Annual report of the Bureau of Vital Statistics of the North Carolina State Board of Health |
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of tI?P Ittttr^rfittg of Nortlj CUarolina (HaiUttian of Nortli Olarnltnmna >187r B38 UNIVERSITY OF N.C. AT CHAPEL HILL 00032761903 FOR USE ONLY IN THE NORTH CAROLINA COLLECTION ANNUAL REPORT OF THE BUREAU OF VITAL STATISTICS OF THE NORTH CAROLINA STATE BOARD OF HEALTH 1938 Lil; N. C. St^ ANNUAL REPORT OF THE BUREAU OF VITAL STATISTICS OF THE NORTH CAROLINA STATE BOARD OF HEALTH 1938 CARL V. REYNOLDS, M. D. SECRETARY AND STATE HEALTH OFFICER CONTENTS Page Introduction - — - -- 7 GENERAL TABLES Table I.—Total births and deaths (exclusive of stillbirths) with rate per 1,000 population for the years 1914-1938, inclusive 14 Table II.—Births (exclusiA'e of stillbirths) in each county, by color, with rate per 1,000 population, per cent attended by physicians and number illegitimate, 1938 15 Table II-A.—Births (exclusive of stillbirths) in each city of 10,000 population or over in 1930, by color, with rate per 1,000 popula-tion; per cent attended by physicians and number illegitimate, 1938 19 Table III.—Deaths (exclusive of stillbirths) for the State as a whole from each cause, by sex, color and age 1938 (includes all deaths occurring in North Carolina) 20 Table IV.—Deaths (exclusive of stillbirths) in each county, by color, with rate per 1,000 population, 1938.._ 62 Table V.—Deaths (exclusive of stillbirths) in each county, by cause of death (abridged international list) and by color of decedent, 1938 -.- 66 Table VI.—Deaths (exclusive of stillbirths) in cities or towns, by cause of death (abridged international list) and by color of decedent, 1938 —-- 116 Table VII.—Death rates per 100,000 population (by place of death, also by place of usual residence) in each county, from nine im-portant causes, with estimated population, 1938 126 Table VIII.—Deaths (exclusive of stillbirths) by cause by certain sub-divisions of the first year of life, 1938 130 Table IX.—Deaths under 1 year of age (exclusive of stillbirths), and maternal deaths in each county with rates per 1,000 live births, 1938 - 132 Table X.—Cases and deaths from special diseases by month of occur-rence, 1938 134 Table XI.—Cases from 30 of the reportable diseases by counties, 1938 138 Table XII.—Death rates per 100,000 population from ten important causes, for the State as a whole, with estimated population for each year, 1914-1938 142 LETTER OF TRANSMITTAL To His Excellency, Clyde R. Hoey, Governor of North Carolina, Raleigh. My dear Governor Hoey I have the honor of transmitting the report for the Bureau of Vital Statistics covering the calendar year 1938. With assurance of my very best respect, I am Sincerely, CARL V. REYNOLDS, M. D., Secretary and State Health Officer. ANNUAL REPORT OF THE BUREAU OF VITAL STATISTICS This annual report of the Bureau of Vital Statistics presents tabulations of births and deaths for the calendar year 1938. The Bureau of Vital Statistics was established July 1, 1913 by legis-lative enactment and began the registration of births and deaths in October of the same year, but it was not until 1916 for deaths and 1917 for births that registration was complete enough for admission to the United States Registration Area. The first annual report contained tabulations for 1914, and a report has been published annually ever since with the exception of 1918 and 1919. Beginning with the 1931 report county and city tabulations have been made according to the abridged Inter-national List of Causes of Death. State tabulations have con-tinued to be made according to the detailed International List. The present report follows the plan begun in 1932 of tabulating births and deaths both by place of occurrence and by place of residence. Births have been allocated to the legal residence of the mother and deaths to the place of legal residence before death of the deceased. In order to permit comparison with years before tabulations by place of residence were begun, deaths and births have been recorded by place of occurrence and by place of resi-dence. Although tabulation by residence corrects one, probably the greatest, source of error in comparing the rates of different localities there are other factors that must be taken into con-sideration. For example, the rates given in this report are crude rates in the calculation of which no allowance is made for the differences in sex, age and color distribution of the population. Furthermore, the degree of completeness of reporting may vary in different localities and this should be taken into consideration when comparing the rates of two areas. Population Population estimates for the State, and more especially for its political sub-divisions, may vary widely from the true population when made this far removed from the 1930 census enumeration. State rates are based on an estimated population of 3,527,000. To arrive at an estimated population for each county the increase computed for the State as a whole was distributed among the counties in proportion to the share which each county had in the increase between 1920 and 1930. No estimate was made for 8 Annual Report Nineteen Thirty-Eight areas where the population decreased between 1920 and 1930, the figures shown being those of the 1930 Federal Census. Natality Live Births: The birth rate of 22.7 per 1,000 population was the same as that for 1937. In actual numbers there were 79,903 births compared to 79,244 in 1937. Of the 79,903 live births, 54,469 were white; 24,647 negro; and 787 Indian, representing rates of 21.9 per 1,000 population for white and 24.0 for negro. The birth rate ranged between 30 and 35 per 1,000 population from 1914 to 1924. From the latter date the rate dropped rapidly to 24.7 in 1929 and since that time there has been only a slight downward tendency. Stillbirths: In conformity with statistical practice, the still-births were not included in the totals of either births or deaths, but tabulated separately. There were 3,086 stillbirths, or 74 fewer in 659 more births than in 1937. This represents a decline in the stillbirth rate from 39.9 to 38.6 per 1,000 live births. Mortality In the compilation of mortality statistics the cause of death as stated by the physician is used as the basis of classification by causes. Since the accuracy of statistics can be no greater than that of the material upon which they are based, it is desirable that physicians give as accurate and complete a diagnosis of the cause of death as possible. A specific cause, rather than a general condition or symptom, is essential if the greatest accuracy is to be expected. Failure to conform with this rule necessitates that hundreds of certificates be queried yearly as to cause of death in order to classify them correctly. The health conditions in North Carolina for 1938 as indicated by the death rate were, in general, more favorable than for the preceding year. There were fewer deaths recorded from all causes combined and consequently a lower death rate than for 1937. The 33,564 deaths, exclusive of stillbirths, represent an annual death rate of 9.5 per 1,000 population. The mortality rate for 1937 was 9.7 per 1,000 population. The mortality rate for 1937 was 9.7; for 1936, 10.3; and for 1935, 9.8. Considered in terms of total deaths, the number reported for 1938 was 407 fewer than for 1937. When the deaths are analyzed by cause it is discovered that the group of degenerative diseases caused more deaths than in North Carolina Bureau of Vital Statistics 9 1937. This group—heart diseases, chronic nephritis, apoplexy, cancer, diseases of the arteries, and diabetes melHtus,—six in all, accounted for 14,153 in 1937 and 14,675 in 1938. These de-generative diseases accounted for approximately 44 per cent of all deaths in 1938 and 42 per cent in 1937. Table 1. Deaths from Degenerative Diseases Number Cause of Death 1937 1938 Heart Diseases -5,758 5,819 Chronic Nephritis 2,755 3,057 Cerebral Hemorrhage 2,940 3,051 Cancer 1,912 1,915 Diseases of the Arteries 402 454 Diabetes 386 379 Total 14,153 14,675 The principal causes of