DEPARTMENT OF COMMERCE BUREAU OF THE CENSUS SAM. L. ROGERS, Director THE FEDERAL REGISTRATION SERVICE OF THE UNITED STATES: ITS DEVELOPMENT, PROBLEMS, AND DEFECTS PREPARED FOR THE SECOND PAN AMERICAN SCIENTIFIC CONGRESS WASHINGTON, DECEMBER 27, 1915, TO JANUARY 8, 1916 BY CRESSY L. WILBUR, M. D. CHIEF STATISTICIAN FOR VITAL STATISTICS OF THE UNITED STATES BUREAU OF THE CENSUS, 1906-1914 IR OF VITAL STATISTICS, NEW YORK STATE DEPARTMENT OF HEALTH, ALBANY WASHINGTON GOVERNMENT PRINTING OFFICE 1916 CONTENTS. Page. Introduction 7 Relation of the Census to vital statistics 7 Extension of the registration area for deaths 9 Growth of registration area for deaths: 1880 to 1915 (cartograms) 10,11 Population, land area, and death rates of the registration area: 1880 to 1914 (table) 12 Growth of registration area for deaths: 1880 to 1914 (diagram) 13 Adequacy of birth and death registration laws: 1915 (cartograms) 16 Use of standard birth and death certificates: 1915 (cartograms) 16 The registration area for births 17 The Model Law 19 Necessary provisions for registration 21 United States standard birth and death certificates 23 T h e standard certificate of death (reduced facsimile) 24 Instructions on standard certificate of death (reduced facsimile).." 24 T h e standard certificate of birth (reduced facsimile) 25 The work of the Federal and state registration services 26 Items returned to the Bureau of the Census on mortality schedules or transcripts: 1850 to 1915 (table) 29 Mortality card used b y the Bureau of the Census: 1914 (reduced facsimile) 32 Problems and defects of the present system of vital statistics 33 When a a d how will the United States obtain complete registration of vital statistics ? 37 Resolution b y Congress 41 Resume 43 Official publications on vital statistics in the United States 49 APPENDICES. APPENDIX 1.—Growth of registration area, population included, b y divisions and states: 1880 to 1915 APPENDIX 2A.—Deaths and death rates from registration sources, b y divisions and states: 1900 to 1914 APPENDIX 2B.—Deaths and death rates from registration and nonregistration sources (the latter very incomplete), b y divisions and states: 1880 to 1900 APPENDIX 3.—Births (exclusive of stillbirths) and birth rates, according to data available (very incomplete), b y divisions and states: 1880 to 1910 APPENDIX 4.—The Model Law: " A bill to provide for the registration of all births and deaths in the state of " (3) 54 66 70 72 77 LETTER OF TRANSMITTAL. DEPARTMENT OF COMMERCE, B U R E A U OF THE CENSUS, Washington, D. C, April 6,1916. SIR: I transmit herewith, by the courtesy of the Secretary General of the Second P a n American Scientific Congress, for printing in pamphlet form, a paper entitled " T h e Federal Registration Service of the United States: Its Development, Problems, and Defects," by Cressy L. Wilbur, M. D., who was chief statistician for vital statistics of the United States Bureau of the Census from 1906 to 1914, and is at present Director of Vital Statistics, New York State Department of Health, Albany. To Dr. Wilbur, more than to any other person, credit is due for the progress made in vital statistics legislation during the past fifteen years. This paper was prepared at my request for presentation at the Second P a n American Scientific Congress, held in Washington, December 27, 1915, to January 8, 1916. Respectfully, flaw. & rycravrt Director of the Census. To Hon. WILLIAM C. R E D F I E L D , Secretary of Commerce. (5) THE FEDERAL REGISTRATION SERVICE OF THE UNITED STATES: ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. INTRODUCTION. The Federal service of the United States in connection with the registration of vital statistics is the Bureau of the Census. Its work relates entirely at present to the collection of statistics of deaths by means of state registration services, supplemented by municipal returns from certain cities in states which do not yet possess satisfactory state laws. Attempts have been made for the regular collection of births, but the birth registration area is not yet organized. 1 Two special reports on marriage and divorce, each covering a period of 20 years, have been made, but returns of marriages and divorces are not regularly collected by the Government. Returns of mortality and sickness are also made for sanitary purposes to the United States Public Health Service, and that bureau has aided in the efforts made for better registration and endeavored especially to promote the adoption of laws for the collection of morbidity statistics. The Children's Bureau of the Department of Labor also, since its organization, has taken an active part in urging the adoption and more thorough enforcement of birth registration laws. To this time, however, the principal work in this connection has devolved upon the Census, and the long series of reports upon mortality statistics and other publications devoted to the propaganda for better vital statistics and the adoption of uniform and comparable methods of collection and presentation of data give the results of the efforts which have been made to perform this duty. The present paper could not have been prepared without the aid of the Bureau of the Census. I desire to acknowledge my obligation to the Director, Hon. Sam. L. Rogers, for the opportunity, and to Mr. Richard C. Lappin, my successor as chief statistician for vital statistics, for the valuable tables and statements supplied. RELATION OF THE CENSUS TO VITAL STATISTICS. Regular decennial censuses of population have been taken in the United States from the First Census (1790) to the Thirteenth Census (1910). They are provided for by the Constitution (Art. I, sec. 2) as a necessary means of ascertaining the number of inhabitants for the 1 The Director of the Census has recently inaugurated the collection annually of birth statistics within an area comprising the states of Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, Pennsylvania, Michigan, and Minnesota, and the District of Columbia. This area, although it represents barely 10 per cent of the territorial extent of continental United States, has a population of approximately 31,150,000, or 31 per cent of the total for the country. The statistics will cover the calendar year 1915. (7) 8 THE FEDERAL REGISTRATION SERVICE. purpose of apportionment of Representatives in Congress and direct taxes. The United States was the first country in the world to establish a regular system of census-taking as an organic portion of its system of government, thus affording that indispensable basis of a full knowledge of population which may serve as a foundation for the vital statistics of the future. No nation at the time when the Constitution was adopted had provided for the registration of vital statistics as a national undertaking. Records of births, marriages, and deaths were maintained—chiefly as church records—but the development of vital statistics as an essential part of political knowledge and more especially as the corner stone of public health administration was not to appear until the following century was well advanced. Indeed, at that time, there was little conception of such a thing as public health or preventive medicine. The sanitary uses and necessity of vital statistics were unknown until the coming of the present " sanitary era," largely founded upon the results of the English registration law of 1837, which called attention to the importance of exact information on this subject. There was not the remotest idea in the minds of the framers of the Constitution as to the necessity of a complete record of vital statistics for the purposes of Federal administration. Hence there appears to be no constitutional authority for the direct collection of births and deaths by the Federal Government except in the areas which are entirely under its control, e. g., the District of Columbia. The early censuses were confined closely to the enumeration of population for political purposes. At the Seventh Census, which was taken in 1850, many additional inquiries were undertaken, among them the enumeration of deaths. I t was well understood, or very soon discovered, that the method proposed for obtaining this information, namely, by an enumeration of deaths at the same time that the population was enumerated, would fail to be effective. Nevertheless, the inclusion of the subject of vital statistics in the Federal census was of great importance, although less so for the value of the statistical data collected than for the recognition of the inquiry as of national interest and significance. The work thus undertaken was continued along substantially the same lines at the censuses of 1860, 1870, 1880, 1890, and 1900, and was not finally done away with until the Thirteenth Census (1910), when it was decided to dispense entirely with the futile attempt to enumerate deaths, and to rely solely upon the results of actual registration. Here it may be well to indicate the sharp distinction which exists between the ordinary census method of enumeration and the method of registration, by which only can vital data be satisfactorily collected. Existing facts, as for example the status of the population at a certain date, can readily be ascertained by a count conducted on that date or extending through a brief interval of time. On the ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 9 other hand, events succeeding one another in time can only be completely and surely recorded by means of a system of registration in constant operation. The lapse of time, even a comparatively short interval, dims the recollection of past events. When the attempt is made to recall the births, deaths, or marriages for a year past and to set down the details, it is found that a considerable number fail to be recorded; and the details concerning those recorded are less trustworthy than if the records had been made immediately after the occurrence of the events. To obtain accurate vital statistics, therefore, requires continuous registration. The establishment of such registration was quite out of the power or scope of the decennial census enumeration, even if authority were available therefor. Hence it was necessary to wait until the states, acting individually, should pass and enforce the proper laws for this purpose. The collection and utilization of data thus registered under state (and municipal) laws mark the establishment of what is known as the "registration area," or more properly the "registration area for deaths," in 1880. The history of the connection of the Government with the subject is mainly a study of the expansion of that area from its original content, only about one-sixth (17 per cent) of the total population of the United States in 1880, until it now embraces, in 1915, over two-thirds (66.9 per cent) of the total population. And the hope of the future is its rapid extension, not only for deaths—to which the registration area solely relates at present—but also for births, until the entire country shall have attained a condition of 100 per cent efficiency in this respect. EXTENSION OF THE REGISTRATION AREA FOR DEATHS. The growth of the registration area for deaths is clearly shown in the diagram on page 13, in which the percentages of population and also the percentages of land area included in the area as compared with the total population and land area of the United States are displayed from 1880 to the present time. The geographic distribution of the registration states is shown in the series of cartograms following for the years 1880, 1890, 1900, 1910, and 1915. Full details of the population, by geographic divisions and states, may be found in the detailed tables of the appendices, 1 together with death rates 2 and birth rates, 3 according to the best data available, for registration and nonregistration states for various years. The rates for nonregistration states are given solely for the purpose of showing the general relation of the returns to population. They are not properly to be compared with rates based upon approximately complete returns from registration sources. 1 2 3 Appendix 1, p . 54. Appendix 2A, p . 66, and Appendix 2B, p . 70. Appendix 3, p . 72. GROWTH OF R E G I S T R A T I O N AREA F O R D E A T H S : 1880 TO 1915. [ In addition to the registration states (shaded in the cartograms) the registration area includes certain cities in nonregistration states.] 12 T H E FEDERAL REGISTRATION SERVICE. POPULATION, LAND AREA, AND DEATH RATES 1880 TO 1914. OF T H E REGISTRATION AREA: REGISTRATION AREA FOR D E A T H S . POPULATION A N D LAND A R E A OF T H E UNITED STATES. Population. L a n d area. D e a t h s from a l l causes. 1 YEAB. L a n d area • Population. (square miles). Calendar Calendar Calendar Calendar Calendar Calendar Calendar Calendar Calendar Calendar year year year year year year year year year year 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 98,781,324 97,163,330 95,545,336 93,927,342 92,309,348 90,691,354 89,073,360 87,455,366 85,837,372 84,219,378 82,601,384 C a l e n d a r y e a r 1903 80,983,390 79,365,396 C a l e n d a r y e a r 1901 77,747,402 C a l e n d a r y e a r 1900. . . . ^75,994,575 Census y e a r 1900 3 Census y e a r 1890 3 62,622,250 Census y e a r 1880 3 . . . 50,155,783 2 2,973,890 2 2,973,890 2 2,973,890 2 2,973,890 2 2,973,890 2,974,159 2,974,159 2,974,159 2,974,159 2,974,159 | 2,974,159 2,974,159 2,974,159 2,974,159 2,974,159 2,973,965 2,973,965 Number. Per cent of total. Square miles. Per cent of total. 65,989,295 63,298,718 60,427,247 59,275,977 53,843,896 50,870,518 46,789,913 43,016,990 41,983,419 34,052,201 33,345,163 32,701,083 32,029,815 31,370,952 f30,765,618 \28,807,269 19,659,440 8,538,366 66.8 65.1 63.2 63.1 58.3 56.1 52.5 49.2 48.9 40.4 40.4 40.4 40.4 40.3 40.5 37.9 31.4 17.0 1,228,644 1,147,039 1,106,777 1,106,734 997,978 765,738 725,117 603,151 603,066 212,744 212,744 212,762 212,762 212,770 212,621 176,878 90,695 16,481 41.3 38.6 37.2 37.2 33.6 25.7 24.4 20.3 20.3 7.2 7.2 7.2 7.2 7.2 7.1 5.9 3.0 0.6 Number. 898,059 890,848 838,251 839,284 805,412 732,538 691,574 687,034 658,105 545,533 551,354 524,415 508,640 518,207 539,939 512,669 386,212 169,453 Rate per 1,000 population. 13.6 14.1 13.9 14.2 15.0 14.4 14.8 16.0 15.7 16.0 16.5 16.0 15.9 16.5 17.6 17.8 19.6 19.8 i Exclusive of stillbirths. 2 Net reduction of 269 square miles as compared with area stated by census of 1900, due to drainage of lakes and swamps in Illinois and Indiana, building of the Roosevelt and Laguna Reservoirs, and overflow of the Colorado River into the Salton Sea in California. »Ending May 31. I t is observed that the registration area increased considerably in population at each decennial census from 1880 to 1900 and that the proportion of land area increased even more rapidly (from 0.6 per cent to 5.9 per cent), although still remaining only an insignificant representative of the entire expanse of the United States. A slight increase is shown in passing from the census year 1900 to the calendar year 1900, which is due to the inclusion of Indiana for the latter year. The proportion of population and land area remained practically constant from 1900 to 1905 (about 40 per cent and 7 per cent, respectively), since which time additions are shown for nearly every year. The Tenth Census (1880) marked the establishment of t h e registration area for deaths. I t included only two states (Massachusetts and New Jersey), the District of Columbia, and 19 cities. The aggregate population was only 8,538,366, or 17 per cent of the total population of the United States. The number of deaths returned as transcripts of registration records was 169,453, corresponding t o a, death rate of 19.8 per 1,000 population, while the deaths obtained b y enumeration from the nonregistration area numbered 562,564, or 13.5 per 1,000 population. The latter figures are considerably increased by the efforts of Dr. John S. Billings to interest the medical profession of the country in the importance of complete returns and b y sending ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 13 individual schedules to all physicians, the results of which were employed to supplement the enumerators' returns. Even so, however, the figures were far below the truth, although it is probable that the results were better than those obtained at later censuses. The registration returns were, of course, far too restricted in the area and character of population included to be considered at all representative of the general mortality of G R O W T H OF REGISTRATION A R E A FOR D E A T H S : the country. 1880 TO 1914. The E l e v e n t h Census a o e o ao (1890) indicated a con1014 77777? 777777? siderable growth of regis777777/V/}/7/\ 3 tration t e r r i t o r y . The 1913 777777,77777? 7777?7?77777X states of C o n n e c t i c u t , 777Z\ Delaware, New Hampshire, 1912 777777,777777.Z777777, New York, Rhode Island, 191 1 V/7/77,777777,777777,7777 and Vermont, t o g e t h e r I9IO 777777?777777 777777,7A with many cities in nonregistration states, w e r e 1909 777777?777777,777X added, raising the percent- 1908 77777? 777777,m age of t o t a l population 1907 777777.777777? | i n c l u d e d to 31.4. The New England group was 1906 777777,Z77777? 1 now complete with the ex- 1905 ?zm ception of Maine, 86.4 per 1904 cent of the total population 7zm b^ing i n c l u d e d . The 1903 ZZZA Middle Atlantic division 1902 VZZA came next, New York and N e w J e r s e y b u t not 1901 7ZZA Pennsylvania, with a per- 1900 7777X centage of 71.5. No other 1900* 777A geographic division had as much as one-fourth of its 1890* population included except 1880* the Pacific (25.6 per cent). The total number of deaths W7777?i obtained from registration sources was 386,212, or 19.6 per 1,000 population, while the enumerators' returns furnished 455,207, or 10.6 per 1,000 of population represented. The latter figure would seem to indicate that the enumeration of deaths in nonregistration territory was considerably more defective than at the preceding census, although this m a y be due in part to the transfer of registration states and cities from the nonregistration to the registration area, assuming t h a t enumerators may to some extent have supplemented their returns from registration records available. I t is, of course, possible that the year 1890 > i PER CENT O 40 I POPULATION I O 7 LAND AREA JtCENAUS YEAR 14 T H E FEDERAL REGISTRATION SERVICE. may actually have been a year of lower mortality than 1880, b u t the known imperfections of the returns under the methods then available cast doubt upon all comparisons. For the Twelfth Census (1900), the last for which mortality statistics were collected from both registration and nonregistration sources, the most notable feature is the beginning of effective registration in the West. Michigan was added for the census year ending May 31, 1900, and Maine completed the roll of the New England states. The aggregate population embraced for the census year was 28,807,269, or 37.9 per cent of the total. One state (Delaware) included in the previous census was omitted, it being found that the completeness of registration was below the standard. Beginning with 1900, the reports of the permanent Census Bureau, which was constituted by act of Congress approved March 6, 1902, have related to calendar years. For the year 1900, as shown in the cartogram, Indiana as well as Michigan is included in the Middle West—the first outposts of the rapid extension of better registration of vital statistics which followed in the succeeding decades. Heretofore there has been no central office of the Federal Government constantly engaged in the work. The organization of the Census Office was entirely disrupted in the interdecennial intervals, a solitary census clerk being left in charge of the records in the Department of the Interior. When the work of each decennial enumeration was undertaken, the pressing requirements attending the sudden organization of a vast force precluded the effort to promote legislation and to improve methods. Such work was begun at once, however, by Mr. William A. King, chief statistician for vital statistics, upon the passage of the permanent census law, and the result is seen in the large additions to the registration area which have been made since that time. For the census year 1900 there were returned 512,669 deaths from registration records, nearly as many as those received from nonregistration sources (526,425). The death rates were 17.8 and 11.2 per 1,000, respectively; the latter is, of course, far too low, although it is probable t h a t the enumeration was a little better than in 1890. The returns for the calendar year 1900, which were exclusively from registration records and in part overlapping with those of the census year, numbered 539,939, thus exceeding the maximum ever obtained by enumeration. No enumeration of deaths has been conducted since 1900 and, I trust, the method has forever gone into disuse except perhaps as a check upon the completeness of registration. The Thirteenth Census (1910) omitted the mortality schedules from the blanks sent to enumerators and relied entirely upon the annual reports based upon transcripts of deaths from the registration area. As shown by the cartogram for the calendar year 1910, ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 15 this area has widely expanded. Penns}dvania (added for 1906) and Ohio (1909) now linked the registration states of the East with those of the Middle West; Wisconsin (1908) and Minnesota (1910) extended it to the great Northwest beyond the Great Lakes; Colorado (1906), Montana (1910), and Utah (1910) contributed data from the Eocky Mountain region; and California (1906) and Washington (1908) covered the long line of the Pacific coast with the exception of Oregon, which state has, during the present year (1915) adopted the Model Law. An important addition also was Maryland (1906), the first state with a considerable proportion of colored population to be included. The total population of the registration area for 1910 was 53,843,896, or nearly three-fifths (58.3 per cent) of the entire population of the country. The total number of deaths returned for the year was 805,412, or 15 per 1,000. The registration area, of which the population in 1908 comprised for the first time more than half (52.5 per cent) of the total inhabitants of the country, is becoming more and more worthy of acceptance as expressing the general condition of the Nation through its vital statistics. Progress since the last census has continued, as shown by the cartogram (p. 11) giving the states included for 1915. Actual accomplishment has begun in the South, that very important section of the country heretofore unrepresented save by municipal statistics. Kentucky and Missouri (both added for 1911), Virginia (1913), and Kansas (1914) make good a line of state registration which extends, with the exception of the slight break in Nevada, entirely across the continent from the Virginia capes to the Golden Gate. North Carolina has also been represented in the registration area since 1910 by returns derived from municipalities over 1,000 population under a state law, which has since been extended (1916) to include the entire state. The condition of the registration area for deaths, encouraging as it is in comparison with former years, is still far from satisfactory. Almost the entire South, with the exception of Kentucky and Virginia, is still unrepresented by complete state returns. The quality of the returns, moreover, from certain of the states recently admitted to the registration area is still open to some question. Phenomenally low death rates suggest that the full standard of efficiency may not have been reached or perhaps maintained. Such as it is, however, it stands for a vast deal of enthusiastic effort. Many pamphlets calling attention to the importance of vital statistics and to the necessary methods for obtaining satisfactory registration have been prepared and distributed by the Bureau of the Census and by the American Medical Association, which organization has taken an especially active part in the revision and recommendation of the "Model L a w / 7 a draft of legislation which has.been largely instrumental in extending the area of satisfactory registration. ADEQUACY OF BIRTH AND DEATH REGISTRATION LAWS. ^ W j ADEQUATE LAWS |%%/flAOEQUATE LAWS UNDER TEST AMENDMENTS OR NEW LAWS NEEDED 1 1' * \ \ USE OF STANDARD BIRTH AND DEATH CERTIFICATES. OF THE STANDARD CERTIFICATE OF DEATH: 1813 |2Z2ST*TES || us,NO STANDARD CERTII | STATES NOT USING STANDARD CERTIFICATE D £ £ 2 STATES USING STANDARD CERTIFICATE | | STATES NOT USING STANDARD CERTIFICATE ITS DEVELOPMENT, PEOBLEMS, AND DEFECTS. 