Recent trends of mortality from violence.

The causes of violent deaths have changed with the growth of civilization. In England the risk of being murdered or hanged is much smaller than three centuries ago when life was held to be cheaper, but in the last 150 years new and potent methods of killing have been introduced. With the development of industrialization new hazards arose from machinery, from railways, and from the internal combustion engine. In the last decades of the 19th century, there was an increasing awareness of the unnecessary waste of life from accidents in industry. The various risks in industry have been greatly reduced, but the more recent campaign against road accidents, although continuous and vigorous, has not met with any great success. As a result of the measures taken, the death rate from accidents fell dramatically. In males, the death rate from accidents and negligence fell from 1,064 per million in 1861-70 to 496 in 1931-35, and in females it declined from 314 to 198 during this period. The death rate from accidents in coal mines fell from 96 per million in 1863-70 to forty in 1931-38. On the railways the death rate in males of 89 per million in 1871-80 fell to only twenty in 1931-38. In males, deaths from accidental drowning were 214 per million in 1863-70 and 58 in 1931-38, and during this period the death rate in males from accidental burns and scalds fell from 109 to 29 per million. The death rate in males from all forms of suffocation was 73 in 1863-70, increased to 81 in 1891-1900, and then fell steadily to twenty in 193138. The death rate from accidents due to horse vehicles was 124 per million in 1863-70, declined to 59 in 1901-10, and fell to five in 1931-38. The very large fall in fatal accidents due to horse vehicles has been more than compensated for, however, by motor vehicles. The first deaths registered as due to motor cars were one male and one female in 1896 and the first motor-cycle deaths registered were two males in 1902. From these small beginnings a terrific stream of deaths has resulted; in 1954 the numbers killed by motor vehicles were 3,289 males and 1,158 females, including 1,049 males and seventy females who died from motor-cycle accidents. Aircraft have begun to be an important cause of violent death. In 1911 six deaths were registered, in 1921 the numbers rose to 64, including 38 in the disaster to airship R38, and in 1954 the number of deaths was 225. The largest annual number of deaths from aircraft accidents was 311 in 1952. The introduction of gas for domestic purposes provided another means of suicide that has become more frequent during the present century. Although there was a large fall in the mortality from violence before 1939, the rate of decline has been much slower than that of the death rate from natural causes. As a result of this trend violence has become relatively more important as a cause of death; in 1861-71 deaths from violence formed 3-4 per cent. of all deaths and in 1931-39 the proportion was 4 6 per cent. During the past 20 years there have been changes in the mortality from violence. The chief is the decline in mortality in males; in females the death rate has fluctuated about a fairly constant level. In 1935 the death rate per million was 743 for males and 345 for females. and in 1954 the rates were 593 and 358 respectively. The actual number of deaths was 14,479 males and 7,301 females in 1935 and 12,630 males and 8,239 females in 1954. The standardized death rates from violence during the past 90 years are shown in Table I. The death rates from all forms of violence have declined faster for males than for females. In males the rate in recent years is less than half the rate at the beginning of the period, while in females it is about two-thirds of its former level; consequently the death rate in males is now 21 times that in females compared with 3j times at the beginning of the period. The course of the standardized death rate for suicide has been