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REPORT The Director-General of Health to the Hon. the Minister of Health, Wellington. I have the honour to lay before vou the annual report of the Department for the vear 1948-49. GENERAL SURVEY From the evidence of the vital statistics for the year 1948, the health of the people, both European and Maori, is being maintained, with definite improvement in many respects during the past few years. The outstanding epidemiological features of 1948 were the continuance unabated throughout the year of the epidemic of poliomyelitis which commenced in November, 1947, and the remarkably low incidence of diphtheria. The birth-rate, whilst slightly below that of 1947, remained high, and the infant-mortality rate, the still-birth rate, and the tuberculosis death-rate all reached new low levels. In the past, Maori statistics have been given in the annual reports of the Department only to a minor extent. This has been due to the incompleteness of these statistics and to doubts as to the accuracy of such as were available. The following extract from the Department's annual report of 1935 indicates the position at that time The vital statistics of the Maori race are necessarily incomplete and inexact because many Maori births and deaths go unrecorded. One of the greatest difficulties in obtaining accurate records of Maori deaths is that a large number of the Maoris are not attended during sickness by a medical practitioner. The regulations that were formerly in force allowed two months as the time in which any death could be registered, and also did not insist on a medical certification of the cause of death prior to burial. This difficulty was partly met in 1934 by advising all Registrars of Maori Births and Deaths that if a death was registered without any cause of death or with only an indefinite cause they should report the facts and supply all particulars available to the nearest District Nurse, who in turn would make inquiries. The cause of death supplied by the District Nurse would, failing one supplied by a medical practitioner, be acceptable for registration and statistical purposes. Following on recommendations made by the Health Department, the regulations governing the registration of births and deaths of Maoris were revised, and the new provisions came into force on the Ist May, 1935. The amended regulations provide for the registration of Maori deaths within seven days if in the South Island and fourteen days if in the North Island, and also do not permit burial unless there has been furnished (1) a medical certificate of cause of death ; or (2) a Coroner's order to bury or (3) a Registrar's certificate that the death has been registered. It is yet too early to state whether there is a greater accuracy in the vital statistics of the Maori, but it is felt that the new regulations are a definite step in the right direction. With the introduction of the new regulations mentioned, and, from 1939 onwards, the introduction of various benefits (maternity, medical, hospital) under the Social Security Act, the position has continued to improve. As an example of this improvement, the percentage of deaths for which a medical certificate of the cause of death has been obtained has risen from 62-2 per cent, in 1939 to 81*3 per cent, in 1947. Coroners' inquest verdicts have remained at approximately 11 per cent. Maori statistics will be dealt with more fully in future, but it must be borne in mind that there is still considerable improvement to be made before they can be accepted as accurate. A table is given later in this report showing for the past ten years some comparisons between Europeans and Maoris.

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