DEPARTMENT OF HEALTH.

Report for Week Ending March 29, 1913:

THE IMPORTANCE AND PRACTICAL UTILITY OF BIRTH RECORDS.

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It was only two decades ago that the New York State law, seeking to better the conditions attendant upon the employment of children, went into effect, and the child entering employment was compelled to furnish proof of his age, the most important element of such proof being a certificate of birth obtained from the local health officer or registrar. The extent to which the law requiring physicians, and midwives to report births had been disregarded then for the first time became apparent. though the reporting of births had been made compulsory and although an adequate penalty had been provided, it was discovered that the law had been disregarded by 40 per cent. of physicians in the City of New York. The law provided, and still provides, that, in the absence of registration at the Health Department, the baptismal certificate or other proof of birth may be accepted by the official granting an employment certificate, and, in consequence of this provision, and the frequent difficulty and inconvenience attendant upon compliance therewith, the registration of births by physicians has shown considerable improvement. In thousands of cases attempts were made to obtain employment certificates for children who were under the age of fourteen, but the lack of official and other proof of the date of birth prevented these attempted violations of the law, and many children eleven, twelve and thirteen years of age were returned to the schoolroom, notwithstanding the protests of their parents. The number of searches for birth records made by the Department of Health without cost to the applicant seeking to obtain employment amounted during 1912 to 47,845 in the Borough of Manhattan.

Birth Records and Infant Mortality in Tenements,

The birth records of the Department of Health are not made use of by the Tenement House Department of the City, for the law creating the latter department does not provide for the keeping of records of infants born in tenement houses, although it does provide for the keeping of records of all deaths occurring therein. These latter records are obtained by the Tenement House Department from the Department of Health. Those who are interested in the subject of infant mortality appreciate fully its value as an index of sanitary conditions, and it will, perhaps, surprise them that the Tenement House Department has made no effort to compile data concerning the mortality among infants living in tenements. From studies made by the Registrar of the Department of Health, it has been found, as one would expect, that the infant mortality in tenement houses greatly exceeds the infant mortality of the City at large. The latter was found to be about 106, while that of the tenement house section varied between 140 and 300, per 1,000 during 1911. There would seem to be a necessity for a special study of infant mortality in tenement houses for the purpose of making comparisons with that of private dwellings and institutions.

Birth Records and the Schools.

About eight years ago the Department of Education, in order to exclude children under school age from the public schools, made it obligatory upon those seeking admission to present a statement certified by the Department of Health in regard to the date of birth. The increase in the population of The City of New York within the past ten years was so enormous that the City authorities were finally unable to furnish a seat for every child of school age, and, in consequence, the exclusion of children below the age of six years was determined upon in order to diminish as much as possible the necessity for part-time classes. With this end in view, the Department of Health was called upon to assist, by means of its birth records. in the dilemma in which the educational authorities found themselves. This necessitated 30,000 additional searches in the year 1900 and the number steadily increased from year to year, until, in 1911, about 50,000 searches were made in order to enable children to obtain admission to school. No charge is made for searching these records.

Filing of "Delayed" Certificates.

This demand upon the Registrar's office resulted in the discovery of many cases in which physicians and midwives, especially the former, had neglected to file certificates of birth. This offense, however, becomes outlawed at the end of two years, and on this account the Department of Health was prevented in many cases from instituting legal proceedings against the delinquents. In such cases the parent is compelled to obtain a certificate of birth from the medical attendant, to prepare a sworn petition requesting the filing of this delayed certificate, and to furnish the affidavits of two witnesses, citizens of the United States, who had personal knowledge of the occurrence of the birth. The expense attendant upon this procedure rendered the parents averse in many instances to the subsequent employment of the medical attendant, and many were the complaints from physicians that their patients had left them on account of the Department's action. As the Department did not, and could not, vary its procedure in the matter, the final outcome has been a more ready compliance with the law.

Enforcement of the Law.

Those who still ignored the law requiring that birth certificates shall be filed within ten days after the birth were prosecuted and fined from $10 to $100 each. Contrary to existing impressions, the midwives who violate the law are very few. A further incentive to registration was the adoption of a resolution of the Board of Health, directing the Registrar to acknowledge the receipt of every certificate of birth. It would certainly be wise for every city in which a fairly complete registration of births is not obtained to adopt measures compelling all applicants for admission into school to furnish a statement from the local health department of the date of birth. This would mean work for the local registrar, but in the end it would serve as a tremendous stimulus to physicians and midwives to comply with the law.

