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5. There has been increasing use of the Department's services by members of the public and attendances at general out-patients and specialist out-patients clinics continued to increase. The number of patients admitted to and treated in Government hospitals has also shown an increase compared with the previous year.
6. The continuing shortage of doctors and certain other professional and technical personnel was a grave problem throughout the year, but the services continued to be satisfactorily maintained despite the difficult conditions.
7. In the following pages are reviewed the state of the public health and the more important developments in the work of the Medical and Health Department and of the major voluntary agencies which are in receipt of substantial subventions from Government funds for the support of their medical activities. Detailed information covering all aspects of these fields is to be found in the statistical appendix to this report, the index to which is at page 58.
IL PUBLIC HEALTH
VITAL STATISTICS
(Sce tables 612)
8. The estimated mid-year population in 1968 was 3,926,500, of which approximately 85% was concentrated in the urban areas of Hong Kong Island and Kowloon. Approximately 40% of the population are under the age of 15 years and only 6% over the age of 60. The general state of health of the population continued to be satisfactorily reflected by the Colony's vital statistics. The crude death rate, at 4.9 per thousand of the population, is extremely low. Age and sex specific death rates are also low and reflect the rapid improvement of health and medical services in a young and expanding population. The birth pattern con- tinued its downward trend and the crude birth rate fell further from 23.0 in the previous year to 21.1 per thousand of population. Based on actual registration of births and deaths, there was a natural increase of 63,673, five thousand less than in the previous year.
9. The gratifying declines in infunt and neonatal mortality rates which are a useful index to the trends of health conditions of the general population are illustrated in Figure 2.
Infant Mortality
FIGURE I
AGE & SEX SPECIFIC DEATH RATES 1963
10. The steady declinc in infant mortality has been due to improve- ment in environmental conditions, development of maternal and child health services and increasing public appreciation of the value of these services in the maintenance of health amongst infants and mothers. Among the major causes of infant mortality there have been great reductions in mortality from the preventable diseases particularly bronchopneumonia, gastro-enteritis, tuberculosis and, for the first time in the year under review, measles. There has also been a steady reduction in mortality from prematurity due to improvement in the midwifery and maternal health services. As has been the experience elsewhere, con- genital malformations and other diseases of the new born are proving more intractable and mortality from these causes has, as yet, been little affected. As shown in Figure 2 Infant and Neonatal Mortality rates have remained relatively steady since 1965, with only the minor fluctuations to be expected in any community when the mortality has reached a low level.
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