death in 1938 in order of their rank were diseases of the heart, nephritis, apoplexy, the pneumonias, congenital malformations and diseases of early infancy, violent and accidental deaths, exclusive of homicides and suicides, cancer and tuberculosis. This order is entirely different from that shown twenty-four years ago, the first year of registration, when tuber-culosis ranked first with a rate of 139 deaths for every 100,000 population. Tuberculosis ranked eighth in 1938 with a rate of 52.5. Heart diseases rank first in 1938 in the list of causes of death. In 1914 there were 1,780 deaths charged to this condition and in 1938 diseases of the heart, including angina pectoris, accounted for 5,819 deaths. This represents a rate twice that of 1914. Nephritis, second in importance, was seventh twenty years ago. The death rate from pneumonias has changed little, but due to the increase in deaths from other conditions, pneumonia has dropped from second to fourth place. Diarrhea and enteritis, a major cause of death in 1914, is ninth in 1938. The rate has fallen from 98.8 per 100,000 population in 1914 to 37.1 in 1938. Modern sanitary measures have played a large part in reducing the death rate from diarrhea among infants. TTjphoid Fever: The death rate from typhoid fever, after a slight increase in 1937, again showed a decrease, continuing the downward trend shown annually since 1932 with the exception of 1937. The 71 deaths were four less than for 1937. The improve- 10 Annual Report Nineteen Thikty-Eight ment in the condition since the beginning of registration can be appreciated by comparing the rate of 35.8 in 1914, or a total of 839 deaths, to the present low rate of 2.2 or 75 deaths. Smallpox: There was no death from smallpox in 1938. With the exception of one death in 1937 there has not been a death reported from this disease since 1931. Thirty-five cases were reported to the Division of Epidemiology in 1938 and eleven in 1937. Diphtheria: The record for 1938 shows approximately the same number of deaths and death rate from diphtheria as for 1937. There were 173 deaths with a rate of 4.9 per 100,000 population compared to 168 deaths with a rate of 4.8 for 1937. There was a seventy per cent reduction in the mortality rate from this disease from 1915 to 1932, but no significant decrease in the rate since. In round numbers, five-sixths of the deaths from diphtheria occur in children under five years of age. This indi-cates that vaccination to be most profitable must be done long before the child becomes of school age. Influenza and PneuTuonia: There were 2,717 deaths from pneumonia and 505 deaths from influenza, making a total of 3,222 recorded for 1938. The deaths from these two conditions give a rate of 91.4 per 100,000 population for 1938 as against a rate of 108.4 for 1937. There were 357 fewer deaths from influenza during 1938 than for the previous year and 206 fewer from pneumonias. Tuberculosis: The death rate from all forms of tuberculosis was 52.2 in 1938 and 54.8 in 1937. This represents a decrease in actual numbers of 59. Tuberculosis ranked first among all causes of death in 1914, but has fallen to eighth place in 1937. In the past twenty years the mortality rate has declined by approxi-mately 65 per cent. Of the 1,853 deaths from all forms of tuberculosis, 51.5 per cent were males and 48.5 per cent females ; 38 per cent were white and 62 per cent colored. The colored rate of 111.2 for tuber-culosis is almost four times the white rate of 28.3. Cancer: Cancer accounted for 1,915 deaths in 1938, giving a rate of 54.3 against a rate of 54.8 for 1937 and 51.6 for 1936. Taken over a number of years the general trend of cancer mor-tality has been upward, but for four years prior to 1937 we had at least held our own. In 1937 there were 93 more deaths than in 1936, and three more this year than in 1937. NoKTH Carolina Bureau of Vital Statistics 11 Pellagra: The 257 deaths from pellagra, representing a mortality rate of 7.3 per 100,000 population, was a decrease over the rate of 13.0 for 1937. There has been a downward trend in mortality from this disease since 1930 with the exception of 1934 and 1937. The peak year for pellagra deaths was 1930 when 1,015 were charged to this disease. Suicides and Ho7mcides: There were 332 suicides in 1938 and 305 in 1937. The 27 more deaths increased the rate from 8.7 per 100,000 population in 1937 to 9.4 in 1938. There were 52 more homicidal deaths in 1938 than in 1937, the totals being 356 and 408 respectively. Accidental Causes: Violent and accidental deaths, exclusive of suicides and homicides, accounted for 2,217 deaths, 267 fewer than in 1937. Violent and accidental deaths rank sixth among the principal causes of death. Automobile accidents accounted for the greatest number of the accidental deaths. There were 906 deaths from all types of automobile accidents in 1938 and 1,056 in 1937. Railroad accidents, exclusive of collisions with automobiles, caused 89 deaths in 1938 and 99 in 1937. Maternal Mortality: The diseases of pregnancy, childbirth and the puerperal state continued to exact a large number of lives. Deaths from maternal causes and the maternal mortality rates per 1,000 live births for the past ten years are shown in Table 2. There were 450 maternal deaths in 1938 to 445 in 1937, or 5 fewer deaths and 659 more births. This gives a maternal mortality rate of 5.6 per 1,000 live births, the same as for last year. There were 240 white, 206 negro and 4 Indian puerperal deaths, accounting for a death rate of 4.5 per 1,000 live births for the white and 8.4 for the colored. Table 2. — Total Maternal Deaths and Rates, 1929-1938 Year No. of Deaths Rate 1929 684 8.8 1930 645 8.4 1931 640 8.5 1932 555 7.1 1933 535 7.1 1934 605 7.6 1935 554 7.0 1936 532 7.0 1937 445 5.6 1938 450 5.6 12 Annual Report Nineteen Thibtt-Eight Albuminuria and eclampsia, as in previous years, accounted for more of the puerperal deaths than any other single cause. The second and third greatest offenders were puerperal septicemia and puerperal hemorrhage, respectively. Albuminuria and eclampsia with other toxemias of pregnancy account for 155 maternal deaths, which is 34 per cent of all maternal deaths. Infant Mortality: The total number of deaths under one year of age was 5,461 or 299 more than occurred in 1937. The rate for 1938 was 68.3 per 1,000 live births and 65.1 in 1937. Of the total deaths 3,244 were white and 2,217 colored. This gave a rate of 59.6 for the white and 87.2 for the colored. The number of deaths of infants under one year of age and the infant mor-tality rates per 1,000 live births for the past ten years are shown in Table 3. Table 3. — Total Infant Deaths and Rates, 1929-1938 Year No. of Deaths Rate 1929 6,112 79.2 1930 6,021 78.4 1931 5,459 73.0 1932 5,173 66.4 1933 4,974 66.0 1934 6,196 77.9 1935 5,407 67.9 1936 5,221 68.4 1937 5,164 65.1 1938 5,461 68.3 Five principal causes of infant mortality accounted for 70 per cent of all infant deaths. These causes with the number of infant deaths charged to each were as follows: Premature birth 1,502 Diarrhea and enteritis 847 Pneumonias 675 Sudden death (cause not specified) 470 Congenital malformations 334 Total 3,828 Of the 5,461 deaths of infants under one year of age 1,238 or 24 per cent died during the first day of life and 2,075 or 38 per cent within the first week. North Carolina Bureau of Vital Statistics 13 Registration Every birth and death occurring in North Carolina should be recorded with the Bureau of Vital Statistics. To the individual the registration of a birth occurring in North Carolina makes it possible always to obtain an official record of the facts surround-ing his advent into life. The purposes for which certified copies of birth certificates are requested indicate that their value is be-coming more generally realized from year to year. Likewise, the demand for death certificates show that this vital record is essen-tial in upholding the right of citizens in the establishment of necessary facts in the closing event of life. Vital Statistics are of inestimable value to the public health workers, but without complete registration full reliance cannot be placed on the data. For health organizations accurate certificates are essential if our true problems are to be known, if our pro-grams are to be intelligently planned and we are to ascertain their effectiveness and if errors in our work are to be detected. It is, therefore, important that every effort be made to promote the completeness of our birth and death records. 