69z 60 z.e 2.6 3.9 e.1

statements. In the first place, there has been a great reduc-U3d0r5 jaars s to 9 yasra---

14S,5Z2 119,777 26,7S41,961 107.5 103.2 L30.o245.5 tion in the death rates for infectious and preventable dLs-14,474 lz,ose 2,Z09 177 10.5 lo.1 12.4 24.0 10 to 14 y03rE--- 13,542 10,eso 2,485 167 9.8 9.1 13.9 Z2.6 eases; in the second place, there has been an increase in the 15 t-a19 yOara--- 17,419 5,e92 Z70 17.1 14.6 23.0 26.6 rates for certain diseases characteristic or older ages.Zu to 24 yBara--- =:% al.,9738,271 344 23.1 ls.4 44.3 %.6 % to Z9 y3aln--- 33,694 24,006 9,249 339 2A.4 20.1 52.4 43.9 Greatest proportional rate decreases have taken place for suchWI

diseases as typhoid and paratyphoid fever, which has declined20to 34 JmJlll--- 36,359 26,S03 9,149 207 36.3 33.5 51.Z U.6 35 to 39 y$3ars--- 45,031 33,Z16 n,50e 307 32.6 27.8 64.4 U.6 trom a rate or 21.O in 1911 to 1.9 in 1938; and diphtheria, 40 to 44 ymrn---- 56,=7 42,538 12,444 32s 40.8 26.4 69.7 44.0 which declined rrom a rate of 18.9 in 1911 to 2.0 in 1938.45 to49 y03ra--- 72,5z6 5e,67u 13,5.?2 334 52.5 49.1 7q.7 45.2 50 to 54 y03m--- 83,720 75,124 15,z14 2az 63.7 62.8 86.2 51.7 These rates, and those following, are for the changing death-

55 to 59 yOam--- 10Z,56O e9,006 13,103 451 74.2 74.5 73.4 61.1 registration area and are the number of deaths per 100,000

60 to 64 yeam--- 120,336 108,234 U,648 472 87.1 =.5 65.2 63.9 estimated midyear population. Greater abeolute reductions, 65 to 69 Y&llW---- 141,6W 229,274 U,959 421 10Z.6 108.1 67.0 5s.3 though smaller proportionate reductions, have been made ror70 to 74 y’8ara--- L41,aol 13Z,176 9,374 331 102.7 110.6 52.5 47.5 7s to 7’9yuar.7-- 13S,Z6Z 129,979 3,325 298 92.6 u3e.7 32.6 40.3 other tiportant causes. The death rate for tuberculosis of

w to 84 yOara--- 97,890 93,625 4,05s 78.3 3%7 2s.’7 the re.@iratory system has shown a remarkable decrease rrom

85 to 89wara--- 51,70Z 43,957 2,612 E z:: dl.o 14.6 17.9 132.7 in 1911 to ‘44.6 in 1938, and that for diarrhea and en-60to 64y40rlJ--- 17,488 16,loe 1,327 32 12.7 13.5 7.4 7.2 teritis has been reduced from 91.2 In 1911 to 14.2 in 1938.65 to 69 ymrs--- 4,063 3,242 675 40 2.9 z.e 3.8 5.4 100Y031WandO’IWC 1,124 538 5s2 0.s 0.4 3.3 3.1 The trend of the rate for influenza and pneumonia is more ir-

E 0.7 0.5 2.4Not atated------- 1,03J3 5s0 427 _LL 1.5 regular. The rate for this cause was 149.6 per 100,000 eeti­mated population in 1911. In the rollowing 4 yeare this rate decreased somewhat, but during the influenza epidemic of 1918,

IOMTS IMTH BY LVX?PIL-Table AB gives the crude death ratee It increased to the extremely high rate of 587.0. In that

by month for the United Statee for the years 1934 to 1938. year more than 1 out of every 200 pereone died from inrluenza

Death rates are consistently low In the months of August and and pneumonia. Since 1930 the rate has in general been lower

whereas the higheet rates are for the first 3 months than during the decade 1920 to 19S9,declining to 80.Z in 1938,.Saptember,€

or the year. For 1938, the highest rate occurred in Jsnuary, the lowest mate since -th~death-registration area was estab­€

when the rate was 11.9. This high rate,as well as the generally lished in 1900.€

----------------

--------------------

---------------------------------------------------------------------------------------

-------------------------------------

------------------------------------------------

12 VITAL STATISTICS OF THE UNITED STATES€TN3.B AD .-DEATE RATES ~ PEB 100,000 lS9TRdATJU) MLDYE4S POPUIA7!IONFoR SSIBO~ CAU8123:IS4ATH-SBGISTRATIONAS&i, UNITSD STATE8

(Numbmnafter wuaes of deathare tho.e of the 1929 revidan of the detailed International Lit)

— OAUBE OF DF..4733 1911 1912 192s 1914 =T= 1917 1918 1919 leso 1921 1982 192s 197A

IAllmwea ------------------------------------------- ,4M.: .202.1 ,409. ,364. ! ( !e ( ,423, ,em.1 ,267., ,303. ,158.2 ,173. ,219.7,1?3.0

