Mortality

MORTALITY. The basic law of population under capitalism is the law of relative overpopulation; the movement of M. (as well as birth rates) is a process of secondary order, subordinate to this basic law and the population structure conditioned by it. Only by studying the development of capitalism can one understand the dynamics of natural population movement and, in particular, M. in capitalist countries. The history of natural population movement, in particular M., is the history of the relentless growth of exploitation, the impoverishment of the proletariat, and the pauperization of other groups of the working population. This basic position remains true despite the fact that the dynamics of the general M. coefficient over a long period of time shows a significant decrease. Bourgeois demography widely publicizes the general M. coefficient and its dynamics, attempting to use the latter as proof of the "reign of well-being" in capitalist countries. For this purpose, bourgeois science uses a rather complex assortment of methods. The most common method for masking the actual state of affairs is the use of "average" M. coefficients for all population layers, without differentiation by social-class groups. Diligently producing all sorts of groupings by sex, age, etc. (which of course is also of great interest), bourgeois scientists as a rule "forget" about the need for social-class study of M. Even those of them who try to address this issue present it as some additional, secondary detail not without interest. Bourgeois demography has not risen (and cannot rise) to an understanding of the leading role of the social factor in the problem of birth rates and M. Meanwhile, Marx wrote as early as: "Indeed, not only the number of births and deaths, but also the absolute size of families is inversely proportional to the level of wages, i.e., to such a mass of means of subsistence as the various categories of workers dispose of. This law of capitalist society would sound like nonsense if applied to savages or even to civilized colonists. It reminds us of the mass reproduction of animal species, individually weak and subject to cruel persecution" (Marx, Capital, Vol. I, Ch. XXIII). Thus, according to Marx, the inverse proportionality of the level of M. depending on the mass of means of subsistence is a law of capitalist society, a law persistently "not noticed" by bourgeois demography. The fallacy of all M. indicators (general and age-specific, see below) also lies in the fact that they provide information only about one part of disease cases, namely those ending in death, and do not shed light at all on other disease cases ending not in death but in permanent or temporary disability. Thus, the M. indicator does not reflect the actual "shifts" in the health of the population. The M. coefficient is incorrectly used as a measure of the health of the population at least because diseases ending in loss of ability to work fall almost entirely on the working masses and do not affect bourgeois circles. Finally, it is incorrect to study mortality in isolation, without interaction with birth rates. This method of study bears the traces of apologetic attempts by bourgeois scientists. Correct analysis requires the study of population recoverability, research into whether individual classes of the population and the entire population reproduce themselves at a given stage of development of this or that socio-economic formation, and to what degree this reproduction occurs. Even the most primitive indicator of population recoverability, the so-called natural population growth coefficient (excess of births over deaths per 1,000 population), shows a continuously falling trend over a long period. However, for the capitalist world, the natural population growth coefficient actually somewhat masks the real processes and smooths over the sharpest aspects of the capitalist system. Special studies by American demographer A. Lotka showed that the positive balance (excess of births over M.), still existing for most capitalist countries (however, the balance is quantitatively negligible and constantly decreasing in dynamics), is explained by the favorable age structure of the population, which resulted from many years of historical layers. The difference in M. levels for individual age groups (see below) is the key to explaining this phenomenon. The predominance of groups with reduced M. against the usual ensures a positive natural population growth coefficient. Lotka's calculations, based on the age structure that would result from the long-term maintenance of modern birth and death rate indicators, showed that by 1926-27, the population of Germany, France, and England was not