The death-rate in the cities is evidently about 60 per 100,000 greater than in the rural districts, due, of course, to the crowding in city tenements. This is true for nearly all cities, although the difference is more marked in some parts of the country than in others. In Massachusetts, for example, the death-rate in rural districts is slightly higher than the death-rate in cities, but tuberculosis is much more prevalent in that state than in any other part of the country. In New York State the rate in cities is about 70 per 100,000 greater than in rural districts, due, presumably, to the larger number of manufacturing centers in this state. In New York City the rate is constantly more than 200, and in 1908 in the borough of the Bronx it was nearly 500. _Diphtheria as affecting the rate._ Diphtheria is another disease that exacts heavier toll from the cities than from the country, about three times as many deaths occurring in the former as in the latter. _Influenza, and its effect on death-rate._ Influenza is, on the other hand, markedly severe on people in rural districts, the death-rate there being more than twice as high as in the cities. It is easy to see why this is. Lack of sidewalks, lack of protection, lack of uniform temperature in the houses, and the lack of care in the first stages of illness, all tend to increase the death-rate from this disease. _Pneumonia._ The death-rate from pneumonia, on the other hand, is higher in the city, the vitality and power of resistance of victims probably being reduced under average city conditions. _Other diseases._ Diseases that are induced by water, all referred to under typhoid fever, but extending into such complaints as diarrhoea and enteritis, are much more severe in cities than in the country. Such an excess of general intestinal diseases shows again that a polluted water-supply is not peculiar to the country, but is responsible for an excessive death-rate in the city. Most of the constitutional diseases also have higher death-rates in the city than in the country. Bright's disease, for example, for the five years 1903-1907, had an average rate in cities of 107.3 per 100,000, while for the same five years in the rural districts the rate was only 68.6. _Old age and the death-rate._ Further showing the advantage of country life, it is to be noted that the number of deaths from old age in rural districts is nearly double that in cities. For example, in the same period already referred to the death-rate in cities of persons over sixty was 27.6, while in the rural districts, for the same period, it was 49.3,--nearly double. _The need for attention to rural hygiene._