(series b - census.gov... 1926... 1926 ... for 1941-1946,the birth and di vorce rates arebased ......

Chapter B

Year

(Series B

UnitedStates,

midyearpopulation

B 1-220. General note.Vital statistics, including statistics of births, deaths, marriages,

and divorces, are compiled for the country as a whole by the NationalCenter for Health Statistics, successor in recent years to the formerNational Office of Vital Statistics. Beginning 1900, the collection of these data was responsibility of the Bureau of the Census. InJuly 1946, this function was transferred to the Federal SecurityAgency, which, in 1953, was reconstituted as the Department ofHealth, Education, and Welfare. The National Center for HealthStatistics is a part of the Public Health Service in that Department.

The live-birth, death, and fetal-death statistics prepared by theNational Center for Health Statistics are based on copies ofrecords received from registration offices of all States, of certain cities,

District of Columbia. Marriage and divorce statisticsare based on information from two sources: (1) Complete counts ofevents obtained from all States and the District of Columbia and (2)samples of marriage and divorce certificates obtained from Statesmeeting certain reporting criteria. In the statistical tabulations, United Stales refers only to the aggregate of the 50 States and theDistrict of Columbia. Alaska has been included in the United Statestotals since and Hawaii since 1960.

The annual report, Vital Statistics of the United Stales, presentsfinal figures and an annual life table. A series of national summariesVital Statistics-Special Reports containing data on particular subjects was issued each year from 1934 to 1959. This series was supersededby Vital and Health Statistics, Series 20, 21, and 22.

Although every State has adopted a law requiring the registrationof births, deaths, and fetal deaths, these laws are not uniformly ob-served. One condition for admission to the national registration areas was a demonstration of registration completeness of a t least 90percent. On the basis of this criterion, all of the States were ad-mitted t o both the birth- and death-registration areas by 1933. It isrecognized, however, that the methods then used in testing complete-ness were subject to considerable error.

The annual collection of mortality statistics for the nationalregistration area began in 1900 with 10 registration States and the District of Columbia; the collection of birth statistics for the nationalbirth-registration area began in 1915, with 10 States and theDistrict of Columbia. The changing composition of the two regis-tration areas makes it impossible to obtain geographically comparablebirth and death data for the entire United States before 1933. Al-though the national birth-registration area was not started until1915, annual estimates of births have been prepared for the period1909-34. These estimates include adjustments for underregistrationand for States not in the birth-registration area before 1933. Begin-ning 1933, the birth- and death-registration areas have comprised theentire United States, including Alaska beginning 1959 and Hawaiibeginning 1960. National statistics on fetal deaths were compiled for 1918 and since 1922.

Prior to 1951, birth statistics were the result of a complete countof the records received in the Public Health Service. Since 1951,they have been based on a 50-percent sample of all registered births(except for 1955 when they reverted to a complete count and for 1967when they were based on a 20-50 percent sample).

Mortality statistics are compiled in accordance with World Organization regulations, which specify that member nations classifycauses of death according t o the International Statistical Classification

44

1929...

1926...

1926...1924...19231922...

1918...1917...1916...1915...1913...

1910...1909...1908...1901906

1905...1904...1903...1901...1900...

Growth of Birth- and Death-Registration Area: 1900 to 1933

077121 ‘770

119117,399

115,832114,113111,950110,055108,541

106,466104,512103 203103’266

100 649

97,227

92,40790,49288,70987,00085,487

85,82082 16580’632

77,58576,094

95

Center-

1,000

1933... 125,679124.840

1931... 124,040

Birth-registrationarea

Midyear population

of Columbiapopulation figures.

excluded from count of

Midyear populationNumber

Number

125 579118 ‘904

117,238115 317113’636107’085

102 032

96 ‘7889287,814

86 079

79’00870’235

61 895

58 15754’848

47,47044 224

33,782

21

20 943

19,965

99’318

343553

20 583

of total

10095.295.3

95.394.794.590.088.4

88.187.086.584.280.9

80.979.676.668.065.7

61.661.559.8

57.5

51.448.9

39.739.5

26.0

26.026.026.126.2

4847

46444241

403938

34

34

302726

2424232222

2018171515

101010101010

47

number of States but included in the

-.of Diseases, Injuries, and Causes of Death. The current (1973) classi-fication, “Eighth Revision International Classification of Diseases,Adapted for Use in the United States,” has been used since

Accurate measures of birth-registration completeness on a nation-wide basis were obtained for the first time in 1940, when studies weremade in connection with the population census of that year. Theyshowed that, for the United States as a whole, birth registration was92.5 percent complete. A corresponding study 10 years later indi-cated that registration had improved considerably, with 97.9 percentof the births in 1950 being recorded. Only in a few States was under-registration shown to be still a problem. The results of this s t u d yhave been published in considerable detail (Bureau of the Census, Infarct Enumeration Study, 1950) and provide a basis for adjustingregistered birth data for underreporting and for making estimatesof registration completeness in post-censal years. Birth registrationhas continued to improve since 1930 and, in 1968, 99.1 percent ofthe live births were registered. (See National Office of Vital Statistics,“Birth-Registration Completeness in the United States andGeographic Areas, 1950,” parts I, 11, and Vital Statistics-Special Reports, vol. 39, Nos. 2 and 4, and vol. 45, No. 9.)

VITAL STATISTICS 1-35

Death registration is believed t o be at least as complete as birthregistration. However, quantitative information on the completenesswith which deaths are reported is limited t o that obtained years agoin applying the “90-percent” standard for entry into the tration area and to information obtained from occasional local areastudies. While underregistration for the country as a whole isnegligible, local studies furnish evidence that in certain isolated placesunderreporting of deaths may still be a problem. Registration offetal deaths is probably significantly incomplete in all areas.

National collections of statistics on marriages and divorces in theUnited States were made for various years from 1867 to 1940 and foreach year since 1944. Estimates have been made for interveningyears and for years in which collections were not complete. Amarriage-registration area was established by the Public HealthService in 1957, and a divorce-registration area in 1958. At the beginning of 1971, the marriage-registration area covered 40 Statesand 3 independent registration areas; the divorce-registration area,29 States and 1 independent area.

Population statistics published or made available by the Bureauof the Census have been used in computing the vital rates shown here. Rates for 1940, 1950, 1960, and 1970 are based on the populationenumerated in the censuses of those years which were taken as ofApril 1. Rates for all other years are based on midyear (July 1)estimates of population made by the Bureau of the Census.

Except for 1941-1946, vital rates are based on the populationresiding in conterminous United States. In those years, the transfer overseas of several million men precluded the computation of birthand divorce rates strictly comparable with such rates for prewar years.For 1941-1946,the birth and divorce rates are based on the populationincluding the Armed Forces overseas. (For a discussion of the inter-pretation of rates during wartime, see “Summary of Natality andMortality Statistics, United States, 1943,” Vital Statistics-SpecialReports, vol. 21, No. 1, and “Marriage and Divorce in the UnitedStates, 1937 t o 1545,” Vita l Statistics-Special Reports, vol. 23, No. 9.)

Vital statistics showing color and race are compiled from entrieswhich appear on certificates filed with vital registration offices. Theclassification “white” includes persons reported as Mexican, Cuban,and Puerto Rican. The Negro group includes persons of mixedNegro and other ancestry. For births, the newborn child is ordinarilyassigned t o the race of the parents. If parents are of different races,the following applies: (1)When only one parent is white, the childis assigned the other parent’s race; (2) when neither is white, thechild is assigned the father’s race. For additional details, see source.

B 1. Live births, 1909-1970.

Source: U S . Public Health Service, 1909-1968, Statistics ofthe United States, 1968, vol. I , p. 1-4; 1969-1970, same report, annualissues.

See general note for series B 1-220.

B 2. Deaths, 1933-1970.

Source: U.S. Public Health Service, 1933-1567, Vital Statisticsthe United States, 1967, vol. part A, 1-2; 1968-1970,same report,annual issues.


B 3-4. Marriages and divorces, 1920-1970.

Source: U.S. Public Health Service, 1920-1965, Vital Statisticsthe United States, 1965, vol. pp. 1-5 and 2-5; 1966-1970, samereport, annual issues.


B 5-10. Birth and for women 15-44 years old, by race,

Source: Series B 1820-1900, Henry D. Sheldon, T h e OlderPopulation United States, John and Sons, New York, 1958,p. 145 (copyright). Series B 6 and B 9, 1800-1900, Warren S.Thompson and P. K. Whelpton, Population Trends in the UnitedStates, McGraw-Hill, New York, 1933, 263 (copyright). SeriesB 5-10, 1909-1968, U.S.Public Health Service, Vital Statistics ofUnited States, 1968, vol. I. 1-4; 1969-1970, same report, annual issues.

Estimates for 1909-1934 were prepared by Pascal K. Whelpton.For 1915-1932, the figures include adjustments for States not in theregistration area; for years prior to 1915, figures are estimates basedon the number of registered births in the 10 original registrationStates for the same period.

1800-1970.

See also general note for series 1-220.

B 11-19. Fertility rate and birth rate, by age of mother, by race,

Source: U.S.Public Health Service, 1940-1968, Vital Statistics ofthe United States, 1968, vol. I, 1-7; 1969, Monthly Vi ta l StatisticsReport, 1969, vol. 22, No. 7, 5; 1970, Vital Statistics of the UnitedStates, 1970, I.

Series B 11-19 is an age-adjusted rate because it is based on theassumption that there are the same number of women in each agegroup. The rate of 2,480 in 1970, for example, means that if a hypo-thetical group of 1,000 women were to have the same birth rate i neach age group observed in the actual childbearing population in1970, the women would have a total of 2,480 children by the time theyreached the end of the reproductive period (taken here as ageassuming that all of the women survive to that age.

1940-1970.

See also general note for series B 1-220.

B 20-27. Birth rate, by race, by live-birth order, 1940-1970.

Source: Public Health Service, 1940-1968, see source note for series B 11-19, p. 1-9; 1969, see same source note, p. 6-7; 1970, seesame source note.

B 28-35. Illegitimate live births and birth rates, by age and race of

Source: U.S.Public Health Service, Vital Statistics of the UnitedStates, 1970, I.

These are estimated data based on certificates of live birth filedfor each child born in the United States. During the 1930’s almostall States had a query concerning legitimacy or illegitimacy on theircertificates. During the concern for confidentiality prompteda number of States t o remove it. These data are based on reports of34 States and the District of Columbia for 1940-1965 and on reportsof 40 States and the District of Columbia for

In making estimates of the number of illegitimate births occurringin the country as a whole, the States were grouped into nine geo-graphic divisions. The combined ratio of illegitimate births per 1,000total live births for all reporting States in a single geographic division was then applied to all live births t o residents of that division. Thisestimating procedure was separately applied for white persons andfor Negro and other persons. The sum of these estimates for thenine geographic divisions represents the estimate for the United States. No adjustments were made for misstatements of legitimacystatus on the birth record or for failure to register illegitimate birthsbecause the extent of such reporting problems is unknown. A birthwith legitimacy status not recorded was considered t o be legitimate.

The rates shown for the years 1951-65 differ from those published in earlier issues of Vital Statistics of the United States. The ratesshown here are based on a smoothed series of population estimatesfor unmarried women by race age which were not available when

45

mother, 1940-1970.

B 36-98 VITAL STATISTICS AKD HEALTH MEDICAL CARE

the rates previously published were computed. For details concern-ing these estimates and other data for illegitimate births, see U.S. Public Health Service, National Center for Health Statistics, “Trendsin Illegitimacy, United States, Vital and Health Sta-tistics, PHS Pub. No. 1000-Series 21-No. 15, February 1968.

B 36-41. Gross and net reproduction rates, by race, 1905-10 to 1970.

Source: Bureau of the Census, 1905-10 to 1935-40, SixteenthCensus Reports, Fertility, and 1910-StandardizedFertility Rates and Reproduction Rates; U.S.Public Health Service,1935, Vital Statistics of the United States, 1950, vol. I, p. 87;1956, Vital Statistics of the United States, 1956,vol. I,p. lxxix; 1957-70,same report, annual issues.

The gross reproduction rate represents the number of daughters ahypothetical cohort of 1,000 women entering the child-bearing periodwould have during their lives, if they were subject to the age-specificbirth rates observed in a given time period, and if none of the cohortwere to die before the child-bearing period was completed. specific birth rate is the ratio of births by age of mother t o women ineach age interval for a specified year. The gross reproduction rateis the sum of the age-specific birth rates of female infants per 1,000women. I t shows the maximum possible replacement of women thatmight be expected from the given set of age-specific birth rates. Ifno migration took place and if the gross rate remained below 1,000,no improvement in mortality alone could prevent the populationfrom declining when a stable age distribution had been reached.

The net reproduction rate is based on the specific fertility andmortality conditions existing in a given time period. If thespecific birth and death rates of a certain year (or years) were t ocontinue until the population became stable, a net reproduction rateof 1,000 would mean that a cohort of 1,000 newly born girls wouldbear just enough daughters t o replace themselves.

Reproduction rates are useful in the analyses of fertility and mor-tality conditions of a given period, but they are not indicators offuture population growth. They do not take into account suchfactors as marital duration, and size of family, and they assume the continuation of the age-specific rates in a given yearthroughout the lifetime of a cohort of women. Since the UnitedStates has experienced major changes in marriage and fertility ratesover short periods of time, variations in reproduction rates should notbe taken as indications of long-run movements in family formationand rates of fertility and mortality.

B 42-48. Percent distribution of ever-married women (survivors ofbirth cohorts of 1835-39 to by race and by number ofchildren ever born, as reported in censuses of 1910, 1940, 1950, 1960, and 1970.

Source: all races, Conrad and Irene Taeuber, TheChanging Population of the United States, 1790-1955, John Wiley andSons, New York, 1957, pp. 255-256 (copyright). By race, U.S.Bureau of the Census, 1910 and 1940, Sixteenth Census Reports,Population, Differential Fertility, and part 2; 1950, U S .Census of Population: 1950, Special Reports, P-E, No. 5C , Fertility.1960 and 1970, Census of Population: 1960 and 1970,Women by Number of Children Ever Born.

These data are based on an analysis of the decennial censuses. I neach of these censuses women who had ever married were asked aboutthe number of children they had ever borne. When these womenare classified according t o age, it is possible to suggest the trend infertility among women who had completed their childbearing ateach census.

Caution should be used in comparing the data from the 1910 census with those from later censuses. The 1910 census may have inad-vertently obtained some stillbirths in the counts of children everborn, resulting in overstatements of fertility. Comparisons of the

46

average number of children ever born to women age 40-44 in 1910with the average for those surviving to age 70-74 in 1940 show aboutten percent more children at the earlier date. In contrast, there islittle difference when the average numbers of children ever born arecompared for women of recently completed fertility in 1940 with the average for survivors at much older ages in the censuses of 1950 t o1970, suggesting that the memory factor does not cause muchcount of children by women long past the childbearing ages.

Illegitimate births are represented in the data insofar as the wonnenever married included births before marriage (as they were supposedt o do) in their reported total number of children ever born. Com-parisons of cumulations of birth data from annual vital statistics (thatinclude all illegitimate births) with recent census data on childrenever born suggest that the census data may be short by about 5percent for all races and about 3 percent for whites.

B 49-66. Children ever born to women ever married, by race and age

1910 and 1940, SixteenthCensus of Population, Special Reports, Differential Fertility, and 1910-Fertility for States and Large Cities, tables 3 and 4; ential Fertility, and 1910-Women by Number of Children EverBorn, tables 9 and 12; and unpublished data. 1950, U.S.Census ofPopulation: 1950, Special Report P-E No. 5C, Fertility, tables 1, 2,and 12; and unpublished data. 1960, Census of Population:1960, vol. I, Characteristics of the Population, part 1, U.S.Summary ,table 190, and Final Report Women by Number of ChildrenEver Born, tables 2 and 8. 1970, U.S.Census of Population: 1970,part 1, Summary, table 213.

These data are based on an 8.9 percent sample for 1910, 3.3 percentfor 1940, 2.4 percent for 1950, 25 percent for 1960 (except that theseparate data for Negroes are from a 5 percent sample), and 20 percentfor 1970. The data shown for 1940 in series B 42-48 and seriesB 49-66 include special adjustments to allow for the fertility ofwomen with no original report on number of children ever borntherefore differ slightly from the data published in the reports onDifferential Fertility, and

See the text for series B 42-48 for cautions regarding thebility of data from the 1910 census with data from later censuses,possible minor shortages in counts of children ever born due toreporting of illegitimate births.

of women, 1910-1970.

Source: U.S. Bureau of the Census.

B 67-98. Number of children under 5 years old per 1,00020 to 44 years old, by race and residence, by geographic divisions,

Source: Series B 67-68,1800-1940,and series B 69-98,1800-1840and 1910-1950, Wilson H. Clyde V. Kiser, and Pascal K.Whelpton, The Fertility of American Women, John Wiley and Sons,New York, 1958 (copyright). Series B 67-68, andB 69-98, 1850-1900 and 1960-1970, U.S. Bureau of the Census,special computations from decennial census reports.

Figures for series B 67-68 were adjusted for underreporting ofchildren in 1800-1940 on the basis of factors obtained for 1925-1930and for underreporting of both women and children in 1950-1970 onthe basis of estimates derived by analytical methods. The ratioshave been standardized for age of women (except for white women for1800-1820) using the 1930 age distribution of women to offset theeffect of changes in the age distribution of the female population.Therefore, the figures represent the fertility ratios of women havingthe same age distribution as those in 1930. Rates forare partly estimated.

For composition of geographic divisions, see text for series A194. The urban-rural classification shown for 1800-1950 is basedon the rules used in 1940. That shown for 1960-1970 is based on therules used for those censuses. For definition of residence by old andnew rules of classification, see text for series A 43-56. The change

1800-1970.

VITAL STATISTICS B 99-166

i n rules is known t o have relatively little effect on the fertility ratiosfor 1960 and probably has little effect on the comparability of thefertility ratios for 1960-1970 with those of earlier years.

B 99-106. Median interval between births, by race, 1930-1969.

Source: U.S. Bureau of the Census, Current Population Reports,series P-20, Nos. 180 and 186, and unpublished data.

The median interval between two sets of events is an estimate ofthe length of time after the first set of events in which half of thesecond set If the first set of events is births of a firstchild and the second set is births of a second child and the estimateof the median interval is 32.2 months, the interpretation is that halfof the second births occur within 32.2 months of the first births.

Data on median intervals between births and first marriage andbetween births of successive orders are useful for comparingspacing and family building patterns between subgroups within apopulation at a given point in time and between different cohortseither of women or (as in series B 67-98) of their children.

B 107-115. Expectation of life at birth, by race and sex, 1900-1970.

Source: U.S.Public Health Service, 1900-1967, Vital Statistics ofthe United Stales, 1967, vol. 11,part A, p. 5-8; 1968-1970, same report, annual issues.

Derivation of estimates is described in “Estimated Average Lengthof Life i n the Death-Registration States,” Vital Statistics-SpecialReports, vol. 33, No. 9.

The expectation of life a t birth is the average number of years thatmembers of a hypothetical cohort would live if they were subjectthroughout their lives to the age-specific mortality rates observeda t the time of their birth. is the most usual measure of the com-parative longevity of different populations. There is some objectiont o the use of the average duration of life as a standard of comparisonbecause the method of calculating it gives great weight to the rela-tively large number of deaths occurring in the first year of life. Thisinfluence may be entirely eliminated by considering instead the aver-age lifetime remaining to those members of the cohort surviving toage 1,or, in other words, the expectation of life at age 1. However,this objection is growing less valid as infant mortality decreases.

B 116-125. Expectation of life at specified ages, by sex and race,

Source: 1901-1910, white population, U.S. Bureau of the Census,United States L i f e Tables, 1900-1 40-47. 1900-1902 and1909-11 t o 1956, U.S. Public Health Service, Vital Statistics of theUnited States, 1956, vol. I, p. 1957-1970, same report, annualissues, vol. I, 1957-1959, and vol. 11, thereafter.

The expectation of life at a specified age is the average number ofyears that members of a hypothetical cohort would continue to liveif they were subject throughout the remainder of their lives t o themortality rates for specified age groups observed in a given timeperiod.

1900-1970.

B 126-135. Expectation of life at specified ages, by sex, for Massa-

Source: 1850, Metropolitan Life Insurance Company, StatisticalBulletin, 9, No. 3, March 1928, pp. 7-8; 1855, Edgarstricker, Health and Environment, McGraw-Hill, New York, 1933,

164 (copyright): 1878-82 to 193941, Louis I. Dublin, Alfred J.Lotka, and Mortimer Spiegelman, Length Li fe , Ronald Press, NewYork, 1949 326 and (copyright); 1949-51, U.S. Bureau of theCensus and U.S.Public Health Service, Statistics-SpecialReports, 41, Supplement March 21, 1956, pp. 193 and 195.

chusetts, 1850 to 1949-51.

See text for series B

B Fetal death ratio, by race,Source: Public Health Service, 1922-1944, Vital Statistics

the United Stales, 1956, vol. I, p. 1945-1967, same report,1967, vol. part A, 3-4; 1968-1970, same report, annual issues.

Lack of uniformity in requirements for registration and variationin completeness of registration influence the comparability of the data over the years, especially in the series based on all reported fetal deaths. Considering the probable total effect of these factors, aswell as that of incompleteness of the registration area until 1933, i tappears likely that the ratios understate any decline in fetal mortality.Changes in the regulations have more often been in the direction ofbroadening the base of fetal death reporting, than in the other direc-tion. With respect to completeness of reporting, the situation hasprobably improved because of the increases in the number of womenreceiving hospital and medical care a t childbirth and also becauseof the general strengthening of the vital registration system.

B 139-141. Neonatal mortality rate, by race, 1915-1970.

Source: Public Health Service, 1915-1929, Vita l Statisticsthe United States, vol. I, 258-259; 1930-1939, Vita l--Special Reports, vol. 45, No. 1,pp. 8-10; 1940-1967, Vita l Statisticsof the United States, 1967, vol. 11, part A, 2-3; 1968-1970, samereport, annual issues.

The neonatal mortality rate represents the number of deaths ofinfants under 28 days (exclusive of fetal deaths) per 1,000 live births.

B 142-144. Infant mortality rate, by race, 1915-1970.

Source: U.S.Public Health Service, VitalSpecial Reports, vol. 45, No. 1, p. 7; 1940-1970, see source for series

The infant mortality rate represents the number of deaths under 1 year (exclusive of fetal deaths) per 1,000 live births. The rates have been computed by the conventional method in which the infantdeaths occurring in a specified period are related to the number oflive births occurring during the same period. Rates computed inthis way are influenced by changes in the number of births and willnot be comparable if the birth rate is fluctuating widely. Deathsunder 1year of age occurring during any calendar year are deaths notonly of infants born during that year but also of infants born duringparts of the previous year. An approximate correction of this errorcan be made by relating infant deaths during a specified year to theyear in which those infants were born. See Bureau of the Census,“Effect of Changing Birth Rates Upon Infant Mortality Rates,” Vital Statistics-Special Reports, vol. 19, No. 21.

B 139-141.

B 145-147. Maternal mortality rate, by race,

Source: U.S. Public Health Service, Vita l Statistics-Special Reports, vol. 46, No. 17, p. 438; 1940-1967, Vital Statistics ofthe United States, 1967, vol. 11, part A, p. 1-41; 1968-1970, samereport, annual issues.

The maternal mortality rate represents the number of deaths from deliveries and complications of pregnancy, childbirth, and theperium per 10,000 live births.

B 148. Infant mortality rate, for Massachusetts, 1851-1970.

Source: 1851-1899, 77th Annual Report of Vital Statistics of Massa-chusetts, p. 132; 1900-1956, U.S. Bureau of the Census and US.Public Health Service, Vita l Statistics of the United States, vol. I,annual issues; 1957-1970, US. Public Health Service, Vita l Statisticsof the United States, vol. 11,part A, annual issues.

B 149-166. Death rate, for selected causes, 1900-1970.

Source: U.S. Public Health Service. Series B 149-150, B163,and B 166,1900-1970, Vita l Statistics of the United States I

47

B 167-220 VITAL STATISTICS HEALTH A N D MEDICAL CARE

to 1954 and vol. 11,part A, thereafter), various annual issues. SeriesB 151, 1900-1920, Vital Statistics of the United States, 1950, vol. I,p. 218; 1921-1940, Vital Statistics Rates in the United States,1940, 266; 1941-1970, unpublished data. Series B 164-165, U.S.Bureau of the Census, 1900-1933,Mortality Statistics, various annualissues; 1934-1938, Vital Statistics of the United States, Special Reports,Deaths Each Cause, United States: 1939-1949, VitalStatistics of the United States, part I ; Vital Statistics of theUnited States, vol. part A, various annual issues.

Mortality data are classified according t o the numbers and titlesof the detailed International List of Causes of Death. A large pro-portion of the death certificates filed annually in the United Statesreport two or more diseases or conditions as joint causes of death.General statistical practice requires that cases involving more thanone cause of death be changed t o a single cause.

I n the French edition of the International List certainprinciples for determining the single cause to be selected from thejoint causes given were incorporated as a part of the general classifica-tion scheme, As an outgrowth of practices in this country after1902, definite relationships among the various conditions represented by items in the International List were put in concrete form in theManual Joint Causes of Death, first published in 1914, and revisedto conform with successive revisions of the International List. Thismanual, which was developed for use in the United States, was fol-lowed until 1949, when an international procedure for joint-causeselection was adopted. The new international rules place the re-sponsibility on the medical practitioner to indicate the underlyingcause of death. This change, in conjunction with the Sixth Revisionof the International List in 1949, the Seventh Revision in 1958, andthe Eighth Revision in 1968, has introduced rather serious breaks in statistical continuity.

Time-trend studies of causes of death would be facilitated if theInternational List were maintained without change over a long period of years. However, if the list were rigidly fixed it would be incon-sistent with current medical knowledge and terminology. To obtainthe advantages of frequent revision, and to retain a fixed list fora number of years, revisions are made at an international conferenceevery 10 years. I n the process of revision, discontinuities are intro-duced into the time trends of death rates for certain specific causesof death (see National Office of Vital Statistics, “The Effect of theSixth Revision of the International List of Diseases and Causes ofDeath Upon Comparability of Mortality Trends,” Vita lSpecial Reports, vol. 36, No. 10).

Improvement in diagnostic procedures and development of medicalknowledge and facilities are other important factors in the study ofchanges in death rates for certain causes.

B 167-173. Death rate, by race and sex, 1900-1970.

Source: 1900-1968, U.S.Public Health Service, Vital Statisticsthe United States, 1968, vol. 11,part A; 1969-1970, unpublished data.

B 174-180. Age-adjusted death rate, by race and sex, 1900-1970.Source: See source for series BThe age-adjusted death rate is a convenient summary index that

“corrects” for differences in age composition. These rates werecomputed by taking the age-distribution of the population in 1940as the “standard” without regard t o sex, color, or other characteristics.The age-specific death rates actually observed in a given year wereapplied to the age distribution of this standard population and atotal death rate was computed. The age-specific death rate is the

rate of deaths per 1,000 population in each age interval for ayear. For a detailed description of the direct method by which these rates were computed, see Vital Statistics Rates in the United States,

66-69.

BSource: 1900-1939, U.S. Public Health Service, Vital Statistics-

Special Reports, vol. 43, No. 1,pp. 10-12; U.S. Bureau ofthe Census, Vita l Statistics of the United States, vol. I, p.

Vita l Statistics of the United States, 1956, vol. I, p.1958-1970, Vi ta l Statistics of the United States, 1968 , vol. 11,partand unpublished data.

