The Infirm

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E.—THE INFIRM.

IN the householder's schedule used in the taking of this census, householders were instructed to state if any person included in the schedule was (1) "Totally Deaf" or "Deaf and Dumb"; (2) "Totally Blind"; (3) "Lunatic"; or (4) "Imbecile" or "Feeble-minded"; and to add whether any such infirmity had existed from infancy. In the schedule used in the census of 1901 the instructions regarding the infirm differed from this and read thus :—"If (1) Deaf and Dumb; (2) Blind; (3) Lunatic; (4) Imbecile, Feeble-minded, write the precise infirmity, if any, as above, opposite the name of the person; and if the infirmity dates from childhood, add 'from childhood.'" The instructions at this census accordingly differed from those of the previous census by the insertion of a heading "Totally Deaf," and by the insertion of the word "Totally" before "Blind." These differences are of some importance when considering the results, and more particularly when considering comparisons between the figures of this and of the previous census, because the difference—the use of the word "Totally "—may have led to the exclusion from the returns of this census of some infirm who would, or should, have been included, had the older instruction been continued. The change of instruction was considered desirable to get rid of a certain ambiguity in the older form, which did not state with sufficient precision the degree of blindness, or of deafness, that was referred to.

The Blind.— The number of persons returned as blind, i.e., "totally blind," was 3,317, of whom 1,638 were males and 1,679 females. In 1901, the blind numbered 3,258, males numbering 1,666, and females 1,587. Thus there is an apparent increase of 92 in the number of blind females, an apparent decrease of 28 in the number of blind males and an apparent increase of 64 in the total number of the blind. How far these observed changes are reliable, and how much is due to modification of instruction, it is impossible to say.

Of the 3,317 blind persons enumerated, 181, or 5.5 per cent., were returned as being blind from infancy, and, per contra, 3,136, or 94.5 per cent., as afflicted with acquired blindness. In 1901, 492, or 151 per cent., of the blind were returned as having been blind from childhood, and 2,761, or 84.9 per cent., as being afflicted with acquired blindness. Thus the apparent intercensal change is an increase of 375 in the number afflicted with acquired blindness, but an apparent decrease of 311 in the number congenitally blind. How far these comparisons are affected by the alteration of the instruction, it is again impossible to estimate.

Of the 3,317 blind persons, 63 were returned as being also deaf, 12 as being also dumb, 40 as being also lunatic, and 26 as being also imbecile.

Of the blind, 238, or 7.2 per cent., were enumerated in special institutions for the blind.

Deaf and Dumb.— The number of persons returned as deaf and dumb was 2,369, as totally deaf but not dumb, 1,656, and as dumb but not deaf, 297. Thus 4,322 in all were afflicted with the want of either hearing, or speech, or both. In 1901, the corresponding total was 3,756, and there thus has been an increase in this number, and this notwithstanding the alteration in the instruction. The increase, however, is small, and may be a mere fluctuation. In 1901, persons returned as deaf and dumb numbered 2,427, as deaf but not dumb, 1,118, and as dumb but not deaf, 211. There is thus an apparent decrease of 158 in the number of the deaf and dumb, but an apparent increase of 538 in the number of those who are deaf but not dumb, and one of 86 in the number of those who are dumb but not deaf.

Of the total number of the deaf, 63 were returned as also blind, 35 as also lunatic, and 30 as also imbecile. Of the total number of the dumb, 12 were returned as also blind, 20 as also lunatic, and 130 as also imbecile. One male was stated to be deaf, blind, and imbecile, and one to be dumb, blind, and imbecile; while one female was stated to be blind, imbecile, deaf and dumb.

Of the 4,025 deaf persons, 1,943 were males, and 2,082 females, the former being 221, and the latter 259, more than in 1901. At both censuses the deaf females have exceeded the deaf males; in 1901 this excess was 101, and it is now found to be 139. Of the 2,666 dumb persons, 1,410 are males, and 1,256 females, the former exceeding the latter by 154, the reverse of what is found among the deaf. A similar difference was found in 1901. Dumb males are the same in number as in 1901, while dumb females show an apparent increase of 28.

Of the 2,369 deaf and dumb persons. 549, or 23.2 per cent., were enumerated in special institutions for those so afflicted.

