CHAPTER IV

INFANT MORTALITY

_In the preceding pages it was stated that a high birth-rate is always accompanied by a high infant mortality. The material presented in this chapter demonstrates the fact that ignorance of methods to prevent conception forces the wives of ill-paid wage-workers to bear an excess of unwanted children. Figures are adduced to show an appalling death rate of infants under five years of age and the economic distress of the survivors in families unwanted and too large._

_MEDICAL GYNECOLOGY. Howard A. Kelly, A.B., M.D., LLD., Professor of Gynecological Surgery in Johns Hopkins University, and Gynecologist to the Johns Hopkins Hospital, etc. D. Appleton Co. New York and London, 1912._

As long as a community can rest content in the belief that a large infant mortality is the natural method of reducing the race of the unfit, the doctrine of _laissez-faire_ can be accepted with complaisance. If, however, it seems probable that the influence of environment must be reckoned as a greater cause of infant mortality and of physical unfitness than the influence of heredity, it may be wiser for society, as it certainly will be easier, to preserve the lives and health of the children born, than to stimulate an increase in a birth rate now diminishing. As it is an open question whether the race as a whole suffers mental and physical deterioration from a diminished rate of production among the superior stocks, it is unquestionably a matter of public policy, as well as of common humanity, that conditions of living in communities should be made favorable to the preservation of the life and health of all infants and children. P. 41.

_EUGENICS AND RACIAL POISONS. Prince A. Morrow, M.D. Pamphlet published by the Society of Sanitary and Moral Prophylaxis, N. Y., 1912._

Observation shows that the class known as degenerates is increasing much more rapidly than the general population and that their average duration of life has been lengthened. Diseases may be cured, but degeneracy, which is usually due to some inherited defect in the physical, mental or moral nature of the individual, is rarely amenable to curative treatment. It is only through applied eugenics that the vast volume of disease and degeneracy which flows through the channels of heredity can be prevented. Obviously this can be accomplished only through education and legislative restriction upon the procreation of the unfit.

In the making of the child, the mother not only contributes one half of the ancestral qualities which enter into its constitution, but furnishes all the nutrition and energy which serve to support its life. From this point of view the mother is the supreme parent of the child, she is the source of its life and from her blood is drawn the material which contributes to its growth and development. The welfare of the mother is the welfare of the child. We have thus come to recognize the dominant influence of the mother’s relation to the health, as well as the life of the race. A high standard of physical motherhood is the most favorable asset of a nation. Havelock Ellis, in his recent work, on the Psychology of Sex, says, “Nations have begun to recognize the desirability of education, but they have scarcely yet come to recognize that the nationalization of health is even more important than the nationalization of education. If it were necessary to choose between the task of getting children educated and the task of getting them well born and healthy, it would be better to abandon education. There have been many great people who never dreamed of national systems of education; there has been no great people without the art of producing healthy and vigorous children.”

Newman, the distinguished author of the work on “Infant Mortality” declares that the problem of infant mortality is not one of sanitation alone, or housing, or indeed of poverty as such, it is mainly a question of motherhood.

It is not probable that the scientific methods which have been successfully applied to plants and the selective breeding of animals will ever replace the haphazard methods of human reproduction.

There is no fact better established than that a man can transmit only that which he is. If his system is weakened by excess or tainted with disease he can beget only physical weakness, or beings tainted with disease. The syphilitic, the consumptive, the epileptic, the alcoholic, should not produce his kind.

_NEO-MALTHUSIANISM AND RACE HYGIENE IN “PROBLEMS IN EUGENICS.” Vol. 2. London, 1913. Dr. Alfred Ploetz, President of the Int. Soc. for Race Hygiene._

Arthur Geissler concluded from a study of about 26,000 births of unselected marriages among miners that the mortality of children was least in the four first-born, and then increased to a very high rate. Following are Geissler’s figures, (marriages with only one or two children are omitted).

Deaths during first year 1st born children 23% 2nd born children 20% 3rd born children 21% 4th born children 23% 5th born children 26% 6th born children 29% 7th born children 31% 8th born children 33% 9th born children 36% 10th born children 41% 11th born children 51% 12th born children 60%

_INFANT MORTALITY. Results of a Field Study in Johnstown, Pa., based on Births in one calendar year. By Emma Duke, Infant Mortality Series, No. 3. Bureau Publication No. 9. U. S. Department of Labor, Children’s Bureau._

The pamphlet embodies the result of a field study in Johnstown, Pa., based on one calendar year. The inspection was made in 1913, of the 1911 babies, so that even the last born baby included had reached its first birthday—or rather had had a chance to reach its first birthday; many of them were dead long before that day. Every mother of a 1911 baby was visited. She was questioned about the health of that child and all her other children. The report takes up the familiar factors—neighborhood environment, sanitary conditions, sewage, housing, nativity, attendance at birth, feeding, age of mother, and like matters. Full information is given on these points. Then the report considers infant mortality from a novel viewpoint—the relation of the death rate to the size of the family. The Johnstown statistics include families varying in number from one child to ten and over, and varying in health from none living to all living. The result of the study of infant mortality in relation to the size of the family is thus stated: “The statistics, based on the results of all her reportable pregnancies, show a generally higher infant mortality rate where the mother has had many pregnancies, but there is not always an increase from one pregnancy to the next.” The following table shows this tendency. It is based on the reproductive histories of 1,491 married mothers who had 5,617 births. Miscarriages are not included.

Infant Mortality Rate for all Children borne by Married Mothers: Table 36

Number of Pregnancies. Infant Mortality Rate. 1 and 2 108.5 per 1,000 3 and 4 126.0 per 1,000 5 and 6 152.8 per 1,000 7 and 8 176.4 per 1,000 9 or more 191.9 per 1,000 Average 149.9 per 1,000

In contemplating these figures we think immediately of wage-earning mothers away from home, ignorant feeding, and lack of care. These are powerful factors in raising the death rate.

Of all the 1911 babies who died before they were a year old, 37% died in the first month of life. So much pain and misery and then no baby after all. All the skill in the world could not have saved those babies who lived only long enough to die.

The infant mortality rate for the babies whose fathers earn under $521 is almost twice as great as for those born into families in the most prosperous group. These figures strengthen the conclusion reached in the study of the babies born in 1911, namely that the economic factor is of far-reaching importance in determining the baby’s chance of life.

One of the tables showing the influence of the economic factor, is calculated on the basis of 1,434 live-born babies with fathers. 187 of these babies succumbed during the first year, giving a general mortality rate of 130.7 per 1,000. In these families a very few of the mothers worked outside the homes.

Father’s earnings Live-births Deaths 1st year Infant mortality rate Under $625 384 82 213.5 $625 to $899 385 47 122.1 $900 or more 186 18 96.8 Ample 476 40 84.0

Expressed in words, this table asserts that when the family income is under $625 a year, the children born alive die before the first birthday at the rate of 213.5 to the 1,000. In striking contrast when the income is $900 or more, they die only 96.8 to the 1,000. “Ample” was the expression used when the investigator could not obtain exact information as to the amount, but saw no evidence of actual poverty. The same ratio held good when it was calculated for the native-born mothers alone and when it was calculated for the foreign-born mothers alone. Even where mothers are American-born women, staying at home to look after their children, the amount of money to be spent on the child strongly influences its chance of life and death.

According to this table the superiority which children in indigent households show over children in well-to-do households is preeminent skill in dying. When father earns $12 a week the children die at the rate of 213 per 1,000; but when father earns $18 a week, only 96 children per 1,000 pass away the first year of their lives. The lower the father’s wages, the higher the babies’ death rate. Many a death certificate should read, “Died of poverty.”

The following table is compiled from the 5,617 children borne by 1,491 married mothers, in Johnstown, Pa.

Order of Birth Deaths per 1,000 1st and 2nd born children 138.3 3rd and 4th born children 143.2 5th and 6th born children 177.0 7th and 8th born children 181.5 9th and later born children 201.1

Apparently the size of the family has much to do with the child’s chance of living, and apparently the earlier in the succession the child is born, the better chance of life it possesses. Death warrants await the coming of the youngest born.

Table 42.—Infant mortality rate for all children of married mothers included in this investigation, distributed according to the father’s earnings.

Father’s annual earnings Infant mortality rate Under $521 197.3 $521 to $624 193.1 $625 to $779 163.1 $780 to $899 168.4 $900 to $1,199 142.3 $1,200 to $1,200 and over 102.2

U. S. DEPARTMENT OF LABOR CHILDREN’S BUREAU

Julia C. Lathrop, Chief

INFANT MORTALITY

RESULTS OF A FIELD STUDY IN JOHNSTOWN, PA., BASED ON BIRTHS IN ONE CALENDAR YEAR

BY EMMA DUKE

1915

(_Certain tables omitted_)

INFANT MORTALITY: JOHNSTOWN, PA.

_INTRODUCTION_

The term infant mortality, used technically, applies to deaths of babies under 1 year of age. An infant mortality rate is a statement of the number of deaths of such infants in a given year per 1,000 births in the same year. Some countries include stillbirths in making the computations, but this method is not generally followed in this country nor has it been followed in this report.

Ordinary procedure is to compare the live births in a single calendar year with the deaths of babies under 12 months of age occurring in that same year, even though those who died may not have been born within the calendar year of their death. The infant mortality rates in this report, however, have not been computed on the usual basis, but for the purpose of securing greater accuracy in measuring the incidence of death this bureau has considered, in making the computation, only so many of the babies born in the year 1911 as could be located by its agents, and has compared with this number the number of deaths within this group of babies who died within one year of birth, even though some of these deaths may have occurred during the calendar year 1912.

Infant mortality can be accurately measured in no other way than by means of a system of completely registering all births as well as all deaths. In 1911 the United States Bureau of Census regarded the registration of deaths as being “fairly complete (at least 90 per cent. of the total)” in 23 States, but the same degree of completeness in the registration of births was found only in the New England States, Pennsylvania, and Michigan, and in New York City and Washington, D.C. An exact infant mortality rate for the United States as a whole cannot be computed owing to this generally incomplete registration. In the 1911 census report on mortality statistics, however, the infant mortality rate is estimated at 124 per 1,000 live births. How this estimated rate compared with the computed rates for other countries is shown in the following summary:

DEATHS OF CHILDREN UNDER 1 YEAR OF AGE PER 1,000 LIVE BIRTHS, BY QUINQUENNIAL PERIODS FROM 1901 TO 1910, AND ALSO FOR THE SINGLE CALENDAR YEARS 1909 TO 1910.[10]

═══════════════════════╤═══════════╤═══════════╤═══════════╤═══════════ COUNTRY. │ 1901 to │ 1906 to │ 1909 │ 1910 │ 1905 │ 1910 │ │ ───────────────────────┼───────────┼───────────┼───────────┼─────────── Chile │ 306│ 315│ 315│ 313 Russia (European) │ ([11]) │ │ │ Austria │ 215│ │ │ Hungary │ 212│ 204│ 212│ 194 Prussia │ 190│ 168│ 164│ 157 Jamaica │ 174│ 191│ 174│ 188 Spain │ 173│ │ │ Ceylon │ 171│ 189│ 202│ 176 Italy │ 168│ │ 155│ Japan │ 154│ │ 166│ Servia │ 149│ │ │ Belgium │ 148│ │ 137│ Bulgaria │ 148│ │ │ France │ 139│ │ 120│ England and Wales │ 138│ 117│ 109│ 105 The Netherlands │ 136│ 114│ 99│ 108 Switzerland │ 134│ │ 115│ Finland │ 131│ 117│ 111│ 118 Scotland │ 120│ │ 108│ Denmark │ 119│ │ 98│ Province of Ontario │ 114│ 127│ 131│ 123 Ireland │ 98│ 94│ 92│ 96 Australian Commonwealth│ 97│ 78│ 72│ 75 Sweden │ 91│ │ 72│ Norway │ 81│ │ 72│ New Zealand │ 75│ 70│ 62│ 68 ───────────────────────┴───────────┴───────────┴───────────┴───────────

Footnote 10:

From the Seventy-third Annual Report of the Registrar General of Births, Deaths, and Marriages in England and Wales (1910). London, 1912.