Death rate, by age and sex, 1900-1970.

B 193-200. Death rate, by sex and by selected cause, for

Source: 1860-1899,computed from 48th Annual Registration Reportfor Massachusetts and 77th Annual Report on the Vital Statistics ofMassachusetts; 1900-1956, US. Bureau of the Census and PublicHealth Service, Vital Statisties of the United States, vol. I , annualissues; 1957-1970, U.S. Public Health Service, Vital Statistics theUnited States, vol. part A, annual issues.

chusetts, 1860-1970.

B 201-213.Source: Annual Registration Report for Massachusetts, p. 321,

and 77th Annua l Report on the Vital Statistics of Massachusetts, p. 126.

Death rate, by age, for Massachusetts, 1865-1900.

B 214-220.Source: Series B 214-218, U.S.Public Health Service, Vital Sta-

tistics the United States, vol. 111, annual issues; series BUS. Bureau of the Census, Current Population Reports, series P-20.

See also: U.S. Commissioner of Labor, A Report on Marriage andDivorce in the United States, 1867 to 1886; U.S. Bureau of the Census,Marriage and Divorce, 1867-1906; Vi ta l Statistics-Special Reports,vol. 9, No. 60, “A Review of Marriage and Divorce Statistics: United States: Marriage and Divorce, 1916 and annual issuesfor 1922-1932; S. A. Stauffer and L. M. Spencer, “Recent Increases in Marriage and Divorce,” American Journal of Sociology, vol. 44, No. 4 (for 1933-1936); U.S. Bureau of the Census, Vital Statistics-Special Reports, vol. 15, Nos. 13 and 18, “Estimated Number ofMarriages by State: United States, and “EstimatedNumber of Divorces by State: United States, respec-tively. For exact population base figures, see VitalSpecial Reports, vol. 46, No. 12, p. 330.

Marriage and divorce records are filed only at the county level in some States, but gradually the various States are requiring by lawthat such events be recorded a t the State level. The completenessof reporting to the State offices varies, but there has been no nation-wide test. A marriage-registration area covering 30 States and 5independent areas was established by the National Office of VitalStatistics i n 1957. A major criterion for admission of a State to theregistration areas was agreement with the National Office ofStatistics t o conduct a test of marriage registration completeiiess.By 1971, the marriage-registration area covered 40 States arid 3independent areas. A divorce-registration area with 14 States and 3 independent areas was inaugurated in 1958. By 1971, it covered29 States and 1independent area.

The marriage and divorce rates shown in series B 215 and B 217are based on those segments of the female population that beconsidered as subject t o possible marriage and divorce.

Marriage rate and divorce, 1920-1970.

48

VITAL STATISTICS

Series 1-4. Live Births, Deaths, Marriages, and Divorces: 1909 to 1970[Inthousands. Birth, marriage, and divorce figures represent estimates of all such events; death figures, the number of registered events]

1928

192519241923.......

_ _ _1920

.

1916

1915 ..

1911

B 1-10

2 61822 6742 '8022

2 909

2 9102 '8823

2 95022 '948 2 '944 2

2 9652 '9662 '3692 '340 2'809

22'777

Divorces

4

.......1949...1948...19471946...1945

1943..

193919381937

.19351934

.19321931

3,6323,6493,6373,8173,411

2 8582 '9393'1042'9892

22'4962'4132

22'396

2 440

Deaths 3

2

1 1271'233

1

1 188

1 2301'134

1'182

Marriages

3

196206200196185

175171

149160

Livebirths

Total

Divorces

White

9

87.986.585 .7R7.691.3

96.6105.0108.5112.2117.2

118.0118.8120.2122.9121.2

118.5118.1115.2113.9111.5

106.2107.1107.3113.3101.9

85.988.894.391.583.4

79.977.679.177.175.8

77.278.5

Livebirths

Deaths 3 Divorces

Year4

Livebirths

1

Year12

1,9211,9221,930

1,863

1,8281,7931,8141,7571,702

1,7121,6571,6431,6331,564

1,4311,5181,4971,482

3

2,1632 1452'0691'9271

1,3001,7251,6541,5771,548

1'4941'4511'518

1 5311'4901'5461'539

1,4521,4441,444

445

1,4021 4111'46011,398

4171'38811,4501,479

1 393

1,342

385397408483610

435400359321293

1 667

1 811

1 6131'452

1'7721

1 5961

3311 '451

1,3271 302

9821,061

1

264251244249236

218204165164188

Iand

3 Excludes fetal deaths

Series B Birth Rate-Total and for Women 15-44Years Old, by Race: 1800 t o 1970on estimated total live births per 1,000 population for specified group. Based on a 50-percent sample of births for 1951-1954, 1956-1966, and on 20- t o

percent sample for 1967. Prior to 1959, births adjusted for underregistration: thereafter, registered live births]

Rate, total population Rate, women 15-44 years Rate, total population Rate, women 15-44 years--Negro

and other

-.---Negro

and

7

Totaland other

7

White Year Total White

6

Negroand other

Year

5 10

18.1

18.4

19.421.021.722.423.3

23.724.024.525.325.2

25.025.325.025.124.9

24.124.524.926.624.1

20.421.222.722.220.3

19.418.819.218.718.4

18.719.018.4

17 .416.91 6 . 616.817.4

18.320.020.721 .422 .2

22.722.923.324.024.0

23.824.224 .024.123.9

23.023.624.026.123.6

19 .720 .522.121 .519 .5

18 .613 .013 .417.917.6

84.182.481.583.186.4

91.499.9

103.7107.5112.2

113.2113.9114.9117.7116.0

113.8113.6111.0110.1107.7

103.6104.3111.8100.4

83.486.392.389.580.7

77.174.876.574.473.3

74.575.873.7

113.0114.8114.9119.8125.9

133.9141.7144.9148.8153.5

153.6156.0160.5163.0160.9

155.3153.2147.3143.3142.1

137.3135.1131.6125.9113.9

106.0108.5111.0107.6105.4

102.4

100.599.495.9

98.4100.497.3

19.520.2

21.321.222.223.524.2

25 .126.126.026.228.1

27.726.128.228.529 .1

29.529.929.529.829.9

30.032.3

2

8

18.719.5

20.620.5

22.23.1

24.125.125.225.427.8

26.92C.327.627.928.5

23.929.328.829.029.1

29.229.230.131.535.2

38.341.443.348.3

51.4

54.355.0

79.082.4

87.187.391.797 .199.2

103.3107.8108.0108.8117.2

115.4

8

123.2124.6122.4123.3123.6

123.8123.6130137155

167184194222

240260274278

103.0102.1

1932 _ _ _19301929

1927.... _ _ _1926

25.124.424.225.026.1

27.629.129.730.531.6

32.132.934.335.335.4

34.734.934.133.633.8

33.333.032.431.238.4

26.527.428.327.727.3

26.726.126.326.025.1

25.826.325.5

105.9106.1111.0121.7130.3

89.2

31.1

106.6

1965- _ _.__.

1963 _ _ _19621961- _ _ _19601959 4 _ _ __ _ _1957- __.

134.0135.6130.5130.8140.8

35.0 117.932.4 111.233.0 119.832.9 121.0

123.4

19151914 _ _ _

17.918.117.6

*Denotes first year for which figures include Alaska and Hawaii. N A Not available.

Computed by relating total births, regardless of age of mother, t o women aged 15-44years.

Based on 20- to 50-percent sample of births.Figures by race exclude New Jersey: State did not require reporting Of race.

4 Includes Alaska.

49

B 11-19 VITAL STATISTICS AND HEALTH AND MEDICAL CARE

Series 11-19. Fertility Rate and Birth Rate, by Age of Mother, by Race: 1940 to 1970fertility rates are the sumsof birth rates, by age of mother multiplied by 5. Birth rates are live births per 1,000women in specified group. Prior to 1959,births adjusted

thereafter, registered live births. 50-percent sample of births for 1956-1966,and 1968-1970;on 20- to 50-percent sample for 19671

Year and race

Totalfertility

rate

2,4802 465 22,5732,736

2 928 3'208

3 65433,7013 7673

3 580

33,269

3 091

33'2742 943

2,4912 5682'7182'628

3'3333'474

3 '543 3'424

2'399

2.3852 360 2'368

2,609

2 790 3'074

3 348

3,5333 544 3'5603'6253 546

3,4463 415

3 250

2 9773'0098'0223'230

2 421 2'501

2 577

22'828

3,0673,1483 1973'385

3,8914 1534'269

4,533

10-14years

12

1.2

1.0

1.01.0

1.0

1.01.01.0

4.84.64.44.14.0

4.04.04.03.94.0

15-19years

13

68.366.166.167.970.6

70.472.876.481.288.0

89.189.191.496.394.6

90.590.688.286.187.6

81.683.481.879.359.3

51.1

61.761.166.954.1

57.455.255.357.360.8

60.763.268.173.178.8

79.479.2

85.283.2

70.072.171.169.850.6

42.145.352.151.847.645.3

133.4133.3133.3135.2135.5

136.1138.7139.9144.6152.8

20-24years

14

167.8166.0167.4174.0185.9

196.8219.9231.2243.7253.7

258.1257.5258.2260.6253.7

242.0236.2224.6217.6211.6

196.6200.1200.3209.7

138.9151.8164.0165.1145.4135.6

163.4161.4162.6168.8179.9

189.8213.1224.7238.0247.9

252.8251.7251.4253.8247.1

236.0230.7219.6212.5206.0

190.4194.6195.5207.9179.8

134.7147.9161.1162.9141.6131.4

196.8197.8200.8212.1228.9

247.3268.6277.3285.7292.9

Birth rate, by age of mother

25-29years

145.1143.0140.3142.6149.4

162.5179.4185.8191.7197.9

197.4198.6198.3199.4194.7

190.5188.4184.1182.0175.3

166.1165.4163.41'76.0161.2

132.2136.5147.8142.7128.7122.8

145.9142.8139.7140.7146.6

158.8176.2181.5187.7194.4

194.9195.5194.8195.8190.6

186.8185.0181.5180.5174.2

140.1

155.9169.3

202.0

217.4221.9

30-34years

16

73.374.174.9

85.9

95.0103.9106.2108.9113.3

112.7114.4116.2118.9117.3

116.2116.9113.4112.610'7.9

103.7102.1103.7111.9108.9

100.298.199.591.885.383.4

71.972.072.576.582.7

91.7100.5102.6105.2110.1

109.6111.3113.0115.9114.4

114.1115.1111.9111.4106.5

102.6101.5103.6113.0110.0

100.598.2100.292.385.283.4

82.588.991.299.1107.9

118.3127.5129.3132.4136.2

35-39years

17

31.733.435.638.542.2

46.450.051.352.755.6

56.257.358.359.959.3

58.757.956.655.854.1

52.953.554.558.958.7

56.954.652.847.946.146.3

30.031.633.836.640.0

44.147.748.950.253.2

54.055.155.857.457.0

56.756.255.154.452.6

51.452.253.558.458.4

54.152.247.245.145.3

42.245.948.652.457.7

63.867.568.972.074.9

40-44years

18

8.18.89.610.611.7

12.813.814.214.815.6

15.515.315.716.316.3

16.116.215.815.515.4

15.115.315.716.616.5

16.616.115.714.715.015.6

7.58.18.99.810.8

12.018.013.414.114.8

14.714.714.815.415.4

15.415.415.014.814.6

14.514.615.216.115.9

16.015.515.014.114.315.0

12.613.915.016.818.4

19.2

21.021.722.3

45-49years

19

1.11.0

1.01.01.01.31.1

1.21.31.3

1.61.4

1.61.71.9

1.0

1.01.11.11.21.3

1.41.21.31.31.41.6

1.01.21.21.4

1.51.5

1.5

'Excludes New Jersey; State did not require reporting of race.

50


20

Series 11-19. Fertility Rate and Birth Rate, by Age of Mother, by Race: 1940 to 1970-Con.

21

Birth rate, by age of mother

19631962

1956...

84.182.481.583.186.4

91.499.9

103.7107.5112.2

113.2113.9114.9117.7116.0

113.3113.6111.0110.0107.7

1941...

83.486.392.389.580.777.1

10-14years

35-39yearsyears

25-29years

40-44years15-19

years45-49years

19

Year and race 30-34years

16 17 1812-_I_

NEGRO AND

13 14 15

4.04.24.35.64.7

22.021.221.823.523.6

22.122.523.021.922.6

21.221 .120.421.421.8

1.71.81 .92.02.0

158.2160.5167.3172.8172.5

168 3170.3165.4162.9166.7

163.5162.8157.3146.6121.9

117.5121.5133.4131.8128.3121.7

294.2297.9805.2307.0299.1

283.4274.7261.4254.0252.5

242.6241.3237.0223.7197.3

172.1182.4137.2182.3175.0168.5

214.6220.2224.2228.1225.9

219.6215.7206.4194.2184.2

178.8167.0159.6150.6139.2

125.4126.8125.1119.6118.1116.3

2.12.12.22.22.2

75.472.9

66.666.5

64.363.962.562.761.0

61.358.456.954.054.153.7

4.84.95.15.25.4

5.15.14.94.63 . 7

3.93.94.03.94.03.7

2.62.52 . 33 .13 .5

3.73 .23 . 74.04 .15.2

Series B 20-27. Birth Rate, by Race, by Live-Birth 1940 to 1970[Rates are live births per 1,000 women aged 15-44 years in specified race group. Live-birth order refers to number of children born alive to mother. Prior to 1959, births ad-

justed for underregistration; thereafter, registered live births. Figures for not stated birth order have been distributed. Based on 50-percent sample of births for 1951-1954,and 1968-1970; on 20- to 50-percent sample for

Birth rate, by live-birth orderIBirth rate, by live-birth order Total

race1st 5th

___-and

7th

26

t h andover

27

1.21.41.61.82 . 1

2.42.72.92.92.9

2.82 .82 .12.72.6

2.52 . 52 .52 .52 .5

2.52.72.62 .72.8

3.08.13.13.13.23 .5

3d 4th 4thYearandrace

5th

25

ith and7th

26

t h andover

27

1 .82.02 . 32 .73 . 2

3 .74 . 14 . 34 . 44 .5

4 . 34 .24 . 24.24.0

3 .83 . 83 .63.63.6

3.63.73 . 63 .73 . 8

4.04 .04.03.94.14.3

2d

24

6.87.07.17.98 . 7

10.211.712.613.314.0

14.113.913.813.713.1

12.612.011.110.49.4

8.47.97 . 47.47.3

7.07.16.96.15.95.9

2520 2122

24.223.422 .522.622.5

23.425.126.127.028.4

29.229.930.631.731.9

31.932.432.532.732.6

32 .132 .130.930.327.9

22.923.825.522.920.720.0

23

13.713.413.213.914 .8

1G.618.819.921.122.4

22.823.023.323.92J .6

23.122.721.921.320.0

18.417.116.115.614.5

13.413.813.511.911.210.9

24

WHITETOTAL

1969-13.313.112.813.514.4

16.218.519.620.922.2

22.722.923.123.723.4

22.922.621.621.019.5

17.916.615.715.314.4

13.213.613.211.510.710.5

3 . 43 . 63 .84.34.9

5 . 86 . 77 . 17 . 57.7

7.57.37.27.06.6

6 .25.95.45.04.5

4 .14.03.94.04 .0

3 .94 . 03 . 93 . 63 . 63 .6

2.72 .93.2

4.3

5.05 . 76.16.26.4

6.15.95.7

5.2

4.94.64.34.03 . 9

3.73.83.73.83 .9

4.04.14.03.83.94 .1

32.891.530.929.730.1

28.929.829.429.830.7

30.831.231.933.433.2

32.633.333.334.135.0

33.336.339.947.839.5

29.030.435.238.332.529.4

84.132.832.130.831.0

29.830.429.930.131.1

31.131.532.233.733 .5

32.933.633.434.084.9

33.336.239.646.738.5

28.930.234.737.532.229.3

7.27 . 47 . 58.39 .2

10.712.313.113.814.6

14.614.614.414.413.9

13.312 .812.011.310.2

9.28.68.07.97.8

7.57.67.46 .66 .46 .4

3.84.04.24.85.4

6.47 .37.83.28.5

8 .38.28.17.97 .6

7.26.86.35.85.3

4.84.74.54.54.5

4.54.54.44 . 14.14 .1

3.23 . 53.94 .55.2

6 .06 .97.37 . 5

7.67.47.37.16.3

6.46 .06.55.25.0

4.74.74.64.64.7

4.84.94 .84 .64.74 . 8

23.722.922.122.122.0

23.024.825.926.9

29.229.930.631.731.9

32.032.832.933.132.9

32.382.231.130.828.5

23.324.225.923.120.720.0

87.986.585.787.691.3

96.6105.0108.5112.2117.2

118.0118.8120.2122.9121.2

118.5118.1

113.9111.5

106.2107.1107.3113.3101.9

85.988.894.391.583.479.9

1963-1962

1960

1950- _ _ _1946-

1945-__.

1943- __.1941- __.__.

See footnotes a t end of table.

51

20-35 STATISTICS HEALTH CARE

Series B 20-27. Birth Rate, by Race, by Live-Birth Order: 1940 to 1970-Con.

1951...1950...

1946...

Birth rate, by live-birth order

35.0 30.7 24.4 1 9 . 1 ' 14.6153.2 35.6 29.7 24.4 19.1 14.2147.2 34.1 29.5 23.8 13.4 13.3143.3 33.1 29.2 24.0 18.1 12.4142.1 34.1 29.9 23.9 16.9 11.2

137.3 33.8 30.3 22.9 15.3 10.4135.1 35.4 30.8 2 1 2 14.0 9 . 8131.6 37.3 29.5 12.9 9 .2125.9 38.4 26.2 17.3 12.1 8.8113.9 31.1 23.4 16 .0 11.8 8.7

Birth rate, by live-birth orderI

14.715.615.5

11.3 8 .711.7 8.611.4 8.4

14.1 10.58 . 18 . 07.8

19641963

133.9 35.8141.7 34.8144.9 33.8

1962 148.81961 153.5

33.138.6

26.6 19.6 14.6 10.8 13.827.4 21.127.6 21.828.0 22.828.8 23.7

29 3 24.024.4

25.725.2

16.0 12.1 15.816.9 1 3 . 1 16.617.8 13.7 17.618.8 14.1 18.4

1 4 . 1 18.414.5 18.7

19.8 1 5 . 3 19.019.7 15.0 18.7

25.4 19.5 14.9 19.1

and race

28I 25-29years

32

30-34 35-44years years

33 34-35

399361339318302

291276259245240

224

26.4 22.425.0 20.L24.423.9 18.623.4

23.5 1 6 . 723.0 15.822.5 15.221.9 14.822.7 15.9

21.6 15.3

7.97 . 37 . 06 . 57 .0

6 . 66 . 5

22.121.220.820.019.7

18.218.3

24.3 1 6 . 624.1 15.922.0 14.219.8 12.619.4 11.3

18.21 7 . 6 10.715.8 10.814.6 10.514.0 9 .2

13.3 8.68 . 7 5.94 .0 2 .5

4 . 94.84 .64.34.2

3.93.63.43.03.0

2.82.01 . 2

93.798.0

104.4118.4143.8

164.7168.7171.5

69.9 21.673.5 22.3

25.297.2 28.9

119.4 33.8

137.8132.3 34.5124.3

172 7 115 2

171.8 104.0168.0 106.5161.2 110.5142.6 115.1132.7 113.7

35.5

114.9

30.3

142133130132125

117105989796

14.1 12.613.3 12.012.5 11.412.1 11.010.9 9 .5

1 0 1 . 1 9 .59.0 8.88 . 3 8.48.0 8 .27 .8 8.07.1 7.4

74.073.874.177.6

76.580.880.481.479.6

152.6164.2161.8163.6169.6

166.5167.8153.2147.7143.5

Year Totaland 1strace

8th an over

27

Year Totalandrace

I: I 4th 5th3d 4th 5thi 7th6th and

7th

26

17.41 6 . 515.414.21 3 . 5

1 2 . 612.21 1 . 711.41 1 . 3

1 1 . 31 1 . 311.0

1 0 . 610.4

andover

27

5.36.37.49.0

10.7

12.614.4

15.716.0

15.615.615.915.6

14.113.512.812.412.2

12.011.811.611.611.7

11.911.611.611.111.311.3,

Excludes New Jersey; State did not require reporring of race.*Denotes first year for which figures includes Aiaska and Hawaii.

Series B 28-35. Illegitimate Live Births and Birth Rates, by Age and Race of Mother: 1940 to 1970[Refersonly to illegitimate births occurring within the United States. Rates are illegitimate live births per 1000 unmarried females in specified group Figures for

not stated are distributed. Based on 50-percent sample of births for 1951-1954, 1956-1966, 'and on 20- to 50-percent sample for

Rate,all

ages

29

11.c

10.0

9.29.28.88.68.3

6 . 13 . 6

89.986.686 .689.592.8

97.697.297.197.5

100.8

98.3100.897.895.392.1

87.271.235.6

Rate, by age of mother Rate, by age of mother

25-29years

32

35-39years

34

13.313.614.915.416.4

17.416.316 .115.6

14.114.113.31 2 . 111.1

10.39.08 . 27 . 5

7.2

5.85.64.4

4 .14.03.83.83.73.4

40-44years

35~-

--_-I


Yearand race years

20-24years

31

38.437.437.338.389.1

39.939.940.340.941.7

39.740.238.237.356.4

33.531.428.025.423.2

21.321.019.818.917.3

15.313.111.411.010.59.5

22.523.023.1

30-34years

33

27.C27.428.229.233.0

37.537.233.229.728.3

27.828.127.526.824.6

22.020.417.315.714.6

13.311.410.09.27 .3

7.17 .06 .76 .36 .05 . 1

14.2

15.1

30 31

TOTAL W H I T E- c o n .

19671966

22.7 14.0 4.723.5 4 .9

1970....19691963... ..

37.138.133.641.445.6

49.350.249.046.746.5

45.144.140.536.835.6

33.531.027.624.822.8

19.918.016.415.715.6

12.110.18.88 . 47.87.2

21.122.422.1

3.63 . 63.84.04 . 1

4 . 54 . 44 . 34 . 03 . 9

8 .63.3

2 .8

2.72 .52.41.92 2

2.01 .91 .61 . 81 .8

1 . 61 . 31.31.21.41.2

p.2

142133

1241141029391

8380757 168

645440

224197184176170

168161151147149

142141134131126

1198849

1964196319621961

1960 . __1959

1957

19551954 _ _ _

__.1952 _ _ _1951

ANDOTHER

1965 _ _ _1963 4 _ _ _19621961

1945 .19441943 _ _ _1941...

WHITE

19701969 4.4

4.44.7 77.6 133.0

68.5 106.442.5 46.1

100.963.5 20.0

32.5 23.4 9 . 3

*Denotes first year for which figures include Alaska and Hawaiicomputed by relating total illegitimate births regardless age of mother to

women aged 15-44 years.Rates total computed by relating illegitimate births to mothers aged 40 and over

t o unmarried women aged 40-44 years. Rates for race detail computed by relatingbirths to mothers aged 35 and over to women aged 35-44 years.

3 Includes Alaska.Excludes New Jersey; State did not require reporting of race.

52

VITAL STATISTICS

Series 36-41. Gross and Net Reproduction Rates, by Race: 1905-10 to 1970on 50-percent sample of estimated total live births for and on 20- to 50-percent sample for

19521951

B 36-48

-I-

36 37

1 637 1 579

Net reproduction rate

1 ,1681,1611 1661'213

1,3761,5071,5641 633

1,7151,7221,7361,7651,729

Gross reproduction rate

1 ,1251 113

1,

1,3141,4471,5061,5771,648

1,6621,6671,6751,7011,665

Net reproduction rate

1950

194819471946 _ _ _

Gross reproduction rate

1,505 1.4461,515 1,4621 514 1,469

1 5681,430

1 , 4 3 51 439

1'4301,344

1,1321 163

1 , 1 8 51 , 0 7 5

1,027975978984

1,336

__-Negro

andother

38

1 3871'3971'4001'492

1 1061'139

1 171

1,002958957972

1,339

Negroand

other

19651964196319621961

19592195819571956...

1,428 1,3571,564 1,4951,623 1,5561,695 1 6301,770

1,7201,7911,807 1 , 7 3 51,837 1 7641,798

Negroand

other

Year of birthof women

Total White

year

Negroand

other

1850-54

Total White

19401940191019101910

Year or period Total White

1845-491840-44

191019101910

1920-241915-19

1900-04

1895-991890-941885-891880-84

1870-74

1860-641855-591850-54

197019701960'1960'1950

19501940194019401940

1940194019101910

1845-49

1835-39

19101910

Year

197019691968...19671966

41

1,4331,4731,495

1,678

1 802

1 973

2,100

2,0932,1182,1782 , 2 0 62,184

2,1012 062

1

38

2 0622

1 9401'9061'8451'7661

49311,5431 4871

1,4221 3501'4131'336

39 40 41

1 897

1 7801 7431 67911,435

1 3231'3341'3481'293

1 2091 1081,1371 0741

1

1,5091,5541,5771,6761.785

1,9192,0512,1022 170

2 2412'271

2,339

2 255

2,118

2'339

1 563 1,5161,472

19451944194319421941

iIncludes Alaska.* Denotes first year for which figures include Alaska and Hawaii.

Excludes New Jersey; State did not require reporting of race.

Series 42-48. Percent Distribution of Ever-Married Women (Survivors of Birth Cohorts of 1835-39 to 1920-24)by Race and by Number of Children Ever Born, as Reported in Censuses of 1910, 1940, 1950, 1960, and 1970

Chil-dren

1,000women

Age ofwomenreport-

ing(years)

65-69

45-4950-5455-59

60-6465-6970-74

45-4950-5445-4950-5445-49

50-5445-4950-5455-5960-64

65-6970-7445-4950-5455-59

60-6465-69

year

Age of

ing[years:

Chil-dren

1,000women

Percent of women, bynumber ofPercent of women, by

number of births

Year of birthof women ione None

42 43

and

44

and

45

14.615.717.718.318.2

18.718.519.1

13.110.93 . 98 . 99 .2

10.912.614.214.116.5

17.5

13.813.612.7

14.214.011.3

7 to 9 10 ormoreand and and t

45

7 to 9 10 ormore

46

11.211.817.419.020.5

20.921.721.8

10.58 .87.87.68.0

8.89.9

10.710.913.0

14.117.618.719.518.7

21.318.421.4

47

5.25.89 .8

10.81 2 . 5

12.613.013.4

5.85.45 .25.04 . 9

6 . 56 .17.38.89.2

11.013.825.528.730.8

30.930.335.4

48

3 5583'741

4 8175 082

5 1235'237

3 3943'0302'7612 '696

3 085

4,046

4 3474 89266'580

6 8837 035

3 '255 3 594

46 47

1 . 51 . 41 . 51 . 72 . 2

2 . 63 .13 . 64.24 . 7

5 . 86 .4

11.21 2 . 313.9

14.01 4 . 314.7

1 .01 . 01.11 . 41 . 9

2 . 32 .73 . 24 . 24 . 3

48

2,7012 854 2 '402

2

2 706

3 301 3

3 700

4 7444'972

5 2665 '364

2 '355

2 '998

2 7912'553

2'3132

2 66523 10633,349

2'354

42 43 44

TOTAL

1920-24

1910-141905-091900-04

1890-94

14.39.69.08 . 4

8.38.07.9

17.923.027.928.528.4

25.523.820.119.317.0

14.512.8

8 . 67.87.2

5.96.95 .4

28.326.622.920.919.1

18.818.217.5

31.333.033.234.031.9

30.928.125.626.523.0

22.118.117.916.416.1

13.916.312.4

25.025.722.722.021.3

20.820.620.3

21.418.916.916.017.6

17.419.522.121.421.3

20.922.615.514.014.5

13.814.114.1

19701970

1950

19501940194019401940

19401940191019101910

191019101910

19701970

196031950

19501940194019401940

45-4950-5445-49

45-49

50-5445-4950-5455-5960-64

65-6970-7445-4950-5455-59

60-6465-6970-74

45-4950-5445-4950-5445-49

60-5445-4950-5455-5960-64

10.613.818.110.810.4

18.616.816.616.715.0

13.912.39 . 58 .98.3

8.27.97 .7

9.912.917.120.01 9 . 5

18.01 6 . 31 6 . 41 6 . 716.6

39.943.144.243.2

39.035.333.130.730 .5

28.42 6 . 622.420.618.8

18.517.917.3

40.944.345.444.342.7

39.936.033.631.430.3

32.828.924.722.322.4

23.925.025.124.725.2

25.126.122.021.320.8

20.320.120.0

33.929.925.623.0

24.525.525.324.724.9

10.78 .87 . 87 . 88 . 4

10.012.21 3 . 11 4 . 11 4 . 4

15.216.01 7 . 317.917.8

18.318.118.7

10.58 . 67.67.68.3

10.012.113.013.713.9

4.53.93.84.2

5.87.78.69.6

10.3

11.612.517.619.020.4

20.821.621.6

3 .83.33 .33 . 84 . 6

5 . 47.48 . 49.29.9

NEGRO I

1845-49

WHITE

1900-04

Denotes first year for figures include Alaska and Hawaii.