17 In the cartograms on the opposite page, which should be examined in connection with t h a t showing the actual registration states in 1915, those states are indicated which appear to have adopted adequate laws; t h a t is to say, laws which, if reasonably provided with funds for execution and with competent administrators, should speedily accomplish excellent results and bring the states into the registration area. The Model Law has recently been adopted, either in full or as rules and regulations under a briefer general law, in almost the entire southeastern portion of the country, excepting only Alabama. The last two states in the country which, up to 1914, possessed no vitalstatistics laws for the state as a whole were Georgia and South Carolina. Both adopted laws last year (1914). The South Carolina law was not signed by the governor until September 1, 1914, and went into effect January 1, 1915. I t has already given most encouraging results. The Georgia law unfortunately carried no appropriation, so that this deficiency will have to be supplied before it goes into actual effect. Florida adopted the complete Model Law this year (1915) and is putting it into execution. The only general section of the country now remaining without adequate legislation is the Southwest, consisting of the four states of Arizona, New Mexico, Oklahoma, and Texas. All these states have laws involving the attempt to collect vital statistics through county officials, a method which has failed to give satisfactory results. The condition of the country with respect to the enactment of satisfactory birth registration laws is apparently about the same as that for deaths. The actual condition of birth registration is probably, however, considerably behind that of death registration, depending upon the great difficulty which is found to exist in actual practice in securing complete returns of births even under good laws in our oldest registration states. THE REGISTRATION AREA FOR BIRTHS. The " registration area for births " is as yet nonexistent. 1 We have seen in the preceding section and in the cartograms showing the existence of satisfactory laws for the registration of deaths and births that a large number of the states have supposedly adequate laws for birth registration. These laws, however, are seldom, if ever, thoroughly enforced. Indeed, we may employ even more definite language and say that a birth registration law has never been thoroughly enforced on a state-wide basis in the history of the United States—with perhaps the single exception of Pennsylvania, in which state hundreds of actual prosecutions have been directed by the state authorities with good results. In practically all other states the enforcement of birth registration laws, beyond the point of gentle remonstrance, is the merest farce. No physician with present or 2 30026°—16 2 See note on p . 7. 18 THE FEDERAL REGISTRATION SERVICE. potential influence with political powers need ever be fined or seriously embarrassed in the United States for failure or neglect to perform his duty with respect to the filing of birth certificates. The few exceptions confirm the general rule. Midwives can be prosecuted successfully and are, as a class, more inclined to obey the law. The subject of births was included with that of deaths in the reports on vital statistics prepared by the Census Office for the Tenth, Eleventh, and Twelfth Censuses (1880, 1890, 1900), but only a brief discussion of the subject was given in the chapters allotted thereto. No attempt was made to enumerate births, but the number of births was taken as the sum of the infants enumerated in the census of population under 1 year of age and the number of infants born and dying during the census year. Unsatisfactory as this method evidently is, it gave better results for the great majority of states than were available from actual birth registration. The "total b i r t h s " were thus: I n 1880, 1,552,297, or 30.9 per 1,000; in 1890, 1,670,821, or 26.7 per 1,000; in 1900, 2,053,386, or 27 per 1,000. A continuance of the method applied to 1910, with perhaps too liberal an allowance for the " b o r n and died" of 10 per cent of the infants under 1 year of age as enumerated, yielded an estimated " total b i r t h s " of 2,439,076, or 26.5 per 1,000, for the United States. I am inclined to think that this is well within the limit and t h a t previous rates, especially t h a t for 1890, were perhaps too low.1 We have in the United States some two and one-half millions of babies born every year, or rather this was the approximate estimate for the year 1910. For the calendar year 1908, with a view to ascertaining the exact condition of birth registration and the feasibility of establishing a permanent birth registration area, the Bureau of the Census undertook the collection, from every possible official source, of all births registered in the United States. Transcripts were received from all states having returns to the central registration office, from all cities with birth registration in other states, and from county officials in Illinois where the returns were then deposited in the offices of the county clerks. I remember that the collection was entirely exhaustive and complete so far as state or local records were available except for a certain county of Illinois; the clerk of which refused to make copies for the Government except at an exorbitant rate. •The total, however, being all registered births which could be found in the entire country, was only 1,271,952, or 19.8 per 1,000 population. (That is to say, 19.8 per 1,000 of the population from which returns were received; for the entire United States the ratio was only 14.3 per 1,000.) The results showed t h a t only about one-half of the births that occur each year in the United States are recorded. Many Appendix 3, p. 72. ITS DEVELOPMENT, PEOBLEMS, AND DEFECTS. 19 states had at that time no state laws and the degree of enforcement, even in some of our largest cities, was shamefully lax. The transcripts of births were continued for 1909 and 1910 for certain areas in which the birth registration seemed to be most efficient, and would have been regularly received and published at present were it not for the necessary discontinuance of the work due to the pressure of work incident to the Thirteenth Census. The 11 provisional birth registration area" consisted, for the years 1909 and 1910, of the following states and cities: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, Pennsylvania, Michigan, New York City, and the District of Columbia (city of Washington). The birth rates, based on the reporting population of these areas, were 24.9 for 1909 and 25.4 for 1910. I t is earnestly to be desired that the regular collection of transcripts of births should be resumed and that a compilation of the same be published annually with the mortality statistics. The collection should be restricted to areas having approximately complete registration and in which the laws are enforced, and careful investigation should be made before admitting states to the permanent birth registration area when it shall be established. Experience has shown, I believe, that it is not good policy to admit a doubtful state with the expectation that conditions will improve. THE MODEL LAW. As the satisfactory collection of vital statistics in the United States is primarily dependent upon the operation of state laws, thus requiring independent but harmonious and effective legislative action in 48 states, it is evident that to accomplish practical results in extending the registration area some general plan of procedure must be chosen. Many worthless laws for registering or attempting to register births and deaths have been adopted by various states. Often the plan of enumerating births and deaths at the end of the year has been selected—a plan proved to be inadequate by the repeated trials of the Census and by other experience. Or the favorite "county system," namely, the attempt to collect returns by or through county officials, would be chosen. The latter, indeed, is a very natural suggestion from the general process of government in this country, especially in the West and South where township organization does not prevail. Other laws were deficient in provisions for central control and enforcement of law, proper compensation to local registrars, and uniform and complete data on the certificates or other forms provided. There was no general directive influence in recommending proper legislation, and accordingly a large part of the efforts made by public health workers and others for the enactment of better registration laws was wasted. 20 THE FEDEEAL REGISTRATION SERVICE. The beginning of the reform which resulted in the present Model Law which is now so extensively in force in this country may be referred to the following resolution which was presented at the meeting of the American Public Health Association, Denver, 1895: Resolved, That a committee be appointed to prepare a draft of a registration law (or to formulate the principles to which a registration law should conform) suitable for adoption by states not having at present an accurate system of registration of births and deaths. The resolution was not adopted by the association, but the committee on vital statistics in which it originated continued to occupy itself with the subject, and at Buffalo, 1900, reported: The development of the registration idea has in different areas followed only a general direction and presents many variations. Your committee proposed, therefore, to formulate the correct outlines of a registration law, emphasizing the essential features and indicating, in the order of their importance, those data which are demanded in the legal and private aspects of registration. The record of death has been generally recognized as of first importance in registration, and your committee has therefore set as its second task to prepare and present at the next or a future meeting a model form of a record of death. From this decision resulted the Model Law and the standard certificate of death, followed by the standard certificate of birth. These have played an important part in the development of American registration of vital statistics and in the procuring of uniform and thoroughly comparable returns from registration areas. The successful outcome was largely dependent upon the practical cooperation of the United States Census Office, which was organized as the permanent Bureau of the Census in 1902. Mr. William A. King, chief statistician for vital statistics, had prepared a circular ("Circular No. 71") in which he related the efforts of the Census Office in the preparatory work of the Twelfth Census (1900) to bring about greater uniformity in methods and to promote more effective legislation, from which the following extract is taken : A complete collection was then made of existing state laws and city ordinances, together with the forms in use and the rules, regulations, and instructions affecting the practice of collecting, recording, and preserving the records. This material was to be used in the preparation of an outline plan for a complete system of registration, including suggestions for necessary legislation and methods of treating the records so as to secure the maximum benefit from them. As this plan was about to be put into effect it was learned that the committee on "Demography and Statistics in their Sanitary Relation" of the American Public Health Association had, at their recent meeting, concluded to take u p the same subject, and it was immediately decided that the best results could be accomplished b y acting in concert with the committee, which is composed of prominent registration officials of extensive practical experience and capable of treating the subject in the most comprehensive and effective manner. The committee's outline of the "Essential requirements of a law for the registration of deaths and the collection of mortality statis- ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 21 tics'' was included in Census Circular No. 71 and subsequently reprinted in Census Pamphlet No. 100, Legislative Requirements for Registration of Vital Statistics, 1903, the first of a series of pamphlets devoted to the extension of registration. The following list of "necessary provisions/' extended to cover the registration of births, is taken from a later pamphlet—No. 108, Legal Importance of Registration of Births and Deaths: NECESSARY PROVISIONS FOR THE REGISTRATION OF 1. Deaths must be registered immediately after their occurrence. 2. Certificates of death should be required. 1. Births must be registered immediately after their occurrence. 2. Certificates of birth should be required. 3. BURIAL or removal PERMITS are essen- 3. SOME CHECK is necessary to secure tial to t h e enforcement of t h e law. Efficient local registrars are necessary. The responsibility for reporting deaths to t h e local registrars should b e fixed. The central registration office should have full control of t h e local machinery, and its rules should have t h e effect of law. The transmission and preservation of returns should be provided for. Penalties should be provided and enforced. enforcement of t h e law. 4. Efficient local registrars are necessary. 5. T h e responsibility for reporting births to t h e local registrars should be fixed. 6. T h e central registration office should have full control of the local machinery, and its rules should have t h e effect of law. 7. T h e transmission and preservation of returns should be provided for. 8. Penalties should be provided and enforced. 4. 5. 6. 7. 8. All laws recommended by the Bureau of the Census since 1901, many of which are now in successful operation, have been drafted on the basis of these essential principles. I t was not thought feasible, in the original report of the committee, to prepare a bill for general adoption, but the demand for such a bill was insistent, and the early census pamphlet (No. 100) contained a "specimen form of law for the registration of deaths." This was followed in Census Pamphlet No. 104, Registration of Births and Deaths—Drafts of Laws and Forms of Certificates, by a draft of a law for the registration of births and deaths—the Model Law in its original form—together with a separate bill for births and a condensed form of law for both births and deaths. The first practical test of the model bill was in the preparation of a bill for introduction before the Pennsylvania Legislature of 1905. Pennsylvania had endeavored for many years to obtain effective registration of vital statistics, a law for that purpose having been passed as early as 1851. The Model Law was adopted in 1905, and the results were such as to warrant the admission of the state into 22 THE FEDERAL REGISTRATION SERVICE. the registration area for the following year, 1906. This gave a great impetus to the movement and set the seal of practical achievement upon the legislation recommended. The Model Law,, or model bill, as it should be called, when proposed for adoption, is by no means an ideal or perfect measure. I t has many imperfections and is still undergoing a process of revision in connection with new or amendatory legislation in various states. Thus, for example, the revised California law passed this year has an important method or legal procedure for placing upon record births not properly recorded at the time fixed by law. The new Illinois law, also passed this year (1915), has several valuable additions. I n time all new features of value will be incorporated in the standard draft. As it is, however, it has undergone several distinct and thorough processes of revision, the last being by a committee of the Public Health Council of the American Medical Association at Washington, 1912, in cooperation with committees or representatives of the American Public Health Association, the American Bar Association, the Children's Bureau, and the Bureau of the Census. The revised draft is published in a pamphlet, " W h y Should Births and Deaths Be Registered V by the American Medical Association, of which many thousands of copies, as well as of previous editions, have been distributed by the association and by the Bureau of the Census. 1 The cardinal principles of the Model Law are two—first, the rigid requirement of burial or removal permits; and, second, prompt direct returns of the original birth and death certificates from the local registrars to the state registration office. The returns are made monthly, on a specified day of each month (4th, 5th, or 10th in different states), and include all certificates of births and deaths which occurred in the preceding calendar month. If no births or deaths occurred, the local registrar makes a postal-card report to that effect. The central office is thus in direct touch with all the local registrars of the state, can check carelessness or neglect promptly, and can utilize the monthly returns for. valuable compilations of current mortality. Local registrars are paid by the county treasurers on warrant of the state registrar, but only for complete certificates promptly filed in accordance with law. They are also paid for prompt and correct reports of no births and no deaths. Local registrars are required to report violations of law coming to their attention and the state registrar is charged with the uniform and thorough enforcement of the law throughout the state, with the assistance of county prosecuting attorneys and of the attorney general, if necessary. Provision is made for the use of the standard birth and death certificates and for the compilation of the data collected in the form of an annual report. 1 Appendix 4, p. 77. ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 23 UNITED STATES STANDARD BIRTH AND DEATH CERTIFICATES. I n order that statistics shall be thoroughly comparable, the primary schedules upon which the data are collected must be uniform. For vital statistics these are the original certificates of birth and of death. A great variety of blanks were used by the various states and cities and in many instances the essential information required for the Federal compilation was either not given or perhaps was given in a form somewhat different from that desired. Despite efforts to secure a greater degree of uniformity, at the time of the Twelfth Census (1900) no two states and but few cities in the country employed precisely the same forms of birth and death certificates. The committee which formulated the essential principles of the Model Law also drafted a model death certificate, which was adopted at once by the states of Michigan, Indiana, and New York in 1901 and approved by the Bureau of the Census, by which it was at once p u t into use as the form for transcripts of deaths made in the various state and city offices. I t was rapidly accepted by a large number of states and in 1909, after a thorough revision, was adopted by the Section on Vital Statistics of the American Public Health Association at the meeting at Richmond as the Revised United States Standard Certificate of Death, and its use recommended to all American registration offices as a "Rule of Statistical Practice." The form of the blank, which measures 7\ by 8J inches, may be seen on page 24 in reduced facsimile. At the present time (1915) the Standard Certificate of Death has been adopted or approved by nearly all the states, both registration and nonregistration, of the country, representing 92.6 per cent of the population. Exceptions are some of the older registration states— Connecticut, Maine, New Hampshire, and Rhode Island, the District of Columbia, and the nonregistration states of Alabama, New Mexico, and West Virginia. This important object of uniformity in the primary schedule of deaths has thus practically been attained. Provision is made for improvements in the form by means of a regular decennial revision by the Section on Vital Statistics of the American Public Health Association. An important feature of the standard death certificate consists of the instructions found upon the reverse side. These are designed to promote greater precision in the statement of occupation (and industry) and of cause of death, and may be supplemented by the more detailed directions contained in the Physicians' Pocket Reference to the International List of Causes of Death, published by the Bureau of the Census. 24 T H E FEDERAL REGISTRATION" SERVICE. T H E STANDARD C E R T I F I C A T E O F D E A T H . DEPARTMENT O F COMMERCE 1 PLACE O F DEATH i County ^ STANDARD CERTIFICATE OF DEATH State of - Village . [If death occurred It ... St.; City 2 Ward) g l v e \% N A M E ,„,,„,} • of street and numberJ FULL NAME.... P E R S O N A L A N D STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH W OATE OP DEATH l COLOR OR RACE I5 KlOOVKEO, W DIVORCf i T H E R E B Y CERTIFY, T h a t I attended d e c e a s e d from 6 DATE OF'BIRTH , 1 9 1 — , to 5: If LESS tti 1 day, hi i 8 OCCUPATION (a) Trade, profession, or particular kind of work.... that Hast taw h , -, 1 9 1 — , alive o and t h a t death occurred, o n t h e d a t e stated a b o v e , a t . . . T h e CAUSE OF D E A T H * wa« a« followai >roptoyer! i '«§!£TiipJb*£!L \1I5J Contributory— .. (Duration). yrs, mos. da. 1 BIRTHPLACE OF FATHER <8Ud» or country) 3 BIRTHPLACE OF MOTHER (SttU or country) u 5 «1 i ill , M. D. 18 LENGTH OF RESIDENCE (FOR HOSPITALS, lN»TrTUT)ON8, TRANENT*. OR RECENT fttaioeirra) At place In the of death yrs mos. „ d « t State yrs _ mos, 4*. Where was disease contracted, If not at place of death 1 _ former or 4THE ABOVE 18 THUS TO THE BEST OF MY KNOWLEDGE. S# * its W PLACE OF BURIAL O R REMOVAL DATE O F BURIAL •a J *» BE7ISED UNITED STATES STANDARD CERTIHCATEOFDEATS (Approved b y U . 8. Census and American Publio Health Association] 1 .' Statement of occupation.—Precise statement of occupation is very important, so t h a t t h e relative healthfulness of various pursuits can bo known. T h e question applies to each and evgry person, irrespective of age. For many occupations a single word or term on t h e first line will b e sufficient, e. g., Farmer or Planter, Physician, Compositor, Architect, Locomotive engineer, Civil engineer, Statixmary fireman, etc. B u t i n m a n y cases, especially i n industrial employments, i t i s necessary to know (a) t h e kind of work and also (6) t h e nature of t h e business or industry, and therefore a n additional lino is provided for t h e latter statement; i t should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (6) Automobile factory T h e material worked on m a y form p a r t of t h e second statement. Never return. "Laborer," " F o r e m a n , " "Manager," " P e a l e r , " etc., without more precise specification, as Day laborer, Farm laborer, Laborer—Coal mine, e t c . Women a t home, who are engaged i n t h e duties of t h e household only (not paid Housekeepers -who receive a definite salary), m a y be entered as Housewife, Homework, or At home, and children, not gainfully employed, aa At tchool or At home. Care should b e taken to report specifically t h e occupations of persons engaged i n domestic Bervice for wages, as Servant, Cook, Housemaid, e t c . If t h e occupation h a s been changed or given u p on account of t h e DISEASE CAU8INO DEATU, state occupation at beginning of illness. If retired from business, t h a t fact m a y b e indicated t h u s : Farmer (retired, 6 yn.). For persons who have no occupation whatever, write None. Statement of cause of death.