REPORT OF THE HEALTH OFFICER. HEALTH DEPARTMENT, DISTRICT OF COLUMBIA, GENTLEMEN: I have the honor to submit herewith the following report as to the sanitary condition of the District of Columbia during the year ending June 30, 1897, and relative to the operations of the health department during that period, being the twenty-sixth annual report of the department, and the eighteenth since its present organization. VITAL STATISTICS. POPULATION. The census taken by the police department during March, 1897, showed a population of 277,782, made up of 189,547 whites and 88,325 colored. Approximately, therefore, 32 per cent of the entire population is colored. Practically the same ratio prevails during the earlier periods of life as in the population as a whole, as 34 per cent of those under 7 years of age, and the same per cent of those under 15 years, belong to the colored race. The annual average increase since the police census of December, 1894, has been 1.43 per cent for the whites, 0.68 per cent for the colored, and 1.18 per cent for the entire population. While the rate of increase for the colored remains very much below that for the whites, the falling off in the rate has been slightly greater among the latter. Of the entire population, 47 per cent is male and 53 per cent female. As between the races we find among the whites 49 per cent male and 51 per cent female, while among the colored the corresponding figures are 45 per cent and 55 per cent. The entire population is therefore made up as follows: The available data does not permit a very accurate distribution of the population according to age; and it is very much to be regretted that the age periods of the police census do not correspond with those of the tabulated vital statistics, having reference, apparently, rather to the ascertainment of the number of children of school age than to the determination of the death rates. Of the entire population, however, approximately 11 per cent is under 7 years of age and 13 per cent under 15. The proportion of children is somewhat greater among the colored race; of the white population approximately 11 per cent is under 7 years old and 13 per cent less than 15, while of the colored people those under 7 make up 12 per cent and those under 15 years 14 per cent of the whole. Ordinarily the entire District of Columbia is regarded as the city of Washington, but for the computation of vital statistics it is desirable that some distinction be made, so as to learn the differences, if any, in the death rates in different sections. No proper subdivision has yet been made, but for present purposes it is sufficient to state that the city proper, or what was formerly comprised in the cities of Washington and Georgetown, contains a population of 236,587, the remainder, 41,195, being distributed throughout the county, in which term is included numerous rather densely populated suburbs, as Anacostia, Brookland, Eckington, Hillsdale, Le Droit Park, Mount Pleasant, Rosedale, and Trinidad-that is, 85 per cent of the population is located within the city. Another and possibly even more important division of the popula tion, according to location of residence, is into those living on streets and those living in the alleys. The entire alley population of the District is 18,978, of which 18,333 live within the city proper. Of the population of the entire District, therefore, 6.83 per cent lives in the alleys; of the white population, 1.13 per cent, and of the colored, 19.05 per cent. If, however, the inquiry be confined to the city, 7.75 per cent of the population inhabits the alleys; of the whites, 2,144, or 1.32 per cent of the white population; and of the colored, 16,189, or 21.75 per cent of the colored population. As the police census was taken in March, 1897, while the middle of the year, to which the statistics included in this report have reference, was December, 1896, the death rates, wherever they are based upon the entire population, or on the entire white or colored portions of it, have been computed upon the estimated population for the latter month, which is as follows: 188,787 whites, 88,176 colored, and 276,963 total population. This is necessary, not only to approximate more closely the actual death rate for the year at present under consideration, but also to permit proper comparison with the death rates for previous years, which have been, as far as possible, computed upon the basis of the December population. Death rates, however, other than those specified above, and other proportions, have necessarily been computed upon the basis of the March population as ascertained by the census. MORTALITY. Having considered the amount and nature of the population of the District, it is necessary to determine the death rates for the community taken as a whole and in its various parts, and the nature of the sickness which makes up these rates. There occurred during the year just ended 5,737 deaths, of which 3,216 were of whites and 2,521 of colored. The corresponding death rates were, therefore, 20.71 for the population as a whole, 17.04 for the whites, and 28.59 for the colored. Upon comparing these figures with those for preceding years, we find that only reliable figures are available, has the general death rate fallen lower than during the past year, having been 20.57 for the fiscal year 1895. At no time during this period has the death rate for the whites been lower, and only once, in 1895, has there been a better showing among the colored people. The following table shows the variations in the death rates during the past twenty-two years: TABLE A.