53

49-98 VITAL STATISTICS AND HEALTH AND CARE

Series B 49-66. Children Ever Born to Women Ever Married, by and Age of Women: 1910 to

Children ever born per 1,000 women ever married, by age of womenPercent childless among women ever married, by age of women

50-59years

35-39years

10-24years

51

25-29years

52

35-39years

LO-44years

25-29years

30-34years

50-59years


58 59

20-24years

45-49years

56

1 0 . 618.120.416.89.5

9.917.119.516.39.6

17.927.928.423.88.6

10-34years

53


49 50

16.4 50.915.0 43.622.8 52.826.5 54.616.2 42.7

16.7 53.714.6 46.021.8 55.425.9 56.415.9 43.5

13.8 32.218.7 25.330.8 38.032.8 46.618.7 39.7

Year and race

54 55

8.614.120.017.410.4

8 . 113.018.916.710.4

13.024.730.125.810.5

57

15.620.718.116.68.7

14.720.017.516.58.8

24.428.125.119.87.4

61 63

2 5202'420

5,076

2 4702'3782'7863'180

2,9382 756

3,6606,709

60

1,0711 441

9871,407

1 0061'370

9411,344

1,6312,0301,4741,2341,696

2,8062 627

1,9642,956

2,7342,5592,034

2,8801,922

3,3953,1902,2502,2433,532

35.724.233.339.924.2

37.525.034.040.324.2

20.717.028.938.724.2

12.621.130.117.2

16.112.320.129.716.8

12.614.230.035.119.6

8.310.417.323.313.7

8.19 .7

15.822.313.4

9.415.830.8

16.5

1,9842 241

1,4632,180

1,9222 1 7 11'62012,099

2 541

1,9311,7612,645

3 170

2 2472'4143

3.0862,6292,2182,3693,683

3,8393,1392,4502,6664,515

2,3602,314 7921 859 604 1'904 572

725

2,285 5792.253 7291,828 5481,870 5392,806 699

2 976 1 026

2,089 9212 096 723

834

7.311.11 9 . 119.911.6

6.910.21 7 . 518.91 1 . 5

9 . 820.032.328.813.3

Series B 67-98. Number of Children Under 5 Years Old Per 1,000 Women 20 to 44Years Old, by Race and Residence,by Geographic Divisions: 1800 to 1970

[Adjusted data standardized for age of women, and allowance made for undercount in censuses; see text. For composition of geopraphic divisions, see text for series A

SeriesNo.

6768

697071

727374

757677

787980

818283

848586

878889

909192

939495

9697

Area

Unadjusted number of childrenper 1,000 white women:

East North Central 999 1,022 1,270 1,467 1 608 1 702UrbanRural 585 605 668 672 1,291 1,484 1,706 1,840

South Atlantic 469 625 572 464 593 694 760 779 851 811 918 937 1,140 1,174 1,280 1,325 1 , 3 4 5861

1,185 1,209 1,310 1,347 1,365_ _ _

West South Central 512 695 474 584 686 845 925 968 1,043 935 1,084 1,046 1,297 1,359 1,418 1,383

977 1,495 1,463 1,522 1,557Urban..

*Denotes first year for which figures include Alaska and Hawaii.

54

VITAL STSTISTICS

1935-1939 1930-1934

Median interval in months from-First marriage of mother to birth of first child _ _ _ _Birth of first child to birth of second child Birth of second child to birth of third child.

SeriesNo.

_._._._.__. .

Race and interval

1965-1969--WHITE

1955-1959 1945-1949 1940-19441950-19541960-1964

Median interval in monthsFirst marriage of mother to birth of firstBirth of first child to birth of second child.-------Birth of second child to birth of child.......Birth of third child t o birth of fourth child........

15.5

35.0

14.525.931.631.2

16.228.233.030.4

17.730.731.3

18.432.933 .132.5

11.124.924.623.8

20.232.834.0

10.727.324.124.0

20 .1 20.332.0 32.234.2 31.832.8 38.1

99100101102

103104105106

NEGRO I12.9 11.922.8 27.622.6

9.023.323.822.1

11.923.423.322.9

12.723.323.422.4Birth of third child t o birth of fourth

B Not shown: base for estimate is too small (number of children reported by womensurviving to 1969 is less than 150,000).

Series B 107-115. Expectation of Life (in Years) a t Birth, by Race and Sex: 1900 to 1970[Prior t o 1929, for death-registration area See general note for series B

Negro and other TotalTotal White Negro and otherWhite

Fe-male

55.253.756.064.651.5

49.247.847.048.945.6

46.747.848.953.051.3

45.244.432.540.843.1

40.540.840.340.038.2

37.537.336.034.033.9

33.132.734.636.435.333.5

naleFe-

maleFe-

maledale Both

113

53.151.854.753.750.4

48.146.746.348.244.6

45.746.648.352.451.5

45.344.531.138.841.3

38.938.938.437.936.4

35.635.734.932.532.9

31.830.833 .134.633.733.0

114

51.350.253.552.819.5

47.345.745.647.643.7

44.945.547.751.851.6

45.544.529.937.039.6

37.537.136.735.934.6

33.834.233.831.131.8

29.629.131.732.932.232.5

Bothsexes

107

Male

108

MaleYear nale

112

i5.06

i4.5i4.7

i3.5i0 .3

i3.959.6

i2.4

59.6i1.932.9

55.657.413.255.355.2

57.557.555.756.254.9

52.054.253.360.451.4

50.649.552.553.851.048.7

Year Bothsexes

107

sexes

110 108115

69.468.467.568.267.4

67.467.266.566.867.0

66.366.565.865.56 6 . 1

66 .165.964.563.863.4

62.962.762.561.961.0

69.657.756.158.255.3

54.956.054.352.551.4

112

75.675.174.975.174.7

74.774.674.474.474.5

74.174.273.973.773.9

73.773.773.072.672.4

72.271.97170.570.3

69.568.465.769.468.5

6 6 . 666.666.863.861.9

1967..............1966..............1965..............1964..............196319621961..............1960 *.............19591958..............1957..............

1955..............1954..............1953..............1952

1950...........................

1948..............1946..............

............1944..............1942..............

1940..............1939..............1938..............

70.970.570.270.570.1

70.270.269.970.070.2

69.769.969.669.569.7

69.669.668.868.668.4

68.268.067.266.866.7

65.965.263.366.264.8

62.963.763.560.058.5

6 7 . 166.366 .667.066.7

66.866.966.666.867.0

6 G . 666.86 6 . 666.466.7

66.766.766 .065.865.6

65.665.264.664.464.4

63.663.662.464.763 .1

60.862.161.958.056.6

74.874.374.074.273.8

73.773.773.473.473.6

73.173.272.972.772.9

72.872.872.071.671.4

71.170.769.969.769.4

67.966.864.467.966.8

65.265.465.362.460.6

j3.9 62.9 61.0i3.3 62.4 50.6j 5 . 1 64.3 ti2.7

63.2 62.062.6 60.8

61.4 59.758.7 58.6 57.258.3 58.4 57.0

62.0 60.558.0 57.0

50.6 60.7 59.331.5 61.4 69.8

58.3 57.160.4 59.1

61.8 61.8 60.8

54.6 54.9 54.456.0 55.8 54.542.2 39.8 37.154.0 52.0 49.354.3 52.5 50.2

56.3 55 .1 53.156.8 54.9 52.755.0 53.0 50.855.9 53.9 51.954.4 53.0 51.3

51.8 50.3 48.653.8 52.5 50.952.8 51.5 49.949.9 48 .1 46.050.8 49.3 47.3

59.959.3

58.155.8

59.055.5

57.658.156.158.46 0 . 0

53.653.536.648.449.6

52.552.050.351.550.9

48.450.549.545.646.9

47.346.249.149.847.646.3

61.761.1

............. 63.3

............. 62.1........... 61.1

71.7 68.071.3 67.871 .1 67.571.3 67.871.0 67.6

71.0 67.671.0 G7.770.8 67.570.9 67.671.0 67.8

70.6 67.470.7 67.570.5 67.470.3 67.770.5 67.5

70.5 67.470.5 67.569.7 66.869.5 66.669.3 66.5

69.1 66.568.8 66.268.0 65.567.6 65.267.5

6 6 . 8 64.466.2 64.564.2 63.267.3 65.966.2 64.4

64.2 62 .164.9 63.365.0 63.261.4 59.359.8 58.0

........... 59.7............. 57.1

56.360.456.7

54.1 61.164.1 6 1 . 163.6 60.964.1 61.564.4 61.9

63.6 61.163.9 61.363.4 61.063.0 60.763.6 61.3

59.0.......................... 57.2

59.6.............

1920............. 54.11919............. 54.71918............. 39.11917.............1916............. 51.7

1915 54.554.2

19131912.............1911 _ _ _ 52.6

1910............. 50.C............. 52.1

1908............. 51.11907............. 47.f

48.7

1905............. 48.747.f

1903 _ _ _ 50. E1902............. 51.E1901............. 49.1

............

63.763.4 61.162.0 59.761.4 59.161.2 59.2

60.8 59.16 0 . 660.0 58.159.7 57.959 .1 57.5

57.7 56.155.8

55.6 55.456.653.8

53.1 51.E54.5 53.252.9 51.750.349.0 47.C

50.2 49.1 47.649.1 48.0 46.652.0 50.9 49.563.4 51.9 50.250.6 49.4 48.048.3 47.6 46.6

I

Includes Alaska.*Denotes first year for which figures include Alaska and Hawaii. Excludes New Jersey; State did not require reporting of race.

55

B

Year or period

--WHITE

VITAL STATISTICS AND HEALTH AND MEDICAL CARE

Series B Expectation of Life a t Specified Ages, by Sex and Race: 1900 to 1970

Male

116

[In years]

Year orperiod

---

Age 70

Male Fe- ' Male Fe- Male Fe- Male Fe- Male Fe-male male male male male

126 127 128 129 130 131 132 ~ 133 ~ 134 135

----__--I_--

Age 20

Year or Male Fe-period male

I 126 127

Age 40

Male Fe- Male Fe- Malemale male ______-----

128 129 130 I 131 132

At birth

1909-111900-02

Age 6 0

66.7 72.1 49.3 54.2 30.763 3 6 47.4 51 0 29 8

54.1 56.6 44.6 45.5 28.849.3 53 1 42.5 44 9 27 0

46.1

46.1

Male

44.11890 42.5

41.71855 38.71850 38.3

Female

125

46.6 41.2 42.8 27.4 29.0 14.4 15.7 9 . 3 10.444.5 40.7 42.0 27.4 28.8 14.7 15.7 9 . 4 10.243.5 42.2 42.8 28.9 30.3 16.9 10.3 11.340.9 39.8 39.9 27.0 28.8 14.4 16.640.5 40.1 40.2 27.9 29.8 15.6 17.0 10.2

Female

9.99 . 18.98.98.68.9

Male

11.610.29 .99 .69.59.6

Female Female Female

123

Male

124118 119 120 121 122117

50.3

49.950.2

50.250.2

50.250.4

50.3

49.950.1

50.149.547.846.045.6

42.742.442.2

44.743.943.644.844.6

68.067.867.567.867.6

67.667.767.567.667.8

67.467.667.267.167.3

67.366.362.859.156.3

50.249.348.2

61.360.560.161.160.7

6 1 . 16 1 . 160.961.561.9

61.161.460.660.36 1 . 1

61.258.952.347.647.1

34.132.5

75.675 .174.975 .174.7

74.774.674.474.474.5

74 .174.273.773.573.7

73.672.067.362.758.5

53.652.55 1 . 1

69.463.467.568.267.4

67.467.266.566.867.0

66.366.56 5 . 565.265.9

65.962.755.549.546.9

37.735.0

57.456.956.756.956.7

56.656.656.456.456.6

5 6 . 256.355.955.755.9

55.854.651.448.546.5

44.944.443.8

52.251.250.551.350.7

50.850.650.050.250.5

49.9

49.348.949.4

49.646.842.137.237.2

36 .186.9

31.931.831.631.831.6

31.731.831.631.731.9

31.631.831.531.431.6

31.731.230.029.229.9

27.427.627.7

28.627.827.428.328.0

28.328.528.128.629.0

28.428.828.027.828.5

23.627.325.223.426.5

21.623.1

38.337.837.637.837.5

37.537.537.337.337.4

37.137.236.736.636.7

36.735.633.331.530.9

29.329.329.2

34.233.332.733.132.8

32.832.732.132.432.6

32.132.431.F

31.E

32.C29.E

23.324.4

16.216.0

16 .1

16.016.0

16.016.1

15.016 .115.715.715.9

16.015.815.114.715.3

14.014.214.4

15.714.914.515.314.9

15.115.214.615.015.3

14.915.514.514.515.2

15.414.914.413.214.7

11.712.6

21.020.520.220.420.2

2 0 . 120.119.919.920.0

19.719.719.219.219.3

19.31R.617.016 .115.9

14.91 5 . 115.2

19.418.517.918.718.1

18.218.117.517.7l R . C

17.718.217.417.417.E

18.117.C

14.2

12.E

10.510.410.210.410.3

10.310.410.210.310.4

10.210.41 0 . 11 0 . 110.3

13.613.012.913.012.8

12.812.812.512.512.6

12.412.512.012.112.2

12.211.710.510.0

9.9

9.4

9.6

10.31 0 . 19 . 49 .29 .5

8 .8

9.0

11.210.910.511.211.0

13.713.713.213.913.4

13.513.412.812.913.0

12.713.013.113.213.6

13.812.311.810.410.3

9.29.6

46.146.345.145.646.0

45.645.845.044.745.4

45.543.739.736.038.4

33.535 .1

11.211.410.710.911.2

10.711.210.911.1

10.18.E9.6

8.3

* Denotes first year for which figures include Alaska and Hawaii.NA Not available.

Data for 1929-31t o 1958 are for conterminous United States, those for 1919-21 fordeath-registration States of 1920 (34 States and the District Columbia); forearlier years, for death-registration States of 1900 (20 States and the District of

Excludes New Jersey: State did not require reporting of race.3 Includes Alaska.

Negroes only.

Columbia).

Series B 126-135. Expectation of Life at Specified Ages, by Sex, for Massachusetts: 1850 t o 1949-51[Inyears]

At birth Age 20 Age 40 Age 70

male

For white population only.NA Not available.

56

VITAL STATISTICS B

Series B Fetal Death Ratio; Neonatal, Infant, and Maternal Mortality Rates, by Race: 1915 to 1970[Prior to 1933,for registration area only. See general note for series B

I145

Fetal death ratioper 1,000live births

146

mortality rateper 10,000live births

Infant mortality rate per 1,000live births

Neonatal mortality rateper 1,000live births

Year Total White Total

139

Total White

142

Jegro andother

andother

144

andother

138

White

140

legro andother

141 147

5.65.66.47.07.28.49.09.79.610.1

12.412.413.813.513.613.914.113.713.914.1

14.114.214.514.514.615.215.515.916.116.7

17.117.518.318.720.421.424.524.225.526.5

27.728.228.129.229.831.131.432.232.733.4

34.034.435.034.835.135.135.835.936.4

22.622.525.625.826.127.228.226.726.727.0

26.827.327.526.827.228.423.929.632.232.1

32.534.636.539.640.942.045.446.249.354.0

56.75961.163.266.968.770.171.174.474.1

79.979.781.574.87373.176.27173.4

15.1

16.116.517.217.717.918.21818.4

18.719.019.519.118.919.119.119.619.820.0

20.521.422.222.824.024.324.724.725.727.7

2829.329.631.332.632.434.134.033.534.6

35.736.937.236.137.937.838.639.539.739.7

41.541.544.243.444.144.4

17.818.419.219.720.621.521.622.222.322.4

22.923.223.823.323.223.623.925.025.525.8

26.828.929.930.131.835.636.937.537.341.2

43.244.347.150.362.951.9454.5

"53.357.4

60.163.264.C

70.C686673.173'72

82.1

9790.t9998

30.932.934.535.938.840.341.141.641.440.7

43.244.045.743.742.142.842.944.747.044.8

44.547.346.548.549.557.060.362.564.674.8

74.279.183.287.683.294.491.38 6 . 293.1

99.9102.2

100.1111.8110112.9117.4110108.5

131.7130.5161.2150.7184.9181.2

1.41.51.72.02.02.12.22.42.42.5

2.62.62.622.93.33.74.44.95.5

6.16.8

10.913.117.218.921.122.226.6

32.035.337.743.651.253.1

454.4456.4458.160.1

60.963.162.759.461.960.360.762.662.864.4

76.069.688.963.260.860.1

2.22.22.52.82.93.23.3

3.7

3.7

3.84.14.14.75.26.16.87.5

8.39.011.713.515.720.72224.525.931.7

37.640.443.548.956.858.2

63.366.1

67.369.569.264.765 .664.76 5 . 666.566.468.2

73.973.791.666.262.260.8

13.814.214.715.015.616.116.216.716.916.9

17.217.517.817.617.517.717.618.318.513.9

19.420.321.221.723.123.323.623.724.b26.1

27.227.828.329.731.031432.3432.1

33.2

34.235.635.73537.136.837.438.6

38.7

40.440.343.34243

.a

20.020.92122.423.724.724.825.225.325.3

21.422.523.023.824.8

26.526.126.126.2

26.927.729.027.827.027.227.027.428.027.3

27.528.629.13131.532.032.532.934.639.0

39.739.639.142.143.942.7445.34 45.843.745.2

47.447.348.846.14849.561.249.949.950.3

55.c55.2

58.C68

15.315.615 7

16.415.815.916.1

16.116.216.516.316.517.117.517.818.318

19.21920.621.122.823.927.026.728.229.9

31.332.032.133.434.435.836.237.037.838.2

39.239.540.238.838.138.139.338.933.4

26.026.427.126.326.026.426.627.828.428.4

910.210.211.811.113.014.416.618.820.1

29.231.33232.233.838.339.840.440.445.3

22.223.530.133.535.445.550.651.054.467.8

77.476.234.985.897.294.6

4 89.7

47.048

54.457.155.760.158.157.661.6 111.4

117.4119.9121.0113.3107.1116.2117.9109.5106.8107.7

64.667.668.764.673.3

70.8

76.275.6

128.1124.4139.3117.7117.9105.6

85.886.6100.993.810199.9

* Denotes first year for which figures include Alaska and Hawaii.For 1945-1970,includes only deaths for which the period of gestation was given as20

For earlier years, includes all fetal deaths, regardless ofIn 1945ratios on all fetal deaths, regardless of gestation, were: Total,

Figures by race exclude New Jersey; State did not require reporting ofIncludes Alaska.

4 Mexicans included with Negro and other.weeks or more or not stated. gestation.26.6;white, 24.1;Negro and other, 44.6.

Series B 148. Infant Mortality Rate, for Massachusetts: 1851 to 1970[Deaths under 1 year per live births. Excludes fetal deaths. Data for 1940 to 1968are by place of residence; for other years, by place of occurrence]

RateYear or period

RatePeriod

RateYear Period

148

16.818.319.920.021.222.219.820.621.8

34.343.253.967.678.7100.2116.7134.3141.4

Excludes approximately 6,000 deathsresidents of the State, covering all ages.

registered in Massachusetts, primarily to

57

B 149-166 VITAL STATISTICS AND ASD MEDICAL CARE

Year

Series 149-166. Death Rate, for Selected Causes: to 1970[Number of deaths, excluding fetal deaths, per 100,000 population. Prior t o 1933, for area only; see general note for series B

Tubeculosi

allform

nanlneo-

plasm

153--

andpara. theri

154

feverand

sorethroat

3.66.6

6.08.6

11.411.112.49 .37.3

Diabrmr

1 1 5 . 217.218.117.618.4

21.119.921.924.22 6 . 3

6.811.612.311.913.69.6

23.529.331.1

33.640.3

Gas-tritis,

enteritis,and

Majc

vas-cularrena

159

and

160

lae

150

m o oing

155

Mealiver

0

163

Acci

164

8 .

1 0

10. :

101 010

10.110.110.112. '12. .

12.:1213.1

13.!

13.1

16.1

16 . i

17.217.119.e20.420.E

19.218.E15.114.814.6

14.714.514.114.014.0

15.413.112.81 2 . 111.4

1111.312.714.8

14.815.015.415.4

L5.4

9

1970. 2

19681967... 3 ,1966

1.41 . 9

2 . 12.02 . 022 . 2

1 .92 . 11 .92 . 32 . 5

2 .73.13.53 . 55 .3

4.62.83.13.53.1

1

156 157

162.1

1 5 5 . :

153151

149

149

146

147.E

146145.f144143140.E

139138134.9132.3

134.0128.8124.3122.0120.1

120.3117.5114.9112.4111.4

108.2106.4102.5102.399.0

97.495.895.795.294.6

92.090.488.486.285.5

83.4

80.880.881.0

80.778.778.577.074.2

76.274.0

71.469.3

73.471.570.066.866.464.0

158

18.119.119.2

17.11 6

16.E1 6 . 4

1 6 . 715.915.91 6 . 015.7

15.515.616.316.416.3

16.216.926.426.224.8

26.526.327.125.425.4

26.625.523.923.723.7

22.322.221.422.020.4

1 9 . 118.819.017.417.9

1 6 . 816.417.718.316.7

16.115.016.116.916.9

17.616.215.415.115.1

15.314.113.814.213.4

1 4 . 114.212.711.711.611.0

161

0.6

33 . 9

4.14 .34 . 44 . 44 .3

4.44.44 .54.74 .5

4 .74 .96.45.65.2

5 . 16 .76.05.65.8

8 .79.99.68.8

10.5

10.311 .61 4 . 314.716.4

1 4 . 118.417.31 6 . 120.5

2623.326.427.132.9

38.633.78 9 . 138.950.7

53.755.272.275.275.5

67.575.186.779.686.8

15.401.812.51523.6

18.411.500.304.918.542.7

C

162

14.1

12.112.:

11

1 01 0 . t11.:10.:

1 01 0 .I

9.2

10.4

9.F8. f9.39.48.9

3.68.38 . 38.58.3

7.97.77 .47.27 .4

7.27.27 . 57.47 .2

7.27.37 . 17 .47.3

7 . 17.99 .6

10.911

12.112.512.913.113.6

13.313.413.514.814.1

14.013.913.513.013.112.5

165 166

1 .1

1.11.41 . 41 . 51 .6

1 . 61 . 7

2.22 .3

2 . 33.03 . 33 . 74 .1

5.05 .88.08 . 89.3

10.611.212.112.213.3

14.415.015.91 6 . 116.2

15.415.915.115.415.4

15.715.616.416.417.1

17.317.817.918.017.5

16.516.218.719.118.6

17.716.716.215.115.3

13.512.912.412.414.1

13.813.913.212.912.512.0

1.11.51.92.12 . 5

2.83.43.63.74.5

4.84.24.95.36.4

7.86.66.77.48.8

7.69.2

12.313.313.2

31.814.717.516.120.1

22.520.223.428.230.9

22.4

24.626.417.631.3

.I

1.4

1.31.42.51.92.8

2.22.33 .73.92 .1

3 . 75.93.64.53.9

4.86.25.46 .88 .8

6 .78 . 19.65.59 . 1

12.55.6

17.010.510.5

8.210.21 0 . 1

9.21 1 . 0

11 .610.010.711.316.1

8.95.8

14.312.48.7

12.2

1 . 41.c1.c1 .7

2.51.21 .0

3 .15.52.21.63.0

3 .22.55.24.18 . 3

2.38.2

10.74.34.2

8.83.9

10.814.111.4

5.26.8

12.87.29.9

12.410.010.69.6

12.9

7.411.38 .89.37 .4

13.3

496.

512.

521.2

521

521.1.!

523

495.1514511513

510502.1

491476

508500.1510479.E475.2

485466.3456.8454.E461.1

431.2430.0413.6418.2407.1

414.4418.9419.1398.3410.6

391.5383.4380.8366.6351.2

364.9348.6387.0396.4389.4

383.5374.5370.6375.7366.5

371.9962.0956.7389.8364.3

33.E

28.E

31.931.137.532.330.1

37.331.233.1

28.2

27.125.43329.731.4

31.330.038.74344.5

51.661.667.155.763.3

70.375.780.4114.9

04.296.995.707.307.5

02.546.542.502.241.7

21.715.251.732.398.7

07.323.088.564.563.3

145.9132.4140.8

145.4

155.9148.1150.9180.0156.3

169.3192.1169.3161.3197.2202.2

21.221.220.720.220.7

20.119.820.11919.4

20.420.120.421.120.9

21.221.523.124.024.5

23.724.328.229.729.8

33.236.037.733.529.2

29.828.127.230.034.9

30.132.031.832.436.1

38.439.740.841.54 3 . 3

46.34 5 . 446.943.84 4 . 1

47.950.559.562.6

52.957.56 4 . 562.666.5

67.077.582.134.134

31.335.431.472.5

72.3

11.611.110.71010.9

11.110.811.010.910.4

10.610.610.79 . 8

10.0

10.210 .11 0 . 11 0 . 010.4

11.411.411.211.511.5

11.210.0

112.8

14.414.1

14.8

1 4 . 314.9

1'7.4

15.618.91 3 . 513.2

12.011.91111.71 2 . 4

1 0 . 211.512.31313.7

16.21 6 . 115.41 5 . 616

16.016.814.51 2

1 3 . 51 2 . 211 3

1 0 . 41 0 . 2

26.227.t

26.527.1

25.4

23.122.c20

21.321.E2122.723.7

23.422.124.024.324.1

23.121.322.122.823.9

21.218.317.721.130.0

26.224.725.130.829.7

28.628.625.023.627.1

26.726.523.221.619.9

16.815.314.612.411.3

10.39.39 .38 .67.1

5.84 . 23 .82.82.1

1.81.2

19651964....19631962

4.445 .5

6 .67 .78

9

121520

22.t26

33.i36.4

39.E41 .I 42.143.1

46.947.149.158.855.9

101965....195319621951

195019491948......19471946

1945...1944...194319421941....1940193919381937 _ _ _1936

384.0388.8I R A A

147.7345.2

* Denotes first year for which figures include Alaska and Hawaii.Z Less than 0.05.11900-1920, excludes aneurysm of the aorta.

pneumonia newborn; excludesnewborn; includes ulcer of

neoplasms of lymphatic and hematopoietic tissues.

excludes collisions with trains and streetcars, andaccidents.

