Health statistics are used to understand risk factors for communities, track and monitor diseases, see the impact of policy changes, and assess the quality and safety of health care. Health statistics are a form of evidence, or facts that can support a conclusion.
June 10, 1772
A Journey from Prince of Wales's Fort in Hudson's Bay to the Northern Ocean in the Years 1769, 1770, 1771, 1772
As to the persons of the Northern Indians, they are in general above the middle size; well-proportioned, strong, and robust, but not corpulent.
As to the persons of the Northern Indians, they are in general above the middle size; well-proportioned, strong, and robust, but not corpulent. They do not possess that activity of body, and liveliness of disposition, which are so commonly met with among the other tribes of Indians who inhabit the West coast of Hudson's Bay.
Their complexion is somewhat of the copper cast, inclining rather toward a dingy brown; and their hair, like all the other tribes in India, is black, strong, and straight. I have seen several of the Southern Indian men who were near six feet high, preserve a single lock of their hair, that, when let down, would trail on the ground as they walked. This, however, is but seldom seen; and some have suspected it to be false: but I have examined the hair of several of them, and found it to be real.
Few of the men have any beard; this seldom makes its appearance till they are arrived at middle-age, and then is by no means equal in quantity to what is observed on the faces of the generality of Europeans; the little they have, however, is exceedingly strong and bristly. Some of them take but little pains to eradicate their beards, though it is considered as very unbecoming; and those who do, have no other method than that of pulling it out by the roots between their fingers and the edge of a blunt knife. Neither sex have any hair under their armpits, and very little on any other part of the body, particularly the women; but on the place where Nature plants the hair, I never knew them attempt to eradicate it.
Their features are peculiar, and different from any other tribe in those parts; for they have very low foreheads, small eyes, high cheek-bones, Roman noses, full cheeks, and in general long broad chins. Though few of either sex are exempt from this national set of features, yet Nature seems to be more strict in her observance of it among the females, as they seldom vary so much as the men. Their skins are soft, smooth, and polished; and when they are dressed in clean clothing, they are as free from an offensive smell as any of the human race.
Every tribe of Northern Indians, as well as the Copper and Dog-ribbed Indians, have three or four parallel black strokes marked on each cheek; which is performed by entering an awl or needle under the skin, and, on drawing it out again, immediately rubbing powdered charcoal into the wound
January 2, 1836
Superintendent Peacock's letter is dated at Happy Valley, Labrador, March 25, 1959
Further evidence of old age Labrador Eskimos exists.
On receiving Professor Laughlin's letters, I sent copies of them along to Superintendent the Reverend F. W. Peacock, M.A., Moravian Mission, Labrador. His records go back well toward 1771, the founding date of the mission; and there are several stations. Knowing that I had available only limited comparison figures for the Aleutians, he sent me only records from his Hopedale community and covering only the same years as Veniaminov's.
Superintendent Peacock's letter is dated at Happy Valley, Labrador, March 25, 1959:
“Upon receipt of your letter I went to the records of the Hopedale [mission] from 1822-36. I discovered that
110 people were born during this period ...
29 died before reaching the age of 10 years;
9 died between the ages of 11 and 15;
4 between the ages of 16 and 20;
6 between 21 and 25;
7 between 26 and 30;
10 between 31 and 35;
4 between 36 and 40;
8 between 41 and 45;
2 between 46 and 50;
10 between 51 and 55;
4 between 56 and 60;
4 between 61 and 65;
8 between 66 and 70;
4 between 71 and 75;
1 reached the age of 79.
“From 1860 to 1879 there were 150 births in the same district, of which number 79 died before they were 5 years old, and a further 10 before they were 10 years old. Another 30 died before they were 60 years old; 30 died between the ages of 61 and 82. One is still living at the age of 81 [in March 1959] ...”
We have examined, then, the mortality records of 1822-36 for 1,170 cases from Alaska and 110 from Labrador. The base line of our immediate concern we shall take at 60, because of the assertion that “a primitive Eskimo over the age of 50 is a great rarity.”
According to our Russian information on 1,170 Aleutian Eskimo births, 46 died in the decade immediately past 60, 34 in the one past 70, 20 in the one past 80, and only 2 lived past 90.