Footnote 11:

Available only for the period from 1896 to 1900, when it was 261.

When it had been decided by the Children’s Bureau to make infant mortality the subject of its first field study and to include all babies born in a given calendar year, regardless of whether they lived or died during their first year, advice and cooperation were enlisted of mothers, physicians, nurses, and others experienced in the care of children, and also of trained investigators and statisticians, in the preparation of a schedule which was submitted to them for criticism.

With its limited force and funds it was not possible for the Children’s Bureau to extend its inquiries throughout the entire United States. It was therefore decided to make intensive studies of babies born in a single calendar year in each of a number of typical areas throughout the country that offered contrasts in climate and in economic and social conditions, the results to be eventually combined and correlated. It was necessary to restrict the choice of the first area to a place of such size as could be covered thoroughly within a reasonable time by the few agents available for the work.

Johnstown, Pa., was the first place selected. It is in a State where birth registration prevails, and hence a record of practically all babies could be secured; it is of such size that the work could be done by a small force within a reasonable period, and it seemed to present conditions that could with interest be contrasted with conditions typical of other communities. Moreover, the State commissioner of health and the State registrar of vital statistics were both working zealously to enforce birth-registration laws; both were actively interested in reducing infant mortality, and they welcomed a study of the subject in their State. In Johnstown the mayor, the president of the board of health, the health officer, and other local officials all showed the same spirit of hearty cooperation and interest.

Inasmuch as the study was confined to babies born in a single calendar year and work was begun in January, 1913, the latest year in which the babies could have been born and still have attained at least one full year of life was 1911.

Work was begun on January 15, 1913, with the transcription from the original records at Harrisburg of the names and other essential facts entered on the birth certificates of babies born in 1911, and, if the baby had died during its first year of life, items on the death certificate were also copied.

In the meantime the people of Johnstown through the press, and through the clergy in the foreign sections, had been informed of the purpose and plan of the investigation. Without the friendly spirit thus aroused and the interest manifested by the Civic Club and other organizations the work could not have been brought to a successful issue. The investigation was absolutely democratic; every mother of a baby born in 1911, rich or poor, native or foreign, was sought, and it is interesting to note refusals were met with in but two cases.

The original plan was to limit the investigation to those babies born in the calendar year selected whose births had been registered, the purpose being to secure facts concerning a definite group and not to measure the completeness of birth registration. Shortly after beginning the work, however, agents of this bureau were told that the Serbian women in Johnstown seldom had either a midwife or a physician at childbirth; that they called in a neighbor or depended upon their husbands for help at such times, or that they managed alone for themselves, and that therefore their babies usually escaped registration. The omission of these babies meant the exclusion of a number of mothers in a group that was too important racially to be omitted from an investigation embracing all races and classes. Accordingly a list of babies christened in the Serbian Church and born in the year 1911 was secured and an attempt made to locate them. In addition an agent called at each house in the principal Serbian quarter to inquire concerning births in 1911. A number of unregistered babies of Serbian mothers were thus found and included in the investigation.

The agents were sometimes approached by mothers of babies born in 1911 who resented being omitted from the investigation simply for the reason that their babies’ births had not been registered. The agents were therefore instructed to interview mothers thus accidentally encountered and to include their babies in the investigation. But no additional baptismal records were copied nor was a house-to-house canvass made of the city; in fact, no further means were resorted to to locate unregistered babies for the purpose of including them in the investigation.

There were 1,763 certificates copied at Harrisburg, and 1,383 of the babies named in them were reached by the agents. In addition, 168 babies for whom there were no birth certificates, but who were located in the ways just noted, were included, making a total of 1,551 completed schedules secured.

Of the 380 not included in the investigation there were 149 who could not be located at all; 220 others had moved out of reach—that is, into another city or State; 6 of the mothers had died; 3 could not be found at home after several calls, and 2 refused to be interviewed.

From the following summary of data recorded on the certificates of the 380 unlocated babies just referred to it appears that the infant mortality rate (134.3) among them is almost the same as that (134) shown in Table 1 for babies included in the investigation. In reality, however, it is perhaps a little higher, as some of these babies no doubt died outside of Johnstown and their deaths were recorded elsewhere.

════════════╤═══════╤═══════╤═════════════╤═════════════ │ │ │ │SEX OF BABY. ├───────┼───────┼─────────────┼─────┬─────── │ │ │ │ │ NATIONALITY │ Total │ Live │ │ │ OF MOTHER. │births.│births.│Still-births.│Male.│Female. │ │ │ │ │ │ │ │ │ │ ────────────┼───────┼───────┼─────────────┼─────┼─────── Total │ 380│ 350│ 30│ 227│ 153 ════════════╪═══════╪═══════╪═════════════╪═════╪═══════ Native │ 134│ 118│ 16│ 76│ 58 Foreign │ 246│ 232│ 14│ 151│ 95 ────────────┼───────┼───────┼─────────────┼─────┼─────── Slovak, │ │ │ │ │ Polish, │ 43│ 41│ 2│ 27│ 16 etc │ │ │ │ │ Croatian and│ 13│ 11│ 2│ 10│ 3 Servian │ │ │ │ │ Magyar │ 1│ 1│ │ 1│ German │ 8│ 8│ │ 6│ 2 Italian │ 41│ 39│ 2│ 26│ 15 Syrian and │ 7│ 6│ 1│ 3│ 4 Greek │ │ │ │ │ British │ 7│ 7│ │ 3│ 4 Austrian │ │ │ │ │ (not │ 123│ 116│ 7│ 73│ 50 otherwise │ │ │ │ │ specified)│ │ │ │ │ Not reported│ 3│ 3│ │ 2│ 1 ────────────┴───────┴───────┴─────────────┴─────┴───────

════════════╤════════════════════════════╤═══════════ │ ATTENDANT AT BIRTH. │ ────────────┼──────────┬────────┬────────┼─────────── │ │ │ │Certificate NATIONALITY │ │ │ │ showing OF MOTHER. │Physician.│Midwife.│Unknown.│ deaths │ │ │ │ during │ │ │ │first year. ────────────┼──────────┼────────┼────────┼─────────── Total │ 158│ 180│ 33│ 47 ════════════╪══════════╪════════╪════════╪═══════════ Native │ 122│ 5│ 7│ 12 Foreign │ 36│ 184│ 26│ 35 ────────────┼──────────┼────────┼────────┼─────────── Slovak, │ │ │ │ Polish, │ 4│ 37│ 2│ 3 etc │ │ │ │ Croatian and│ │ 7│ 6│ 5 Servian │ │ │ │ Magyar │ │ 1│ │ German │ 2│ 5│ 1│ 2 Italian │ 3│ 36│ 2│ 4 Syrian and │ 3│ 4│ │ 1 Greek │ │ │ │ British │ 5│ 2│ │ Austrian │ │ │ │ (not │ 19│ 89│ 15│ 20 otherwise │ │ │ │ specified)│ │ │ │ Not reported│ │ 3│ │ ────────────┴──────────┴────────┴────────┴───────────

RELATION OF INFANT MORTALITY TO ENVIRONMENT NEIGHBORHOOD INCIDENCE

The rate of infant mortality is regarded as a most reliable test of the sanitary condition of a district. (Sir Arthur Newsholme, Elements of Vital Statistics, p. 120. London, 1899.)

Johnstown is a hilly, somewhat Y-shaped area of about 5 square miles which spreads itself out into long, narrow, irregularly shaped strips, detached by rivers and runs and steep hills. In some places it is not over a quarter of a mile wide, but its extreme length is about 4 miles. The city is composed of 21 wards and is an aggregation of what were formerly separate unrelated boroughs or towns. The names of these different sections, together with the numerical designations of the wards included in or comprising them, are shown in the following table. This table gives for each section not only the total population according to the Federal census of 1910, but also the number of live-born babies included in the investigation and the number and proportion of deaths among such babies during their first year.

TABLE 1.—DISTRIBUTION OF POPULATION, LIVE BIRTHS AND DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE ACCORDING TO SECTION OF JOHNSTOWN, FOR ALL CHILDREN INCLUDED IN THIS INVESTIGATION.

════════════════════════════════╤═══════════╤═════════╤══════╤═════════ │ │ │Deaths│ │ │ │during│ │ │ │first │ │Population,│ Total │ year │ Infant SECTION OF CITY AND WARD. │ 1910.[12] │live-born│ of │mortality │ │ babies. │babies│ rate. │ │ │ born │ │ │ │ in │ │ │ │ 1911 │ ────────────────────────────────┼───────────┼─────────┼──────┼───────── The whole city │ 55,482│ 1,463│ 196│ 134.6 ════════════════════════════════╪═══════════╪═════════╪══════╪═════════ Down-town section (wards 1, 2, │ 5,944│ 80│ 4│ 52.0 3, 4) │ │ │ │ Kernville (wards 5, 6) │ 6,070│ 104│ 6│ 57.7 Homerstown (ward 7) │ 4,476│ 109│ 17│ 156.0 Roxbury (ward 8) │ 2,862│ 85│ 19│ 117.6 Conemaugh Borough (wards 9, 10) │ 5,282│ 136│ 16│ 117.6 Woodvale (ward 11) │ 3,945│ 107│ 20│ 271.0 Prospect (ward 12) │ 1,893│ 55│ 11│ 200.9 Peelorville (ward 13) │ 1,443│ 13│ 4│ ([13]) Minersville (ward 14) │ 2,403│ 72│ 9│ 125.0 Cambria City (wards 15, 16) │ 8,706│ 310│ 55│ 177.4 Moxham (ward 17) │ 5,735│ 157│ 14│ 39.2 Morrellville (wards 18, 19, 20) │ 5,757│ 194│ 15│ 32.5 Coopersdale (ward 21) │ 968│ 36│ 8│ ([13]) ────────────────────────────────┴───────────┴─────────┴──────┴─────────

Footnote 12:

Federal census of 1910.

Footnote 13:

Total live births less than 50; base therefore considered too small to use in computing an infant mortality rate.

To learn where the babies die is perhaps the first step in solving the infant mortality problem. The modern health officer recognizes this and generally has in his office a wall map upon which are indicated sections, wards, city blocks, and sometimes even houses. As infant deaths are reported, pins are stuck in the map in the proper places, a density of pins on any part of the map indicating, of course, where deaths are most numerous, although the percentage of infant deaths may not be the highest.

The highest infant mortality rate, 271, is found in the eleventh ward, known as Woodvale, although this is neither the most populous ward nor the one having the largest number of births. The infant mortality rate here, however, is double the rate for the city as a whole and more than five times as great as it is for the most favorable ward.

This is where the poorest, most lowly persons of the community live—families of men employed to do the unskilled work in the steel mills and the mines. They are for the most part foreigners, 78 per cent. of the mothers interviewed in this ward being foreign born.

Through Woodvale runs the main line of the Pennsylvania Railroad. To the north of the tracks rises a steep hill, toward the top of which is Woodvale Avenue, the principal street north of the railroad. (See plate A.) Sewer connection is possible for the houses along this avenue, as a sewer main has recently been installed, but the people have not in all cases gone to the expense of having the connection made, and in other cases where they have done so sometimes only the sinks are connected with the sewer and the yard privy is retained.

On the streets above Woodvale Avenue dwellings are more scattered and the appearance is more rural. A few of the families still have to depend upon more or less distant springs for their water, although city water is quite generally available throughout Woodvale.

The streets near the bottom of the hill, as Plum Street, for example, are so much below the level of the sewer mains that they can not be properly drained into the sewer. Private drain pipes from houses are buried a few feet below the surface and protrude from the sides of the hills, dripping with house drainage which flows slowly into ditches and forms slimy pools. (See Plates B and C.)

None of the streets on the north side of the railroad track are paved; sidewalks and gutters are lacking. In cold weather the streets are icy and slippery and even dangerous on account of the grade. In warm weather they are frequently slippery and slimy with mud.