Lunatic, Imbecile, and Feeble-minded .—Of all the census returns those dealing with the numbers of mentally infirm persons are probably the least satisfactory. This is so for two reasons. One is the dislike of householders, and more particularly of those who are parents, to admit the existence of mental infirmity in their households or families, and the other a confusion that exists regarding the significance of the terms used—lunatic, imbecile, and feeble-minded. There is, intact, too much room for the individual opinion of the householders, and too great a probability of many persons who should be described as mentally infirm not being so returned.

For instance, in the case of a person slightly mentally infirm—say suffering from mild senile dementia, or from a mild mental neurasthenia—it rests with the householder to decide whether he should be described as mentally infirm—i.e., as lunatic, as feeble- minded or as imbecile—or excluded from the category of infirm; and as such a decision would in many cases puzzle experts, it is only reasonable to discount the value of the householders' decisions in such matters. No doubt the returns of "lunatics" and "imbeciles" include all certified cases and some others, but—assuming an arbitrary standard of intelligence below which all should be described as mentally infirm.—the difficulty is to estimate the proportion which these " others" bear to the total who should come within the category of mentally infirm. It is probable, however, that the error arising from imperfect returns, due to want of precise limit and definition in the terms used, and to the absence of skilled knowledge on the part of householders, has been more or less the same in this and in the previous census, when the instruction to the householder regarding the mentally infirm was similarly worded, and this being so, even if the returns be incomplete and unreliable as a measure of the absolute number of mentally infirm, they may be used as an approximate indication of any marked intercensal change in the number.

The other reason why the returns regarding the number of mentally infirm persons are unsatisfactory is due to the risks arising from the confusion of terms. The terms themselves are not defined in the scheduled instruction. This was scarcely possible; but the term " lunatic " is intended for use in cases where the infirmity has been acquired during life, while the terms "imbecile " and "feeble-minded" are intended for use in cases where the infirmity has existed from birth, or from an early age, the former being applied to the more extreme cases, and the latter to the milder. An examination of the returns, however, provides ample evidence that these distinctions have not been uniformly made. Two points may be mentioned as indicative of this confusion, the one being the age distribution of persons returned as "imbecile" or "feeble-minded," and the other their former occupations. It. is a well-established fact that imbeciles are subject to a higher death-rate than the general population, and, as all imbecility dates from childhood, it is evident that the ratio of the number of imbeciles to the general population should decrease as the age advances. Precisely the opposite, however, is found in the Census returns, for not only is the ratio found not to be a diminishing quantity, but it is a markedly increasing quantity. It is less than 1 per thousand in age groups under 10, rises to nearly 2 per thousand in age group 15 to 19, is between 1.7 and 1.9 in age groups between 20 and 50, and thereafter steadily increases, exceeding 2.5 in age group 65 to 69, and exceeding 4.0 in age group 75 to 79. Figures such as these clearly show that the terms "imbecile" and "feeble-minded" are applied to cases in which the mental infirmity has arisen, not at an early age, but in middle and advanced life. A study of the former occupations of those returned as imbecile or feeble-minded demonstrates the same confusion, for while it is reasonable to assume that those who are mentally infirm from childhood are incapable of qualifying for a learned profession, or for a skilled trade, the returns include many examples of these infirm being reported to have had such occupations. For instance, the list of those returned as "imbecile" or "feeble-minded" includes an officer of the Royal Navy, two ministers of the Established Church of Scotland, an advocate, two sick nurses, a school mistress, and a very considerable number with other occupations requiring skill and technical knowledge.

From these considerations it is evident that the numbers returned as mentally infirm should not be accepted as an accurate measure of the frequency of the infirmity, and further that much reliance should not be placed on the division of the infirm into those described as "lunatics," and " imbeciles" or "feeble-minded," respectively.

In all 23,630 persons have been returned as being either lunatic or imbecile or feeble-minded; 15,719, or 66.5 per cent., being returned as lunatic, and 7,911, or 33.5 per cent., as imbecile or feeble-minded. In 1901 those returned as mentally infirm collectively numbered 20,291; 13,668, or 67.0 per cent., being returned as lunatic, and 6,623, or 33.0 per cent., as imbecile or feeble-minded. There is thus an apparent intercensal increase of 3,339, or 16.5 per cent., in the total number; of 2,051, or 15.0 per cent., in the number of lunatics, and of 1,288, or 19.4 per cent., in the number of imbeciles or feeble-minded; but to what extent these apparent increases are real, and to what extent merely due to wider recognition of mental infirmity on the part of the householders, is a question which cannot be answered from information provided by the census.