14 Annual Report Nineteen Thibtt-Eight -Total Births and Deaths (Exclusive of Stillbirths) With Rate Per 1,000 Population for the Years 1914-1938 Inclusive North Carolina Bureau of Vital Statistics 15 1 1 16 Annual Report Nineteen Thirty-Eight North Carolina Bureau of Vital Statistics 17 lO -H 1 1 I t- -< t~ ««• m o * oo r* -f eo o tTojn«00Oa0iOO»«t^O'*0s»0<MOt^-^'^CSIC0C0 ^HOStOOSt^COOSt^'*^'^ ittSt^Oa s s § s «OtS>CilN;s0s-*0 « o to te^o rmt coq to * ss Annual Report Nineteen Thirty-Eight "P u? t~ (M c<l O « <M -H (M o 00 o> o >ra iO CO C��5 t^ t^ fo Oi Oi *n T»iiOT-i>rat^in,-iM^t^cO'H-«" i0t^0i03OC0O»0C^t^00ir5O QO*-»OI^OOCOeO«OOo6cDO^ (M (M -H rt -at to o •Mioeoc^ioiiOc^icsTjioiioo CO^CQOCOCOCOOOO-^rOr^ W»-tC»<0»^iOCO'<*'»-tO m g n _^ c5 a, :i^ North Carolina Bureau of Vital Statistics 19 Jl 20 Annual Report Nineteen Thirty-Eight Table III — Deaths (Exclusive of Stillbirths) for the Entire Cause op Death I. Infectious and Parasitic Diseases: Males 1. Typhoid fever. 2. Paratyphoid fever. 3. Typhus fever 5. Undulant fever. Whooping-cough. Total.. White... Indian.. Colored Total..- White... Indian.. Colored. Total. -- White... Indian.. Colored. Total... Indian.. Colored. W I Male 1 Female C JMale \Female.... W Female... 18,253 11,746 96 6,411 15,311 9,323 100 5,888 2,080 1,004 10 1,066 1,877 865 18 994 5,461 3,030 1,810 32 1,188 2,431 1,434 37 NoBTH Carolina Bureau of Vital Statistics 21 State From Each Cause, By Sex, Color and Age—1938 2,849 1,574 1,275 591 6 2,008 1,199 4,420 2,570 1,748 10 812 1,850 1,163 7 2,752 2,045 11 2,202 1,643 1,936 1,628 2 306 1,840 1,551 2 287 22 Annual Report Nineteen Thirty-Eight Table III-Cause op Death 10. Diphtheria. 11. Influenza. 13. Dysentery. 15. Erysipelas. 16. Acute poliomyelitis and acute polioencephalitis- 17. Lethargic or epidemic encephalitis. 18. Epidemic cerebrospinal meningitis. Tuberculosis of the respiratory system. North Carolina Bureau of Vital Statistics 23 Continued Annual Repobt Nineteen Thibty-Eight Table III-Cause op Death 24. Tuberculosis of the meninges and central nervous system 25. Tuberculosis of the intestines and peritoneum I 26 Tuberculosis of the vertebral column 27. Tuberculosis of the bones and joints (vertebral column excepted) 28. Tuberculosis of the skin and subcutaneous cellular tissue - 29. Tuberculosis of the lymphatic system (bronchial, mesenteric, and retroperitoneal glands excepted) 30. Tuberculosis of the genitourinary system 32. Disseminated tuberculosis _. I 34, Syphilis I Gonococcus infection and other venereal diseases. 36. Purulent infection, septicemia (nonpuerperal) North Cabolina Bureau of Vital Statistics 25 Continued 1 3 26 Annual Report Nineteen Thibty-Eight North Carolina Bureau of Vital Statistics 27 Continued 28 Annual Report Nineteen Thirty-Eight Table III-Causb of Death 45. Cancer and other malignant tumors of the buccal cavity and pharynx - - - 46. Cancer and other malignant tumors of the digestive tract and peritoneum 47. Cancer and other malignant tumors of the respiratory system 48. Cancer and other malignant tumors of the uterus. 49. Cancer and other malignant tumors of the female genital organs 50. Cancer and other malignant tumors of the breast. 51. Cancer and other malignant tumors of the male genitourinary organs -. 52. Cancer and other malignant tumors of the skin. 53. Cancer and other malignant tumors of other or unspecified organs 54. Non-malignant tumors. 55. Tumors of which the nature is not stated. North Carolina Bureau of Vital Statistics 29 OS s 30 Annual Report Nineteen Thibtt-Eight North Carolina Bureau of Vital Statistics 31 Continued 2 32 Annual Report Nineteen Thirty-Eight Table III-Causb of Death Race and Sex 65. Diseases of the pituitary body 66. Diseases of the thyroid and parathyroid glands. 67. Diseases of the thymus gland. Diseases of the adrenals (Addison's disease, not specified as tuberculous) Other general diseases. IV. Diseases of the Blood and Blood-Makino Organs: Males 70. Hemorrhagic conditions 72. Leukemias and pseudoleukemias. 73. Diseases of the spleen 74. Other diseases of the blood-making organs. V. Chronic Poisonings and Intoxications: Males North Carolina Bureau of Vital Statistics 33 Continued i 2 S 34 Annual Report Nineteen Thirty-Eight Table III— Cause of Death 75. Alcoholism (acute or chronic) Chronic poisonings by other organic substances- Chronic poisonings by mineral substances Diseases of the Nervous System and of the Organs of Special Sense: 78. Encephalitis (nonepidemic) 79. Meningitis. Progressive locomotor ataxia (tabes dorsalis). Other diseases of the spinal cord. Cerebral hemorrhage, cerebral embolism and thrombosis 1,973 1,274 7 1,739 1,005 5 729 12 18 10 5 37 16 2 18 17 1 1 4 1 19 6 1,050 844 3 4 536 614 North Carolina Bureau of Vital Statistics 35 Continued 3 36 Annual Report Nineteen Thirty-Eight Table III-Causb of Death North Carolina Bureau of Vital Statistics 37 Continued 1 3 to 3S Annual Report Nineteen Thirty-Eight Table III- North Carolina Bureau of Vital Statistics Continued 1 s. 40 Annual Repobt Nineteen Thirty-Eight Table III — Cause of Death North Carolina Bureau of Vital Statistics 41 Continued 1 2 •a 42 Annual Report Nineteen Thikty-Eight Table III-Causb of Death 109. Pneumonia, unspecified. 110. Pleurisy. 111. Congestion, edema, embolism, hemorrhagic infarct, and thrombosis of the lungs 112. Asthma. 113. Pulmonary emphysema. 114. Other diseases of the respiratory system (tuberculosis excepted) IX. Diseases o? the Digestive STSTEia: Males 115. Diseases of the buccal cavity and annexa and of the pharynx and tonsils (including adenoid vegetations) 116. Diseases of the esophagus. 117. Ulcer of stomach and duodenum. W Male. W fMale..., \Female. I Male... C fMale..., 1 Female. Total... White... Indian.. Colored. Total... White... Indian.. Colored. W (Male 1 Female... I JMale ^Female.. - C JMale (Female... Female Male.. W fMale... iFemale. C JMale... [Female. 1,422 915 9 498 1,265 776 12 477 49 54 1 NoBTH Carolina Bubeau of Vital Statistics 43 Continued OS s 44 Annual Report Nineteen Thibty-Eight Table III-Causb of Death North Carolina Bureau of Vital Statistics i5 Continued i -2 46 Annual Report Nineteen Thirty-Eight North Carolina Bureau of Vital Statistics 47 Continued 1 48 Annual Repoet Nineteen Thikty-Eight Table III-Cause of Death 137. Diseases of the prostate f 138. Diseases of the male genital organs, not specified as venereal 139. Diseases of the female genital organs, not specified f as venereal \ XI. Diseases of I^eqnanct, Childbirth and the Puerperal State: Females 1 140. Abortion with septic conditions f 141. Abortion without mention of septic abortion f (to include hemorrhages)... \ 142. Ectopic gestation --f 143. Other accidents of pregnancy (not to include f hemorrhage) \ I 144. Puerperal hemorrhage 145. Puerperal septicemia (not specified as due to abortion) 146. Puerperal albuminuria and eclampsia 147. Other toxemias of pregnancy 148. Puerperal phlegmasia albadolens, embolus, sudden death (not specified as septic) 149. Other accidents of labor XII. Diseases of the Skin and Cellular Tissue: Males I W Male... C Male-.. C Male... W Female. C Female. Total White Indian Colored White Colored White Colored White Colored White Indian Colored White Indian Colored White Colored White.. Indian Colored White _ Colored White Colored White Colored Total White Indian Colored North Carolina Bureau of Vital Statistics 49 Continued 50 Annual Report Nineteen Thirty-Eight Table III-Cause of Dbath 161. Furuncle, carbuncle. 152. Phlegmon, acute abscess. 153. Other diseases of the skin and annexa, and of the cellular tissue XIII. Diseases of the Bones and Organs of Locomotion: 154. Osteomyelitis 155. Other diseases of the bones (tuberculosis excepted). 