Furthermore, in towns there is greater difficulty in securing satisfactory arrangements for the storage of food, especially milk, and in obtaining fresh milk and vegetables; and there is the serious disadvantage, especially for children, that their playgrounds are in streets instead of the fields, and that the possibilities of deriving infection from dried expectoration and from fæcal or other organic contamination in yards and backstreets as well as directly from other children or adults are multiplied manifold. Even more important, town life for the father of a family generally means an indoor and often a dusty indoor occupation; the mother not infrequently is also industrially employed; and these adverse circumstances, so far as they are allowed to continue, now affect three-fourths of the population of England and Wales and probably one-half of that of the United States. And yet the death-rate from all causes, and especially from communicable diseases is steadily declining, to an even greater extent in urban than in rural communities. It is but fair to add that the differences between urban and rural populations tend to decrease; at least this is so in England; probably the same is true to a less extent in America. The nominally rural population is becoming more and more urban in character, and composed not solely of rustics,—who live in and by the soil and are altogether more natural in their habits,—but largely of town-dwellers who only sleep in country dormitories. But this makes it all the more remarkable that notwithstanding the multitudinous circumstances which have tended to increase disease, the death-rate has been lowered to an amount already indicated, and life has been prolonged to an extent which has secured an increase in its average expectation of 10 or 11 years within the last thirty years. _Industrialism_ Considerations of time render it impracticable to discuss in this address the mischievous influence of modern industrialism on national health. This influence runs collaterally with that of urbanization; and in it in the past can be seen the evil results of overwork, of dust inhalation, of chemical poisoning, of industrial infections including tuberculosis, and of the general depressing effect of protracted monotonous work. The evils of industrialism like those of urbanization are happily being in a large measure counteracted. _Poverty_