a | — 3 bi enc ota % : * : : : ac Q\ Sein Cae . | 4 < i: ON A \ oe oss Remarks before the Committee oh Public Health of the Massachusetts State Legislature in consideration of an Amendment to the Vital oe Statistics Law. Held at the State House, Thursday morning, - | March 5th, 1914, = x by ; Louis I. Dublin, Statistician, Metropolitan Life Insurance Company, New York, NY. gi re yy &é : Gentlemen: I will limit myself te one point; em which is in keeping with my own experience in managing a Large statistical office in New York. I desire to snehanine the great practical utility of the proposed Amendment. At the present time the vital statistics reports issued by the Secretary of State's Office are available only a year after the elo se of the ealontiex year which they deseribe. I am afraid that these reports are more ornamental than useful. I take it that the greatest value of statistics lies in their _ practical application to affairs. You want to make your statistics work. To be most useful, the figures should describe current conditions and should be in the hands of those who are doing the practical health work of the State. (The statistics should be one of the machines at the disposal of your Health Board with which they may do their work. This is to my mind the real reason why you should make the change — that is comtemplated by the Amondzent and place a qualified registrar of vital statistics in charge. You spend a great deal of maney supporting a Board of Health. This Board is engaged in controlling the infectious diseases, especially tuberculosis, typhoid fever, scarlet fever and other diseases dangerous te the public. health. Naturally the Board wants to tout the efficiency of its work. | They desire to know whether the diseases which I have mentioned are increasing in prevalenee or decreasing. At the present time such information as comes to the Board of Health comes either voluntarily from the cities and towns, or the informa- tion covers only a portion of a whole population. It is only mas Yabulatione ef U. & Bureau of the Census and Office of the Secretary | of the Coomonmvealth of Massachusettes for the year 1 9 1 0. ; 4 { a : typhoid Fever 421. 124 413, 42-2 Medalen | 902 U6 240 Tek | ~ Seariet Fever 272 800 884 16 Whooping Cough 286 8.5 | 183 5.4 - “Diphtheria @ croup 705 208 679 2002 pS daha SS a Tuberculosis (all forme) 6,504 16207 6,086 179.9 Cancer (all forms) 3,159 9304 3,028 90.0 TOTAL (ALL CAUSES): $4, 302 1,605.8 $4, 407 1,616.3 through the courtesy of the Secretary of State's Office that they can learn what conditions prevail threughout the Commonwealth. I believe that that is the wrong way to do it. It is unecenom feal and ineffictent to do it in thet way. What they need is a statement of the deaths when they occur in order that the Board, which is responsible for the health werk of the state, may know what is trenepiring. Nothing discourages a Health Board so much as to get information toc late. Thet is exactly what is happening. My thought then, is that your vitel statistics should be tied up to the Department that ean best use them <= the Department of Health. I believe that it is the only Department of the Conmon- wealth that has a right to collect then, One more word. It is extremely important that vital statistics be accurate. Inaccurate statistics are worse than no stativtios at all. I hava very carefully examined the re- porte that are now issued by the Secretary of the Commonwealth and I am impressed with the fact that they show defects which arise from their separation fron the Department of Health. I am distrib- uting among you a sheet showing a number of discrepancies in your reports as compared with the Gensus Bureau tabulations for Massa- chusetts for the year 1910. You will see that the figures for Ty- phoid Fever agree pretty closely. On the other hand, the Census Bureau records 152 more deaths from Measles than appear in the Cormmenwealth re- port. In the same way, the figures for Whooping Cough are very dif- ferent in the two reports. Your rate for all forme of Tuberculosis is seventeen per hundred thousand higher in the Cenmonwealth report than it appeare to be according te the Bureau of the Census. These discrepancies reflect on the care with which your figures are pre- pared. IZ am inclined to believe that the death certificates, which sits, ‘ fiamantins 3 Sm cS a ee Pe Nothing denot give the information in the first instance, are not as carefully questioned by the Secretary of State's Office as they are by the Bureau of the Census. This explains the differences in the rates which appear in the two reports. I am certain that your reports will be much more in agree- ment with those prepared by the experts of the Census Bureau when you have appointed a competent registrar of vital stetistics, as this Amendment provided. Under the new regiméd, when physicians make out birth and death certificates they will realize that _.- there is a responsible person in charge at the State House and a their reports will be much more complete and satisfactory. gut lizes a system of vital statistics so much as oe “i by “ the knéwledge by physicians that there is no person, “ technically qualified, in charge of the machinery. The re- ports then détericrate and you get the form of a statistical repert and lese the substance.