156. Diseases of the joints and organs of locomotion XIV. Congenital Malformations: Males 157. Congenital malformations (stillbirths not included) Feniales Total... White... Indian.. Colored. W fMale.... \Female., I Male.... C fMale..., \ Female. W [Male... I Female. C ("Male... [Female. I Male.. C fMale.. 1 Female Total... White... Colored Total... White... Colored. W fMale... Wemale. C |Male... \Female. W Male... C Male... W I Male... \ Female. Total... White... Indian.. Colored. Total... White- Indian.. Colored. North Cabolina Bubeau of Vital Statistics 51 Continued 52 Annual Report Nineteen Thirty-Eight Table III — Cause of Death XV. Diseases op Early Infancy: Males 158. Congenital debility 159. Premature birth. 160. Injury at birth. 161. Other diseases peculiar to early infancy. XVI. SENitrrY: Males. .. 162. Senility Females. XVII. Violent and Accidental Deaths: Males Total... White... Indian.. Colored. Total... White.. Indian.. Colored W [Male... 1 Female. I |Male... ^Female. C JMale... \ Female. W (Male— ^Female. I |Male... ^Female. C JMale... [Female. W I Male.... 1 Female. C fMale.-.. \Female. W ("Male.... \Female. I Female. C ("Male... 1 Female. Total... White... Colored. Total... White... Colored. Total... White... Indian.. Colored. Total... White... 1,172 756 10 406 2,186 1,436 15 735 723 1,171 755 10 406 919 576 North Carolina Bureau of Vital Statistics 53 Continued 3 54 Annual Repoet Nineteen Thirty-Eight NoKTH Carolina Bureau of Vital Statistics 55 Continued en 2 2 56 Annual Repokt Nineteen Thirty-Eight Table III— Cause of Death North Carolina Bureau of Vital Statistics 57 Continued i s 58 Annual Report Nineteen Thirty-Eight North Carolina Bureau of Vital Statistics 59 Continued Annual Report Nineteen Thikty-Eight North Carolina Bureau of Vital Statistics 61 Continued E 3 62 Annual Report Nineteen Thirty-Eight North Carolina Bureau of Vital Statistics 63 = 64 Annual Report Nineteen Thirty-Eight North Carolina Bureau of Vital Statistics 65 66 Annual Repobt Nineteen Thirty-Eight Table V — Deaths (Exclusive of Stillbirths) in Each County, by Cause of Cause of Death Place of death Place of White Place of death Place of Place of death Col. All causes—Total recorded-. Typhoid and paratyphoid fever Typhus fever. _-_ Smallpox Measles Scarlet fever.. Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system Other forms of tuberculosis Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus Alcoholism (acute or chronic) ___ Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis.. Other diseases of the nervous system and organs of special sense Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted). Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis Other diseases of the genitourinary system Puerperal septicemia Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility Suicide (total) Homicide (total) Automobile fatalities (total) _ Violent and accidental (suicide, homicide and automobile excepted) Cause not specified or ill-defined... 12,300 34 356 4,017 1 123 29 177 1,043 100 304 40 42 3 58 18 99 27 142 95 51 1,151 219 1,758 163 23 1,077 87 426 33 45 283 1,076 152 51 155 40 805 114 26 233 238 North Carolina Bureau of Vital Statistics 67 Death 68 Annual Report Nineteen Thirty-Eight Table V- North Carolina Bureau of Vital Statistics 69 Continued Ashe 70 Annual Report Nineteen Thibtt-Bight Table V- North Carolina Bureau of Vital Statistics 71 Continued Bladen 72 Annual Report Nineteen Thibty-Eight Table V — North Carolina Bureau of Vital Statistics 73 Continued Cabarrus 74 Annual Report Nineteen Thiety-Eight Table V— NoBTH Carolina Bureau of Vital Statistics 75 Continued CasweU 76 Annual Report Nineteen Thirty-Eight Table V- NoBTH Carolina Bureau of Vital Statistic! 77 Continued Chowan 78 Annual Report Nineteen Thirty-Eight Table V-Cause of Death Place of death Place of res. Place of death Place of Place of death All causes—Total recorded Typhoid and paratyphoid fever Typhus fever.. Smallpox Measles Scarlet fever Whooping-cough— Diphtheria Influenza Tuberculosis of the respiratory system Other forms of tuberculosis Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra -- Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis.. Other diseases of the nervous system and organs of special sense Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted). Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis Other diseases of the genitourinary system Puerperal septicemia Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility Suicide (total) Homicide (total) Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) -- Cause not specified or ill-defined North Carolina Bureau of Vital Statistics 79 Continued Craven 80 Annual Report Nineteen Thirty-Eight Table V- NoBTH Carolina Bureau of Vital Statistics 81 Continued Annual Report Nineteen Thirty-Eight Table V— Cause or Death All causes—Total recorded Typhoid and paratyphoid fever Typhus fever Smallpox Measles Scarlet fever Whooping-cough Diphtheria.. Influenza .-- - Tuberculosis of the respiratory system Other forms of tuberculosis Syphilis Malaria Dysentery-. Acute poliomyelitis and polioencephalitis _. Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis.. Other diseases of the nervous system and organs of special sense Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted). Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis — Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Ncphritb - Other diseases of the genitourinary system _ _ _ Puerperal septicemia Other diseases of pregnancy and puerperal state.. Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility - Suicide (total) Homicide (total).. Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) Cause not specified or ill-defined Place of death Place of Place of death Place of North Carolina Bureau of Vital Statistics 83 Continued Edgecombe 84 Annual Report Nineteen Thibtt-Eight Table V-Cause op Death Place of death Place of Place of death All causes—Total recorded . Typhoid and paratyphoid fever.. Typhus fever Measles Scarlet fever Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system. Other forms of tuberculosis Syphilis Malaria Dysentery - Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases . Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout.. - Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis Other diseases of the nervous system and organs of special sense . Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted) Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis Other diseases of the genitourinary system. Puerperal septicemia Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy.. _. Senility Suicide (total) Homicide (total). .^ Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) Cause not specified or ill-defined... 2 North Carolina Bureau of Vital Statistics Gates Annual Repoet Nineteen Thirty-Eight Table V- North Carolina Bureau of Vital Statistics 87 Continued Guilford Annual Report Nineteen Thibty-Bight Table V- North Carolina Bureau of Vital Statistics Continued Henderson Annual Report Nineteen Thirty-Eight Table V- North Carolina Bureau of Vital Statistics 91 Continued Iredell 92 Annual Report Nineteen Thikty-Eight Table V — North Carolina Bureau of Vital Statistics Continued 94 Annual Report Nineteen Thirty-Eight Table V — North Carolina Bureau of Vital Statistics 95 Continued Macon Annual Report Nineteen Thebtt-Eight Table V-Caube of Death Mecklenburg Place of death Place of Place of death All causes—Total recorded. Typhoid and paratyphoid fever.. Typhus fever Smallpox Measles Scarlet fever Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system. Other forms of tuberciilosis . Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis Other diseases of the nervous system and organs of special sense. Diseases of the heart Other diseases of the circulatory system Bronchitis. Pneumonias Other diseases of the respiratory system (T. B. excepted) Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis Other diseases of the genitourinary system Puerperal septicemia Other diseases of pregnancy and puerperal state. . Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility Suicide (total) Homicide (total) Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile ( Cause not specified or ill-defined scepted) NoETH Carolina Bureau of Vital Statistics 97 Continued MitcheU Annual Report Nineteen Thiety-Eight Table V— North Carolina Bureau of Vital Statistics 99 Continued New Hanover 100 Annual Report Nineteen Thibty-Eight Table V — North Carolina Bureau of Vital Statistics 101 Continued 102 Annual Report Nineteen Thirty-Eight Table V- North Carolina Bureau of Vital Statistics 103 Continued Person 104 Annual Report Nineteen Thibtx-Eiqht Table V-Cause of Death Randolph Place of death Place of res. Place of death All causes—Total recorded Typhoid and paratyphoid fever. Typhus fever Smallpox Measles Scarlet fever Whooping-cough Diphtheria -.- Influenza Tuberculosis of the respiratory system. Other forms of tuberculosis Syphilis Malaria.. Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout. Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis... Other diseases of the nervous system and organs of special s Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted).. Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis. Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis Other diseases of t he genitourinary system Puerperal septicemia Other diseases of pregnancy and puerperal state. Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy 9. Senility. Suicide (total) Homicide (total) .., Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) Cause not specified or ill-defined 18 North Caeolina Bureau of Vital Statistics 105 Continued Richmond 106 Annual Report Nineteen Thiety-Bight Table V— Cause of Death of death Place of res. Place of death All causes—Total recorded . 1. Typhoid and paratyphoid fever.. 2. Typhusfever Measles Scarlet fever Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system. Other forms of tuberculosis Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases. _ Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout --- Diabetes mellitus Alcoholbm (acute or chronic).. Other general diseases and chronic poisonings Pellagra -- Progressive locomotor ataxia and paresb Cerebral hemorrhage, cerebral embolism and thrombosis _. Other diseases of the nervous system and organs of special sense. Diseases of the heart Other diseases of the circulatory system Bronchitis -- Pneumonias Other diseases of the respiratory system (T. B. excepted) Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis - Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis -- Other diseases of the genitourinary system Puerperal septicemia ..- Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy 39. Senility. 40. 4L 42. 42. 43. Suicide (total) Homicide (total) -- Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) Cause not specified or ill-defined - 24 NoBTH Cabolina Bueeau of Vital Statistics 107 Continued Rutherford 108 Annual Report Nineteen Thikty-Eight Table V — North Carolina Bureau of Vital Statistics 109 Continued Stokes no Annual Report Nineteen Thirty-Eight Table V- North Carolina Bureau of Vital Statistics 111 Continued Tyrrell 112 Annual Report Nineteen Thibty-Eight Table V— Cause of Death Place of death Place of Place of death Ail causes—Total recorded . Typhoid and paratyphoid fever.. Tjrphus fever Measles Scarlet fever Whooping-cough Diphtheria. _ _ Influenza... Tuberculosis of the respiratory system Other forms of tuberculosis Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisoninp. Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis Other diseases of the nervous system and organs of special sense. Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted) Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis -.. Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis Other diseases of the genitourinary system Puerperal septicemia Other diseases of pregnancy and puerperal state — Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility Suicide (total) Homicide (total) Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile exceptec Cause not specified or ill-defined 9 North Cabolina Bureau of Vital Statistics Continued Warren 114 Annual Report Nineteen Thiety-Eight Table V — Cause of Death Wayne Place of death Place of res. Place of death All causes—Total recorded Typhoid and paratyphoid fever.. Typhus fever Smallpox Measles --- Scarlet fever Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system. Other forms of tuberculosis Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus _' Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis Other diseases of the nervous system and organs of special sense Diseases of the heart Other diseases of the circulatory system - Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted) Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) _ Appendicitis - Cirrhosis of the liver _ Other diseases of the liver Other diseases of the digestive system Nephritis -- Other diseases of the genitourinary system Puerperal septicemia Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility Suicide (total) Homicide (total) _-_ - Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) Cause not specified or ill-defined _ North Carolina Bureau of Vital Statistics 115 Continued Wilkes 116 Annual Repokt Nineteen Thiety-Eight Table VI — Deaths (Exclusive of Stillbibths) in Cities or Towns, by Cause Cause of Death Place of death Place of Place of death Place of res. Place of death All causes—Total recorded. __ Typhoid and paratyphoid fever. Typhus fever 5,70J 12 2 Measles Scarlet fever Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system Other forms of tuberculosis Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis.. Other diseases of the nervous system and organs of special sense _ Diseases of the heart Other diseases of the circulatory system Bronchitis... Pneumonias Other diseases of the respiratory system (T. B. excepted). Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis Cirrhosis of the liver Other diseases of the liver Other diseases of the digestive system Nephritis Other diseases of the genitourinary system I^lerpcral septicemia Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility Suicide (total) __ Homicide (total) Automobile fatalities (total) _ Violent and accidental (suicide, homicide and automobile excepted) ._ Cause not specified or ill-defined 4,049 11 North Carolina Bureau of Vital Statistics 117 OF Death (Abridged International List) Also by 118 Annual Report Nineteen Thirty-Eight Table VI— Causb of Death Place of death Place of Place of death Place of All causes—Total recorded.- Typhoid and paratyphoid fever Typhus fever Smallpox Measles Scarlet fever Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system Other forms of tuberculosis Syphilis Malaria Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases -- Cancer and other malignant tumors Tumors non-malignant or unspecified Chronic rheumatism and gout.. Diabetes mellitus Alcoholism (acute or chronic) - Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis. .. Other diseases of the nervous system and organs of special sense -- Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias Other diseases of the respiratory system (T. B. excepted). Diarrhea and enteritis (under 2 years) Diarrhea and enteritis (2 years and over) Appendicitis Cirrhosis of the liver Other diseases of the liver - Other diseases of the digestive system Nephritis Other diseases of the genitourinary system Puerperal septicemia. _ _ - Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility Suicide (total) Homicide (total) Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) Cause not spprificd or ill-defined, _ NoBTH GaboonA Bureau of Vital Statistics 119 Continued Elizabeth City 120 Annual Repobt Nineteen Thtrty-Eight Table VI— Cause of Death Place of death Place of res. White White Place of death All causes—Total recorded - Typhoid and paratyphoid fever.. Typhiis fever Smallpox Scarlet fever. Whooping-cough Diphtheria Influenza Tuberculosis of the respiratory system. Other forms of tuberculosis. Syphilis Malaria - Dysentery Acute poliomyelitis