reproducing itself. The corresponding recoverability coefficients: -3.37, -2.60, -6.30. Lotka's calculations show that the capitalist world has actually already moved from natural increase to natural decrease. Widely using methods to mask actual facts, bourgeois science attempts to use the decreasing dynamics of the general M. coefficient as an indicator of the "progressive mission" of capitalism. In reality, this decrease is the result of a complex interweaving of opposite trends in the development of M. not only for different population groups, but also for each of them individually, first and foremost for the proletariat. On the one hand, these are trends of continuous increase in M. as a reflection of the ever-increasing exploitation of the broad working masses, and on the other hand, these are trends of decreasing M. insofar as the blood need of the bourgeoisie itself is concerned. The latter must primarily include the fight against epidemics. Engels wrote: "Modern natural science has shown that the so-called 'bad quarters', where workers are crammed, are foci of all those epidemics that visit our cities... The capitalist gentlemen cannot with impunity indulge in the pleasure of spreading epidemic diseases among the working class; the consequences fall on themselves, and death cuts down its victims among capitalists as ruthlessly as among workers" (Engels, The Housing Question). The need for the bourgeoisie to fight epidemics emerged already in the era of the development of commercial capitalism, in particular commercial shipping, which raised the question of the sap. sanitization of ports and points of export of goods. The development of sanitary-technical measures for the prevention and control of epidemics, caused by this circumstance, the proportion of which in the overall M. was significant, led to a significant decrease in the M. of the population, although of course far from uniform for its individual classes. The rapid concentration of population in cities, primarily the growth of large cities in the era of industrial capitalism, led to an increased danger of epidemic growth. The bourgeoisie was forced to expand the network of sanitary-technical measures. With the further growth of cities and the needs of the bourgeoisie itself, sanitary technique increasingly turned into an independent branch of industry, into a source of additional exploitation of the working masses. As a branch of industry, sanitary-technical affairs was subject to and developed according to all the laws of capitalist society, in particular it developed in the competitive struggle of individual capitalists with each other. Being at a certain stage of capitalism a stimulus for the development and expansion of production, capitalist competition contributed to the advancement of sanitary technique and the sanitary-cultural level of the population. Incidentally, one of the contradictions of the capitalist system breaks through here. By organizing sanitary affairs to save its own life and thereby strengthening itself in the struggle against the proletariat to create the possibility of intensifying exploitation, the bourgeoisie was forced to a certain extent to organize some sanitary minimum (albeit very insignificant) for workers as well. But this is not the result of the "good intentions" of the bourgeoisie, its "progressive mission" about which bourgeois scientists love to speak, but a consequence of the iron necessity of the development of capitalism. At the same time, it must be added that for a number of leading capitalist countries, the possibility of creating some sanitary minimum for their workers, mainly for the labor aristocracy, was obtained at the expense of the robbery of colonial and semi-colonial peoples and reducing their standard of living to terrifyingly low levels. The sharp decline in birth rates in capitalist countries, causing a parallel phenomenon of a decrease in the number of deaths in infancy, also played a significant role in the overall trend of decreasing M. These are the trends leading to a decrease in M. As for the trends of increasing M., they are at first glance less obvious. As stated above, modern M. coefficients by their very construction cannot reveal the actual state of health of the population and even less so in a class breakdown. The trends of deterioration in the health of the population are quite clear.

