Criticar la inmanencia de la Modernidad y alcanzar desde ella la transcendencia (Sciacca).

Beyond yearly reporting, the abstracts of mortality published additional detail on when deaths occurred. For most colonies, deaths were also tabulated by month of registration. In addition, weekly and monthly reports were compiled and published in colonial Government Gazettes for some jurisdictions such as Sydney and Melbourne and their suburbs.

During much of the nineteenth century, the search for disease aetiology focussed on the relationship between temperature and illness. Climate was seen to be a contributing factor—especially to high rates of infant mortality—and so many of the abstracts were accompanied by detailed information on maximum and minimum daily and monthly temperatures.

Monthly tabulations of deaths make possible a more detailed examination of trends and patterns in mortality than that provided by annual compilations alone. Deaths attributable to a number of causes, most notably infectious diseases but also cardiovascular disease and others, follow a cycle that peaks in certain seasons and occurs less frequently in others (AIHW: de Looper, 2002; Dewdney, 1960).

However, deaths were tabulated by month of registration, rather than by the month of their occurrence, and it is occurrence which is preferred for epidemiological purposes. Some deaths were registered many months after the event, due to factors such as delayed notification, requirements for a coronial inquest, end-of-year delays or even coder shortages among Registration Office and Statistical Bureau staff (Taylor, Lewis & Powles, 1998a). These were the exception, however. In 1905, the registration of an infant death in Sydney typically took place two days after the event (Armstrong, 1905, p.517). Any lags between occurrence and registration will have some effect on monthly tabulations, less effect on seasonal (3-monthly) tabulations, and less effect still on yearly tabulations.

The Registration Acts specified the time period during which deaths were to be notified to Deputy Registrars or to those responsible for registration. This requirement varied between colonies; as specified in the original Acts it was within eight days following a death in South Australia, 10 days in Tasmania, 15 days in Victoria, and one month or thirty days in Western Australia, New South Wales and Queensland. As Acts were altered or repealed, the time periods often changed – in 1856, the period for notifying a death in Western Australia was revised to 14 days by the new Registration of Births, Deaths and Marriages Act (19 Vic. 12).

Longer time periods for notification led to greater opportunities for lags between the occurrence and registration of death. Queensland Registrar- General Henry Jordan noted that

‘Considerable variations will be observed in the number of registrations in the monthly returns. These cannot be made to exhibit the exact number of deaths actually occurring in each month of the year, because some delay in registration is allowed by law, for the convenience especially of persons resident in country places; but compared, as these monthly returns are, with the corresponding months of the previous year, the record is on the whole a safeguard, and has its special value in keeping up public attention to a subject of vital importance; for, as it has been well said, “It is not with these events a mere question of money, or of fluctuations of prosperity that come and go, but of life itself.”’ (QldRG, 1876).

In the abstracts, deaths in New South Wales and Victoria combined—two colonies with readily available data—numbered approximately 126,000 during 1880–1884, at an average of 2,100 for every month, or 69 for every day of the year over these five years. Deaths occurred (or to be more precise, were registered) more frequently in some months than in others (Figure 4.12). There was an average of 77 deaths per day in January and December, whereas during each day in September there were 61. Deaths tended to occur more often in the warmer months (December to March) and less often in colder months (June to September).

Longer time periods shows the same cyclical pattern (Figure 4.13). When the monthly average of deaths is compared with the average over the entire year, deaths exhibit a peak in summer and a trough in winter, varying by 30 per cent or more between low and high months. In some months, such as January 1875, the peaks are higher, indicating an excess due to a seasonal epidemic.

The pattern of summer peaks in mortality—largely because of the increased incidence of diarrhoea, dysentery and other enteric diseases—was a reversal of the experience in England, where peaks of deaths from influenza, pneumonia, tuberculosis and bronchitis were the norm during the wet and cold of winter (Stevenson, 1981).

Figure 4.12: Average daily number of deaths, by month, New South Wales and Victoria, 1880–1884

Figure 4.13: Seasonality of deaths, New South Wales and Victoria, January 1871 to December 1890

The summer peak in Australian mortality underwent change throughout the nineteenth century. In the mid-1850s, deaths during summer months averaged

50 60 70 80

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Number of deaths per day

50 75 100 125 150

Jan 1871 Jan 1873 Jan 1875 Jan 1877 Jan 1879 Jan 1881 Jan 1883 Jan 1885 Jan 1887 Jan 1889

20–30 per cent higher than for the entire year. This excess declined progressively until the first decade of the twentieth century, when excess winter deaths began to occur (Figure 4.14). In this way, the seasonal pattern of deaths in Australia began to resemble that of England. Excess summer deaths continued to decline throughout the twentieth century until the 1960s, when the decline levelled. Excess winter deaths peaked in the 1960s, and have declined somewhat since then (AIHW: de Looper, 2002).

Dewdney (1960) commented on the disappearance of excess summer deaths and the emergence of a new peak in winter. He noted a decline in mortality from certain diseases which had previously been most severe in the summer months, such as dysentery, gastroenteritis and other infectious and parasitic diseases. Accompanying this was an increase in diseases associated with a high mid-year mortality rate, such as diseases of the circulatory system and respiratory diseases such as pneumonia and influenza. Certain other causes also changed in their seasonal incidence.

Figure 4.14: Seasonal excess mortality, New South Wales and Victoria, 1856–1906

-30 -20 -10 0 10 20 30 40 1856 1861 1866 1871 1876 1881 1886 1891 1896 1901 1906

Per cent excess

Summer excess

SUMMARY

All-cause mortality in Australia fluctuated considerably from 1856, at between 1,300 and 2,000 deaths per 100,000 population. Mortality rates were highest among the youngest and oldest age groups, age 0 and 75 years and over.

The year 1885 was identified as a turning point in mortality in Australia, after which death rates began to exhibit a steady decline, and with less annual fluctuation. From 1,580 deaths per 100,000 population in 1885, all-cause mortality fell to below 1,000 deaths per 100,000 population by 1906, a reduction of more than one-third over two decades. The largest declines were among the younger age groups of 0 and 1–4 years, with the decline among infants becoming more rapid after the mid-1880s.

Life expectancy in Australia increased over the period. For the years 1856–60, life expectancy at birth for males was 43.08 years, and for females 46.00 years. By 1901–06, this had increased to 54.26 and 58.02 years, with most of the increase in years of life occurring between 1881–90 and 1901–06. Over half of the gain in life expectancy between 1856–60 and 1901–06 can be attributed to reductions in under-five mortality. Life expectancy in Australia was high between 1890 and 1906, compared with other European countries.

Mortality declines in the twenty years after the mid-1880s were most apparent in urban areas, with rural death rates remaining largely unchanged. Mortality in Australia was seasonal, initially with a summer peak, although this disappeared over the course of the second half of the nineteenth century, to be replaced by a winter excess.

Chapter 5