and polioencephalitis Epidemic cerebrospinal meningitis Other infectious and parasitic diseases Cancer and other malignant tumors Tumors, non-malignant or unspecified Chronic rheumatism and gout Diabetes mellitus Alcoholism (acute or chronic) Other general diseases and chronic poisonings Pellagra Progressive locomotor ataxia and paresis Cerebral hemorrhage, cerebral embolism and thrombosis Other diseases of the nervous system and organs of special sense. Diseases of the heart Other diseases of the circulatory system Bronchitis Pneumonias - Other diseases of the respiratory system (T. B. excepted) Diarrhea and enteritis (under 2 years). . _ Diarrhea and enteritis (2 years and over) Appendicitis Cirrhosis of the liver. Other diseases of the liver Other diseases of the digestive system. Nephritis Other diseases of the genitourinary system Puerperal septicemia --- Other diseases of pregnancy and puerperal state Diseases of skin, bones and organs of locomotion Congenital debility, malformation and early infancy Senility -- Suicide (total) -_ Homicide (total) - Automobile fatalities (total) Violent and accidental (suicide, homicide and automobile excepted) _ Cause not specified or ill-defined North Carolina Bureau of Vital Statistics 121 Continued Place of Place of death Place of res. High Point Place of death Place of Place of death Place of res. Place of death Place of Place of death Annual Report Nineteen Thirty-Eight Table VI— North Carolina Bureau of Vital Statistics 123 Continued Raleigh 124 Annual Report Nineteen Thikty-Eight Table VI — North Carolina Bureau of Vital Statistics L26 Continued Place of res. Place of death Wilmington Place of death Place of Place of death Place of Place of death Place of Plac, of death Place of Winston-Salem 126 Annual Report Nineteen Thibty-Eight 1« 1 i8 I North Carolina Bureau of Vital Statistics 127 8.0 14.2 6.3 7.8 128 Annual Report Nineteen Thikty-Eight North Carolina Bureau of Vital Statistics 129 c^ 130 Annual Report Nineteen Thirty-Eight Table VIII — Deaths (Exclusive of Stillbirths) By Cause and Cause of Death North Carolina Bureau of Vital Statistics By Certain Subdivisions of the First Year of Life—1938 131 132 Annual Report Nineteen Thirty-Eight Table IX — Deaths Under 1 Year op Age (Exclusive of Stillbirths) and Maternal Deaths in Each County With Rate Per 1,000 Live Births—1938 Entire State. Alamance Alexander Alleghany Anson Ashe Avery Beaufort. Bertie Bladen Brunswick Buncombe Burke Cabarrus Caldwell Camden Carteret-.- Caswell Catawba Chatham Cherokee Chowan Clay Cleveland Columbus Craven Cumberland Currituck Dare Davidson Davie Duplin Durham Edgecombe Forsyth Franklin Gaston.-- Gates Graham Granville Greene Guilford Halifax.. Harnett Haywood Henderson , Hertford. Hoke Hyde Iredell Infant Mortality Place of Death 5,461 51 15 9 47 47.8 45.9 73.8 61.8 52.5 47.0 96.1 87.3 47.7 59.3 58.2 34.5 70.1 53.1 69.9 41.1 59.1 59.6 68.4 108.2 60.8 35.6 90.9 104.6 96.2 53.6 29.4 63.8 62.3 67.6 102.9 80.8 72.1 63.9 65.3 51.4 28.2 59.1 37.5 57.6 66.2 57.9 40.5 52.9 40.7 56.9 Place of Residence 5,443 62 16 8 46 21 88 70 40 27 116 28 75 6 28 27 64 Maternal Mortality 54.5 47.8 64.5 62.5 50.3 49.3 94.0 85.8 55.2 63.8 57.6 36.2 69.1 73.8 52.2 73.7 47.9 57.8 61.1 68.8 110.3 59.2 93.4 105.8 71.8 76.9 46.7 66.1 60.6 77.1 78.2 80.1 72.3 74.2 67.4 50.4 26.7 63.7 56.1 54.4 70.3 73.3 44.8 54.0 71.6 68.9 38.3 55.9 450 2 2 4.3 9.1 2.5 1.4 5.2 4.4 2.0 3.2 17.9 1.9 2.7 6.9 2.0 11.2 13.5 13.8 17.8 1.9 13.5 3.9 5.7 4.3 3.7 7.0 10.3 1.9 6.9 8.0 3.7 2.5 3.6 2.2 5.2 Place of Residence NoBTH Carolina Bureau of Vital Statistics 133 Table IX — Continued Infant Mortality Number Rate 50.4 71.5 74.5 66.5 124.4 53.6 65.6 51.6 68.9 74.3 58.4 47.8 45.9 72.7 100.1 33.3 89.1 27.5 72.9 109.9 78.0 71.1 43.5 82.5 146.1 48.5 65.8 76.1 55.5 54.8 52.7 59.3 107.4 51.4 68.5 74.4 71.9 66.6 62.9 82.6 70.3 67.7 42.7 106.5 42.5 111.9 59.0 51.2 Place of Residence Number Rate Number Rate 129 23 26 99 27 34 20 41 57 174 27 15 30 104 64 25 57 21 18 41 43 16 40 128 18 45 52 163 74 67 55 92 57 40 36 73 27 17 10 65 41 171 43 23 19 127 Maternal Mortality 54.8 78.9 83.6 66.2 105.7 55.7 61.2 49.3 69.7 70.9 65.3 58.7 44.5 51.9 68.1 69.7 35.3 106.5 42.2 71.1 110.5 95.1 69.3 52.0 86.4 84.1 54.9 64.8 75.8 60.2 55.0 54.1 73.2 109.0 55.4 67.9 75.4 63.4 70.4 68.2 62.1 81.0 72.1 72.6 45.8 107.0 44.2 108.2 61.3 51.2 6.1 6.5 6.4 6.8 8.4 8.5 4.5 2.0 5.0 4.0 20.9 2.4 4.4 2.1 9.1 3.3 2.5 4.0 9.1 9.8 5.4 5.9 5.0 7.6 7.4 3.2 1.5 8.9 3.4 6.5 4.7 6.8 0.9 5.7 2.2 4.5 Place of Residence 134 Annual Report Nineteen Thirty-Eight Table X — Cases and Deaths from Special Diseases North Carolina Bureau of Vital Statistics Diseases By Month of Occ urrence—1938 135 March 136 Annual Report Nineteen Thiett-Eight Table X-DlSKASBS NoBTH Carolina Bureau of Vital Statistics 137 Continued March 138 Annual Report Nineteen Thirty-Eight North Carolina Bureau of Vital Statistic: Reportable Diseases by Counties—1938 139 j 140 Annual Report Nineteen Thirty-Eight Table XI— County or Crrr Jones Lee Lenoir_ --- Lincoln McDowell Macon MadLson Martin Mecklenburg Charlotte Mitchell Montgomery Moore Nash Rocky Mount. New Hanover Wilmington... Northampton Onslow Orange Pamlico Pasquotank Pender Perquimans Person Pitt Polk Randolph Richmond Robeson Rowan Rutherford. Sampson.... Scotland Stanly Stokes Surry Swain Transylvania... Tyrrell Union Vance Wake Raleigh Warren Washington Watauga Wayne Goldsboro. Wilkes Wilson Yadkin Yancey Total. 102 5,316 2,442 758 101 20 4 150 16 669 2,775 296 31 447 836 315 940 ,561 146 132 520 140 272 204 137 877 397 890 56 593 57 963 162 276 217 1,194 25 1,402 1,198 8 3 53 436 350 234 1,071 473 255 49,614 North Carolina Bureau of Vital Statistics 141 Continued 1 s 142 Annual Report Nineteen Thikty-Eight Table XII — Death Rates Per 100,000 Population from Ten Important Causes, for the State as a Whole, with Estimated Population for Each Year—1914-1938, Inclusive
Object Description
Description
Title | Annual report of the Bureau of Vital Statistics of the North Carolina State Board of Health |
Other Title | Biennial report of the Bureau of Vital Statistics of the North Carolina State Board of Health. |
Creator | North Carolina. |
Date | 1938 |
Subjects |
Diseases--Reporting--North Carolina North Carolina--Statistics, Vital--Periodicals Public health--North Carolina |
Place |
Raleigh, Wake County, North Carolina, United States North Carolina, United States |
Time Period |
(1929-1945) Depression and World War Two |
Description | Title varies slightly: Biennial report of the Bureau of Vital Statistics of the North Carolina State Board of Health, 1916-1917.; No reports issued for 1918-1919; reports for 1920-1921 published in The health bulletin / North Carolina State Board of Health. |
Publisher | Raleigh :The Bureau,1915-1949. |
Agency-Current | North Carolina Department of Health and Human Services |
Rights | State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754 |
Physical Characteristics | 33 v. ;24 cm. |
Collection | Health Sciences Library. University of North Carolina at Chapel Hill |
Type | text |
Language |
English |
Format |
Annual reports Statistics Periodicals |
Digital Characteristics-A | 6641 KB; 168 p. |
Digital Collection |
Ensuring Democracy through Digital Access, a North Carolina LSTA-funded grant project North Carolina Digital State Documents Collection |
Digital Format | application/pdf |
Title Replaced By | North Carolina. State Board of Health..Annual report of communicable disease morbidity statistics of the North Carolina State Board of Health |
Audience | All |
Pres File Name-M | pubs_edp_annualreportvitalstatistics1938.pdf |
Pres Local File Path-M | \Preservation_content\StatePubs\pubs_edp\images_master\ |
Full Text |
of tI?P
Ittttr^rfittg of Nortlj CUarolina
(HaiUttian of Nortli Olarnltnmna
>187r
B38
UNIVERSITY OF N.C. AT CHAPEL HILL
00032761903
FOR USE ONLY IN
THE NORTH CAROLINA COLLECTION
ANNUAL REPORT
OF THE
BUREAU OF VITAL
STATISTICS
OF THE
NORTH CAROLINA
STATE BOARD OF HEALTH
1938
Lil;
N. C. St^
ANNUAL REPORT
OF THE
BUREAU OF VITAL
STATISTICS
OF THE
NORTH CAROLINA
STATE BOARD OF HEALTH
1938
CARL V. REYNOLDS, M. D.