~h~id & ~mt~~~d fm~-------------------—--l, 2 ?,1.( 16.! 17.9 ls.f 12.4 12.3 13.! 12.e 9.; 7.s 9.C 7.. 6.8 6.7 s-lD0X-----------------------.------------_-----------@ o.: 0.: 0.2 o.: 0.3 0.2 0.2 0.4 0., o.[ 0.7 o.{ 0.1 0.9 Wa8les---------------------------------_---_--_-.-7 10.( 7.( we 6.{ 5.4 11.1 M.: 10.E 3.4 8.[ 4.3 4.: 10.7 8.5 scarlet feve&------------------_--------—--------_--g e.~ 6.1 e.7 6.1 3.6 3.9 4.: 3.C 2.1 4.( 5.s 3.1 3.! al moopmao~---—-------—--------------------.--—-$ 11.: 9.: 10.C 10.< 8.1 10.2 1o.: 16.$ 5.1 12.{ 9.1 5.1 9.7 8.2

IDiPhti.fia---------------------------------------------IC 18., 18.: 1s.9 17.! 15.7 14.5 16.( 13.$ 14., 16.$ 17.6 14.( 12.[ 9.3

1Infl-audwemcmia {all f027M)-------_---ll,lO7-lO91

149.( 142.7 u4.e 126., 149.1 L64. a 167.[ 387.C 22,3.: 208.( 99.3 ls2.1 1.38.4 116.7Innv.9nz.a-----------------------------.-------------115.: 10.? 1.2.2 9.1 16.0 26.5 17.: SOO.E 98.1 70.< 11.4 31.$ 44.2 19.4 Bmnchopnewnia ~--------------------------------l~ 44.! 47.1 49.2 42.! 49.9 49.2 SO.( 70.C 47.1 54.t 39.1 44.< 47.2 40.6I LoW pnemonia-----------------------------------ux 42.: 49.7 51.6 56.: 65.8 76.7 27.2 1s7.6 66.: 73.( 42.5 50.1 53.7 50.6 Pnetmonia, mspecifld---..---------.------------~og a.: 35.( 31.E 22.. 17.4 12.0 Is.f 2s.6 9.! 9.? 6.2 6.< 7.3 6.1

4.: 3.s 4.0 S.f 3.5 3.0 3.E 3.2 2.( 3.1 2.! 2.7 2.5 Spidexnlaiernbmspznal ~tia---—-------—--------i~ o.! 2.4 1.9 1.5 1.4 2.2 3.! 3.4 l.t l.t R 1.( 1.0 1,0mbermlosis of the z.wpimtom syste 1s2.: 1.25.C I.ss.o 1.2s.: 12s.5 L19.9 L24.( 128.6 107.: 97.< 35.6 24.: 2M 78.0 Tubemulosin (other fo~]--------------------------2+3z 26.! 24.7 24.E 23.! Zs.e 22.2 22.! 2,1.4 16!.1 17.C 13.s lm U.% 11.7 wlma-------------------------------.-------------3e 3.( 3.1 2.6 2.1 2.3 3.0 s.: 3.1 3.[ 3.6 3.8 M 2.8 2.4

Oancern nnd other ralignmit tmrs----------—-------&m 74.< 77.1 79.0 79.< 81.4 az.1 2s.( 80.s 20.! 62.2 85.6 26.s 86.7 91.1 Diabetes mlli?,uz----------------—-------.-------------~g 14.! 15.C M.3 16.: 17.5 17.1 17.C 15.9 14.< 16.0 16.8 18.: 17.7 16.4 Cerebral hemmrbage and sofien~----—---.----------m,o 76.: 77.E 76.6 79.[ 81.2 2s.9 e-i.r 81.2 78.( sl.7 20.6 6s.$ 2s.9 28.9 Diseases of the heart ~-----------------------------9o-95 167.1 159.s 155.0 159.! 16S.7 lsa.7 171.7 170.1 1%.! 159.1 156.3 144.6 1’73.8 176.5 Bmn~tis------------------------------------------lo6 19.t 19.2 18.0 17.4 17.4 16.2 16.4 16.7 lz. f ls.z 9.0 9.9 9.0 7.2

Diarrhea and enteritis ~---------------------—---ll9,l2O 91.: 24.1 90.3 79.[ 72..1 79.5 79.3 72.7 55.: 64.5 51.4 59.: 39.6 34.5 Ap-df0itis-------------------------------------------l~ 11.? 11.6 12.1 1.2.? 18.5 12.8 12.6 1.2.2 11.E 13.4 14.4 14.1 14.’7 14.8 Emnia, intestinal ob~tictim ~------------—--------l~ 11.! 1.I..9 11.6 11,? 11.3 11.5 11.f 11.5 10.4 10.6 10.? 10.5 10.4 10.5 Olrrhosis of the liTeF-------------—----------------I24 14.( ls.6 13.4 I.s.c 12.6 12.3 L1.4 9.6 7.: 7.1 7.4 7.4 7.2 ?.3 Nqhritia----------------------.----------.-----__-l~-m2 97.7 103.2 la5.0 los.f 105.1 105.6 W7.9 97.6 28.1 89.2 23.0 87.9 89.3 28.e

Puerperzl 7.6 6.5 Otherpumpml mwes----------------lQ,l4W-lM,l46-l5o 8.( 8.5 6.6 8.$ 9.0 9.6 9.E Moe 11.2 12.: 10.1 9.$ 9.7 9.6 cw~im E=Momztions allaaieeaz.m of early imcY—------------------------------157.161

swti&a-------------_---_-------~~,~4~,1a7.2 7,1 6.3 6.7 6,$ 6.5 5.C 6.6 6.8 5.7 5.0 6.7