Maple Avenue is the principal street of that part of Woodvale lying to the south of the railroad tracks, and it is the only properly paved and graded street in Woodvale. The streets on this side of the tracks, however, are not in as bad a condition as those to the north, nor are the drainage and general sewerage conditions as offensive as north of the tracks, but many of the streets are nevertheless muddy and filthy. (See Plate D.)

Prospect ranks next to Woodvale in infant mortality, having a rate of 200. This section, lying along a steep hill and above one of the big plants of the steel company, has not a single properly graded, drained, and paved street. The sewers are of the open-ditch type, and the natural slope of the land toward the river is depended upon for carrying off the surface water that does not seep into the soil. The closets are generally in the yard and are either dry privies or they are situated over cesspools. Some of the people who live on the lower part of the slope have wells sunk directly in the course of the drainage from above. (See Plate E.)

Cambria City, which is composed of the two most populous wards of Johnstown, has the third highest infant mortality rate, 177.4. It has a large foreign element, as is evidenced by the fact that 90.6 per cent. of the mothers interviewed were foreign born. It is situated along the river, between the hills of Minersville and Morrellville, and somewhat to the north of Prospect. The sewage from other residential sections and from the steel mills above them empties into the river at this point. In warm, dry seasons the river is low, flows slowly, and forms foul-smelling pools.

Sewer connection is possible for most of the houses in Cambria City, although all are not connected. Some, on the streets bordering the river, have private drain pipes that empty out into the stream. Others have their kitchen sinks connected with the sewer but still retain yard privies, which, of course, are not sewer connected.

There is considerable crowding of houses on lots, rear houses being commonly built on lots intended for but one house. Density of population and house congestion are greater here than elsewhere in the city.

The streets of Cambria City are somewhat better graded and more generally paved than those of Woodvale, but muddy streets and unpaved sidewalks nevertheless exist here. Broad Street, however, which is the business thoroughfare and runs through the center of the section, is the widest and best constructed street in Johnstown. Bradley Alley, on the other hand, running the length of Cambria City and parallel to Broad Street, is the most conspicuous example in the city of a narrow lane or alley used as a residence street. A number of small dwellings, generally housing more than one family, have their frontage on this alley, which is 19 feet 10 inches in width and without sidewalks. It is unpaved and in bad condition, generally being either muddy or dusty and littered with bottles, cans, and other trash. (See Plates F. and G.)

Homerstown has an infant mortality rate of 156, ranking fourth among the several sections of Johnstown in this respect. It has a fairly prosperous and somewhat suburban appearance, but its comparatively high infant mortality rate can perhaps be partly accounted for by the bad street conditions and the fact that refuse of all sorts is dumped into the shallow river at this point.

Minersville is a district where a high rate would be expected from prevailing conditions. The rate is 125, or less than the average for the city but more than double that for the most favorable sections. This ward is built on a hill and so located that the rising clouds of grit-laden smoke from the steel mills envelop it much of the time. Only one street in this section is well paved, and this is seldom clean. Houses on some of the streets near the top of the hill are not sewer connected, and streams of waste water trickle down the hill and give rise to unpleasant odors. (See Plates H and I.)

Conemaugh Borough, with an infant mortality rate of 117.6, ranks sixth in this respect among the sections into which Johnstown has been divided. It comprises wards 9 and 10 and begins at the edge of the down-town section and spreads upward over the hills to the southwest. Some of the houses on streets near the top of the hill are not sewer connected, and streams of water constantly trickle down the numerous alleys and streets that descend the hill. (See Plate J.) This section makes a very unfavorable first impression because of the open drainage and of the many dirty, badly paved streets. (See Plate K.) Unlike some of the other wards, it has a rather evenly distributed population and is without the vast uninhabited areas and acutely congested spots found in some other sections. On the whole there is little crowding on the lots and there are many good-sized yards. One-third of the population is foreign born. Of these the Italians are the most numerous. Despite certain ugly spots this section has not the unwholesome atmosphere that characterizes Woodvale and to a lesser extent Prospect, Cambria City, and Minersville.

The infant mortality rate of 117.6 per thousand in Roxbury is the same as that of Conemaugh Borough. For reasons not plainly apparent the rate here is higher than in Moxham, Morrellville, Kernville, or the down-town section, although it appears to be as favorably conditioned as these sections are from a social, economic, and sanitary standpoint. Here, as in all these sections, however, are many conditions not conducive to health. For example, parts of Franklin Street are in bad repair. The roadway is full of ruts and holes; the street, which is seldom sprinkled, is dusty in dry weather and muddy in wet weather, and in front of good houses along one section of this street runs an open ditch that receives house drainage.

Moxham has the eighth highest infant mortality rate, it being 89.2. Conditions here are generally rather favorable, although there is some complaint that at “high water” the sewage received by one of the runs in this section backs into some of the houses and then the sinks and water-closets overflow. Some of the homes here, near the city limits, are not supplied with city water but are still dependent upon wells and springs.

One of the three wards constituting Morrellville (ward 18) has a rural appearance; there is little house crowding on lots, big yards are common, and the streets are not paved. It is, however, marred by an offensive open-ditch sewer. Ward 19 of Morrellville has a more finished, less rural appearance. One of its objectionable features is that house drainage and the bloody waste of slaughterhouses are emptied into a shallow stream that flows through it. Ward 20 adjoins ward 19, and although it spreads out into a suburb it appears for the most part to be a comfortable and busy little village. Strayer’s Run winds about here and receives sewage. The fact that it is without a guardrail in some places and that the railing is inadequate in others makes it a source of danger, and according to common report such accidents as children falling into the stream have occurred. The infant mortality rate for Morrellville is 82.5.

Kernville, a section with a considerable proportion of prosperous people, has a very favorable infant mortality rate, it being 57.7. Parts of this section, however, are on a hill stretching upward from Stony Creek, which is both unsightly and offensive in warm weather and when the water is low.

The down-town section, i.e., wards 1, 2, 3, and 4, where are to be found many of the best conditioned houses, the homes of many of the well-to-do people, has the lowest infant mortality rate in the city, it being but 50.

No infant mortality rate is presented in the tables for Coopersdale or for Peelorville. In the first-named section only 36 live-born infants were considered, and 8 of them died in their first year. But this high rate need not be considered as especially significant, as the base number is small for such a computation. Coopersdale, however, is a suburban-appearing community in which one would expect the infant mortality rate to be low.

Peelorville is that part of the thirteenth ward which adjoins Prospect. A number of company houses are located here in which sanitary conditions are fairly good. The ward seems to have good drainage and no sewage nuisances. It is a community of wage earners and not of prosperous homes. Only 18 babies are included in the report for this district, one of whom died. With such a small base the infant mortality rate is not significant. (See Plate L.)

SANITARY CONDITIONS—SEWERAGE, PAVEMENTS, GARBAGE COLLECTIONS

The general inadequacy of the sewerage system which has been indicated for the city as a whole is due in part to the fact that the city is largely an aggregation of sections, formerly independent of Johnstown itself, which have been annexed at different periods. Some of these boroughs had sewer systems more or less developed when they were taken into Johnstown; others had none. Not only the sewerage of Johnstown but that of outlying boroughs pollutes the two shallow rivers, the Conemaugh and the Stony Creek, that flow through Johnstown. These are burdened with more waste than they can properly carry away, and the deposits which are left on the rocks in various sections of both rivers create nuisances that are the subject of much complaint, especially during the warm summer months. (See Plates M, N, O, and P.) At various times agitation has been started to improve the rivers which, as they flow through Johnstown, are, at the low-water stage, little better than swamps of reeking slime from the waste matter emptied into them from the hundreds of sewers along their banks. The pipes through which waste matter is emptied into the streams go only to the river edge, leaving their mouths uncovered and making the river beds at times pools of slowly flowing filth. These unsightly, malodorous conditions could be remedied if pipes were extended out into the middle of the streams, where the water is deeper.

With the exception of sprinkling a few wagon loads of lime along the banks of the streams each year, the city has done nothing to abate the nuisances arising from the use of these rivers as sewers or to restrain the coal and steel companies from allowing the drainage from mines and mills to enter the streams.

The engineer’s records show that Johnstown had in 1911 a total of 41.1 miles of sewers and 36 sewer outlets, and 82 miles of streets, 52.7 miles being paved. The alleys in Johnstown are generally inhabited. They are narrow and without sidewalks. Their length is 52.88 miles and 47.35 miles are unpaved. The combined length of streets and alleys is 134.88 miles. A comparison of this combined length of streets and alleys with the 41.1 miles of sewers having 36 outlets shows the inadequacy of the sewer system.

Not only is there an absence of paving, but the roadways are in very bad condition. A protest by “A Citizen” in the _Democrat_ of June 26, 1913, says that there are nine months in the year when it would be impossible for the proposed fire-department automobile engines to attend a fire in the seventh, eighth, eleventh, seventeenth, eighteenth, nineteenth, twentieth, and twenty-first wards owing to the condition of the streets.

The scavenger system is also very defective. Citizens are required to pay for the removal of their ashes, trash, and garbage. Garbage collections are not made by the municipality, but by private contractors, and any sort of receptacle, covered or uncovered, can or box, is pressed into service by householders. It is by no means uncommon to find streets and alleys littered with ashes, garbage, bottles, tin cans, beer cases, and small kegs. Dirty streets are by no means exceptional in Johnstown, even though the State of Pennsylvania has a law (act of Apr. 20, 1905) which provides for the punishment of any person who litters paved streets. It reads, in part, as follows (sec. 7 of Pamphlet Laws, 227):

“From and after the passage of this act, it shall be unlawful, and is hereby forbidden, for any person or persons to throw waste paper, sweepings, ashes, household waste, nails, or rubbish of any kind into any street in any city, borough, or township in this Commonwealth, or to interfere with, scatter, or disturb the contents of any receptacle or receptacles containing ashes, garbage, household waste, or rubbish which shall be placed upon any of said paved streets or sidewalks for the collection of the contents thereof.

“Any person or persons who shall violate any of the provisions of this act shall, upon conviction thereof before any magistrate, be sentenced to pay the cost of prosecution and to forfeit and pay a fine not exceeding $10 for each offense, and in default of the payment thereof shall be committed and imprisoned in the county jail of the proper county for a period not exceeding ten days.”

In a report on infant mortality to the registrar general of Ontario, 1910, Dr. Helen MacMurchy says: “Improve the water supply, the sewerage system, and the system of disposing of refuse; introduce better pavements, such as asphalt, and at once there is a decline in infantile mortality.” All these are sanitary features in need of great improvement in Johnstown, and unquestionably a lowered infant mortality rate would reward any efforts for their betterment.

HOUSING

In Johnstown the so-called “double” house predominates, usually frame. The double house is in reality two semidetached houses built upon a single lot. Rows of three or more houses of two, three, or four rooms each are common, and they are known locally as three-family, or six-family houses, as the case may be. Sometimes these are “rear houses,” that is, they are built behind other houses that face the street, on the same lots and in fact are approached by way of a narrow alley running alongside the house that has its frontage directly on the street. For this type of house water-closets or privies are often in rows in the yard or court that is used in common by all families. (See Plates Q and R.) In some places they are too few in number to permit each family to have the exclusive use of one.

Johnstown has three or four comparatively high-grade apartment houses, and in several office buildings rooms are rented to families for housekeeping. These are generally taken by native families.

In one of these office buildings the two lower floors are used for business purposes and the two upper floors are given over entirely to tenement purposes. From 40 to 50 families live here, many of whom have but one room. To serve the 20 or 25 families on each floor there is one bath and toilet room for men and another for women. Adjoining the toilet rooms is a small room containing garbage cans and trash receptacles for the use of the tenants.

The sanitary conditions in some of the best tenements or apartments, however, are not up to the standards of other cities, and in those occupied by the poorer people conditions are much worse than are usually permitted to exist in cities having large tenement houses in great numbers, where a tenement-house problem is recognized as such and active efforts are made by the municipality to improve conditions.