According to our Moravian information on 110 Labrador Eskimo births, 8 died in the decade next past 60 and 5 in the one next past 70, only one of these reaching 79.
Thus the most nearly “primitive” sample group I was able to obtain does not support Dr. Keys very strongly in his contention that “a primitive Eskimo over the age of 50 is a great rarity.” Nor does it quite confirm Dr. Greist's statement that “the Eskimo of the North ... lived to a very great age.” More nearly do the largely non-Europeanized natives of Veniaminov and Peacock accord with the Biblical: “The days of our years are threescore years and ten ..
January 3, 1850
Between 1850 and 1885, the Inuit population of coastal arctic Alaska declined by 50 percent. In two generations, the Mackenzie Delta Inuit were reduced from about 1,000, to fewer than 100. Labrador's Inuit numbered about 3,000 in 1750. In 1946, 750 were left.
This is, perhaps, too rosy a view of early Inuit life. It was hard, precarious, and in some regions haunted by recurring famines. But it did have that saving grace of contentment known only when a people are secure within their society and in harmony with their natural environment. That ancient balance was broken when Europeans came to the Arctic - the whalers who took from the North much of its wildlife, the basis of the Inuit's existence, and who brought to the North diseases to which the long-isolated Natives had no immunity.
Between 1850 and 1885, the Inuit population of coastal arctic Alaska declined by 50 percent. In two generations, the Mackenzie Delta Inuit were reduced from about 1,000, to fewer than 100. Labrador's Inuit numbered about 3,000 in 1750. In 1946, 750 were left. With the whales nearly exterminated, the whalers departed, leaving a people wracked by disease and accustomed to, and dependent upon, many southern goods. Into the vacuum created by the whalers' departure stepped the fur traders, and to pay for the southern goods they had come to regard as essential, the Inuit became trappers. Where once they had been poor but independent, they were now dependent and still poor, their ancient autarky destroyed beyond redemption.
January 1, 1890
Seventeen Years among the Eskimos
The Eskimo of the far North was healthy and lived to a very great age.
When Dr. John Simpson published the account of a two-year study in northern Alaska in 1855, he put his finger on a statistical difficulty when he said of primitive Eskimos that they “take no heed to number the years as they pass.”
At Point Barrow, a statistically valuable numbering was begun in the 1890's through missionary recording of births. The tally has established that in northern Alaska long life is not common. This, along with similar twentieth century statistical results from other northern fields, has strengthened two sets of convictions — the convictions of the frontier doctors and the convictions of their critics.
The medical missionaries, already committed to the opinion that primitive Eskimos were long-lived, see in the up-to-date figures confirmation of what they believe themselves to have observed, that Europeanization breaks down formerly good native health and thus tends to shorten life. But the critics of the missionaries, who always disbelieved what to them was a baseless legend, see in these first available statistics proof that the frontier doctors of the nineteenth century were deluded, and that primitive Eskimos were never either healthy or long-lived. I shall quote statements by a typical frontier doctor and one by a typical critic.
On behalf of the medical missionaries, and the rest of the frontiersmen, let Dr. Henry Greist speak (from Seventeen Years among the Eskimos, previously quoted at greater length): “For untold centuries ... the Eskimo of the far North was healthy ... He lived to a very great age.”
August 2, 1893
Elliott P. Joslin
Dr. Joslin Makes First Entry in Diabetic Ledger
Dr Joslin begins a ledger on diabetes after meeting a frail young Irish girl named Mary Higgins who was suffering from Type 1 Diabetes. He prescribed a low carb diet and recorded all of his cases over his entire career in his ledger.
On this day in 1893, a student at Harvard Medical School made the first entry in a ledger he would keep for the rest of his long career. Elliott Joslin examined a frail young Irish girl, who was suffering from diabetes. Long before he became one of the world's leading authorities on diabetes, he understood the importance of careful documentation. Keen observation of his patients helped him develop a novel approach to the treatment of diabetes. He prescribed a strict diet that regulated blood sugar levels and helped patients manage their own care. The introduction of insulin in 1921 confirmed the effectiveness of Joslin's approach. Elliott Joslin saw 15 patients a day until a week before his death in 1962, at age 93.