93.: 95.4 ea.5 96.E 92.1 94.0 91.9 92.3 79.! 64.7 es.9 77.7 77.5 77.6 5ticide------------------------------------_-------~~3-~7~ 16.: 16.0 15.8 16.6 16.7 14.2 13.4 1.2.2 11.4 10.2 12.5 11.c 11.5 18.1 Hmoide-----------------------------------------l72-l75 6.6 6.6 7,2 7.4 7.0 7.1 7.7 6.8 7.t 7.1 8.6 8.? 8.1 8.4€Automobile aocidents (pI’imry)-------------------------2lo 2.: 2.9 9.9 4.? 5.9 7.3 9.( 9.9 9.4 10.4 11.4 12.4 14.7 1.S.5€%ilmad .S@ antctmblle 0011isi0n8---------------------206 ti ~ w w S/ ti Y ti S/ $ 1.0€Street W? ma autwmbile colliniw ~ Q/ Q/ ~4 ~€Other eXterxlalwwzes 7_/------—----------176 -l98,2Ol-2l4 22.4 79.5 81.6 . 70.T

$/9 ~.: S/ %62.:

g.% P56.9

357.1 61.1 5$;€73.0

fU*- end ill-defined diseaeee------------------l99,2w 12.: 11.5 14.1 12.1 11.4 15.2 18.2 19.2 18.! 17.7 15.9 1.7. 17.0 17.5 = =

1925 1926 1927 1922 1929 1%0 1931 1932 192s 1924 19s5 19s6 1937 1938

Q?. wues------------------_ -------------------_ ----, lW.1 225.4 ,143.4 206.6 191.9 l,lSS.9 107.0 287.8 ,067.1 10’3.2,092,2 151.+ E 122.1 ,060.9

Tgphoia cuvipamtyphoia f~~-------------------------l,z 8.0 6.5 5.5 4.9 4.6 3.f 3.3 ~lP0X-------------------------------------------------6 wmlea--------------. ------------------------------_---7

0.7 2.3

0.4 8.2

0.1 4.1

0.1 6.4 2.5

0.1 3.2

0.1 3.0

4.7 1.6

El 2.z

w 5.5

{; ;.=1.C

{;: dg2.5

Saarlet timP 2.7 2.5 2.s 2.0 2.1 1.9 2.2 2.1 2.C 2.0 2.1 1.9 1.4 0.9 Whooping-oowh 9 8.7 8.9 6.9 5.5 6.s 4.8 3.9 4.5 a.: 5.9 3.7 5.1 3.9 3.7 Diphtherla------------------_-.---------_-------_----~o 7.8 7.6 7.8 7.2 6.6 4.9 4.e 4.5 3.$ 3.a 3.1 2.4 2.0 2.0

Influenzn andpneumonia (all fomu)------------ll,lC%lO9 129.4 1S.5 KK4.2 143.5 147.2 L02.7 K.7.7 1W7.7 95.t 96.7 104.0 119.s IJ.4.6 80.2 Influenzn---------------------—---------—-----il 29.7 40.8 22.6 45.9 S5.5 19.5 26.5 30.s 26.4 17.3 22.1 26.3 29.4 12.7 Bronohopwmonia ~-----------------------.--------lo? 22.7 44.0 33.8 99.8 37.6 24.s X3.6 32.6 29.6 3s.1 39.4 36.8 36.4 sn.4 L&N ~emnia 49.9 %4.o 43.2 62.4 49.5 4s.4 44.4 41.2 36.4 43.9 4s.2 62.8 46.6 34.2[ Fnemonia, unspaoified-----------------------------lO6 5.1 4.7 S.7 B.1 4.6 3.6 3.2 3.1 3.2 3.0 5.2 3.4 3.1 2.9

Emiplas--------------------------------------_------~5 2.5 2.1 1.9 1.6 1.6 1.5 1.7 1.6 1.0 0.68.4 8.0 2.4 Epidwlc aembrospirml mmin@ti.---------------------7-18 1.1 1.3 1.6 ::: 4.5 S.6 2.4 1.4 1.2 1.0 2.1 2.4 1.7 0.8

of thm renpim$orz ~ptc!r.-----------------2S 75.9 76.6 71.4 70.9 67.6 53.4 40.7 56.4 0s,6 51.1 49.8 00.6 49.0 44.6‘fuberoulo.sis Tutmraulosis (other rOms)--------------------------24-s2 10.8 10.7 9.5 9.0 8.4 8.1 7.4 6.4 5.9 5.5 5.2 5.0 4.6 4.4

ze 8.1 1.9 2.7 3.6 3.5 2.9 2.1 8.1 5.7 3.6 3.5 3.1 2.1 l.a ,!