This includes: the increase in occupational diseases, the reduction in work capacity that does not directly lead to death, the growing role of household diseases—venereal diseases, tuberculosis, leading to degeneration but not directly affecting M., and others. Finally, all the increasingly frequent wars, characteristic of the capitalist era, play a huge role in directly increasing M. Bourgeois demography tends to interpret war as a phenomenon that goes beyond the gradual development of capitalism. For this reason, bourgeois demography seeks to single out the mortality of military years from the general dynamic curve of M. as 'abnormal', 'catastrophic' and to contrast it with the 'normal' M. of the population in 'peaceful' years. Indeed, the level of M. of the population during capitalist wars is extremely high, and not only due to the military population at the front, but to a large extent (if not more) due to the civilian population. Thus, the imperialist war of 1914-18 corresponded to a colossal increase in general mortality with a maximum of extraordinary height in 1918. The cause of this increase was the severe pandemic of 'Spanish flu' that struck the world's population, exhausted by the hardships of war, with great force (see G pun). Table 1. Mortality of the population in Western European states (rates per 1,000 population). Austria .... England and Wales Belgium .... Germany . . . Denmark..... Italy .... Spain .... Netherlands . . Norway . . . France . . . Switzerland . . Sweden .... Bulgaria . . . Hungary .... Ireland . . . Latvia .... Lithuania..... Poland .... Portugal . . Romania . . . Finland . . Czechoslovakia Scotland . . Estonia .... Years 1930 1931 1932 13.5 14.0 13.9 11.4 12.5 12.3 13.2 12.7 - 11.1 11.2 10.8 10.8 11.4 - 13.7 14.8 14.6 17.3 17.8 16.4 9.1 9.7 9.0 10.4 10.8 - 15.7 16.3 15.8 11.6 12.1 12.2 11.7 12.6 11.6 16.8 16.3 - 15.3 16.6 17.8 14.1 14.6 14.4 14.2 13.8 13.6 15.9 15.8 15.2 15.8 16.5 15.0 18.8 17.2 17.5 19.4 20.3 21.7 13.2 13.3 - 14.2 14.3 14.1 13.2 13.3 14.9 16.0 14.9 Bourgeois scientists do not understand the fact that wars are not extraordinary phenomena at the current stage of capitalist development, but, on the contrary, are internally inherent to it, inseparably connected with it, and are for it a perfectly 'normal' phenomenon. If, however, the so-called 'peaceful years' are combined with 'war years', then the analysis of mortality will show a somewhat different picture compared to that usually depicted by bourgeois scientists, and the halo of constantly decreasing mortality will significantly fade, even if this indicator is taken as a characteristic of the actual state of health of the population, which in itself is very conditional. Table 2. Mortality of the population in states of Asia, Africa, America and Australia (per 1,000 population). States 1928 1929 1930 1931 Asia Japan....... Ceylon ....... British India Philippines .... Africa Egypt........... South African Union America Costa Rica........ Salvador ......... Argentina......... Chile............ Uruguay........... Venezuela ......... Australia Australian union . New Zealand . . . 20.0 24.6 26.0 27.4 9.5 11.9 24.0 14.3 13.6 25.1 10.7 16.8 18.2 24.4 21.6 9.7 11.3 22.3 18.4 12.5 23.7 10.5 8.6 8.6 19.0 11.1 12.5 22.0 The peculiarities of capitalist development in individual countries, primarily the differences between metropolitan countries and colonies, are clearly reflected in the level and dynamics of M. A comparison of the data in Tables 1 and 2 shows us that for colonial countries, with the observed dynamics of M., this dynamics is slower and the level of M. in the colonies is more than 1¹)_st-2 times higher than the level of M. in the so-called advanced countries. Thus, for example, in Table 3, per 1,000 people, there are deaths: table 3. Country name Hong Coefficient ^d mortality 1932 1832 1928 1928 12.3 26.0 11.7 18.8 Such a gap in the levels of M. occurs even without adding the unaccounted number of deaths in colonial and semi-colonial countries, which is very significant. Marxist analysis requires the mandatory study of mortality in a socio-class aspect as the leading aspect of the matter. Above we cited Marx's position on the law of inverse dependence of M. on the mass of means of subsistence. In another place, Marx expresses the same idea in a slightly different form: 'Dr. Lee, sanitary doctor of the city of Manchester, established that in this city the average life expectancy for the wealthy class is 38 years, for the working class - only 17 years. In Liverpool it is 35 years for the first and 15 years for the second. From this it follows that the privileged class receives from life an allowance twice as large as that of their fellow citizens who are in less favorable conditions' (Capital, Vol. I, Ch. XXIII). A number of research works have confirmed the correctness of the positions put forward by Marx. The study of M. of the population by social groups was conducted in the last century in Denmark, in the city of Copenhagen (Sorensen). The first group consisted of workers and