The Health bulletin [serial] - University of North Carolina at Chapel Hill

32 The Health Bulletin June, 1951eating parents of first-born children asto caring for the child in its first twelvemonths of life. A series of twelve mentalhygiene pamphlets are sent to the parentson a monthly basis. Approximately30,000 sets of twelve pamphlets eachwere addressed and mailed monthlyduring the year.Further selected statistical studies onthe prevalence of tuberculosis in differentsections of the state, by age, color,sex, and occupation were carried on duringthe year.Routine ActivitiesOn a comparable basis, more work ofa statistical nature has been done onwhat is generally thought of as vitalstatistics — births, deaths, stillbirths,population—than for any of the sectionsnamed.During the year, approximately 122,-000 current and delayed births were recorded,32,000 deaths, and 3,000 stillbirths.Recording these certificatesmeant editing for promptness, completeness,and accuracy, authorizing for paymentby each county treasurer, coding,microfilming, preparing punch cards,verifying, tabulating, printing, binding,indexing, and a host of other operationsnecessary to process efficiently such avolume of certificates.From this routine of activities, severalinvaluable indices of the state's progressin health were derived.There were 34.6 infant deaths per1000 live births (provisional figure) in1950. This compares favorably with recentyears and resumes a downwardtrend interrupted in 1948 and again in1949.The provisional maternal mortalityrate was 1.2, the same as in 1949.Birth and death certificates receivedthrough December 1950 indicate thatthe official crude birth and death rateswill be slightly lower than in 1949. Theprovisional rates based on all certificatesof residents received in 1950, with noregard to year of occurrence, are 26.4live births per 1000 population and 7.7deaths. The official rates will be slightlylower since the final figures will include1950 occurrences received through March1951. Approximately two per cent of ourcertificates are received too late to beincluded in the ofiBcial figures.Since 1925, diseases of the heart havebeen the leading cause of death in thisstate and each year a greater proportionof all deaths are claimed by this cause.In 1925, the heart disease death rate was123.5 per 100,000 population; in 1950,the provisional rate was 239.1. Statedanother way, 11 per cent of all deathsin 1925 were due to diseases of the heart,whereas 31 per cent were due to thiscause in 1950.Certain other leading causes of death,with provisional rates were 100,000 population,are as follows: JCause Number RateVascular lesions 3,855 95.4Cancer 3,115 77.1Influenza and pneumonia__l,383 34.2Non-motor vehicleaccidents 1,251 31.0Motor vehicle accidents 1,089 27.QImmaturity (unqualified) __ 880 21.8Due to the revised method of assigningcauses of death begun in 1949,nephritis dropped out of the seven leadingcauses of death.The program to improve registrationwas intensified in 1950. A full-time fieldrepresentative continued to visit personsresponsible for filing certificates and toinvestigate cases of unusual delay in registration.Teaching periods were continuedfor midwives to improve theirknowledge of correct birth registration.The outbreak in Korea resulted in anincreased demand for certificates neededfor wartime reasons. More certifiedcopies of births and deaths and verificationswere issued in 1950 than in anyyear since World War II.Two more county health departmentsassumed the responsibility of registeringall certificates in 1950. Local city andtownship registrars still serve in 59counties. There are approximately 600such registrars at present. At one timethere were 1,500 local' registrars. Thenumber of local registrars is decreasedevery time a local health officer is appointedlocal registrar for an entirecounty. This simplifies the whole registrationprocess, and is being insti-