Ommem ud other mliginrit twm----------.------~-~ 92.e 96.1 65.7 96.1 26.9 97.s 98.9 102.0 102.2 106.2 lcn.9 m.a U&o 114.6 Diabetes m911itIw--------------------------------------69 16.9 10.0 17.5 19.0 18.8 19.0 .?0.4 21.9 21.9 22.1 .82.2 23.7 23.7 29.8 Cembra.1 hmcmrhage--------------------------------92a,e S1.o 8S.8 60.4 83.4 28.1 81.0 79.0 79.s 75.e 77.3 76.6 al.z 77.0 76.2 Diseasm of the haart 2+--—------------------------90-95 1s6.9 199.5 196.0 202.2 Sloe 203.7 201.8 20&9 Z05.8 212.9 21s.1 2S7.9 222.3 216.9 BM*itin--------------------------------------------lO6 6.5 6.6 6.4 5.2 4.7 4.8 3.8 3.6 5.2 5.3 3.1 S.4 3.1 2.8

Mm’rhea an6 onteriti.?4---------—---------------119,1S0 59.4 rS.6 27.6 26.9 2s.5 .26.3 20.7 16.S 17.2 18.3 14.1 16.3 14.6 14.2 Amemlicitia -----------------------------------------la ls.e ls.o 15.0 la.s 1s..3 15.a 15.2 14.2 14.1 14.9 12.7 ls.s 11.9 IJ..o Bmnia, intestinal.obBtrwtion Q/----------------------l38 10.8 11.s 10.6 10.5 10.6 10.3 10.5 lo.n 10.0 10.5 10.3 10.5 10.1 9.7 oirrhosin of the limr-------------—-----------------l24 7.s 7.8 7.5 7.6 7.2 7.2 7.4 7.$? 7.4 7.7 7.9 8.8 8.5

2NqMti6-----------------------------------------l3O-lW 96.3 9a,B 92.6 26.* 91.2 90.e 67.1 8?.1 33.9 24.2 al.2 ‘ES. 79.6 7?: Pwrpeml sopTiodQ------------_ ------------~@,l*,~* 8.5 5.3 8.3 5.0 5.0 4.7 4.6 4.1 3.9 4.0 4.L &6 2.9 2.6 Other puerperal mwe~—-------—-----ll ~lab-lti,l~.l~ 9.3 9.1 0.5 .2. 8.8 8.1 7.4 6.9 6.4 6.2. 5.8 5.9 5.4 6.1 co-w DnJ.fomatic.m and Eimamms

of early inranOp---------—------------—------1.07-161 74.0 71.7 67.8 S6.e 62.4 61.0 56.4 5s.1 30.5 62.9 49.4 49.7 49.0 4s.5 Stioide-------------------------------------------l63-l7l 12.1 Lz.a X6.5 2.s.0 14.0 15.7 16.0 17,4 15.9 14.9 14.3 14.8 14.9 ls.2 ~oide---------------------------------_-----~7g-L73 8.6 8.0 0.8 8.8 8,s 9.0 9.s 9.8 9.6 9.5 s.a 0.0 7.6 6.8

Autowbile aeoiflmita[P-] -------------------.-21o 17.1 18.0 19.K 20.8 2S.3 24.5 85.1 21.9 23.3 86.8 26.8 27.8 22.8 33.5 Sailroad and automobile 0011181M—--—-------------2M 1.2 1.5 1.3 1.8 1.7 1.5 1.4 1.2 1.1 1.2 1.2 1.3 1.4 1.1 street mrma autcm.abileaO1llSiOM-------—-------2w 0.5 0.4 0.4 0.5 0.4 0.4 0.4 0.3 0.s 0.s 0.8 0.s 0.8 0.1 OthOr oxtcmml w&w~-—---------------176 -l9E,2Ol-2l4 59.7 62.9 57.0 04.s 66.0 64.2 51.6 42.0 47.7 s1.6 50.1 56.5 51.0 47.4 Unknown md ill-defined flisea8em---------—-------l99.2OO 17.4 17.8 17.6 20.6 54--.34 m.a 17.5 17.5 1s.5 16.1 16.4 16.9 ld.1

a

~Exolunivo of stillbirths. g Inoluains 0c4pillarytlmnohitim yEx01u6m.2diseaw3. of 00ronaryarteri.s. ~Inoln6tivlcerof the @Ic.ienunfran1911to1920. EJExOl@m.gadh..i0M Orinte.tines m1911t01920. ~Not a.pzmtoly tatmlated. ~Exulunim ora.oiamt. a..ooiatea mtia.t~bil*n (206,202,210). 4J/Less than one-tenth or 1 per 100,003 pop.il.atim.

.

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---------

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--------

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A

I.NTROI)UCTION 13 For certain diseases characteristic of older ages, the ‘rABIa AE.-mFAm ?do~ BIRTE-lWGEWtlION ABJIA,UNITED STATES

most notable increase 1s in+the rate for cancers smd other malignant tumors. The crude death rate for cancer, ‘forthe DE4zas UNmR

registration area in 1911, was 74.4 per 100,000 estimated Pop- lY8Aa~

ulation. This rate has gradually increased to 114.6 In 1938. mm I.1’Ta . ateper I&e Even this change in rate does not fully indicate the large in- births

Number 11=1 birtti Rate per l,OCO

crease in deaths reported from cancer. The addition to the il- Number 1,000live

registration area of States with younger populations has tend- r births birtlm

ed to minimize the increase that would be observed in a geo­

graphically constant area. For example, while the cancer 193e---- 2,286,962 116,702 51.0 1926--- 1,256,068 136,11S 73.3 1937---- 2,203,337 119,931 54.4 192e- l,s?e,eao 124,652 71.7

death rate for the growing registration area increased from 1936--- 2,144,790 122,535 57.1 1924-- 1,930,614 136,730 70.s

