demographic yearbook annuaire demographique 1951

ates of less than 1 per 1,000 in 14 of the 17 countries. Areas
ofless favorable mortality record rates as high as 8 per 1,000.
Between the ages of 15 and 45 years death rates in the
same group of 17 countries showed decreases of one-third to
one-half, a few decreasing by more than two-thirds. The
percentage of decrease tends to diminish with the advance
of age, reductions in the age group 20-24 being generally
higher than reductions in the age group 40-44. The level
of mortality at these ages is low, the maximum rate at age
40-44 being 5.6, the minimum 2.4, for the terminal years
of the series.
The relative decrease in the age groups between 45 and
65 during the period under consideration was generally less
than one-third, and in a significant number of cases less
than one-tenth. Absolute decreases, however, were larger
than at the younger ages. In a few isolated instances there
were very small percentage increases in the male rates at
ages above 50 but such changes are probably without significance
and no doubt indicate either that the current rate is
about the same as at the beginning of the period, or that
the basic statistics are not fully comparable. Even at these
ages the level of the death rates remains quite low, ranging
from about 4 per 1,000 to less than 8 per 1,000 in the age
group 45-49 and continuing well below 20 per 1,000 until
age 60. In six of the seventeen countries the terminal rate
was still below 20 per 1,000 in the age group 60-64. This
contrasts with rates close to 50 per 1,000 in countries of less
favorable mortality.
Above age 65 relative decreases are much less striking
but in several countries (e.g. Denmark, France, Northern
Ireland) a decrease of approximately one-fifth occurred in
the age group 65-69.
Some of the countries showed increases in death rates at
ages above 75. With the sharp reductions in mortality at the
young and intermediate ages, it is not to be expected that
the mortality rates among the aged population can show
much decline. As increasing proportions of the population
survive to older ages the rates in the terminal age groups are
bound to rise eventually. Death rates rise very rapidly from
about age 65, increasing from a level of approximately 30
to 40 per 1,000 to a level of about 200 per 1,000 at age 85
and over. The age composition of the population within
these age groups, in combination with the sharp rise in
mortality, has an important effect on the rates. The distribution
by single years of age (approximating a rectangular
shape in these low mortality countries) means that the
higher death rate of the older persons within the age group
has a strong effect on the rate for the age group as a whole.
This is the same phenomenon, though on a smaller scale,
that was discussed in connection with the crude death rate.
The reliability of statistics at the advanced ages is open
to some question. Even in countries with generally accurate
data, numbers are smaller at these ages and the accuracy
of age-reporting is probably subject to considerable error.
Differences between the low mortality countries and the
high mortality countries are less marked at the advanced
ages than at the younger ages. Because of the dubious quality
of the data, quantitative comparisons are not attempted.
Some attention should be given to changes in mortality
during the years of the recent war. The countries for which
annual data are available are again those with generally
low death rates. The European countries most directly
affected by the war (e.g. England and Wales, Netherlands,
France) experienced increases during that period at most
ages. These increases occurred among infants, young children
and women as well as among males in the military
ages. Even Sweden, a non-combatant country, showed mild
increases at some ages. These temporary rises were followed
by a quick postwar decline which appears to have brought
the rates back into line with prewar trends.
In combatant countries farther removed from the scene
of military operations (e.g. Australia, the United States)
death rates other than those of males in the military ages
followed a comparatively smooth downward trend.
Sex differences. It is a recurrent phenomenon in the mortality
patterns of most countries which have generally adequate
statistics that male death rates are higher than female
rates. The basic causation of this differential is not clear,
but it seems likely that the disparity cannot be explained
entirely by environmental factors, since it appears at the
very earliest ages and persists to the oldest ages. Even prenatal
deaths are predominantly male, if reliance can be
placed on the statistics of stillbirths.
Among the countries for which data on infant mortality
are shown in table 21, male rates are higher than female
rates almost without exception. The few exceptions that do
occur appear to be attributable to the chance fluctuations
of small numbers or to a temporary loss of efficiency in the
registration system during World War II.
Some of the countries for which age-specific death rates
by sex are presented in table 17 show rates that are higher
for females than for males in the ages past infancy. These
areas are among those which have higher general mortality.
The appearance of the excess in the female rate usually
occurs in the age group 15-19 and continues to age 40 or
45, no doubt reflecting the inroads of maternal mortality.
This reversal of the differential that is currently observed in
countries of low general mortality agrees with similar reversals
in the earlier statistics of these same countries.
Apparently the conquest of maternal mortality has so reduced
female death rates in the child-bearing ages that a
former excess in the female rates has beel1 superseded by an
excess in the male rates.
According to the statistics of many countries, the gap
between male and female rates has tended to increase in
recent times. This is clearly true with respect to the 17
countries for which statistics are shown in table G. Percentage
decreases in female age-specific rates are consistently
larger than those for males. No doubt environmental factors
in an industrial society make some contribution to this
increasing differential. Male death rates from such causes
as accident and suicide, and from conditions that are evidently
associated with occupational hazards, are significantly
higher than female rates from such causes.
Death rates of women in the oldest age groups are frequently
higher than those for men, but this is explainable
in terms of the distribution of the population among the
grouped ages. In the age group 85 and over, for example,
the women have a higher average age than the men. Consequently,
the rate for the age group as a whole is higher
for women.
CAUSES OF DEATH
Statistics on causes of death are exposed to still more
imperfections than are vital statistics in general. The particular
problems of accuracy and comparability that apply
to these data are discussed in some detail in Chapter II.
Faulty as may be the statistics on causes of death, they
nevertheless suffice to demonstrate the different patterns of
"how people die" in areas having high mortality as com-
15