Uses of Birth Records.

The benefits resulting from the employment of infant birth records by sanitary officials and philanthropic societies in their efforts to minimize the mortality of infants are many. In order to conserve the lives of infants, especially among the uneducated and ignorant in the community, parents should be instructed as soon as possible after the infant's birth, and advantage has repeatedly been taken of birth records in order to reach recent mothers immediately. The benefits of so utilizing birth records are so evident that further consideration under this heading is unnecessary.

Within the past two years applicants for certain positions in the classified list of the civil service have been compelled to furnish certified copies of the records of their birth before being permitted to take the necessary examinations. As these positions include those of Policemen, Firemen and Inspectors, the number having recourse to the birth records amounts to several thousands annually.

The number of searches made with the object of proving the age of the applicant has been a constant quantity for many years. In criminal cases the innocence or guilt of the accused not infrequently depends upon his age and the law provides for the acceptance by the court of certified copies of the records. In civil cases, such as the passing of title, inheritances by minors, etc., much use is made of the records of birth. Several of the countries of continental Europe require certificates of birth to be produced before marriage can take place, and upon a number of occasions our records have been consulted in order to obtain a certified copy in cases where one of the contracting parties was American born. In 1912 the number of searches of all records in the office of the Registrar was over 173,481; 45,361 of these were for certified copies of certificates of death; 4,803 for copies of marriage certificates, and the remainder, 123,317, for searches of birth records, 90 per cent. of these last for school and employment purposes. These figures are mentioned in order to give an idea of the relative demand made for the various purposes specified. This demand will undoubtedly increase and with it, perhaps, will come ultimately a complete record of births, marriages and deaths.

A NEW PRECAUTION AGAINST TYPHOID FEVER.

At a meeting of the Board of Health of the Department of Health of The City of New York held March 25, 1913, the following resolution was adopted concerning the provision of privies by contractors and their duties in regard thereto. It was designated as section 37a of the Sanitary Code, and reads as follows:

"Section 37a. Contractors or builders shall provide or cause to be provided temporary privies for the use of the men employed during construction work, at some

DEPARTMENT OF HEALTH.

Report for Week Ending March 29, 1913:

THE IMPORTANCE AND PRACTICAL UTILITY OF BIRTH RECORDS.

It was only two decades ago that the New York State law, seeking to better the conditions attendant upon the employment of children, went into effect, and the child entering employment was compelled to furnish proof of his age, the most important element of such proof being a certificate of birth obtained from the local health officer or registrar. The extent to which the law requiring physicians, and midwives to report births had been disregarded then for the first time became apparent. Although the reporting of births had been made compulsory and although an adequate penalty had been provided, it was discovered that the law had been disregarded by 40 per cent. of physicians in the City of New York. The law provided, and still provides, that, in the absence of registration at the Health Department, the baptismal certificate or other proof of birth may be accepted by the official granting an employment certificate, and, in consequence of this provision, and the frequent difficulty and inconvenience attendant upon compliance therewith, the registration of births by physicians has shown considerable improvement. In thousands of cases attempts were made to obtain employment certificates for children who were under the age of fourteen, but the lack of official and other proof of the date of birth prevented these attempted violations of the law, and many children eleven, twelve and thirteen years of age were returned to the schoolroom, notwithstanding the protests of their parents. The number of searches for birth records made by the Department of Health without cost to the applicant seeking to obtain employment amounted during 1912 to 47,845 in the Borough of Manhattan.

Birth Records and Infant Mortality in Tenements.

The birth records of the Department of Health are not made use of by the Tenement House Department of the City, for the law creating the latter department does not provide for the keeping of records of infants born in tenement houses, although it does provide for the keeping of records of all deaths occurring therein. These latter records are obtained by the Tenement House Department from the Department of Health. Those who are interested in the subject of infant mortality appreciate fully its value as an index of sanitary conditions, and it will, perhaps, surprise them that the Tenement House Department has made no effort to compile data concerning the mortality among infants living in tenements. From studies made by the Registrar of the Department of Health, it has been found, as one would expect, that the infant mortality in tenement houses greatly exceeds the infant mortality of the City at large. The latter was found to be about 106, while that of the tenement house section varied between 140 and 300, per 1,000 during 1911. There would seem to be a necessity for a special study of infant mortality in tenement houses for the purpose of making comparisons with that of private dwellings and institutions.