74.4 in 1931 to 114.6 in 1938, the rate ror the registra- 1935- 2,155,105 130,1S8 55.V 1923-- r,792,646 128,259 V7.1 1934---- 2,167,636 130 ,1s5 60.3. 1922-- 1,774,911 135,.228 ?6.2

tion States or 19C0 increased rrom 83.9 to 143.0 in the ssnie 1933-- 2,081,232 120,es7 5e.1 1921---- 1,714,261 129,55S 75.6

interval. 1932--- 2,074,042 1.19,431 57.6 192a--- l,502,e74 129,531 25.s€.1931--- 2,112,760 130,124 61.6 1919- 1,373,43s 119,300 e6.6€

A large increase in ~te is also noticeable ror diseases 1930--- 2,203,958 142,413 64.6 191s--- 1,363,669 137,64V 100.9€

or the heart. The re.teof 157.1 in.1911 increased to 216.9 in 1929- 2,169,920 146,661 6’Y.6 1917--- 1,353,792 T93.8 192e--- 2,233,149 153,492 62.7 1916— eza,923

1938. Here again the full signiricence of this increase is 19z7--- 2,13V,E36 1.2S,01’Y 64.6 1915-- 776,304

not evident when only data ror the chamging registration area II K 126.950

are considered. The rate reductions ror Infectious and preventable dis­

eases cem be largely attributed to the development or modern public-health. practice. The increases rrom such causes as cancer end heart diseases are doubtless due to several reasons. The decrease in deaths from diseases or infancy end childhood, along with the decllne in the birth rate, is producing in the United States a population with a higher proportion or per-

sons in the older-age groups. Thie fact in itselr tends to ‘increasethe total death rates ror diseases associated prima­

rily with advanced age. Also, there is’ little doubt but that improved diagnostic facilities end increasing hospitalization

have increased the number or deaths charged to cancer, es well as to certain other types of disease. An accurate determina­tion or the ohange in mortelity ror these causes requires a

careful study in which the age composition of the population

and other pertinent factors are considered. As shown in table ~, diseases of the heart led all other

causes of death in 1938 with a rate of 216.9 ror the United States. Cancers end other malignant tumors ranked second with a death rate or 114.6. Inrluense and pneumonia, and tubercu­

losis (all forms), which ranked first end second, respective­ly, as causes of death in 1900, were third and sixth, respec­

tively, in 1938.

INFANT MORTALITY STATISTICS

Detailed tables for infant mortality are given in the sec­tion containing general infant-mortality tables. Rates ror individual States ,ror a eeries of yeare are given in rate table x; and the number of infant deaths md death ~tes for each city and county are included in table XIII.

T2END OF EJFANI MclWWrP.-In 1938 there were 116,702 infant deaths registered in the United states. This is the smallest

number of Infmt deaths reported since the birth-registration

area was completed in 1933. This reduced number of deaths, taken with an increased number of births in 1938, reeults in an infant death rate or 51.0 (number or deaths under 1 year of age per 1,000 live births) which is the lowest infant death

rate ever recorded for the registration area. Rates for each

year, together with the number of infant deaths and the number

of live births, are given in table AE. These data are Pre­sented ror the birth-registration area, inasmuch as the infant mortality rate is computed on the number or live births. The number or infant deaths for the death-registration area can be found in general mortality tablee in which the data are clas­

sified by age. The infant mortality rate was 99..9 In 1915, end twice

thereafter (in 1916 and 1918) the rate exceeded 100.0. Since 1918 there has been a steady and a rapid decrease in infant mortality. The rate or 51.0 ror 1938 is only 51.1 percent of

the rate ror 1915. The reduction in infant mortality has occurred in both the

?!white?~~d !tNegr@mces ae shovm in table AF. Although the

fite ror Negroes is considerably higher then that for the !!White,!!the proportionate reduction over the last 19 Ye.WS

has been approximately the same ror both grows. The data in table AF rOr ‘*otherracss’~is based on relatively few deaths

end the rate is therefore quite variable. :~ym(w,+-4

~ Exclusive of stillbirth.:

TABIZ AF.-INFANT MORTALITYRAZES (DEATHS1/ UNDES 1 YEAS PIM 1.000 LIVE BIRTES 3Y RACE: B=-REGIS=tiN AXS.&, UNITED STA’E&

OtherSh4t0 Othm

Total mite racesramsT

1 1928——— 51.0 47.1 77.9 102.4 1926----- 73.s Vo.o 113.1 10s.9 1937--- 54.4 50.3 22.0 1925--—-- 71.7 62.3 112.o 95.6 1936--- 57.1 52.9 e6.1 1924---- vo.e 66.e 114.1 95.0 1.935--- 55.7 51.9 81.9 192.s---- 77.1 73.5 119.9 S&s 1934----- 60.1 54.5 91,0 1922------ 76.2 73.2 11.1.7 89.9 1933---- 58.1 52.s 26.4 1921-—- 75.6 72.5 I.lo.v ve.a 1932----- 57.6 53,3 84.1 19m---- S5.8 62.1 135.6 e9.6 1931—- 61.6 56.7 %?..7 117.8 1919-— 86.6 F3.o 134.3 28.2 1930---- 44.6 59.6 99.5 141.1 191 120.9 97.4 162.5 126.4 1929-—- 67.6 43.2 101.5 119.5 19Y7-— 93.s 90.6 14S.6 142.5 192a—— 62.7 64.0 LOS.9 m.e 1916-—-- 101.0 99.0 L24.3 234.s 1927-—--- 64.6 60.6 i 99.9 103.4 1915-— 99.9II90.6 1.SO.6 196.2

~ Sxcluslva of stillbltihm

lNFANr?alRIMLTTXBY STAT2.-A comparison or the infant death rates or the various States is given in table AG. The lowest rate, 36.3, was reported for Connecticut; and the highest

rate, 108.7, for New Mexico. With a few exceptions the rate is highest in the southern and southwestern parts or the coun­try. The comparability or Infant death rates between States is affected by incomplete birth and death registration in some States. However,the indicated dirrerences in infant mortality are much too large to be explained by this ractor.