An absolute measure of the importance of each single housing defect in a high mortality rate can not be secured from this study. But it is not without interest to note that in homes where water is piped into the house the infant mortality rate was 117.6 per thousand, as compared with a rate of 197.9 in homes where the water had to be carried in from outdoors. Or that in the homes of 496 live-born babies where bathtubs were found the infant mortality rate was 72.6, while it was more than double, or 164.8, where there were no bathtubs. Desirable as a bathtub and bodily cleanliness may be, this does not prove that the lives of the babies were saved by the presence of the tub or the assumed cleanliness of the persons having them. In a city of Johnstown’s low housing standards, the tub is an index of a good home, a suitable house from a sanitary standpoint, a fairly comfortable income, and all the favorable conditions that go with such an income.

The same trend of a high infant mortality rate in connection with other housing defects is noted in the next table.

TABLE 3.—DISTRIBUTION OF LIVE BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE, ACCORDING TO HOUSING CONDITIONS.

Deaths during First Year HOUSING CONDITIONS Live births Number Infant mortality rate

Total 1,463 196 134.0 Dry homes 808 99 122.5 Moderately dry homes 336 47 139.9 Damp homes 319 50 156.7 Bath 496 36 72.6 No bath 965 159 164.8 Not reported 2 1 ([14]) Water supply in house 1,173 138 117.6 Water supply outside 288 57 197.9 Not reported 2 1 ([14]) City water available 1,333 176 132.0 City water not available 128 19 148.4 Not reported 2 1 ([14]) Yard clean 801 80 99.9 Yard not clean 632 107 169.3 No yard 28 8 ([14]) Not reported 2 1 ([14]) Water-closet 739 80 108.3 Yard privy 722 115 159.3 Not reported 2 1 ([14])

Footnote 14:

Total live births less than 50; base therefore considered too small to use in computing an infant mortality rate.

The following summary may be of interest in indicating some relation between infant mortality and cleanliness or uncleanliness combined with dryness or dampness of homes:

TABLE 4.—DISTRIBUTION OF LIVE BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY, ACCORDING TO CLEANLINESS AND DRYNESS OF HOME.

Deaths during First Year TYPE OF HOME Live births Number Infant mortality rate

All types 1,463 196 134.0 Clean 943 107 113.5 Moderately clean 354 58 163.8 Dirty 166 31 186.7 Dry 807 99 122.7 Damp 656 97 147.9 Clean: Dry 581 61 105.0 Damp 362 46 127.1 Moderately clean: Dry 158 27 170.9 Damp 196 31 158.2 Dirty: Dry 68 11 161.8 Damp 98 20 204.1

Dirt is doubtless unhealthful, but the amount of ill health or the number of infant deaths caused by a home being dirty can hardly be measured, when, as is usually the case, the dirt is accompanied by so many other bad conditions arising from poverty. For example, a home in close proximity to railroad tracks or mills whose stacks send forth clouds of soot, smoke, and ashes is generally the poorly built home of those who have neither time nor means to secure and retain cleanliness under such difficulties.

Overcrowding in homes is another factor the relative importance of which can not be exactly determined, because of its close connection with other ills. But the degree of overcrowding is greatest in the small cheaper houses, those of one, two, three, or four rooms. The average number of persons per room in the homes of all live-born babies for whom the data were secured was found to be 1.38. Homes of four rooms were more numerous than those of any other size and they housed an average of 1.58 persons per room. The number of babies in homes of various sizes with the number of persons per room for homes of each size was as follows:

TABLE 5.—NUMBER OF BABIES LIVING IN HOMES OF EACH SPECIFIED SIZE, AND AVERAGE NUMBER OF PERSONS PER ROOM IN HOMES OF EACH SIZE.

Size of home Live-born babies Persons per room

All homes 1,463 1 room 33 4.42 2 rooms 165 2.27 3 rooms 147 1.83 4 rooms 526 1.58 5 rooms 222 1.22 6 rooms 233 1.07 7 rooms 38 .96 8 rooms 43 0.83 9 rooms 22 .93 10 rooms 4 .88 11 rooms 4 .64 12 rooms 1 .75 13 rooms 1 .69 14 rooms 2 .43 Not reported 22

In homes of one, two, three, or four rooms or where the number of occupants ranged from 4.42 to 1.58 persons per room the infant mortality rate was 155, as compared with a rate of but 101.8 in larger homes, where the number ranged from 1.22 to 0.43 persons per room.

The 1910 census returns show that the greatest overcrowding was in ward 15, where the average number of persons per dwelling was 9.9. Wards 16, 11, and 14 came next with rates of 8.3, 7.7, and 7.2 respectively. The infant mortality rate for these four wards is 190.2, which is over one-third more than the rate for the whole city.

The mortality rate among infants who slept in a room with no other person than their parents was much lower than among those who slept in a room with more than two persons. The babies that slept in separate beds also had a much lower infant mortality rate than those who did not sleep alone, as shown in the next table. (Table omitted.)

In presenting statistics on sleeping and ventilation, only the babies who lived at least one month have been considered, for the reason that so many deaths during the first month of life were due to prenatal causes.

The incidence shown in the foregoing table is significant, even though it can by no means be deduced therefrom that the health of a large proportion of babies was so impaired by sleeping with older and more or less unhealthy persons that death resulted. But irregular night feeding and overfeeding are undoubtedly harmful, and the mother is tempted to subject the baby to this when it sleeps with her and disturbs her rest.

Of the 1,389 babies who lived at least one month, 600, or 43.2 per cent., lived in homes where the baby slept in a room with not more than two other persons. The fact that the baby slept in a room with no more persons than its parents generally argues that the family’s means permitted them to have one or more additional rooms for other members of the family, but in other cases, of course, merely that there were no other persons in the family.

Almost every home visited had means for good ventilation of the baby’s room at night, yet but 604, or 43.5 per cent., of the 1,389 babies who lived at least a month slept at night in well-ventilated rooms—that is, in rooms where, according to the mother’s statement, a window was open all night. Some mothers opened windows when the weather was neither cold nor damp; or opened them in a hall or room adjoining that where the baby slept; others emphatically stated that at night the windows were “always shut tight.” The babies subjected to differences of ventilation show corresponding variations in infant mortality rates.

A high death rate in badly ventilated homes can not be charged wholly to bad air. The mother who did not, or could not, provide proper ventilation was generally the mother without the means or the knowledge necessary to enable her to care for her baby properly in other respects, and yet the marked differences suggest that ventilation is itself a very important ally of the baby in its first year of struggle for existence.

In many rooms that were poorly ventilated, windows were not opened for the reason that the room was not properly heated and the houses themselves were flimsy and drafty. The problem in such houses is to keep warm. If the windows were frequently or constantly opened, the houses would be too cold to live in. In some localities the outside air is so laden with soot, ashes, dirt, and smoke that every effort is made to keep it out of the house.

The foreigners, who generally have the most miserable homes, are not dirty people who select bad living conditions through innate poor judgment, low standards, and lack of taste. The squalid homes which housed the natives and later the Germans and the Irish until the present type of immigrants came to do the more poorly paid work were the only homes available within the purchasing power of their low wages. The new immigrants demanded practically nothing and the owners did practically nothing in the matter of improving these homes, which naturally became more and more squalid as time went on. An excessive infant mortality rate and insanitary homes in unhealthful sections were found to be coexistent.

NATIONALITY

GENERAL NATIVITY

The investigation embraced 860 babies of native mothers (of whom 6 were negroes) and 691 babies of foreign mothers, making a total of 1,551. The infant mortality rate for the entire group was 134 per 1,000 live births; for the babies of native mothers 104.3, and for those of foreign mothers 171.3. The stillbirth rate for native mothers having children in 1911 was less than that for foreign mothers, being 52.3, as compared with 62.2 per 1,000 total births.

The line between the natives and foreigners is very sharply drawn in Johnstown. The native population as a rule knows scarcely anything about the foreigners, except what appears in the newspapers about misdemeanors committed in foreign sections. The report of the Immigration Commission[15] comments “on the attitude of the police department toward foreigners ... with regard to Sunday desecration,” and states that “the Croatians are accustomed to spend Sunday in singing, drinking, and noisy demonstrations. The police have been instructed to show no leniency on account of ignorance of the municipal regulations, and, without any attempt at explaining the laws, they arrest the offenders in large numbers.” Again, it states: “They are arrested more often for crimes that make them a nuisance to the native population than for mere infractions of the law.... Few arrests are made for immorality among foreigners.” “Sabbath desecration” is the crime foreigners are most frequently charged with.

Footnote 15:

United States Immigration Commission Reports, Volume VIII., “Immigrants in Industries: Part 2, Iron and Steel Manufacturing in the East,” p. 387. Reference is to Johnstown and is a very true picture of various immigrant institutions and of the comparative progress and assimilation of different races there. Although the immigration report was made five years before our investigation, conditions remain practically the same.

Foreigners are employed largely in the less skilled occupations of the steel mills, which operate 24 hours a day, seven days a week. At the time the investigation was made some of the men in the steel mills worked for a period of two weeks on a night shift of 14 hours, then two weeks on a day shift of 10 hours, and back again to the night shift of 14 hours for another two weeks, and so on. When shifts were changed, one group of men was required to work throughout a period of 24 hours instead of for the usual 10 or 14 hour period and another group had 24 hours off duty. Some departments of the steel mills, however, shut down on Sundays, and in some departments for certain occupations an eight-hour day prevails, but these more favorable conditions do not prevail among the majority of the unskilled foreign workers whose homes were visited.

The foreigners who work on a 24-hour shift in a mill on one Sunday frequently “desecrate” their alternate free Sabbath by “singing, drinking, and noisy demonstrations,” in spite of the known danger of arrest for “crimes that make them a nuisance to the native population” or for “Sabbath desecration,” laws concerning which are strictly enforced in Johnstown; for example, children are not permitted to play in public playgrounds on Sunday and mercantile establishments are required to be closed on that day. Also, it is “unlawful for any person or persons to deliver ice cream, or to sell or deliver milk from wagon or by person carrying same, within the city on the Sabbath day, commonly called Sunday, after 12 o’clock m.” The ordinance from which the foregoing sentence was quoted became a law on January 25, 1914.

SERBO-CROATIAN

The foreign group having the highest infant mortality rate is the Serbo-Croatian[16] where infant deaths numbered 263.9 per 1,000 live births.

Footnote 16:

A distinct and homogenous race, from a linguistic point of view, among Slavic peoples. They are divided into the groups “Croatian” and “Servian,” on political and religious grounds, the former being Roman Catholics and the latter Greek Orthodox. Their spoken language is the same but they can not read each other’s publications, for the Croatians use the Roman alphabet, or sometimes the strange old Slavic letters, while the Servians use the Russian characters fostered by the Greek Church.

Three Krainers have also, for convenience, been included in this group. Krainers are Slovenians from the Austro-Hungarian Province of Carniola and are designated “close cousins of the Croatians but with a different though nearly related language” by Emily Greene Balch in her book entitled “Our Slavic Fellow Citizens.”

The men of the Serbo-Croatian group are fine looking and powerful and are employed in the heavy unskilled work of the steel mills and the mines. They greatly outnumber the women of their race in Johnstown, and a man with a wife frequently becomes a “boarding boss”; that is, he fills his rooms with beds and rents out sleeping space to his fellow countrymen at from $2.50 to $3 a month each. The same bed and bedding is sometimes in service both night and day to accommodate men on the night and the day shifts of the steel mills.

The wife, without extra charge, makes up the beds, does the washing and ironing, and buys and prepares the food for all the lodgers. Usually she gets everything on credit and the lodgers pay their respective shares biweekly. These conditions exist to some extent among other foreigners, but are not as prevalent among other nationalities in Johnstown as among the Serbo-Croatians.

In a workingman’s family, it is sometimes said, the woman’s work-day is two hours longer than the man’s. But if this statement is correct in general, the augmentation stated is insufficient in these abnormal homes where the women are required to have many meals and dinner buckets ready at irregular hours to accommodate men working on different shifts.