58


Series Death Rate, by Race and Sex: 1900 to 1970[Number of deaths, excluding fetal deaths, per 1,000 population. Prior to 1933 for death-registration area only; see general note for series

Year

1969...1968...1967...1966...

19631962

.19601959 .1956...

1953....

1951...

.1946...

1944...1943...1941...

1915

White

9.59 .59.79.49 .5

9 .49.49.69 . 59 .3

0 . 59 . 49 . 59.69.4

9 .39.29.69.69 . 7

9 . 69.79 .9

10.110.0

10 .610 .610.910.310.5

10.810.610.611.31 1 . 6

10.9

10.710.911.1

11.311.912.0

12.1

11.711.612.111.711.5

13.012.918.114.013.8

13.213.313.813.613.9

14.714.214.715.915.7

15.916.4

16.417.2

11.1

9 . 49 . 5

9 . 4

9 . 59 . 49 . 3

9 . 39 . 49 . 59 . 3

9 . 29 . 19 . 49 . 49 . 5

9 . 59 . 59 . 79 . 99 . 8

10.410.410.71 0 . 110.2

10.410.310.3

11.1

10.610.61 0 . 3

10.6

10.811.311.410.811.6

11.111.011.711.311.1

12.612.41 7 . 513.513.4

12.913.01 3 . 513.413.7

14.514.014.515.715.5

15.716.215.415.316.217.0

10.910.911.110.810.9

10.810.811.01 0 . 810.7

11.01 0 . 810.911.010.8

10.710.611.011.011.0

10.911.011.211.411.2

12.512.212.211.411.4

11.611.311.312.012.3

11.611.711.211.311.6

11.712.212.311.61 2 . 3

11.811.812.311.911.6

13.013.019.31 4 . 614.4

14.5

14.E

14..

17.1

17.1

Death rate _---Negro and other

Female

170

8 . 18 . 28 . 28 . 08 . 1

8 . 08 . 08 . 18 . 07 . 8

8 . 07 . 98 . 08 . 07 . 8

7 . 87 . 68.08 .08 . 0

8 . 08 . 18.38 . 58 . 5

8 . 68 . 89 . 28 . 78 . 9

9 .29 .29 . 29 .69 .9

9 . 59.69 . 39.69.6

9 .810.410.510.0

10.4

11.c

10.f

12.1

12.12.:

12.1

15.:

14..

16.:

13.1

Bothsexes

171

9.49 . 69.99 . 49 . 7

9 . 69 . 7

10 1

9 . 6

10.19.9

1 0 . 3

10.1

10.01 0 . 110.811.011.1

11.211.211.411.411.1

11.912.412.812.713.5

13.813.514.014.916.4

14.314.814.114.515.5

16.316.917.116.417.8

17.417.116.515.215.5

1 7 . 717.9

20.41 9 . 1

20.220.220.320.621.3

21.7

22.424.224.2

25.526.124.523. t

25.c

Male

172

11.211.311.610.911.3

11.111.1

11.210.9

11.6

11.4

11.311.412.3

12.5

12.512.512.712.512.2

13.513.814.014.014.8

15.114.715.216.416.9

15.6

15.1

17.4

15. '

18.26.'

20.

21.21.

22.22.22

24.25.25.

__-Female

173

7 . 88 . 08 . 37.98 . 3

8 . 28 . 38 . 78 . 58 . 4

8 . 78 . 69 . 09 . 18 . 8

8.88 . 89.49.f

1o.c10.110.:

11.1

12.:

12.t

13.'

13.13.13.14.

16.15.

16.16.16.

15.

17.17.

18.

19

19

21222323

242423222324

Age-adjusted death rate

White-__---Total

Both Male

7 . 17 . 37 . 57 . 37.5

7.47 .47.67 .57.4

7 .67 . 57.77 . 87.6

7.77 . 68.08.18 . 3

8.48 . 58 . 89 .09 . 1

9.59.7

10.29.9

10.3

10.810.71 0 . 911.712.2

11.611.911 .611.912.1

12.513.213.412.613.5

13.012.913.513.012.7

14.214.019.015.3

14.414.515.014.815.2

15.815.315.817.116.7

1 6 . 71 7 . 316.516.217.217.8

6.86.97.16.97.1

7 .17 . 17.27.17.0

7.37.27 . 37.47.3

7 . 47.37 . 77.87 .9

8.08 . 18 . 38.68 . 8

9 . 19 . 39 . 79 . 49 . 7

10.210.210.311.1

11.111.311.011.311.4

11.712.412.611.912.7

12.312.212.912.612.2

13.713.418.414.714.7

14.114.114.614.614.9

15.615.015.516.816.4

1 6 . 517.116.216.017.017.6

8 . 99 . 09 .29 .09 . 2

9 . 19 . 09 . 29 .08 . 9

9 . 29 . 09 . 19 . 29 . 1

9 . 19 . 09 . 49 . 59 .6

9 .69 . 7

10.1

10.510.E

11.:

12.1

12.112.:12.

13.13.12.13.

13.13.13.13.12.

14.

20.16.

15.

16

17.

17.18

18.18.

Female

177

5.05.25.35.25.3

5.35.35.55.45.4

5.65 .55 .75 .85.7

5.75 .86 . 16 . 26.3

6 . 56 . 66 .87.17 . 3

7.88.28.08.3

8 .88.99.19.7

10.1

9.810.09.9

1 0 . 2

ll.t10.111.t

11.:12.

11.1

13.1 2 .16.13.13.

13.13.

13.13.

14.14.14.

15.

15.1 6 .

14.1 6 .1 6 .

Negro and other ---

Both Malesexes

178 179

9.810.510.810.210.5

10.310.610.31 0 . 0

10.510.310.610.810.5

10.410.611.411.711.9

12.312.312.512.512.4

13.113.814.51 4 . 5

16.316.016.617.818.5

17.317.917.217.819

2 0 . 121.020.919.821.4

20.920.519.818.318.2

20.620.528.023.422.2

23.122.622.723.123.7

24.124.124.726.626.2

28.329.127.225.926.927.8

12.318.013.312.412.7

12.412.212.512.011 .6

12.111.912.212.411.9

11.912.013.013.213.3

13.613.513.813.618.5

14.514.915.715.816.9

17.617.117.719.220

18.519.018.118.619

21.121.:

22.:

21.:20.1

20.

28.24.22.

23.2324.24.

24.24.

27.1

29.'30.'28.

28.'

Female

180

7.78 . 38 . 68 . 23 .6

8 .58 .68 .98 . 78 .6

8 . 98.89.29 .49 . 1

9 . 19 .29.9

10.210.5

10.911.111.211.411.3

11.912.613.41 3 . 314.3

14.915.516.317.0

1 6 . 116.716.417.018.119.2

19.320.8

20.420.019.71 8 . 418.6

21.020.827.122.721.6

22.621.922.022.222.9

23.223.324.126.726.5

26.927.425.924.625.527.1

* Denotes first year for which figures include and Hawaii.Excludes New Jersey; State did not require reporting of race.

Includes Alaska.

59

B 181-192 VITAL STATISTICS AND HEALTH A S D MEDICAL CARE

Series B 181-192. Death Rate, by Age and Sex: 1900 t o 1970[Number of deaths, excluding fetal deaths, per 1,000 population for specified group. Prior to 1933, for death-registration area only; see general note for series B

Total

181

25-34years

35-44years

45-54years

55-64years

189

65-74years

190

1-4years

183

5-14years

15-24years

75-84years

191

Under1year 85 years

and over

192

Year

184 187

3 . 13.23.23 . 13.1

3 . 13.13.03

3 . 02 .9

3 . 13

83.13.33.43.5

3.63 .73.94 . 14.2

4.64.644.8

5.25.35.66 . 26.5

6.26.26 . 26 .36

6.87.37.57 .17.4

7.27.17.37.16.8

8 .18.6

13.498.8

8 .38.58.78.68.9

9.08.79

10.29.8

9.810.29.89.6

10.310.2

3

5

185

1 . 41.11.11.1

1.11.11.111

1.11.11.111.1

1.11.11 . 21 .31 . 3

1.311 . 41

1 . 92.c2.11 . 92.c

2.02.122.62

2.722.72.93.2

3.333.73.53.7

3.E33.93.83 .9

4.95.3

4.74.4

4 .14.24 .44 . 34.5

4.54.44.85 .35 . 3

5.25.55.25.15.55.9

186

1 . 61 . 61 .61 . 51 . 5

1 .51 .51 . 51 . 51.4

1 . 51 . 51 .51 . 51 . 5

1 . 51 . 51 . 61 . 71

1122 . 12 . 3

2 . 72.72.722.9

3 . 13.23 .43 .94 . 1

4.04.14.14.24.5

5.04 .74 .9

4.84.85.05.04.9

7 . 516.4

6.56 .2

5 .86 .06 . 26 . 16 .4

6.56 . 36 . 77.57.5

7.47 .81 . 57.58 . 08 . 2

188

7.37 . 37.57.37.4

7 . 47.47 .57 .47.3

7 .67.47 . 57.77 . 5

7 . 57 .78 . 18 . 38 .4

8 . 58.19.09.29 .2

9 .69 . 7

10.210.110.3

10.310.710.911.812.1

11.611.811.411.612.0

12.212.712.812.012.7

12.212.112.21111.2

12.212.315.213.913.6

13.113.113.513.413.5

13.713.313.815.114.5

14.715.114.314.015.0

9.E999.49.E

9.49.49.69.59.3

9.59.49.E

9.4

9.39.29.69.69

9.69

10.11 o . c1 0 . 610.610.910 .310.5

10.810.610 .611.311.6

10.911.110.710.911.1

11.311.912.011.312.1

11.711.612.111.711.5

13.012.918.114.013.8

13.213.313.813.613.9

14.714.214.715.915.7

15.916.415.615.516.417.2

21.421.522.322.323.3

24.124.625.325.325.4

27.0

28.128.028.3

28.529.230.732.132.3

33.035.235.734.546.3

42.544.244.048.852.6

54.9

58.061.362.9

60.966.861.361.364.4

69.071.673.168.877.9

0.8

111 . 01 . 0

1.11.11.11.11.1

1.11 . 21 . 31 . 41 . 4

1 . 41 . 51 . 61 . 61 .8

22.32.62 . 42.8

2.93 .23.84.24.4

4.45 . 14.74.65 . 3

5 .66.36.55 . 97.2

6 . 46 . 88 . 17.48 . 0

9.99.3

15.710.711.1

9 . 210.211.910.911.8

14.013.614.014.715.8

1515.915.416.617.019.8

0.4

1 . 0

1 .0

1 . 01.11.21 .41 . 5

1 . 51 . 51 . 51 . 7

1 .71.91 .91.91 . 9

2.02.02 . 12 .12 . 5

2.62 .74 . 12 . 62 . 5

2 . 32 . 52 . 72.52 .7

2.92.83.03 . 23 . 3

8.43 .78 . 43 . 33.53.9

16 .616.817.216.717.0

16.917.017.316.916.7

17.417.117.417.817.5

17.317.418.418.618.8

19.319.720.119

20.520.821.521.021.3

22.222.122.123.524.1

23.228.523.223.423.6

24.024.524.222.924.1

23.323.023.923.222.1

23.623.126.526.826.5

25.525.125.525.825.8

26.225.626.228.627.1

27.728.527.225.927.827.2

36.337.438.537.538.4

37.937.838.938.037.2

38.237.638.438.937.8

37.937.639.139.240

40.841.442.141.2

42.643.946.244.946.2

48.447.247.149.050.8

48.749.449.050.049.9

51.45454.351.253.8

51.75153.352.249.0

52.550.055.157.357.2

55.654.154.154.555.0

55.653.953.858.855.0

56.258.255.052.956.256.4

80.079.c80.879.c81.7

81.9

85.284.3

87.5858788.488

8987.192.i91.E93.:

93 .I

95.1

95.1

101.1

101

112.c112.E

113.1114.1111114.3110.5

112.7122.2125.2115.9125.4

119.3117.2123.5117.5111.2

118.9107.8113.0123.9123.9

120.1115.6117.9120.2120.1

122.2118.4119.5128.7120.4

122.4126.1120.8114.1124.6123.3

93

163.4190.8196.1194.2200.6

198.6194.2198188.4181.8

224.6224.8222.3233.3222.8

228.0254.3268.3250.1279.7

75.476.8

77.680.6

92.391.0

111.7104.6105.7

102.4107.2114.8111.1114.0

131.8126.7133.2138.6144.8

141.2139.2132.6138.9141.4162.4

250.3244.9248.6269.1255.1

60

VITAL STATISTICS

Series B . Death Rate. by Age and Sex: 1900 to 1970-Con.

Year

........

Total

181

1970........................1969........................1968........................1967........................1966........................965........................

1964........................1963........................1962........................1961........................1960 *.......................1959........................1958........................1957........................1956........................1955........................1954........................1953........................1952........................1951........................1950........................1949........................1948........................1947........................1946........................1945........................1944........................1943........................1942........................1941........................1940........................1939........................1938........................1937........................1936........................1935........................1934........................1933........................1932........................1931........................1930........................1929........................1928........................1927........................1926........................1925.- .......................1924........................1923........................1922........................1021........................1920........................1913........................1918........................1917........................1916........................1915.........................1914........................1918........................1912........................1911........................1910........................1909........................1908........................1907........................1906........................1905........................1904........................1902........................

.......................1900........................

See footnotes at end of table.

10.911.011.110.811.0

10.910.811.110.910.7

11.010.811.011.110.8

10.310 .711.111.111.1

11.111.111.3

11.3

12.612.412.411.711.8

12.011.711.712.512.7

12.012.1l l . G11.712.0

12.312.812.812.112.9

12.412.312 .712.311.9

13.413.519.815.014.8

14.014.214.814.514 .7

15.615.115.517.016.7

16.717.316.416.417.317.9

.Under1year

182

2 4 . 124.225.225.226.3

27.127.728.628.728.6

30.631.131.631.632.1

32.133.034.736.236.6

37.339.640.238.852 .1

47.649 .149.354.458.6

61.960.365.268.770.7

68.974.868.368.572.2

77.080.082.377.587.1

84.686.290.287.09 0 . 1

103.6101.9124.5117.4118.2

114.5118.9127.6123.3125.9

145.5139.9147.0152.9160.2

156.6

146.6153.4156.4179.1

.1-4

years

183

...

0.9.9.91 .01 .0

1.01 .01.11.01.1

1 . 21.21 . 21 . 21 . 2

1 .21 . 31 . 41.51 . 5

1 . 51 . 61 . 71.82 .0

2 .22.52 . 82.63 .0

3 . 13 .44 . 14.54.7

4.75.45.04.95.6

6.06 . 66.86.27.6

6.77.28.57.98.4

10.39.7

16.011.211.7

9.710.712.5

12.2

14.114.C1 5 .16.4

15.E16.t

17.117.

.5-14years

184

0.5.5.5.5.5

.5.5.5.5.5

.6.6.6.6.6

.6.6.7.7.7

.7.3.8.81.0

1.11.11.11.11.1

1.21 . 31 . 41.51.7

1.71 . 71 . 71 .71.8

1.92 .12 .12 .12.1

2.22.22.3

2.7

2.E

22.c

2.42.c

2 . t2.1

3 ..3 ..3.'3.1

3 . '3.

4.5

.15-24years

185

1 . 91 . 91 . 81.71 . 7

1 .61 . 51 . 61 . 51 . 5

1 . 51 . 51 . 51 . 61 . 7

1 . 61 . 61 . 71.31 . 7

1 . 71 . 71 . 81 . 92 . 1

2 . 72 . 82 . 62 32 . 8

2 . 32 . 42 . 52.93 . 0

2 . 93.02 . 93.03.4

3.53.73.e3.53 . 1

3.E3.E3.r3.E

5..12.

4.1

4 ..4.'4 . !4 . '

4 .4.1

5. '

5 .5.5.5.5 .5 .

.25-34years

186..

2.22.22 . 12 .02.0

2.02.01 .91.91 .8

1 .91 .91 .91 .91 .9

1 .92.02 . 12 .22.2

2 .22.22.32.42.6

3 .53 .23.23.23.3

3.43 .43.64.24.4

4.34.34.34.34.7

4.95.25 . 1

5.c

5.15.C4.t

7 . f

7.16.L6 ..6.'6.1

6 .

8 .7 .7 .8 .7 .7 .8 .8 .

.35-44years

187

4.04.14.13.93.9

3.93.83.83.73.7

3.73.73.73.83.7

3.83.84.14.24.3

4.34.44.74.R4.9

5.55.45.55.65.7

5.96.06 .27.07.4

7.07.06.86.97.4

8.08.07 . 67.9

7.f7.f7 . 77.46.S

9.115.1

9 .9 ..9.'9 .

9 .9 .

11.10.10.11.10.10.11.10.

7.5

.

.45-54years

188

9.69.69.89.69.8

9.79.79.39.79.6

9.99.79.89.99.6

9.79.9

10.410.510.6

10.710.311.211.311.2

11.611.712.21 2 . 112.2

12.512.512.613.814.1

13.313.512.912.913.4

13.614 .114 .113.213. S

13.113.112..12..16. '

15 . '

14.14.14.1 5.14..16.16.1 6 .1 6.15.15.16.1 5.

12.

.55-64years

189

22.82 3 . 123.723.023.3

23 .123.023 .222.622.4

23.122.823.023.523.0

22.722.723.924.023.9

224.024.224.625.024.3

25.025.025.725.125.3

25.525.327.227.7

26.326.626.026.126.2

26 .26.E25.C26.C

25.124.125 .24.23 ..24.124 ..28.'29 .

27 .27 .27 .28 .28 .28 .27.28 .31.29 .29 .31.29 .28 .29 .28.

.65-74years

190

48.750.351.950.251.2

50.549.951.149.448.1

49.147.943.548.847.2

46.946.347.647.548.6

249.348.448.849.247.5

49.150.252.651.352.6

52.752.554.556.1

53.754.353.654.164.4

55.858.458.555.257.6

55.454.756.255.151 .1

54.551.958.561.160.6

58.E57.E57.757.E58.1

58.757.c56.462.758.2

59.c61.758.556.559.259.8

.75-84years

181-192

100.197.698.896.298.5

98.297.1

100.798.797.8

101.899.1

101.4100.7100.6

98.5103.4102.6103.9

104.3103.8105.1106.6104.1

110.7117.2111.0115.2

121.3120.7118.8126.4130.6

121.7122.2118.3121.1117.5

119.1123.9132.3122.6131.8

125.3122.8127.4121.8114.4

122.11 1 1 . 0118.1129 .C128.7

124.120.L122.E

125.1

127.4123.125.E134.C126.5

128.8132.6126.8120.5129.7128.3

.

.15 yearsnd over

192

178.2195.5203.9203.8209.3

212.8210.4224.6219.0209.1

211.9205.4208.3201.9195.1

191.7185.0197.8194.6207.4

216.4215.0226.4229.3221.1

220.7225.5242.6222.1231.9

246.4232.6222.2238.0252.7

234.7235.1232.7242.3234.1

236.7

254.2281.3

273.5263.8279.4257.8241.2

253.0229.6227.6261.1255.5

246.7236.9241.4248.6249.3

255.8251.4251.5275.0261.6

270.5280.7262.7248.6268.1268.8

61


Series B 181-192. Death Rate, by Age and Sex: 1900 to 1970-Con.

1year

181

Year

8.28.08.1

8.08.08.28 . 17.9

8.18.08.18.17.9

7.97.88 . 18.18.2

8.28.38.58.78.6

8.89.09.49.09.2

9.59.59.6

10.010.4

9.910.09.7

10.010.1

10.411.011.110.511.3

10.910.911.511.111.0

12.612.316.412.912.8

12.312.412.812.713.0

13.713.413.814 314.7

15.015.514.814.615.616.5

18.18.19.19.20.

20.’

22.1

23.123.1

24.:

24.5

26.E

30.631.C30.C40.1

37.239.038.542.946.3

47.746.850.753.654.9

52.858.554.053.956.5

60.762.963.660.068.4

66.067.071.667.970.8

80.779.798.591.592.8

90.095.1

101.793.5

117.6113.2119.1123.9129.2

125.5124.2118.3124.1126.1145.4

1-4years

183

I.I

11

1.c1 . c

1 . 01.11.21.31.3

1.31.41.51.51.7

1 .92.22 .42 .32.6

2 .72 .93.63 .94 . 1

4 . 14.74.44.44.9

5.25.96 .15.66.3

6 .16.47 .77.07.6

9.58.8

15.510.110.5

8.89 . 7

11.410.411.3

13.412.913.414.115.2

14.215.214.916.016.219.1

5-14years

184

1.11.21.3

1.41 . 41.31.41.5

1.51 .71 . 71.71 .7

1 .81.82.02.02 . 3

2 . 52 . 64.12 . 42 . 3

2.22.42 . 52 . 32.6

2.92.72.93 . 08.2

3.38.63.43.23.43.9

15-24years

185

0.

C

CC

1.11 . 21.3

1.41.41 . 51.61.7

1.81.92 .12 . 32.5

2.52.52.62.73.0

3.23.53.63.43.7

3.83.83.93 . 33.9

5.05.39.44.44.2

3.94.04.14.04.3

4.24.24.54 .84 .9

5 . 15 .55.05 . 15 .45.8

25-34years

186

1.1.1.

1.

1..1.:1.:1.1

111.:1.:1

1.11.11 . 511 . 4

1 . 4

1.5

2.12.22.42.42.6

2.72.93.13.58.8

3.83.83.94.04.3

4.44.84.84.64.8

4.84.75.05 . 15.0

7 .17.6

14.05.9

5.45.65.75.76.0

6.16.06.36.97.0

7 .27.67.37.37.88.2

35-44years

187

2.:2.‘

2.:2.:

2.:2.:2.:2. :2.:

2.22.:2.4

2.42.42.E2.72.E

2.9

3.23.33.5

3.83.94 .14 . 14.3

4.54.64.95.45.6

5.45.55.55.76.0

6 .16 . 66.96.56.8

6.76.66.96.86 . 6

8.08 .1

11.37.97.7

7.47.57.77.6

7.97.88.08.88.5

8.99.29.08.89.69.8

45-54years

188

5.:5.15.:

5.1

5.2

5.55 . 25.1

5.25.4

5.4

5.45.76.06 . 16.3

6.46.66.87.17.1

7.57.68 . 18 . 08 .3

8.68.99 . 19.7

10.0

9 . 89.99.8

10.110.4

10.611.111.3

11.4

11.011.111.211.010.7

11.711.513.612.011.9

11.611.611.811.611.9

12.111.712.213.112.9

13.313.713.012.813.914.2

55-64years

189

1111.:11.:

11.:11.4

11l l . E

12.cl l . f12.112.412.3

12.212.313.113.413.8

14.314.8

15.3

15.916.417.216.717.1

18.618.619.620.3

19.820.220.120.620.7

21.221.821.820.622.0

21.221.022.021.520.8

22.421.624.024.023.9

23.222.722.923.323.4

23.723.423.925.924.6

25.626.025.423.926.025.8

65-74years

190

27.1

28.1

28.728 . t29.430.C29.4

29.729.631.231.532.2

33.333.634.335.335.1

37.839.938.739.8

41.741.843.445.4

43.744.444.345.845.4

46.849.449.947.049.9

47.947.150.449.246.3

50.548.051.553.453.6

52.550.4

51.151.9

52.450.851.154.951.8

53.554.951.849.553.453.6

75-84years

191

66.866.368.366.969.6

70.070.473.573.372.8

76.375.577.478.578.7

79.578.483.182.884.1

84.083.886.488.587.3

90.293.799.093.497.3

103.7105.1103.7108.4113.5

106.1106.5104.7108.0104.0

106.6116.0118.6109.6

113.8112.9119.8

103.3

115.9105.0108.3119.2119.5

116.0111.0113.4115.5115.5

117.4113.3113.7124.0114.8

116.7120.3115.4108.3120.0118.8

85 yearsand over

192

166.21813.0

7188.6

4

190.1

191.. 0179.5

164.3173.7176.1

203.120

201.38

221.29

216.3

219.0236.3

217.0217.1214.4226.6214.3

221.4250.2265.9247.0278.4

271.3260.3279.9258.4237.6

244.7216.8218.1242.1246.6

235.3227.3231.7237.1244.2

246.0239.9246.4264.7250.3

254.9262.1247.1226.1255.6255.2

* Denotes first year for which figures include Alaska and Hawaii.Age not reported included in “Total,” but not distributed among specified age Based on enumeratedpopulation adjusted for age bias in the population for Negro

and other races, 55 to 69 years old.groups.

62


Series B 193-200. Death Rate, by Sex and by Selected Cause, for Massachusetts: to 1970[Includes only deaths, excluding fetal deaths, occurring within Massachusetts, except for 1940-1970; for these years, data are for deaths occurring to residents of Massachusetts1

40-49 50-59 60-69 70-79years years years years

209 210 I 211 212-----and

213

1-4 5-9years years

203 204

10-14 15-19years

205 206

12.012.713.413.0

11.713.012.011.9

21.3 41.0 85.8 197.820.5 89.4 82.4 184.720.4 37.5 76.0 174.219.7 36.2 76.2 182.3

17.9 33.9 73.1 184.018.3 34.8 71.1 176.417.0 30.1 68.9 170.017.5 32.9 70.5 168.2

57.864.568.167.0

68.17462.968.6

5.3 2.9 4.86.2 3.2 5.36.6 3.6 6.87.5 3.8 6.4

8.5 8.8 6.69.8 4.7 7.75.9 3.7 7.29.6 5.1 9 .6

7.07 .18.49.1

9.510.510.512.6

8.89

10.410.6

10.311.310.611.7

sex per By cause per 100,000 populationsex per populatior By cause per 100,000 population

Tuber-ulosis

torysystem

'yphoicand

para-typhoidfever

198

'yphoicand

fever

Tuber-ulosis of

tnry

Diph-theria

Small-poxDiph-

theria

197 200

Year Total Male Measles

199

Year Total MaleFemale

195 196

244.8239.6

258.6256.5270.8285.6295.1

306.6303.6316317.9324.5

308.1297.4308.4320.4317.6

347.4328.0353.6362.6339.3

343.3328.8322325.5353.0

367.9375.7372.6342.8365.2

. ,

198196 197

62.253.2

72.6101.7

86.679.278

78.486.286.496

131.4

134.3180.6145.5186.6196.4

113.856.747.449.150

46.454.356.745.363.7

92.8158.7182.492.189.268.0

193 194

1970- _ _ _ 10.11969- 10.61968- 10.9

10.71966- 10.7

1965 111964 9.619631962 10.81961 10.8

1960 111959 10.71958 11.3 _ _ _1957 11.11956- 10.9

35.335.9

37.340.944.644.840.0

39.545.845.858.559.1

49.536.339.347.852.5

64.171.289.5

111.174.7

91.585.065.072.083.7

133.7106.7115.191.179.976.1

1

4.38.0

15.119.821.0

22.152.833.226.454.5

65.571.473.658.3

0.1

3 . 38 . 49 .17.3

11.6

8 . 411 .78.83.16.0

5.44 . 74.0

11.5

20.919.7

3.8 0 .110.3

7.95.1

10.422.1

6.5

2.42.42.93.53 .3

43 .34.44.85.7

66 .668.28.6

9 .320.236.934.642.9

57.270.196.8

116.8138.3

163.5190.3190.4197.4207.4

216.4223.4223.4231

19.4 20.0

19.818.6

19.6 20.219.0

1883 20.119.920.1

16.1 1.03.9

17.13.7 2.4

12.7 2.6

13 .2 2.11.1

17.67.9 1.42.8 1.8

19.8 20.318.118.1

1877 18.419.8

21.7 21.818.621.622.918.7

1870 18.8 19.518.4

1868 18.617.018.2

20.6 21.722.822.218.5

1955 10.91950 10.5 11.6

1935 11.5 12.2

1930 11.6 12.21925 12.5 13.01920 13.8 13.91915 14.3 15.01910 16.1 17.0

1905 16.7 17.61900 18.4 19.2

17.417.513.1

1896- _ _ _19.120.5

14.1 2.110.0 1.611.5 42.527.9 67.28.8 19.7

18.5 9 .015.7 4.220.8 1.514.5 14.68.4 10.8

10.7 17.425.4 19.211.3 3.429.6 3.216.9 2.718.2 27.1

Excludes approximately 6,000 deaths registered in Massachusetts, primarilyresidents of the State.- Represents zero. NA Not available. Z Less than 0.05.