Of the total number returned as mentally infirm, 11,688 were male and 11,942 female, the former being 1,974, or 20.3 per cent., more than in 1901, and the latter 1,365, or 12.9 per cent., more. Of these males, 7,701, or 65.9 per cent., were returned as lunatic, and 3,987, or 34.1 per cent., as imbecile or feeble-minded; the former are 1,233, or 19.1 per. cent., more than in 1901, and the latter, 741, or 22.8 per cent., more. Of the females, 8,018, or 67.1 per cent., were returned as lunatics, and 3,924, or 32.9 per cent., as imbecile or feeble-minded, the former being 818, or 11.4 per cent., more than in 1901, and the latter 547, or 16.2 per cent., more. Thus the apparent increase of mental infirmity has been greater in the male than in the female sex, and in both sexes it is found that the apparent increase in the number of imbeciles and feeble-minded has been relatively greater than in the number of lunatics.

Of the total number returned as lunatics, 15,147, or 96.4 per cent., were enumerated in institutions for the insane, i.e., in lunatic asylums and licensed lunatic wards of poorhouses; and of the total number returned as imbecile or feeble-minded, 531, or 6.7 per cent., were enumerated in institutions for imbeciles.


Age Distribution of the Infirm.— The age distribution of the infirm is shown in Tables XX and XXI, and from the figures there given the proportion of the infirm in each 1,000 of the population of various age groups has been calculated. These proportions are collected in Table F. The corresponding proportions of the 1901 census have also been calculated, and are collected in Table G.

The frequencies of the infirmities at all ages, expressed as the rate per 1,000 of the total population, are found to be:—mental infirmity, including lunacy and imbecility, 4.96; deafness, 0.85; blindness, 0.70; and dumbness, 0.56. Of the 4.96 mentally infirm in each 1,000 of the population, 3.30 were returned as lunatics, and 1.66 as imbeciles or feeble-minded. Of the 0.85 deaf, 0.50 were returned as also dumb, and of the 0.56 dumb, 0.50 were returned as also deaf.

In the age groups, the proportion of mentally infirm is found to increase as the age of the groups increases. Thus the rate is below 1 per 1,000 in age group over 5 but under 10, but is over 2 per 1,000 in age group over 15 but under 20, over 5 in age group over 25 but under 35, over 10 in age group over 45 but under 55, and reaches a maximum of 18.97 in age group over 85.

The age distribution of the deaf is found to be very similar, the rate of deafness increasing as the age increases. In age group over 5 but under 10 this rate is 0.66 per 1,000, in age group over 35 but under 45 it is 0.96 per 1,000, and thereafter it steadily increases, becoming 1.14 in age group over 45 but under 55, 1.28 in age group over 55 but under 65, 1.62 in age group over 65 but under 75, 2.25 in age group over 75 but under 85, and 3.20 in age group over 85.

TABLE F.—CENSUS 1911.—RELATIVE FREQUENCY OF INFIRMITIES
PER 1,000 OF THE POPULATION AT EACH AGE GROUP.

INFIR-
MITY.
AGE GROUPS. ALL
AGES.
Under
5
Years.
5-
9
10-
14
15-
19
20-
24
25-
34
35-
44
45-
54
55-
64
65-
74
75-
84
85
and
over.
Blind 0.083 0.167 0.235 0.292 0.341 0.418 0.613 1.106 1.619 3.130 7.113 11.859 0.697
Deaf 0.115 0.656 0.816 0.720 0.796 0.839 0.964 1135.000 1.284 1.616 2.250 3.197 0.845
Dumb 0.900 0.613 0.796 0.590 0.608 0.548 0.601 0.629 0.635 0.573 0.570 0.722 0.560
Deaf and Dumb 0.068 0.516 0.655 0.480 0.544 0.519 0.556 0.593 0.598 0.519 0.523 0.722 0.498
Lunatic 0.010 0.024 0.389 1.454 3.332 5.724 8.194 9.873 9.698 8.365 10.519 3.302
Imbecile
or Feeble-
minded
0.152 0.938 1.467 1.997 1.831 1.864 1.832 2.078 2.224 2.784 4.325 8.353 1.662

TABLE G.—CENSUS 1901.—RELATIVE FREQUENCY OF INFIRMITIES
PER 1,000 OF THE POPULATION AT EACH AGE GROUP.

