move or lessen some of the causes of excessive disease. There does not seem to be any sign that the desire of modern man to build himself cities and to live in them is weakening. So far ahead as any one can see, cities will continue to crowd to the edge of the stream of human life in 'a blacker, incessanter line.' Unknown forces will doubtless arise in the future which will ameliorate the conditions of city life in the way that the trolley has already done, but there will always exist certain problems peculiarly urban and created by what some curiously term the artificial conditions of city life. It should be the task of a well-conceived, far-seeing art of municipal hygiene to deal with the sanitary aspect of these problems. It does not by any means follow because some of the conditions of city life at present are distinctly inimical to human welfare that they should always remain so. And it should be recognized, furthermore, that the city possesses, within and because of its own structure, certain hygienic advantages, of which to be sure it does not always avail itself, but which in the long run will count heavily in its favor. There are already indications that these factors are becoming operative. The approximation of the urban to the rural death rate shown by the last census to have occurred in several states is not in all probability to be accounted for by a sudden shifting of the age and sex distribution of the population, but marks a real improvement in the sanitary conditions surrounding city life.
Excess of Urban Over Rural Death Rate.
| Registration State. | 1890. | 1900. |
| Connecticut | 3.9 | .1 |
| Massachusetts | 2.7 | .8 |
| New Hampshire | 1.0 | 1.3 |
| New Jersey | 7.9 | 3.3 |
| New York | 9.3 | 4.0 |
| Rhode Island | 1.1 | .4 |
| Vermont | 3.0 | .7 |
Since it is not true that urban life necessarily and inherently entails a higher death rate than rural life, it would seem time to dismiss the gloomy forebodings sometimes expressed that the cities are destined to become 'the graveyard of the human race,' that an inevitable physical degeneration is bound to attend life in the great centers of population, and that density of population is in itself a deplorable accompaniment of modern industrial development. Rather do the signs point to an increasing consciousness on the part of the city dweller of the hygienic advantages bestowed upon him by his position, to a deliberate and intelligent attempt on his part to master the forces that make for the excessive prevalence of disease in crowded centers, and especially to a growing realization of the necessity for a careful study and appreciation of the hygienic possibilities of his environment.