-Population, deaths, and death rates for the twenty-two years ended June 30, 1897, based upon results of police censuses. Distributing the deaths according to sex, the death rate for white males is found to be 19.28, while for colored males it is 33.07. Among the female portion of the white race the death rate was 14.79, and among the colored 26.78. The death rate of the males as a whole was 22.72, and that of the females 18.79. As before stated, the recent police census did not include such information in reference to the age distribution of the population as would enable the usual computations of death rates to be made, viz, the death rates of all under 1 year of age and for those under 5 years. In order to approximate this, however, the number of persons in each of those age periods has been computed upon the basis of the United States census for 1890, assuming that the age distribution in the community is the same as at that time. Upon comparing the results thus secured with the figures given by the police census as to the number under 7 years of age, they appear to be at least approximately correct. By the method of computation above referred to, the white population under 5 years of age amounted to 16,152 and the colored to 8.321. The corresponding death rates per 1,000 were, therefore, 52 for the whites, 121 for the colored, and 76 for the entire population. The principal causes of death were: diarrheal diseases, 324 deaths; acute lung affections, 332; tubercular diseases, 157; convulsions, 106; congenital debility and premature births, 216. If the inquiry be limited to those under 1 year of age, we find the population to be 4,389-of whites, 3,503; and of colored, 1,886. The mortality for this period of life, therefore, reaches the enormous figure of 262 per 1,000 per annum-for the white 189 and for the colored 397. Distributing the mortality by locality, we find the death rate of the city proper-that is, what was formerly comprised within the cities of Washington and Georgetown-to be 19.39, and that for the county to be 27.92. It should be noted that in determining these death rates due allowance has been made for the deaths occurring in the various asylums and hospitals located in each section, so that this factor may be practically disregarded in making such comparisons as the reader may desire. As a statement of the population and number of deaths for each square within the city and for each portion of the county is published in the appendix, no effort will be made at present to determine the death rate for different parts of the District, otherwise than as stated above. I can not refrain, however, from calling attention to the very considerable excess of the death rate of that portion of the county lying along the Eastern Branch over that for the county as a whole. This district includes the suburbs known as Anacostia, Congress Heights, Garfield, Giesboro, Hillsdale, Harrison street, Good Hope, Twining City, and Benning. These contain a population of 6,589, exclusive of the inmates and attendants of the Government Hospital for the Insane. The number of deaths actually reported from this population was 210. Upon the basis of population, it is fair to assume that of the 1,151 persons who died in the asylums and hospitals during the year 26 came from this section. The total deaths would therefore amount to 236, and the death rate would be 35.82 per thousand. When compared with the death rate of the county as a whole (27.92) it is evident that in this section local causes must be at work to make the difference, and it would appear probable that some, at least, of these causes might be removed and the death rate lowered. The most evident feature of this section which appears likely to account for such an abnormal mortality is the vast tract of marsh commonly known as the Eastern Branch Flats, and the most important step toward lowering the death rate would seem to be the removal of these flats. If, after this has been done, or at the same time, if possible, proper systems of drainage be introduced into such of these subdivisions as are not now so provided, and a water supply be introduced which will permit the abandoning of the shallow wells which are now in use, there is every reason to believe that the diminution in the death rate would amply repay the cost, however great it might be. Altogether the most remarkable feature of the mortality tables is the unexpectedly low death rate in the alleys. For all alleys in the District of Columbia the death rate is 20.34, or somewhat lower than that for the District as a whole. But in view of the fact that no deaths appear to have been reported from any of the alleys outside of the city, it seems probable that deaths occurring in these places have not been accurately located on the death returns, owing, possibly, to the open character of the country in which they are situated. Our inquiry may, therefore, be properly confined to the alleys within the city. Here we find a death rate of but 7.93 for the whites, 22.67 for the colored, and 20.95 for the entire population. While it has not been practicable in this case to make corrections for deaths of alley residents which occurred in hospitals, it does appear that such correction would materially alter the result. The comparative mortality in the various alleys, having reference to |