INFIR-
MITY.
AGE GROUPS. ALL
AGES.
Under
5
Years.
5-
9
10-
14
15-
19
20-
24
25-
34
35-
44
45-
54
55-
64
65-
74
75-
84
85
and
over.
Blind 0.073 0.170 0.290 0.311 0.360 0.431 0.728 1.202 1.721 3.691 6.738 17.749 0.727
Deaf 0.129 0.546 0.767 0.704 0.699 0.843 0.911 1.051 1.177 1.709 2.485 4.765 0.793
Dumb 0.131 0.566 0.784 0.632 0.605 0.663 0.648 0.644 0.641 0.735 0.578 0.953 0.590
Deaf and Dumb 0.120 0.489 0.680 0.579 0.556 0.611 0.623 0.620 0.622 0.696 0.543 0.715 0.543
Lunatic 0.002 0.008 0.023 0.428 1.304 3.192 6.161 8.284 9.058 9.164 7.000 5.479 3.056
Imbecile
or Feeble-
minded
0.098 0.712 1.351 1.702 1.509 1.593 1.745 2.066 2.381 2.882 3.693 6.671 1.481

The age distribution of the blind also varies in the same way, the relative frequency increasing as the age increases, bat with this difference that in youth blindness is a rarer infirmity than deafness, the frequency increasing more rapidly with age. Accordingly, more blind persons than deaf persons are found in the older age groups. In age group over 5 but under 10 the proportion of blind is 0.17 per 1,000 of the population, in age group over 15 but under 20 the ratio is 0.29; in age group over 25 but under 35, 0.42; in age group over 45 but under 55, 1.11; in age group over 75 but under 85, 7.11; and in age group over 85, 11.86.

The age distribution of the dumb is essentially different. The highest rate, 0.80 per 1,000 is found in age group over 10 but under 15, while in all older age periods it is less, varying from 0.55 in age group over 25 but under 35, to 0.72 in age group of over 85. The age distribution of the deaf and dumb generally follows that of the dumb, and is characterised by an absence of increase with increasing age.

The relative frequency of the four infirmities, blindness, deafness, dumbness, and mental infirmity, as age varies, is shown in a simple manner in the following short table which gives the frequencies of each infirmity per 1,000 of the general population at three characteristic age periods, the first that of youth, the second that of middle age, and the third that of older age.

INFIRMITY. AGES
10-15
AGES
35-45
AGES
65-75
Blind 0.2 0.6 3.1
Deaf 0.8 1.0 1.6
Dumb 0.8 0.6 0.6
Mentally infirm 1.5 7.6 12.5

Distribution of the Infirm by Birthplace .—For the purpose of studying the geographical distribution of the infirm, and the proportion of the infirm in localised communities, the place of enumeration is of little service, and often misleading, because of the frequent removal, for the purpose of care or treatment, of the infirm from their county, or burgh, or parish, of usual residence, to some other county, burgh, or parish. And it is for this reason that the birthplaces of the infirm, instead of the places of their enumeration, are here taken as a basis for the study of their distribution.

The relative proportions of the infirm to the general population, and to the sections of the population with birthplaces in the individual counties, are shown in Table H. In the preparation of this Table, the figures which appear against the counties in Tables XVIII and XIX, were adjusted so as to include their due proportion of cases in which the county of birth was unstated. This course was rendered necessary by the fact that as regards many of the infirm, especially the lunatics, the county of birth was not stated. Had this adjustment not been made, the county rates would hare been correspondingly less than their true, or approximately true, amounts. In the case of the mentally infirm, without this adjustment the errors would have averaged fully 7 per cent.

