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July 29, 1916


JAMA. 1916;LXVII(5):362. doi:10.1001/jama.1916.02590050040017

The comparison of the crude death rates of cities for the purpose of determining relative "healthfulness" has long been a favorite pastime for some newspaper writers, and even, it must be said, in some municipal health departments. The complexity of the problem and the multiplicity of the factors involved, however, have deterred professional statisticians from attaching much importance to such comparisons. The principal objection to the use of crude death rates-the annual number of deaths per thousand population —as a measure of healthfulness is that it takes no account of the age and sex distribution of the population. Since the proportion of the sexes and of the population of each age group varies considerably in different places, and since the death rate in each group is different, it is plain that crude death rates may give quite misleading information as to actual conditions. Two communities having identical death rates in

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