—Name, first, t h e DISEASE CAUSJNO DEATH (the primary affection with respect to time and causation), using always t h e same accepted term ior t h e same disease. Examples: Cerebrospinal fever (the only definite synonym is " E p i d e m i c cerebrospinal meningitis"); Diphtheria (avoid use of " C r o u p " ) ; Typhoidj"ever NDERTAKER (never report " T y p h o i d p n e u m o n i a " ) ; Lobar pneumonia; Bronchopneumonia ( " P n e u m o n i a , " unqualified, is indefinite); Tuberculosis of lungs, meninges, peritoneum, etc., Carcinoma, Sarcoma, etc., of (name origin; "Canc e r " is less definite; avoid use of " T u m o r " for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. T h e contributory (secondary or intercurrent) affection need n o t be stated unless important. Example: Measles (disease causing death), 29 ds.; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as " A s t h e n i a , " " A n e m i a " (merely symptomatic), " A t r o p h y , " "Collapse," " C o m a , " "Convulsions," " D e b i l i t y " ("Congenital," " S e n i l e , " etc.), " D r o p s y , " " E x h a u s t i o n , " " H e a r t failure," " H e m o r r h a g e , " " I n a n i tion," "Marasmus," "Old age," "Shock," "Uremia," "Weakness," etc., •wb.eri a definite disease can. b e ascertained as t h e cause. Always qualify all diseases resulting from childbirth or miscarriage, as " P U E R P E R A L septicemia," " P U E R P E R A L peritonitis," etc. State cause for which surgical operation was undertaken. For VIOLENT DEATHS shite MEANS of INJURY a n d qualify as ACCIDENTAL, SUICIDAL, or HOMICIDAL, or as probably such, if impossible to determine definitely. Examples; Accidental droicning; Struck by railway train—accident; Revolver wound of head— 'homicide; Poisoned by carbolic acid—probably suicide. T h e nature of the injury, as fracture of skull, and consequences (e. g., sepsis, tetanus) may bo stated under t h e head of "Contributory." (Recommendations on etatement of cause of death approved,by Committee on Nomenclature of t h e American Medical Association.) NoTE.—lmUvidual offices may add to above list ot undesirable terms and refuse to accept certificates cont&tcJng theru. Thus the form In use in New York City states: "Certificates will b e returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, conrul» stoos, hemorrhage, gaagrettf, gastritis, erysipelas, meningitis, miscarriage, necrosis, peritonitis, phlebitis.pyemia, septicemia, tetanus." B u t generij Adoption of t!ie minimum list suggested will work vast Improvement, and its scope caa \se extended at a later date. ITS DEVELOPMENT, PROBLEMS. AND DEFECTS. 25 THE STANDARD CERTIFICATE OF BIRTH. PLACE OF BIRTH STANDARD CERTIFICATE OF BIRTH Township of - i si S »l I oS* 1 z31 * Z u o - a a; | t> ^ o is Registered No.- Village of City of Twin, triplet, Number In order or other? ) of birth (To be answered ODly In evept of plural births) Sex of Child FATHER FULL NAME Legitimate 7 i Date of MOTHER FULL MAIDEN NAME RESIDENCE RESIDENCE li- X COLOR AGE AT LAST BIRTHDAY - AQe AT LAST COLOR 1 > = •* BIRTHPLACE BIRTHPLACE & " 5 SI OCCUPATION OCCUPATION W ^o,cM^bQ f f l Number of chi.dren of tni, , o , . mother, Including pretont birth CERTIFICATE OF ATTENDING PHYSICIAN OR MIDWIFE* 1 a >: I I 3 I I hereby certify that I attended the birth of this child, who was * * on the date above stated. *When there was no attending physician' (Signature) or midwife, then the father, householder, etc., should make this return- A stillborn child is one that neither breathes nor shows other evidence of life after birth. I Given name added from a supplemental report . ,-.,--—,•""(BoHTiUvVlr'Stlirbofn) fBorn alive <*• Stillborn* at.. (Physician or Midwife) Address... %\9 A standard form of birth certificate, with a supplemental blank for reporting given names of children n o t named when the births were registered, has also come into very general use, states representing 84.6 per cent of the total population having adopted or approved it. The general extent of uniformity with respect to the use of standard birth and death certificates is shown in the cartograms on page 16. The action of the Bureau of the Census in promoting the adoption of uniform blanks for registration purposes is a part of its general policy for the standardizing of methods and the securing of comparable results. I n this work it has sought the voluntary cooperation of state and city registration officials and has been greatly aided by the formation of the special Section of Vital Statistics of the American Public Health Association, the decisions of which (see Census Bulletin No. 108, pp. 37 to 42) are promulgated as "Rules of Statistical Practice " and are generally observed b y American registration offices. They deal with such subjects as the statistical definitions of births, stillbirths, and deaths, treatment of premature births, deaths of nonresidents (a question n o t yet satisfactorily solved), deaths in institutions, methods of testing accuracy of registration, and standard forms of tables and blanks, including the standard certificates. In this connection may be mentioned the agreement of American registrars and the active support of the Bureau of t h e Census in bringing about the general adoption and very extensive use of the 26 THE FEDERAL REGISTRATION SERVICE. International List of Causes of Death, or the International Classification, as it is generally called. The use of a uniform method of classifying causes of death is fundamental in mortality statistics. The Committee on Vital Statistics of the American Public Health Association, which then included the three countries of Canada, Mexico, and the United States, early recommended this reform, and with the cordial approval of registration officials of Argentina, Brazil, Costa Rica, and other countries of South and Central America, proposed the First Decennial Revision of the International Classification, which was accomplished at Paris in 1900. The Bureau of the Census adopted the system for its mortality statistics, beginning with the calendar year 1900, and representatives of the bureau, the American Public Health Association, and the American Medical Association were delegated to attend the Second Decennial Revision called by the French Government and held at Paris in 1909. I t may be recalled with pleasure by the members of the present Congress t h a t all the leading countries of the Western Hemisphere—North, South, and Central America—united in the adoption of the International Classification of Causes of Death before the date of the first revision in 1900. THE WORK OF THE FEDERAL AND STATE REGISTRATION SERVICES. The work of the Federal and state registration services is intimately related. Many state laws have been enacted or amended in accordance with recommendations of the Bureau of the Census, representing the interest of the Federal Government in effective registration, and the value of the transcripts of the original certificates registered under state law largely depends upon the character of the administration of such law by the state and local registration officials. Hence a brief view of the mechanism of registration of births and deaths as conducted under the Model Law and the manner in which the results are utilized by the Census Bureau will be desirable. la. B I R T H S : D U T Y OF PHYSICIANS AND MIDWIVES.—The physician or midwife who attends a confinement is charged with the duty of filing a complete and correct certificate of birth of the child (separate certificates for twins or other plural births) with the local registrar of the primary registration district in which the birth occurred within a brief period after the birth. The time permitted varies in different states, b u t is usually 5 days (Michigan, 1915—formerly 10 days; New York, 1914—formerly 3 days, 10 days, 30 days) or 10 days (Model Law, Ohio, Pennsylvania). The certificate must be legibly written in permanent black ink so t h a t it will serve the purpose of a lasting official record. Provision is made for filing a supplemental statement of given name by the parent if the child had not been named at the time the original birth certificate was filed. If there were no attending ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 27 physician or midwife, it becomes the duty of the parent, householder, etc., to notify the local registrar, who is charged with the duty of preparing a birth certificate. (Further procedures in birth registration are practically the same as those relating to deaths, so that for the sake of simplicity reference will be made only to the treatment of deaths in the remarks following.) lb. D E A T H S : D U T Y OF UNDERTAKERS, INFORMANTS, AND PHYSI- CIANS.—The sole responsibility for filing a satisfactory certificate of •death with the local registrar and obtaining his permit in advance of interment is placed upon the undertaker. I t is the duty of the undertaker (or of any person who acts as undertaker in the final disposition of a dead human body) when called upon to take charge of a body to cause to be filled out a proper certificate of death, which shall contain or satisfactorily account for all the items contained upon the form of (standard) death certificate required by law. These itens are of two classes: (1) The personal and statistical particulars and (2) the medical certificate of cause of death. The personal and statistical particulars may be written by the undertaker or preferably b y the relative or friend (informant) who actually furnishes t h e information if literate; the statement must be signed b y the informant if able to write. Having obtained the personal particulars in the first column of the standard certificate, duly signed by the informant, the undertaker next presents the certificate to the physician last in attendance, who certifies as to the time of attendance, fact and time of death, and cause of death (and duration) with contributory or secondary cause (and duration), if any. Place of burial and date of burial are entered with the signature and address of the undertaker to make a complete certificate, which he is required to file with the local registrar of t h e district in which the death occurred in order to obtain a burial or removal permit. This must be done before the body is interred or removed and in all cases within seventy-two hours after death. Provision is made in various ways for the certificate of cause of death in cases where there is no medical attendant, usually by referring to the health officer or coroner. A valuable provision in the new Illinois law (1915) is that for a temporary certificate to be filed for " cases pending" b y coroners. 2. D U T Y O F LOCAL REGISTRAR.—Upon the knowledge and interest of the local registrar depend to a very large degree the efficiency of registration and the satisfactory character of the returns. I n the average state there should be from 1,000 to 2,000 of these officials (New York, for example, has 1,440), so distributed that there will be no difficulty or hardship with respect to the prompt filing of birth and death certificates. Subregistrars are of service in sparsely settled rural districts. Upon the proper distribution of the local registrars 28 THE FEDERAL REGISTRATION SERVICE. largely depends the success of the law; hence their appointment, qualifications, and size of districts assigned should be under the control of the state registrar as far as possible. The duty of the local registrar is to examine carefully all birth and death certificates filed with him, see that they are properly filled out, without erasures or alterations, and t h a t any omitted information which could reasonably be obtained is at once supplied. This should be done before he accepts the certificates for registration. Whencorrect and complete, he should number them in order of his serial numbers, beginning with " N o . 1 " for the first birth and for the first death which occurs in each year, enter the date of filing, and then record them, making a careful copy of each item in the local register which is permanently preserved and indexed in the local office. After numbering and recording each death certificate, he issues a burial or removal permit to the undertaker who filed it. While the law requires certificates to be filed, many are mailed to the registrar with comparatively small risk except the possibility of nonacceptance on the ground of incompleteness. In some cases, however, delay or even failure of registration may result from mailing certificates to the wrong districts. On a specified day of the following month the local registrar returns all the original certificates for the preceding calendar month to the state registrar, together with a statement card to t h e effect t h a t no births or deaths other than those returned occurred in his district. I n order that this statement may be truthful and thus the state registrar have full assurance t h a t the law is being faithfully executed in all parts of the state, it is necessary t h a t the local registration districts outside of cities and villages should be sufficiently small so t h a t the local registrar may be personally assured, with reasonable effort and vigilance, that his registration is complete. If no births or deaths occurred, he reports t h a t fact. An important part of the duty of the local registrar, which is not yet very fully developed and can only be done very cautiously unless the local registrar happens to be a qualified medical man, is to examine the medical certificates of causes of death as filled out by physicians with a view to obtaining more precise statements in certain cases. At least the minimum instructions as printed on the back of the standard death certificate should be carried out. I n cities, especially those of large size, these duties and many additional ones are very thoroughly performed. Valuable compilations of monthly and annual data are made and certificates are scrutinized very carefully for imperfections. From certain cities, e. g., Boston, Baltimore, New York, the certificates do not go to the state office, but transcripts are sent directly to the Bureau of the Census. ITS DEVELOPMENT, PEOBLEMS, AND DEFECTS. 29 ITEMS R E T U R N E D TO THE B U R E A U OF T H E C E N S U S ON MORTALITY SCHEDULES OR TRANSCRIPTS: 1850 TO 1915. * CALENDAR Y E A R S . ITEMS OF I N Q U I R Y . 1915 Total N a m e of s t a t e P l a c e of d e a t h : C o u n t y , t o w n s h i p , village, or c i t y . I n a city, street a n d n u m b e r , a n d w a r d . [If d e a t h occurred i n a hosp i t a l or i n s t i t u t i o n , give i t s name m s t e a d of street a n d n u m b e r ] C o u n t y , t o w n , or t o w n s h i p ; city or village. I n cities, street a n d house n u m b e r . If i n a h o s p i t a l or other i n s t i t u t i o n , give p r e v i o u s residence if k n o w n . If n o t , give n a m e 1910 1903 1900 to to to 1914 1 9 0 9 1902 1900 1890 1880 1870 1860 1850 25 23 21 17 17 2 19 3 16 3 13 13 13 1 1 1 1 1 1 1 1 1 1 1 1 1 1 County, city, t o w n , borough, village, t o w n s h i p , precinct, district, b e a t , or other m i n o r civil division; n a m e of i n s t i t u t i o n . W a r d — i n cities 1 1 1 1 1 1 1 1 i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Color W h i t e , b l a c k , or m i x e d blood; also w h e t h e r Chinese, J a p a n e s e , or I n - 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Sex Color: CENSUS YEARS. 1 1 | l l 1 W h i t e , b l a c k , m u l a t t o , Chinese, or White black, or m u l a t t o Conjugal condition: Single, m a r r i e d , w i d o w e d , or di- 1 1 1 Married or w i d o w e d D a t e of b i r t h : M o n t h and. year M o n t h of b i r t h , if b o r n i n census 1 i l 1 1 1 l l 1 Age: Years, m o n t h s , a n d d a y s ; if less t h a n Years, m o n t h s , a n d d a y s A t last b i r t h d a y ; if u n d e r 1 y e a r , i n months E x a c t or e s t i m a t e d ; if u n d e r 1 y e a r , in m o n t h s Occupation: a T r a d e , profession, or p a r t i c u l a r k i n d of w o r k 6 General n a t u r e of i n d u s t r y , business, or e s t a b l i s h m e n t i n w h i c h e m p l o y e d (or employer) Occupation O c c u p a t i o n , t r a d e , or profession B i r t h p l a c e (state or c o u n t r y ) Place of b i r t h of person Place of b i r t h (state, territory, or c o u n t r y ) 1 1 1 i l 1 1 1 1 1 1 1 1 1 1 1 i i l 1 1 1 1 1 l 1 i 1 i 1 i Based on table for the years 1850-1890, given in "History and Growth of the United States Census, 1790-1890," by Carroll D. Wright and William C. Hunt, p. 98. 2 Not including inquiry as to " Number of ward or sanitary district." 3 Not including inquiry as to "Number of family," for purposes of identification. 30 T H E FEDERAL REGISTRATION SERVICE. ITEMS R E T U R N E D TO THE B U R E A U OP T H E CENSUS ON MORTALITY SCHEDULES OR TRANSCRIPTS: 1850 TO 1915 X —Continued. CALENDAR Y E A R S . I T E M S OF I N Q U I R Y . 1915 Parentage: Birthplace of father (state or country) Birthplace of mother (state or country) CENSUS Y E A R S . 1910 1903 1900 to to to 1914 1909 1902 1 1 1 1 1 1 1900 1890 1880 1870 1860 1850 Place of birth of father (state, terri- 1 1 1 1 1 1 1 Place of birth of mother (state, terri- 1 1 1 Date of death: Month and year Month in which the person died Cause of death * (Duration) years, months, and days Contributory (Duration) years, months, and days. *(State the disease causing death or in deaths from violent causes, state (1) means of injury, and (2) whether accidental, suicidal, or homicidal). 1 1 1 1 1 1 1 1 1 1 1 Street address of attending physician... Physician's statement of the cause of Length of residence (for hospitals, institutions, transients, or recent residents) : At place of death—years, months, I n the state—years, months, and days Where was disease contracted, if not 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 l ; Name of place where disease was conSoldier, sailor, or marine (United States or Confederate) in Civil War, or l 1 1 1 1 Based on table for the years 1850-1890, given in ''History and Growth of the United States Census, 1790-1890," by Carroll D. Wright and William C. Hunt, p . 98. 3. D U T Y O F THE STATE R E G I S T R A R . — T h e state registration office receives the monthly returns of original birth and death certificates from the local registrars, binds, indexes, and permanently preserves them as legal records, of which it furnishes certified copies as required. I t usually employs the returns for statistical purposes, making monthly and annual compilations which are published in the form ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 31 of bulletins and reports. In large offices the data are transferred to punched cards which are tabulated by mechanical methods. The first duty of the state registrar is to examine carefully all certificates filed in order to see that they are correct and complete. If essential information is omitted it is obtained by correspondence with the local registrars, or, in some cases, directly with the physicians. The state registrar should check the promptness of returns from local registrars, scrutinize the dates of filing, investigate complaints of violation of the law which local registrars are required to make, correspond with physicians, midwives, and undertakers relative to alleged violations of law on their part, and when necessary refer cases for prosecution to the district attorneys or other legal officers. In general, he is charged with the responsibility of seeing that the law is thoroughly and uniformly executed throughout the state. Under instructions from the Bureau of the Census he prepares transcripts from the original certificates which contain such items as are required for the Federal compilation. 4. FUNCTION OF THE B U R E A U O F THE CENSUS.—The Director of the Census authorizes transcripts from the registration records of such states and cities as, in his judgment, can afford satisfactory data in necessary detail (registration area). The transcripts are sent monthly, as a rule, with check list verifying the count by months and subdivisions of the state. This is done for the purpose of avoiding marked discrepancies between the Federal and state compilations. The data contained upon the transcripts consist (1915) of some 25 separate items. The tendency has been to increase the number of minor details included and considerably more are now required than in 1900 (17 items). The Census Bureau examines the transcripts when received, verifies the count by months and minor civil divisions, and corresponds with the state registrar for "corrections" of missing information or for obvious inconsistencies; also for imperfect or unsatisfactory statements of causes of death. In some cases letters of inquiry asking for more satisfactory statements of causes of death are sent directly to the physicians who signed the death certificates, not through the state registration offices. The transcripts, completed and with the statements of causes of death rendered as definite as practicable, are then "edited" by assigning the numbers of the International List of Causes of Death and otherwise and the data transferred to punched cards for machine tabulation. The results of this, with editorial analysis, form the material of the annual reports on mortality statistics published by the Federal Government. At the census of 1890 there was introduced the card system of tabulation, which, with modifications and improvements, is still 32 THE FEDERAL REGISTRATION SERVICE. employed. Under this system, by which the population and mortality statistics are tabulated, the various details as to color, age, sex, parentage, occupations, etc., are transferred from the schedule to a card 6f by 3 J inches in size, by means of a mechanical punch, the position of the hole on the card indicating the particular fact to be recorded. A reduced facsimile of a punched card is shown herewith. MORTALITY CARD USED IN T H E BUREAU OF T H E CENSUS: 1914. $ H-S B ot A Jan D 50 R-0 0 1 O O Feb M 60 6"—d" I O 1 1 Mar Y 60 l I 2 • 4 5 e • IUB U3 Un Oc IU8 Un Un Can Ity 0 ;3 For i O ; 1 3 a h B Apr • 66 a B a 2 \i a 3 8 Ob MAJT 10 70 3 3 3 3 j .i 3 4 4 Jp 10 76 4 <4 4 4 0 ;•(I C»n IB a B 3 O D • Ity 3 • Den 1 » lie O 11 • A 13 4 14 4 3 IB 6 £ 16 6 T Nor 6 In Jul SO 80 6 5 6 5 ]i » - W Pol E-W Pol 0 a Ot Aug 26 85 0 6 6 e ; IO 1 7 6 7 a 7 e 8 9 7 30 3 a 4 • 9 6 • Nov 4 0 + Dec 45 ;Un~\ Hoi Bzd 9 • K 9 Hun Ot For Hun Ot For The person to whom this card refers died at Albany, N. Y.; was a female; white; married; death occurred in May; 25 years of age; had no occupation; born in the United States; father born in the United States; mother born in Canada; cause of death, tuberculosis of the lungs. After the cards are punched they are first run through a verification machine which throws out all inconsistencies and also provides a count for subsequent checking purposes; next they are separated into classes or groups by an automatic sorting machine which will take care of 300 cards a minute; then, depending upon requirements, they are run through a machine which counts them at the rate of 500 a minute; and, finally, they are run through an electric tabulating machine, capable of handling from 350 to 400 cards a minute, which not only counts the cards themselves, but records each of the items of information indicated on them. I n brief summary, as stated in an outline of registration prepared by the Census Bureau for the International Congress on Tuberculosis, 1908? accurate mortality statistics are dependent upon the faithful service and cooperation of many individuals. I t is necessary that there should be— 1. Obedience to the law on the part of the undertakers. 2. Care in filling out the statement of age, occupation, etc., by a relative or friend (informant) of the deceased person. ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 33 3. Care and special knowledge on the part of the attending physician, health officer, or coroner in making a definite statement of the primary and secondary causes of death, with the duration of each. 4. Interest and care on the part of the local registrar in seeing that the certificates filed with him are completely and properly filled out and that all births and deaths which occur in his district are promptly registered. 