The Serbo-Croatian women who, more than any of the others, do all this work are big, handsome, and graceful, proud and reckless of their strength. During the progress of the investigation, in the winter months, they were frequently seen walking about the yards and courts, in bare feet, on the snow and ice-covered ground, hanging up clothes or carrying water into the house from a yard hydrant.

Whether it harmed them to expend their force and vigor as they did could not be determined in individual cases, but their babies are the ones who died off with the greatest rapidity, their infant mortality rate being 263.9, as compared with the rates of 171.3 for all the foreign; 104.3 for the natives; and 134 for the entire group as shown in Table 18. Excluding babies of Serbo-Croatian mothers, the infant mortality rate for babies of foreign mothers is but 159.7.

ITALIAN

The Italian mothers visited in Johnstown bore 75 children in 1911, 4 being stillborn. The infant mortality rate among the live born was 183.1, the highest of any racial group excepting the Serbo-Croatian, where it was 263.9.

The Italians have been in Johnstown somewhat longer than the Serbo-Croatians and they seem to have a little firmer grip on the community life there. Their homes are a shade better, a trifle cleaner, and somewhat less crowded than those of the Serbo-Croatians, although their hygienic standards seem little if any higher and they rank no better in literacy. The women do not perform the arduous duties that are the lot of so many of the Serbo-Croatian women; they have not the robust physique of the latter and the men are not found in those branches of the steel industry which require the extraordinary strength possessed by the Serbo-Croatians. The occupations of the Italian fathers were found to be more diversified than those of the Serbo-Croatians, some being fruit, grocery, or cheese merchants; steamship agents; bricklayers, carpenters, or workers at other skilled and semiskilled trades.

SLOVAK, POLISH, ETC.

The infant mortality rate in the group designated “Slovak, Polish, etc.” is 177.1. In this group are included all the Slavic races represented in the investigation excepting the Serbo-Croatian. The babies of Slovak[17] mothers were found to be most numerous, there being 276 of them. There were 108 babies of Polish,[18] 2 of Bohemian,[19] and 7 of Ruthenian[20] mothers. In addition, one baby of a Scandinavian (Danish) mother was included, not because Scandinavians bear the least racial resemblance to the Slavic races, but because the few Scandinavians in Johnstown happened to be on about the same economic footing as the “Slovak, Polish, etc.”

Footnote 17:

Slovaks occupy practically all except the Ruthenian territory of northern Hungary; also found in great numbers in southeast Moravia. They are the Moravians conquered by Hungary. In physical type no dividing line can be drawn between Slovaks and Moravians. It is often claimed that Slovak is a Bohemian dialect.

Footnote 18:

The west Slavic race native to the former Kingdom of Poland. For the most part they adhere to the Roman rather than the Greek Orthodox Catholic Church.

Footnote 19:

The westernmost division or dialect of the Czech and the principal people or language of Bohemia. Czech is the westernmost race or linguistic division of the Slavic (except Wendish, in Germany), the race or people residing mainly in Bohemia and Moravia.

Footnote 20:

Also known as Little Russians; live principally in southern Russia; also share Galicia with the Poles but greatly surpassed by Poles in number. In language and physical type resemble Slovaks. Generally Greek Orthodox, but a few are Greek Catholics of the Roman Catholic Church, whose priests marry, and are separated from other Roman Catholics by marked religious differences.

The rate for this group is lower than that for either the Serbo-Croatians or the Italians, but it is nevertheless very high and one exceeded by only a few European countries, as shown by the table on page 12.

Some of the “Slovaks, Poles, etc.,” live in the same squalid sections as the Serbo-Croatians, and in the same type of inferior houses, but on the whole they have been in Johnstown longer, are more prosperous, and are therefore beginning to move from Cambria City and Woodvale, where formerly practically all lived, into more desirable sections. Those who have been in this country longest and intend to stay here are buying homes with large yards in the less crowded sections and are raising vegetables and flowers. Others, however, still remain in poor neighborhoods and sometimes buy houses there for from $300 to $600 each, built close together on rented ground.

Lodgers are by no means uncommon among the people in this group, but usually their homes are cleaner, less crowded, and possessed of more comforts than those of the Serbo-Croatians and Italians.

OTHER NATIONALITIES

The British[21] infant mortality rate in Johnstown is 129 and the German 127.7. The British and Germans in Johnstown are more prosperous than the Slavic, Magyar, Jewish, Italian, Syrian, and Greek peoples, and regard the others as “foreigners.” It was strange to hear a man, one who could speak English, say, “We are not foreigners; we are Germans.” The British and Germans occupy the same relative position economically that they occupy in the infant mortality scale with relation to other races.

Footnote 21:

English, Irish, Scotch, and Welsh included in the term British.

In the Magyar group, of 38 babies born alive 4 died in their first year, making an infant mortality rate of 105.3, which is almost as low as that for babies of native mothers. The Magyars are little if any better off than the other “foreigners” among whom they live, but they possess somewhat higher standards of living. They live in poor neighborhoods and have inferior houses, but their homes are cleaner and they themselves somewhat more alert, personally cleaner, and less illiterate than the other foreigners.

There were but 10 babies of Hebrew mothers and 12 of Syrian and Greek mothers; among these there were no deaths. These groups are too small numerically to be significant in a comparative race study of infant mortality.

STILLBIRTHS

In all there were but 88 stillbirths included in the investigation. They were more numerous proportionately among the Germans than among the mothers of any of the other nationalities. No single nationality group, however, has a very large representation, and hence a comparison of the rate for one with that for another nationality is not as significant as the difference in rate between native and foreign mothers. Although a special study of the causes of stillbirths was not made in connection with a study of deaths of infants during their first year of life, nevertheless the incidence of these births among the different nationality groups is believed to be of some interest, and therefore shown in the next table. (Omitted.)

ATTENDANT AT BIRTH

The native mother usually had a physician at childbirth; the foreign-born, a midwife. The more prosperous of the foreign mothers, however, departed from their traditions or customs and had physicians, while the American-born mothers, when very poor, resorted to midwives. The midwives usually charged $5, and sometimes only $3; they waited for payment or accepted it in installments, and they performed many little household services that no physician would think of rendering.

Two-thirds of those having no attendant were Serbo-Croatians. It was a Polish woman, however, who gave the following account of the birth of her last child:

At 5 o’clock Monday evening went to sister’s to return washboard, having just finished day’s washing. Baby born while there; sister too young to assist in any way; woman not accustomed to midwife anyway, so she cut cord herself; washed baby at sister’s house; walked home, cooked supper for boarders, and was in bed by 8 o’clock. Got up and ironed next day and day following; it tired her, so she then stayed in bed two days. She milked cows and sold milk day after baby’s birth, but being tired hired some one to do it later in week.

This woman keeps cows, chickens, and lodgers; also earns money doing laundry and char work. Husband deserts her at times; he makes $1.70 a day. A 15-year-old son makes $1.10 a day in coal mine. Mother thin and wiry; looks tired and worn. Frequent fights in home.

The infant mortality rate was lower for babies delivered by physicians than for those delivered by midwives or for those at whose birth no properly qualified attendant was present. This is not necessarily an indication of the quality of the care at birth, although in some cases the inefficiency of the midwife may have directly or indirectly caused deaths, just as in some instances a physician’s inefficiency may have caused them. The midwife, however, is resorted to by the poor, and in their homes are found other conditions that create a high infant mortality rate.

Frequently the Serbo-Croatian women dispense altogether with any assistance at childbirth; sometimes not even the husband or a neighbor assists. Over 30 per cent. of the births among the women of that race took place without a qualified attendant. More than one-half of those delivered by midwives, less than one-fifteenth of those delivered by physicians, and about one-fifth of those delivered without a qualified attendant had babies who died in their first year of life.

Fifteen of the 19 Serbo-Croatian women whose babies died under 1 year of age kept lodgers.

In Johnstown the midwife is resorted to principally by the poor. Recent laws that the State is now trying to enforce require that the standard for the practice of midwifery be raised. If this can be done midwives might become definitely helpful persons in the community. One or two of the intelligent graduate midwives in Johnstown have been an educational force among the foreign mothers for some years past. On the other hand there were others who were so dirty and so ignorant that they were a menace to the public health.

MOTHERS

LITERACY[22]

There are differences in the infant mortality rate between the babies of literate and the babies of illiterate mothers; between those with mothers who can speak English and those with mothers who can not; and between babies of the mothers who have been in this country for a considerable period and those of the newer arrivals. Comparisons of this nature are confined to the foreign mothers, as only three cases of illiteracy were found among native mothers, and the other comparisons would not, of course, be applicable in any case to native mothers.

Footnote 22:

By literacy is meant ability to read and write in any language and not simply in English.

The next table shows that the infant mortality rate among the children of illiterate foreign mothers was 214, or 66 per thousand greater than the rate among literate foreign mothers.

TABLE 13.—DISTRIBUTION OF BIRTHS AND OF DEATHS DURING FIRST YEAR, INFANT MORTALITY RATE, AND NUMBER AND PER CENT OF STILLBIRTHS, ACCORDING TO LITERACY OF FOREIGN MOTHERS.

═══════════════════════╤═══════╤═══════╤═════════════╤═════════════════ LITERACY OF FOREIGN │ Total │ Live │STILLBIRTHS. │ DEATHS DURING MOTHERS. │births.│births.│ │ FIRST YEAR. ───────────────────────┼───────┼───────┼───────┬─────┼───────┬───────── │ │ │ │ Per │ │ Infant │ │ │Number.│cent.│Number.│mortality │ │ │ │ │ │ rate. ───────────────────────┼───────┼───────┼───────┼─────┼───────┼───────── Foreign mothers │ 691│ 648│ 43│ 6.2│ 111│ 171.3 ═══════════════════════╪═══════╪═══════╪═══════╪═════╪═══════╪═════════ Literate │ 445│ 419│ 26│ 5.8│ 62│ 148.0 Illiterate │ 246│ 229│ 17│ 6.9│ 49│ 214.0 ───────────────────────┴───────┴───────┴───────┴─────┴───────┴─────────

ABILITY TO SPEAK ENGLISH

The next table shows that babies whose mothers can not speak English were characterized by a more unfavorable infant mortality rate than other babies.

TABLE 14.—DISTRIBUTION OF BIRTHS AND OF DEATHS DURING FIRST YEAR, INFANT MORTALITY RATE, AND NUMBER AND PER CENT OF STILLBIRTHS, ACCORDING TO ABILITY OF FOREIGN MOTHER TO SPEAK ENGLISH.

═══════════════════════╤═══════╤═══════╤═════════════╤═════════════════ ABILITY TO SPEAK │ Total │ Live │STILLBIRTHS. │ DEATHS DURING ENGLISH. │births.│births.│ │ FIRST YEAR. ───────────────────────┼───────┼───────┼───────┬─────┼───────┬───────── │ │ │ │ Per │ │ Infant │ │ │Number.│cent.│Number.│mortality │ │ │ │ │ │ rate. ───────────────────────┼───────┼───────┼───────┼─────┼───────┼───────── Foreign mothers │ 691│ 648│ 43│ 6.2│ 111│ 171.3 ═══════════════════════╪═══════╪═══════╪═══════╪═════╪═══════╪═════════ Speak English │ 263│ 247│ 16│ 6.1│ 36│ 145.7 Can not speak English │ 428│ 401│ 27│ 6.3│ 75│ 187.0 ───────────────────────┴───────┴───────┴───────┴─────┴───────┴─────────

YEARS IN THE UNITED STATES

In addition to a consideration of the babies according to their mothers’ ability to speak English, it is of interest to note the infant mortality rates among babies whose mothers have been in this country for different periods of time.

The high infant mortality rate for the children of newer immigrants, illiterates, and those who can not speak English is perhaps affected by the fact that they are at the same time generally of the poorest families and are housed in the most insanitary and unhealthful part of the city.