SECRETARY
AND STATE HEALTH OFFICER
CONTENTS
Page
Introduction - —
-
-- 7
GENERAL TABLES
Table I.—Total births and deaths (exclusive of stillbirths) with rate
per 1,000 population for the years 1914-1938, inclusive 14
Table II.—Births (exclusiA'e of stillbirths) in each county, by color,
with rate per 1,000 population, per cent attended by physicians
and number illegitimate, 1938 15
Table II-A.—Births (exclusive of stillbirths) in each city of 10,000
population or over in 1930, by color, with rate per 1,000 popula-tion;
per cent attended by physicians and number illegitimate,
1938 19
Table III.—Deaths (exclusive of stillbirths) for the State as a whole
from each cause, by sex, color and age 1938 (includes all deaths
occurring in North Carolina) 20
Table IV.—Deaths (exclusive of stillbirths) in each county, by color,
with rate per 1,000 population, 1938.._ 62
Table V.—Deaths (exclusive of stillbirths) in each county, by cause
of death (abridged international list) and by color of decedent,
1938 -.- 66
Table VI.—Deaths (exclusive of stillbirths) in cities or towns, by cause
of death (abridged international list) and by color of decedent,
1938 —-- 116
Table VII.—Death rates per 100,000 population (by place of death,
also by place of usual residence) in each county, from nine im-portant
causes, with estimated population, 1938 126
Table VIII.—Deaths (exclusive of stillbirths) by cause by certain sub-divisions
of the first year of life, 1938 130
Table IX.—Deaths under 1 year of age (exclusive of stillbirths), and
maternal deaths in each county with rates per 1,000 live births,
1938 - 132
Table X.—Cases and deaths from special diseases by month of occur-rence,
1938 134
Table XI.—Cases from 30 of the reportable diseases by counties, 1938 138
Table XII.—Death rates per 100,000 population from ten important
causes, for the State as a whole, with estimated population for
each year, 1914-1938 142
LETTER OF TRANSMITTAL
To His Excellency, Clyde R. Hoey,
Governor of North Carolina,
Raleigh.
My dear Governor Hoey
I have the honor of transmitting the report for the Bureau
of Vital Statistics covering the calendar year 1938.
With assurance of my very best respect, I am
Sincerely,
CARL V. REYNOLDS, M. D.,
Secretary and State Health Officer.
ANNUAL REPORT OF THE BUREAU OF
VITAL STATISTICS
This annual report of the Bureau of Vital Statistics presents
tabulations of births and deaths for the calendar year 1938. The
Bureau of Vital Statistics was established July 1, 1913 by legis-lative
enactment and began the registration of births and deaths
in October of the same year, but it was not until 1916 for deaths
and 1917 for births that registration was complete enough for
admission to the United States Registration Area.
The first annual report contained tabulations for 1914, and a
report has been published annually ever since with the exception
of 1918 and 1919. Beginning with the 1931 report county and
city tabulations have been made according to the abridged Inter-national
List of Causes of Death. State tabulations have con-tinued
to be made according to the detailed International List.
The present report follows the plan begun in 1932 of tabulating
births and deaths both by place of occurrence and by place of
residence. Births have been allocated to the legal residence of
the mother and deaths to the place of legal residence before death
of the deceased. In order to permit comparison with years before
tabulations by place of residence were begun, deaths and births
have been recorded by place of occurrence and by place of resi-dence.
Although tabulation by residence corrects one, probably the
greatest, source of error in comparing the rates of different
localities there are other factors that must be taken into con-sideration.
For example, the rates given in this report are crude
rates in the calculation of which no allowance is made for the
differences in sex, age and color distribution of the population.
Furthermore, the degree of completeness of reporting may vary
in different localities and this should be taken into consideration
when comparing the rates of two areas.
Population
Population estimates for the State, and more especially for its
political sub-divisions, may vary widely from the true population
when made this far removed from the 1930 census enumeration.
State rates are based on an estimated population of 3,527,000.
To arrive at an estimated population for each county the increase
computed for the State as a whole was distributed among the
counties in proportion to the share which each county had in the
increase between 1920 and 1930. No estimate was made for
8 Annual Report Nineteen Thirty-Eight
areas where the population decreased between 1920 and 1930, the
figures shown being those of the 1930 Federal Census.
Natality
Live Births: The birth rate of 22.7 per 1,000 population was
the same as that for 1937. In actual numbers there were 79,903
births compared to 79,244 in 1937. Of the 79,903 live births,
54,469 were white; 24,647 negro; and 787 Indian, representing
rates of 21.9 per 1,000 population for white and 24.0 for negro.
The birth rate ranged between 30 and 35 per 1,000 population
from 1914 to 1924. From the latter date the rate dropped rapidly
to 24.7 in 1929 and since that time there has been only a slight
downward tendency.
Stillbirths: In conformity with statistical practice, the still-births
were not included in the totals of either births or deaths,
but tabulated separately. There were 3,086 stillbirths, or 74
fewer in 659 more births than in 1937. This represents a decline
in the stillbirth rate from 39.9 to 38.6 per 1,000 live births.
Mortality
In the compilation of mortality statistics the cause of death
as stated by the physician is used as the basis of classification by
causes. Since the accuracy of statistics can be no greater than
that of the material upon which they are based, it is desirable
that physicians give as accurate and complete a diagnosis of the
cause of death as possible. A specific cause, rather than a general
condition or symptom, is essential if the greatest accuracy is to
be expected. Failure to conform with this rule necessitates that
hundreds of certificates be queried yearly as to cause of death in
order to classify them correctly.
The health conditions in North Carolina for 1938 as indicated
by the death rate were, in general, more favorable than for the
preceding year. There were fewer deaths recorded from all
causes combined and consequently a lower death rate than for
1937. The 33,564 deaths, exclusive of stillbirths, represent an
annual death rate of 9.5 per 1,000 population. The mortality rate
for 1937 was 9.7 per 1,000 population. The mortality rate for
1937 was 9.7; for 1936, 10.3; and for 1935, 9.8. Considered in
terms of total deaths, the number reported for 1938 was 407
fewer than for 1937.
When the deaths are analyzed by cause it is discovered that
the group of degenerative diseases caused more deaths than in
North Carolina Bureau of Vital Statistics 9
1937. This group—heart diseases, chronic nephritis, apoplexy,
cancer, diseases of the arteries, and diabetes melHtus,—six in all,
accounted for 14,153 in 1937 and 14,675 in 1938. These de-generative
diseases accounted for approximately 44 per cent of
all deaths in 1938 and 42 per cent in 1937.
Table 1. Deaths from Degenerative Diseases
Number
Cause of Death 1937 1938
Heart Diseases -5,758 5,819
Chronic Nephritis 2,755 3,057
Cerebral Hemorrhage 2,940 3,051
Cancer 1,912 1,915
Diseases of the Arteries 402 454
Diabetes 386 379
Total 14,153 14,675
The principal causes of death in 1938 in order of their rank
were diseases of the heart, nephritis, apoplexy, the pneumonias,
congenital malformations and diseases of early infancy, violent
and accidental deaths, exclusive of homicides and suicides, cancer
and tuberculosis. This order is entirely different from that shown
twenty-four years ago, the first year of registration, when tuber-culosis
ranked first with a rate of 139 deaths for every 100,000
population. Tuberculosis ranked eighth in 1938 with a rate of
52.5.
Heart diseases rank first in 1938 in the list of causes of death.
In 1914 there were 1,780 deaths charged to this condition and in
1938 diseases of the heart, including angina pectoris, accounted
for 5,819 deaths. This represents a rate twice that of 1914.