servants; the second - artisans, small traders; the third - merchants, higher officials. In all groups, the force of M. was determined by age classes, separately for men and women. It turned out that in all ages the general M. correctly follows a decreasing order when moving from the working group to the middle and from the middle to the higher. Completely analogous results were obtained in France when studying professional M. in 1907-08 (Huber) with the determination of age coefficients of M. for 3 social groups - owners, employees, and workers. The same was established in the Netherlands (professional M. 1908-11) by age M. in connection with social position, with the division of owners and workers in agriculture and industry. The study of professional M. of the population in England (1921-23) based on 5 social groups (higher classes, entrepreneurs, skilled workers, semi-skilled workers, unskilled workers) also established a gradual increase in M. when moving from higher to lower. In another series of studies, the significance of the economic factor in a narrower sense for life expectancy and the force of M. is traced. One of the first observations in this direction belongs to the famous French statistician Bertillon, who, based on materials from European capitals - Paris, Berlin, and Vienna (1901-^L05) - established that the M. of the child population from infectious diseases is distributed by districts of these cities in direct dependence on the material insecurity of the residents of these districts. In the city of London (1902), a comparative study of M. of the population was conducted in two districts - a rich and a poor one; it was found that in all ages of both sexes, the M. of the population in the poor district is much higher than in the rich district. For the city of Paris (1911-13), a comparison of the prosperity of the population with the force of its M. was made across all 19 city districts; a complete parallelism was established between the increase in M. and the growth of poverty among the residents (Hersch). A number of similar observations are also found in the literature of Germany (for the city of Bremen, for districts of the city of Hamburg, for districts of the city of Brunswick). Also instructive are the comparisons of population mortality with population density in housing, conducted in Hungary (Budapest), Austria (Vienna) and England (London). From Russian works, one can mention studies of M. of the population of St. Petersburg by districts of the city in connection with economic indicators of these districts. A parallelism was established between decreasing economic prosperity and increasing general, child, and tubercular M. in the districts of the city. Confirmation of the same regularity was also found in the data on the spread of the epidemic of typhus (1909-10, S. A. Novoselsky). A striking indicator of the dependence of the level of M. of individual population groups on their position on the social ladder can be the comparison of the M. coefficient of the white and black populations of the USA. The mortality coefficient of the US population in 1927 (per 1,000 population died): for the white population - 10.8, and in cities - 11.6, for the colored population - 17.5, and in cities - 22.2. Thus, the higher M. of the working and exploited masses is an irrefutable fact in capitalist society and is explained by the direct conditions of labor - the most severe exploitation, unemployment in all its forms, etc., an extremely low level of material well-being and difficult living conditions - overcrowding, unsanitary housing, etc. Within individual social groups, the M. of the population must be further studied differentially by sex and age of the population. Observations of differences in sex M. showed that M. of the male population is generally higher than that of the female. In most capitalist countries, this excess of male M. over female M. is 1-2%. The process of 'extinction' in the male half of the population occurs somewhat more rapidly than in the female half; the average life expectancy for men is shorter than for women. This phenomenon is explained by the different participation of men and women in productive labor. The increasing participation of women in the production process and social activity under capitalism acts to bring the indicators of general mortality of the male and female populations closer together.