Beginning 1958, includes "other salmonella infections."

Series B 201-213. Death Rate, by Age, for Massachusetts: 1865 to 1900[Includes only deaths, excluding fetal deaths, occurring within Massachusetts. Rate per 1,000 population for

20-29 30-39yearsTotal

Year207 208201 202

1880 19.81875 21.2 226.61870 18.8 138.11865 20.6 205.3

63

B 214-220

Per 1,000unmarriedfemales Year

215

VITAL STATISTICS AND HEALTH AND MEDICAL CARE

Series B 214-215. Marriage Rate: 1920 to 1970

Per 1,000population

214

Per 1,000 Per 1,000population unmarried

Year females Year

214 215--

Per 1,000population

214

78.082.480.979.883.7

1944 10.91943 11.7

13.219421941 12.71940 12.1

1969.- .__19671966

19651964196319621961...

10.6 76.7 8.910.6 80.0 9.510.4 79.1 1955 9.39.7 76.4 9.29.5 75.6 9

9.3 75.0 9.99.0 74.6 10.48.8 73.4 1950 11.18.5 71.2 1949 10.68.5 72.2 12.4

83.286.690.286.798.5

106.2118.183.6

1989 10.71938 10.31937 11.31936 10.71935 10.4

1934 10.31933 8.71932 7.9

Perunmarriedfemales

populationPer 1,000

Year

214 215215

76.583.09388.582.8

7369.978.074.012.5

71.861.356.0

61.967.6

75.574.177.078.779.2

80.385.279.783.092

8.5 73.5 13.973.6 16.4

1958 72.0 1945 12.2

* Denotes first year for which figures include Alaska and Hawaii.years old and over.

Includes Alaska.

Series B 216-220. Divorce: 1920 to 1970[Includes reported annulments]

DivorceMedianduration

ofmarriage

Divorcedpersons per

1,000 married,Divorce rate

Percent ofspouses

separated[EL-Per 1,000

-Per 1,000marriedfemales

Per 1,000married

females

217

spousepresent

PerpopulationYear Year

216 217 218 219 220

3.53.22.92.62.5

2 . 52.42.32.22.3

2.22.22 .12.22.3

14.913.412.411.210.9

10.610.09.69.49.6

9.29.38.99.29.4

9.39.59.9

10.19.9

10.3

6.76.97.07.1

7.27.47.57.37 . 1

1.81 .91 . 81 . 81.9

2 . 01.91 . 81.91.9

1 .81.91 .81 . 61.8

4746454343

4141393737

3533323132

3133312929

292933

2.92.62.42.2

12.011.010.19.4

8.88.58.48.78.3

1.71.61 .31.31.5

7.87.56.16.17.1

7.27.06.46.76.5

7 . 51.61.71.71.61.6

2.32.42.52.52.5

6.46.46.16 .16.0

1.8

1.51.41.5

7.87.87.5

1.5

1 .51.4

1.6

7.2

7.16.67.28.0

2.62.73.83.44.33.5

* Denotes first for which include Alaska and Hawaii. Persons 14 years old and over.Includes Alaska.15 years old and over. Population enumerated as of April 1 for 1940, 1950, and

1960, and estimated as of July 1for all other years; includes Armed Forces abroad for

64

Chapter B

and ical Care

B Total and per capita national health expenditures,

Source: U.S. Social Security Administration. Com-pendium of National Health Expenditures Data, DHEW Pub.No. table 6; 1969-1970, National Health Expenditures, Calendar Years 1929-71, Research and Statistics Note, No. 3, 1973,DHEW Pub. No. tables 2 and 8.

The generai method of estimating national health expenditures ist o estimate the outlays for each type of medical service or ex-penditure and t o deduct the amounts paid to public and privatehospitals, physicians in private practice, etc., under each publicprogram. The figures for each public program are allocated by typeof expenditure on the basis of published and unpublished reportsfor each program.

The estimates of expenditures for hospitalcare are based on the data on hospital finances published by the

Hospitai Association, and increased slightly to fornonreporting and for osteopathic hospitals. Salaries of physiciansand dentists on the staffs of hospitals and hospital outpatient facili-t i es are considered a component of hospital care and are, therefore,included. Expenditures for the education and training of physiciansand other health personnel are included only where they are notseparable from the cost of hospital operations.

B physicians’ services, dentists’ services, and other pro-fessional services. The estimates of expenditures for the servicesof physicians, dentists, and other health professions in private practiceare based on the gross incomes from self-employment practice re-ported t o the Internal Revenue Service on Schedule C of the income-tax return (as shown i n Statistics of Income, published by the InternalRevenue Service). Data are totaled for practitioners in sole pro-prietorships and partnerships. The total also includes the estimatedgross income of offices that are organized as corporations, the grossreceipts of medical and dental laboratories estimated to representpat ient payments to medical laboratories, and the estimated expensesof group-practice prepayment plans in providing physicians’ services(to t h e extent that these are not included in physicians’ income fromself-employment). Estimated receipts of physicians for making lifeinsurance examinations are deducted.

Salaries of physicians and dentists on the staffs of hospitals andhospital outpatient facilities are considered a component of hospitalcare (series B 223).

Salaries of visiting nurse associations, estimated from surveys con-ducted b y the National League for Nursing, are added to the privateincome of other health professionals. Deductions and exclusionsare made in the same manner as for expenditures for physicians’ anddentists’ services.

227-228, drugs and drug sundries, and eyeglasses and appliances.T h e basic source of the estimates for these items is the report ofPersonal consumption expenditures in the Department of Commercenational income accounts in the monthly Survey of Current Business.Tota l expenditures for drugs and appliances are the sum of the De-partment of Commerce estimates and the expenditures under allpublic programs for these products.

nursing-home care. Expenditures for nursing-home care are derived by applying an estimated cost per patient day to theto ta l days of care. Total days of care are estimated by applying anaverage occupancy rate, as reported b y the Federal Housing Ad-ministration, t o the number of nursing-home beds, as reported byt h e Division of Hospital and Medical Facilities of the Public HeslthService in their annual report, Hill-Burton State Plan

type of service, 1929-1970.

B 223, hospital care.

The cost per patient day was based on unpublished data from asurvey of nursing homes financed by the Social Security Adminis-tration.

B 230,expenses for prepayment and administration. Prepaymentexpenses represent the difference between the earned premiums orsubscription charges of health insurance organizations and theirclaim or benefit expenditures (expenditures in providing such servicesin the case of organizations that directly provide services). In otherwords, i t is the amount retained by health insurance organizations for operating expenses, additions t o reserves, and profits, and is con-sidered a consumer expenditure. The data on the financial experi-ence of health insurance organizations are reported annually in aSocial Security Bulletin article on private health insurance.

The administration component represents the administrative ex-penses (where they are reported) of federally financed healthprograms.

The Federal portionconsists of outlays for the organization and delivery of health servicesand prevention and control of health problems by the Health Servicesand Mental Health Administration, the National Institutes of Health,and the Environmental Health Service of the Public Health Service.Also included are outlays by other Federal agencies for similar healthactivities. The data for these programs are taken from Office ofManagement and Budget, Special Analyses, Budget of theStates.

The State and local portion represents expenditures of all andlocal health departments and intergovernmental payments to theStates and localities for public health activities. It excludes ex-penditures by other State and local government departments forpollution and water-pollution control, sanitation, water supplies, andsewage treatment. The source of these data is Governmentpublished annually by the Bureau of the Census.

This series covers items of expendi-tures not elsewhere classified. It includes, for each public program, the residual amount of expenditures not classified as a specific type ofmedical service. I n addition, it includes the following programs:(1) Industrial in-plant services and activities of private voluntary health agencies in the private sector and school health services andnonhospital Federal activities in the public sector.

B research and medical-facilities construction. Expendi-tures for medical research, series B 234, include all such spending byagencies whose primary object is the advancement of human health.Also included are those research expenditures directly related t ohealth that are made by other agencies, such as those of the Depart-ment of Defense or the National Aeronautics and Space Administra-tion. Research expenditures of drug and medical supply companiesare excluded since they are included in the cost of the product. TheFederal amouats represent those reported as medical research in theOffice of Management and Budget, Special Analyses, Budget of theUnited States. The amounts shown for State and local governmentsand private expenditures are based on published estimates that havebeen prepared by the Resources Analysis Branch of the NationalInstitutes of Health, primarily in the periodic publication,

to the National Health.Expenditures for construction, series B 235, represent “value

put in place” for hospitals, nursing homes, medical clinics, and medi-cal-research facilities not for private office buildings providingoffice space for private practitioners. Excluded are amounts spent fo r construction of water-treatment or plants andFederal grants for these purposes,

B 231, government public health activities.

B 232, other health services.

65

B 236-261 VITAL STATISTICS HEALTH CARE

The data for value put in place for construction of publicly andprivately owned medical facilities in each year are taken from theDepartment of Commerce monthly report, Construction Review.

B 236-247. National and personal health care expenditures, by source

Source: See sources for series B 221-235 (tables and 6 insource; tables 2 and 5 in second).

For the general method of estimating national health expenditures,see text for series B 221-235. For the dollar amounts of gross na-tional product used as the bases for series B 237, see series F 1.

For the most part, private expenditures represent direct payments made by private consumers and insurance benefits paid in their behalfby private insurers. In addition, they include private philanthropy; amounts spent by industry for maintenance of in-plant health services;expenditures made from capital funds for expansion, renovation, ornew construction of medical facilities; and outlays for research byprivate foundations.

of funds, 1929-1970.

Public funds come from Federal, State, and local governments.Personal health care expenditures include all such expenditures

except research, construction, expenses for prepayment and adminis-tration, government public health activities, and expenses of privatevoluntary agencies for fund-raising and general-health activities.

B 248-261. National health expenditures, by type of expenditure,

Source: See sources for series B (tables 6 and 10 in first

For the general method of estimating national health expenditures,For the dollar amounts of grossnational

1929-1970.

source; 2 and 3 in second).

see text for series Bproduct used as the bases for series B 249, see series 1.

See also text for series BB 253, veterans’ hospital and medical care. All veterans with

service-connected disabilities are eligible for a wide range of hospitaland medical services, as are veterans with nonservice-connected dis-abilities who are unable t o pay for care. The medical care programincludes inpatient and outpatient hospital and clinic care, nursing bedcare (and a community nursing-home program where nursing bedfacilities are not available), day-care centers for psychiatric patients,outpatient dental care, and the provision of prosthetic appliances.

There were Veterans Administration hospitals which collec-tively in 1970 had a capacity of about 100,000 beds. Medical careis also given to veterans in other Federal hospitals, in hospitalsattached to VA domiciliaries, and in State and local government and private hospitals at the expense of the Veterans Administration.

All veterans’ health and medical benefit data are provided by theVeterans Administration together with administrative costs. See also series 993-994 and Y

254, general hospital and medical care. The Federal Govern-ment has directly provided hospital and medical care for specifiedgroups of beneficiaries since 1798 when President John signedinto law Act for the relief of sick and disabled seamen.” Sincethat time, federally sponsored and financed medical care for specifiedbeneficiaries has been expanded to include Indians, natives,lepers, narcotic addicts, commissioned officers of the Public HealthService and their dependents, personnel of the Coast Guard and the former Coast and Geodetic Survey (now part of the National Oceanicand Atmospheric Administration) and their dependents, and ownersof commercial fishing boats. The Federal Government also providesmedical care in Federal prisons, in-plant health services for Federalemployees, medical care for certain Foreign Service employees over-seas, medical care in the Islands (returned to Japan in the Trust Territories, American Samoa, and the Canal Zone, andsupport for certain medical institutions in the District of Columbia.

Federal outlays include operation of hospitals and medical care

66

units other than military and veterans’ facilities and reimburse-ments to public and private hospitals for the care of Federal civilianbeneficiaries. Excluded where separately identifiable are traininggrants and fellowships and expenditures for research and the con-struction of medical facilities.

The main source of these Federal civilian expenditures data is theOffice of Management and Budget, The Budget of the United StatesGovernment and its Appendix and Special Analyses.

State, local, and county governments also provide hospital andmedical care for their residents. They own and operate long- andshort-term general, psychiatric, and tuberculosis hospitals and alsopay to or for the support of a few nongovernment facilities.tures for psychiatric and tuberculosis care, traditionally considered agovernment responsibility, represent the largest portion of all Stateand local expenditures for hospital and medical care.

Data shown for series B represent net expenditures for services. State and local vendor payments for specific programs covered other series, as well as capital outlays and patient revenues, havebeen excluded. State and local gross totals, as well as figures on.capital outlays and patient revenues are shown annually in Bureau.of the Census, Governmental Finances.

B 255, public assistance. Public assistance programs existed priort o most of the social insurance programs. They compriseage assistance, medical assistance for the aged, aid to the blind, aid to families with dependent children, aid t o the permanently andtotally disabled, medical assistance, and State and locally financedgeneral assistance programs.

Health expenditures for public assistance include money pay-ments to needy recipients, assistance in kind, and vendor paymentson behalf of recipients for medical care and for other goods and services(payments directly to the suppliers of service) made from Federal,State, and local funds for the categorical assistance programs andfrom State and local funds for the general assistance programs.Administrative expenditures under the public assistance programsare included, along with grants for demonstration projects undersection of the Social Security Act.

Beginning in 1966 the Medicaid program, enacted as Title X I Xof the Social Security Act in 1965, enabled the States to provide asingle health program for the indigent and medically indigent, withFederal financial participation. Benefit standards required tha t aparticipating State must provide a minimum of five basic servicesto all Medicaid recipients (inpatient hospital care, out-patienthospital services, other laboratory and X-ray services, skilled home services for individuals aged 21 or older, and physicians’services). In addition, States may offer other services-such asdrugs and dental care-for which they receive Federal matchingfunds. Wide variation exists among the individual State programs in terms of eligibility, and scope and duration of benefits.

Many States, with and without Medicaid programs, contributeadditional vendor medical payments out of State and local fundsunder the category of general assistance.

Vendor payments for medical care under public assistance programsare published annually by the National Center for Social Statisticsin Source of Funds Expended for Public Assistance Payments (report

B 256, workmen’s compensation. Workmen’s compensationlegislation, designed to provide cash benefits and medical care whena worker is injured on the job and an income to his survivors if heis killed, was the first form of social insurance to develop widely inthe United States. The Federal Government led the way covering its employees with an act in 1908, reenacted in 1916. Similarlaws were enacted by 10 States in 1911; by the beginning of 1929,all but five States had such laws and, by 1948, all States had them.

text for series H 332-345.Each of the States operates its o w n workmen’s compensation

program, independent of any Federal legislative or administrativeresponsibility. As a result, there are wide differences among States

See also text for series H 346-367.

.

HEALTH AND MEDICAL CARE 257-276

in the scope of employments covered, the amount and duration ofbenefits paid, and the methods used to insure that compensation willbe paid when due.

Workmen’s compensation expenditures include: (1) Periodic cashpayments to the worker during periods of disability and (in someStates) to his dependents; (2) death and funeral benefits t o theworker’s survivors; (3) lump-sum settlements; (4)medical and re-habilitative services; and (5) the administrative costs incurred by government bodies in operating or supervising the programs.

Workmen’s compensation medical benefits include those for medical and rehabilitative services. Specific medical benefits are included inthe law of each State; they are provided without limit as to timeand amount in about four-fifths of the States.

Medical benefit payments include the estimated amounts paidout by private insurance carriers, by State insurance funds, andby employers as self-insurers. Also included are the amounts paidunder the Federal workmen’s compensation programs such asthe Federal Employees’ Compensation Act, Longshoremen’s andHarbor Workers’ Compensation Act, War Hazards CompensationAct, and the Defense Bases Compensation Act. Data for periods prior t o 1959 exclude expenditures under the laws in Alaska andHawaii.

Workmen’s compensation medical benefit data are estimatedannually by the Social Security Administration, using data primarilycompiled by the National Council on Compensation Insurance. The data are published regularly in the Social Security Bulletin (forrecent years, in January issues).

See also text for series 332-345.B 257, Defense Department hospital and medical care. Hospital

and medical care for military personnel have been a Federal respon-sibility since the 18th century, Active-duty personnel have beenprovided with complete medical care incident t o other necessitiesof life-food, shelter, and clothing. The armed services provide preventive treatment, curative and rehabilitative services in military hospitals, outpatient clinics, dispensaries, and field and shipboardstations. In 1965 there were 187 hospitals owned and operated bythe armed services-51 Army hospitals, 37 Navy hospitals and 99Air Force hospitals-with a total complement of 36,066 beds.

Figures for series B 257 include the expenses of operating military hospitals, clinics and other medical facilities, the salaries of militarymedical personnel, payments for medical care in nonmilitary facilitiesand expenditures for the dependents’ medical care program.

School healthprograms of educational agencies are programs financed and ad-ministered by State and local departments of education. These programs include medical and dental screening, first aid, the salariesof school nurses and/or doctors employed by local school districtsand the expenses of health supplies. Data are from t h e Office ofEducation.

Programs for maternal and child health at the Federal level wereestablished under Title V of the Social Security Act. They aredesigned t o encourage, extend, and improve health services formothers and children, especially in rural and low-income areas.

Under the maternal and child health program, Federal grantsare matched and used by State health agencies t o provide maternityclinics, well-child and pediatric clinics, inpatient hospital services,health services for school children, dental care, and immunization.

Under the crippled children’s program, Federal grants are usedState health and crippled children’s agencies to locate crippled

children; t o provide medical, surgical, corrective and other servicesand care for crippled children; and t o provide facilities for diagnosis,hospitalization, and after-care for these children.

259, other. The category “other” includes the following:temporary disability insurance, (2) other public health activities,medical vocational rehabilitation, (4) special Office of Economic

Opportunity (OEQ) programs, and (5) beginning 1966, healthinsurance for the aged (Medicare).

B 258, school, maternal, and child health services.

The temporary disability programs, as enacted by four States(Rhode Island, California, New Jersey, and New York) in theare designed to replace one-half or more of the weekly wage lossattributable to illness or off-the-job injury.

For a description of other public health activities, see text abovefor series B 231.

Medical vocational rehabilitation refers to assistance given thephysically and mentally handicapped so that they may be preparedfor and placed in gainful occupations. Included among vocational rehabilitation basic services are such medical services as study anddiagnosis to assess the extent of disability and the individual’s workcapacities; medical, surgical, and hospital treatment and relatedtherapy t o remove or reduce the disability; and provision of prostheticdevices. Data on Federal, State, and local expenditures for thisprogram are provided by the Rehabilitation Services Administra-tion.

The OEQ programs are aimed a t developing and demonstratingmore effective ways of delivering quality health care to poorfamilies. health funds include grants and contracts to aidlocal health services and resources and are reported in the SpecialAnalysis of the Budget (see above for series B 254).

Federal health insurance for the aged (Medicare) became effective July 1, 1966, providing hospital and medical protection to an en-rolled population aged 65 and over. Benefits under the hospitalprogram (Part A) cover specified inpatient hospital services, post-hospital services in a “participating” extended-care facility, andhome health visits. Under the supplementary medical program (Part B), payment is provided for physicians’ services (includinghome and visits), home health visits, outpatient hospitalservices, outpatient physical therapy services, diagnostic X-ray andlaboratory tests, radiation therapy, prosthetic devices, ambulanceservices, and certain other medical supplies. Payments fordeductibles, coinsurance, and noncovered services are not includedhere.

Financing of the hospital insurance program is on a self-support-ing basis through a Federal tax applied to a portion of current earn-ings and paid by employees, employers, and self-employed persons.The tax proceeds are placed in the hospital insurance trust fund,from which benefits and administrative expenses are paid. Thesupplementary medical insurance program is financed throughmonthly premium payments paid by enrollees and matched by theFederal Government. These amounts are paid into the supple-mentary medical insurance trust fund from which benefits andadministrative expenses are paid. Premium payments are thus in-cluded in the expenditures of the Medicare program.

For additional detail for public program expenditures, see U.S.Social Security Administration, Personal Health Care Expenditures,by State, vol. I, Public Funds, 1966 and 1969.

B 262-274.

various monthly issues.

index, see text for series E

medical care prices.

Indexes of medical care prices, 1935-1970.Source: U.S. Bureau of Labor Statistics, Consumer Price Index,

For description and historical development of the consumer price

See the source for more detail for various component indexes of

B 275-276. Physicians, 1850-1970.Source: Superintendent of the U.S. Census, 1850, Statistical View

of the United States. ..a Compendium of the Seventh Census; 1860,Population of the United States in 1860. U.S. Bureau of the Census,1870-1930 (decennial years), Sixteenth Census Reports, ComparativeOccupation Statistics for the United States, 1870 to p. 111;1940and 1950, U.S. Census of Population, 1950, vol. part 1,pp. 1-266to 1-269. American Medical Association, 1870-1934, R. G. Leland,Distribution of Physicians in the United Slates, Chicago, 1936, 7and 79 (copyright) the American Medical Directory,

67

B 277-287 VITAL STATISTICS AND HEALTH ASD CARE

vols. 14-20 (copyright). 1958 edition includes summary for1957. U.S. Public Health Service, 1958-1970, Health ResourcesStatistics, 1971, p. 147, and unpublished data; compiled from dataprovided by American Medical Association and American OsteopathicAssociation.

The census data for 1940 and 1950 are for employed civilian physi-cians; figures for prior census years are largely for gainful workers and may include physicians not in active medical practice. Seetext for series D 75-84 for explanation of difference between employed persons and gainful workers. The 1910 census figure includes osteo-paths; earlier census figures include osteopaths, chiropractors, andhealers (not elsewhere classified).

The American Medical Directory figures pertain to the total number of physicians, including those retired or not in practice for otherreasons and those in the Federal service. They exclude graduatesof the years concerned.

Population figures used to compute physician-population rate forcensus years, 1850-1930, include Armed Forces overseas; only thecivilian population is used for 1940 and 1950. Rates for years priort o 1963, excluding 1960, are based on the Census Bureau population estimates as of July 1, including Armed Forces overseas. Rates foryears 1960 and 1963-1970 are based on Census Bureau estimates ofcivilian population in the 50 States, District of Columbia, outlyingareas, U.S. citizens in foreign countries, and the Armed Forces in theUnited States and abroad as of December 31.

B 277. Physicians admitted to U.S. as immigrants, 1901-1970.Source: U.S.Public Health Service, Foreign Trained Physicians

and American Medicine, DHEW Publication No.table Al. Compiled from the U.S. Immigration and Naturaliza-tion Service data.

B 278-280. Medical schools, students, and graduates, 1810-1970.Source: 1810-1840, American Medical Association, 1956 American

Medical Directory (copyright); later years, annual reports of theCouncil on Medical Education and Hospitals of the American Medical Association as follows: 1850-1919, Journal of the American MedicalAssociation, vol. 79, No. 8, 629-633, Aug. 1922; 1920-1930,Journal of the American Medical Association, vol. 105, No. 9, p. 686,Aug. 1935; Edward L. Turner, et Journal of theAmerican Medical Association, vol. 165, No. 11, p. 1420, November1957. (Copyright,) U.S. Public Health Service, HealthResources Statistics, 1971, p. 88, and unpublished data.

Data on the number of medical schools, students, and graduatesprior t o 1900 are fragmentary and of dubious accuracy. The first medical school in the United States was founded in 1765. I n 1800three schools graduated students, with the number of schools increas-ing steadily from 52 in 1850 to a maximum of 162 in 1906. From1906 t o 1929, the number of schools declined sharply, largely becauseof the inspection and classification system begun in 1904 by the American Medical Association Council on Medical Education. By1929, only one unapproved school remained.

B Dentists, 1810-1970.Source: 1810 and 1840, John T. and Leroy M. Miner,

Dental Education in the United States, B. Saunders Co., Phila-delphia, 1941, 298 (copyright). 1820 and 1830, Harris’ Principlesand Practice of Dental Surgery, Lindsay and Blakiston, Philadelphia,1848, pp. 36-37. 1850-1950 (decennial years), same sources as series B 275-276. Polk’s Dental Register and Directory of United Slates and Dominion of Canada, R. L. Polk and Co.,Chicago, 1928, and prior editions (copyright). 1947-1957, Distribu-tion of Dentists in the United States by State, Region, District, andCounty, American Dental Association, Chicago, 1958, and prioreditions. (Copyright by the American Dental Association. Reprintedby permission.) U.S. Public Health Service, HealthResources annual issues, and unpublishedfrom American Dental Association

68

The census data for 1940 and 1950 are for employed civilian den.-tists; figures for prior census years are largely for gainful workers and may include dental students and dentists not in active dental practice. See text for series D for explanation of differencebetween employed persons and gainful workers.

The 14 editions of Polk’s Dental Register and Directory of the UnitedStates and Dominion Canada list by State all dentists for 1893-1928.The American Dental Directory, first published in 1947, lists by Stateall dentists, including those retired or not in practice for other reasonsand those in the Federal dental service. The figures for all datesinclude graduates of the years concerned.

Prior to 1963, the population figures used to compute thepopulation rate are the same as those used for the

rate. See text for series B Population figures usedto compute the dentist-population rate for 1963-1970 include allpersons in the United States and in the Armed Forces overseas of July 1.

B 283. Dental schools,Source: 1840-1945,Harlan Hoyt Horner, Dental Education Today,30 (copyright 1947 by University of Chicago); 1946-1957,American

Dental Association Council on Dental Education, DentalRegister, Chicago, annual publications (copyright). 1958-1970,Public Health Service, Health Resources Statistics, 1971, 77, andunpublished data.

Homer’s data are compiled from Dorothy Fahs Beck, The Develop-ment of the Dental Profession in the United States, dissertation ofUniversity of Chicago, 1932, and from records of the Council onDental Education of the American Dental Association. Additionaldata may be obtained from the following sources cited byW. J. Gies, Dental Education in the United States and Canada,Foundation for the Advancement of Teaching, Bulletin No. 19,1926, p. 42; Polk’s Dental Register and Directory of the Unitedand Canada, R. Polk and Co., Chicago, 1925, p. 35; W. J.“Additional Remarks on a Reference t o the Carnegie FoundationsStudy of Dental Education,” Journal of Dental Research, vol. 10,p. 32, February 1930; W. J. Greenleaf, Dentistry, Career Series,Leaflet No. 7, Office of Education, pp. 7-10. The Beck tabulationalso appears in Frederick B. Noyes, “Dental Education, Oral Hygiene, vol. 26, p. 24, January 1936.