T&33 AG.-INEWT MORTAYZIYNfl%S:UN17XD STA13SAND EACS ST-, 19=

] Math& under 1

Arc4. I‘nor AmA year pm.1,030117s

[m’a-------------------- 40.5 South Dakota---------------- 43.e [Mm.+-— 43.0 ~emeamo~------------------ 63.5 t6ntu0kY——————— 61.3 Faxes 55.1

ml riula——— .— 67.1 Utah 46.8 aln*-—----———--- 56.2 hmont-----------—---- 42.4&x’ylwl--—.——------ 55.7 Virginia------—--— 66.2 &msa&u80ttm---——- 39.9 Raabington—--------—---- 28.7 tichigm---— 44.6 went mrgintc.— 63.S ~e@ot*.-.-——---—------- S8.8 ria.3msin--—--— 41.8

51.s

f birtlm

Unit ●d .Stat@#--—------ 51.0 Mi.mouri— 51.5 Mmtum--—-— 45.5

-+

Alab-----—-— 60.e Mebraska--—-----—----m.Ta&. .....--. .-..__

36.4 47.7

iu’izOna-- 9s.e New iiUWbti*-—--— 4V.6 &kan6as---—--———— calf Ornia-- —.

5k.4 42.7

Now Jermy---— New Mod cn---—-———

39.6 10s.7

Celorado---———---- 60..2 Hew YO*----—-——--- 40.6 COnnOaticut---— 26.3 North Carollna—---------- 68.6 D81ma1’a--—— 52.e Horth Dakota—----.---—---- 49.8

Diatriot of Calumbia—---- 4s.1 Ohio------------------- 42.3 Florida-—-—--— 57.s Oklahma----------—---- 49.0 Ceorgim-----— 67.IY Oregon-----------— 39.2 rdahO----—— ~~oi*——--—

44.6 40.9

?mzuJylwuliu-—---------F&ode Island---—

45.9 42.e

tmUalm—— 42.5 ~u~h ~lm--—-.-----—— 80.3

6iasis0iDPi-------—--——456.7 Rydng 1lf Sxoluaim of stillblrthn.

INFAWI!DEtirSBATES BY A82.-Death rates for infants at vari­ous ages during the rlrst year or lire are given In tabls AH. Theee data are given for the birth-registration area ror each year beginning with 1925. The most notable feature or this

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14 VITAL STATISTICS OF THE UNITED STATES table 1s that, although reductions in rate have been made for INFANTM3EJ!ALITPBY i231WH.-TableAJ shows the lnfent death almost every age group, llttle reduction has been made in the rates of the United States, by month, t’oreach year from 1934 rate for deaths under 1 daY. Since 1932, ths rate for deaths to 1938. The I’ate fOr each month has declined during this under 1 day has been approximately 15.0 per 1,000 llve births period. The decline from 1937 to 1938 was much greaterfOr Jen­until 1938, when it declined to 14.1. While this rate has de- u=’Y, February, and March than for the other months. The indi­creased very 1ittle, the total infant death rate has decreased cated decrease of the rate for the winter months seems to have mom 71.7 in 1925 to 51.0 In 1938, end the rate for Infant been due partly to fewer deaths from Influenza and pneumonia. deaths over 1 month has decreased IYoro33.8 to 21.4 in the

TABLE AJ. —EiFANT MORTALITYRATES (DEATSS~ UNDER 1 ~AR Pm 1-000 efoneperiod. LIVE BIRTHS ) BY MONTH: UNITED STAYES

—,

TAB13 AH.-INFANT MORTALITYRATES (DEATHS~ UNDER 1 YEAR PER 1,000 Moms 1938 1937 ,93, I L935 1934LIVE BIRTRB ) BY AGE: BIRTH-REGISTRATION AREA, uNITED STAT’Et3 1

Total---— 61.0 54.4 60.1

Umler 1 month--------------------------1 month----------------------------—----

29.6 3.9

31.3 4.3

32.6 4.4

32.4 4.4

34.1 4.s

24.0 4.5

33.5 4.7

No-r—---------— 50.8 Deoemter--------- —-----------“r 55.6

52.0 55.3

59.2 68.6

53.9 52.7

59.3 63.S

2 months-------------------------------- 3.2 3.5 3.6 3.5 3.e 3.5 3.6 3 to 5 months—-------------------------6 to S months----------—-—

6.7 4.4

7.2 4.8

7.7 5.1

7.1 4.e

7.s 5.4

7.2 5.0

7.2 4.9

~ Ex01usiv9 Of ,tillbirthe.