Nephritis, second in importance, was seventh twenty years ago.
The death rate from pneumonias has changed little, but due to
the increase in deaths from other conditions, pneumonia has
dropped from second to fourth place. Diarrhea and enteritis, a
major cause of death in 1914, is ninth in 1938. The rate has
fallen from 98.8 per 100,000 population in 1914 to 37.1 in 1938.
Modern sanitary measures have played a large part in reducing
the death rate from diarrhea among infants.
TTjphoid Fever: The death rate from typhoid fever, after a
slight increase in 1937, again showed a decrease, continuing the
downward trend shown annually since 1932 with the exception of
1937. The 71 deaths were four less than for 1937. The improve-
10 Annual Report Nineteen Thikty-Eight
ment in the condition since the beginning of registration can be
appreciated by comparing the rate of 35.8 in 1914, or a total of
839 deaths, to the present low rate of 2.2 or 75 deaths.
Smallpox: There was no death from smallpox in 1938. With
the exception of one death in 1937 there has not been a death
reported from this disease since 1931. Thirty-five cases were
reported to the Division of Epidemiology in 1938 and eleven in
1937.
Diphtheria: The record for 1938 shows approximately the
same number of deaths and death rate from diphtheria as for
1937. There were 173 deaths with a rate of 4.9 per 100,000
population compared to 168 deaths with a rate of 4.8 for 1937.
There was a seventy per cent reduction in the mortality rate from
this disease from 1915 to 1932, but no significant decrease in the
rate since. In round numbers, five-sixths of the deaths from
diphtheria occur in children under five years of age. This indi-cates
that vaccination to be most profitable must be done long
before the child becomes of school age.
Influenza and PneuTuonia: There were 2,717 deaths from
pneumonia and 505 deaths from influenza, making a total of 3,222
recorded for 1938. The deaths from these two conditions give a
rate of 91.4 per 100,000 population for 1938 as against a rate of
108.4 for 1937. There were 357 fewer deaths from influenza
during 1938 than for the previous year and 206 fewer from
pneumonias.
Tuberculosis: The death rate from all forms of tuberculosis
was 52.2 in 1938 and 54.8 in 1937. This represents a decrease in
actual numbers of 59. Tuberculosis ranked first among all causes
of death in 1914, but has fallen to eighth place in 1937. In the
past twenty years the mortality rate has declined by approxi-mately
65 per cent.
Of the 1,853 deaths from all forms of tuberculosis, 51.5 per
cent were males and 48.5 per cent females ; 38 per cent were white
and 62 per cent colored. The colored rate of 111.2 for tuber-culosis
is almost four times the white rate of 28.3.
Cancer: Cancer accounted for 1,915 deaths in 1938, giving
a rate of 54.3 against a rate of 54.8 for 1937 and 51.6 for 1936.
Taken over a number of years the general trend of cancer mor-tality
has been upward, but for four years prior to 1937 we had
at least held our own. In 1937 there were 93 more deaths than
in 1936, and three more this year than in 1937.
NoKTH Carolina Bureau of Vital Statistics 11
Pellagra: The 257 deaths from pellagra, representing a
mortality rate of 7.3 per 100,000 population, was a decrease over
the rate of 13.0 for 1937. There has been a downward trend in
mortality from this disease since 1930 with the exception of 1934
and 1937. The peak year for pellagra deaths was 1930 when
1,015 were charged to this disease.
Suicides and Ho7mcides: There were 332 suicides in 1938
and 305 in 1937. The 27 more deaths increased the rate from
8.7 per 100,000 population in 1937 to 9.4 in 1938. There were 52
more homicidal deaths in 1938 than in 1937, the totals being 356
and 408 respectively.
Accidental Causes: Violent and accidental deaths, exclusive
of suicides and homicides, accounted for 2,217 deaths, 267 fewer
than in 1937. Violent and accidental deaths rank sixth among
the principal causes of death. Automobile accidents accounted
for the greatest number of the accidental deaths. There were
906 deaths from all types of automobile accidents in 1938 and
1,056 in 1937. Railroad accidents, exclusive of collisions with
automobiles, caused 89 deaths in 1938 and 99 in 1937.
Maternal Mortality: The diseases of pregnancy, childbirth
and the puerperal state continued to exact a large number of
lives. Deaths from maternal causes and the maternal mortality
rates per 1,000 live births for the past ten years are shown in
Table 2. There were 450 maternal deaths in 1938 to 445 in 1937,
or 5 fewer deaths and 659 more births. This gives a maternal
mortality rate of 5.6 per 1,000 live births, the same as for last
year. There were 240 white, 206 negro and 4 Indian puerperal
deaths, accounting for a death rate of 4.5 per 1,000 live births
for the white and 8.4 for the colored.
Table 2.
—
Total Maternal Deaths and Rates,
1929-1938
Year No. of Deaths Rate
1929 684 8.8
1930 645 8.4
1931 640 8.5
1932 555 7.1
1933 535 7.1
1934 605 7.6
1935 554 7.0
1936 532 7.0
1937 445 5.6
1938 450 5.6
12 Annual Report Nineteen Thibtt-Eight
Albuminuria and eclampsia, as in previous years, accounted
for more of the puerperal deaths than any other single cause.
The second and third greatest offenders were puerperal septicemia
and puerperal hemorrhage, respectively. Albuminuria and
eclampsia with other toxemias of pregnancy account for 155
maternal deaths, which is 34 per cent of all maternal deaths.
Infant Mortality: The total number of deaths under one
year of age was 5,461 or 299 more than occurred in 1937. The
rate for 1938 was 68.3 per 1,000 live births and 65.1 in 1937. Of
the total deaths 3,244 were white and 2,217 colored. This gave a
rate of 59.6 for the white and 87.2 for the colored. The number
of deaths of infants under one year of age and the infant mor-tality
rates per 1,000 live births for the past ten years are shown
in Table 3.
Table 3.
—
Total Infant Deaths and Rates,
1929-1938
Year No. of Deaths Rate
1929 6,112 79.2
1930 6,021 78.4
1931 5,459 73.0
1932 5,173 66.4
1933 4,974 66.0
1934 6,196 77.9
1935 5,407 67.9
1936 5,221 68.4
1937 5,164 65.1
1938 5,461 68.3
Five principal causes of infant mortality accounted for 70 per
cent of all infant deaths. These causes with the number of infant
deaths charged to each were as follows:
Premature birth 1,502
Diarrhea and enteritis 847
Pneumonias 675
Sudden death (cause not specified) 470
Congenital malformations 334
Total 3,828
Of the 5,461 deaths of infants under one year of age 1,238 or
24 per cent died during the first day of life and 2,075 or 38 per
cent within the first week.
North Carolina Bureau of Vital Statistics 13
Registration
Every birth and death occurring in North Carolina should be
recorded with the Bureau of Vital Statistics. To the individual
the registration of a birth occurring in North Carolina makes it
possible always to obtain an official record of the facts surround-ing
his advent into life. The purposes for which certified copies
of birth certificates are requested indicate that their value is be-coming
more generally realized from year to year. Likewise, the
demand for death certificates show that this vital record is essen-tial
in upholding the right of citizens in the establishment of
necessary facts in the closing event of life.
Vital Statistics are of inestimable value to the public health
workers, but without complete registration full reliance cannot be
placed on the data. For health organizations accurate certificates
are essential if our true problems are to be known, if our pro-grams
are to be intelligently planned and we are to ascertain
their effectiveness and if errors in our work are to be detected.
It is, therefore, important that every effort be made to promote
the completeness of our birth and death records.
14 Annual Report Nineteen Thibtt-Eight
-Total Births and Deaths (Exclusive of Stillbirths) With Rate
Per 1,000 Population for the Years 1914-1938 Inclusive
North Carolina Bureau of Vital Statistics 15
1
1
16 Annual Report Nineteen Thirty-Eight
North Carolina Bureau of Vital Statistics 17
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