The first dental school in the United States was organized in 1840.Before that, all physicians practiced some dentistry, a few limitingtheir practice to this specialty. The dental practitioners who were not physicians learned their trade as apprentices or were self-taught.From 1840 to 1880 apprentice training was the chief source of supply,but by 1880 most States had enacted laws requiring graduation froma dental school.

B 284. Dental students, 1921-1970.Source: 1921-1934, Frederick B. Noyes, “Dental Education,

36,” Oral Hygiene, 26, January 1936, p. 28 (copyright);1957, American Dental Association Council on Dental Education, Dental Students’ Register, annual publications (copyright);see source for series B 283.

Sources cited by Noyes are: W. J. Gies, Journal of the AmericanDental Association, 18, p. 593, April 1931, and Dental EducationalCouncil of America, statistical reports.

B 285. Dental graduates, 1850-1970.Source: See source for series B 283.Annual figures for graduates for 1841-1924, are also presented in

Polk’s Dental Register, 1925, p. 34; but the figures for the early yearsfar exceed those shown elsewhere in histories of dentistry as well a sthose shown here.

B 286-287. Graduate nurses, 1910-1970.Source: 1910-1950, Public Health Service, Health Manpower

Source Book Nursing Personnel, pp. 14-15. 1953 and 1955,

HEALTH AND CARE

can Nurses Association, Facts About Nursing, New York,edition, p. 8 (copyright). 1956-1970, U.S.Public Health Service,Health Resources Statistics, 1971, p. and unpublished data;compiled from data provided by American Nurses Association.

The estimates for 1910-1950 were obtained by subtracting studentnurses from the number of nurses reported in the decennial censuses.

Census data for 1910-1930 are for gainful workers; for 1940 theyinclude employed nurses and those seeking work; and for 1950 theyinclude employed civilian nurses. See text for series D 75-84 forexplanation of difference between employed persons and gainfulworkers.

The estimates for 1953 and 1955 were prepared jointly by theAmerican Nurses Association, the National League for Nursing, andthe Public Health Service. They are based partly on informationsupplied by hospitals, schools of nursing, public health agencies,boards of education, and nursing homes. Estimates of nurses in private duty, doctors’ industry, and other nursing fields were based on the American Nurses Association Inventory of 1951 adjustedaccording to trends observed in more recent State surveys of nursingneeds and resources.

Population figures used to compute nurse-population rates for1910-1940include Armed Forces overseas. The 1950 rate is based on the civilian population. Rates for 1953-1955 and 1958-1962 arebased on the Census Bureau population estimates, including Armed Forces overseas, as of January 1 of the following year. Rates for1964-1970 are based on Census Bureau population estimates forcivilians and the Armed Forces in the United States as of December 31.

B 288-290. Nursing schools, students, and graduates, 1880-1970.Source: and 1931, Office of Education, Biennial

Survey of Education in the United States: vol. 11, chap. IV,p. 294. 1929 and 1932, The Committee on the Grading of NursingSchools, The Second Grading of Nursing Schools, New York, 1932, p. 9.1935-1939, American Nurses Association, Facts About Nursing,New York, 1946, pp. 32 and 34; 1940-1955, Facts About Nursing,1957, pp. and 71 (copyright). 1956-1970, Public Health Service, Health Resources Statistics, 1971, p. 181; compiled from dataprovided by American Nurses Association.

Nursing education began in this country in 1873 with the opening of three schools.These schools offered students a n opportunity to learn by doing. under the tutor-ship for 1 year of a who had been trained in one the Europeanschools. . .. State licensingbodies came into existence, counts of State approved and of their students

to he availahle. Since only graduates State approved schools could standfor examination- nonapproved schools tended to close as the effect of

berame felt. until 1923 was machinery for approving schools inoperation in every State. (U.S.Public Health Service, Health

Personnel,

B y 1893 about 70 schools were in operation.. ..

291-304. Rates per 100,000 population for specified reportable

Source: 1912-1919, U.S. Public Health Service, Public HealthReports, various issues; 1920-1950, National Office of VitalStatistics, Vital Statistics-Special Reports, vol. 37, No. 9; 1951-1970,U.S. Center for Disease Control, Morbidity and Mortality, Weekly Report, Annual Supplement, Summary, 1960 and 1970.

The rates refer to the number of notifiable diseases occurring within the United States per 100,000 population. For rates arebased on the total resident population. Each State makes its ownlaws and regulations prescribing the diseases to be reported, theagencies and persons required t o report, and penalities for failure toreport. All States have entered voluntarily into a cooperative agree-ment to report t o the Federal Government.

The notification of disease in the United States began in the colonialperiod on a local basis, particularly in port cities. It was usually limited t o periods when epidemics of pestilential disease threatenedor were in progress. Statewide notification was not required until

when Michigan passed a law requiring physicians and house-holders t o report certain diseases to health officers or boards of health.During the next three decades all States made similar requirements.

diseases, 1912-1970.

In response t o the need for nationwide statistical information on epidemic diseases, a law was passed in 1878 providing for the collec-tion of such statistics. By 1912, data were supplied regularly by 19States and the District of Columbia on diphtheria, measles, polio-myelitis, scarlet fever, tuberculosis, typhoid fever, and smallpox.State health authorities now report weekly on 25 diseases and annuallyon about 40. Most States require the reporting of additional diseases.

The Public Health Service has changed its form of reporting severaltimes and some of the rates shown here do not appear in the publishedreports. Since the data were originally shown only for the individualStates, a rate for the country was obtained for each disease by com-bining the information only for those States reporting it, the denomi-nators being the population of the reporting States.

For trends of sickness and accident among groups of male andfemale industrial workers (1917-1950, for cases disabling for 1day orlonger, and 1921-1952, for cases disabling for 8 days or longer), seeW. M. Gafafer, “Industrial Sickness Absenteeism Among Males andFemales During 1950,” Public Health Reports, vol. 66, No. 47,1550-1552, November 1951. See also “Rates for Specific Causes in1952 for the Year and Last Two Quarters-Industrial Sickness Ab-senteeism,” Public Report, vol. 68 , No. 11, pp. 1052-1055,November 1953; and S. D. Collins, “Long-Time Trends in Illness andMedical Care,” Public Health Monograph, No. 48, p. 32.

Civilian illness rates for the United States are not available for along period. However, records of illness (admission to sick report)among the active-duty personnel of the Army are available back to1819, and those for the Navy back to 1865. See U.S. Army, AnnualReports of the Surgeon General on Medical Statistics, and U.S. Navy,Annual Reports of the Surgeon General on Medical Statistics. Forannual days sick per person, computed from Army and Navy data,see S. D. Collings, “Long-Time Trends in Illness and Medical Care,”Public Health Monograph, No. 48, p. 37.

B 305-400 and B 413-422. General note.

Until 1953, when i t discontinued registration of hospitals, theAmerican Medical Association (AMA) collected data annually from all hospitals registered by it, and published them in the HospitalNumber of the Journal of the American Medical Association. Regis-tration was a basic recognition extended to hospitals and relatedinstitutions in accordance with requirements officially adopted by itsHouse of Delegates.

Figures from the AMA presented in series B B 345-358,and B are not entirely comparable with similar data pro-vided by the American Hospital Association (AHA) because thestandards required for “listing” or “recognition” of hospitals by theAHA differ from those required by the AMA. Statistics of hospitalsobtained from the annual survey of hospitals are publishedannually in Hospitals, Guide Issue, and cover all hospitals accepted for registration by the AHA. To be accepted for registration, ahospital must meet certain requirements, as follows: It must have atleast 6 beds for the care of nonrelated patients for an average stay ofover 24 hours per admission; be constructed and equipped to insuresafety of patients and t o provide sanitary facilities for their treat-ment; have an organized medical staff, registered nurse supervision,and nursing care for round-the-clock patient care; maintain clinicalrecords on all patients and submit evidence of patient care by doctors;provide minimal surgical and obstetrical facilities or relatively com-plete diagnostic and treatment facilities; have diagnostic X-ray andclinical laboratory services readily available; and offer services moreintensive than those required merely for room, board, personal ser-vices, and general nursing care.

Short-term hospitals are those in which over 50 percent of allpatients admitted have a stay of less than 30 days; long-term, thosein which over 50 percent of all patients admitted have a stay of 30days or more. General hospitals accept patients for a variety of acutemedical and surgical conditions, and, for the most part, do not admitcases of contagious disease, tuberculosis, and nervous and mental

69

305-412 VITAL STATISTICS AND HEALTH AND MEDICAL CARE

disease. Special hospitals are those devoted to the treatment ofparticular disease or group of diseases or some particular group

in the population. Among the former are orthopedic, contagiousdisease, chronic and convalescent, and eye, ear, nose, and throat hospitals; the latter include maternity, children's, and industrialhospitals. Psychiatric hospitals include those providing temporaryor prolonged care for the mentally ill, the mentally retarded, epileptic,and persons with alcoholic or other addictive diseases. Tuberculosishospitals include sanatoria or hospitals specifically for the care oftubercular patients.

Governmental hospitals include those operated by Federal, State,and local governments, the latter including county, city, city-county,and hospital district. Nonprofit hospitals are those operated notfor profit by churches and by associations of citizens or fraternalorganizations. Proprietary hospitals are operated for profit byindividuals, partnerships, or corporations.

Number of'beds includes beds, and pediatric bassinets nor-mally available for inpatients. It excludes newborn infant bassinets.

Data from the AHA relate generally to the year ending September 30 or t o the fiscal year closest t o that date.

B Hospitals and beds, by type of service and ownership

Source: American Hospital Association, Chicago, Hospitals, GuideIssue, part annual issues (copyright; reprinted with permission).

See general note for series B 305-400 and B 413-422.

(AHA), 1946-1970.

319-330. Hospitals and beds, by type of service (AMA), 1909-1953.

Source: American Medical Association, Chicago, 1909, 1914, 1918,and 1921, American Medical Directory, 1921 and prior editions; 1920and 1923-1953, Journal of American Medical Association, HospitalNumber: 1920, April 1921 issue, pp. 1083-1103; 1923 and 1927-1933,March 1934 issue, pp. 1008-1009; 1924, March 1925 issue, pp.970; 1925, April 1926 issue, pp. 1009-1055; 1926, March 1927 issue, pp. 789-839; 1934-1953, May 1954 issue, pp. 9-10. (Copyright.)

Although the annual census was begun in 1920, complete data on the number of hospital beds classified by type of service areavailable only from 1925. In addition to information on number ofhospitals and beds, the Hospital Number of the AMA Journal pre-sented statistics on admissions, average daily census, and births.

See also general note for series B 305-400 and B 413-422.

B 331-344. Hospitals and beds, by ownership or control (AHA), 1946-1970.

Source: See source for series B 305-318.See general note for series B 305-400 and 413-422.

B Hospitals and beds, by or control (AMA),

Source: American Medical Association, Chicago, Journal of theAmerican Medical Association, Hospital Number: 1909, 1914, 1918,and 1934-1953, May 1954 issue, pp. 4, 7-8; 1923 and 1927-1933,March 1934 issue, pp. 1924, March 1925 issue, pp. 970; 1925, April 1926 issue, pp. 1009-1055; 1926, March 1927 issue,pp. (Copyright.)

1909-1953.

See general note for series B 305-400 and B 413-422.

B 359-370. Average census and admissions to hospitals, bytype of service and ownership (AHA), 1946-1970.

Source: See source for series BAverage daily census is defined as the average number of inpatients

receiving care each day during the 12-month period, excluding thenewborn.

Admissions refer to the number of patients accepted for inpatient service during the 12-month period, either as first admissions orreadmissions. Births are excluded.


B Average daily census and admissions to hospitals, by

Source: American Medical Association, Chicago, JournalAmerican Medical Association, Hospital Number: 1925, April 1926issue, p. 1009; 1923, 1927, and 1929-1933, March 1934 issue, pp.1008-1009; 1934-1953, May 1954 issue, pp.

See text for series B 359-370 and general note for series B 305-400and B 413-422.

type of service (AMA), 1923-1953.

(Copyright.)

B 381-388. Hospital use rates, 1931-1970.Source: 1931-1966, U.S. Public Health Service, Health, Education,

and Welfare Trends, part 1, various annual issues (based on dataprepared by American Medical Association and American HospitalAssociation); 1967-1970, American Hospital Association, Chicago, unpublished data.

See text for series B 359-370 and general note for series B 305-400and B 413-422.

B 389-400. Hospital expense per patient day, 1946-1970.Source: American Hospital Association, Chicago, 1946-1964,

Hospitals, Guide Issue, part 2, Aug. 1, 1965, pp. 448-449;Hospitals, Guide Issue, part 2, Aug. 1, 1972, pp. 460-462. (Copy-right.)

Payroll expenses include all salaries and wages except, beginning1951, those paid to interns, residents, student nurses, and othertrainees. professional fees and the salary expenditures excluded from payroll are defined as nonpayroll expenses and are included intotal expenses.


B 401-412. Persons covered by private health insurance for hospitaland surgical benefits, 1939-1970.

Source: U.S. Social Security Administration, Social SecurityBulletin, February 1973 and earlier issues.

The data for insurance companies are from the Health Insurance Institute, Source Book of Health Insurance Data, and were developedfrom surveys and reports of insurance companies and other healthinsurance plans, government agencies, and hospital and medicalassociations. The data for Blue Cross-Blue Shield are from annualreports of the Blue Cross-Blue Shield Associations. The data forindependent plans-plans other than Blue Cross-Blue Shield andinsurance companies-are from annual surveys of these plans bythe Social Security Administration.

In 1970, there were many different health insurance organizationsin the United States-75 Blue Cross plans, 72 Blue Shield plans, about1,000 commercial insurance companies, and more than 500 inde-pendent plans. They insured in varying degree against the costs ofhospital and surgical care, other physicians' services, nursing care, dental and vision care, and prescribed drugs.

Health insurance policies, both group and individual, are writtenby health insurance companies, as well as by life and health, casualty,and multiple line companies.

Because one plan may provide only one type of benefit and becausethe benefits may be limited, families frequently carry several forms ofhealth insurance; for example, Blue Cross for hospital insurance,Blue Shield for surgical insurance, in-hospital medical expense in-surance, and an insurance policy applicable to all three types of ex-pense. Multiple coverage may also when husband and wifeare both employed and both cover self, spouse, and dependents underthe insurance plan at the work place.

70

HEALTH MEDICAL CARE B

Hospitalization insurance provides benefits for hospital chargesincurred by a n insured person because of an illness or injury. Surgicalinsurance pays benefits toward physicians’ surgical fees. TheSocial Security Administration publishes its own estimates of thenet number (of different persons) and the percentage of the civilianpopulation covered by hospital and surgical insurance. These estimates, which usually run 5-10 percentage points lower thanthose published by the Health Insurance Institute, are based onhousehold interviews conducted by the National Center for HealthStatistics (NCHS) during 1967 and 1968, and on findings of varioushousehold surveys by the Health Information Foundation and thePublic Health Service in 1953-1963.

B 413-422. Hospitals-assets, expenses, and personnel, by type ofcontrol and service, 1946-1970.

Source: See source for series B 389-400.Assets comprise plant assets (land, buildings, equipment, and

reserves for construction, improvement, and replacement-less deduc-tions for depreciation) plus all other assets, including endowment fund principal and general and temporary fund balances.

Expenses include all expenses covering the 12-month period, bothtotal and payroll. Payroll expenses include all salaries and wagesexcept those paid t o interns, residents, student nurses, and othertrainees. All professional fees and those salary expenditures excludedfrom payroll are defined as nonpayroll expenses and are included intotal expenses.

Data on personnel refer to the number of persons on the payrolla t the close of the 12-month reporting period. Except as noted, theyinclude full-time equivalents of part-time personnel but excludetrainees (student nurses, interns, residents, and other trainees), private duty nurses, and volunteers. Full-time equivalents are calculated on the basis that two part-time persons are equal to onefull-time person.


B 423-427. Patients in mental hospitals, by type of hospital,

Source: U.S. Census Office, 1904, Insane and Feeble-Minded inHospitals and Institutions, (special report). U.S.Bureau of theCensus, 1910, Insane and Feeble-Minded in Institutions, 1910;1946, Patients in Mental Institutions (annual reports, varying titles).

National Institute of Mental Health, 1947-1966, Patients inMental Institutions, annual issues; 1967-1970, Mental Health Statistics,Series A, Reference Tables, and unpublished data.

For 1923-1932, the annual enumerations of patients in mentalinstitutions, conducted by the Bureau of the Census, were confined to State hospitals for mental disease and State institutions for mentaldefectives and epileptics. Since 1933, the annual censuses conductedby the Bureau of the Census until 1946 and subsequently by theNational Institute of Mental Health (NIMH) have covered all typesof hospitals and institutions caring for the mentally ill, mental defec-tives, and epileptics. For a discussion of these developments, see the

issue of NIMH,Patients in Mental Institutions, pp. 1-4. Addi-tional information on admissions, patients, personnel, and expendi-tures of institutions for mental defectives and epileptics, as well asfor hospitals for mental diseases, appear in various issues of thatreport.

The figures represent patients who are resident in hospitals whichprovide care solely for the mentally ill, as distinguished from thephysically ill and from the mentally deficient and epileptic. These hospitals may provide care over a n unlimited period of time or tem-porary care, as in psychopathic hospitals. Hospitals included arethose under control of State and local governments, nonprofit andProprietary organizations, the Veterans Administration, and the Federal Government in the District of Columbia (included here under State hospitals).

(The

1970.

These facilities contain 93 percent of the psychiatric beds.

other 7 percent are in general hospitals and residential treatmentcenters for emotionally disturbed children.) The number of residentpatients in these hospitals peaked in 1965 (the year during which theuse of tranquilizers became widespread in these hospitals) and hasdecreased since. Coupled with this decrease in residents an in-crease in admissions offset by the practice of returning many hos-pitalized patients to the community for treatment.

There are also programs for preventing hospitalization in the many outpatient psychiatric clinics and community mental health centers.These, along with the general hospital psychiatric services, provideabout three-fourths of the care to the mentally ill in the existingpsychiatric facilities.

Public institutions for the mentally retarded, 19364970.

Source: 1936-1945, Bureau of the Census, Patients in MentalInstitutions, 1946, pp. 31 and 35-37; 1946-1970, U.S. Social andRehabilitation Service, Residents in Public Institutions for the Men-tally Retarded, annual issues.

From 1946 to 1968 the National Institute of Mental Health wasresponsible for collecting and publishing data on the institutionalizedmentally retarded in the United States. Since 1969, the annualcensus of the public institutions of the mentally retarded has been theresponsibility of the Social and Rehabilitation Service.

admissions. Includes first and readmissions. Firstadmissions are all patients admitted to a public institution for thementally retarded without a record of previous care, a record ofan admission and a formal discharge, in either a public or privateinstitution anywhere. Thus, a patient coming into a public institu-tion for the mentally retarded from a hospital for mental diseasewould be considered a first admission. Readmissions are all patientsadmitted with a record of previous care in a public or private institu-tion. Admissions per 100,000 civilian population, series B 433,measures the proportion of people coming under care during the year.

This category includes only deathsoccurring t o patients resident in the institution and does not includedeaths among patients on leave, even though these patients are stillon the institution books.

This concept takes into account move-ment of patients into and out of the institution since this quantityis the number of placements on extramural care plus direct discharge from the institution less the number of returns from extramural care,all occurring during any one year. National data on placements andreturns from extramural care are not available but net releases maybe computed from less detailed movement data as:

B 435, deaths in institutions.

B 436, net live releases.

Net Resident admissions Deaths Residentlive = patients excluding - in - patientsreleases beginning transfers tution end of year

of year

Interpretation of net live releases should be made with caution. This quantity is the net number of releases alive from the publicinstitutions in the State system and includes not only direct dis-charges to the community and placement on leave but also directdischarges to other inpatient facilities outside the State systemas public mental hospitals, boarding care homes, and public institu-tions in other States. The number of net releases is used as a measureof movement out of the institution rather than the total numberdischarges because many discharges occur while patients are already outside the institution on extramural care. The number of netreleases may be considered an estimate of the number of effectivereleases from the institution under the assumption that subtractingreturns from leave during the year removes only the short term visits,leaves, and escapes, and retains the effective releases; those fromwhich the patients did not return to the institution within the timeperiod covered.

Themost commonly used ratio for comparing institution expenditures.Its major limitation is that it does not adequately take into account

71

B expenditures per average daily resident patient.

444-459 VITAL, STATISTICS HEALTH CARE

the number of admissions for which a large share of the expenditureis required. If the patient base were enlarged t o include admissions during the year, the resulting sum would be the best available estimateof patients under treatment during the year.

444-447. Four indexes of per capita food consumption,

Source: U.S. Department of Agriculture, Economic ResearchService, Food Consumption, Prices, and AgriculturalEconomics Report No. 138 and its Supplement for 1971, tables 5,6, and 38.

Three methods are commonly used to measure the total amount offood consumed, or otherwise “disappearing” through the marketingsystem. Total food consumed is measured in terms of its monetaryvalue, physical weight, or nutritive value.

Civilian disappearance, the residual from all other known uses,normally is the estimate of annual U.S. civilian food consumption.This estimate is usually derived from supply and utilization “balance sheets,” which summarize production, imports, and beginning stocks;and deduct exports, all known nonfood uses, military procurement, and end-of-year inventories of each commodity. The residual, afteradjustment for marketing losses up to the retail level, is assumed tohave been consumed for food.

B 444, food consumption. This index measures per capita con-sumption (civilian, beginning 1941) of quantities of individual foodsmeasured in pounds equivalent to the form sold at retail food stores. The quantities used for this series have been combined into indexeson the basis of average 1947-49 retail prices through 1954 and 1957-59prices thereafter; the indexes are linked at 1955. Component indexesfor individual groups of animal and crop products are presentedin the source (table 1). For comparison with the food use index,see below.

B 445, food use. In concept, this index parallels the food con-sumption index, except that i t combines farm products ultimately used for food (farm weight or an equivalent) weighted by constantprices received by farmers, or an equivalent. It is a component ofthe system of index numbers that integrates the entire supply andutilization of farm commodities a t the farm level (see tables 91-93in the source). It is not available in as much detail as the food con-sumption index, but serves as a check on it.

The food consumption and food use indexes are based on roughlythe same kind of data. But development of the food consumptionindex at the retail rather than the farm level introduces variationsamong products in farm-retail marketing margins into its weightingscheme. Consequently, crop products are more heavily weightedin the food consumption index than in the food use index (see tables4 and 93 in source).

Shifts in consumption are reflected in these indexes. A 1-poundincrease in consumption of a relatively high-priced food (meat, forexample) and a simultaneous 1-pound decrease in consumption of arelatively low-priced food (potataes, for example) would result inan increase in both indexes. Major differences in the forms in which food is sold affect the food Consumption index. For example, fruitsand vegetables sold fresh and those sold in processed form are weightedseparately. Accordingly, the index reflects, to a limited extent,the trend toward consumption of more highly processed foods.

The food use index tends to reflect changes in the form of agri-cultural commodities sold by farmers. Instead of weighting indi-vidual food items on the basis of price, as is done in the food consump-tion index, the food use index weights food groups, such as dairyproducts, fruits, and vegetables. This difference makes the foodconsumption index more sensitive t o smaller shifts in food consump-tion patterns than the food use index.

446, food consumed, pounds. This index was based on data

presented in pounds in the source (table 6). Pounds of the variousfoods consumed are totaled on the basis of retail weight, or a n equiva-lent, t o achieve consistency in aggregating grossly different foods.Nevertheless, the different forms in which food is marketed and theproblems of summing pounds of liquids, solids, and concentratedproducts make i t difficult to interpret changes in these data. Quanti-ties of food consumed are roughly equivalent to the weight of foodsold (or a t least saleable) by retail food stores. No aggregation ofpounds a t the farm level has been made, partly because of the problemof allocating joint raw farm products among various ultimate foodand nonfood uses.

This index was computed data pre-sented in calories of food energy available for consumption per capita per day in the source (table 38). These data were in turn based onestimates of per capita food consumption (retail weight), includingestimates of produce of home gardens. No deduction was made forloss or waste of food in the home nor use for pet food.

B 447, calories per day.

B 448-452. Index of per capita consumption of selected nutrients,

Source: U.S. Department of Agriculture, Economic ResearchService, Food Consumption, Prices, and Expenditures, AgriculturalEconomics Report No. 138 and its Supplement for 1971, table 38; andNational Situation, NFS-142, table 10.

These indexes were computed from data presented in the sourcein terms of grams and milligrams. The nutritive value of food ismeasured by the amount of food energy (see calories per day, seriesB protein, fat, carbohydrate, and several vitamins and mineralsi t contains.

The data on nutrients are derived by applying composition valuest o food consumption data reported in terms of retail weight equiva-lents. Allowances are made for bones, rinds, and peelings, but notfor bruises and rot. No deduction is made for nutrient losses thatoccur in household storage and meal preparation. Quantities of fooddiscarded as plate waste or fed t o pets are not deducted. As a result,these data overstate nutrients actually ingested.

For additional data on other nutrients, see source.

1909-1970.

B 453-459. Controlled fluoridation of water systems, 1945-1970.

Source: Series B and B 1945-1969, U.S. PublicHealth Service, Fluoridation Census 1969, table 3; 1970, unpublisheddata. Series B 456, computed on basis of U.S.resident populationin series A 7.

Controlled fluoridation is defined as the conscious maintenanceof the optimal fluoride concentration in the water supply. Thismay be accomplished by adding fluoride chemicals todeficient water; by blending two or more sources of water naturallycontaining fluoride to the optimal concentration; or by defluoridation,that is, removing fluorides in excess of the recommended level. Watersupply systems are considered to have natural fluoridation if theycontain 0.7 parts per million or more naturally occurring fluoride. (See Natural Fluoride Content of Water Supplies, 1969,Division of Dental Health, U.S. National Institutes of Health.)

The current population on controlled fluoridation was estimatedapplying the Bureau of the Census population projection factors

the population on fluoridated water expressed in terms of the 1960census population.

The data on operative and discontinued systems are based uponthe year in which institution, discontinuation, or reinstitution offluoridation (shown separately in the source) were reported to theU.S. Public Health Service and not necessarily the year in which theevent occurred.

72

HEALTH AND MEDICAL CARE

-235. Total and Per Capita National Health Expenditures, by Type of Service: 1929 to[Calendar year data]

Total

221

Health services and supplies Research and medical-facilitiesconstruction

Total Hospital Physi-cians' Dentists' profes-Other Drugs drug and glassesand Nursinghome Expensespaymentpre- publicment health Other Total Research Construc-

services admin- activitiesservices services sundries and health services tion

istration

224 225 226 227 228 229 230 I 232 233 234 235--______-

4,7914,0553,7093,534

3,3813,0862,6402,4382,018

1 7101'524

1,223898

853850

1,0391,080

960765428

1,84411'79

1,574

1 4691'3241'184

844

662526416344270

210183164150134

11710589

7.036.376.225.735.62

35.0133.0430.1927.9626.55

343.44 318.45311.06 287.33277.14 257.28250.77 232.42224.89 207.22

204.68 187.58191.88 176.07174.15 160.44164.89 152.05154.02 143.23

146.30 137.00137.94 129.49128.81 120.88121.00 113.99112.32 107.07

105.38 100.27101.54 96.3796.84 91.6193.69 87.1988.95 82.08

132.42116.84102.4989.7677.92

68.8165.0460.8156.1653.09

49.4645.3442.5539.5137.04

35.0433.2631.2729.2927.04

5.254.814.784.754.72

24.5322.7722.0021.5820.46

4.694.444.113.363.56

3.343.273.072.872.71

19.8919.5418.2817.2515.67

14.1613.1813.2412.9512.64

81.86 75.6671.08

70.97 68.11

29.62 28.7422.65 22.1829.49 27.77

24.9023.3921.42

7.515.895.36

Year

1,8661,765

1,6091,413

1952

804

776722673678668

604606612586551

491458436

189133133

1,4661 3131'2711'158

1,038940921902882

862801729673610

562541499459426

396371354

174153252

27,59724,09320,92618,14515,583

13,60512,69711,70910,6589,921

9,0928,1777,5486,8926,347

5,9005,5025,0854 685 4

3 ,8513,5573,203

1,011763663

2 0982'1092 '00711,681

1 2931'172

1,085995

861754633682620

624

498401321

316271287

16795

110

1 5681'316

942885

693610540505452

414428424415402

377374378427416

361338306

15311796

2,6902 5922 '3322 '099

1,4921 5111'380

1 3361'138

1,011965

924904911952883

666539470

1126491

14,29412,65411,09910 287

8,7458 06566

5,6845,4814,9104,4194,067

3,6893,5743,2783,0422,868

2 747

2,611

973773

1,004

5,895

4,4194 04733 360

2,8082,6482 27722,067

1 9771'8941'850

1,625

1,5081,4061,2341,098

997

961920900

419302482

1

7,2976,8126,1655 652

4,8504 4464'2354'095

3,6573,5253 24232,686

2,3842 181

2 071

1,7261,6571,466

637475606

3,0702 65021,8581,526

1,3281,214

891695606

526434363368358

312270248228207

187168150

33.