The age composition of the deceased is determined as the percentage content of age groups in the total mass of deaths and reveals significant differences in different states and population groups, mainly due to the high child mortality and mortality of the population in old age. Age-specific mortality sharply fluctuates for different ages. The maximum mortality falls on the first period of human life (in the first hours, days, weeks and months of life; the higher the mortality, the closer to the moment of birth). Then mortality decreases and reaches a minimum for the age of 14-15 years, after which a continuous increase in the mortality rate begins, initially very slow, then increasingly rapid, reaching a second maximum in the oldest ages. The difference in the age-sex structure of the population for different classes and social groups, with sharp fluctuations in age-sex mortality coefficients, makes general mortality coefficients unsuitable and highlights the need for differentiated consideration of age-sex coefficients for different classes and social groups of the population. Such a study makes it possible to eliminate the age-sex characteristics of each social group and more deeply penetrate the social essence of the phenomenon of mortality. The peculiarities of the social and age-sex structure of the population of individual states, within them - of urban and rural populations, and finally of individual populated areas, reflecting their socio-economic characteristics against the background of the general stage of development of the capitalist system, are reflected in the differences in the levels and dynamics of mortality for the listed types of populated areas, individual states and cities (tables 1, 2, 4 and 5). Dynamics of mortality in Russia and the USSR. The mortality of the population in European Russia has been recorded with more accurate figures since the late 1860s of the last century. Throughout this period of observation, a clear parallelism between birth rates and mortality is observed at much higher levels compared to all other European states. In the dynamics of numbers, increases in mortality mark all decisive moments in the sanitary-epidemiological history of Russia: 1871-1872 - a severe cholera epidemic; 1878 - Russo-Turkish War; 1882 - crop failure and epidemics; 1892 - famine and cholera; 1905 - Russo-Japanese War; 1910 - cholera, crop failure. The movement of birth rates in Russia is much more uniform than mortality; however, even here, critical years with a sharp decline are noted (1877-78, 1892, 1901, 1905, 1912) (table 6). A clear expression is also given to the long-term decrease in both phenomena. At the beginning of observations, the mortality of the Russian population is at the level of 37-38‰ and on the eve of the world war at the level of 26-27‰; birth rates at the same time 49-51‰ and 43-44‰. With the beginning of the world war, the continuity of statistical observations of population movement is disrupted; they become more complete in the USSR from 1923-24. From this point, statistics already records the onset of a new era in the sanitary condition of the country, characterized by incomparably more favorable indicators. New trends in the development of mortality, associated with the peculiarities of the Soviet system, are most clearly demonstrated on the thoroughly studied materials of Moscow and Leningrad (table 7). The pre-war period (1910-14) corresponds to a uniformly high general mortality in both cities, slightly above 20‰; the transitional period - war, its liquidation, a severe epidemic of influenza and typhus, civil war - is marked by large fluctuations in mortality with an unprecedented increase in 1919, especially in Leningrad; in 1923 a new era of regular uniform decrease in mortality in the Soviet capitals opens, at a level almost twice as favorable as it was in the past. The movement of mortality in the USSR compared with European capitalist countries shows a much faster rate of its decrease in the USSR. Therefore, with a simultaneously more favorable movement of birth rates in the USSR, the natural increase in population in the USSR significantly exceeds the analogous indicator in Western Europe. The number of deaths in the USSR in 1930 compared to 1913 decreased by 23%, while in Europe only by 13.1%. As a result of this, as well as a more favorable movement of birth rates, the 160-million population of the USSR (in 1930) gives the same natural increase as the 360-million population of Europe outside the USSR. This is the best proof that only with the transition to the construction of socialism, and even more so to the direct construction of a classless society, does the real struggle against mortality of the broad working masses begin, and only then does the decrease in mortality become truly general. 