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To the Editor:
—I wish to comment on how false may be the impression of betterment of any one city's record comparable to neighboring cities as shown in the recent fifth annual report on typhoid fever. Each year the footnote reads that a false exaggeration is possible because nonresident deaths are recorded as well as resident deaths. For the cities in Connecticut there was reported to the state board of health for 1916, as total typhoid deaths, Bridgeport, 11; Hartford, 20, and New Haven, 12. This would give a rate per hundred thousand population of 9, 18.1 and 8, respectively. As printed in The Journal, the rates read 9, 6.3 and 8, respectively. The difference I find is that Hartford alone of the three cities returned resident deaths alone, seven in number. Instead of leading, Hartford either has a record no different from the previous year, or else if nonresident
Lewis DM. TYPHOID IN AMERICAN CITIES. JAMA. 1917;LXVIII(19):1428. doi:10.1001/jama.1917.04270050130022