3 366

2 260

1,960

1 912'762

1'456

1,174

1,048998990879628

651670686889946

843660339

11661

213

26,895 25,18524,878 23,35422,848 21,44221,108 19,88519,246 18,348

12,662 11,70211,576 10,81110,612 10,184

3 987 3,8682,875

3,649 3,436

PER CAPITA 5

21.2019.6317.7416.6214.82

14.7312.8511.179.197.63

6.726.224.633.663.24

2.862.412.162.112.09

1.851.631.531.431.32

1.211.101.00

. .

8.838.818.798.427.87

7.436.786.155.444.52

3.602.922.351.971.58

1.251.111.01

.94

.85

.76

.69

.60

68.5961.3754.8650.8945.78

44.23

35.7934.2431.55

30.9230.3927.6825.3323.73

21.9121.6020.1619.0218.23

17.3117.46

7.235.968.11

10.0710.239.839.288.41

6.546.005.685.725.32

4.684.183.573.913.62

3.713.553.062.512.04

2.04

1.92

1.24.73.89

7.526.385.384.664.43

3.538.122.802.662.42

2.252.372.392.382.35

2.242.262.322.672.64

2.332.222.05

1.14

.78

8.958.568.437.967.07

6.225.494.944.784.30

4.224.003.823.893.90

3.593.663.763.663.50

3.173.012.92

1.401.031.07

12.9112.5711.4210.389.00

7.557.747.176.737.06

7.276.315.895.805.63

5.495.465.605.955.61

4.313.543.14

.83

.49

24.9923.2319.8618.3517.67

17.1015.8113.7112.8510.80

9.308.467.937.015.24

5.115.165.236.496.87

6.215.032.86

16.1514.4111.079 .929.80

9.679.037.567.416.28

5.70

5.585.043.66

3.874.054.225.566.01

5.454.342.27

.86

.471.72

14.2013.5611.8311.7711.06

10.7510.5010.439.969.48

8.968.507.596.866.34

2.562.44 10.242.37 9.80

6.216.056.02

3.112.333.90

1.29 4.731.18 3.672.04 4.90

of registered and practical nurses in private duty, visits of nurses, podi-

Research expenditures of companies included in expenditures for drugs and

Includes fees of optometrists and expenditures for hearing aids, orthopedic ap-

Includes the net cost of insurance and administrative expenses of federally financed

Based on July 1data from the Bureau of the Census for total U.S. population,Armed Forces and Federal civilian employees overseas and the civilian popula-

tion of outlying areas.

physical therapists, clinical psychologists, chiropractors, naturopaths, and health programs. Christian Science

sundries and excluded from research expenditures.

pliances, artificial limbs, crutches, wheelchairs, etc.

73

B 236-261 VITAL STATISTICS AND HEALTH MEDICAL

Series B 236-247. National and Personal Health Care Expenditures, by Source of Funds: 1929 to 1970[Inmillions of dollars, except percent. Calendar year

195519541953

19501949

194019351929

17,74516.79915.74514,98813.992

12.66211,57610,612

3,9872.9363,649

13,19012.42111,38810,5589,846

12,28211,57210,629

9,6908,962

4.54.54 .1

4.04 .03.5

9,222 8,4258.716 8,0428,208 7,691

3,178 3,0512.372 2,2883.154 2,937

facilities Veteranshospital

andmedical

care

2,2032,0001,367

1,7631,5411,387

536390373346192

241215167309

913862822769732

723701661643

299224108

10105

582579554

635049

Personal health care expendituresI National health expenditures

Total Private Private--

Total

--

Insurancebenefits

OtherYear IPercent

of gross Total Consumer!nationalproduct

Public Total PublicPhilan-thropy

and otherDirect

payments

241

26,887'24.09521,58818,14112,821

10,0669.2668,5587,9247,278

6,6376,2805,9185,4614,968

4,5554,3784,3574,4314,148

3,4402,8602.404

811563495

244

23,75821,95819,38318,96519,166

18,04916,91514,947

13,232

12,99012.19011,26610,4039,750

9,1328,8168,2247,6977,302

7,1337,0266,829

245

15,74413,06811,3449,5459,142

8,7297,8326,9806,3445,695

4,9964,3993,8773,4743,015

2,5362,1791,9191,6041,353

992767606

659

246 247242

62,28255,54149,06043,85338,594

34.82132,32228,99027,02325,082

23,68021,95320,177

17,140

15,70814,81813,86012,96812,031

10,88510,0739,473

3,5482,6633,202

243

35,881

29.27529,051

27,47525.41522,56821,05619,504

18,52317,14115,64514,35713,221

12,10011,40810,5259,6628,997

8,4458,0787,694

2,9802,2692,913

240

3,7423,4322,7172,4852,422

2.2951,9691,8581,602

1,4281,2671 1691,101

904

908849759868884

797674517

12784

217

855795765744

697668641608577

552502480456

432413382361342

320285259

947484

21,85119,66017,53714,5789 543

7,3466,9056,4205,9685,579

5,1574,8104,5344,2353,919

3,6083,4103,3353,3073,035

2,4401,9951,779

570392289

1960 26,8951959 24,8781958 22,84819571956 19,246

4.44.64.34.34.3

Series B 248-261. National Health Expenditures, by Type of Expenditure: 1929 to 1970[In millions of dollars, except percent. Calendar year data]

IPrivate expenditures Public expendituresTotal

'ercentgross

nationa'product

249

Health and medical services

Othermen's

256

YearHealth

andmedicalservices

DefenseDepart-

menthospital

andmedicalcare

257

facilities

261

Amount

248

Generalhospital

andmedical

care

Medicalresearch

Medicalresearch School,

naternalchild

services

258

Public

255250 251 252 253 259 260254

3,5603,1962,9692,8682,772

2,6182,4812,3602,2042.179

2,1001,9091,8031,7181,573

1,3841,2631,2061,1371,034

933834739

306231125

71,57364,14256,58750,69644,974

40,46837 46133 53031,29528,783

26,89524,87822 84821,10819,246

17,74516,79915,74514,98813,992

12,66211,57610,612

3,9872.9363,649

7.36.96.56 . 46

5.95.95 . 75.65.5

5.3

5.14.84.6

4.44.64.34.34.3

4.54.54.1

4.04.03.5

194192188181172

166

151141132

125106867870

6054514540

383632

..

1,043930833752678

610562527492463

435405380362345

325305282257230

204186174

946975

(in mill14.

676657589514451

377346327310284

254234216200184

1681531177666

636057

321513

'9,432

7,3585,921

22,272

818693618575520

474484473458439

408402403450435

376845312

15311796

1,64321.62621.60821,52221,402

1,3031,1661,033

892712

538420330266200

15012911310594

796957

3..

1,163973893782732

703564545541518

512608617533486

410455519580589

544436231

8351

108

42,288

33 44431,15030,753

29,02326,83723,90822,36720,719

19.59818,10016,47315,22414,016

12,88912,15211,17010,2049,449

8,8858,4568,068

3,1452.3623,049

5,7454 8714 2542.9442,040

1,4791,2581,068

919686

514451365304270

232194165137110

7626

.

..

.

the1970, $7

1,8581,7551,6991,5401,269

1,0221,1041,0421,003

961

896907911851788

754777890

1,046976

584825280

752929

1961

1,210 1,1381,198 1,092

911 1,038865 988656 955

payments$6,918;

Includes military dependents. Beginning 1966 includes the following amounts for "Medicare," health insurance

74

$1,199; 1967, $4,736; 1968, $5,979; 1969,

HEALTH MEDICAL CARE

Series Indexes of Medical Prices: t o11967 100. U.S. city average, consumer price index for urban wage earners and clerical workers]

53 16 008 3 700 000 345 1 328 150 795 43 639348 328 166 3,158 107 39,666 8 799 118 58338’962 163 2,756 104 37 712 57 52 338

50 14,955 3,457 659,000 331 2 262 141 948 41 555

313,559 93 56

49 13,876 5,181 613,188 319 1 153 129 629 34 686305 115 153 2,012 93 84,089 7,808 109,301 56 48 13 691 3,213 582,000 306 1’142 35’259297’089 159 2 249 92 83,595 7 691 107 820 56

48 3 233 1’128 123’861 82’398149 92 33,072 7’631 106’230 5647 13 513 550,000 297 1’118 123’012 31’186

270,136 797 92 32,633 7’530 105’252 56 47 131580 3,290.__ 92 32,232 1033596 56

330’732 161 3 128 100 8,400 113,63657 49 14 421 3 360 640 000 325 1’219 139’070 38’237158 95 35 212 8 148 112 15256 49 6213000 319

19601959....

.1957 . ..

.

195519541953

1951

274 833

. .. .226,625. .. .

218 061

210’900207’900

*9185858582

*31 999 508 101 94729’614 6’86029’473 6’861 98’540

6’796 100’53428,639

47

4543

4343424242

4713 509 3

13,004 312,730 430,000 262

12 601 3 081 7430 000 259244

12 3702,975

11,891 2,830

460,000 268

1191’126

1’1151

1 1391’1411’148

1’167

057113’518

114’674114

107 572 103’019102’019

102’5501031433

112’989

8180797979

28 583 6 977 97 5296’361 95’883

27,683 6’668 93’726 27,07626,186 6,135

Professional services Hospital servicesand prescription

Totalmedical

careYear

Medicalcare

servicesPhysicians’ fees Tonsil-

lectomyand

ectomy

Optometr

andcasesDentists

feescharges

Privaterooms

Prescrip-tions

265

--Housevisits

268

Total

266

Officevisits

267 269 270 271I__-262-_ 263

124.2116

100.092.0

87.384.682.680.277.7

74.972.068.765.562.8

60.458.757.055.051.7

49.248.146.443.540.1

87.936.935.433.732.7

32.582.532.432.331.931.8

264

103.6101.3100.2100.0100.5

100.2100.5100.8101.7103.3

104.5104.4102.899.396.7

94.793.792.691.891.0

88.587.486.181.876.2

74.8

73.573.071.4

70.871.1

70.970.570.7

272

113.5107.6103.2

95.8

92.890.989.789.287.8

85.183.082.181.378.2

77.075.976.977.876.8

73.572.870.56765.1

63.963.161.65958.3

53.157.657.2

56.856.7

273

143.5127.S113.21oo.c84.C

76.672.469.064.960.6

56.352.749.947.248.7

41.539.637.435.232

28.927.825.72218.5

16.215.715.11412.9

12.712.612.612.312.011.9

274

141.7126.7112.7100.084.7

77.773.470.166.662.4

57.853.8514846.0

44.142.289.737.534.2

81.330.628.624.921.3

18.918.317.616.415.4

15.115.115.014.714.314.2

120.6

106.1100.093.4

89.587.385.683.581.4

79.176.473.269.967.2

64.863.461.459.356.3

5352.751.148.144.4

42.141.139.988.037.0

86.836.736.736.636.386.1

121.4112.9105.6100.093.4

88.385.283.181.379.0

77.075.1

70.367.4

65.463.261.459.857.3

55.254.453.451.448.8

4644.9

40.639.8

39.639.639.539.639.439.2

101.299.698.3100.0101.8

102.0103.1104.5107.1111.5

115.3115.7113.1108.2104.7

101.6100.298.398.397.1

92.690.288.181.374

71.570.669.468.867.0

66.266.266.265.765.465.4

122.f

92.5

84.182.180.077.1

75.974.572.169.567.2

65.463.761.259.256.8

54.954.253.351.248.1

45.744.342.239.939.1

39.18938.93938.938.8

122.4114.5106.5100.093.5

87.684.181.679.777.2

7572.8

67.568.5

61.258.857.656.354.6

52.951.950.849.546.6

44.744.042.540.439.6

39.639.639.639.739.639.1

121.8113.5105.2100.093.0

89.087.185.083.781.1

79.477.775.573.570.9

68.664.461.560.264.4

51.250.649.946.743.5

4140.238.535.138.6

33.033.032.832.532.332.1

117.1110.3104.9100.094.9

9188.485.983.881.9

80.377.174.371.969.5

69.067.466.064.362.0

60.760.253.555.151.5

48.847.545.448.041.8

41.542.642.442.141.941.8

119.4112.9105.5100.095.2

92.289.487.184.782.5

82.180.578.676.274.4

73.072.370.067.866.4

63.962.460.056.952.5

49.647.645.143.142.0

42.042.041.941.840.940.8

Physicians, Dentists, and Nurses; and Medical, Dental, and Nursing Schools: 1810 to 1970[Census figures in italics. Figures for schools and students are lor academic session ending in the specified

Dental schools Active professional

,graduate nurses !I , --

Physicians Medical schools Dentists

Rate per cians Rate per Rate per

uatesYear Num- 100,000 admitted Num- Students Grad- Num- 100,000 Num- Students Grad- Num- 100,000 Num- Students

to beras immi-

*30 11330’31230’41029 933

57411,9341,9901,388

56* 57575959

28 72928’539

29,01628,794

1 0461

1,3881,210

58

132132132132133

footnotes a t end of table.

75

B 275-290 VITAL AND HEALTH CARE

Medical schools Dentists 4 Dental schools Active professionalgraduate nurses Physicians

Rate per Rate per

uates ber popula-Year Grad- Num- 100,000 Num- Students Grad- Num- 100,000

Rate per Physi-ciansI

to ber 3 uates ber popula- ber 5tion as immi- tion tion

grants

275 276 277 278 279 280 281 282 283 284 285 286 287

1950 203,400 134 1,878 79 25,103 29,441 59 4 1 11,460 2,565'375,000 249128

1949 201,277 135 1,141 78 23,670 5,094 4 1 10,132 1,57440 8 1,755

77 82,990 58 40 2,2251946 77 5,826 39 7,274 .

77 22 735 5 543

Professional nursing schools

ber uatesNum- Students Grad-

288 289

1,203 98,712 25,790

11 215 889 1 817 21 3791 253 106 900 40 744

77 24,028 77 1957677 22 03177

77 21,271

21,30221,58722 095

19301980 158,808 1251929 152,503 125

1927 149,521 126487

5,136810,303

5,2235,1635,275

5,097 --_.--.- 39 7,407 1,757 '284,200 216 1 ,311 85,156 23,600_ _ _ _ _ _ _ . I _ _ _ _ _ . _ _

39 7 331 1,794 1 328 82 095 22 4865,194 39 1,704 74'306 20'655

39 7 397 1,739 1,3895,3775,183 39 1,736 1,417 69,589 18,600

69,921

202156218290706

1,095

1,384738533462

304353187259329

1925 147,010 127 5401 ,391

1923 145,966 130 7041922 4581921 145,404 134 557

82.0001

19391938

1936

175,163 138165,989 126

169,628 1 3 1

165,263 129

77 22,8881 5,101 7,175 1,472 67,533 19,600

22,79922 5,035 7,160 1,86476 4,936 1,840 1 781 84,390 25,31276 21,982 4,735 1,842 100,419 25,971

76 20 87880 20'545

79,

4,565

4 44667,334 56

4,0353,962

71,0554,565

4 44667,334 56

4,0353,962

71,055

80 18.200 3,974 64,481 56 43 11,86379 17'728 3,562 43 3,42280 16'960 3,120 45 13,099 3,271 _ _ _ _- -81 15'635 2,520 4583 3,186 45 11,745 1,795

46 98 1,755 54,953 14,980_ _ _ 506 105.90085 13,798 3,047

85 13 052 2,656 4690 2,670 46 3,346

.13 764 3,579 45,988 44

14,891 3 49 2,388 1,509 46,141 11,118 16,502 42,606 43 48 ........ 2,254

51 2,02252 1,94054 1,742

54 55 1,129 32,636 8,140 __. . 1,646 50,500131 21,526 4,440 37,684 41

56 1,761140 22

159 24,276 4,980 55 1,724

26 147 5 600 55 2,621 862 5,795160 52,204 39

28,109 36 56 2,294

1,765 . . .

_ _ _ 56,152

46 3,010 . . __. . .. . . 3,518 49 2,835 ........

17,0151 3 98118 38,866 4 1

4,273

48

4,741 36,670 41 55 2,005

162 25,204 5,364' 35,238 4 1 55 1,519

160 27 615 5 698 55 2,198

160 26,417 5,444 57 . 2,304 , . . ..

,*Denotes first year for which include and Hawaii. For 1840 and offering courses in dentistry; for 1850-1925,NA Not available. schools conferring degrees; for other years, schools in operation. Includes Puerto

Beginning 1960 includes osteopaths. Puerto Rico; beginning 1960, includes osteopaths and their Includes Hawaii and Puerto Rico beginning 1950 for number and students and

7 Census estimate adjusted to exclude student nurses enumerated as graduates.4 Beginning 1958, excludes graduates of year stated. Reflects enrollment of more than 1class in some schools under accelerated program

Rico.

1952 for graduates.

in operation during World War 11.

schools.Approved medical and basic science schools.

1959

1956_ _ _1955

1951

1949-

1944

19401939

1931...

HEALTH AND MEDICAL CARE 291-3634

4. Rates Per Population for Specified Reportable Diseases: to 1970[Rate per 100,000population enumerated as of April 1 for 1940,1950,1960,and 1970.and estimated as July 1 for all other years]

Malaria

294

Scarletfever and

strep-tococcal

sorethroat 3

Meningc

infection

Acutepolio-

myelitisand its

sequelae

292

Typhoidand para.typhoidfever

295293

I coughMeaslesHepatitis Smallpox

304296 297 298 299

0.2

1.21.31.51.92.6

8.85.46.58.511.7

14.110.611.012.113.5

11.818.423.522.223.4

30.834.140.248.057.1

54.170.175.989.880.7

82.1105.6131.4156.9190.7

139.0144.7101.5133.0129.2

132.7152.5142.1139.0

300

2.11.62.44.93.9

3.56.89.19.66.3

8.322.718.616.619.0

38.237.823.528.944.8

80.146.761.1109.178.4

101.082.7142.9142.9166.9

139.6140.0175.1166.6115.0

141.9

142.6172.5139.1

135.6162.1134.3152.4172.2

131.2145.0146.797.7

302 30330

23.412.E11.1

104.2

135.1239.4204.2259231.6

245.4230.1440.5285.9365.9

337.9423.5283.7438.5345.6

210.1420.6421.0155.0496.8

110.2474.3472.0

671.7

220.7

633.8249.6234.0

584.6682.6319.2323.2382.8

340.8300.6

587.1

463.7680.0241.8274.5

480.5203.2474.9611.6621.8

254.1295.8368.5310.0

19.421.323.124.4

25.326.6

28.729.4

30.832.536.539.2

49.353.070.577.3

80.490.793.894.185.2

86.895.089.687.579.3

7879.482.487.283.6

87.989.491.197.7100.7

101.5

43.848.149.953.257.1

59.762.969.368.169.7

69.368.578.377.1

76.087.5100.8110.8131.8

154.2197.3234.7264.6271.7

282.3367.9447.0363.4368.2

359.7367.1372.0264.3212.6

205.6186.7193.4

197.4

185.4

174.2171.9196.1

181.2174.2156.2157.7172.3

145.3113.2

. .

.

. .

. .

. . .

285.2245.9219.2193173.6

163.8154.5145.7142.8147.8

139.6137.1129.3129.8142.4

149.2152.0157.4161.3179.5

204226.7252284.2275

225.8236.5213.6160.9146.7

133.8139.8153.8143.4

130.8124.11.21.4132.5137.0

135.5135.4138.3140.7157.2

149.3144.5142.2140.4177.7

175.4147.8

. ..

1.51.51.21.0

4.53.7

1.42.86.610.534.7

47.443.440.644.951.1

59.263.264.984.2104.6

108.1105.410055.056

80.0134.7138.2118.298.9

86.398.4124.2142.9174.7

173

0.2

1

11.31.41.51.4

1.62.72.52.82.8

3.74.04.14.66.5

7.410.011.512.412.4

14.417.618.621.421.4

22.119.122.629.235.5

40.031.03133.048.5

38.842.950.063.082.3

74.082.484.281.8

239.2238.2226238.1226.8

210.6

170.0185.0

175.8189.6152.41'3.3105.5

91.7847354.9

42.868.762.565.289.6

140.1150.9112.0101.4104.7

125.9132.3152.8183.5195.6

211.0180.0174.4172.7166.3

144.5152.9148.9179.8166.7

161.9164.2

148.1178.7

151.6118.394.5139.2114.5

108.6133.0143.1138.2

11.11

1.21.2

1.a1.21.51.61.6

2.12.83.23.12.7

2.52.42.32.44.1

6.212.313.62.91.5

1.31.52.24.35.7

4.62.02.32.54.4

6.88.74.82.61.8

1.51.41.91.92.2

2.63.17.26.22.7

2.93.43.4.

1.84.83.33.29.1

17.623.922.537.218.5

22.128.3197.5

18.3

10.314.39.33.16.8

7.45.61.37.43.5

8.55.94.03.112.8

7.52.44.38.82.3

5.34.63.12.05.8

2.22.32.84.941.1

2.44.05.5

--* Denotes first year for which figures include Alaska and Hawaii.

Less than 0.05. 3 excludes streptococcal sore throat. Beginning 1950,excludes paratyphoid fever.

4 infectious only; thereafter, infectious and serum.Includes Alaska.

Includes Alaska and Hawaii €or all years. Prior to 1953,active and inactive cases; Reportingincomplete.thereafter, new active cases only.

77


Series 305-318. Hospitals and Beds, by Type of Service and Ownership (AHA): toI I

955,869907,133892,934853,318859.446802,065813,926755,722

4,041

3,798

Beds per 1,000Federal, all types population

Non-Federal

Short-term general Long-term general Psychiatric Tuberculosisand special and special

Total

YearHospitals Beds

305 306

term

307 308 313 316 317

55'8535'820

5,8125 7365'712

5,460

5 4075'364

5,309

5,066

5 0314'585

4 4154

526 889 101

593 916 116609'075

685 175 178691 187714 661716'781

222

19,720' 40820,56222,21318 41630 42537 196 44339'589

44 687446

50966,517 505'80,31167,337

73 474536 483

8.0 4.28.3 4.1 8.4 4.18.5 4.08.7 4.08.9 3.99.0 3.89.1 3.79.2 3 . 79.2 3.6

236

741,292720 810 300698 323676,795658,521

1969

1966...1965....1964...1963...1962...

1960...1958...

1951

1948...1947

3.69.2 3.59.1 3.59.2 3.59.6 3.59.8 3.59.8 3.410.0 3.510.0 3.49.9 3.4

639 308'619'877 330609'732 321594'529 340586567553'068 406545'903 406 530'669

6768'3231

75 646 525 76

546

69,73162,768 551

78'383 475

52 101 43557'392 438

646 261 57'077 439641 455 280 437

384 72 253 435675 749 391 439

722,493688 410

695 315 66,096 432707 162 347 194 428691 176 368 430

399 72,642 422

504,5041476 584 395 465,2091 362

413,059

72 178376

75 906 38670 '307 40374

3.39.7 3.2

3.23.2

10.3 3.4

6 788 1 455 8256'2776'160 1'411'460,6'173 1'400'318

* Denotes first year for which figures include and Hawaii. short-term general and hospitals.

Series B Hospitals and Beds, by Type of Service (AMA): t o

Tuberculosis All other eds per 1,000populationTotal General Mental

Beds Hospitals Beds Hospitals Beds Hospitals Beds General

330

Total

322 323 326 328 329327325

420428430

431444438441450449453455468477

324

749,393732,929728,187

9.99.910.0

9.69.79.79.910.513.11312.310.39.9

9.39.18.98.78.68.48.38.28.17.9

7.87.47.47.27.36.97.16.8

7 . 75.96.44.7

4.14.14.2

3.93.93.94.14.67.07.06.34.44

6,8406 , 6 6 56,637

6,4306,5726,3356,2766,2806,5116,6116,6556,3456,868

6,2916,2266,1666,1286,1896,2466,8346,4376,5626,613

6,719

6,8526,8076,9466,8967.3706,830

6 152

5,0474,359

5,0874,9244,890

4,7184,7614,5894,5394,5234 7444,8384,8854,5574,518

4,4324,3564,2864,2454,2074,2574,1984,2374,3054,309

4,3024,2684,3614,322

653,752640,923640,207

593585596

88,40689,57188,379

740728721

81,463

73,215

71,32875,45473,56970,52869,26680 228

67,82561,07770,374

75 534

711,921705,423691,499680,913674,930657,393648,745

646,118638,144

86,74683,47081,99381,32883,18178,77479,84879,86082,37282,365

707761722711732755759740

7673.53.43.383.13.23.13.13.28.1

1,226,2451,195,0261,161,3801,124,5481 096 721

1391,048,1011,027,0461,014,354974,115

462,360444,947425,324412.091402,605406 174393 425386,713395,543384.333

871,609357,034363 337345 364

293,301

311,159

602600692579584592614621624

78,24675,97216,02276,75173,69270,37370,063

69,67665,923

778790795796892901

1,0271,0821,1211,208

64,35567,82368,21265,09071,47269,28170,76870,69669,58772,614

437,919414,386394,268373,364

65.940 3.02.93.02.9

193019291928 _ _ _19271926192519241923

62,11363,170

817,020 4,013612,251532.481421,065

Excludes hospitals with leas than 10 beds.

