All the 1559 delivery cases in the town of Omama, Gunma Prefecture during the 5 year period of 1964-68 were surveyed with regard to the state and places of delivery, and obstetrical facilities, and changes in these items were investigated with special reference to social patterns . Principal findings are as follows: 1) During the survey period, the number of total births was about 340 each year, with live birth rate of 18 (per 1, 000 of the population) . In 1966, that is the particular year of hinoeuma, the rate significantly fell to 12.0 (P<0.01) . 2) The rate of delivery in other than hospital and clinics (at one's own home or elsewhere), which is one of important indices of maternity care, fell abruptly from 29.6% in 1964 to 1.5% in 1968. 3) As for the change in the place of delivery, the initial rate of delivery in the institutions in the town of Omama was 67.2%, but fell to 46% 5 years later . By contrast, the rate in the neighboring city of Kiriu increased from 25.5% to 46.6%, the latter surpassing the corresponding figure in Omama. The rate of delivery in other places than these two remained almost invariably at 7-9% a year. 4) As for the change in the birth rate by birth order, the rate in 1966 showed marked decrease for the second infants. The birth rate in other than obstetrical institutions was lowest for the first infants, and increased in the order of the 2nd, 3rd and so on. Differences in delivery rate by the birth order was statistically significant . 5) Abrupt fall in birth rate in other than obstetrical institutions was accelerated by the establishment of the community-owned maternity center in 1966. Thus the change occurred in the direction, from one's own home to maternity center and finally to hospitals or clinics. 6) As for the birth weight, deliveries of premature or postmature infant were infrequent in maternity homes. The proportion of such deliveries at home was not markedly different from that in maternity hospitals or clinics. Perinatal prognosis of delivery at home is the object of anxiety. 7) To summary, it is rejoicing to confirm that the proportion of deliveries in obstetrical institutions tended to increase year after year, although the condition is not yet so favorable that "those needing hospitalization for medical reason can be hospitalized." Enhanced community activity in and around the maternity center is now greatly expected.
Beliefs and knowledges about uterine cancer, toxemia of pregnancy and artificial abortion, which possess local women in an urban and rural regions of Gunma Prefecture were surveyed by using the enquete blanks (originally devised by Jenkins). Subjects of the survey were 238 women, aged 20-59, who all attended the local woman class or mother class. The findings are as follows: 1) Those who believed that there is some probability of their eventual suffering from uterine cancer represented the highest proportion. Also those who believe the probability to be small represented a peak. Distribution of these beliefs was different in the urban and mountainous regions, and in other regions, it was intermediate between them. 2) Those who believed the prevention of uterine cancer to be difficult accounted for nearly a half. Next in order were those who believed that the prevention will be possible if they make a little endeavor for it. In mountainous communities those having such a belief constituted 17.2%, which is significantly lower than in the other surveyed regions (P<0.01). 3) Those who believed that the prognosis of toxemia of pregnancy sometimes warns of death were more numerous in mountainous communities. And those who relatively despised the toxemia, though, they thought, it might cause some pain represented higher proportion in mountainous communities than in the others. 4) As for the mental reaction to artificial abortion, those who rejected it as unacceptable were most numerous. In the urban and rural regions, next in order were those considering it shameful, but in mountainous communities, they were nearly same in number with those who thought it acceptable. In mountainous communities those considering it shameful represented significantly lower proportions than in the others (P<0.01) 5) To summarize the results in territorial comparison, urban women gave unimodal or bimodal distributions, whereas mountainous women showed scatter in their knowledges 6) The same can be said in comparison between age groups of 20-30 and 40-50 in rural regions. Thus the 40-50 age group tended to show scatter in their knowledges in comparison with the 20-30 age group.
Although the infant mortality rate in Iwate Prefecture was annualy reported to be the highest in the country in the period of ten years from 1955 to 1964, the perinatal mortality rate in the Prefecture was on a little lower level than the rate in all the country. From this fact, it is surmised that the factors influencing upon the perinatal mortality rate are somewhat different from the factors influencing upon the infant mortality. In order to elucidate the meaning of the perinatal mortality rate as a maternal and child health indicator, the author has performed statistical investigation. Perinatal mortality rate in each city, town, or village in Iwate Prefecture was calculated using the vital statistics of the Prefecture in 1955 and 1960, and the association between the perinatal mortality rate in 1955 and the rate in 1960, as well as the association between perinatal mortality rate or other maternal and child health indicator were studied. Perinatal mortality rate was also observed to be not always low in the areas where the health level was evaluated to be high by life expectancy or other indicator. Using the vital statistics of Japan in 1960, correlation coefficients between two of seven indicators, that is, late fetal mortality rate of 29 weeks or more, early neonatal mortality rate under one week, perinatal mortality rate, infant mortality rate, maternal mortality rate, Uematsu's Indicator (normal deviation of mortality) for female and the Indicator for male, were studied. And then, factor analysis was performed with the obtained correlation matrix. According to the result of factor analysis, seven indicators studied could he classified into next three groups; 1. Late fetal mortality rate of 29 weeks or more. 2. Perinatal mortality rate and maternal mortality rate. 3. Early neonatal mortality rate under one week, infant mortality rate, Uematsu's Indicator for female and Uematsu's Indicator for male. Taking these facts into consideration, it has been deducted, according to the author's opinion, that perinatal mortality rate is a useful indicator for evaluating maternal and child health level of the communities.
This is the first of a series of studies seeking to find basic dimensions of levels and styles of living (LSL) emphasizing their health—related aspects, and thus to yield ?ecomprehensive health indicators' of a population . First, 41 measures, including economic, social—cultural, and health indicators, were obtaind for all 46 prefectures of Japan in 1965. They were correlated and factored . Two basic factors of LSL, ?eurbanization' and?egerontization increase of the proportion of aged in the population—', were extracted. The 46 prefectures were classified into seven groups according to their factor scores describing LSL. Secondly, by examining their factor loadings, several health indicators representing each basic factor of LSL were picked out : indicators corresponding with urbanization were death rate caused by vascular lesions, infant mortality rate and neonate mortality rate ; indicators coresponding with gerontization were PMI, death rate caused by malignant neoplasms, and senility death rate. Finally, the seven prefectural groups were compared using 19 health indicators, mostly death rates. Large inter-group differences were found in standardized death rate, PMI, infant mortality rate and death rates caused by vascular lesions and (combined) nephritis and nephrosis.
This is the second of a series of studies aiming at identifying basic dimensions of levels and styles of living(LSL)and finding health indicators representative of these dimensions . First, two or three prefectures were chosen as typical of each of the seven prefectural groups differing in LSL. These prefectures, 16 in all, were described in terms of LSL by 71 economic, socio cultural and health indicators at three different times-1955, 1960 and 1965. They were dealt with as if they had been 48 (16×3) independent descriptions, and were correlated and factor-analysed by D-method of Osgood et al.Two basic dimensions, ?etemporal changes' and?eregional differences in urbanization', were found with a considerable positive correlation. The former was a?enew' dimension, because only relationships between indicators and between prefectures at a time had been considered in the previous study. The latter proved to be the same as the dimension of?eurbanization' found previously. In other words, LSL had changed through time in one and the same direction in all prefectures, but there had remained similar inter-prefectural differences in those ten years. Secondly, using correlation coefficient, we tried to match 28 health indicators with the basic dimensions of LSL. Death rate by tuberculosis, PMI, infant mortality rate and neonate mortality rate were the four most corresponding with temporal changes ; death rate by pneumonia and bronchitis, death rate by gastritis and enteritis, infant mortality rate and neonate mortality rate corresponded most with regional differences in urbanization.