AGE

The age of the mother is frequently believed to be a factor in the health of the child. The highest infant mortality rate was found to be that for the group of babies with mothers over 40 years of age, and the lowest for babies of mothers from 20 to 24 years of age.

TABLE 16.—DISTRIBUTION OF BIRTHS AND OF DEATHS DURING FIRST YEAR, INFANT MORTALITY RATE, AND NUMBER AND PER CENT OF STILLBIRTHS, ACCORDING TO AGE OF MOTHER.

════════════════╤════════╤════════╤═════════════════╤══════════════════ AGE OF MOTHER. │ Total │ Live │ STILLBIRTHS. │ DEATHS DURING │births. │births. │ │ FIRST YEAR. ────────────────┼────────┼────────┼────────┬────────┼────────┬───────── │ │ │ │ Per │ │ Infant │ │ │Number. │ cent. │Number. │mortality │ │ │ │ │ │ rate. ────────────────┼────────┼────────┼────────┼────────┼────────┼───────── All mothers │ 1,551│ 1,463│ 88│ 5.7│ 196│ 134.0 ════════════════╪════════╪════════╪════════╪════════╪════════╪═════════ Under 20 │ 105│ 95│ 10│ 9.5│ 13│ 136.8 20 to 24 │ 476│ 454│ 22│ 4.6│ 55│ 121.1 25 to 29 │ 410│ 391│ 19│ 4.6│ 56│ 143.2 30 to 39 │ 480│ 449│ 31│ 6.5│ 61│ 135.9 40 and over │ 80│ 74│ 6│ 7.5│ 11│ 148.6 ────────────────┴────────┴────────┴────────┴────────┴────────┴─────────

The youngest mothers have a higher stillbirth rate than other mothers, and the oldest group of mothers has the next highest rate. In this connection not only the foregoing table is of interest, but also Table XII, based upon the entire reproduction histories of the mothers included in this study. As all the children borne by these mothers are included, the base numbers in the latter table are larger and the figures therefore somewhat more significant.

BABY’S AGE AT DEATH AND CAUSE (DISEASE) OF DEATH

_A baby who comes into the world has less chance to live one week than an old man of 90, and less chance to live a year than one of 80.—Bergeron._

The most dangerous time of life is early infancy; even old age seldom has greater risk. Death strikes most often in infancy. The Johnstown babies died during their first year of life at the rate of 134 per 1,000 born alive, and they paid their heaviest toll in their very earliest days. If the total of 196 deaths had been distributed evenly throughout the 12 months, 8.3 per cent. of the babies would have died each month and 25 per cent. during each quarter. But instead of that 37.8 per cent. died in the first month; 9.2 per cent. in the second, and 8.2 per cent. in the third, or over 55 per cent. in the first quarter.

TABLE 17.—NUMBER AND PER CENT DISTRIBUTION OF DEATHS OF BABIES, BY AGE AT DEATH.

═══════════════════════════════════╤═══════════════════════════════════ AGE AT DEATH. │ DEATHS OF BABIES OF ALL MOTHERS. ───────────────────────────────────┼─────────────────┬───────────────── │ Number. │ Per cent. │ │ distribution. ───────────────────────────────────┼─────────────────┼───────────────── Total deaths in first year │ 196│ 100.0 ═══════════════════════════════════╪═════════════════╪═════════════════ First quarter │ 108│ 55.1 First month │ 74│ 37.8 ═══════════════════════════════════╪═════════════════╪═════════════════ First week │ 45│ 23.0 ───────────────────────────────────┼─────────────────┼───────────────── Less than 1 day and 1 day │ 30│ 15.3 2 days │ 4│ 2.0 3 to 6 days │ 11│ 5.6 │ │ Second week │ 14│ 7.1 Third week │ 7│ 3.6 Fourth week │ 8│ 4.1 │ │ Second month │ 18│ 9.2 Third month │ 16│ 8.2 │ │ Second quarter │ 42│ 21.4 Third quarter │ 31│ 15.8 Fourth quarter │ 15│ 7.7 ───────────────────────────────────┴─────────────────┴─────────────────

The large number of deaths in the first few hours or days of life indicates that many babies are born with some handicap and that in many instances the mother has been subjected to some condition which resulted in the birth of a child incapable of withstanding the ordinary strain of life. Of the 45 babies who died in Johnstown less than a week after birth, 38 died of prematurity, congenital debility or malformations, or injuries received at birth. In one other case the cause of death was given as “bowel trouble” and in six other cases it was not clearly defined. In addition to the 45 babies just referred to as having died in their first week, 12 died later either from prematurity or from congenital defects.

Of the deaths from causes arising after birth, 52 were attributed by the attending physicians to diarrhoea and enteritis, 50 to respiratory diseases; and 44 to some other or to some ill-defined cause.

TABLE 18.—DISTRIBUTION OF DEATHS DURING FIRST YEAR AND INFANT MORTALITY RATE, ACCORDING TO CAUSE OF DEATH AND NATIVITY OF MOTHER.

═════════════════╤═════════════════════════════════════════════════════ CAUSE OF DEATH. │ DEATHS DURING FIRST YEAR OF BABIES OF— ─────────────────┼─────────────────┬─────────────────┬───────────────── │ All mothers. │ Native mothers. │Foreign mothers. ─────────────────┼───────┬─────────┼───────┬─────────┼───────┬───────── │ │ Infant │ │ Infant │ │ Infant │Number.│mortality│Number.│mortality│Number.│mortality │ │ rate. │ │ rate. │ │ rate. ─────────────────┼───────┼─────────┼───────┼─────────┼───────┼───────── All causes │ 196│ 134.0│ 85│ 104.3│ 111│ 171.3 ═════════════════╪═══════╪═════════╪═══════╪═════════╪═══════╪═════════ Diarrhea and │ 52│ 35.5│ 17│ 20.9│ 35│ 54.0 enteritis │ │ │ │ │ │ Respiratory │ 50│ 34.2│ 19│ 23.3│ 31│ 47.8 diseases │ │ │ │ │ │ Premature births │ 24│ 16.4│ 11│ 13.5│ 13│ 20.1 Congenital │ │ │ │ │ │ debility or │ 19│ 12.9│ 5│ 6.1│ 14│ 21.6 malformation │ │ │ │ │ │ Injuries at birth│ 7│ 4.8│ 6│ 7.4│ 1│ 1.5 Other causes or │ 44│ 30.1│ 27│ 33.1│ 17│ 26.2 not reported │ │ │ │ │ │ ─────────────────┴───────┴─────────┴───────┴─────────┴───────┴─────────

The latest census report on mortality statistics characterizes diarrhoea and enteritis as the “most important preventable cause of infant mortality” in the United States, and numerically at least it proves to be the most important cause of infant death in Johnstown.

Holt[23] says that one of the most striking facts about diarrheal diseases in infants is their prevalence during the summer season. In Johnstown the infant diarrheal deaths were least prevalent in the first quarter of the year, next in the second, next prevalent in the fourth, and most prevalent in the third or summer quarter.

Footnote 23:

The Diseases of Infancy and Childhood, by L. Emmett Holt. p. 345. New York, 1912.

TABLE 19.—DISTRIBUTION OF DEATHS, ACCORDING TO CAUSE OF DEATH AND QUARTER OF CALENDAR YEAR IN WHICH DEATH OCCURRED.

═══════════════════════════════╤═══════╤═══════════════════════════════ CAUSE OF DEATH. │ All │ QUARTER OF CALENDAR YEAR IN │deaths.│ WHICH DEATH OCCURRED. ───────────────────────────────┼───────┼───────┬───────┬───────┬─────── │ │First. │Second.│Third. │Fourth. ───────────────────────────────┼───────┼───────┼───────┼───────┼─────── All causes │ 196│ 54│ 29│ 74│ 39 ═══════════════════════════════╪═══════╪═══════╪═══════╪═══════╪═══════ Diarrhea and enteritis │ 52│ 3│ 5│ 32│ 12 Respiratory diseases │ 50│ 24│ 8│ 7│ 11 Premature births │ 24│ 7│ 5│ 9│ 3 Congenital debility or │ 19│ 5│ 2│ 8│ 4 malformation │ │ │ │ │ Injuries at birth │ 7│ 5│ 1│ │ 1 Other causes or not reported │ 44│ 10│ 8│ 18│ 8 ───────────────────────────────┴───────┴───────┴───────┴───────┴───────

Our figures are too small to admit of broad generalizations or a very full discussion of infant deaths according to the period of the year.

This excess of infant deaths from diarrhea in the summer months has been established by statistics in many countries, and the cause of such an excess has been the subject of much discussion, but as yet there is no general agreement. Liefmann and Lindemann[24] conclude, however, that in this field of controversy there are certain facts which are at present well established, these being the dependence of the high summer mortality on methods of feeding, on hot weather, and on the living and social condition of the parents. The last factor mentioned by these authors, including as it does housing conditions, economic status, and degree of intelligence, is becoming more and more the subject of study and investigation. It has been shown that the distinctly harmful effect of hot weather on the infant is increased when the housing conditions are bad; in overcrowded homes with bad ventilation the indoor temperature may be many degrees higher than the outdoor temperature. The ignorance and carelessness of mothers has also been shown to increase the bad effect of hot weather. With hygienic care, including cool baths, much fresh air, and careful feeding, many infants are able to pass through extremely hot weather without diarrheal disturbances.

Footnote 24:

Liefmann, H., and Lindemann, H., Die Lokalization der Sauglingsterblichkeit und ihre Beziehungen zur Wohnungsfrage. Med. Klinik 1912, pp. 8, 1074.

Respiratory diseases were reported as a cause of death with almost as great frequency as diarrheal diseases. As shown by Table 19, these deaths occurred principally in the colder months of the first and fourth quarters of the calendar year.

FEEDING

Food is recognized as of such importance in relation to infant mortality that studies of this subject frequently resolve themselves into studies of feeding only. Invariably these demonstrate the truth of the statement of Dr. G. F. McCleary[25] that “in human milk we have a unique and wonderful food for which the ingenuity of man may toil in vain to find a satisfactory substitute.” Many mothers, however, still fail to appreciate the risk their young babies face in being given any except the natural infant food, and consequently babies are in large numbers wholly or partly weaned from the breast in the earliest months of their lives.

Footnote 25:

Infantile Mortality and Infants’ Milk Depots. London.

Breast feeding is far more general, comparatively, among the poorer mothers than among the well to do, as shown by the following summary which gives the number and per cent. of babies of mothers with husbands earning varying incomes, who had been completely weaned from the breast when they were 3, 6, or 9 months of age, respectively. For each of the periods indicated the percentage completely weaned from the breast is much greater in the groups where earnings are highest.

TABLE 20.—DISTRIBUTION OF BABIES ALIVE AT 3, 6, AND 9 MONTHS OF AGE BY TYPE OF FEEDING AT EACH OF SAID AGES, ACCORDING TO ANNUAL EARNINGS OF FATHER AND NATIVITY OF MOTHER.