5. Alert supervision b y the State Registrar so that the law will be thoroughly enforced in all parts of the state; with the will and power to compel obedience on the part of the undertakers, physicians, midwives, and local registrars when necessary. 6. Careful examination of the returns by the State Registrar and prompt securing of missing data or corrections of imperfect statements of causes of death. 7. Accurate copying (which implies comparison) of the original certificates upon the transcripts sent to the Bureau of the Census. 8. Prompt examination of transcripts upon receipt by the Bureau of the Census, and immediate correspondence for necessary corrections. 9. Careful " e d i t i n g , " especially for the classification of causes of death, by expert compilers thoroughly acquainted with the International Classification and the use of medical terms. 10. Accurate transferal of data to the punched tabulation card. These are "compared back " with the original transcripts in order to insure correctness. 11. Careful tabulation of punched cards. Electrical tabulating machinery has reduced this to a mechanical basis and thus largely eliminated the "personal equation." 12. Lastly, the editorial work proper, or the analysis of the figures presented in a registration report. The analysis is subject to error, b u t the figures themselves, if correct, stand as witnesses of their own significance. Figures do not lie—when carefully compiled and interpreted. PROBLEMS AND DEFECTS OF THE PRESENT SYSTEM OF VITAL STATISTICS. From the preceding account of the process of registration and return of the materials of vital statistics to the Bureau of the Census and from the nature of the development of the various state registration services which supply these materials, it is evident that the Federal registration service in its work of collecting and compiling the vital statistics of the United States is hindered by certain unfavorable conditions which it has no power to remove. I t is easy to criticize present defects. " T h e United States is practically the only country among civilized nations without an effective system of vital statistics." But it is not easy to point out, or rather to work out, the remedy. The reform does not pertain entirely or even largely to the Federal service itself. The problem of the Federal registration service is how to unify all the various agencies concerned in registration and thus to build up an efficient machinery which will be fully dependable from the first step in registration—the making out of the original birth and death certificates by physicians, midwives, and undertakers—through all the successive stages of treatment in the local and state offices and in the Census Bureau until the completed 30026°—16 3 34 T H E FEDERAL REGISTRATION SERVICE. statistical product is available. I t must begin, not in the Federal office, not in the state offices primarily, but in the far-fiung local registration offices and in the education of the local registrars and of the persons charged by law with the duty of filing certificates. I t will only be thoroughly effective when the public generally, through constant enlightenment, is brought to understand the great importance of complete and accurate vital records. Some of the more obvious imperfections may be listed: 1. The greatest defect of the vital statistics of the United States at present is the lack of registration of deaths for the entire country. While the " registration area for deaths" has increased very rapidly during the past fifteen years, it seems ridiculous that the United States should be represented in the International statistics, for example, those published by the Registrar-General of England and Wales in his annual reports, by anything less than figures representing the entire country. As the registration area increases from year to year the rates presented are not comparable; many important sections of the country are not shown; and the returns for the colored and rural populations are especially incomplete. Hence the most important duty of the Federal registration service and of all its cooperating agencies is to extend the registration area for deaths until it includes the entire United States, Alaska, and all our insular possessions. 2. Our next most serious defect lies in the imperfect registration of births. A "registration area for births" should be established at the earliest practicable moment and every effort be made to extend it until, with the "registration area for deaths," it embraces the entire population under the American flag.1 The provisional birth registration area of 1910 included only about one-fourth of the population, so that it is evidently a more difficult task than that of complete registration of deaths. 3. Even for the registration area for deaths as at present constituted, we do not have full assurance that the registration is uniformly complete in all states. The standard of admission is low—90 per cent—and the means of testing the compliance therewith are inadequate. Efforts should be made to test and standardize the thoroughness of registration both for deaths and births, the results of such tests should be published in connection with the statistics, and states which fall below the minimum standard of requirement should be dropped from the Federal compilation. As soon as feasible the standard should be elevated so t h a t it will represent practically 100 per cent of efficiency. 4. The quality of the returns is poor in some cases, especially in the recently admitted states, and in all is susceptible of improvement. 1 See note on p. 7. ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 35 Many important questions relating to birthplace of the decedent or his parents are often disregarded or answered with lack of precision. Greater stress should be laid by state and local registration officials upon requiring all the questions upon the standard certificates to be answered fully as affording record information which may perhaps be of great legal value. There would then be little difficulty with respect to the completeness of the returns for statistical purposes. Perhaps the greatest degree of imperfection is found in the statements of occupation (and industry) and cause of death. To improve the latter, physicians must be instructed, beginning with lectures on the subject in the curriculum of the medical school, and constant correspondence be carried on for the correction of unsatisfactory statements. Autopsies should be encouraged and some means be found of insuring that the results thereof be reported instead of the frequently misleading clinical diagnoses alone. I t would be well for the standard certificate of death to provide, after its next decennial revision, for statement of post-mortem in connection wTith the cause of death. The Swiss method of confidential reports for statistical purposes might be employed to obtain exact information concerning certain causes relative to which physicians are reluctant to make reports on the ordinary death certificates which are open to public inspection. I t should not be understood in the foregoing criticisms of the quality of the returns of vital statistics that the data are markedly inferior to those of other countries. An unusually large proportion of deaths are certified by physicians, and the chief defects with respect to the statements of causes are due to lack of knowledge as to what is required for a satisfactory statistical compilation and to the small number of autopsies. Rapid improvement usually follows the admission of a state to the registration area and special inquiries for the verification of diagnoses, such as were made by the Census in the recent investigation of cancer, have an excellent effect. 5. The usefulness of the annual compilations of vital statistics which are made by the Bureau of the Census and by state and city registration offices may be discussed. Undoubtedly there is much duplication of labor and data may differ as presented for the same areas in Federal, state, and municipal reports. This condition is incident to the state of transition through which the registration of vital statistics in the United States is passing. Prior to 1900 there were no annual reports on mortality published by the Government, hence reliance was necessarily placed on the state and city reports. The Bureau of the Census has each year since 1900 presented tables showing, for the most essential details, the results of registration for all states and cities in the registration area, places of 8,000 (or 10,000 since 1910) being shown separately and also rural counties. The 36 THE FEDERAL REGISTRATION SERVICE. Federal statistics are compiled with a high degree of uniformity, which was not true of the state and city reports considered as a whole, and rates are presented based on uniformly estimated populations. For general reference, therefore, the Federal compilation should replace the state and municipal compilations, and it is merely a question of detail as to how it can be made more fully to serve the purposes of the users of statistics. State and city offices may very properly desire to present data concerning minor civil divisions, villages, towns, and wards, which it would not be feasible to include in the Federal compilations as printed. I t would perhaps be possible for the Census Bureau to supply the more general tables in manuscript for the use of state and city offices, leaving further details to be worked out locally; or duplicate punched cards might be placed at the disposition of the state or city offices. As a result the Federal, state, and municipal compilations would be in greater accord and the proper sphere of each would be defined. If the state services could give greater attention to the thorough enforcement of law, the attainment of practically complete registration of both births and deaths, and the elimination of indefinite and unsatisfactory records, relying upon the Federal service for the statistical compilation of the data, the general purpose would be more fully accomplished. 6. The question of the inclusion or exclusion of the deaths of nonresidents has aroused much discussion. I t has been the practice of the Census Bureau and of most state offices to base the compilation of mortality statistics on the total number of deaths which occurred in each area. For 1914 a separation of nonresidents will be given in one table and efforts are being made in the American Public Health Association to devise rules for this purpose. The practical treatment is very difficult, involves many perplexing questions, as deaths removed from one area should be assigned to another, and can not be satisfactorily carried out for the country as a whole until it is all included in the registration area. 7. Too much stress is sometimes laid upon the comparison of crude or general death rates for the purpose of establishing the healthfulness of American states or cities. Such rates are presented in the census reports with all necessary cautions, and also for white and colored separately for areas where the colored population forms a considerable proportion of the total. Age and sex distribution sometimes have a marked influence on the rates, hence an effort should be made to present corrected or standardized rates, at least for census years. I t is necessary, for the purposes of vital statistics, t h a t there should be more frequent enumerations of population, so that postcensal estimates, with some detail of color and age distribution, can be made with greater precision. Specific death rates, limited to definite groups of age, sex, and color, should replace the ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 37 general rates now chiefly used for the study of the incidence of various diseases. The Life Tables now in course of preparation by the Census will be of great value and should be continued for each decennial period. Figures of occupational mortality should have been prepared and the population data should be presented in a form available for that use. Also in the general census of population, both Federal and state, the primary age and sex distribution of population, by color, should be given for each county so that rural and urban mortality may be studied in detail. There are many other features which might be mentioned as susceptible of improvement or as deserving commendation and encouragement. That vital statistics reports may be made as useful as possible, especially for public health purposes, requires the helpful suggestions and constructive criticism of all concerned. I t would be well if an authoritative advisory board or council could be constituted, with representatives of the American Statistical Association, American Public Health Association, American Medical Association, and other organizations and services. Methods of presentation, however, are secondary to the prime duty of complete collection of the fundamental data by thorough registration. WHEN AND HOW WILL THE UNITED STATES OBTAIN COMPLETE REGISTRATION OF VITAL STATISTICS? I t is with some feeling of mortification that we are obliged to confess in the presence of this Second Pan American Scientific Congress that the United States does not now possess the means of recording the births and deaths of all its inhabitants, a matter deemed most important among all civilized nations. I t is with even greater regret that it must be admitted that, according to the present rate of progress, unless motives unforeseen should induce the American people to demand more speedy action, it will be many years before this object is accomplished. I t may be of service to glance at some predictions which have been made in the past in order to see how likely our hopes of the future are to be justified. Some of the colonies took action at a very early date for the registration of vital records. Virginia passed such a law in 1632, Massachusetts Bay in 1639, Connecticut in 1644, and New Plymouth in 1646. The " Fundamental Constitutions," prepared in 1669 for the government of Carolina by the philosopher John Locke, contained stringent provisions for a " Registry in every Signiory, Barony, and Colony, wherein shall be recorded all the births, marriages, and deaths that shall happen." 1 According to Kuczynski, 2 "Massachusetts 1 See letter from Dr. J. Howard Way, Journal of American Medical Association, Sept. 18, 1915, p. 1048. 2 Publications American Statistical Association, September, 1900. 38 THE FEDERAL REGISTRATION SERVICE. was the first state in the Christian world which recorded births, deaths, and marriages by government officers'" as such instead of baptisms, burials, and weddings. Yet these records were not maintained and, with some exceptions, registration was practically nonexistent. The first records of deaths in New York City are for 1804 and of births and marriages (a few only) for 1847. In 1842 Massachusetts passed the first state registration law of modern type, it being a direct consequence of the enactment of the English law of 1837, which made vital statistics the foundation of modern sanitary progress. The American Medical Association in 1846, the first year of its organization, appointed a committee on vital statistics, which later included a representative from each state. Dr. Edward Jarvis, of Massachusetts, prominently associated with the early Federal Census work hi vital statistics, reported in 1858 as a member of this committee: As now this system [of registration of vital statistics] is well established and in operation in Kentucky, South Carolina, Virginia, New Jersey, Connecticut, Rhode Island, Massachusetts, and Vermont, eight states, and as Maine and Michigan have taken the preliminary steps for this purpose, and men of science, and even politicians, are using their influence in other states for this object, there is much reason to believe that their example will be followed, and that state after state will, in the progress of time, follow in the same path, until finally, and we trust at no distant period, the system will be adopted, and this record of life and death be made complete throughout our Nation. The Civil War halted the march of registration, but Michigan (1867), Ohio (1869), and other states passed laws soon after its close. In 1877, in a " Report on Plans for Complete and Authentic Eecords of Deaths and the Causes of Deaths in the United S t a t e s / ' which was presented at the fifth annual meeting of the American Public Health Association at Chicago, Dr. Elisha Harris, of New York, said: Before the national census of 1880 is commenced all of the states ought to have a good system of vital statistics organized and in harmonious operation, contributing comparable and numerically complete results. If this were the case the last two decades of the present century would have such records of the population as will be most needed by the public economist and all students of human welfare in our country. The United States Government might promote and help perfect the interstate systems of vital statistics by organizing model examples of such a system in the Army and Navy and in all territorial governments. * * * Another decade of neglect to adopt an effectual system of registration in the United States would be greatly to the discredit of the intelligence and public spirit of American citizens. At Denver in 1895, again, approximately 20 years later, in a paper on " T h e Outlook for a General System of Registration of Vital Statistics in the United S t a t e s / ' read before the American Public Health Association, I quoted Dr. Harris's prediction and essayed to join the roll of statistical prophets. Basing my judgment chiefly on ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 39 the expected increase of population, with the attendant improvements of civilization, I ventured to surmise that— At that time [the latter part of the twentieth century] we may fairly hope with Dr. Harris that each of these United States, if left entirely to their own necessities, as determined b y their increase in populousness, will have an accurate system of vital statistics in operation furnishing statistics perfectly comparable with those of other states and foreign countries. This is, of course, without taking into consideration any possible advance in public opinion during the next century, whereby men in general may come to believe that statistics bearing directly and helpfully upon the most sacred functions of human life are at least as well worth liberal treatment and careful attention as those that pertain more directly to the pocket. Even under the most favorable circumstances, however, we can hardly expect this result to come about spontaneously before the middle of the twentieth century. Now, in 1915, after a dozen years spent personally with all the force available in the Census Bureau and the cooperating agencies in the effort to extend and improve the registration of vital statistics in the United States, I see little reason to revise this judgment. Since the placing of the Census Bureau upon a permanent basis, the movement for better vital statistics has not been dependent upon merely spontaneous support, but has been under a directive influence that, by means of the Model Law and in other ways, has averted much misdirected energy and avoided serious mistakes that would have meant the waste of years in certain states. I should be sanguine, however, if I felt that this additional impetus and guidance have hastened the coming of effective registration for the United States by more than a decade—that is, by 1940 instead of 1950 or later. A third of the population—and by far the most difficult third—is even yet to be brought into the registration area for deaths alone, while the far more difficult task of securing thorough and complete registration of births remains to be accomplished for perhaps three-fourths of the population of the United States. Mountain, desert, sparsely settled prairie, difficult communication, high proportion of illiteracy among white and colored population—these and other factors of difficulty are found in greater proportion among the states not as yet included in the registration area for deaths and with practically absent or exceedingly defective registration of births. Indeed, the registration of births is incomplete even in our oldest registration states, and until this unfortunate condition is removed we can not be too sanguine in anticipating the coming of thorough and complete registration of vital statistics for the entire United States. I t is true, as has been shown in preceding sections of this paper, that rapid advances have been made since 1900 in the admission of registration states for deaths and the adoption of laws which, in the light of our present knowledge, seem well adapted to secure satisfac- 40 T H E FEDERAL REGISTRATION SERVICE. tory results—if thoroughly enforced. This is the crucial point of the situation, namely, the thorough enforcement of the law. I t has been said that if the Model Law for the registration of births and deaths were at once adopted by states at present without satisfactory legislation, the entire United States might be brought into the registration area within a year. As fully as I am convinced of the excellence of the Model Law, from the results which it has accomplished, I can not subscribe to this statement. Experience has shown t h a t it is not true. The administration of even a most excellent law is, in many of our states, a most difficult task. Up to a certain point results may be obtained with comparative ease, but when the effort is made to register all births and all deaths, by enforcement of the penalty of the law, progress is not so easy. Yet the " essential principles " declare, and I believe that it is absolutely necessary for complete results, that " penalties shall be provided and enforced." If this were done, and the Model Law were generally adopted, the coming of complete vital statistics would be near. Excellent results have followed the systematic prosecution of delinquents in New York City since 1910, and also, for some years past, their prosecution by the state registration service of Pennsylvania and of Minnesota. Recently (October, 1915) the state board of health of North Carolina has employed a special agent, a former deputy sheriff and local registrar, to visit all localities in the state where defective registration is suspected: The state board of health is determined to enforce the state registration law. Mr. Mclntyre's continuance in office will be based on his ability to find infringements of this law and to secure convictions. I n addition to knowing where people are dying and the relative importance of the various causes of their deaths, the board proposes to secure good standing with the United States Bureau of the Census and to be admitted as a registration state. To this end the bureau will employ county and district agents, in addition to the state agent, to find and prosecute violators of the vital-statistics law. Nevertheless, the big " I F " — t h e difficulty and uncertainty of the actual enforcement of law—stands in the way of obtaining complete vital statistics in nearly all of our states. I t is not peculiar to registration laws, but merely incidental to our general disregard, as a people, of mere laws—although the abiding faith and reverence of the Anglo-Saxon for law remains deep-rooted within us. The disgust for laws is consequent upon the myriads of useless laws which cumber our statute books and are turned out in apparently neverending profusion at the annual or biennial sessions of our state legislatures. " P a s s a l a w " is the slogan of every reform, but the great majority of the laws which are passed become more or less dead letters. Hence the effort to secure actual compliance with the pro- ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 41 visions of a registration law, enforcing the penalty in each and every case of violation—or at least in a sufficient number of cases to act effectively as a deterrent—seems almost grotesque and absurd. Only a small proportion of the most heinous offenses, including the crime of murder, are actually visited with the penalty imposed by law. There is much delay and uncertainty attending legal action, and personal and political influence are readily invoked to prevent enforcement of the penalty for what are regarded as merely trivial or technical misdemeanors. We are improving, doubtless. But the time seems long before we shall have a standard of compliance with law throughout the country, with the full understanding and support of the people behind it, that will insure perfect registration. The Federal Government occupies a weak and apparently helpless position in this important matter of vital statistics, which so intimately affects the welfare of all its citizens and of the Nation as a whole. Its relation is set forth in the following joint resolution of Congress, originally drafted by Mr. William A. King, and approved February 11, 1903: RESOLUTION BY CONGRESS. JOINT RESOLUTION R E Q U E S T I N G STATE AUTHORITIES TO COOPERATE WITH C E N S U S OFFICE IN SECURING A UNIFORM SYSTEM OF B I R T H AND D E A T H REGISTRATION. Whereas the registration of births and deaths at the time of their occurrence furnishes official record information of much value to individuals; and Whereas the registration of deaths, with information upon certain points, is essential to the progress of medical and sanitary science in preventing and restricting disease and in devising and applying remedial agencies; and Whereas all of the principal countries of the civilized world recognize the necessity for such registration and enforce the same b y general laws; and Whereas registration in the United States is now confined to a few states, as a whole, and the larger cities, under local laws and ordinances which differ widely in their requirements; and Whereas it is most important t h a t registration should be conducted under laws that will insure a practical uniformity in the character and amount of information available from the records; and Whereas the American Public Health Association and the United States Bureau of the Census are now cooperating in an effort to extend t h e benefits of registration and to promote its efficiency b y indicating the essential requirements of legislative enactments designed to secure the proper registration of all deaths and births and the collection of accurate vital statistics, to be presented to the attention of the legislative authorities in nonregistration states, with the suggestion t h a t such legislation be adopted: Now, therefore, Resolved by the Senate and House of Representatives of the United States of America in Congress assembled, That the Senate and House of Representatives of the United States hereby expresses approval of this movement and requests the favorable consideration and action of the state authorities, to the end t h a t t h e United States may attain a complete and uniform system of registration. Approved, February 11, 1903. 