The rates in Table H must be used with caution, and cannot be accepted as very dependable, for two reasons. In the first place, as already pointed out, the census records dealing with infirmities are not altogether reliable, but are, without doubt, loaded with considerable error; and, in the second place, many of the rates are based on small numbers, and may be greatly influenced by the variations, or errors, of sampling. No attempt has been made to allow for the first of these two factors, but some attempt has been made to allow for the second, and this has been done in the following manner. The national rate applicable to each infirmity was arbitrarily taken as a probability, and for these probabilities the standard deviations of sampling were calculated for each county population, and by loading the national rate with three times the county standard deviation "Limits of an Expectation Rate" were obtained for each county, these limits being the limits between which the county rate would be found to lie, provided the frequency of the infirmity in the county was not essentially different from that in the entire country. For instance, the national rate of mental infirmity is found to be 4.963 per 1,000, and from this the probability of being mentally infirm (p) may be taken as 0.004963, and the probability of not being mentally infirm (q) as 0:995037. Using these figures, it is found that if these probabilities held good for those born in the County of Haddington, who number 46,165, the mental infirmity rate would be found to be something between 3.982 and 5.944 per 1,000. The ascertained rate, however, is 6.737 per 1,000, and is greater by 0.793 than the higher limit of the "Expectation Rate," and is therefore accepted as indicative of mental infirmity being more frequent among those born in the County of Haddington than throughout Scotland. The test, the use of three times the standard deviation of sampling, may be a severe one, but its adoption may be justified by the unsatisfactory nature of the original returns.1

The frequency of blindness in the general population of Scotland is found to be one in 1,435, or 0.70 per thousand. This rate is found to vary within fairly wide limits in the sections of the population born in the individual counties, but the application of the test above explained shows that few of the apparent differences are of real significance. High rates are found among those born in Ross and Cromarty, 1.70 per 1,000; Sutherland, 1.41 per 1,000; Shetland, 1.27 per 1,000; and Inverness, 1.14 per 1,000; and low rates among those born in Selkirk, 0.41 per 1,000; Nairn, 0.44 per 1,000; Edinburgh, 0.45 per 1,000; Kincardine, 0.45 per 1,000; and Linlithgow, 0.46 per 1,000. The test of loading these rates with three times the standard variation of sampling shows that the rates of the counties of Inverness, Shetland, Sutherland, and Ross and Cromarty are significantly greater than that of the general population, and that the rate of the county of Edinburgh is significantly less, but that none of the other county rates are significantly different from that of the general population.

TABLE H.—RELATIVE FREQUENCY OF INFIRMITIES ACCORDING TO
THE BIRTHPLACES OF THE POPULATION.

NOTE—In calculating the Rates in this and the following Table, the number of Persons of Unstated Birthplaces in the Total Population and among the Infirm have been respectively distributed pro rata among the various Counties.

BIRTHPLACES. PER 1,000 OF POPULATION.
Blind. Deaf. Dumb. Deaf
and
Dumb.
Lunatic. Imbecile.
All Birthplaces 0.70 0.85 0.56 0.50 3.30 1.66
             
Scotland 0.67 0.85 0.58 0.51 3.26 1.72
             
ENGLAND 0.70 0.80 0.38 0.36 3.14 0.98
WALES 0.29 2.03 0.87
IRELAND 1.45 0.76 0.34 0.31 4.58 1.09
ISLE OF MAN AND CHANNEL ISLANDS 0.90 6.33
BRITISH COLONIES or DEPENDENCIES 1.17 0.95 0.56 0.56 3.80 1.45
FOREIGN COUNTRIES            
  BRITISH
SUBJECTS
{ By Birth 0.66 1.65 1.10 0.99 4.52 2.20
Naturalised 0.56 1.11 0.56 0.56 1.67 3.34
FOREIGNERS 0.44 0.53 0.24 0.24 2.63 0.69
BORN AT SEA (British) 1.59 7.96
             
COUNTIES            
             
Aberdeen 0.64 0.78 0.49 0.44 3.49 1.88
Argyll 0.67 0.84 0.75 0.57 6.73 2.03
Ayr 0.57 0.94 0.67 0.62 2.78 1.39
             
Banff 0.76 0.73 0.60 0.52 1.39 2.12
Berwick 0.55 0.77 0.58 0.53 2.96 1.99
Bute 0.91 2.20 1.62 1.49 6.27 1.23
             
Caithness 1.00 1.00 0.71 0.62 3.68 2.54
Clackmannan 0.65 1.15 0.65 0.53 2.18 1.68
Dumbarton 0.60 0.74 0.55 0.47 2.64 1.08
             
Dumfries 0.57 0.73 0.47 0.45 4.57 1.82
Edinburgh 0.45 0.91 0.58 0.55 3.53 1.69
Elgin 0.62 0.45 0.31 0.31 4.16 2.66
             