9 to 11 rannthz 3.2 3.4 3.6 3.5 4.2 3.9 3.8

AcE 1938 1937 19s6 1935 1934 1933 1932 =4====b

J.9r91ary---—----------——————— 54.3 69.1 60.8 I 66.7 60.6 Undm 1 year--------------------- 51.0 54.% 57.1 55.7 60.1 5e.1 57.6

EObruar$-------— 53.2 63.4 62.0 66.0 66.5=4==/= ink----------------------------- 51.9 57.1 56.7 62.3 67.?l=== Under 1 6w-------------— 14.1 14.7 15.1 15.o 15.4 15.1 14.9

April-—--—--------— 52.0 52.9 69.4 se.6 64.9 —------------------— 53.7 61.6 55.5 57.3 fio.e

1 dq------d----— 3.6 9.7 3.9 3.7 3.9 3.e 3.s Jam-—----------------------- 52.0 54.3 52.e 53.4 60.2

2 d~s-----—-----------—-------— 2.3 2.3 2.5 2.4 2.6 2.7 2.6 3 to 6 OamJ-------------—— -------- 3.7 4.0 4.3 4.4 4.6 4.7 4.7€1 walk-— 2.6 2.9 3.0 3.1 3.4 3.5 3.4 July--------------------------- 47.9 52.2 62.7 49.2 58.9€

2 wmeka-----— l.e 1.9 2.0 2.0 2.3 2.2 2.2 August 47.1 47.8 4S.6 47.7 52.2

46.1 47.0 51.7 46.3 51.6 3 weaks---------------------------- 1.5 1.7 1.2 l.e 1.9 1.9 1.s *ptimr_------------------——

Oatob%r—--------— 42.0 51.1 59.4 51.0 67.0

1 ~iilWDEKITI BATES BY CAUSEOF I B?E.—T leAK Isa lbtia-

1931 1920 1929 192S 1927 1926 192-5 tlon of infant death rates for selected cauees. Rates are T given for the United States for the years 1934 to 1938. Out-.

Under 1 year--------— 61.6� 64.6 67.6 4==6+3.7 64.6 73.3 / 71.7 standing causes of infant deaths are premature birth, pneu­+ monia, diarrhea and enterltis, congenital malformatlone, and

Under 1 day---— 15.0 15.0 15.3 15.3 ld.1 15.2 16.0 injury at birth.

1 say------------------------_-—---- b.cl 4.2 4.4 4.4 4.1 4.2 4.2

3 to 6 dew--------------— 1 ok----------------------------

4.7

3.6

5.1 3.9

5.3 3.9

6.4 4.1

6.3 3.9

6.? 5.s 4.3 4.4

LIVE BIRTS8) FOR SELEC~ CAUBE9: UNITED STATES — —

2 R29ks-------—-------------------- 2.4 2.6 2.6 2.6 2.6 3.0 2.9 I 3 wmeka-----------------------------

k 2.0 2.1 2.3 2.3 2.2 .2.4 2.3 2ADSE OF D3ATH 193E L937 .9s L935

Ur&.r 1 month---—---—--— 34.6 35.7 36.9 37.2 26.1 37.9 37.8

2 days------------------------------ 2.7 2.9 3.0 3.1 9.0 3.2 3.2 TABLE AK.-INPANT MORTALITYSATES (DEATHSU ~ 1 ~ ~R 1>ooo

1 month----— 15.0 5.3 5.6 5.5 6.1 6.0 5.e All causes--—----------------------—--------- 51.C 54.4 }7.1 55.7 ;0.1

3 months---------— 4.0 4.3 4.3 4.4 4.0 4.7 4.6 — . — 3 to 6 months---------— e.o e.s 9.2 9.3 S.6 1.O.4 10.3 += 6 to S months--------------------------- 6.7 6.2 6.5 6.9 6.1 7.9 7.4 Measlea-----------------------------------------4 0.3 0.4

9 to 11 InOnthe---——--— 4.3 4.6 5.1 5.4 4.7 S.xu-letfever—-------—---—------------—---------2 u Y Y 0.1 Y w~p~+~h 9 1.4 1.4 0.s 1.4 2.1 Diphthetia---------------------------------------lO 0.1 0.1 0.1 0.1 0.2

~ 3xelua1v!3Of stillbirths. mlue------ll-------_ ------------------------n 0.9 1.7 1.6 1.5 1.2 Dysentex3----------------------------------------- 0.5 0.5 0.5 0.4 0.4 E~Sipela@----------------------------------------- 0.1

Infant death mrtes at various ages during the flret year Z3uenbalitia (letharizic.eDldemlO]‘----------------17 v Y Y ~ Y

of 1lfe, by race, are shown in table AI for 1938. The differ- M6ni”wit1.s[eDideuic-ca~L& pinal1------------—--18 0.1 0.1 0.1 0.1 -. .—-.-------------------------------------------22 0.1 0.1 0.1 0.1 0.1

ence between ‘White’tand ‘T!egro’tInfant mortalIty 1s propor- lhbereulosis of renpimtory cIyntem-----------------23 0.1 0.1 0.1 0.1 0.1

tionately greater during later Inrancy than during the first� lhberculoais of nmninges, oentral nervous B@ am---.% 0.1 0.1 0.1 0.1 0.1

‘lhber.uloei.[other forms)----------—--------—35*2 0:1 0.1 0.1 0.1 0.1 days or life. The rate ror the ‘%hlte” under 1 day is 13.9, 3muliB------_----- _-------_---_--------_-_----—4 0.6 0.7 0.7 0.7

0.1 0.1 Yor 86.9 percent of the rate of 16.0 for Negroee, while the Furulent infection, sept1.emia-------------------46 0.1 ~0.1 0.1 0.2 0.2mhrti-----------------------------------.-------3s 0.1

rate ror the “white” under 1 year 1s 47.1, only 60.5 percent other tifectiou. ad parasitio —--l-6 ,12,14,16,19-21,33,35,37,3944 0.1 0.1 0.1 0.2 0.2disc@..ms-----­as high ae the rate of 77.9 for Negroes. Bioket*--_------------_--------__--__------------_~3 0.1 0.1 0.1 0.1 0.1