42 T H E FEDERAL REGISTRATION SERVICE. Is it necessary to wait until the last one of our states, until the slowest, the least enlightened or the most handicapped by adverse conditions, shall adopt and enforce successfully adequate laws for the registration of vital statistics before the United States can have complete national vital statistics? The Federal Government has contributed nothing, besides this resolution and the propaganda that the Bureau of the Census has conducted thereunder, to advance registration. The entire burden of the collection of vital statistics is borne by the states, the expense to the Government for returns being limited to the mere cost of transcription from the original state records. Can not the Federal Government take a more active part in the practical conduct of registration and greatly shorten the time during which we must remain in the barbarous state of existence without complete vital records ? This is the great problem of American vital statistics. I believe that the Congress of the United States, if it should consider the question seriously and with a view to effective action, could bring about the approximately complete registration of births and deaths in the entire United States in a comparatively brief time—perhaps within a decade. I t is no criticism of Congress to say that the subject has never received careful attention, nor has its great practical importance been fully realized; that not half a dozen members of Congress have, since the formation of the Government, given even the most superficial attention to the matter. This merely indicates that the question has not yet come home to the American people as a thing desirable, a proper object to be accomplished, and an essential part of modern American life. When the demand shall actually arise, Congress will be ready to take all necessary action, and some of the theoretical difficulties which have seemed to stand in the way may vanish. Our future development will perhaps be along one of several lines: (1) Continuance of the present status of independent state registration of vital statistics, with partial and comparatively ineffective cooperation of the Federal Government confined mainly to the statistical compilation of data copied from the state records. (2) Provision, by act of Congress, for more effective cooperation of the Government with the states, embracing the thorough registration, return, and standardization of records as well as the compilation of statistical data based thereon. The cost of collection, or at least the cost of supervision, might be shared by the state and Federal governments, very much in the way that similar cooperation has been effected in the taking of interdecennial censuses. State, and perhaps local, registrars might be commissioned in the Federal service; trained inspectors be supplied for field service; and, most important of all, the franking privilege (use of penalty envelopes and labels) extended to all registration returns and supplies. This should not ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 43 be done, of course, in any state until the state law and its execution were fully approved. Such use of the mails has long been customary in Canada and other countries, and no single action within the power of Congress would be more useful for the cause of registration. (3) I t is not unthinkable, despite the present absence of constitutional authority, that the Federal Government will at some future time take over the entire subject of the civil status involving the registration of births and deaths, marriages and divorces. An amendment to the Constitution would be necessary, but such amendment has for some time been urged in order to permit uniform legislation for marriage and divorce. The Government is at present unable to fulfill certain treaty obligations concerning the reporting of the deaths of aliens to their countries, as pointed out by Hemenway, 1 on account of the lack of registration of deaths in certain states. When such records become, as they are fast becoming, indispensable under the increasingly complex conditions of society, governmental control will readily be brought about. The question of possible conflict of the Federal work in vital statistics with the jurisdiction of the states has never arisen during my experience in the Census service, with possibly a single exception. The state authorities have been anxious for aid and the sole object has been how to obtain the greatest efficiency. That there would be little objection to such possible solution of the problem may be indicated by the words of Dr. James A. Hayne, secretary of the state board of health of South Carolina, in his paper on "One Year's Experience with the new Model Vital Statistics Law in South Carolina," read before the section on vital statistics of the American Public Health Association at Rochester, September 9, 1915: The relation of the Federal Government to vital statistics.—I may be accused of being a backslider from the good old Democratic principles of states' rights and local selfgovernment, but I firmly believe that vital statistics and the information obtained by them, belong to the United States Government, and that this Government should work out a universal plan for obtaining them; and, moreover, the most important idea of my belief is that all expenses necessary to obtain vital statistics should be borne by the United States Government. Meantime, with peace and general prosperity, the lack of adequate vital statistics is, after all, one of the minor afflictions which will be alleviated just as soon as the people generally are taught the importance of vital records. RESUME. The Federal registration service of the United States consists of the Bureau of the Census, which has compiled and published reports on mortality statistics from the date of the Seventh Census (1850) to the present time. No authority for the Government to conduct 1 Legal Principles of Public Health Administration, p. 244. 44 T H E FEDERAL REGISTRATION" SERVICE. the registration of vital statistics is found in the Constitution, hence this work has been relegated to the states and data derived from state records now chiefly form the basis of the Federal compilation. From 1850 to 1900 the Census attempted, b u t only for the census years ending with the date of enumeration, to collect data with respect to deaths by enumeration at the time of taking the general census of population. This method necessarily failed to secure accurate results because long experience has shown t h a t vital events, such as births, marriages, and deaths, must be registered—that is, recorded—immediately after occurrence, in order to afford valuable records and statistics. Beginning with the Tenth Census (1880) a " registration area for d e a t h s " was established, for which transcripts of deaths were made from state and city records based on immediate registration. The registration area for this year embraced only two states, Massachusetts and New Jersey, and 20 cities, the aggregate population being only 17 per cent of the total population of the United States. From 1880 to the present time the history of vital statistics in the United States has been the development of the registration area, which now includes over two-thirds (66.9 per cent) of the total population of the United States. At the Thirteenth Census (1910) the attempt to enumerate deaths for any portion of the country was abandoned, sole reliance being placed on the registration records available. The registration of births is much less effective in the United States generally than the registration of deaths. The early census reports presented figures for births based on the number of infants enumerated under 1 year of age plus those born and dying in the census year. For 1908 an attempt was made to obtain transcripts of all births registered in the United States under either state laws or city ordinances. The results showed that probably less than one-half of the births that occur in the United States were recorded. Returns were continued from a "provisional birth registration a r e a " for 1909 and 1910, and it is the purpose of the Bureau of the Census to establish a permanent " birth registration area." 1 Much of the improvement in the registration of vital statistics in the United States and the rapid extension of the registration area is due to the establishment of the Census Bureau upon a permanent basis, which was accomplished by the act of Congress approved March 6, 1902. Since t h a t time it has been in continuous active cooperation with state authorities and with the American Public Health Association, American Medical Association, and other organizations interested in the improvement of registration. 1 See note on p . 7. ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 45 As a result of such cooperation the "Model L a w " for the registration of births and deaths was drafted and passed in many states. I t has proved effective in operation under widely differing conditions and has prevented the waste and loss of time which formerly often resulted from ill-devised legislation. The standard birth and death certificates form part of the Model Law and afford primary schedules for registration returns of identical character, thus making the data collected of greater comparable value. At present states representing 92.6 per cent of the total population of the United States have adopted or approved the standard death certificate and 84.6 t h a t for births, while in 1900 no two states employed uniform blanks for these purposes. The value of the Federal statistics depends largely upon the completeness and thoroughness of state registration, which latter, in turn, is based on the efficiency of local registrars and the intelligence and care shown by physicians, midwives, and undertakers in filing the original certificates. Hence, to build up a thoroughly effective registration of vital statistics in the United States there must be a high degree of cooperation and full understanding, especially by the primary reporters, of the importance and significance of the certificates filed by them. These relations may be indicated in the following general outline: T H E VALUE OF T H E REGISTRATION RECORDS OF B I R T H S AND D E A T H S , AND OF THE FEDERAL, STATE, AND CITY VITAL STATISTICS B A S E D T H E R E O N , D E P E N D S UPON THE EFFECTIVE COOPERATION OF (a) PHYSICIANS, MIDWIVES, U N D E R T A K E R S , AND INFORMANTS; (6) LOCAL REGISTRARS; (C) STATE REGISTRARS; AND (d) B U R E A U OF THE C E N S U S . 1 (&) Duty of local registrar of city, village, or township. (c) Duty of state registrar. (d) Duty of Federal Bureau of the Census. To examine birth and BIRTHS. death certificates when Physician or midwife filed; if correct and commust file a complete and plete, to record them; to correct birth certificate issue a burial or removal with the local registrar permit for deaths to the within the limit fixed by undertaker; to return all original certificates for law (10 days). each month to the state registrar on the day DEATHS. set by law; to see that Undertaker must pro- the law is fully executed cure a complete and cor- in his district and to rect certificate of death, report any violations with personal and statis- thereof to the state tical data signed by in- registrar; to procure formant and medical cer- additional information tificate of cause of death when required for the signed by physician, and legal or statistical corfile same with the local rection of imperfect recregistrar and obtain a ords; and to prepare burial or removal permit such statistical compibefore the final disposition lations as may be necesof the body and within 72 sary for the local health service or other purhours. poses. To procure the prompt and complete registration of all births and all deaths in every registration district of the state, with prompt returns of all the original certificates from local registrars on the day set by law; to examine, preserve, bind, index, and issue certified copies of the original certificates; to obtain additional data for the correction of imperfect records; to prepare and publish such statistical compilations as may be necessary for the use of the public health service or otherwise required. To obtain accurate copies (transcripts) of the necessary items of the original certificates; to examine them and to procure corrections of omitted or unsatisfactory data; to prepare and publish annual or other reports which will present the statistics in a form most serviceable to the people of the United States, to the Federal, state, and municipal health authorities, and permit of satisfactory international comparisons. (a) Duty of physicians, midwives, and undertakers. i Outline based on provisions of the Model Law. 46 T H E FEDERAL REGISTRATION SERVICE. The chief defects and therefore the resulting problems of Federal registration of vital statistics are due to the nature of the development of the work in this country, the dependence of the General Government upon the states for the adoption and enforcement of laws, and the lack of control of the means of registration. Hence the efforts of the Bureau of the Census, in cooperation with the state authorities, have been directed to the promotion of adequate legislation and the standardization of the records made thereunder. The most vital need at present is the extension of the registration area for deaths until it shall include the entire United States instead of only two-thirds of the population as at present. Next in importance is the necessity for the development of birth registration, the establishment of a "birth registration area" corresponding to the death registration area, and the improvement of the completeness of birth registration, which is defective even in our oldest registration states. The standard of admission to the registration area (only 90 per cent of completeness as a minimum) should be raised until the country is yielding practically 100 per cent of efficiency in this respect. The quality of the returns should be improved, especially those relating to causes of death. Correspondence with registrars and physicians should be conducted and the holding of autopsies should be encouraged. In the matter of statistical compilations, some measures should be taken to avoid the unnecessary duplication of labor and the issue of inconsistent figures by Federal, state, and city registration offices. Reports should be made of more practical value for reference and use of public health workers. An equitable distribution of nonresident deaths is desirable, and specific death rates, based on sex, age, color, occupation, and other determining factors of mortality, should be employed as far as practicable instead of placing undue reliance upon the ordinary general or crude death rates. All predictions made during the past 60 years relative to the early advent of satisfactory vital statistics for the United States have failed to be realized. The great difficulty which stands in the way of effective registration, especially that of births, is the enforcement of law by means of the penalties provided therein. Voluntary, or semivoluntary, "enforcement" of law, with the mere threat of penalties which are never carried out is worse than useless. Registration laws are not peculiar in lack of general enforcement; we suffer from too many laws and too little real execution of law. While the extension and enforcement of good laws have been greatly accelerated since 1900, the coming of fairly complete registration of both births and deaths for the entire United States can not safely be set much before 1940—at least another quarter century of wasted and misdirected energy for lack of the fundamental bookkeeping of adequate vital statistics. I t would be possible, if the American people really ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 47 desired complete vital records, to accomplish the result within the next decade. Future progress is likely to be either as (1) a continuation of the present relation of the Federal and state services, in which the Government occupies the weak and apparently helpless position of receiving only what may in time become available; or (2) if Congress, reflecting a higher public appreciation of the necessity, should provide much more efficient and thorough cooperation, with sharing of cost and extension of postal facilities, complete registration could be brought about; (3) possibly at some future time the complete nationalization of vital statistics may be effected. The history of the registration of vital statistics in the United States has been that of a most valuable and necessary institution of modern society neglected amid more or less pioneer and primitive conditions. There was little thought of the making of permanent records of individuals in the rapid march of civilization across the continent. There was comparatively little need, for many a citizen of the United States has been born and has died without once having been required during the course of a long life to produce documentary evidence depending on such records. American life was purely individualistic. Restrictions of government and laws affecting personal freedom in any respect were few. I n many parts of the country to-day the people see no reason for reporting births, and consider it an entirely uncalled for interference with their rights that the law should forbid them to bury their dead without first obtaining some official's "permit." We are changing all this—and we can not contemplate all features of the change without a sigh of regret. As people come into closer contact in our crowded communities, vital records are of increasing importance to protect the rights and insure the privileges of the individual. Schools are overcrowded, child labor must be prevented, widows with minor children receive pensions from the state—perhaps old age pensions are coming—in a multitude of ways the state is entering into the daily life of the people and requiring records of births and marriages and deaths for the interest of the individual. I can not better describe the march of progress than to give a brief extract, with my own italics stressing the words descriptive of vital statistics, from President Finley's " T h e French in the Heart of America": I described in an earlier chapter a frontier community in that valley. See what has come in its stead, in the city into which it has grown. The child coming from the unknown, trailing crowds of glory, creeps into the community as a vital statistic and becomes of immediate concern.1 From obliging the nurse to take certain precautions at 1 That is to say, provided he is numbered among the fortunate children—about one-half of the total number born in the United States—whose births are registered. 48 T H E FEDERAL REGISTRATION SERVICE. 1 its birth, the state follows the newcomer through life, sees that he is vaccinated, removes his tonsils and adenoids, furnishes him with glasses if he has bad vision, compels him to attend school [supplying him with a certificate of birth as evidence of school age], prepares him not only for citizenship but for a trade or profession, prevents the adulteration of his food, inspects his milk, filters his water, stands by grocer and butcher and weighs his bread and meat for him, cleans the street for him, stations a policeman at his door, transports his letters of business and affection, furnishes him with seeds, gives augur of the weather, wind, and temperature, cares for him if he is helpless, feeds him if he is starving, shelters him if he is homeless, nurses him in sickness, says a word over him if he dies friendless, buries him in its potter's field, and closes his account as a vital statistic in the mortality column.2 1 Which are duly noted on the birth certificate—if born in a state having this requirement. 2 Even his death may fail to be registered at the present time in a considerable portion of the country. OFFICIAL PUBLICATIONS ON VITAL STATISTICS IN THE UNITED STATES. The chief source of information concerning the vital statistics of the United States is the series of Census Reports, decennial and relating to the census years ending May 31 (1850 to 1900) and annual for calendar years (1900 to 1914): D E C E N N I A L CENSUS R E P O R T S . SEVENTH CENSUS (1850). Mortality statistics of the Seventh Census. Seventh Census of t h e United States. Compendium of the Seventh Census; births and deaths, p p . 105-111, p . 400. Abstract of t h e Seventh Census. EIGHTH CENSUS (1860). Preliminary Report on t h e Eighth Census; mortality, p p . 22-32, 138-167. Statistics of t h e United States: Eighth Census; mortality, p p . xxiii-lxvi, 1-287. N I N T H C E N S U S (1870). Vital Statistics of the United States: Ninth Census. T E N T H CENSUS (1880). Mortality and Vital Statistics: Tenth Census, Parts I and I I . Compendium of the Tenth Census, Part I I ; mortality, p p . 