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October 28, 1933

Cancer and Other Chronic Diseases in Massachusetts.

JAMA. 1933;101(18):1418. doi:10.1001/jama.1933.02740430064038

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In this comprehensive volume the authors discuss the broad problem of chronic disease and point out that the aim of any serious social problem is a conscious and rational control of sickness and death. In fifty years the death rate in Massachusetts has dropped 25 per cent, while the birth rate has correspondingly fallen 30 per cent, indicating an aging of the population. The increase in cancer is not apparent but real. Fifty years ago chronic diseases made up one third of the deaths in Massachusetts, whereas today they constitute two thirds of the deaths. According to the authors, the medical approach to chronic disease has five aspects: (1) prevention, (2) early diagnosis, (3) cure, (4) alleviation and (5) terminal care. Concerning terminal care, the authors advise against segregation of the dying and point out that few institutions can keep their good names with a death rate over 30 per

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