Di.eases of thy!mm glend-------------------------47 0.5 0.5 0.5 0.5 0.6 ,xmdltior,.-----------------------------70 0.1 0.1 0.1 0.2 0.3TABLWAI.—INYANT MORTALITYRATE9 (D- U UNDER 1 YEAR PER 1,000 Hmrorl.hgai.s

LIVE BIR1’ht3) .——. 0.1 0.1 0.1 0.1BY AGE AND RACE: UNITED sTA~, 19= En,2qlhalitl,(nnnepidemi.)------------------------7s W Y ?/ I v Menlngitis (Dtmple, nonepidomlo omrebrospinnl)----79 0.2 0.3 0.3 0.3 0.2 Cerebral hmrarrhwe, embolism, thromboalo---------42 0.1 0.1 0.1 0.1 D.1

AG3 Total WhitO conti.iom_------- —__. ----------------------—-m 0.2 0.2 0.3 0.3 0.3i of ear, miwtoid Bx.ao.c..s------------------~9 0.2 0.3 0.3 0.3 0.3D1se.ac.en

Other dioeas.a of nermus nyatem, organa of

spmd mm--------------------m ,81,e3a5, S7,28 0.1 0.1 0.1 0.1 0.1 D1.eane# of olrcuhtory nyBte!n----------------’3C-l03 0.2 0.2 0.3 0.3 0.2-------------------------------i=+=‘tier =+= PmwmOnia (all fonnsl-—;---------------------107-109 7.0 7.5 8.3 7.7 e.3

Under 1 day-----------------------------—-

I14.1 13.9 16.0 12.6 other dineaoea of rewirntory ayatmn--lO4-lO6,110-114 0.6 0.6 0.7 0.6 0.6

3.6 3.5 4.6 3.0 Disensc.aof bucoel oavity and aQWXG3,

J.Ow-----------------------——-----------——— 2.3 2.2 3.2 3.2 phal’wx and tonmllB-------------_--— 0.1 0.1 0.1 0.1 0.1

2 days------------ —--— ——€3 to 6 days---------------------—-------------- 3.7 3.4 5.6 6.6

Di.seaaesof ntamaah---------------------------ll7,118 0.2 0.2 0.2 0.2 0.3€Diarrhea ad entarltis----------------------------ll9 5.0 5.3 5.7 4.9 6.1

1 WV3k---— 2.6 2.3 4.6 5.6 z -w---—---------— 1.8 1.8 z.e 2.6

mmia-------------------------------------------l2= 0.1 0.1 0.1 0.1 y4Intestinal ob8tnuatlon---------------------------l22b 0.4 0.4 0.5 0.4 .

3 Wxlkz—--------------—---------------———— 1.5 1.4 2.4 2.1 Fnritonit1s (cause not w30 ifled)----------—-----129 0.1 0.1 0.1 0.1 0.1

Under 1 mamth-------------—-— --------------------- 29.6 28.3 39.2 3.%8 Other disc.aea of digestive ey6t----ll6 ,121,1.?3-12S 0.1 0.1 0.1 0.1 0.1

1 mnth 3.9 3.5 6.s 9.s DiHeases of w.nitwr inary nyatem------l% ,131,132-129 0.2 0.2 0.2 0.2 0.2

2 Kmtha------------------------------—------------ 3.2 2.9 5.4 7.7 Diaea.e8 of tin, o.llular t.imue -------------151-133 0.1 0.1 0.1 0.1 0.2

3 mOmtb 2.6 &3 4.6 e.6 Congenital nnlrOnw.tiOns------------------------B7 4.6 4.6 4.9 4.2 5.2

4 nwnths-------------------------------------------- Z.2 1.9 4.0 6.9 Congcmltal debility-----------------------------—l6S 1.4 1,6 1.s 1.7 1.9

$ momtha---------------------------------------------- l.e 1.6 3.5 5.2 prmwi~ birth----------------------------------159 14.3 L5.3 5.7 .5.4 6.2

6 mnth—---— ~.~ 1.4 3.5 5.6 IJIjWY at btith--------------_----------------—_~6o 4.4 4.4 4.5 4.5 4.5

7 mOntbs------------------------------------------- 1.4 1.2 2.7 4.7 Other diseases of early infEznOY-------------------l6l 2.3 .2.2 2.2 Z.z 2.4

s 9 months——---—-------------------------------——— 10 montba-------—

1.2 1.0

1.0 0.9

2.2 I.e

4.5 6.1

UmkMUII and ill-deflnnd diseaaes—--------—--l99 ,220 2.8 3.0 All other aauaee ~-----—-------------------------—- 0.2 0.3

3.3 0.3

3.4 0.3

3.5 0.3

U mantle-—-----------------------—------------ 1.0 0.9 1.8 4.1 — —

I ~ Sxclusiv. of stillbirth,. ~ uss than one-tenth of 1 per l,COO llva birtlw.

~ EXOIUSITU of stillbirths. SJ Refer t..ocanpleteInternational Li8t title., table XI.

Imnltha------—-----—----------------------—---- 1.3 1.2 2.4 4.3 Rkel’nal .3aun0a------—-----——------l72-l95 ,201-214 1.0 1.1 1.2 1.0 1.0