1703-1731 E L E V E N T H C E N S U S (1890). Vital and Social Statistics: Eleventh Census, Parts I, I I , I I I , and IV. Compendium of t h e Eleventh Census, Part I I ; mortality, p p . 3 to 131. Abstract of t h e Eleventh Census; mortality, p p . 264-274. Vital Statistics of Boston and Philadelphia: Six years ending May 31, 1890. Vital Statistics of t h e District of Columbia and Baltimore: Six years ending May 31, 1890. Vital Statistics of New York and Brooklyn: Six years ending May 31, 1890. T W E L F T H CENSUS (1900). Vital Statistics: Twelfth Census, Parts I and I I . Supplementary Analysis and Derivative Tables; vital statistics, p p . 493-510. A Discussion of t h e Vital Statistics of t h e Twelfth Census: Bulletin 15. Abstract of t h e Twelfth Census; mortality, p p . 179-213. P E R M A N E N T CENSUS PUBLICATIONS. REPORTS. Mortality Statistics: 1900-1904 (one volume). Mortality Statistics: 1905. Mortality Statistics: 1906. Mortality Statistics: 1907. Mortality Statistics: 1908. 30026°—16— -4 (49) 50 THE FEDERAL REGISTRATION SERVICE. P E R M A N E N T CENSUS PUBLICATIONS—Continued. Mortality Statistics: 1908. Bulletin 104 (preliminary Mortality Statistics: 1909. Mortality Statistics: 1909. Bulletin 108 (preliminary Mortality Statistics: 1910. Mortality Statistics: 1910. Bulletin 109 (preliminary Mortality Statistics: 1911. Mortality Statistics: 1911. Bulletin 112 (preliminary Mortality Statistics: 1912. Mortality Statistics: 1913. Mortality Statistics: 1914 (in preparation). Marriage and Divorce: 1867-1906, Parts I and I I . report). report). report). report). PAMPHLETS. Circular No. 71. Registration of Deaths: 1902. No. 100. Legislative Requirements for Registration of Vital Statistics: 1903. No. 101. Practical Registration Methods: 1903. No. 102. Relation of Physicians to Mortality Statistics: 1903. No. 103. Medical Education in Vital Statistics: 1903. No. 104. Registration of Births and Deaths: 1903. No. 105. Statistical Treatment of Causes of Death: 1903. No. 106. Extension of the Registration Area for Births and Deaths: 1906. No. 107. Modes of Statement of Cause of Death and Duration of Illness Upon Certificates of Death: 1907. No. 108. Legal Importance of Registration of Births and Deaths: 1908. No. 109. Tuberculosis in t h e United States: 1908. No. 110. Physicians' Pocket Reference to the International List of Causes of Death: 1910; revised 1913, 1914. No. 111. Explanatory List of Diagrams Relating to Deaths of Infants: 1910. CLASSIFICATION OF CAUSES OF D E A T H . Manual of International Classification of Causes of Death: 1902. (First revision, 1900). International Classification of Causes of Sickness and Death: 1910. Manual of t h e International List of Causes of Death: 1911. (Second revision, 1909.) Index of Joint Causes of Death: 1914. PUBLICATIONS OF O T H E R B U R E A U S . The Public Health Service, Treasury Department, publishes vital statistics chiefly as reported from cities in its Weekly Public Health Reports. I t has also issued a valuable monograph on Vital Statistics: A discussion of what they are and their uses in public health administration, by John W. Trask, Assistant Surgeon General. The Children's Bureau, Department of Labor, began its work with a pamphlet on Birth Registration: An aid in protecting the lives and rights of children, which has been revised, 1914. The bureau publishes investigations relating more particularly to infant and child mortality. The Weather Bureau, Department of Agriculture, began the publication of a monthly compilation, "Climate and H e a l t h , " in July, 1895, which was designed to set forth the relation between mortality and meteorological conditions. I t was discontinued in March, 1896. ITS DEVELOPMENT, PROBLEMS, AND DEFECTS. 51 PUBLICATIONS O F O T H E R BUREAUS—Continued. The National Board of Health during its brief existence (1879-1885) made an effort to improve t h e registration of vital statistics in the United States which would doubtless have resulted in great benefit if continued: National Board of Health, Supplement No. 5 to the bulletins, 1880-81, contains proceedings of the Conference of t h e National Board of Health, with recommendations for uniform tables, etc. Annual Report: 1880. Report of committee on the nomenclature of diseases and on vital statistics, Appendix O, pp. 537-544. Annual Report: 1881-82. The Registration of Vital Statistics, Appendix E, p p . 355-461. Annual Report: 1885. Report on mortality in certain cities and towns in the United States in 1884, Appendix D, p p . 341-356. STATE R E P O R T S . State reports on vital statistics are usually contained in the reports of the state boards of health (except when otherwise noted below). Prior to t h e establishment of t h e Census Bureau upon a permanent basis and t h e beginning of the annual reports on mortality statistics (1900), these are the only sources of information for intercensal years and for calendar years, also for statistics of births, stillbirths, and marriages in detail. The state reports are of very uneven value, some being almost worthless, while others are carefully compiled and present data for a long series of years. The most important are those of Massachusetts (1842-1914) in t h e East and Michigan (1867-1914) in the West. T h e reports are annual and for calendar years, except as indicated (e. g., Michigan, 1867-68, is an annual report for a year ending in 1868 (April 5), b u t not a calendar year): Alabama: 1883; 1884; 1887-1895; 1914. California: Biennial, 1880-81 to 1911-12. Colorado: 1892-1900; biennial, 1901-2 to 1911-12. Connecticut: (State librarian), 1854-1877; 1878-1913. Delaware: Biennial, 1901-2 to 1911-12. District of Columbia: 1871-72 to 1912-13. Idaho: Biennial, 1911-12. Illinois: 1906; 1913. Indiana: 1882-83 to 1912. Iowa: Biennial, 1898-99 to 1911-12. Kansas: 1887 to 1900; biennial, 1901-2 to 1912-13. Kentucky: Registration reports (auditor), 1852-1859; 1878-79 to 1882-83; biennial, 1910-11. Louisiana: Biennial, 1898-99 to 1912-13. Maine: 1892 to 1913. Maryland: 1899 to 1912. Massachusetts: Department of State, 1841-42 to 1913. Michigan: Department of State, 1867-68 to 1912. Minnesota: Biennial, 1886-87 to 1896-97; 1909-10, 1911-12. Missouri: 1911 to 1914. Montana: Biennial, 1901-2 to 1913-14. New Hampshire: 1880 to 1893; biennial, 1894-95 to 1910-11, New Jersey: 1871; 1872; 1874; 1873 to 1912. New York: 1884 to 1913. North Carolina: Biennial, 1885-86 to 1911-12. North Dakota: Biennial, 1901-2 to 1913-14. 52 T H E FEDERAL REGISTRATION SERVICE. STATE REPORTS—Continued Ohio: Department of State, 1909 to 1913. Oklahoma: Biennial, 1909-10 to 1911-12. Oregon: 1908 to 1913. Pennsylvania: Department of Health, 1885 to 1911. Rhode Island: Department of State, 1852-53 to 1876; 1877 to 1912, South Dakota: Department of History, 1906 to 1913. Tennessee: Biennial, 1880-1884 to 1909-10. Texas: Biennial, 1910-1912. Utah: Biennial, 1907-8 to 1911-12. Vermont: 1857 to 1896; biennial, 1896-97 to 1912-13. Washington: Biennial, 1903-4 to 1913-14. West Virginia: Biennial, 1904-5 to 1912-13. Wisconsin: Biennial, 1903-4 to 1911-12. CITY R E P O R T S . The city reports are legion. The data on vital statistics are usually included in the report of the city health ofiicer or department. Only a few of the most important can b e mentioned: New York: City inspector, 1818-1827; 1829; 1831-1837; 1835-1844; 1847-1865; metropolitan board of health, 1866 to 1868-69; 1870-71 to 1911. Chicago: 1867 to 1910. Philadelphia: Health officer, 1860 to 1887; department of health, 1873 to 1912. Boston: City registrar, 1849-1878; 1881-1885; 1887-1889; 1890 to 1911; 1900 to 1913. Providence: City registrar, 1855 to 1913; superintendent of health, 1856-57, 1884 to 1912. New Orleans: 1846; 1849; 1850; 1856; 1860; 1866 to 1889; biennial, 1898-99 to 1912-13. Savannah: 1858-59; 1865-66 to 1881; 1888; 1890 to 1912. Richmond: 1871 to 1912. Charleston: Report of interments, 1828 to 1846; city registrar, 1846-1849; 1867 to 1869; 1874 to 1878; 1889 to 1909. APPENDICES. (Tables prepared by the United States Bureau of the Census.) APPENDIX 1.—GROWTH OF REGISTRATION AREA, POPULATION INCLUDED, BY DIVISIONS AND STATES: 1880 TO 1915. APPENDIX 2A.—DEATHS AND DEATH RATES FROM REGISTRATION SOURCES, BY DIVISIONS AND STATES: 1900 TO 1914. APPENDIX 2B.—DEATHS AND DEATH RATES FROM REGISTRATION AND NONREGISTRATION SOURCES (THE LATTER VERY INCOMPLETE), BY DIVISIONS AND STATES: 1880 TO 1900. APPENDIX 3.—BIRTHS AND BIRTH RATES, ACCORDING TO DATA AVAILABLE (VERY INCOMPLETE), BY DIVISIONS AND STATES: 1880 TO 1910. APPENDIX 4.—THE MODEL LAW: " A BILL TO PROVIDE FOR THE REG ISTRATION OF ALL BIRTHS AND DEATHS IN THE STATE OF ." (53) 54 T H E FEDERAL REGISTRATION SERVICE. APPENDIX 1.—GROWTH OF REGISTRATION AREA, POPULATION [NOTE.—The year in parenthesis in the " Registration or nonregistration" column is that for which the state geographic section became complete. South Dakota was included for the years 1906 to 1909 only. Where certain years, the former portion embraces the population of cities in the state for which the results ofregCarolina, for which state returns collected under a state law which applied to municipalities over a certain extended to cover the entire state. The population embraced under the term "nonregistration" for a especially for the earlier years shown, the term is used simply to distinguish the population either without not been accepted for the time specified.] A N N U A L COMPILATION ( C A L E N D A R Y E A R S ) . DIVISION A N D STATE. 1 Registration ( a n d year for w h i c h ent i r e area w a s first i n c l u d e d ) or n o n registration. 1915 1914 Population estimated as of J u l y 1. Per cent of total. Population Per e s t i m a t e d ' c e n t of as of J u l y 1. total. 100,399,318 100.0 98,781,324 100.0 Registration Nonregistration 67,193,647 83,205,671 66.9 83.1 65,989,295 32,792,029 66.8 83.2 Registration(1900). J Nonregistration.. Registration (1906).. Nonregistration 7,059,361 100.0 6,962,079 100.0 21,352,400 100.0 I 20,961,391 ioo.6 16,056,072 8,389,191 7,627,254 4,691,308 5,106,317 8,012,320 3,014,996 5,849,623 578,943 9,393,482 1,806,153 1,333,090 4,592,151 536,657 82.6 17.41 61.9 38.1 1 38.9 61.1 34.0 66.0 5.8 94.2 57.5 42.5 89.5 10.5 15,856,254 3,359, 638 7,550,619 4,637,260 4,924,947 8,016,333 2,984,897 5,792,415 566,078 9,178,272 1,756,669 1,285,473 4,426,361 522,638 82.5 17.5 62.0 38.0 38.1 61.9 34.0 66.0 5.8 94.2 57.7 42.3 89.4 10.6 U N I T E D STATES 2 1 3 G E O G R A P H I C DIVISIONS: 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 00 Middle A t l a n t i c E a s t N o r t h Central Nonregistration W e s t N o r t h Central South Atlantic Registration E a s t S o u t h Central Registration W e s t S o u t h Central Mountain Registration Nonregistration.. Registration Nonregistration Pacific 21 NEW ENGLAND: Maine R e g i s t r a t i o n (1900).. 767,638 100.0 762,787 100.0 24 ?5 New Hampshire Registration (1890).. 440,584 166.6 438,662 ioo.6 ?6 97 *>8 9Q Vermont R e g i s t r a t i o n (1890).. 362,452 361,205 Massachusetts R h o d e Island Registration (1880).. R e g i s t r a t i o n (1890).. 3,662,339 602,765 166.6 ioo.6 100.0 1 3,605,522 591,215 ioo.6 ioo.6 Connecticut Registration (1890).. 1,223,583 100.0 i , 202,688 ioo.6 New York R e g i s t r a t i o n (1890).. 10,086,568 100.0 9,899,761 100.0 N e w Jersey Pennsylvania R e g i s t r a t i o n (1880).. Registration (1906).. 2,881,840 8,383,992 100.0 100.0 2,8i5,663 8,245,967 100.0 Ohio R e g i s t r a t i o n (1909).. 5,088,627 100.0 5,026,898 100.0 Indiana Registration (1900).. 2,798,142 100.0 2,779,467 100.0 Nonregistration R e g i s t r a t i o n (1900).. 2,680,328 8,389,191 3,015,442 44.2 55.8 100.0 2,627,i43 3,359,638 2,976,030 43.9 56.1 100.0 R e g i s t r a t i o n (1908).. 2,473,533 ioo.6 2,446,716 100.0 R e g i s t r a t i o n (1910).. 2,246,761 100.0 2,213,919 100.0 Nonregistration R e g i s t r a t i o n (1911).. 2,221,038 3,391,789 100.0 100.0 2,221,755 3,372,886 100.0 100.0 9? 9S 30 SI 39 100.0 MIDDLE ATLANTIC: 33 34 35 36 37 ioo. 6 E A S T NORTH CENTRAL: 38 39 40 41 49 43 44 45 46 47 Illinois Michigan Wisconsin W E S T NORTH 48 49 50 51 52 53 54 55 56 57 58 59 60 61 CENTRAL: Minnesota Iowa. Missouri North Dakota 718,083 Nebraska Kansas R e g . (1906to 1 9 0 9 ) . . . Nonregistration j Registration Nonregistration R e g i s t r a t i o n (1914).. lbb.'o 680,046 181,483 1,077,141 1,807,221 1'0'o.b 14.4 85.6 100.0 686,966 100.0 661,588 178,917 1,066,956 1,784,897 100.0 14.4 85.6 100.0 APPENDIX 1. GROWTH OF REGISTRATION AREA. 55 INCLUDED, B Y DIVISIONS AND STATES: 1880 TO 1915. was admitted to the registration area as a whole, or for which, by the admission of the last state included, the the population of a state is shown as partly in the registration area and partly in the nonregistration area for istration under municipal ordinance were accepted by the Bureau of the Census. An exception is North size were accepted for places of 1,000 population and over for the years 1910 to 1915; the law has since been given year is not necessarily deprived of all registration service for deaths, although this is frequently true, laws for this purpose, with inadequate laws, or with laws of satisfactory character, but whose results have ANNUAL COMPILATION (CALENDAR Population estimated as of J u l y 1. 97,163,330 63,298,718 33,864,612 6,864,796 1911 1912 1913 YEARS)—continued. Population estimated as of J u l y 1. Per cent of total. 100.0 92,309,348 100.0 1 63.0 37. 0 53,833,553 38,475,795 58.3 41.7 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Per c e n t of total. Population estimated as of J u l y 1. Per c e n t of total. Population estimated as of J u l y 1. Per cent of total. 100.0 95,545,336 100.0 93,927,342 59,211,061 34,716,281 100.0 65.1 1 34.9 100.0 | 60,427,247 35,118,089 63.2 1 36.8 6,767,513 100.0 1 6,670,231 20,570,382 \ 1910 100.0. 20,i?9,37i 100 0 I 19,788,361 6,572,948 100.0 19,397,352 100.0 15,652,299 3,334,221 6,017,268 6,009,929 4,800,518 7,963, 403 2,844,284 5,845,722 553,215 8,963,060 1,707,185 1,237,858 4,258,771 510, 419 82.4 17.6 50.2 49.8 37.6 62.4 32.7 67.3 5.8 94.2 58.0 42.0 89.3 10.7 15,452,330 3,304,819 5,983,459 5,943,054 2,900,450 9,686,112 2,852,879 5, 749, 822 540,351 8,747, 849 1,657,703 1,190,243 4,093,191 496,190 82.4 17.6 50.2 49.8 23.0 77.0 33.2 66.8 5.8 94.2 58.2 4L8 89.2 10.8 1 i s , 254,226 3,273,558 5,766,160 6,029,670 2,855,663 9,553,541 2,816,010 5,699,385 527,192 8,532,932 1,608,221 1,142,625 3,925,003 484,570 82.3 17.7 48.9 51.1 23.0 77.0 33.1 66.9 5.8 94.2 58.5 41.5 89.0 11.0 15,049,466 3,248,940 3,423,916 8,241,229 2,763,220 9,468,627 832,297 7,595,792 474,681 8,357,368 1,558,738 1,095,009 3,760,935 468,830 82.2 17.8 29.4 70.6 22.6 77.4 9.9 90.1 5.4 94.6 58.7 41.3 88.9 11.1 757,936 100.0 753,085 100.0 1 ' 436,740 100.0 434,8i8 100.0 748,234 100.0 743,382 100.0 432,895 100.0 43*6,972 100.0 100.0 | 359,957 100.0 358,7i6 100.0 357,463 100.0 356,216 100.0 3,548,705 579,665 100.0 100.0 3,491,888 568,114 100.0 100.0 3,435,070 556,565 100.0 100.0 3,782,52 545,016 100.0 100.0 1,181,793 100.0 1,160,898 100.0 1,140,664 100.0 i,ii9,iio 100.0 9,712,954 100.0 9,526,146 100.0 9,339,339 100.0 9,152,532 100.0 2,749,486 8,107,942 100.0 100.0 2,683,309 7,969,916 100.0 100.0 2,6i7,i32 7,831,890 100.0 100.0 2,556,954 7,693,866 100.0 100.0 4,965,169 100.0 4,903,439 100.0 4,841,710 100.0 4,779,981 100.0 2,760,792 100.0 2,742,H7 100.0 2,723,442 100.0 2,704,767 100.0 2,569,822 S, 334, 221 2,936,618 43.5 56.5 100.0 2,516,486 3,304,819 2,897,207 43.2 56.8 100.0 2,465,009 3,273,558 2,857,795 43.0 57.0 100.0 2,406,888 3,248,940 2,818,383 42.6 67.4 100.0 2,419,898 100.0 2,393,081 100.0 2,366,264 100.0 2,339,447 100.0 2,181,077 100.0 2,148,235 100.0 2,115,392 100.0 2,082,550 100.0 2,222,472 3,353,983 100.0 100.0 2,223,189 3,335,080 , 100.0 100.0 2,223,906 3,316,177 100.0 100.0 k, 224,622 1,016,745 2,280,528 100.0 30.8 69.2 608,614 100. b 660,849 643,121 176,351 1,056,771 335,857 1,426,716 100.0 100.0 14.3 ! 85.7 19.1 80.9 1 634,731 624,658 173,785 1,046,586 326,359 1,413,890 100.0 100.0 14.2 85.8 18.8 81.2 \ 606,196 171,219 1,036,402 163,372 1,554,552 100.0 14.2 1 85.8 9.5 90.5 1 582,497 100.0 587.734 168,604 1,026,266 156,017 1,539,582 100.0 14.1 85.9 9.2 90.8 22 23 24 ?5 26 ?7 28 29 30 31 33 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 56 THE FEDEEAL REGISTRATION SERVICE. APPENDIX 1.—GROWTH OF REGISTRATION AREA, POPULATION [See note at head of this table, p . 54.] ANNUAL COMPILATION (CALENDAR YEARS). DIVISION AND STATE. SOUTH ATLANTIC: Delaware Maryland District of Columbia. Virginia West Virginia... North Carolina.. South Carolina.. Georgia Florida EAST SOUTH CENTRAL: Kentucky Alabama... Mississippi. W E S T SOUTH CENTRAL: Arkansas Louisiana... Oklahoma 2.. Texas MOUNTAIN: Montana. Idaho Wyoming— Colorado New Mexico.. Arizona...... Utah Nevada PACIFIC: Washington. Oregon.... California. Registration (and year for which entire area was first included) or nonregistration. Registration (1890) *. Nonregistration Registration (1906).. Nonregistration Registration (1880).. Registration (1913).. Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration (1911). Nonregistration Registration .... Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration. Registration Nonregistration. Registration Nonregistration. Registration Nonregistration. Registration (1910). Nonregistration Registration Nonregistration Registration Nonregistration Registration (1906). Nonregistration Registration Nonregistration Registration Nonregistration Registration (1910). Nonregistration Registration Nonregistration— Registration (1908). Nonregistration Registration Nonregistration Registration (1906). Nonregistration— 1915 Population estimated as of July 1. 1914 Per cent of total. Population estimated as of July 1. Per cent of total. 93,161 118,437 1,351,941 44.0 56.0 100.0 92,057 117,760 1,341,075 43.9 56.1 100.0 358,679 2,171,014 100.0 100.0 353,378 2,150,009 100.0 100.0 42,817 1,290,093 472,295 1,867,157 60,121 1,529,894 296,660 2,479,853 116,535 731,576 3.2 96.8 20.2 79.8 3.8 96.2 10.7 89.3 13.7 86.3 43,097 1,316,377 480,488 1,890,607 133,018 1,474,727 303,082 2,513,207 171,837 3.2 96.8 20.3 79.7 8.3 91.710.8 89.2 19.7 80.3 2,365,185 100.0 2,350,731 100.0 376,636 1,894 J43 273,175 2,028,102 16.6 83.4 11.9 88.1 370,662 1,884,092 263,504 2,006,441 16.4 1,926,778 100.0 1,901,882 1,713,102 366,484 1,434,822 100.0 20.3 79.7 2,114,307 212,459 4,131,251 100.0 95.1 361,221 1,412,261 2,026,534 204,857 4,052,997 446,054 100.0 432,614 100.0 4.9 11.6 88.4 100.0 20.4 79.6 100.0 4.8 95.2 395,407 100.0 174,148 935,799 100.0 100.0 168,736 909,537 100.0 100.0 441,996 396,917 100.0 383,551 100.0 "247',299 424,300 100.0 100.0 239,053 414,518 100.0 100.0 102,730 100.0 98,726 100.0 1,471,043 100.0 1,407,865 100.0 272,833 536,657 2,848,275 33.7 66.3 100.0 260,601 33.3 66.7 100.0 i Dropped from registration area in census year 1900. 522,638 2,757,895 APPENDIX 1. 57 GROWTH OF REGISTRATION AREA. INCLUDED, BY DIVISIONS AND STATES: 1880 TO 1915—Continued. [See note at head of this table, p. 54.] A N N U A L COMPILATION (CALENDAR 1912 1913 Population estimated as of J u l y 1. YEARS)—continued. 1910 1911 Population estimated as of J u l y 1. Per c e n t of total. Population estimated as of J u l y 1. Per c e n t of total. Per c e n t of total. Population estimated as of J u l y 1. Per c e n t of total. 90,953 117,083 1,330,209 43.7 66.3 100.0 89,849 116,406 1,319,343 43.6 56.4 100.0 88,745 115, 729 1,308,477 43.4 56.6 100.0 87,641 115,053 1,297,610 43.2 56.8 100.0 348,077 2,129,003 100.0 100.0 342,776 343,034 1,764,964 42,257 1,237,524 385,790 1,890,375 59,509 1,495,045 233,070 2,463,891 84,822 717,907 100.0 16.3 83.7 3.3 96.7 16.9 1 83.1 1 3.8 96.2 8.6 91.4 10.6 89.4 337,476 336,534 1,750,459 41,978 1,211,239 374,314 1,870,208 59,202 1,477,621 225,785 2,431,399 83,152 696,886 100.0 16.1 83.9 3.3 96.7 16.7 1 83.3 1 3.9 96.1 8.5 91.5 10.7 89.3 332,i75 283,746 1,782,242 41,699 1,184,954 361,941 1,850,938 58,897 1,460.196 220; 917 2,396,491 78,594 678,753 100.0 13.7 86.3 3.4 96.6 16.4 83.6 3.9 96.1 8.4 91.6 10.4 89.6 42,537 1,263,808 396,927 1,910,882 59,815 1,512,470 290,243 2,446,494 3.3 96.7 17.2 1 82.8 3.8 96.2 10.6 89.4 13.7 86.3 112,754 712,666 2,336,277 100.0 2,321,823 100.0 2,307,370 100.0 254,173 1,983,955 253,834 1,984,780 11.4 88.6 11.3 88.7 287,387 1,934,116 243,669 1,963,614 12.9 87.1 11.0 89.0 28L226 1,923,651 227,414 1,948,638 12.8 87.2 10.5 89.5 330,813 1,962,103 278,403 1,909,849 223,081 1,921,540 14.4 85.6 12.7 87.3 10.4 89.6 1,876,987 100.0 1,852,092 100.0 i,827,'l96 100.0 '1,802,300 100.0 1,659,859 355,958 1,389,700 100.0 20.4 79.6 ! 1,633,238 350,695 1,367,139 100.0 20.4 79.6 i, 606,617 345,433 1,344,576 100.0 20.4 79.6 i,'579,'996 340,172 1,322,012 100.0 20.5 79.5 1,938,761 197,257 3,974,740 100.0 1 4.7 95.3 1,850,987 189,656 3,896,485 100.0 4.6 95.4 1,763.2Y4 181,759 3,818,625 100.0 1 4.5 | 95.5 1,675,441 134,509 3,779,919 100.0 3.4 96.6 419,174 100.0 405,734 100.0 392,294 100.0 378,853 100.0 378,818 1 ibb.b i'ob.b 362,229 100.0 j 345,64b 100.0 320,05! 100.0 157,914 857,016 ibb. b 100.0 '162,602 830,756 100.0 100.0 j i.J7,0^ 804,496 100.0 100.0 356,819 ibb.b 343,452 ibb.b 330,055 100.0 222, 563 394,953 ibb.b 214,317 385,171 ibb.b 375,389 100.0 100.0 163,325 883,276 370,185 230,808 404,735 100.0 ibb.b \ ibb.b \ 100.0 100.0 100.0 j 90,718 ibo.b 86,714 82,709 100.0 1,344,686 100.0 1,281,508 100.0 1,218,330 100.0 1,155,152 100.0 246,569 510,419 2,667,516 32.6 67.4 100.0 234,546 496,190 2,577,137 32. i 67.9 100.0 219,915 484,570 2,486,758 3i.2 68.8 100.0 209,404 468,830 2,396,379 30.9 69.1 100.0 94,722 ibb.b \ i'ob.b 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 ?4 25 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 4? 43 44 45 46 47 48 49 50 51 52 53 54 55 a Includes the population of Indian Territory from 1900 to 1907. In 1907 Indian Territory and Oklahoma were admitted to the Union as the state of Oklahoma. 58 T H E FEDERAL REGISTRATION SERVICE. APPENDIX l.—GKOWTH OF REGISTRATION AREA, POPULATION [See note at head of this table, p. 54.] A N N U A L COMPILATION (CALENDAR Y E A R S ) . DIVISION AND STATE. 1 Registration (and y e a r for w h i c h ent i r e a r e a w a s first i n c l u d e d ) or n o n registration. 1908 Population estimated as of J u l y 1. Per c e n t of total. Population estimated as of J u l y 1. Per c e n t of total. 100. 0 90,691,354 U N I T E D STATES 2 3 1909 Registration Nonregistration 100.0 89,073,360 50,917,810 39,773, 644 56.1 43.9 46,903,290 42,170,070 52.7 47.3 J G E O G R A P H I C DIVISIONS: 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 New England R e g i s t r a t i o n (1900).. 6,475,665 100.0 6,378,384 100.0 Middle A t l a n t i c R e g i s t r a t i o n (1906).. 19,006,345 ioo.6 i£,615,336 ioo. 6 E a s t N o r t h Central Registration Nonregistration Registration 14,859,789 3,209,247 2,485,541 9,048,925 2,401,216 9.663,271 745,294 7,595,489 464,409 8,139,563 890,686 1,665,960 3,588,865 461,089 82.2 17.8 21.5 78.5 11,661,946 6,177,719 2,411,304 8,992,478 2,367,351 9,509,776 731,141 7,522,336 453,973 7,921,925 860,061 1,599,485 3,423,794 446,351 65.4 34.6 21.1 78.9 19.9 80.1 8.9 91.1 5.4 94.6 35.0 65.0 88.5 11.5 R e g i s t r a t i o n (1900).. 738,531 100.0 733,679 100. 0 R e g i s t r a t i o n (1890).. 429,050 166.6 427,128 ioo. 6 Vermont R e g i s t r a t i o n (1890).. 354,968 353,722 ioo. 6 Massachusetts Rhode Island R e g i s t r a t i o n (1880).. R e g i s t r a t i o n (1890).. 3,321,435 533,466 166.6 166.6 100.0 3,264,618 521,917 ioo. 6 Connecticut R e g i s t r a t i o n (1890).. 1,098,215 ioo.6 1,077,320 ioo. 6 W e s t N o r t h Central South Atlantic Nonregistration Registration Nonregistration West South C e n t r a l . . . . Registration Nonregistration Mountain Nonregistration Pacific Registration Nonregistration E a s t S o u t h Central NEW 2? 23 24 25 26 27 28 29 30 31 32 19.9 1 80.1 8.9 91.1 5.4 94.6 34.8 65.2 88.6 U-4 ENGLAND: Maine 100.0 MIDDLE ATLANTIC: 33 34 35 36 37 New York N e w Jersey Pennsylvania R e g i s t r a t i o n (1890).. Nonregistration R e g i s t r a t i o n (1880).. R e g i s t r a t i o n (1906).. Nonregistration 8,965,726 100.0 8,778,918 100.0 2,484,778 7,555,841 166.6 2,418,601 7,417,817 ioo. 6 100.0 100.0 E A S T N O R T H CENTRAL: 38 39 40 41 42 43 44 45 46 47 R e g i s t r a t i o n (1909).. Nonregistration R e g i s t r a t i o n (1900).. 