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tralia, Mr. H. Dillon Gouge, F.S.S.," but these same figures had previously appeared in Appendix XVI (Vol. III, p. 68) to the Report of the (British) Inter-Departmental Committee on Physical Deterioration, published in London in 1904, and as Dr. Newsholme's Comment is substantially identical with that made in the Appendix (to Evidence of Mr. W. McAdam Eccles and Dr. Robert Jones) of "Statements upon which the Evidence on the Relation of Alcohol to Physical Deterioration was Based," in all probability he had derived his data from that presentation of prohibition argument, rather than from the original report of Mr. Gouge—which, in common with other reports by that Public Actuary of South Australia, I have carefully overhauled. In other words, the parallelograms in Diagram No. I undoubtedly have as a basis certain official figures, and, thus having a specific basis, are worthy of critical analysis.
While Diagram No. 2 presumably was drafted on the basis of some alleged figures for the "relative death-rates" of "abstainers," "men of average habits," and "liberal drinkers," the very nature of the loosely-drawn classification in question obviously places it outside the pale of serious scientific discussion. Even so commonlyused a phrase as “non-abstainer” is practically meaningless, except as a designation for all adults who are not actual "total abstainers, and I feel entirely safe in positively asserting that no actuary or statistician worthy of the name would even think of undertaking to set up any classification of men under such undeterminable groupings as "men of average habits" and "liberal drinkers." Probably no two physicians or actuaries could be found who would be able to agree as to the precise meanings of these two phrases, no life insurance company of any standing would be willing to admit that it had sufficient policyholders who could possibly be classified as “liberal drinkers” to warrant any attempt at a separate grouping of the mortality of such a class, and in default of a comprehensive and exhaustive tabulation by life insurance authorities on these lines, of course there could be no authoritative determination of the relative death-rates of "men of average habits" and "liberal drinkers.” In my judgment, therefore, the parallelograms presented in Diagram No. 2, and their alleged ratings of the relative mortality of the three impossible groups in question, are palpably unworthy of serious consideration. Aside from mere expressions of personal opinion, which have no scientific value, I know of no figures to be found in all the literature of life insurance on which any such diagrams could be based. And only carefully worked-out life insurance tabulations of many years' experience would offer data of the slightest value for such a purpose.
As previously stated, the case with Diagram No. I is entirely different, in that its parallelograms are laid out, and correctly laid out, on the basis of certain specific figures, to wit, those presented for the relative sickness experience of certain Friendly Societies restricted to total abstainers and certain other Friendly Societies not so restricted, by the Public Actuary of South Australia. The figures in question, hailing from an actuarial source and doubtless being mathematically correct in so far as the records of the Friendly Societies in question are concerned, are fairly entitled to thoughtful attention. Of course, the mere arithmetical accuracy of the figures is only one of the many points involved; their magnitude, or lack of magnitude, the comparability of the class with which they deal to the class with whose experience comparison is made, the conditions under which the figures for the two classes were respectively compiled, the period covered by the compilation, and the applicability of the comparative showings to abstainers and nonabstainers in general must all be weighed before the accuracy of the American Museum of Safety's Diagram No. I can be properly measured.
As stated in the Appendix to the Report of the (British) InterDepartmental Committee on Physical Deterioration (Vol. III, p. 68), the comparison therein presented is made between the sickness experience ofotwo groups of Friendly Societies having branches in South Australia, Group 1 including the local branches of the Albert District of Rechabites, the South Australian District of Rechabites, and the Sons of Temperance, all of which “may be regarded as being conducted on strictly teetotal principles,” and Group 2 including the three largest of the mixed Societies, viz., the Foresters, the Odd Fellows (Manchester Unity), and the G. U. Odd Fellows. The period for which the comparison cited was made is not stated in the Appendix, but, as the Report of the InterDepartmental Committee was published in London in 1904, presumably it was the quinquennial period 1895-1899 included in the Fourth Report of the Public Actuary of South Australia, Mr. Gouge, which was published in 1904 and included the “report of the second valuation of the liabilities and assets of all Friendly Societies in South Australia, as at the 31st December, 1899” In detail the figures presumably presenting the sickness experience of the two groups of abstaining and non-abstaining Friendly Societies in South Australia above named, for the five-year period 18951899, were as follows, showing the average weeks of sickness per sick member:
As will be noted, the above tabulation purports to show that the average duration of sickness for each member sick was 6.4 weeks in Group No. I as compared with an average of 10.9 weeks in Group No. 2, and this showing is evidently responsible for the American Museum of Safety's Diagram No. I naming 6.4 weeks and 10.9 weeks, respectively, for Abstainers and Non-Abstainers in its “Comparison of the average amount of time lost by sickness each year among moderate drinkers and abstainers." Having thus reproduced in detail the date obviously responsible for the diagram, I propose to consider the question, is the American Museum of Safety justified in applying this mere handful of Fraternal Society sickness experience in far-away South Australia in 1895-1899 to the world at large in 1914?