'As a result of the implementation of Bolshevik rates of socialist construction and the elimination in principle of parasitic classes - already in the first five-year plan the main sources of the exploitation of man by man are eliminated, the national income grows at rates unattainable for capitalist countries, unemployment and poverty (pauperism) are eliminated, the 'price scissors' and the opposition between city and countryside are eliminated, the well-being and cultural level of workers and working peasants grow year by year, mortality falls and the population of the USSR rapidly increases' (from the resolution of the XVII Party Conference). The further development of the national economy of the USSR, the improvement of the material and cultural level of the broad masses of the working population of the USSR, the transformation of all collective farms into Bolshevik collective farms, and collective farmers into well-to-do ones, will undoubtedly ensure a further steady decrease in mortality. Statistics of causes of death. For a long time, there has been an effort to study mortality not only as a whole, but also in terms of diseases causing death, or, as is customary to say, by causes of death. However, the proper direction from the point of view of modern requirements for mortality statistics was taken by this study at the end of the last century, partly at the beginning of the present century, when through the efforts of international scientific thought, a number of methodological and organizational prerequisites for the correct organization of this branch of statistics were developed. By a special commission organized by the International Statistical Institute, a series of methodological principles for the classification of causes of death was developed, which formed the basis of the international classification of causes of death, adopted in Paris in 1900 and subsequently revised in 1929. The main task of mortality statistics by causes is to establish the direct cause of death, i.e., the disease or injury that directly caused death. In practice, this task encounters significant difficulties, since in many cases death is the result of a complex of diseases, and it is not always possible to determine which of them was the direct cause. In such cases, the practice is to record as the cause of death the disease that was the main reason for death, or the disease that was the immediate cause of death. In addition, in some cases, death is the result of external causes, such as accidents, suicides, homicides, etc. In such cases, the external cause is recorded as the cause of death. The classification of causes of death is based on the international classification, which includes a list of diseases and other causes of death, grouped into classes and sub-classes. The classification is periodically revised to take into account new medical knowledge and changes in the causes of death. The statistics of causes of death is an important tool for the study of mortality, as it allows to identify the main causes of death and to develop measures for their prevention. The statistics of causes of death is also used to evaluate the effectiveness of medical measures and to plan health care services. The statistics of causes of death is published in the form of tables, which show the number of deaths from each cause, as well as the mortality rate for each cause. The mortality rate is calculated as the number of deaths from a particular cause per 100,000 or 1,000,000 population. The statistics of causes of death is an important source of information for public health authorities and medical researchers. It is used to identify trends in mortality, to evaluate the effectiveness of health care measures, and to plan health care services. The statistics of causes of death is also used to study the social and economic factors that influence mortality. Table 4. General mortality of the population in Western European states 1928-1931 in major cities (per 1,000 population). Country Name of city Population 1928 1929 1930 1931 in thousands Spain Seville Granada Barcelona Madrid Portugal Lisbon Greece Athens Piraeus France Bordeaux Lille Marseille Paris Italy Naples Venice Milan Rome Great Britain Glasgow Manchester Liverpool London Poland Warsaw Lodz Vienna Prague Austria Hungary Germany Dresden Munich Berlin Hamburg Switzerland Geneva Zurich Bulgaria Sofia Czechoslovakia Amsterdam The Hague Brussels Denmark Stockholm Sweden Oslo Norway Oslo Table 5. General mortality of the population in major cities of Africa, North and South America, Asia and Australia. City Name Population (in thousands) I. Africa Egypt Upper prov. Cairo Egypt Lower prov. Alexandria Suez Tunis Algiers Johannesburg II. North America Mexico Cincinnati Baltimore Washington Philadelphia San Francisco Cleveland Chicago Los Angeles Detroit New York III. South America Santiago Salvador Rio de Janeiro Buenos Aires IV. Asia Calcutta Singapore Hong Kong Bombay Yokohama Osaka Kobe Tokyo V. Australia Sydney Melbourne