4,718,251 100.0 2,686,093 166.6 1,659,754 2,996,768 2,667,418 100. 0 Registration Nonregistration R e g i s t r a t i o n (1900).. Nonregistration R e g i s t r a t i o n (1908).. Nonregistration 2,363,843 3,209,247 2,778,972 42.4 57.6 100.0 2,309,400 3,180,951 2,739,561 42.1 67.9 100.0 2,312,630 166.6 2,285,813 100. 0 1 609,576 1,440,133 29.7 70.3 591,905 1,424,962 29.3 70.7 2, 225,341 996,866 2,281,504 100.0 30.4 69.6 ! 2,226,058 966,725 2,292,741 Yob. b North Dakota , R e g i s t r a t i o n (1910).. Nonregistration . . . Registration Nonregistration R e g i s t r a t i o n (1911).. Nonregistration Registration South Dakota R e g . (1906 to 1909)... 556,380 569,271 100.0 100.0 530,262 550,809 100.0 100.0 Nebraska Registration Nonregistration R e g i s t r a t i o n (1914).. Nonregistration 166,036 1,016,084 143,792 1,529,483 14.0 86.0 8.6 i63,468 1,006,901 138,397 1,512,554 14.0 86.0 8.4 91.6 Ohio Indiana Illinois Michigan Wisconsin 35.6 64.4 W E S T N O R T H CENTRAL: 48 49 50 51 52 53 54 55 56 57 58 59 60 61 Minnesota Iowa Missouri Kansas 91.4 1 29.7 70.3 APPENDIX 1. 59 ROWTH OF REGISTRATION AREA. INCLUDED, BY DIVISIONS AND STATES, 1880 TO 1915—Continued. [See note at head of this table, p. 54.] A N N U A L COMPILATION (CALENDAR Population estimated as of J u l y 1. Per c e n t of total. 100.0 85,837,372 100.0 49.4 50.6 42,258,513 43,578,859 49.2 j 50.8 1 Population estimated as of J u l y 1. Per c e n t of total. 87,455,366 43,220,889 44,234,477 1905 1906 1907 YEARS)—Continued. 1904 Population estimated as of J u l y 1. Per c e n t of total. Population estimated as of J u l y 1 . Per c e n t of total. 84,219,378 100.0 82,601,384 100.0 I 34,410,845 49,808,533 40.9 59.1 33,651,025 48,950,359 40.7 59.3 0 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 6,281,102 100.0 6,183,819 100.0 \ 6,086,536 100.0 5,989,254 100.0 i8,224,327 100.0 i7,833,318 100.0 j | 9,53i,455 7,849,4*0 2,216,496 8,925,917 2,249,619 9,272,796 551,572 7,527,293 433,105 7,486,640 776,213 1,489,132 2,482,916 1,027,611 54.8 45.2 1 19.9 80.1 19.5 80.5 6.8 93.2 5.5 94.5 34.3 65.7 70.7 29.3 13,175,294 4,267,015 9,382,977 7,768,577 1,778,502 9,233,226 1,529,580 9,815,478 546,185 7,445,374 389,462 7,302,208 297,651 1,870,594 1,224,658 2,106,061 75.5 24.5 54.7 45.3 16.2 83.8 13.5 86.5 6.8 93.2 5.1 94.9 13.7 86.3 36.8 63.2 12,867,966 4,183,334 9,201,258 7,720,923 1,732,913 9,148,131 1,503,969 9,663,732 540, 799 7,363,454 379,815 7,083,780 285,469 1,785,676 1,149,582 2,001,329 75.5 24.5 54.4 45.6 15.9 84-1 13.5 86.5 6.8 93.2 5.1 94.9 13.8 86.2 36.5 63.5 9,681,069 7,929,225 2,277,945 8,995,151 2,297,876 9,401,897 580,090 7,586,081 443,539 7,704,282 805,999 1,556,447 2,628,942 1,061,394 55.0 45.0 20.2 79.8 19.6 | 80.4 7.1 92.9 5.4 94.6 34.1 65.9 71.2 28.8 728,828 100.0 723,977 100.0 719,126 100.0 714,275 100.0 425,205 100.0 423,282 100.0 421,359 100.0 419,437 100.0 352,475 100.0 351,228 100.0 349,981 3,207,801 510,367 100.0 100.0 3,150,984 498,817 100.0 100.0 3,094,167 487,267 166.6 ioo.6 i , 056,426 100.0 L i,035,531 100.0 1,014,636 348,734 100.0 100.0 3,037,350 475,717 100.0 100.0 ioo.6 993,741 100.0 8,592,111 100.0 8,405,304 100.0 8,218,497 100.0 8,031,690 100.0 2,352,424 7,279,792 100.0 100.0 2,286,247 7,141,767 100.0 100.0 2,220,070 2,736,727 4,267,015 100.0 39.1 60.9 2,153,893 2,682,383 4,183,884 100.0 39.1 60.9 1,620,692 2,974,101 2,648,743 35.3 64.7 100.0 j 1,580,831 2,952,233 2,630,069 34.9 65.1 100.0 ! 1,540,929 2,930,406 2,611,394 34.5 65.5 100.0 1,482,024 2,927,582 2,592,718 33.6 66.4 100.0 2,233,253 8,174,359 2,700,149 41.3 58.7 100.0 2,i75,89i 3,148,984 2,660,737 40.9 59.1 100.0 2,123,930 3,118,207 2,621,325 40.5 59.5 100.0 2,069,930 3,089,468 2,581,913 40.1 59.9 100.0 478,232 1,780,765 21.2 78.8 483,927 1,748,253 21.7 78.3 485,399 1,719,964 22.6 78.0 474,673 1,703,873 21.8 78.2 574,234 1,409,791 28.9 1 71.1 556,564 1,394,619 28.5 71.5 538,894 1,379,447 118,874 2,109,336 906,303 2,296,453 28.1 71.9 5.3 94.7 28.3 71.7 521,223 1,364,276 116,270 2,112,656 886,163 2,297,690 27.6 ,72.4 5.2 94.8 27.8 72.2 451,908 100.0 425,791 100.0 495,420 155,767 975, 349 58,664 1,525,813 100.0 13.8 86.2 3.7 96. S 476,958 153,201 965,164 56,056 1,505,596 100.0 13.7 86.3 3.6 96.4 2,226,775 946,584 2,293,978 2,227,493 926,443 2,295,216 100.0 28.8 71.2 604, i'u 532,346 1 100.0 29.2 70.8 100.0 100.0 478,026 513,883 100.0 100.0 i60,90i 995,717 63,880 1,664,746 13.9 86.1 3.9 96.1 ] i58,334 985,533 61,272 1,545,030 13.8 86.2 3.8 1 96.2 \ 3 22 ?3 24 ?5 26 ?7 28 29 30 31 3? 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 60 T H E FEDERAL REGISTRATION SERVICE. APPENDIX 1.—GROWTH OF REGISTRATION AREA, POPULATION [See note at head of this table, p. 54.] ANNUAL COMPILATION (CALENDAR YEARS). DIVISION AND STATE. Registration (and year for which entire area was first included) or nonregistration. SOUTH ATLANTIC: Registration (1890)i, Nonregistration Registration (1906).. Nonregistration District of Columbia... Registration (1880).. Registration (1913).. Virginia Nonregistration Registration West Virginia... Nonregistration Registration North Carolina.. Nonregistration Registration South Carolina.. Nonregistration Registration Georgia Nonregistration Registration Florida Nonregistration Delaware Maryland EAST SOUTH CENTRAL: Kentucky Tennessee.. Alabama... Mississippi. W E S T SOUTH CENTRAL: Arkansas Louisiana... Oklahoma 2 . Texas MOUNTAIN: Montana. Idaho Wyoming Colorado..... New Mexico.. Arizona Utah Nevada PACIFIC: Washington.. Oregon California. Registration (1911). Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration. Registration Nonregistration. Registration Nonregistration. Registration Nonregistration. Registration (1910). Nonregistration Registration Nonregistration Registration Nonregistration Registration (1906). Nonregistration Registration Nonregistration Registration Nonregistration Registration (1910). Nonregistration Registration—.... Nonregistration 1909 Population estimated as of July 1. 1908 Per cent of total. Population estimated as of July 1. Per cent of total. 86,536 114,377 1,286,745 43.1 56.9 100.0 85,432 113,700 1,275,879 42.9 67.1 100.0 326,873 280,332 1,764,650 41,419 1,158,670 44,604 2,136,632 58,590 1,442,773 201,047 2,376,584 75.070 659,585 100.0 13.7 86.3 3.5 96.5 2.0 98.0 3.9 96.1 7.8 92.2 10.2 321,570 276,906 1.747,070 41,139 1,132,386 44,147 2,105,445 58,282 1,425,353 192,177 2,345,678 71.819 640,144 100.0 13.7 86.3 3.5 96.5 2.1 97.9 3.9 96.1 7.6 92.4 10.1 89.9 323,183 1,955,280 262,577 1,909,049 159,534 1,953,755 U.2 85.8 12.1 87.9 7.5 92.5 320,403 1,943,606 259,751 1,895,251 150,987 1,930,969 14.2 85.8 12.1 87.9 7.3 92.7 1,777,405 100.0 1,752,510 100.0 1,553,3/4 334,909 1,299,451 100.0 20.5 79.5 1,526,751 329,645 1,276,892 100.0 20.5 79.5 1,587,667 129,500 3,699,071 100.0 3.4 96.6 124.328 f, 618,388 100.0 3.3 96.7 365,413 100.0 "3'12','46'i "l'oo'.b 351,972 100.0 "m'.Wi "lbb'.o 136,270 100.0 100.0 141,681 778,235 100.0 100.0 751,974 316,719 100.0 303J53 197,826 253,155 100.0 30.8 69.2 108,087 247,737 100.0 30.4 69.6 78,705 100.0 74,702 100.0 Registration (1908). 1,091,973 100.0 Nonregistration 190,893 29.3 Registration 461,089 70.7 Nonregistration 100.0 2,305,999 Registration (1906). Nonregistration 1 Dropped from registration area in census year 1900. 1,028,794 100.0 179,382 446,851 2,215,618 28.7 71.3 100.0 112,451 APPENDIX 1. 61 GROWTH OF REGISTRATION AREA. INCLUDED, BY DIVISIONS AND STATES: 1880 TO 1915—Continued. [See note at head of this table, p. 54.] A N N U A L COMPILATION (CALENDAR 1907 YEARS)—Continued. 1905 1906 1904 Per c e n t of total. Population estimated as of J u l y 1. Per c e n t of total. Population estimated as of J u l y 1. Per c e n t of total. Population estimated as of J u l y 1. Per cent of total. 84,328 113,024 1,265,013 42.7 57.3 100.0 83,224 112,347 1,254,147 42.6 57.4 100.0 3i6,269 239,703 1,768,268 40,859 / , 106,103 37,854 2,080,095 57,975 1,407,930 187,307 2,310,773 68,568 620, 704 ioo.6 12.0 88.0 3.6 96.4 1.8 98.2 4.0 96.0 7.5 92.5 9.9 90.1 3JL0,968 217,881 1,764,084 40,579 1,079,819 37,398 2,048,908 57,668 1,390,507 182,437 2,275,867 65,317 601,264 100.0 11.0 89.0 3.6 96.4 1.8 98.2 4.0 96.0 7.4 92.6 9.8 90.2 82,120 111,670 552,883 690,398 305,667 214,674 1,746,286 40,299 1,053,535 36,942 2,017,721 57,362 1,373,088 177,567 2,240,961 62,066 5S/,S#4 42.4 57.6 44.5 55.5 100.0 10.9 89.1 3.7 96.3 1.8 98.2 4.0 96.0 7.3 02.7 9.6 90.4 81,016 110,993 547,747 684,668 300,366 211,468 1,728,487 40,019 1,027,251 36,485 1,986,535 57,056 1,355,659 170,997 2,207,755 58,815 502,384 42.2 57.8 44.4 55.6 100.0 10.9 89.1 3.7 96.3 1.8 98.2 4.0 96.0 7.2 92.8 9.5 90.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 14.1 85.9 10.4 89.6 2.0 98.0 1 312,145 1,922,956 199,079 1,922,673 40,348 1,978,946 14.0 86.0 9.4 90.6 2.0 98.0 309,517 1,911,130 196,629 1,908,498 40,039 1,947,924 13.9 86.1 9.3 90.7 2.0 98.0 306,889 1,899,304 194,180 1,894,322 39,730 1,916,902 13.9 86.1 9.3 90.7 2.0 98.0 i, 67 7,822 100.0 i, 652,926 100.0 18 19 20 21 22 23 ?4 25 1,W,887 313,856 1,209,209 100.0 20.6 70.4 i,420,266 308,593 1,186,648 100.0 20.6 70.4 27 28 i, 236,572 75,606 3,409,5/^0 100.0 2.2 07. 8 i, i'4'8,798 71,222 3,328,068 ibb.b 31 32 33 Population estimated as of J u l y 1. 317,804 1,931,751 221,629 1,916,748 40,657 2,009,968 1,727,614 100.0 1,702,718 100.0 1,500,129 324,382 1,254,331 100.0 20.5 79.5 1,473,508 319,119 1,231,770 100.0 20.6 79.4 1,412,120 119,157 3,537,702 100.0 3.3 96.7 1,324,346 113,986 3,457,016 100.0 3.2 96.8 338, 531 100,0 325,090 100.0 311,650 100.0 298,210 100.0 279,281 ibb.b i'ob.b 262,692 ibb.b ibb.b 246,102 100.0 229,511 100.0 120,038 225,715 447,477 100.0 33.5 00.5 114,627 216,957 420,074 100.0 33.5 66.5 263,255 J00.0 249,889 100.0 '164,843 71,936 ^4,539 ibb.b 156,598 68,512 248, *8i ibb.b iw.o 58,686 100.0 245,622 530,450 133,341 387,388 770,619 1,083,482 31.6 68.4 25.6 130,860 725,714 100.0 125,449 699,453 1 100.0 j 289,987 181,334 80,285 265,756 ido. b ibb.b 23.2 76.8 276,621 173,088 76,760 259,498 ibb.b ibb.b 22.8 77.2 70,698 ibb.b 66,694 ibb.b 62,690 334,833 630,783 168,871 430,611 2,125,238 34.7 65.3 28.2 71.8 100.0 290,696 611,741 157,361 415,870 2,034,859 32.2 67.8 27.5 72.5 100.0 267,759 571,500 146,851 400, *00 810,048 /,^34,430 1 *>6 22.0 78.0 31.9 68.1 26.8 73.2 41.7 58.3 1 2.1 07.0 21.6 78.4 74-4 41.6 58.4 29 SO 34 35 36 37 38 39 40 41 4? 43 44 45 46 47 48 49 50 51 52 53 54 55 2 Includes the population of Indian Territory from 1900 to 1907. In 1907 Indian Territory and Oklahoma were admitted to the Union as the state of Oklahoma. 62 T H E FEDERAL REGISTRATION SERVICE. APPENDIX 1.—GROWTH OF REGISTRATION AREA, POPULATION [See n o t e a t h e a d of t h i s t a b l e , p . 54.] A N N U A L COMPILATION (CALENDAR Y E A R S ) . DIVISION AND STATE. Registration (and y e a r for w h i c h e n t i r e area w a s first i n c l u d e d ) or nonregistration. 1903 Population estimated as of J u l y 1. 1902 •Per cent of total. 80,983,390 UNITED STATES. Population estimated a s of Julyl. 79,365,396 Registration Nonregistration 32,932,515 48,050,875 40.7 59.3 Registration (1900). Nonregistration R e g i s t r a t i o n (1906). Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration.. Nonregistration Registration Nonregistration Registration Nonregistration 5,891,971 100.0 5,794,687 12,562,118 4,098,173 9,034,673 7,658,136 1,706,816 9,043,546 1,480,059 9,510,281 535,415 7,281,533 370,168 6,865,353 273,787 1,700,258 1,077,508 1,893,595 75.4 24.6 54.1 45.9 15.9 84.1 13.5 86.5 6.8 93.2 5.1 94.9 13.9 86.1 36.3 63.7 12,257,847 4,011,435 8,873,681 7, 589, 757 1,660,706 8,958,974 1,456,153 9,356,827 528,881 7,200,761 360,521 6,646,925 252,530 1,624,417 1,005,437 1, 785, 857 32,190,443 47,174,953 G E O G E A P H I C DIVISIONS: New England Middle A t l a n t i c East North Central.. West North Central. South Atlantic East South Central.. West South Central. Mountain Pacific NEW Per cent of total. 40.4 59.6 100.0 75.3 24.7 53.9 46.1 15.6 84-4 13.5 86.5 6.8 93.2 5.1 94.9 13.5 86.5 36.0 64.0 ENGLAND: Maine New Hampshire. Vermont Massachusetts. Rhode Island.. Connecticut. R e g i s t r a t i o n (1900). Nonregistration R e g i s t r a t i o n (1890). Nonregistration Registration (1890). Nonregistration R e g i s t r a t i o n (1880). R e g i s t r a t i o n (1890). Nonregistration R e g i s t r a t i o n (1890). Nonregistration 709,424 100.0 704,573 "4i7,*5i5" "i66."6" " 415," 593" 100.0 346,239 347,487 2,980,533 464,167 100.0 100.0 2,923,716 452,616 972,845 100.0 100.0 100.0 951,950 MIDDLE ATLANTIC: New York New Jersey... Pennsylvania. R e g i s t r a t i o n (1890). Nonregistration Registration (1880). Registration (1906). Nonregistration 7,844, g 100.0 7,658,076 100.0 2,087,716 2,629,519 4, 098,173 100.0 39.1 60.9 2,021,539 2,578,232 4,011,435 100.0 39.1 60.9 R e g i s t r a t i o n (1909). Nonregistration R e g i s t r a t i o n (1900). Nonregistration Registration Nonregistration R e g i s t r a t i o n (1900). Nonregistration R e g i s t r a t i o n (1908). Nonregistration 1,438,312 2,909,565 2,574,043 33.1 66.9 100.0 1,398,093 2,888,055 2,555,368 32.6 67.4 100.0 2,017,370 3,059,290 2,542,501 39.7 60.3 100.0 1,965,409 3,028,513 2,503,089 39.4 60.6 100.0 462,447 1,689,281 21.5 78.5 451,722 R e g i s t r a t i o n (1910). Nonregistration Registration Nonregistration R e g i s t r a t i o n (1911). Nonregistration Registration Nonregistration R e g . (1906 t o 1909).. Nonregistration Registration Nonregistration R e g i s t r a t i o n (1914). Nonregistration 503,552 1,349,105 133,157 2,096,486 866,024 27.2 72.8 6.0 485,880 1,333,935 130,032 2,100,328 845,885 2,300,162 21.3 78.7 26.7 73.3 5.8 94.2 26.9 73.1 EAST N O R T H CENTRAL: Ohio Indiana Illinois Michigan.. Wisconsin. W E S T N O R T H CENTRAL: Minnesota Iowa Missouri North Dakota.. South Dakota.. Nebraska Kansas 94.0 27 A 72.6 399,674 100.0 373,557 100.0 458,496 150,635 954,979 53,448 100.0 13.6 86.4 3.5 440,033 148,069 944,795 50,840 100.0 13.5 86.5 3.4 96.6 96.6 1,466,164 Uh 1 The registration returns for the censuses of 1880, 1890, and 1900 were only for the census years ending May 31. No data were collected for interdecennial years (except a special return for the cities of Baltimore, Washington, New York, Brooklyn, Boston, and Philadelphia for the five years from June 1,1884, to May 31,1889). APPENDIX 1. 63 GROWTH OF REGISTRATION AREA. INCLUDED, BY DIVISIONS AND STATES: 1880 TO 1915—Continued. [See note at head of this table, p. 54.] ANNUAL COMPILATION ( C A L E N D A E YEARS)—continued. 1901 1900 1900 Population estimated as of J u l y 1. Per cent of total. 77,747,402 1 31,460,633 46,286,769 DECENNIAL COMPILATION ( C E N S U S Y E A R S ONLY).* 1890 Population estimated as of J u l y 1. Per cent of total. Population enumerated as of J u n e 1. Per cent of total. 100.0 76,129,408 100.0 75,994,575 100.0 40.5 59.5 30,810,930 45,318,478 1880 Population2 Per enumeratcent ed a s of of J u n e 1. total. Population enumerated a s of J u n e 1. Per cent of total. 62,622,250 100.0 50,155,783 100.0 1 40.5 1 28,807,269 47,187,306 59.5 37.9 1 19,659,440 42,962,810 62.1 31.4 68.6 8,538,366 41,617,417 17.0 83.0 2 3 100.0 1 4,061,360 639,385 9,087,158 76.0 3,613,642 24.0 2,784,413 40.3 10,687,427 59.7 1,138,304 16.0 7,752,135 84.O 1,166,756 13.3 7,691,164 86.7 451,281 7.0 5,977,489 93.0 384,528 5.5 4,159,595 94.5 106,713 14.3 1,049,613 85.7 478,927 35.4 1,392,360 64.6 86.4 13.6 71.5 28.5 20.7 79.3 12.8 87.2 13.2 86.8 7.0 93.0 8.5 91.5 9.2 90.8 25.6 1,887,942 2,122.587 3,907,637 6,589,241 1,109,113 10,097,555 350,518 5,806,925 665,999 6,931,198 167,108 5,418,043 216,090 3,118,130 47.1 52.9 37.2 62.8 9.9 90.1 5.7 653, H 9 233,959 880,619 100.0 21.0 79.0 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 648,936 100.0 99 93 346,991 100.0 1 5,697,406 100.0 5,600,123 100.0 5,592,017 i i , 953,928 3,924,342 8,720,916 7,513,151 1,614,747 8,874,249 1,425,249 9,210,373 523,297 7,119,041 350,874 6,428,497 240,849 1,538,998 933,367 1,678,118 75.3 24.7 53.7 46.3 15.4 84.6 13.4 86.6 6.8 93.2 5.2 94.8 13.5 86.5 35.7 64.3 l i , 715,298 3,771,964 8,584,354 75.6 699,722 413,670 344,992 1,588,877 8,769,436 1,399,845 9,058,416 517,514 7,037,518 341,228 6,210,068 239,759 1,442,990 823,932 1,607,745 53.6 46.4 15.3 84.7 13.4 86.6 6.8 93.2 5.2 94.8 14.2 85.8 33.9 66.1 ii,74i,073 3,713,605 6,447,885 9,537,696 1,658,638 8,688,785 1,387,870 9,055,610 529,280 7,018,477 356,438 6,175,852 238,772 1,435,885 855,296 1,561,396 100.0 694,870 100.0 694,466 100.0 100.0 411,748 100.0 4ii,588 100.0 21,701 639,385 376,530 3.3 i 96.7 100.0 100.0 343,745 100.0 343,641 100.0 332,422 100.0 1 7,420,341 U-4 74.4 2,866,899 441,067 100.0 100.0 2,810,081 429,518 100.0 100.0 2,805,346 428,556 100.0 100.0 2,238,943 345,506 100.0 100.0 931, 056 100.0 910,161 100.0 908,420 100.0 746,258 100.0 7,284,461 100.0 7,268,894 100.0 5,997,853 100.0 i , 955,36i 2,527,299 3,924,342 ioo.6 39.2 60.8 1,889,184 2,541,653 3,771,964 100.0 I 40.3 59.7 i , 883,669 2,588,510 3,713,605 100.0 41.1 58.9 1,444,933 1,644,372 3,613,642 ioo.6 1 1,358,542 2,865,876 2,536,693 32.2 67.8 100.0 1,330,043 2,832,646 2,518,018 32.0 68.0 100.0 i 39.6 1,877,760 2,950,685 31.9 68.1 14.9 85.1 39.2 60.8 100.0 \ 862,207 2,810,109 228,928 1,963,476 1,222,330 2,604,021 241,390 1,852,499 229,558 1,457,322 23.5 76.5 10.4 89.6 31.9 68.1 11.5 1 88.5 1 13.6 86.4 309,154 992,672 104,212 1,807,684 584,486 2,094,698 23.7 76.8 5.5 94.5 21.8 78.2 8.8 91.2 3.0 97.0 6.5 93.5 ?4 332,286 1,783,085 104,857 171,674 100.0 100.0 37.9 62.1 100.0 7,471,268 &£.,? 100.0 28 29 30 31 39 1,772,962 3,309,909 1,131,116 1,003,559 3,279,332 34.9 65.1 100.0 23.4 76.6 33 34 35 36 37 415,285 2,782,777 75,056 1,903,245 503,185 2,574,686 13.0 87.0 3.8 96.2 16.3 88.7 1,636,937 115,587 1,199,910 100.0 8.8 91.2 38 39 40 •11 42 43 44 <15 46 47 622,700 i, 913,324 2,997,860 2,463,678 61.0 100.0 1 2,424,266 1,326,944 2,830,601 374,594 [• 2,141,868 38.9 1,891,998 61.1 2,929,552 100.0 2,420,982 448,679 1,649,415 2i.4 78.6 434,267 1,637,010 21.0 79.0 433,367 1,635,675 20.9 1 79.1 468,208 1,318,765 127,058 2,104,019 825,746 2,301,397 26.2 73.8 5.7 94.3 26.4 73.6 450,537 1,303,594 133,298 2,098,495 805,607 2,302,633 25.7 74.3 6.0 94.O 25.9 74.1 449,065 1,302,329 159,233 2,072,620 841,969 2,264,696 25.6 321,322 ibb.b 347,439 421,571 145,503 934,610 48,232 i'ob. b ibb.b 13.5 86.5 3.2 1,U6,U8 \ 96.8 1 403,109 142,937 924,426 56,498 1,415,857 J Yob. b 13.4 86.6 3.8 319,146 401,570 142,724 923,576 65,647 1,404,848 7 ti\ 92.9 27.1 72.9 ibb.b i'ob. b 13.4 86.6 4.5 95.5 1 182,719 328,808 140,452 918,458 '1,427,096 31.3 68.7 ibb.b 1 2 Not including Indian Territory nor Indians on reservations, 3 Dakota Territory, 96.2 1 780,773 100.0 1,624,615 350,518 1,817,862 100.0 16.2 83.8 ibb.b I s 135,177 3100.0 i'ob. b 13.3 86.7 ?5 *?6 97 452,402 100.0 996,096 100.0 48 49 50 51 52 53 54 55 56 57 58 59 60 61 64 T H E FEDEKAL REGISTRATION SERVICE. APPENDIX 1.—GROWTH OF REGISTRATION AREA, POPULATION [See note at head of this table, p. 54.] ANNUAL COMPILATION (CALENDAR YEARS). DIVISION AND STATE. SOUTH ATLANTIC: Delaware Maryland District of Columbia Virginia. West Virginia North Carolina South Carolina Georgia Florida EAST SOUTH CENTRAL: Kentucky Tennessee Alabama Mississippi W E S T SOUTH CENTRAL: Arkansas Louisiana Oklahoma 4 Texas MOUNTAIN: Montana Idaho Wyoming Colorado New Mexico Arizona Utah Nevada PACIFIC: Washington Oregon California Registration (and year for which entire area was first included) or nonregistration. Registration (1890) s Nonregistration Registration (1906). Nonregistration Registration (1880). Registration (1913). Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration (1911). Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration Registration Nonregistration. Registration Nonregistration. Registration Nonregistration. Registration Nonregistration. Registration (1910). Nonregistration Registration Nonregistration Registration Nonregistration Registration (1906). Nonregistration Registration Nonregistration Registration Nonregistration Registration (1910). Nonregistration Registration Nonregistration Registration (1908). Nonregistration Registration Nonregistration Registration (1906). Nonregistration 1903 Population estimated as of July 1. 1902 Per cent of total. Population estimated as of July 1. Per cent of total. 42.0 58.0 44.4 55.6 100.0 10.9 89.1 3.8 96.2 1.8 98.2 4.1 95.9 7.1 92.9 9.3 90.7 78,808 109,638 537,475 673,208 289,763 205,061 1,692,883 39,459 974,682 35,571 1,924,163 56,444 1,320,810 161,258 2,137,941 52,314 41.8 58.2 44.4 55.6 100.0 10.8 89.2 3.9 96.1 1.8 98.2 4.1 95.9 7.0 93.0 9.1 90.9 1,885,880 13.9 86.1 9.3 90.7 2.0 98.0 301,485 1,875,800 188,284 1,866,967 39,112 1,854,858 13.8 86.2 9.2 90.8 2.1 1,628,031 100.0 1,603,136 100.0 1,393,645 100.0 20.7 79.3 1,367,024 298,067 1,141,526 100.0 20.7 79.3 100.0 2.0 98.0 973,252 62,454 3,165,123 100.0 1.9 98.1 100.0 271,330 79,912 110,315 542,611 678,938 295,064 208,264 1.710,686 39,739 1,000,967 36,028 1,955,349 56,750 1,338,235 166,127 2,172,8^8 55,564 304,262 1,887,477 191,732 1,880,145 39,421 303,330 1,164,087 1,061,025 66,838 3,246,596 ,770 "lb'o'.o 109,215 208,699 411,970 100.0 33.6 66.4 103,804 191,866 402,543 100.0 148,353 100.0 "lb'o'.o 3,157 100.0 21.2 78.8 140,108 100.0 32.3 67.7 223,485 489,418 122,831 371,647 731,192 1,032,530 236,464 100.0 20.4 79.6 100.0 65,088 50,678 100.0 31.3 68.7 24.8 75.2 41.5 58.5 201,349 31.0 69.0 24.0 76.0 41.3 58.7 60,664 448,375 112,321 355,906 691,767 981,576 1 The registration returns for the censuses of 1880,1890, and 1900 were only for the census years ending May 31. No data were collected for interdecennial years (except a special return for the cities of Baltimore, Washington, New York, Brooklyn, Boston, and Philadelphia for the five years from June 1,1884, to2May 31,1889). Not including Indian Territory nor Indians on reservations. 3 Dropped from registration area in census year 1900. APPENDIX 1. 65 GROWTH OF REGISTRATION AREA. INCLUDED, BY DIVISIONS AND STATES: 1880 TO 1915—Continued. [See note at head of this table, p. 54.] A N N U A L COMPILATION (CALENDAR YEARS)—continued. 1900 1901 Population estimated as of Julyl. Per cent of total. Population estimated a s of J u l y 1. 77,704 108,961 532,339 667,478 284,462 201,858 1,675,081 39,180 1 948,397 35,114 1,892,976 56,138 1,303,386 149,390 2,110,033 49,064 504,061 41.6 58.4 44.4 55.6 100.0 10.8 89.2 4.0 96.0 1.8 98.2 4.1 95.9 6.6 98.4 8.9 91.1 76,600 108,283 527,204 661,746 279,160 197,155 1,658,779 38,901 922,113 34,657 1,861,790 55,832 1,285,962 144,522 2,075,124 45,814 484,619 298,658 1,864,174 185,836 1,852,790 38,803 1,823,836 13.8 86.2 9.1 90.9 2.1 97.9 295,632 1,852,746 183,388 1,838,613 38,494 1,792,814 1,578,241 100.0 1,553,345 D E C E N N I A L COMPILATION ( C E N S U S Y E A R S O N L Y ) . l Population enumerated as of J u n e 1. Per cent of total. 76,508 41.4 58.6 108,227 44.3 526,778 55.7 1 661,266 100.0 1 278,718 10.6 186,903 89.4 1,667,281 4.0 38,878 96.0 919,922 1.8 34,619 98.2 1 1,859,191 55,807 4.2 95.8 1,284,509 6.5 144,116 98.5 2,072,215 8.6 45,543 91.4 482,999 41.4 58.6 44.3 55.7 100.0 10.1 89.9 4.1 95.9 1.8 98.2 4.2 95.8 6.5 93.5 8.6 91.4 Per cent of total. 13.8 9.1 90.9 2.1 97.9 100.0 295,416 1,851,758 183,185 1,837,431 38,469 1,790,228 12,210 1,539,060 1880 1890 1900 Population2 Per enumeratcent ed a s of of J u n e 1. total. 100.0 41.7 55.3 100.0 7.5 92.5 762,794 12,678 1,605,269 54,955 1,096,194 142,022 1,695,331 100.0 0.8 99.2 \ 4.8 95.2 7.7 92.3 391,422 100.0 13.8 86.2 9.1 90.9 2.1 97.9 0.8 99.2 173,926 1,684,709 192,298 1,575,220 79,137 1,433,880 5,920 1,283,680 9.4 90.6 10.9 89.1 5.2 94.5 0.5 99.5 11,311 1,116,868 242,039 576,545 1.0 99.0 21.6 78.4 100.0 20.7 79.3 1,813,782 287,542 1,096,402 100.0 20.8 . 7S. 2 1,311,564 303,117 1,078,508 100.0 21.9 78.1 885,478 58,070 8,083,651 ibb.b 797,705 53,686 3,002,179 Too. b 790,391 53,321 2,995,389 100.0 1.7 98.3 61,534 131,178 2,104,345 100.0 5.9 94.1 10,770 232,559 4.4 95.6 132,159 100.0 1.8 1 98.2 5 Per cent of total. 