78

HEALTH AND MEDICAL CARE

331-344. Hospitals and Beds, by Ownership or Control (AHA): 1946 to 1970

Governmental

State Local

Totai

- _ _ _ _ _ _ _ _ ~ ~ - _-Hospitals Beds Hospitals Beds

33 332 335 336 337 338__I_____

Nonprofit

Church Other

Proprietary

Hospitals Beds Hospitals Beds Hospitals Beds

339 340 341 342 343 344_ _ ~ ~ _ _ _ -

7 123 1 615 771 408 160,9897’144 1’649’663 415 169,6817’137 1’663 ’203 416 174,645

416 175,0657,160 1,678,658 425 173,005

7,123 1,703,522 443 173,9627 127 1 696 039 441 175,4907’138 1’701’839 446 176,3187’028 1’689‘414 447 177,677

437 177,554

6,876 1,657,970 435 177,1056 845 1 612 822 438 178.8206’786 1’572’036 439 180 5746’818 1’558’691 437

432 184,121

6 956 1 604 408 428 183,1626’970 1’577’961 430 189 233 6’978 435

439 213 018 6,832 1,521,959 422

6,788 1,455,825 414 189,4776,277 1,435,238 376 186,7646 160 1 411 450 386 185 846

4036,125 1,435,778 404 235,964

1,6801,6651,6311,5891,554

1,4951,5001 446

1,374

1 324

1 257

1,263

1,2531,2481,2391 747

1,654511

1

21,504

219,353220 447

216 338

215 554215 891210 527

205,732

201 322 195’328

194,740202,368

203 179

203,836896,596

2870,517

843 672 3842’089

826

2811,702

13,600660

‘3,675

2 404

2,3922 3642 328

2 3382’3282’288

2,304

2,3392,2252 259

13,297

25013’04413’022

12,921

1618 548594,845578 560

336 201320’798

305 189294 840

288 843 281275,365267,555265,633

264 761247’658

1398 530

1368,1371355 3311349’310

577565559552550

546555561558551

556555543543553

552552556

59 33055’28554’63554’233

54 10853’6805349 93946

45,80944 88345’65646 84850,447

51,87051 51554 ‘10353 ’665

54 5395149 917

53,245

53

557 571 598’064620‘455646’929

707,974719,343738 839746’490

752 148725’455691’226636’255

739,153717 558

* Denotes year for which figures include Alaska and Hawaii.Church-operated and affiliated hospitals included with “Other.”

858856871923956

969980

1,022990973

9821 0121’0341’0891

1 ,2831,3191 3791

,412

1,4701 3461’27811,296

State hospitals included with “Local.”

Total

Hospitals Beds

345 346---_

Series 345-358. Hospitals and Beds, by Ownership or Control (AMA): 1909 to 1953

~ _ _ _ -Federal

Hospitals Beds

347 348I------------

Year

Governmental

State Local

Hospitals Beds Hospitals Beds

349 350 351 352

Nonprofit

Church Other

__- Proprietary

Hospitals Beds Hospitals Beds Hospitals Beds

3 53 3 355 356 357 358

2,2062,1462,121

2,0722,0672,0161,9651,942

1,954

11’952961

1,917

1,9031,83911’718

1 670

677

243,653232 598

218 788213’576208’936

198,885

195 805

195’624190,150182,140

177 681172’765169’980162’4741621586

155 300

1216,7331217,432

1950...

1930...

6 8406

6 4306’5726’3356’276

6 5116’6116 ’6556 ‘345

6 2916’2266’1666’12861189

6 2466’3346 ’437

6,613

6,7196,6656,8526,8076,946

6,896

1 3291’305

1,3491,4781,3511 343

1,3381,3681 4151’4951 584

1,6231,6461,6811,7131,754

1,8821,939

1 573 892 200,535 550 711,824 1 194 200 645 1 169 164,0531’541 ‘61 386 211 510 549 691,408 158,389

388 554 683,376 1,090 197,405 1,116 154,053

1 456 912 355 186,793 552 665,019 1,005 185,229 1 097 150,078361 182,254 573 656,611 1,003 186 290 146,315

1’423’520 372 185,098 567 648 386 961 186’283 1’063 144,0361’425’222 401 213 204 563 953 1’051 141,920

464 557 628,363 941 139,885 138,096

1 738 944 705 546,384 549 619,642 929 190 692 1 135 481798 551,135 539 609,025 925 1’020 133’090

1’649 ’254 827 476,673 531 115 926 189,351 130’4881’383’827 474 220 938 530 606’437 920 188,406 977

428 530 906 185,989 993 123,331

998 120,8091 226 336 108,928 521 572 079 910 192 6821’195’02; 329 96,338 523 560’575 888 1,001 120,7401’161’380 330 92,248 523 541’279 875 181,609 981 119 5211’124’548 329 97 951 522 508’913 871 181,885 975

323 524 877 176,300 969 113,288

1 075 139 316 83,353 526 483 994 882 174 970 113,2681’048’101 313 77,865 544 892 166’988 970 113 2631’027 ’046 295 75 635 557 459 646 924 159’192 984 1151840110141354 301 568 442’601 935 1,001 117 555

974,115 291 69,170 576 949 153,072 1,011

955 869 288 63,581 581 405,309 943 150,836 1,017 116,846907 292 59,901 578 385 706 925 136,930 1 024 113 555892,934 294 61 765 595 369’759 924 135 910 1’056853 318 301 60’444 592 354’786 916 108,5828591445 3341984

802 06: 299 57 091 351 317 264

1 3 890 1219 2971211’041

13,938 1199 567

52 3045152,312

51 005 53‘98450’781

48,999

50 94048’9535051’755

54 06656 ’37556’74358 ’042

64 859

53

I I I I I I

Proprietary hospitals and beds included with “Other nonprofit.”Not available.

79

B 359-380 VITAL STATISTICS HEALTH AKD CARE

Series B Average Daily Census and Admissions to Hospitals, by Type of Service and Ownership (AHA):1946 t o 1970

19701969

1987...

1965

_ _ _ _ _ _1961

[Inthousands]

1,298 31,759 6621,346 30,7291,378 29,766 6301,380 29,361 6121,398 29,151 588

1,403 28,812 5631,421 28,266 5501,430 27,502 5301,407 26,531 5091,393 25,474 489

TotalShort-term general

and special

1959 *

Non-Federal

1,402 25,027 477 1,363 23,605 4621,323 23,697 4511,320 22 993 438 1,356 22.090 425

1955 _ _ _1954

1952...

19501949

1947

1,363 21 073 407

1,342 20,184 3941,336 19,624 3851,298 18,783 378

1,253 18,483 3721,240 17,224 352

16 821 361354,341

1,843 393

Federal, all typesLong-term general

and specialTuberculosisPsychiatric

___-Year

Average Admissions Average daily

census census duringyear

Averagedaily

census

Admissionsduringyear

Averagedailycensus


Averagedaily

census

Averagedaily

census

AdmissionsAdmissionsduringyear

duringyear

359 360 361 362 363 364 365 366 367 368 369 370

29,25228,25427,27626,98826,897

26,46325,98725,26724,30723,375

4952556857

5659626260

5859676763

6561565851

6068707363

132105149155144

166157148159155

151149160198175

158155160156163

164132128

139

447490532540582

607632657649654

672642604609659

677668663651636

607597595558517

698565538492451

491442435413376

362349359303343

312289291392275

1213141221

2628293336

3945444953

5661626262

6266665555

128140146149151

3636362645

5262556065

6879697176

8789777683

1,7411,7691,7661,7001,615

150152152154153

154156157157156

157160168180171

152157149150166

1,6401,6191,598

1,503

22,97021,60521,68421,00220,107

1,4761,4241.4251,4191,388

19,10018,39218,09817,41316,677

16,66315,428

15,908

1,4151,421

1,5861,586

293269267266202

791281129485

1,2841.2681,2411,2711,593

* Denotes first year for which figures include and Hawaii.

Series B 371-380. Average Daily Census and Admissions to Hospitals, by Type of Service (AMA): 1923 to 1953[In thousands]

Total Mental TuberculosisGeneral All other

Averagedaily

census


372

Averagedaily

census


Averagedaily

censushverage

dailycensus

Averagedaily

census



380

Year duringyear

378373 374 375 379371 376 377

19,86918,91518 237

477475471

433429438457496

18,69317,760

1,3331,3091,294

719704698

688675664652636

624619619610603

591

562547525

507488475455427

415395350322

577

328312307

307308305292271

249226209214209

190190199196185

173172171170

757574

726966

62

6063657071

6765666563

6160606056

108

107

11311310699100

615552

4951494645

5647

4150

4346444449

4645434345

739733757

1,2431.2251.2171,2171,239

17,02416,66016,42315,83015,153

15,83015.450

14,66514,052

773789862

7311,4051,2991,2571,1261,087

15.22815,06014,45511,68410,647

868892102101

694662620596639

1,026996966944909

10,0889,8799,4219,2228,647

9,2199,0188,5468,3507,756

919110110299

587580576574607

876830810808775

7,7177,1477,0387,2287,156

261237232250248

6,8756,2926,0726,3046,322

8682849381

763727672629553

56515140

52474374

80

HEALTH

Series Hospital Use Rates: 1931toare annual rates per 1,000 population, except as noted, based on Bureau of the Census estimated resident population as of July

TotalSays in

B 381-400

Averagelengthof stay

Tuberculosis hospitals

sions

and special hospitals

days inhospital

and special hospital!

Year

Mental hospitals Tuberculosis hospitals

Admis-sions

381

Mental hospitals

1,2411,2421,244

1,1651 1791'215

1,4121 987

1,5561,216

1,019832860

Totalin

iospital

385

1,6591,6501,660

1 659

1,6601,6581,657

1 7201 700

1,662

1,6341,455

1

1,257

1 0 . 110.510.7

10.610.811.111.913.4

16.514 3

13.3

13.715.015.3

lengthi f stay(days)

388

9581 ,060

0841

I---~----

1948....194

--Total

days iniospital

110109110108

sions

1945....1944....1943....1942

1201181129 1

165173178191

185174165

Year Amount Federal

,-

Total

395

Federal

396

Totaldays iniospital

387

Totalin

iospitallengthof s tay(days)

388

lengthof s tay(days)

383

9 . 59 . 89.99 . 99 . 5

9 . 19 .29 . 29 .39.3

9 . 39 .69 . 59.69 .7

9 .91 0 . 0

Year Admis-sions sions

Admis-sions

-I

385 386 384

2 . 12 .02.0

2 .02 . 12 . 12 .01 . 9

1 . 91 . 71.61

1 . 41 . 40 . 8

386 387384

3 . 33 . 13.02 . 72 .6

2 . 92 . 72 . 62 .62.4

2 . 32 . 32 . 32 .12 . 3

2 . 22 . 1

381 382I----

252250

233224230231

253

260252

269257254

2224272340

57607078

122

145167168

183

172186190

200

211223231

219232

1 440

1 '43811,387

1 '452

1,3291,3271 3141'2951

1 26511,2741 , 2 6 51,248

2381

1953 123119

1951 116175

1,2611,3261,3931,3991,431

1,491

1 ,4061,4431 ,576

1 6451

1,45386

104108123135

940 74595fi

1461571955

124

* Denotes first year for which figures include Alaska and Hawaii.

Series B Hospital Expense Per Patient Day: 1946 to 1970[In dollars. Covers hospitals accepted €or registration by the American Hospital Association]

Total expenses Payroll expenses----Non-FederalNon-Federal

Psychiatric(including

Short-termgeneral

specialShort-termgeneral anr

special

Long-termgeneral

special

398

24 .OO20.6018.5815.1014.39

13.961311.6110.6210.12

9.018.396.916.796.84

5.365.6354.0533.322.351.991.641.64

Psychiatric(including

short-term)

Long-termgeneral

special

392

36.1729.7727.0021.4520.59

19.7918.9116.5715.1014.49

12.8212.5010.3210.3310.20

8.068.538.266.636.30

5.394.078.818.032.97

400399394391 397

47.3041.3636.6132.4429.41

27.4425.2624.0122.7921.54

20.0818.7617.1915.7414.85

14.2613.2111.8610.669.65

8.867.967.175.994.98

393

16.6313.61119.628.11

7.506.975.985.725.53

4.914.714.403.913.63

3.733.222.832.682.46

2.432.841.951 .601.39

23.9420.4017.3814.6613.36

12.2010.7810.3110.389.89

8.928.547.917.146.51

6.485.775.114.614.25

4.063.703.172.822.38

3429.4725.1321.3619.16

17.3915.7215.1315.2214.72

13.3712.8012.0811.1610.19

10.139.328.547.857.37

7.226.686.255.444.57

37.4433.4127.4825.3523.96

29.1222.38

20.4219.15

16.3415.9814.8014.2713.74

11.6312.0610.4410.358.68

9.359.536.195.234.06

53.1045.8937.9733.0429.69

28.6727.1726.2824.9723.34

20 .ll19.6218.3817.6816.97

14.5015.9213.9314.1011.91

12.7713.30

8 . 8 17.396 .14

81.0170.0361.3854.0848.15

44.4841.5838.9136.8334.98

32.2330.1928.2726.0224.15

23.1221.7619.9518.3516.77

15.6214.8313.0911.099.39

12.241 0 .oo87.106.11

5.605.164.404.164.00

3.453.263.082.662.41

2.172.031.741.581.43

1.381.531 .03

.84

33.1628.1123.7820.7618.27

16.7015.3813.9313.1212.25

10.9210.379.638.767.98

7.206.836 .105.635.01

4.794.633.603.072.93

Includes Alaska.* Denotes first year fo r which figures include Alaska and Hawaii.Includes full-time equivalents part-time personnel; beginning 1951, excludes

residents, interns, and students.

81

B 401-422 VITAL STATISTICS AND CARE

Series B 401-412. Persons Covered by Private Health Insurance for Hospital and Surgical Benefits: 1939 to 1970[In thousands. As of end of year]

35.8 17,25327.5 12,842

18.2 6,18713.2 4,236

Hospitalization insurance

21,219

11,1038,661

Surgical insurance

30,12829,09728,20128,719

Insurance companies

10,5329,9508,7528,580

ndepenrienplans 3

23,01222,19820,80820 34918'83118

15,62318,354

7 3366'188

5'9905 '89955'9706

4,510 5,258

71.169.669.968.264 162.961.558.555.9

55,06453 62353'282

48,92445,35543,68441 353

13 718 96,9444,8752,0001,8001 600

1,2001,000

3 7603'0262'6702'5502'460

2 323

50.744.241.536.429.924.022 9

15.212.4

37,64533 576

27 64624'34218'961

12,69610.2958,469

9.27.96 .35 .1

4.02.4

5'6251,065

815 3.2752,300

260 1.400......................

Year

Total Federal

Total

413 414 415 I

Persons covered

Percent ofopulation

Blue Cross-Blue Shield

Independentplans 3

Blue Cross-Blue Shield

Grouppolicies

Individualpolicies

405

Number Grouppolicies policies

--I----402 403 406 407

162,655158,584153,977148,729143,284139,437135,433131,954126,900122,951

410 411 412404

84,13381,36377,41574,31870,268

64 939 63'28859 787

55,504

49,91748,95545,906

35,72334,03929 62129 376

39,725

82,71280,09376,05973.35169,57067.10464 50662 '8175957

43,48041,46939,70937,90838,64137,372

857

32,92130,951

8,1317,7027,2777,0506,6336,9846,8407 165

7,102

5 9946'38066 411

6,5456 6806'9736'120

4 4453

3 0402'820

2,4952 3192 '2902

86.4 75,46485.0 73,21184.1 70,51081.6 67,51380.1 65,63878.5 63.662

62,42960,69859,618

73 .7 57,960

1970............1969............1968............1967............1966............1965............1964............1963............1962............1961............

304112'842107 527105 229

88 85685

72 45964

1960............1959............1958............19571956............

30 13728'97126'7842625'570

22'17221'86021 '412

1955............1954............1953............1952............1951............1950............I1949............1948............

...........1946............1945............1943............1942............1941............

1944............

1940............I

42.5 22,052

22,305697

1614 19011'7,8048 40065 0803

1 7 296

7,5843 0002'7002'400

1'800

.....................2,500 1,200

.........__I__

2,250.........

5,3503,103

6 , 0 7 26 . 1 .......

I Net number of as estimated hv Health Insurance For 1939. based on total all other based on Bureau of the............... ..........................of America an association of insurance Estimate of net

number enrolled summary of individual categories for early years becauseHIAA data includr estimated enrollment of college and university health services.

estimates civilian as end ofPlans-community group and individual practice plans, em

group and individual practice plans, private group clinics, and servicenot affiliated with Blue Cross-Blue Shield or insurance companies.

Series B 413-422. Hospitals-Assets, Expenses, and Personnel, by Type of Control and Service: 1946 to 1970[Covers hospitals accepted for registration by the American Hospital Association]

I Non-Federal

I I Short-termTuberculosis Long-term State a n d local

Total Voluntary Fornonprofit profit government

Psychiatric

417 418 419 420 421 422

ASSETS (mil.

416

............._ _ _ _ _ _196 ............1966...............1965...............1964- .1963...............

36 159 333127 9222624,50223,27521 30919 '98019 079

4,8164 9224'659

4,0844 167

3 716558

3,515

3 437107

2,7732,4222,3182 2321'931

1'802

871647539484412414413343288266

,176128

179

998,143073

992

787777742818766575422562509351

449435349343

__. .1959

1957...............1955

...............__. _ _ _. _ _ _

1950............... 7,791

1947...............19486,9466 490

1,131874905812

1,4411 261

966

421442395322

861702675612

See footnotes at end of table,

82

Total

Year

Non-Federal--Federal Short-term

Total Psychiatric Tuberculosis Long-termTotal Voluntary For State and local

413

1,6621,6081,4331,3551,322

1,2051,102972870873

923786685686571

539619424325262

nonprofit profit government

420 421 ! 422

I--...-414 415 416 417 418 419

1965

1970-_ _ _1969-_ _ _1968-

25,556 2.483 23,07322,103 2.350 19,753

2.032 17,0301,795 14,600

14,193 1,633 12,565

216213210214206

199193206207202

186179181186198

192195198206197

169161154161162

1964-

1961

12,948 1,568 11,38012,031 1,503 10,52810,956 1,458 9,49310,129 1,408 8,7219,387 1,303 8,080

9,1478,3497.5326,8416,250

15214313394

147

165163158

192

192208195

197

208206192177167

16216015010991

6,6436.0395,4914,9994.584

PERSONNEL

4,6554,1613,743

3,4343,1212.8682.5772.314

1318191524

29302934

3941414345

4849474747

4545433636

37

3,4273,0502,739

2,5032,2762,0801.8791.688

649565

529427

406407376343316

273269262252236

192190167141117

117101988168

2,3212.2132,1001,9881,900

1,7541,6931,6341,5561,494

1.4121,3411,284

1,177

1,051971913878

6968727869

305303292277274

274, 264

261251248

238215203

, 201191

155151

474640

3237

,333,277,207,149

,080

9x4926878

826777719674648

662696586539505

14,16312,13710,317

12,081 3,30610,276 7,485

1,011 70 962 67921 64875 57 835 51

792 48758 46 720 45680 43 639 41

597 41 568 40520 40486 39464 38

473 41435427 34392 85362 35

1960*19571956

1,5981,5201,4651,4011,375

2,120 1,5231,842 1,3331,724 1,2641,434 1,048

888803785722

510493417346304

14713212611799

14312511910994

1,387 97 8884

1 619 1,175 811,104 77

4 3283 6243 125

2,288

1 994

1,6241,4961,362

1,2031,0891,003911816

752683619547486

444407382363352

30B304291276263

241227219203198

188169159149146

148126124111108

See footnotes at end of table.

83

B 413-427 VITAL STATISTICS HEALTH CARE

Series 413-422. Hospitals-Assets, Expenses, and Personnel, by Type of Control and Service: 1946 to 1970-Con.

Total

Year

413

Non-Federal

Short-term

Total Voluntary For State a n d localprofit government

416 417 418 419 420 421 422

Federal

414 415

292280272265261

246242241237

226223218211207

203198183175171

178169

292284276268264

, 247244241240

232229224218213

210207193184181

180191

_ _ _ _ _ _ _ _ _

..__.__.

1959*1958 _ _ _ __. ._ _ _

196180168160151

139, 133

129125122

114112111107101

1969.....1967.....

1965

19631962.....

1960

1956.....

391424

493523

550566579

603

611618621622

1951...1950...1949...1948...1947...1946...

1944...

634625612599587

580567558544531

522510503502496

390393392390389

386384384381384

6057

5303

5454555449

409402394383377

4541

3635

169

144144137

133128135134132

120114116

127

122122118115116

111102

9797

6862

47

4542403938

3534343231

2827252424

2422212119

146138128122117

111105102104103

9993938885

R5

76

75

74

656566

140

131115120

115113

102100

9591848283

7176726363

4145

256244237233234

21s212214208205

196195189185179

182178161162155

161

145139137

215210206197195

11311111010498

188176161153151

149144

126129

Denotes first year for which figures include Alaska and Hawaii.Composed both general and other special.Includes Alaska.

3 Excludes cost of new construction.Beginning 1951, residents, interns, and students; beginning 1954, includes

full-time equivalents of part-time personnel.

Series B 423-427. Patients in Mental Hospitals, by Type of Hospital: 1904 to 1970[Inthousands, except rate. As of end of year. Completeness of reporting varies from year to year]

Total S ta teand

Sta teand

ountyandFederal

TotalTotalPrivate Private

ospitalPrivate

hospitalsYear Number

--

Rate I Year Number Year Number

424 425 426 427 423 424 426 427 423I----___

426 427

194212231252270

287299311322333

343354363369350

4343485357

6262626263

6263626 162

338370399426452

475490505516527

536542545549

1111101414

1313131413

1414141414

559564545532520

513499490477470

463456453454450

14141314

141413

12

13

121211

434433421409400

389376366332

230

1111111211

1110108

9

479476462448

1936... 435

1935... 4221934... 407

395353

34

356 30348 27

24

284 12

*Denotes first year lor which figures include Alaska and Hawaii.Patients per 100,000 population estimated as of July 1. Total population used

prior t o 1936; civilian, thereafter.Includes veterans with mental disorders resident in VA hospitals and through

all patients in public health service hospitals at Fort Worth. Tex., and

3 Includes patients State-operated psychopathic hospitals and, through 1950, i n

Includes Alaska.Beginning 1959, includes Alaska; 1960, Hawaii.Includes

city hospitals.

State mental only.

84

CARE

Series B 428-443. Public Institutions for the Mentally Retarded: 1936 to 1970

Personnel,full-time 5

428-447

Maintenanceexpenditures

Deathsin

institu-tions

AverageNet Resident dailylive patients, resident

releases end of patientyear popula-

Rateper

100,000civilianpopula-

tion 3

Patientsunder

Total

Rate per100

average Totaldaily (mil.

resident dol.)natient

Year

Patients PatientsNumber 'patients, in

begin- 100,000 institu-facilities ning populations

of year (1,000) Number

I___

187189193193192187180177174167

14,68115

1959... __. __.19581957 _ _ _

1952

108 158 682 96106 156 95102 152'876 9499 94100 145,997 9399 141,053 9397 136,926 9398 133 431 9196 9195 130,294 91

128

122119113113112107109102

12 23

11 2111'1210'82

11 54

_ _ _1939 _ _ _

99,222 80

97'516 8295'112 79

79757

78

101991019898

11 2212'23

1950

1946........19451944194319421941

95949497999796939293

19701969196819671966 __.1965

. __._ _ _19621961

103

989798979696

1960 __.1958.- _ _ _1957.-

1952.-1951 _ _ _

96979596989796969594

Admissions

Per average daily patient

popula-tion

443I4 635 12.70

10.953,472 9.512 965 8.122'615 7.162'335 6.40

1,984 5.441,859 5.091,727 4.73

6.00

117 327 62.4 87156.3 761

100,804 52.094 900 48.888'974 46.3 501

41.874,128 40.869,494 38.863 810 36.4

34.7

3 4963'621

3,6013,5833 384

33,158

3,2023

2'8182'730

2,7032,7802,7212,552

2 6782 8332 7422'8733'0632'7202'9992'6732'531

3,635

3'49s

3'499

2,907

14158'154

13,971146144 13,091140 13 51

132130,

1650 4.524.12

1409 3.863.51

1'166 3.192 . 7 62.79

970 2.86923 2.53808 2.21

54,277 33.249 892 31.6 23146'218 30.141'235 27.5

27.1 16636,333 25.5 15334 336 24.8 14131'025 23.1 13029'416 22.6

21.1 103

732 2.01703 1.93627 1.72537 1.47439 1.20379 1.04355 .97333 .91

25,744 20.1 9224 162 19.5 8721'554 18.0 7518'810 16.6 61

15.7 49 15,926 14.0 43

6.9 137,6018 4 135 94

8.38.18.7 1238.5 123'61

120'929.1

8 4

6 091 101 5'241 99'581

5 726 98,709

8.1 109 938.08 7 108 74

107'34

Population estimated as of July 1.

Includes city institutions through 1945.3 Based on Bureau of the Census resident population as of July 1.

Total population used prior t o 1936;civilian, Excess of patients released alive from hospital over those returning to hospital.thereafter. Reporting facilities only.

Includes salaries and wages, purchased provisions, fuel, light, water, etc.

Series B 444-447. Four Indexes of Per Capita Food Consumption: 1909 toBeginning 1941,civilian consumption only]

Food

poundsFooduse

445

969596100103101100979495

93918889888589888789

Food

poundsFooduse

Foodsnsumedpounds Year sumption

Foodcon-

Year ~ sumption

447445 446 447 446

108110109108110109110109109105

108107109106105110109110113

111113

447

102100100102

103104105103106

104104102102102100102102

106

446

106106107112115115114111110110

108108106106106105104104105108

107108109108108107108107107100

102107105104105

107108108108

109110

102102102100989798989697

969896981009997979695

1011011011009999999999100

101101101102103

103104104105

103102102100999899989797

98999797999998999998

86 89 87 908787 9088 9286 9187 92878580 _ _ _

* Denotes first year for which figures include Alaska and Hawaii.

85

Year

STATISTICS CARE

Series B 448-452. Index of Per Capita Consumption of Selected Nutrients: 1909 to 1970Beginning 1941, civilian only]

Protein

448

scorbicacid

452

10098

10094

9493949999

10098949997

9897989799

1949

Fat

449

96969699

450

1928...

Fat

449

8991908989

899090868 1

8287868 184

84858383848385

969796

Carbo-hydrate

450

1942

Iron

451

104101

9996

acid

452

1940...1939...

1932...1931...

Fat

9594929293

9093929394

Iron

1909...

9599999898

99100102104103104106

Protein

Year448

Protein

448

acid

449

10510310310098

9799979595

9598959497

9795959593

450

10210210110099

9910099

100100

101

101100101

1 0 1102108104105

451

10310099

10096

9597969595

9594949495

9493959494

9793939595

9295959396

9593898989

8589898990

108107106110110

112114115114119

116116117

117115117120123

127126129128128

127127125129118

123128124126126

1291291 3 11 3 1

133133

8383848484

8385868482

88898583

85848688888990

95103

979796

98100101

9696

9693949 189

97939596929997

971 0 1104110114

116116106108106

106107106102101

104100

9799

101

969595

100106

104102949084

838 180798 1

788 1798082

9798

1923 981922.... 96

93

Series B 453-459. Controlled Fluoridation of Water Systems: 1945 to 1970[As of December

Operative systems

Number

Discontinued systems Operative systems Discontinued systems

Number Percent Numberof total

popula- Watersupply munitiesystems

YearWater

Year Populationserved

PopulationCom- servedunities

454 455

Water

systems

Populationserved

459

Watersupply munitie:systems

453 456 457 458 456 457 458

21.320.3 56 73

453

. . ..2,6532,3722,0911,785

1,6921,5731,4821,3501.249

1,1721,081

995

41.139.837.436.431.9

30.925.324.823.723.1

22.922.422.2

109 14698 , 1229787 112

879772

672572482353171

6229131183

1 717 215 2081 583

83,725,7714,834 80,096,8604,229 74,579,6663,8273,145 62,427,290

1,347 ,278,8201,1941 ,007 17,666,339

751 13,875,005 368 5,079,321

16.0 47 6013.9 30 32 11.2 12 12 8 . 9 7 73 . 3 2 2

3,0302,758 48,363,0662,612 46,678,3802,321 44,045,3922,197 42,201,115

10049 1,062,77926 581.68316 458,74812 332,4676 231,920

86

(series b - census.gov... 1926... 1926 ... for 1941-1946,the birth and di vorce rates arebased ......

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