In this article on the “Mortality and Morbidity Experience of the Leipsic Communal Sick Fund," published in the New York Spectator of July 14, 1910, Frederick L. Hoffman, the Statistician of the Prudential Insurance Company of America, made the statement that: "There has been no extended and qualified inquiry into the subject in America, corresponding to the highly scientific valuation
of Friendly Societies by English actuaries, particularly the Manchester Unity.
Sickness insurance on a scientific basis can hardly be said to have been developed in the United States." There have, to be sure, been a comparatively small number of sickness and accident companies in operation in this country for several years, and some of the fraternal orders operating in the United States have paid one form or other of sick benefits to their disabled members for many years. With the single notable exception of the Loyal Protective Insurance Company of Boston, which in 1911 compiled and published an exceedingly interesting analysis of its health and accident experience for the ten years, 1895-1904, none of the health (or sickness insurance companies, or fraternal orders paying sick benefits in this country has ever made public the results of its sickness experience. It may therefore be as truly said in 1914 as Mr. Hoffman observed in 1910, that “sickness insurance on a scientific basis can hardly be said to have been developed in the United States," and in so far as any data of the slightest value for an American comparison of the relative rates of sickness among abstainers and non-abstainers are concerned there is to all intents and purposes an entire vacuum.
The Friendly Societies, and their branches, in Great Britain are numbered by thousands and their aggregate membership runs into the millions, and most of them pay sick benefits to their disabled meinbers. Tabular studies of both the mortality and morbidity experience of a few of the principal Societies have been compiled and published, but most of these tabulations too far antedate the present conditions to be accepted as of any great current value, and the most widely-recognized authority on the subject of the morbidity experience of the Fraternal Societies is the comprehensive actuarial study of the Independent Order of Odd Fellows, Manchester Unity, compiled and published by its Actuary, Alfred W. Watson, in 1903, under the title of “An Account of an Investigation of the Sickness and Mortality Experience of the I. O. O. F., Manchester Unity, during the five years, 1893-97." This colossal work of nearly 500 pages, supplementing Ratcliffe's previous study of the Society's experience from 1866 to 1870, ranks at the head of all works in this particular branch of insurance literature, and the rates of sickness therein laid down for the whole Society” formed the sickness basis for the calculations under the recent National Insurance Act.
In the Report of the Actuaries in relation to the Scheme of In
surance against Sickness, Disablement, &c., embodied in the National Insurance Bill, 1911," published in that year, this authoritative statement is made (p. 15):
“There are no general statistics dealing adequately with the rates of sickness in the United Kingdom generally. The combined experience of the Friendly Societies would have been an invaluable guide, but this has not been collated within recent years, if we except the investigation undertaken by the Registry of Friendly Societies, and carried out by the late William Sutton, dealing with the sickness and mortality experience for the years 1876 to 1880, inclusive, which, even at the time of collation, included only a minority of the Societies, and is now out of date.
"The result of an extensive investigation of the experience of the Manchester Unity of Odd Fellows by Mr. A. W. Watson, F.I.A., Actuary to the Society, was published in 1903 and covered the five years 1893 to 1897, dealing only, however, with male lives. Notwithstanding the fact that this experience related only to the various branches of a single affiliated order, it may be considered as fairly representative of the general experience of Friendly Societies. The investigation brought together a larger body of facts than had been before available, and owing to the care and thoroughness which characterized it, we have found the results of great service to us in the present inquiry. An important result of this investigation was to show that a steady increase in the average rate of sickness among male lives at all ages had been taking place for many years previously."
This official statement over the signature of two of the foremost actuaries of the world, Messrs. George F. Hardy and Frank B. Wyatt, both Past Presidents of the Institute of Actuaries, supplementing the well-known lack of any authoritative data on the subject of American morbidity experience, would seem conclusively to establish the fact that no up-to-date sickness experience in any English-speaking country is now available on which the “Monthly Bulletin” of the American Museum of Safety could have worked out any diagram accurately showing "the average amount of time lost by sickness each year” among males in general—let alone, "among moderate drinkers and abstainers."
One of the basic principles of statistical work requires that there shall be a substantial uniformity of groups subjected to analytical comparison, or, in other words, that groups of men in the case of