42,478 104,130 332,313 602,630 177,624 63,600 1,448,965 168,493 434,439 607,951 230,392 123,777 1,532,203 1,340,403 292, 804 1,118,965 1.8 98.2 Population enumerated a s of J u n e 1. 29.0 71.0 35.5 64.5 100.0 4.2 95.8 618,457 100.0 1,399,750 49,, 984 945,593 100.0 5.0 95.0 1,542,180 100.0 269,493 100.0 123,758 1,524,932 43,350 1,499,009 7.5 92.5 2.8 97.2 1,262,505 100.0 1,131,597 100.0 802,525 216,090 723,856 } (6) 100.0 23.0 77.0 (6) { 1,591,749 100.0 39,159 100.0 100.0 , 10,784 233,665 4.4 95.6 179,744 100.0 168,154 100.0 i^i, 77^ 100.0 84,385 100.0 82,610 100.0 98,393 183,609 884,540 100.0 32.3 67.7 92,982 175,159 366,730 100.0 32.3 £7.7 92,531 174,471 355,229 100.b 32.3 67.7 60,705 106,713 305,455 100.0 25.9 74.1 20,789 100.0 194,827 100.0 209,790 100.0 196,424 195,310 100.0 153,593 100.0 119,565 100.0 131, 868 57,240 280,106 ibb.b 1 123,618 53,816 223, 748 mo mo ioo.o 59,620 100.0 40,440 100.0 19.4 122,931 53,531 223,218 19.3 80.7 207,905 100.0 143,968 100.0 45,761 100.0 62,266 100.0 349,390 ibb.b ibb.b 75,116 100.0 174,768 233,959 630,785 100.0 27.1 72.9 257,889 19.9 80.1 46,673 100.0 42,669 100.0 j 42,335 iob.b 179,213 407,333 101,811 840,164 652,343 930,621 30.6 69.4 23.0 77.0 41.2 55.5 119,710 403, 658 91,301 324,423 612,921 879,664 22.9 77.1 22.0 78.0 41.1 55.9 155,233 362,870 90,426 323,110 609,637 875,416 30.0 70.0 21.9 78.1 41.1 55.9 318,767 478,927 729,203 39.6 60.4 1 ? 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 53 5a 54 55 * Includes the population of Indian Territory from 1900 to 1907. In 1907 Indian Territory and Oklahoma were admitted to the Union as the state of Oklahoma. 5 Population of Greer County (5,338), in Indian Territory (also claimed by Texas), included in that of Oklahoma Territory for census purposes. a Oklahoma organized as a territory May 2,1890. 30026°—16 5 66 T H E FEDEKAL REGISTRATION SERVICE. APPENDIX 2A.—DEATHS AND DEATH RATES FROM REGISTRATION [Figures de signa te d b y asterisks (*) a r e for cities only i n w h i c h d e a t h s w e r e registered A N N U A L COMPILATION (CALENDAR Y E A R S ) . I 1914 DIVISION AND STATE. 1912 Number of d e a t h s . 2 UNITED STATES. Death rate per 1,000 population. Number ofdeaths.2 898,059 13.6 890,848 104,297 300,441 205,373 84,724 77,895 42,591 12,174 19,211 51,353 15.0 14.3 13.0 11.2 15.8 14.3 21.5 10.9 11.6 104,415 302,953 212,523 71,586 75,252 40,368 11,727 19,674 52,350 15.2 14.7 13.6 11.8 15.7 14.2 21.2 11.5 12.3 102,454 292,229 204,247 69,705 50,573 40,287 11,655 17,975 49,126 11,925 7,166 5,430 52,854 8,702 18,220 15.6 16.3 15.0 14.7 14.7 15.1 11,565 7,459 5,688 53,286 8,698 17,719 15.3 17.1 15.8 15.0 15.0 15.0 11,672 7,134 5,440 52,250 8,644 17,314 145,708 39,901 114,832 14.7 14.2 13.9 145,522 39,437 117,994 15.0 14.3 14.6 142,608 37,779 111,842 65,132 35,930 *37,379 39,751 27,181 13.0 12.9 *14.2 13.4 11.1 68,493 36,699 *38,799 40,81.6 27,716 13.8 13.3 *15.1 13.9 11.5 65,466 35,763 *37,275 38,756 26,987 23,483 10.6 Death rate per 1,000 population. Number ofdeaths. 2 838,251 G E O G R A P H I C DIVISIONS: New England Middle A t l a n t i c East North Central.. West N o r t h Central.. South Atlantic East South Central.. "West S o u t h C e n t r a l . Mountain Pacific N E W ENGLAND: Maine New Hampshire Vermont Massachusetts R h o d e Island Connecticut MIDDLE ATLANTIC: New York N e w Jersey Pennsylvania E A S T N O R T H CENTRAL: Ohio Indiana Illinois Michigan Wisconsin W E S T NORTH CENTRAL: Minnesota Iowa Missouri North Dakota South Dakota Nebraska Kansas 22,787 10.4 20,488 41,561 "41," 356 "*i2.4 42,155 *2,388 17,497 *13.3 9.8 *2,446 *4,792 *13.9 *14.3 *2,266 *4,796 *1,460 21,314 5,854 30,117 *687 3 8,966 *1,673 *5,744 *2,080 *15.9 15.9 16.6 14.0 *16.0 3 19.0 *27.8 *19.4 *17.8 *1,412 21,493 6,006 29,647 *716 3 6,684 *1,616 *5,679 *1,999 *15.5 16.2 17.3 13.9 *16.8 3 16.8 *27.0 *19.6 *17.7 *1,481 20,477 6,259 *6,721 *731 3 6,672 *1,836 *4,753 *1,643 30,360 *7,222 *5,009 12.9 *19.5 *19.0 30,646 *4,949 *4,773 13.1 *19.5 *18.8 29,859 *5,785 *4,643 SOUTH ATLANTIC: Delaware Maryland D i s t r i c t of C o l u m b i a . Virginia W e s t Virginia N o r t h Carolina S o u t h Carolina Georgia Florida E A S T SOUTH CENTRAL: Kentucky Tennessee Alabama Mississippi W E S T SOUTH CENTRAL: Arkansas Louisiana Oklahoma Texas *7,417 *20.5 *7,088 *19.9 *7,054 ~*4,*757 "*23."2 "*4,'639 '*23."5 '*4*60i 4,846 11.2 5,033 12.0 4,083 10,166 11.2 10,197 11.5 9,979 4,444 11.0 3,913 11,397 *2,347 38,606 8.5 *9.5 14.5 10,187 *2,223 36,716 MOUNTAIN: Montana Idaho Wyoming Colorado N e w Mexico Arizona Utah Nevada "*4,"i99 PACIFIC: Washington Oregon California 11,448 *2,363 37,542 8.1 *9.1 13.6 1 T h e p o p u l a t i o n figures u s e d i n c o m p u t i n g t h e d e a t h r a t e s s h o w n i n t h i s t a b l e , for e a c h y e a r , m a y b e y diligent inquiry, to obtain any item cr items of information contemplated in Section 14 of this Act, it shall then be the duty of the local registrar to secure from the person so reporting, or from any other person having the required knowledge, such information as will enable him to prepare the certificate of birth herein contemplated, and it shall be the d u t y of t h e person reporting the birth or who may be interrogated in relation thereto to answer correctly and to the best of his knowledge all questions put to him by the local registrar which may be calculated to elicit any information needed to make a complete record of the birth as contemplated b y said Section 14, and it shall be the d u t y of the informant as to any statement made in accordance herewith to verify such statement by his signature, when requested so to do by the local registrar. S E C 14.—That the certificate of birth shall contain the following items, which are hereby declared necessary for the legal, social, and sanitary purposes subserved by registration records: 2 (1) Place of birth, including state, county, township or town, village or city. If in a city, the ward, street, and house number; if in a hospital or other institution, the name of the same to be given, instead of the street and house number. (2) Full name of child. If the child dies without a name, before the certificate is filed, enter the words " D i e d unnamed. " If the living child has not yet been named at the date of filing certificate of birth, the space for "full name of child " is to be left blank, to be filled out subsequently b y a supplemental report, as hereinafter provided. (3) Sex of child. (4) Whether a twin, triplet, or other plural birth. A separate certificate shall be required for each child in case of plural births. (5) For plural births, number of each child in order of birth. (6) Whether legitimate or illegitimate. 3 (7) Date of birth, including the year, month, and day. (8) Full name of father. (9) Residence of father. (10) Color or race of father. 1 A proviso may be added that shall require the registration, or notification, at a shorter interval than ten days, of births that occur in cities. 2 The following items are those of the United States standard certificate of birth, approved by the Bureau of the Census. 3 This question may be omitted if desired, or provision may be made so that the identity of parents will not be disclosed. APPENDIX i. T H E MODEL LAW. 83 (11) Age of father at last birthday, in years. (12) Birthplace of father; at least state or foreign country, if known. (13) Occupation of father. The occupation to be reported if engaged in any remunerative employment, with the statement of (a) trade, profession, or particular kind of work; (b) general nature of industry, business, or establishment in which employed (or employer). (14) Maiden name of mother. (15) Residence of mother. (16) Color or race of mother. (17) Age of mother at last birthday, in years. (18) Birthplace of mother; at least state or foreign country, if known. (19) Occupation of mother. The occupation to be reported if engaged in any remunerative employment, with the statement of (a) trade, profession, or particular kind of work; (6) general nature of industry, business, or establishment in which employed (or employer). (20) Number of children born to this mother, including present birth. (21) Number of children of this mother living. (22) The certification of attending physician or midwife as to attendance at birth, including statement of year, month, day (as given in Item 7), and hour of birth, and whether the child was born alive or stillborn. This certification shall be signed by the attending physician or midwife, with date of signature and address; if there is not physician or midwife in attendance, then b y the father or mother of the child, householder, owner of the premises, or manager or superintendent of public or private institution where the birth occurred, or other competent person, whose d u t y it shall be to notify the local registrar of such birth, as required by Section 13 of this Act. (23) Exact date of filing in office of local registrar, attested by his official signature. and registered number of birth, as hereinafter provided. SEC. 15.—That when any certificate of birth of a living child is presented without the statement of the given name, then the local registrar shall make out and deliver to the parents of the child a special blank for the supplemental report of the given name of the child, which shall be filled out as directed, and returned to the local registrar as soon as the child shall have been named. SEC. 16.—That every physician, midwife, and undertaker shall, without delay, register his or her name, address, and occupation with the local registrar of the district in which he or she resides, or may hereafter establish a residence; and shall thereupon be supplied b y the local registrar with a copy of this Act, together with such rules and regulations as may be prepared by the state registrar relative to its enforcement. Within thirty days after the close of each calendar year each local registrar shall make a return to the state registrar of all physicians, midwives, or undertakers who have been registered in his district during the whole or any part of the preceding calendar year: provided, that no fee or other compensation shall be charged b y local registrars to physicians, midwives, or undertakers for registering their names under this section or making returns thereof to the state registrar. 1 SEC. 17.—That all superintendents or managers, or other persons in charge of hospitals, almshouses, lying-in or other institutions, public or private, to which persons resort for treatment of diseases, confinement, or are committed by process of law, shall make a record of all the personal and statistical particulars relative to the inmates in their institutions at the date of approval of this Act, which are required in t h e forms of the certificates provided for by this Act, as directed by the state registrar; and thereafter such record shall be, b y them, made for all future inmates at the time of their admittance. And in case of persons admitted or committed for treatment of i This section may be omitted if deemed expedient, and the duty of supplying instructions may be assumed by the state officer. 84 T H E FEDERAL REGISTRATION SERVICE. disease, the physician in charge shall specify for entry in the record, the nature of the disease, and where, in his opinion, it was contracted. The personal particulars and information required b y this section shall be obtained from the individual himself if it is practicable to do so; and when they can not be so obtained, they shall be obtained in as complete a manner as possible from relatives, friends, or other persons acquainted with the facts. SEC. 18.—That the state registrar shall prepare, print, and supply to all registrars all blanks and forms used in registering, recording, and preserving the returns, or in otherwise carrying out the purposes of this Act; and shall prepare and issue such detailed instructions as may be required to procure the uniform observance of its provisions and the maintenance of a perfect system of registration; and no other blanks shall be used than those supplied b y the state registrar. H e shall carefully examine the certificates received monthly from the local registrars, and if any such are incomplete or unsatisfactory he shall require such further information to be supplied as may be necessary to make the record complete and satisfactory. And all physicians, midwives, informants, or undertakers, and all other persons having knowledge of the facts, are hereby required to supply, upon a form provided b y the state registrar or upon the original certificate, such information as they may possess regarding any birth or death upon demand of the state registrar, in person, b y mail, or through the local registrar; provided, that no certificate of birth or death, after its acceptance for registration by the local registrar, and no other record made in pursuance of this Act, shall be altered or changed in any respect otherwise than b y amendments properly dated, signed, and witnessed. The state registrar shall further arrange, bind and permanently preserve the certificates in a systematic manner, and shall prepare and maintain a comprehensive and continuous card index of all births and deaths registered; said index to be arranged alphabetically, in the case of deaths, by t h e names of decedents, and in case of births, by the names of fathers and mothers. H e shall inform all registrars what diseases are to be considered infectious, contagious, or communicable and dangerous to the public health, as decided by the State Board of Health, in order that when deaths occur from such diseases proper precautions may be taken to prevent their spread. If any cemetery company or association, or any church or historical society or association, or any other company, society, or association, or any individual, is in possession of any record of births or deaths which may be of value in establishing the genealogy of any resident of this state, such company, society, association, or individual, may file such record or a duly authenticated transcript thereof with t h e state registrar, and it shall be t h e duty of t h e state registrar to preserve such record or transcript and to make a record and index thereof in such form as to facilitate the finding of any information contained therein. Such record and index shall be open to inspection by the public, subject to such reasonable conditions as the state registrar may prescribe. If any person desires a transcript of any record filed in accordance herewith, the state registrar shall furnish the same upon application, together with a certificate that it is a true copy of such record, as filed in his office, and for his services in so furnishing such transcript and certificate he shall be entitled to a fee of (ten cents per folio) (fifty cents per hour or fraction of an hour necessarily consumed in making such transcript) and to a fee of twenty-five cents for the certificate, which fees shall be paid b y the applicant. SEC. 19.—That each local registrar shall supply blank forms of certificates to such persons as require them. Each local registrar shall carefully examine each certificate of birth or death when presented for record in order to ascertain whether or not it has been made out in accordance with the provisions of this Act and the instructions of the state registrar; and if any certificate of death is incomplete or unsatisfactory, it shall be his duty to call attention to the defects in the return, and to withhold the APPENDIX 4 . — T H E MODEL LAW. 85 burial or removal permit until such defects are corrected. All certificates, either of birth or of death, shall be written legibly, in durable black ink, and no certificate shall be held to be complete and correct that does not supply all of the items of information called for therein, or satisfactorily account for their omission. If the certificate of death is properly executed and complete, he shall then issue a burial or removal permit to the undertaker; provided, that in case the death occurred from some disease which is held by the State Board of Health to be infectious, contagious, or communicable and dangerous to the public health, no permit for the removal or other disposition of the body shall be issued by the registrar, except under such conditions as may be prescribed by the State Board of Health. If a certificate of birth is incomplete, the local registrar shall immediately notify the informant, and require him to supply the missing items of information if they can be obtained. H e shall number consecutively the certificates of birth and death, in two separate series, beginning with number 1 for the first birth and the first death in each calendar year, and sign his name as registrar in attest of the date of filing in his office. H e shall also make a complete and accurate copy of each birth and each death certificate registered by him in a record book supplied by the state registrar, to be preserved permanently in his office as the local record, in such manner as directed by the state registrar. And he shall, on the tenth day of each month, transmit to the state registrar all original certificates registered by him for the preceding month. And if no births or no deaths occurred in any month, he shall, on the tenth day of the following month, report that fact to the state registrar, on a card provided for such purpose. SEC. 20.—That each local registrar shall be paid the sum of twenty-five cents for each birth certificate and each death certificate properly and completely made out and registered with him, and correctly recorded and promptly returned by him to the state registrar, as required by this Act. 1 And in case no births or no deaths wxere registered during any month, the local registrar shall be entitled to be paid the sum of twenty-five cents for each report to that effect, but only if such report be made promptly as required by this Act. All amounts payable to a local registrar under the provisions of this section shall be paid by the treasurer of the county in which the registration district is located, upon certification by the state registrar. And the state registrar shall annually certify to the treasurers of the several counties the number of births and deaths properly registered, with the names of the local registrars and the amounts due each at the rates fixed herein. 2 SEC. 21.—That the state registrar shall, upon request, supply to any applicant a certified copy of the record of any birth or death registered under provisions of this Act, for the making and certification of which he shall be entitled to a fee of fifty cents, to be paid by the applicant. And any such copy of the record of a birth or death, when properly certified by the state registrar, shall be prima facie evidence in all courts and places of the facts therein stated. For any search of the files and records when no certified copy is made, the state registrar shall be entitled to a fee of fifty cents for each hour or fractional part of an hour of time of search, said fee to be paid b y the applicant. And the state registrar shall keep a true and correct account of all fees by him received under these provisions, and turn the same over to the state treasurer: Provided, That the state registrar shall, upon request of any parent or guardian, supply, without fee, a certificate limited to a statement as to the date of birth of any child when the same shall be necessary for admission to school, or for the purpose of securing employment. And provided further•, That the United States i A proviso may be inserted at this point relative to fees of city registrars who are already compensated by salary for their services. See laws of Missouri, Ohio, and Pennsylvania. 2 Provision may be made in this section for the payment of sub-registrars and also, if desired, for the payment of physicians and midwives. See Kentucky law. 86 THE FEDERAL REGISTRATION SERVICE. Census Bureau may obtain, without expense to the state, transcripts or certified copies of births and deaths without payment of the fees herein prescribed. SEC. 22.—That any person, who for himself or as an officer, agent, or employee of any other person, or of any corporation or partnership, (a) shall inter, cremate, or otherwise finally dispose of the dead body of a human being, or permit the same to be done, or shall remove said body from the primary registration district in which the death occurred or the body was found, without the authority of a burial or removal permit issued by the local registrar of the district in which the death occurred or in which the body was found; or (b) shall refuse or fail to furnish correctly any information in his possession, or shall furnish false information affecting any certificate or record, required by this Act; or (c) shall willfully alter, otherwise than is provided by Section 18 of this Act, or shall falsify any certificate of birth or death, or any record established by this Act; or (d) being required by this Act to fill out a certificate of birth or death and file the same with the local registrar, or deliver it, upon request, to any person charged with the duty of filing the same, shall fail, neglect, or refuse to perform such duty in t h e manner required by this Act; or (e) being a local registrar, deputy registrar, or sub-registrar, shall fail, neglect, or refuse to perform his duty as required by this Act and by the instructions and direction of the state registrar thereunder, shall be deemed guilty of a misdemeanor and upon conviction thereof shall for the first offense be fined not less than five dollars ($5.00) nor more than fifty dollars ($50.00), and for each subsequent offense not less than ten dollars ($10.00) nor more than one hundred dollars ($100.00), or be imprisoned in the county jail not more than sixty days, or be both fined and imprisoned in the discretion of the court. 1 SEC. 23.—That each local registrar is hereby charged with the strict and thorough enforcement of the provisions of this Act in his registration district, under the supervision and direction of the state registrar. And he shall make an immediate report to the state registrar of any violation of this laAV coming to his knowledge, by observation or upon complaint of any person, or otherwise. The state registrar is hereby charged with the thorough and efficient execution of the provisions of this Act in every part of the state, and is hereby granted supervisory power over local registrars, deputy local registrars, and sub-registrars, to the end that all of its requirements shall be uniformly complied with. The state registrar, either personally or by an accredited representative, shall have authority to investigate cases of irregularity or violation of law, and all registrars shall aid him, upon request, in such investigations. When he shall deem it necessary, he shall report cases of violation of any of the provisions of this Act to the prosecuting attorney of the county, with a statement of the facts and circumstances; and when any such case is reported to him by the state registrar, the prosecuting attorney shall forthwith initiate and promptly follow u p the necessary court proceedings against the person or corporation responsible for the alleged violation of law. And upon request of the state registrar, the attorney general shall assist in the enforcement of the provisions of this Act. i Provision may be made whereby compliance with this Act shall constitute a condition of granting licenses to physicians, midwives, and embalmers. NOTE.—Other sections should be added giving the date on which the Act is to go into effect, if not determined by constitutional provisions of the state; providing for the financial support of the law; and repealing prior statutes inconsistent with the present Act. It is desirable that the entire bill should be reviewed by competent legal authority for the purpose of discovering whether it can be made more consistent in any respect with the general form of legislation of the state in which the bill is to be introduced, without material change or injury to the effectiveness of registration. O