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The significance of the declining birth-rate
340
PUBLIC HEALTH.
THE SIGNIFICANCE OF THE DECLINING BIRTH-RATE.* By A. CAMPBELL MUNRO, M.B., B.Sc., County Medical Officer of Health, Renfrew. H E declining birth-rate of the country is, to my mind, a sure sign o f decadence. If the decline persists it will undoubtedly lead to national decay. For it is to be observed that the decline is unequal, that it is great among the more capable classes of the population, while there is but little decline amongst the least capable. If this tendency persists the result is inevitable. In a few generations the least capable will have swamped the more capable elements o f the population, and Britain's predominance amongst the nations will have passed away. The principal influence at work in the reduction of the birth-rate amongst the more provident and capable classes o f the community is the retardation of the age at marriage. Taking this " a g e at marriage" factor alone, the result can be wrought out arithmetically. An average early age at marriage acts in a threefold way. First, it results in larger families ; second, it produces more generations in a given time; third, there are more generations alive at the same time. Take as an illustration two men, M. and N., both aged twentytwo, and each with an expectation of life of thirtythree years. M., the casual labourer, marries at once ; his descendants will marry at the same age. N. delays marriage in order to make some provision for the future. H e does not marry until he is thirty-three, and his descendants marry at the same age. Race M. will probably produce an increase of I½ in the next generation, and 3½ generations in a century, while N. produces an increase of only ~ in a generation, and only 2½ generations in a century. It follows that the increase in race M. at the end of a century will be greater than that of race N. in the proportion of I8 to 7. In two centuries the product of race M. will be more than six times that of race N. BUt the proportion of race M. in the total population will be greater than that of race N., owing to the greater number of generations of race M. alive at the same time. The ratio of race M. at the end of a century wilt therefore really be as 4 ° to 27, and at the end of the second century race M. will number ten times race N. In other words, the race inferior in character--which term includes ability, energy, health, manliness and courtesy~will be ten times as numerous as that which is higher in character. And this calculation leaves out of account the relative fertility of the two races, which, if taken into account, would very greatly increase the disparity in numbers between the two races. This question of race suicide is a very grave one, much more serious than questions of politics
T
Annual Report, i9o 9.
JONE,
and armaments which absorb the interest of the people, and it is a matter which health officers ought to press upon the attention of their consti'tuents. Legislation could effect a good deal in the matter. If, for instance, it were determined that every man who passes the age of twenty-five unmarried, and who pays income-tax, should lose his vote and pay a doubled income-tax, there would be a considerable stimulus to earlier marriages, and a wholesome public opinion on the subject would be created. There are other directions in which race suicide proceeds. Parenthood ought to be made impossible to the chronic inebriate or dipsomaniac, to the irreclaimable criminal, to the irreclaimable tramp and loafer, to the feeble-minded. "Inebriate reformatories " have been established--and given up because of their comparative failure to reform. But Dr. Branthwaite, the inspector of such reformatories, found that out of 2,227 cases of inebriates 62"6 were mentally defective. Of these Dr. Branthwaite says : " They are not in the least affected by orthodox temperance efforts ; they continue to propagate drunkenness. Their children, born of defective parents, educated by their surroundings, grow up without a chance of decent life, and constitute the reserve from which our present army of habituals is maintained." W h a t we require are inebriate colonies, not " reformatories," in which, while every effort is made to reform the reformable, the main object will be to segregate the irreformable and prevent him or her from reproducing their kind, to the detriment of the race. THE
DUNDEE MUNICIPAL DISPENSARY FOR CONSUMPTION AND DISEASES OF THE CHEST.
following account of the Dundee Municipal T H EConsumption Dispensary appears in the Annual Report for t9o 9 of Dr. C. Templeman, medical officer of health for Dundee : The Municipal Dispensary for Consumption and Diseases of the Chest has been carried on during the third year on much the same lines as formerly, with only such modifications as experience in its working has suggested. W e are indebted to the directors of the Royal Infirmary for the use of the out-patient department of that institution, and for the supply of medicines to the patients. The number of new patients was 26o--a slight increase on that of last year. Of these, 7o were due to other diseases, which at their onset gave rise to a suspicion of commencir~g consumption. Patients with consumption presented themselves at all stages of the disease; Io 5 were actively infectious, while a large number were either slight cases or showed very indefinite symptoms. This
PUBLIC HEALTH.