Birth Records and the Schools.

About eight years ago the Department of Education, in order to exclude children under school age from the public schools, made it obligatory upon those seeking admission to present a statement certified by the Department of Health in regard to the date of birth. The increase in the population of The City of New York within the past ten years was so enormous that the City authorities were finally unable to furnish a seat for every child of school age, and, in consequence, the exclusion of children below the age of six years was determined upon in order to diminish as much as possible the necessity for part-time classes. With this end in view. the Department of Health was called upon to assist, by means of its birth records, in the dilemma in which the educational authorities found themselves. This necessitated 30,000 additional searches in the year 1900 and the number steadily increased from year to year, until, in 1911, about 50,000 searches were made in order to enable children to obtain admission to school. No charge is made for searching these records.

Filing of "Delayed" Certificates.

This demand upon the Registrar's office resulted in the discovery of many cases in which physicians and midwives, especially the former, had neglected to file certificates of birth. This offense, however, becomes outlawed at the end of two years, and on this account the Department of Health was prevented in many cases from instituting legal proceedings against the delinquents. In such cases the parent is compelled to obtain a certificate of birth from the medical attendant, to prepare a sworn petition requesting the filing of this delayed certificate, and to furnish the affidavits of two witnesses, citizens of the United States, who had personal knowledge of the occurrence of the birth. The expense attendant upon this procedure rendered the parents averse in many instances to the subsequent employment of the medical attendant, and many were the complaints from physicians that their patients had left them on account of the Department's action. As the Department did not, and could not, vary its procedure in the matter, the final outcome has been a more ready compliance with the law.

Enforcement of the Law.

Those who still ignored the law requiring that birth certificates shall be filed within ten days after the birth were prosecuted and fined from $10 to $100 each. Contrary to existing impressions, the midwives who violate the law are very few. A further incentive to registration was the adoption of a resolution of the Board of Health, directing the Registrar to acknowledge the receipt of every certificate of birth. It would certainly be wise for every city in which a fairly complete registration of births is not obtained to adopt measures compelling all applicants for admission into school to furnish a statement from the local health department of the date of birth. This would mean work for the local registrar, but in the end it would serve as a tremendous stimulus to physicians and midwives to comply with the law.

Uses of Birth Records.

The benefits resulting from the employment of infant birth records by sanitary officials and philanthropic societies in their efforts to minimize the mortality of infants are many. In order to conserve the lives of infants, especially among the uneducated and ignorant in the community, parents should be instructed as soon as possible after the infant's birth, and advantage has repeatedly been taken of birth records in order to reach recent mothers immediately. The benefits of so utilizing birth records are so evident that further consideration under this heading is unnecessary.

Within the past two years applicants for certain positions in the classified list of the civil service have been compelled to furnish certified copies of the records of their birth before being permitted to take the necessary examinations. As these positions include those of Policemen, Firemen and Inspectors, the number having recourse to the birth records amounts to several thousands annually.

The number of searches made with the object of proving the age of the applicant has been a constant quantity for many years. In criminal cases the innocence or guilt of the accused not infrequently depends upon his age and the law provides for the acceptance by the court of certified copies of the records. In civil cases, such as the passing of title, inheritances by minors, etc., much use is made of the records of birth. Several of the countries of continental Europe require certificates of birth to be produced before marriage can take place, and upon a number of occasions our records have been consulted in order to obtain a certified copy in cases where one of the contracting parties was American born. In 1912 the number of searches of all records in the office of the Registrar was over 173,481; 45,361 of these were for certified copies of certificates of death; 4,803 for copies of marriage certificates, and the remainder, 123,317, for searches of birth records, 90 per cent. of these last for school and employment purposes. These figures are mentioned in order to give an idea of the relative demand made for the various purposes specified. This demand will undoubtedly increase and with it, perhaps, will come ultimately a complete record of births, marriages and deaths.

A NEW PRECAUTION AGAINST TYPHOID FEVER.

At a meeting of the Board of Health of the Department of Health of The City of New York held March 25, 1913, the following resolution was adopted concerning the provision of privies by contractors and their duties in regard thereto. It was designated as section 37a of the Sanitary Code, and reads as follows:

"Section 37a. Contractors or builders shall provide or cause to be provided temporary privies for the use of the men employed during construction work, at some