age rate in cities
of 107.3 per 100,000, while for the same five years in the rural
districts the rate was only 68.6.

_Old age and the death-rate._

Further showing the advantage of country life, it is to be noted that
the number of deaths from old age in rural districts is nearly double
that in cities. For example, in the same period already referred to the
death-rate in cities of persons over sixty was 27.6, while in the rural
districts, for the same period, it was 49.3,--nearly double.

_The need for attention to rural hygiene._

One must conclude, therefore, that the chances of living are increased
through residence in the country or in rural districts, and one is
therefore led to ask why, if conditions there are superior to those in
the city, is it necessary to deal with the question of rural hygiene,
and why attempt to improve conditions which are already evidently
superior to those in cities. The answer to this must lie in the
statement that the death-rate does not tell the whole story of public
health. So far as the real welfare of a community is concerned, the
standard should be that of the efficiency of the lives in the different
age periods rather than the length of those periods. By efficiency in
such a connection is meant not merely a life that is free enough from
disease to permit the full number of working days in the year, and the
full number of years in the man's life usually devoted to toil, or all
together a life that contributes something of value to the world,
whether produce from the farm or books evolved from the brain; but
efficiency here means that composite development of the whole man--body,
mind, and spirit--which we believe must have been intended when man was
created with this threefold nature. It is in this composite development
that those living in the country are sadly lacking in efficiency.

Not to the same extent as twenty-five years ago, but still too often is
the farmer so exhausted by bodily toil that he has left no strength for
the cultivation of either mind or spirit. For the brief period of spring
and summer, the good farmer in the Eastern States works himself harder
than any slave of old. Up with the sun, or earlier, he follows through
the long day the hardest kind of manual labor. When the end of the day
comes, after fifteen hours' physical strain, his weary body demands
sleep, and no vitality is left for mental improvement. In the winter,
on the other hand, a lack of exe