THE SIGNIFICANCE OF THE DECLINING BIRTH-RATE.* By A. CAMPBELL MUNRO, M.B., B.Sc., County Medical Officer of Health, Renfrew. H E declining birth-rate of the country is, to my mind, a sure sign o f decadence. If the decline persists it will undoubtedly lead to national decay. For it is to be observed that the decline is unequal, that it is great among the more capable classes of the population, while there is but little decline amongst the least capable. If this tendency persists the result is inevitable. In a few generations the least capable will have swamped the more capable elements o f the population, and Britain's predominance amongst the nations will have passed away. The principal influence at work in the reduction of the birth-rate amongst the more provident and capable classes o f the community is the retardation of the age at marriage. Taking this " a g e at marriage" factor alone, the result can be wrought out arithmetically. An average early age at marriage acts in a threefold way. First, it results in larger families ; second, it produces more generations in a given time; third, there are more generations alive at the same time. Take as an illustration two men, M. and N., both aged twentytwo, and each with an expectation of life of thirtythree years. M., the casual labourer, marries at once ; his descendants will marry at the same age. N. delays marriage in order to make some provision for the future. H e does not marry until he is thirty-three, and his descendants marry at the same age. Race M. will probably produce an increase of I½ in the next generation, and 3½ generations in a century, while N. produces an increase of only ~ in a generation, and only 2½ generations in a century. It follows that the increase in race M. at the end of a century will be greater than that of race N. in the proportion of I8 to 7. In two centuries the product of race M. will be more than six times that of race N. BUt the proportion of race M. in the total population will be greater than that of race N., owing to the greater number of generations of race M. alive at the same time. The ratio of race M. at the end of a century wilt therefore really be as 4 ° to 27, and at the end of the second century race M. will number ten times race N. In other words, the race inferior in character--which term includes ability, energy, health, manliness and courtesy~will be ten times as numerous as that which is higher in character. And this calculation leaves out of account the relative fertility of the two races, which, if taken into account, would very greatly increase the disparity in numbers between the two races. This question of race suicide is a very grave one, much more serious than questions of politics
T
Annual Report, i9o 9.
JONE,
and armaments which absorb the interest of the people, and it is a matter which health officers ought to press upon the attention of their consti'tuents. Legislation could effect a good deal in the matter. If, for instance, it were determined that every man who passes the age of twenty-five unmarried, and who pays income-tax, should lose his vote and pay a doubled income-tax, there would be a considerable stimulus to earlier marriages, and a wholesome public opinion on the subject would be created. There are other directions in which race suicide proceeds. Parenthood ought to be made impossible to the chronic inebriate or dipsomaniac, to the irreclaimable criminal, to the irreclaimable tramp and loafer, to the feeble-minded. "Inebriate reformatories " have been established--and given up because of their comparative failure to reform. But Dr. Branthwaite, the inspector of such reformatories, found that out of 2,227 cases of inebriates 62"6 were mentally defective. Of these Dr. Branthwaite says : " They are not in the least affected by orthodox temperance efforts ; they continue to propagate drunkenness. Their children, born of defective parents, educated by their surroundings, grow up without a chance of decent life, and constitute the reserve from which our present army of habituals is maintained." W h a t we require are inebriate colonies, not " reformatories," in which, while every effort is made to reform the reformable, the main object will be to segregate the irreformable and prevent him or her from reproducing their kind, to the detriment of the race. THE
DUNDEE MUNICIPAL DISPENSARY FOR CONSUMPTION AND DISEASES OF THE CHEST.
following account of the Dundee Municipal T H EConsumption Dispensary appears in the Annual Report for t9o 9 of Dr. C. Templeman, medical officer of health for Dundee : The Municipal Dispensary for Consumption and Diseases of the Chest has been carried on during the third year on much the same lines as formerly, with only such modifications as experience in its working has suggested. W e are indebted to the directors of the Royal Infirmary for the use of the out-patient department of that institution, and for the supply of medicines to the patients. The number of new patients was 26o--a slight increase on that of last year. Of these, 7o were due to other diseases, which at their onset gave rise to a suspicion of commencir~g consumption. Patients with consumption presented themselves at all stages of the disease; Io 5 were actively infectious, while a large number were either slight cases or showed very indefinite symptoms. This