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JAMA 100 Years Ago
May 14, 2008


Author Affiliations

JAMA 100 Years Ago Section Editor: Jennifer Reiling, Assistant Editor.

JAMA. 2008;299(18):2220. doi:10.1001/jama.299.18.2220

Of all the advances made in medicine during recent decades, no step has been more fraught with benefit to the common weal than the birth of a science of public health. The first step in this direction, and one that was absolutely essential to its development, was the institution of what is known as vital statistics, i. e., an efficient official registration of births and deaths, with the causes of the latter, and of infectious diseases. The science of epidemiology, also, itself a subordinate part of the science of public health, took its rise with that of vital statistics. In this country, until recently, very little effort was made, save in large cities, to establish an official statistical record. By the growth since 1895 of what is known as the registration area of the United States, the vital statistics now cover a total of 48.7 per cent. of the entire population, so far as mortality returns are concerned. But in the “Report of Mortality Statistics,” for 1906, of the Departments of Commerce and Labor, Bureau of the Census, there is to be noted an inquiry as to why there is no registration area for births. The bureau, with a view to answering this question, sent out an inquiry to all states and to all cities of 50,000 population or over in 1900, concerning the status of the registration of births therein. After eliminating replies which for one reason or another were inadequate, the reasons for the inadequacy of birth returns assigned by registration officials in 64 state or city areas show, on analysis, that in no less than 41 the inadequacy is attributed to the “negligence,” “unwillingness,” “failure,” “indifference,” etc., of physicians. In one case this attitude of the physicians is emphasized by the statement, “no difficulty from midwives, but considerable from physicians.” Occasionally a reason is given for the laxity of the physicians, such as an objection to do clerical work for nothing, or the fact that the physician witholds the report in order to obtain the name, and ultimately forgets it altogether.