s, the death-rate in cities is very markedly
higher than in rural districts, and the superiority of the country as a
place to live is hereby plainly demonstrated. The preceding table shows
the death rate from tuberculosis in cities for the years 1903-1907, the
data being taken from the United States Census Reports.

The death-rate in the cities is evidently about 60 per 100,000 greater
than in the rural districts, due, of course, to the crowding in city
tenements. This is true for nearly all cities, although the difference
is more marked in some parts of the country than in others. In
Massachusetts, for example, the death-rate in rural districts is
slightly higher than the death-rate in cities, but tuberculosis is much
more prevalent in that state than in any other part of the country. In
New York State the rate in cities is about 70 per 100,000 greater than
in rural districts, due, presumably, to the larger number of
manufacturing centers in this state. In New York City the rate is
constantly more than 200, and in 1908 in the borough of the Bronx it was
nearly 500.

_Diphtheria as affecting the rate._

Diphtheria is another disease that exacts heavier toll from the cities
than from the country, about three times as many deaths occurring in the
former as in the latter.

_Influenza, and its effect on death-rate._

Influenza is, on the other hand, markedly severe on people in rural
districts, the death-rate there being more than twice as high as in the
cities. It is easy to see why this is. Lack of sidewalks, lack of
protection, lack of uniform temperature in the houses, and the lack of
care in the first stages of illness, all tend to increase the death-rate
from this disease.

_Pneumonia._

The death-rate from pneumonia, on the other hand, is higher in the city,
the vitality and power of resistance of victims probably being reduced
under average city conditions.

_Other diseases._

Diseases that are induced by water, all referred to under typhoid fever,
but extending into such complaints as diarrhoea and enteritis, are
much more severe in cities than in the country. Such an excess of
general intestinal diseases shows again that a polluted water-supply is
not peculiar to the country, but is responsible for an excessive
death-rate in the city. Most of the constitutional diseases also have
higher death-rates in the city than in the country. Bright's disease,
for example, for the five years 1903-1907, had an aver