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N.H. Way Back: Sickliest state in the nation? No way!

These days demographers and economists fret about New Hampshire’s quickly aging population. Turns out, 100 years ago, New Hampshire’s population was also older than most of the rest of the country – and it led unfairly to a poor reputation. In fact, the state Department of Health went out of its way in 1914 to issue a report disputing allegations that the state’s high mortality rate was related to unhealthy conditions. Apparently, old people were dying because they were old – not because it wasn’t safe to live here. Here’s what the state had to say about it:

Misleading statements have been made in alleging that New Hampshire has the highest death rate of any state in the Union.

That statement may be correct with reference to the crude, or actual, death rate, but it is entirely misleading from a sanitary or public health viewpoint.

The crude death rate of a state, while showing the actual mortality, does not afford a reasonable comparison with the mortality of another state unless the population areas are similarly constituted with respect to birth rate, sex and age groups.

It is apparent to anyone that in a population area having a large number of births and a large number of aged people, the mortality must be much larger than in areas with different age distribution. In commenting upon this point, the Federal Bureau of the Census says:

“In some cases the sanitary conditions might be precisely the same, and yet the difference in the crude death rates might lead to the conclusion that one area was much more healthful than the other.”

The only way to obtain an exact understanding on this point is to have a standard for comparison – that is, a standard population – and compute the mortality returns from other states and areas upon this standard. The United States government did this for the years 1911 and 1912, and the following table gives the standard, or specific, rates per each one thousand of the population for each of the New England states:

Standard or Specific Death Rate per 1,000 Population.

Maine: 13.0 (1911), 15.5 (1912)

New Hampshire : 14.2 (1911), 13.6 (1912)

Vermont: 12.6 (1911), 15.2 (1912)

Massachusetts: 15.0 (1911), 14. (1912)

Rhode Island: 15.7 (1911), 15.2 (1912)

Connecticut: 14.8 (1911), 14.2 (1912)

The only New England states with a specific rate lower than that of New Hampshire in 1911 were Maine and Vermont, while in 1912 New Hampshire had the lowest specific rate of the New England states.

The Census Bureau, in further commenting upon the wrong impression conveyed by the crude death rate, says:

“For states like Maine, New Hampshire and Vermont, in which are unusually large proportions of persons of more advanced age, the corrected rates are far more representative of the true sanitary conditions, as compared with those of other states, than the crude rates.”

The U.S. Census Report for 1910 shows that New Hampshire has a larger percentage of persons living above 45 years of age than any other New England state.

This brief statement is for the purpose of refuting the inferential allegation that New Hampshire is an unhealthful state.

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