Unlike many other men who made Boston a center of medical innovation, Elliott Joslin was born in Massachusetts — in the town of Oxford, 40 miles west of Boston. The son of a wealthy shoe manufacturer, Elliott was an unusually focused, driven young man. He attended Yale College, graduated at the top of his Harvard Medical School class, and served an internship at Massachusetts General Hospital. After additional study in Europe, he returned to Boston in 1898 and opened a private office in the house his father had bought in the Back Bay.
Although Joslin had been interested in diabetes since medical school, he began his career as a general practitioner. Physicians who specialized in one particular disease were still rare in American medicine, and it would be almost 20 years before Elliott Joslin emerged as one of the most influential people in the study and treatment of diabetes.
Mary Higgins's case sparked his interest and convinced him of the need to chart in detail the course of a patient's illness. Joslin began keeping a diabetic ledger in 1893; Mary Higgins was the first entry in the first volume. He documented every patient he treated for the next 70 years. Eventually, his ledgers filled 80 volumes and became the central registry for diabetes in the United States, the first system for recording patient diabetes data outside of Europe.
Cairo, Cairo Governorate, Egypt
Cardiology in Ancient Egypt by Eugene V. Boisaubin, MD
Egyptians describe coronary ischemia: "if thou examinest a man for illness in his cardia and he has pains in his arms, and in his breast and in one side of his cardio... it is death threatening him."
The classic pattern of cardiac pain--radiation to the left arm--was so well known that the ancient Egyptians and Copts even identified the left ring finger as the "heart" finger.
Altogether, ancient Egyptians were aware of a variety of abnormal cardiac conditions, particularly of angina pectoris and sudden death, arrhythmia, aneurysm, congestive heart failure, and venous insufficiency. Numerous remedies for afflicitions of the heart are found throughout the Ebers payrus.
There were a range of them using different foods, some even including carbohydrates like dates or honey and dough, but interesting, there is another combination of "fat flesh, incense, garlic, and writing fluid".
Extensive histologic analysis of mummies began, however; well before the development of the scanning electron microscope. In 1912, Shattock' made sections of the calcified aorta of Pharaoh Merneptah; and the work of Sir Marc Armand Rufer, published posthumously in 1921, is our most valuable early source of information about vascular disease in ancient Egyptians. Ruffer was able to study a relatively large number of tissue specimens from mummies, mainly from New Kingdom (1600-1100 BC) burials, but covering a wide period of time. In a mummy of the 28th to 30th Dynasty (404-343 BC), he observed atheromas in the common carotids and calcific atheromas in the left subclavian, common iliac, and more peripheral arteries. Ruffer concluded from the state of the costal cartilage that this mummy was not that of an old person. A mummy of a man of the Greek period (ca. 300 to 30 BC), who died at not over 50 years of age, showed atheromas of the aorta and brachial arteries. Since the discoveries of Rufer, numerous other mummies, whose ages at death ranged from the 4th to the 8th decade, have shown similar vascular changes (Fig.4).
In 1931, Long described a female mummy of the 21st Dynasty (1070-945 BC), found at Deir-el- Bahari-that of the lady Teye, who died at about 50 years of age. The heart showed calcification of one mitral cusp, and thickening and calcification of the coronary arteries. The myocardium is said to have had patchy fibrosis, and the aorta "nodular arteriosclerosis." The renal capsule was thickened, many of the glomeruli were fibrosed, and the medium-sized renal vessels were sclerotic. The condition appears to be that of hypertensive arteriosclerotic disease associated with atheromatous change. In the 1960s, Sandison examined and photographed mummy arteries using modern histologic methods (Fig.5). Arteries in the mummy tissues were described as tape-like, but could be dissected easily, whereupon arteriosclerosis, atheroma with lipid depositions, reduplication of the internal elastic lamina, and medial calcification were readily visible under microscopy.
Still more recently, one of the most extensively studied Egyptian mummies has been PUMIL from the Pennsylvania University Museum(hence its initials), now on loan to the National Museum of Natural History at the Smithsonian. It is believed to be from the later Ptolemaic period, circa 170BC. The heart and portions of an atherosclerotic aorta were found in the abdominal cavity. Histologically, large and small arterioles and arteries from other organs showed areas of intimal fibrous thickening typical of sclerosis. These findings are particularly striking since the estimated age of PUM I at time of death was between 35 and 40 years.