In Japan, the seasonal variation of mortality from stroke (Int. List No. 330-334, Vascular lesions affecting central nervous system) has undergone a chronological change from the summer maximum late in the 19th century through the bimodal distribution to the current concentration in winter. In various contries abroad, it follows different curves peculiar to each of them, depending upon the degree of cultural progress. For instance, the winter concentration is much less prominent in Egypt than in the advanced countries, while on the other hand the Scandinavian countries as well as the United States indicates signs of the steady slowing-down of seasonal variation itself or gradual deseasonality. In this paper, a comparative study is made in the different forms of seasonal variation in mortality from stroke in England (including Wales), the City of New York, and the City of Tokyo (23 old wards), for which vital statistics are chronologically available.
1) In England, there was no summer peak whatever and the winter summit has got higher decade after decade, and the winter concentration now is conspicuous.
2) In the City of New York, little seasonal variation has been seen, and signs of the moderation of seasonal variation has been increasing since 1930.
3) In the City of Tokyo, representing the whole of Japan, the above-mentioned three stages of seasonal variation have been witnessed since early in the current century.
In the high latitude areas (the Scandinavian countries) or the United States with a wide difference between heat and cold, or a very cold district like Hokkaido in Japan, where human living is neither possible nor comfortable without adequate environment control, the system of central heating or area heating has developed markedly. In the medium latitude countries or districts, where nearly no provision is necessary for artificial climate, the recent development of medical science and service has reduced the death rate in the hot season to the extent that old people have been on the steady gain in the age structure. And deaths among them occur most frequently in winter, bespeaking the winter concentration of mortality in these countries. It is to be emphasized that the seasonal variation of mortality, the winter concentration in particular, can be checked, if not eliminated, by artificial climate as seen in New York.
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