Fife 0.82 0.83 0.51 0.48 3.04 1.52
Forfar 0.67 1.01 0.65 0.60 4.57 1.44
Haddington 0.95 0.93 0.59 0.50 4.90 1.84
             
Inverness 1.14 0.93 0.70 0.51 5.96 3.23
Kincardine 0.45 0.53 0.36 0.36 2.66 1.45
Kinross 0.94 1.05 0.59 0.59 3.63 0.94
             
Kirkcudbright 0.67 0.49 0.23 0.18 3.76 2.02
Lanark 0.61 0.85 0.61 0.52 2.39 1.53
Linlithgow 0.46 0.72 0.57 0.49 2.18 1.17
             
Nairn 0.44 0.66 0.78 0.66 5.09 3.32
Orkney 0.81 0.49 0.29 0.26 3.70 2.98
Peebles 0.67 0.47 0.13 0.13 3.88 1.41
             
Perth 0.81 0.88 0.48 0.42 4.88 1.90
Renfrew 0.61 0.79 0.45 0.41 2.67 1.30
Ross and Cromarty 1.70 0.94 0.74 0.58 4.38 3.72
             
Roxburgh 0.71 0.71 0.47 0.43 4.14 1.25
Selkirk 0.41 0.91 0.69 0.59 2.92 1.10
Shetland 1.27 1.34 1.07 1.01 4.12 3.72
             
Stirling 0.55 0.81 0.51 0.46 2.41 1.51
Sutherland 1.40 0.98 0.68 0.64 3.83 3.58
Wigtown 0.77 0.84 0.42 0.40 3.30 2.28

The rate of deafness in the general population is 0.85 per 1,000, or one in every 1,180, and varies from 2.20 per 1,000 in the case of those born in Bute, 1.34 among those born in Shetland, 1.15 among those born in Clackmannan, and 1.05 among those born in Kinross, to 0.45 among those born in Elgin, 0.47 among those born in Peebles, and 0.49 among those born in Kirkcudbright and Orkney. The application of the adopted test of significance, however, shows that, with the one exception of Bute, none of these county rates are significant of real difference, because in all, with that one exception, the maximum or minimum limits of the county rates overlap those of the national rate. The rate of deafness in Bute is found to be something between 2.90 and 1.50 per 1,000, and as the national rate is between 0.88 and 0.81, there appears to be a significant difference.

The rate of dumbness in the general population is found to be 0.56 per 1,000, or one in every 1,786. This rate shows variations extending from 1.62 among those born in Bute, and 1.07 among those born in Shetland, to 0.13 among those born in Peebles, and 0.23 in Kirkcudbright. But, as in the case of the deaf, the differences, that of Bute excepted, are not found to be significant. The limits between which the true rate for Bute lies are found to be 1.99 and 1.24, and as the minimum is greater than the maximum of the rate for the general population (0.59), it is significant of some excess in the aggregate number.

TABLE J.—RATE OF MENTAL INFIRMITY AMONG PERSONS BORN
IN THE COUNTIES OF SCOTLAND.

(See Note to Table H.)

COUNTY OF BIRTH. Persons
born in
County.
Lunatics
and
Imbeciles
born in
County.
Limits of
Expectation Rate.*
Ascertained
Rate.*
Upper. Lower.
Scotland 4,760,904 23,630     4.963
           
(a) Counties in which the Rate appears to be significantly greater
than the General Rate.
Inverness 97,911 900 5.638 4.288 9.192
Argyll 81,902 717 5.701 4.225 8.754
Ross and Cromarty 85,540 693 5.683 4.243 8.101
           
Shetland 29,836 234 6.184 3.742 7.843
Perth 134,222 910 5.539 4.387 6.780
Nairn 9,035 76 7.180 2.746 8.412
           
Sutherland 23,494 174 6.337 3.589 7.406
Elgin 48,541 331 5.920 4.006 6.819
Bute 15,468 116 6.658 3.268 7.499
           
Haddington 46,165 311 5.944 3.982 6.737
Dumfries 78,631 502 5.716 4.210 6.384
Forfar 271,561 1,632 5.368 4.558 6.010
           
Orkney 30,838 206 6.163 3.763 6.680
Caithness 42,078 262 5.992 3.934 6.227
Aberdeen 324,159 1,742 5.332 4.594 5.374
           