══════════════╤═════════════════════════════════════════ ANNUAL │ EARNINGS OF │ FATHER AND │ BABIES LIVING AT AGE OF— NATIVITY OF │ MOTHER. │ ──────────────┼────────────────────┬──────────────────── │ 3 months. │ 6 months. ──────────────┼──────┬─────────────┼──────┬───────────── │ │ Completely │ │ Completely │Total.│ weaned from │Total.│ weaned from │ │ breast. │ │ breast. ──────────────┼──────┼───────┬─────┼──────┼───────┬───── │ │Number.│ Per │ │Number.│ Per │ │ │cent.│ │ │cent. ──────────────┼──────┼───────┼─────┼──────┼───────┼───── Total │ 1,355│ 193│ 14.2│ 1,313│ 250│ 19.0 ══════════════╪══════╪═══════╪═════╪══════╪═══════╪═════ Under $624 │ 341│ 22│ 6.5│ 322│ 32│ 9.9 $625 to $899│ 358│ 48│ 13.4│ 351│ 63│ 17.9 $900 and │ 629│ 114│ 18.1│ 616│ 146│ 23.7 over[26] │ │ │ │ │ │ Not │ 27│ 9│ 33.3│ 24│ 9│ 37.5 reported[27]│ │ │ │ │ │ │ │ │ │ │ │ Mother │ 765│ 155│ 20.3│ 747│ 195│ 26.1 native │ │ │ │ │ │ ──────────────┼──────┼───────┼─────┼──────┼───────┼───── Under $624 │ 69│ 10│ 14.5│ 66│ 13│ 19.7 $625 to $899 │ 180│ 36│ 20.0│ 177│ 46│ 26.0 $900 and │ 491│ 100│ 20.4│ 482│ 127│ 26.3 over[26] │ │ │ │ │ │ Not │ 25│ 9│ 36.0│ 22│ 9│ 40.9 reported[27]│ │ │ │ │ │ │ │ │ │ │ │ Mother │ 590│ 38│ 6.4│ 566│ 55│ 9.7 foreign │ │ │ │ │ │ ──────────────┼──────┼───────┼─────┼──────┼───────┼───── Under $624 │ 272│ 12│ 4.4│ 256│ 19│ 7.4 $625 to $899 │ 178│ 12│ 6.7│ 174│ 17│ 9.8 $900 and │ 138│ 14│ 10.1│ 134│ 19│ 14.2 over[26] │ │ │ │ │ │ Not │ 2│ │ │ 2│ │ reported[27]│ │ │ │ │ │ ──────────────┴──────┴───────┴─────┴──────┴───────┴─────

══════════════╤════════════════════ ANNUAL │ EARNINGS OF │ FATHER AND │BABIES LIVING AT AGE OF— NATIVITY OF │ MOTHER. │ ──────────────┼──────────────────── │ 9 months. ──────────────┼──────┬───────────── │ │ Completely │Total.│ weaned from │ │ breast. ──────────────┼──────┼───────┬───── │ │Number.│ Per │ │ │cent. ──────────────┼──────┼───────┼───── Total │ 1,282│ 358│ 27.5 ══════════════╪══════╪═══════╪═════ Under $624 │ 309│ 57│ 18.4 $625 to $899│ 342│ 85│ 24.9 $900 and │ 608│ 201│ 33.1 over[26] │ │ │ Not │ 23│ 10│ 43.3 reported[27]│ │ │ │ │ │ Mother │ 735│ 251│ 34.1 native │ │ │ ──────────────┼──────┼───────┼───── Under $624 │ 65│ 18│ 27.7 $625 to $899 │ 173│ 55│ 31.8 $900 and │ 476│ 168│ 35.3 over[26] │ │ │ Not │ 21│ 10│ 47.6 reported[27]│ │ │ │ │ │ Mother │ 547│ 102│ 18.6 foreign │ │ │ ──────────────┼──────┼───────┼───── Under $624 │ 244│ 39│ 16.0 $625 to $899 │ 169│ 30│ 17.8 $900 and │ 132│ 33│ 25.0 over[26] │ │ │ Not │ 2│ │ reported[27]│ │ │ ──────────────┴──────┴───────┴───── Footnote 26:

Includes those reported as earning “ample.” “Ample,” as used in this report has a somewhat technical meaning; when information concerning the father’s earnings was not available and the family showed no evidences of poverty, the word “ample” was used. When, however, the family was clearly in a state of abject poverty, it was included in the group “Under $521.”

Footnote 27:

Unmarried mothers’ babies also included.

Breast feeding, wholly or in part, is continued for a longer period by foreign than by native mothers, as indicated in the preceding table, showing that 20.3, 26.1, and 34.1 per cent. of the native mothers’ babies as compared with 6.4, 9.7, and 18.6 per cent. of the foreign mothers’ babies had been weaned from the breast at the age of 3, 6, and 9 months, respectively.

TABLE 25.—DISTRIBUTION OF ALL BIRTHS, LIVE BIRTHS, AND STILLBIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE, ACCORDING TO SEX OF BABY AND NATIVITY OF MOTHER.

═══════════════════════╤═══════╤═══════╤══════════════╤════════════════ SEX OF BABY AND │ All │ Live │ STILLBIRTHS.│ DEATHS DURING NATIVITY OF MOTHER. │births.│births.│ │ FIRST YEAR. ───────────────────────┼───────┼───────┼──────┬───────┼──────┬───────── │ │ │ │ Rate │ │ Infant │ │ │Total.│ per │Total.│mortality │ │ │ │ 1,000 │ │ rate. │ │ │ │births.│ │ ───────────────────────┼───────┼───────┼──────┼───────┼──────┼───────── BABIES OF NATIVE │ │ │ │ │ │ MOTHERS. │ │ │ │ │ │ │ │ │ │ │ │ Total number │ 860│ 815│ 45│ 52.3│ 85│ 104.3 ═══════════════════════╪═══════╪═══════╪══════╪═══════╪══════╪═════════ Male: │ │ │ │ │ │ Number │ 433│ 406│ 27│ 62.4│ 46│ 113.3 Per cent. │ 50.3│ 49.8│ 60.0│ │ 54.1│ Female: │ │ │ │ │ │ Number │ 427│ 409│ 18│ 42.2│ 39│ 95.4 Per cent. │ 49.7│ 50.2│ 40.0│ │ 45.9│ │ │ │ │ │ │ BABIES OF FOREIGN │ │ │ │ │ │ MOTHERS. │ │ │ │ │ │ │ │ │ │ │ │ Total number │ 691│ 648│ 43│ 62.2│ 111│ 171.3 ═══════════════════════╪═══════╪═══════╪══════╪═══════╪══════╪═════════ Male: │ │ │ │ │ │ Number │ 380│ 355│ 25│ 65.8│ 59│ 166.2 Per cent. │ 55.0│ 54.8│ 58.1│ │ 53.2│ Female: │ │ │ │ │ │ Number │ 311│ 293│ 18│ 57.9│ 52│ 177.5 Per cent. │ 45.0│ 45.2│ 41.9│ │ 46.8│ ───────────────────────┴───────┴───────┴──────┴───────┴──────┴─────────

MOTHER’S HOUSEHOLD DUTIES, CESSATION AND RESUMPTION OF

The extent to which the native and foreign mothers in Johnstown relinquished a part of their household duties as the time for their confinement approached is shown below:

TABLE 26.—DISTRIBUTION OF BIRTHS ACCORDING TO TIME OF THE MOTHER’S RELINQUISHMENT OF PART OF HOUSEHOLD DUTIES BEFORE CONFINEMENT, BY NATIVITY OF MOTHER.

════════════════════════════════════════════╤════════╤════════╤════════ TIME OF RELINQUISHMENT OF PART OF HOUSEHOLD │ All │ To │ To DUTIES BEFORE CONFINEMENT. │births. │ native │foreign │ │mothers.│mothers. ────────────────────────────────────────────┼────────┼────────┼──────── All mothers │ 1,551│ 860│ 691 ════════════════════════════════════════════╪════════╪════════╪════════ No household duties relinquished to day of │ 1,350│ 695│ 655 confinement │ │ │ Part of duties relinquished: │ │ │ Less than 7 days before confinement │ 3│ 1│ 2 7 to 13 days before confinement │ 7│ 5│ 2 2 weeks to 1 month before confinement │ 16│ 12│ 4 1 month or more before confinement │ 174│ 146│ 28 Had no household duties │ 1│ 1│ ────────────────────────────────────────────┴────────┴────────┴────────

Among the 174 babies of mothers who relinquished part of their household duties a month before confinement, the infant mortality rate was 112.5, as compared with 136.7 for those of other mothers.

TABLE 27.—DISTRIBUTION OF BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE, ACCORDING TO TIME OF RELINQUISHMENT OF PART OF HOUSEHOLD DUTIES OF MOTHER BEFORE CONFINEMENT.

══════════════════════════════════╤════════╤════════╤════════╤═════════ TIME OF RELINQUISHMENT OF PART OF │ │ │ Deaths │ Infant HOUSEHOLD DUTIES BEFORE │ All │ Live │ during │mortality CONFINEMENT. │births. │births. │ first │ rate. │ │ │ year. │ ──────────────────────────────────┼────────┼────────┼────────┼───────── All mothers │ 1,551│ 1,463│ 196│ 134.0 ══════════════════════════════════╪════════╪════════╪════════╪═════════ No cessation or less than 1 month │ 1,376│ 1,302│ 178│ 136.7 1 month or more │ 171│ 160│ 18│ 112.5 No housework │ 1│ 1│ │ ──────────────────────────────────┴────────┴────────┴────────┴─────────

To what extent the relinquishment of household duties at a given time directly affected the health of the child can not be definitely shown. A relation may exist, but on the other hand the difference in the mortality rate may be due to the fact that the mothers could afford to give consideration to their condition and escape some of their heaviest tasks as their pregnancy approached its end, and were members of families who were thoughtful of them and relieved them of these tasks or employed extra household assistance at such times.

Another indication of intelligence and of comfortable surroundings is the care given a mother in the early days of her baby’s life, particularly if she is a nursing mother. The duration of her rest period before the resumption of part of her household duties is one measure of this. The foreign mothers, with less education, more numerous and arduous tasks, less opportunity for leisure, and smaller incomes, begin to resume their housework sooner than the native mothers with young babies.

TABLE 28.—DISTRIBUTION OF LIVE BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE, ACCORDING TO TIME OF MOTHER RESUMING PART OF HOUSEHOLD DUTIES AFTER CONFINEMENT, BY NATIVITY OF MOTHER.

═══════════════════════════╤══════════════════════════╤════════════════ TIME OF RESUMING PART OF │ │ DEATHS DURING HOUSEHOLD DUTIES AFTER │ LIVE BIRTHS TO— │ FIRST YEAR. CONFINEMENT. │ │ ───────────────────────────┼────────┬────────┬────────┼──────┬───────── │ All │ Native │Foreign │ │ Infant │mothers.│mothers.│mothers.│Total.│mortality │ │ │ │ │ rate. ───────────────────────────┼────────┼────────┼────────┼──────┼───────── Total │ 1,463│ 815│ 648│ 196│ 134.0 ═══════════════════════════╪════════╪════════╪════════╪══════╪═════════ 8 days or less │ 467│ 44│ 423│ 79│ 169.2 9 to 13 days │ 560│ 446│ 114│ 70│ 125.0 14 days or more │ 427│ 318│ 109│ 41│ 96.0 Mother died or not reported│ 9│ 7│ 2│ 6│ ([28]) ───────────────────────────┴────────┴────────┴────────┴──────┴─────────

Footnote 28:

Total number of live births less than 50; base therefore considered too small to use in computing an infant mortality rate.

The fact that a mother takes up her housework in the early days of her baby’s life does not necessarily increase the danger of its death. In some cases, however, mothers stated that the quantity of their breast milk was noticeably impaired when they got up and resumed their work too soon. Naturally this would affect the baby’s nutrition. In other cases a mother’s cares and duties may be so absorbing that she can not give the baby full attention. Whatever the exact explanation, attention should be called to the greater frequency of infant deaths when the mother resumed household duties very soon after childbirth.

A statement of the time of the mother’s resumption of household duties in full, like that giving the time of resumption in part, shows that the native mothers have the longer period of rest.

TABLE 29.—DISTRIBUTION OF LIVE BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE, ACCORDING TO TIME OF MOTHER RESUMING ALL HOUSEHOLD DUTIES AFTER CONFINEMENT, BY NATIVITY OF MOTHER.

═══════════════════════════╤══════════════════════════╤════════════════ TIME OF RESUMING ALL │ │ DEATHS DURING HOUSEHOLD DUTIES AFTER │ LIVE BIRTHS TO— │ FIRST YEAR. CONFINEMENT. │ │ ───────────────────────────┼────────┬────────┬────────┼──────┬───────── │ All │ Native │Foreign │ │ Infant │mothers.│mothers.│mothers.│Total.│mortality │ │ │ │ │ rate. ───────────────────────────┼────────┼────────┼────────┼──────┼───────── Total │ 1,463│ 815│ 648│ 196│ 134.0 ═══════════════════════════╪════════╪════════╪════════╪══════╪═════════ 8 days or less │ 219│ 13│ 206│ 37│ 168.9 9 to 13 days │ 182│ 132│ 50│ 30│ 164.8 14 days or more │ 1,053│ 663│ 390│ 123│ 116.8 Mother died or not reported│ 9│ 7│ 2│ 6│ ([29]) ───────────────────────────┴────────┴────────┴────────┴──────┴─────────

Footnote 29:

Total live births less than 50; base therefore considered too small to use in computing an infant mortality rate.

