民族衛生

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Among the inhabitants of a coastal area of Miyagi Prefecture, 2, 679 hypertensives (more than 150 mmHg systolic and/or 90mmHg diastolic) aged 40 and over were followed-up for four-year period, and the probability of death from cerebrovascular lesions was studied. 1. Mortality from cerebrovascular diseases among the hypertensives was 5.4 % for males and 2.9 % for females during the four-year period. The sex difference of the mortality was observed in the last two years. 2. Positive correlations of the mortality with age and both systolic and diastolic pressures were observed. Age dependence became less among the hypertensives above 210 mmHg of systolic pressure. 3. The mortality was less at females even when the conditions of age, blood pressure, retinal and E. C. G. findings, and albuminuria were the same degree.4. In comparison between the deceased and the survivals from cerebrovascular lesions, the former was higher for both age and blood pressures. 5. The mortailty was significantly high among the hypertensives who had auricular fibrillation and myocardial damage on E. C. G., retinal bleeding, SIV grade of ocular fundus by Scheie classification, systolic pressure above 210 mmHg and albuminuria. No effect was observed on the mortality of glycosuria and serum total cholesterol.

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As measured by impairments and disorders, rural health is rather clearly poorer than urban. Rural areas tend to have smaller and less effective force of all types of medical and related personal than the cities. In the Siga Prefecture situated in rural territory these tendencies have been true since the Meiji era. Moreover most of physicians in this prefecture did not go through the regular medical education in the Meiji era : herb doctors and some others of old types. The remarkable maldistribution of physicians in rural districts was recorded in the times of agricultural panic of the Showa era. It was natural tnat private physicians having a service to sell chosed to sell it where purchasing power was greatest. The basic factor accounting for the rural-urban distribution of physicians was the economic level of the areas in which they practiced. From the economic disadvantage springed a whole series of consequencies affecting the quantity and quality of rural physicians.

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