(b) Counties in which the Rate appears to be neither significantly
greater nor significantly less than the General Rate.
Berwick 36,179 179 6.070 3.856 4.948
Clackmannan 33,898 131 6.109 3.817 3.865
Edinburgh 406,044 2,122 5.293 4.633 5.226
           
Fife 235,572 1,076 5.398 4.528 4.568
Kincardine 47,005 193 5.935 3.991 4.106
Kinross 8,547 39 7.243 2.683 4.563
           
Kirkcudbright 39,102 226 6.028 3.898 5.780
Peebles 14,940 79 6.688 3.238 5.288
Roxburgh 51,020 275 5.896 4.030 5.390
           
Selkirk 21,909 88 6.388 3.538 4.017
Wigtown 40,333 225 6.013 3.913 5.579
           
(c) Counties in which the Rate appears to be significantly less
than the General Rate.
Ayr 283,989 1,186 5.359 4.567 4.176
Stirling 147,869 580 5.512 4.414 3.922
Dumbarton 98,859 368 5.635 4.291 3.722
           
Renfrew 254,394 1,009 5.380 4.546 3.966
Banff 76,511 268 5.725 4.201 3.503
Linlithgow 73,385 246 5.740 4.186 3.352
Lanark 1,176,918 4,611 5.158 4.768 3.918

* See explanatory reference in text.
The numbers entered against Scotland refer to the totals enumerated, irrespective of birthplace.

Of the general population, one in every 201, or 4.96 per 1,000, was returned as mentally infirm, i.e., either lunatic, imbecile, or feeble-minded. The county rates vary within fairly wide limits, and as 21 of them are found to be significantly different from, the national rate, a special table (J) has been constructed showing the application of the test of significance. The highest rates per thousand are found in Inverness, 9.19; Argyll, 8.75; Nairn, 8.41; Ross and Cromarty, 8.10; Shetland, 7.84; Bute, 7.50; and Sutherland, 7.41 : and the lowest in Linlithgow, 3.35; Banff, 3.50; Dumbarton, 3.72; Clackmannan, 3.86; Lanark, 3.92; Stirling, 3.92; and Renfrew, 3.97. The counties in which the rate of mental infirmity is found to be significantly greater than the national rate include Argyll, Bute, Caithness, Dumfries, Elgin, Forfar, Haddington, Inverness, Nairn, Orkney, Perth, Ross and Cromarty, Shetland, and Sutherland, and those in which this rate is significantly less than the national rate include Ayr, Banff, Dumbarton, Lanark, Linlithgow, Renfrew, and Stirling. This distribution is not without interest. Scotland is sometimes divided into a Highland portion and a Lowland portion by a line running from the mouth of the Dee in a south-westerly direction to the Mull of Kintyre, counties to the north-west of the line being grouped as Highland counties, and those to the south-east of the line as Lowland. Using this division, it is found that there are thirteen Highland counties and twenty Lowland counties. Of the former all except one, Banff, are found to be subject to a significantly high mental infirmity rate; while of the latter only three have a high rate, while six have a significantly low rate, and eleven are subject to a rate not significantly different from the national rate. There are in all fifteen counties with significantly high mental infirmity rates, and seven with significantly low. The former—Haddington, Dumfries, and Forfar excepted—are all Highland; while the latter—Banff excepted—are all Lowland. Six of the counties with low mental infirmity rates are contiguous; they are Lanark, Dumbarton, Stirling, Linlithgow, Renfrew, and Ayr.

The occupations, or former occupations, of the infirm are dealt with in Table XXII, which table is inserted in this volume more for reasons of continuity with previous census reports than for any reasons of inherent administrative importance or specific interest. It is for the same reason that Table XXIV, dealing with the occupations and former occupations of inmates of poorhouses, prisons, and common lodging-houses, has been prepared and published.


1 The standard deviation of sampling was found from this well-known formula— p and q being as stated, and n being the number of persons born within the county—S = (p.q/n)½ the use in this manner of the standard deviations of sampling for the purpose of determining the significance of a series of rates is believed to be original, and to test the reliability of the method the significance of the county rates of mental infirmity was also determined by the method of comparing observed differences with the standard errors of these differences. The results were found to be identical. Preference was given to the method adopted because of the simplicity of the tabulated results.

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