Adelaide....... 324 1 196 331 646 222 202 262 206 3 393 .1 2S3 1 586 7 218 2 167 1197 446 627 1 299 735 2 604 854 2 102 and o г-< ^{-гЧ w} 40,0 40,4 33,0 36,8 33,2 27,1 25,8 29,0 30,1 28,7 26,9 30,3 24,4 27,3 23,5 27,9 23,8 24,8 20,1 23,0 22,4 23,3 21,6 24,7 18,6 18,8 17,2 17,0 12,3 11,8 12,8 12,3 24,1 28,9 26,3 27,6 18,3 16,8 15,5 15,6 15,1 14,5 13,9 14,2 15,2 15,4 15,2 15,9 14,0 13,1 12,6 12,8 13,5 12,7 13,-0 13,1 11,7 12,3 11,0 11,0 12,1 11,2 10,4 10,4 10,2 11,4 11,1 10,8 11,6 11,6 19,3 8,1 11,6 11,3 10,8 10,9 17 6 21,2 25,1 27,7 £0,2 20,6 20,4 - 14,7 15,0 14,4 14,7 12,9 13,7 12,7 - 29,4 28,1 26,3 28,5 27,0 24,9 26,3 24,2 25,8 27,7 27,0 23,5 23,4 22,8 23,7 19,4 19,9 20,3 15,6 17,5 16,8 17,7 15,4 18,8 16,8 18,8 16,7 18,3 14,8 14,6 13,0 14,8 9,3 10,2 8,7 9,0 10,2 9,3 8,9 9,6 9,8 9,4 9,2 9,8 ин-том, была разработана международная номенклатура и классификация б-ней и причин смерти (см. Номенклатура болезней), к-рая в значительной мере содействовала сравнительному исследованию причин C. разных государств и крупных городских центров. B работах отдельных сессий названного института было уделено немало места и внимания обмену опытом по организации и методике постановки врачебной регистрации причин смерти, содействовавшему разъяснению и пропаганде правильных идей в этой области. Подобная же работа им была проделана и в области установления единства программы при разработке наблюдений o причинах смерти. Наконец за самое последнее время эта же организация проделала большую работу по публикации сравнительных данных o причинах смерти в городах и государствах Европы и Америки. Должно однако отметить, что. во всех этих несомненно очень крупных и важных работах Международный статистический ин-т оставался конечно верным заветам буржуазной науки, призванной на службу капитализма, и твердо охранял доверенный ему капитализмом научный участок (см. Номенклатура болезней). Кроме того следует отметить также, что те рекомендации в области статистики причин смерти, к-рые исходили из Международного ин-та, не всегда проводились в разных странах, входив- Табл. 6. Смертность и рождаемость населения в Европейской России за 1867- 1914 гг. (на 1 000 жит.). Годы Смерт- Рожда- Годы Смерт- Рожда- ность емость ность емость 36,8 51,2 ' 33,3 50,4 39,7 48,8 31,4 50,0 38,3 49,7 33,2 48,6 35,0 49,2 31,2 49,3 37,9 61,0 31,1 49,3 41,2 50,0 32,1 47,9 36,5 52,3 31,3 49,1 35,2 51,4 30,0 48,1 34,6 51,5 29,9 48,6 34,9 50,6 31,7 45,0 34,4 49,6 39,9 47,1 38,2 47,3 23,4 47,5 34,8 50,2 28,3 44,8 36,1 49,7 29,5 44,7 34,1 49,1 31,5 45,1 40,4 51,6 27,4 45,0 37,5 50,6 26,5 48,7 44,4 51,5 27,4 43,1 35,8 50,0 26,7 43,7 33,2 49,5 1870-1874 37,4 50,8 33,8 49,9 1875-1879 35,4 49,8 33,4 51,6 1880-1884 36,5 50,5 35,5 50,3 1885-1889 34,5 50,3 36,7 49,6 1890-1894 36,4 48,9 35,8 50,6 1895-1899 33,0 49,5 41,0 46,0 1900-1904 30,9 48,6 34,4 48,8 1905-1909 29,4 45,8 34,3 49,2 1910-1914 27,9 44,1 35,5 50,1 ших в его состав. Сплошь и рядом при своем осуществлении они получали такое содержание, которое отвечало интересам данной страны. При очередном пересмотре номенклатуры и классификации причин смерти на Международной конференции в Париже в 1929 г. советская делегация внесла свой проект изучения смертности как одного из показателей в комплексной характеристике сдвигов в здоровьи населения и отвечающий такому пониманию проект построения номенклатуры и классификации причин смерти. B ряде выступлений на конференции отмечалась научная обоснованность проекта и его прогрессивность, однако он явно не отвечал классовым позициям буржуазной статистики причин смерти. Поэтому советский проект по формальным причинам не был даже поставлен на обсуждение. Утвержденная Эконом.-стат. сектором Госплана CCCP (c 1932 г. ЦУНХУ) в 1930 г. номенклатура и классификация причин смерти, обязательная для всех работ, проводимых в CCCP, построена в соответствии c советским проектом, представленным на Международную конференцию. Однако в него внесен ряд изменений (в основном не принципиального характера), необходимых для сопоставимости данных по причинам смерти в CCCP и в капиталистических странах. Статистика причин смерти в большинстве стран строится на основании наблюдений врачей, пользовавших умерших перед смертью, или на основании врачебных осмотров трупов, производимых соответствующими лицами. B Англии, Шотландии, Голландии, Швейцарии и Италии больше чем на 90% статистика причин смерти построена на основании наблюдений врачей, лечивших умерших. B отношении городского населения Франции она строится так- же на врачебных наблюдениях; для внегородского населения-только частично, т. к. предъявление врачебного удостоверения для регистрации смерти там обязательно только в случае, если б-ной пользовался перед смертью врачебной помощью. B отдельных округах Баварии и Саксонии источником статистики причин смерти служили результаты записей «осмотрщиков трупов» не-врачей. Содержание врачебных записей o причинах смерти весьма различно. B нек-рых странах они заключают в себе только причину смерти, фамилию, адрес и возраст умершего (Англия, Голландия, города Бельгии); в других-кроме того ряд статистических признаков (Франция, Германия и др.). B б. Россия статистика причин смерти развивалась только в городах. B 1913 г. она существовала в 120 городах c 9 млн. жителей. У нас в CCCP статистика причин смерти ведется органами ЦУ НХУ в отношении всего городского населения. Статистические данные o смертности от отдельных б-ней и их групп-см. соответствующие слова. Способы измерения. Наиболее простым и в то же время общепринятым показателем C. отдельных государств, областей и т. п. административно-территориальных объединений и коллективов является т.н. общий показатель (или коеф.) C. Он представляет собой число умерших, приходящихся в среднем на каждую тысячу населения в год. Математически он выражается в форме отношения общего числа умерших (D) в течение года к среднему числу жителей (P), в среде которых наблюдались случаи смерти, приведенному к тысяче (-^=----). Подобно всем общим показателям, коеф. C. является средней величиной, нивелирующей все' особенности, которые могут быть присущи отдельным группам населения и проистекают от характера его социального и воз-растно-полового состава и т. п. Ho несмотря на эту слабую его сторону как аналитического измерителя им все-таки широко пользовались до сих пор, т. к. сопоставление его c другим аналогичным по содержанию показателем (рождаемости) позволяет в простейшей и достаточно выразительной форме определять основные черты процесса воспроизводства населения. Его недочеты, используемые статистикой капиталистических стран, отмечены выше. B последнее время даже буржуазная статистика начинает признавать недостаточность общего коеф. C. ввиду возникших после мировой войны и особенно в годы экономического кризиса крупных изменений и сдвигов в составе населения разных государств. B целях уяснения особенностей, присущих C, производится построение «специальных» показателей C. по полу, отдельным возрастным группам, коллективам разного соц.-классового положения и т.д. Bce специальные показатели представляют собой также отношения между числами случаев смерти, объединенных по данному признаку, и средними числами населения данной группы, приведенные в каждом случае к 1 000 (или 10 тыс., 100 тыс. и т. д.). Наличие специальных показателей C. позволяет не только ориентироваться в особенностях и частностях C, но и представить общие ee показатели в сравнительной форме, освобождая их от влияния возрастных и иных различий. Последнеедостигает-ся путем перестройки общих показателей в индексы или стандартизованные показатели. Для детального исследования особенностей, наблюдаемых в повозрастной смертности, и изменений в населении, связанных c ней, пользуются особым методом измерения C. в виде так наз. таблиц смертности (или доживаемости). Таблица C. представляет в численном выражении порядок вымирания определенной группы родившихся (или сверстников), в к-ром эта группа c каждым годом возраста постепенно уменьшается в своем численном составе под влиянием вымирания. B обычном своем строении таблица заключает в себе следующие элементы: a) числа лиц, доживающих до каждого последующего года возраста, начиная от 0 до 100 лет; б) числа умирающих при переходе от одного возраста к следующему (однолетние возрастные промежутки); в) вероятности умереть в течение следующего года жизни; г) вероятности остаться в живых в течение года; д) средней продолжительности предстоящей жизни для каждого года жизни и e) вероятной продолжительности предстоящей жизни. Заметим здесь, что средняя продолжительность жизни представляет число лет, к-poe в среднем предстоит прожить одному лицу исследуемой совокупности по достижении им того или иного года жизни. B зависимости от возраста и условий C. величина эта различна для разных возрастов. Вероятная продолжительность жизни показывает число лет, по истечении к-рых остается в живых половина лиц, достигших взятого возраста.

The first official table of M. for the population of the USSR was constructed for the period 1926-27. Practical importance belongs to the accounting of the survival of the population to military conscription age (20-21 years), which determines what percentage of born boys reaches the age of conscription. This indicator was used by sanitary statistics among the signs for evaluating the sanitary condition of individual localities (in parallel with indicators of child mortality)