The infant mortality rates for all mothers in the group just referred to, according to the time of resuming housework in full after childbirth, show fewer infant deaths proportionately when the mother has had a longer rest; that is, a rest of two weeks or more.

ECONOMIC FACTORS

EARNINGS OF FATHER

A grouping of babies according to the income of the father shows the greatest incidence of infant deaths where wages are lowest, and the smallest incidence where they are highest, indicating clearly the relation between low wages and ill health and infant deaths.

For all live babies born in wedlock the infant mortality rate is 130.7. It rises to 255.7 when the father earns less than $521 a year or less than $10 a week, and falls to 84 when he earns $1,200 or more or if his earnings are “ample.”[30] The variation in the infant mortality rate from one earnings group to another is not perfectly regular and consistent, but if any two or more consecutive groups are combined an invariable lowering of the infant mortality rate from one such combined group to that next higher results.

Footnote 30:

“Ample” as used in this report has a somewhat arbitrary meaning. When information concerning the father’s earnings was not available and the family showed no evidences of actual poverty, the word “ample” was used. If no information concerning earnings was available when, on the other hand, the family was clearly in a state of abject poverty, then the income was tabulated as “Under $521.”

TABLE 30.—DISTRIBUTION OF LIVE BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE, ACCORDING TO ANNUAL EARNINGS OF FATHER AND NATIVITY OF MOTHER, FOR LEGITIMATE LIVE-BORN BABIES.

═════════════════════════════════════════╤═════════╤═════════╤═════════ │ Total │ Deaths │ Infant ANNUAL EARNINGS OF FATHER ACCORDING TO │ live │ during │mortality NATIVITY OF WIFE. │ births. │ first │ rate. │ │ year. │ ─────────────────────────────────────────┼─────────┼─────────┼───────── Total │ 1,431│ 187│ 130.7 ═════════════════════════════════════════╪═════════╪═════════╪═════════ Under $625 │ 384│ 82│ 213.5 ─────────────────────────────────────────┼─────────┼─────────┼───────── Under $521 │ 219│ 56│ 255.7 $521 to $624 │ 165│ 26│ 157.6 │ │ │ $625 to $899 │ 385│ 47│ 122.1 ─────────────────────────────────────────┼─────────┼─────────┼───────── $625 to $779 │ 224│ 24│ 107.1 $780 to $899 │ 161│ 23│ 142.9 │ │ │ $900 or more │ 186│ 18│ 96.8 ─────────────────────────────────────────┼─────────┼─────────┼───────── $900 to $1,199 │ 138│ 14│ 101.4 $1,200 or more │ 48│ 4│ 83.3 │ │ │ Ample[1] │ 476│ 40│ 84.0 │ │ │ Husbands with native wives │ 785│ 76│ 96.8 ═════════════════════════════════════════╪═════════╪═════════╪═════════ Under $625 │ 80│ 16│ 200.0 ─────────────────────────────────────────┼─────────┼─────────┼───────── Under $521 │ 32│ 9│ ([31]) $521 to $624 │ 48│ 7│ 145.8 │ │ │ $625 to $899 │ 193│ 20│ 103.6 ─────────────────────────────────────────┼─────────┼─────────┼───────── $625 to $779 │ 86│ 6│ 69.8 $780 to $899 │ 107│ 14│ 130.8 │ │ │ $900 or more │ 129│ 10│ 77.5 ─────────────────────────────────────────┼─────────┼─────────┼───────── $900 to $1,199 │ 92│ 7│ 76.1 $1,200 of more │ 37│ 3│ ([31]) │ │ │ Ample[1] │ 383│ 30│ 78.3 │ │ │ Husbands with foreign wives │ 646│ 111│ 171.8 ═════════════════════════════════════════╪═════════╪═════════╪═════════ Under $625 │ 304│ 66│ 217.1 ─────────────────────────────────────────┼─────────┼─────────┼───────── Under $521 │ 187│ 47│ 251.3 $521 to $624 │ 117│ 19│ 162.4 │ │ │ $625 to $899 │ 192│ 27│ 140.6 ─────────────────────────────────────────┼─────────┼─────────┼───────── $625 to $779 │ 138│ 18│ 130.4 $780 to $899 │ 54│ 9│ 166.7 │ │ │ $900 or more │ 57│ 8│ 140.6 ─────────────────────────────────────────┼─────────┼─────────┼───────── $900 to $1,199 │ 46│ 7│ 152.2 $1,200 or more │ 11│ 1│ ([31]) │ │ │ Ample[32] │ 93│ 10│ 107.5 ─────────────────────────────────────────┴─────────┴─────────┴─────────

Footnote 31:

Total live births less than 50; base therefore considered too small to use in computing an infant mortality rate.

Footnote 32:

See note on page 45.

In considering the babies of native and of foreign mothers separately in the foregoing table, similar variations in mortality rates according to earnings of father are found, although the foreign infant death rate is higher in each group. The foreign are less numerous both actually and relatively in the higher wage groups.

The foreigners of a given wage group almost always live in a poorer neighborhood than the natives earning the same amount. The foreigners go where they find their own countrymen, most of whom are poor, and hence even those who earn a fair wage find themselves, until they become Americanized, surrounded by poor conditions and an ignorant class of people.

It is of interest to note what per cent. of the native and what per cent. of the foreign are in the several earnings groups. The next table shows this for all married mothers and not simply for those of live-born babies as in the foregoing table.

TABLE 31.—NUMBER AND PER CENT OF MOTHERS BY NATIVITY, ACCORDING TO THE ANNUAL EARNINGS OF HUSBAND.

═════════════════╤═════════════════╤═════════════════╤═════════════════ ANNUAL EARNING OF│ ALL MOTHERS. │ NATIVE MOTHERS. │FOREIGN MOTHERS. HUSBAND. │ │ │ ─────────────────┼────────┬────────┼────────┬────────┼────────┬──────── │Number. │ Per │Number. │ Per │Number. │ Per │ │ cent. │ │ cent. │ │ cent. ─────────────────┼────────┼────────┼────────┼────────┼────────┼──────── Total │ 1,491│ 100.0│ 816│ 100.0│ 675│ 100.0 ═════════════════╪════════╪════════╪════════╪════════╪════════╪════════ Under $521 │ 233│ 15.6│ 36│ 4.4│ 197│ 29.2 $521 to $624 │ 174│ 11.7│ 50│ 6.1│ 124│ 18.4 $625 to $779 │ 229│ 15.4│ 86│ 10.5│ 143│ 21.2 $780 to $899 │ 166│ 11.1│ 108│ 13.2│ 58│ 8.6 $900 to $1,199 │ 146│ 9.8│ 98│ 12.0│ 48│ 7.1 $1,200 and over │ 50│ 3.4│ 39│ 4.8│ 11│ 1.6 Ample[33] │ 493│ 33.1│ 399│ 48.9│ 94│ 13.9 ─────────────────┴────────┴────────┴────────┴────────┴────────┴────────

Footnote 33:

See note on page 45.

The 1,491 married mothers included in the foregoing table bore 1,517 babies in 1911, the excess being due to plural births. The 33 unmarried mothers and their 34 babies (one mother had twins), although included in some of the general tables, are not included in those relative to the earnings of the husband.

GAINFUL WORK OF MOTHER

In localities where large numbers of women are engaged in industrial work, comparisons are frequently made of the death rates among their babies with those of the babies of mothers not so engaged. In Johnstown, however, industrial occupations are not open to women, and but 3.1 per cent. of the mothers visited went outside their homes to earn money. All mothers who gained money by keeping lodgers or in any other way are, for convenience, designated “wage-earning” mothers, even though their earnings were not in the form of a definite wage at stated periods.

Although not industrially engaged, nearly one-fifth of the mothers did resort to some means of supplementing the earnings of their husbands. Usually they kept lodgers. This was done by the foreign mothers principally, exactly one-third of whom had lodgers, as compared with less than 1 per cent. of the native women. Usually work done outside the home consisted either of char work or of assisting husbands in their stores. Generally these stores were in the same building with the home.

When a mother of a young baby does not give her full time to her duties within the home but resorts to means of earning money, it generally indicates poverty. This is true to a greater degree in Johnstown than in places which have many inducements for women to work. In Johnstown, with its excess of males, especially in the foreign population, the woman’s services are particularly needed to make the home.

In the group where the husband earns $10 a week or less—that is, under $521 a year—many of the women are wage earners. In each group showing better earnings for the husband the number and percentage of wage-earning wives decline. Such a tabulation as the following almost automatically fixes the minimum wage on which a man, wife, and a child or two can live with any degree of comfort in Johnstown at about $780 a year. When the husband’s wage is less than $780 a year, it is shown that the wives, in considerable number, must be wage earners. As shown in the next table, in nearly half of the families where the husband earns $10 a week or less (less than $521 a year), the wife resorted to some means of earning money; when he earned as much as $900 a year, only 8.9 per cent. of the wives worked, and in the small group where the man earns as much as $1,200 a year, only 1 in 50.

TABLE 32.—NUMBER AND PER CENT OF HUSBANDS WITH WAGE-EARNING WIVES, BY NATIVITY OF WIFE AND ANNUAL EARNINGS OF HUSBAND.

═══════════════╤══════════════════════════╤══════════════════════════ │ TOTAL HUSBANDS. │ HUSBANDS HAVING NATIVE │ │ WIVES. ───────────────┼────────┬─────────────────┼────────┬───────────────── ANNUAL EARNINGS│ │ Husbands with │ │ Husbands with OF HUSBAND. │Number. │ wage-earning │Number. │ wage-earning │ │ wives. │ │ wives. ───────────────┼────────┼────────┬────────┼────────┼────────┬──────── │ │Number. │ Per │ │Number. │ Per │ │ │ cent. │ │ │ cent. ───────────────┼────────┼────────┼────────┼────────┼────────┼──────── Total │ 1,491│ 278│ 18.6│ 816│ 26│ 3.2 ═══════════════╪════════╪════════╪════════╪════════╪════════╪════════ Under $521 │ 233│ 111│ 47.6│ 36│ 9│ 25.0 $521 to $624 │ 174│ 57│ 32.8│ 50│ 3│ 6.0 $625 to $779 │ 229│ 51│ 22.3│ 86│ 4│ 4.7 $780 to $899 │ 166│ 25│ 15.1│ 108│ 6│ 5.6 $900 to $1,199 │ 146│ 13│ 8.9│ 98│ 1│ 1.0 $1,200 and over│ 50│ 1│ 2.0│ 39│ │ “Ample”[34] │ 493│ 20│ 4.1│ 399│ 3│ .8 ───────────────┴────────┴────────┴────────┴────────┴────────┴────────

═══════════════╤══════════════════════════ │ HUSBANDS HAVING FOREIGN │ WIVES. ───────────────┼────────┬───────────────── ANNUAL EARNINGS│ │ Husbands with OF HUSBAND. │Number. │ wage-earning │ │ wives. ───────────────┼────────┼────────┬──────── │ │Number. │ Per │ │ │ cent. ───────────────┼────────┼────────┼──────── Total │ 675│ 252│ 37.3 ═══════════════╪════════╪════════╪════════ Under $521 │ 197│ 102│ 51.8 $521 to $624 │ 124│ 54│ 43.5 $625 to $779 │ 143│ 47│ 32.9 $780 to $899 │ 58│ 19│ 32.8 $900 to $1,199 │ 48│ 12│ 25.0 $1,200 and over│ 11│ 1│ 9.1 “Ample”[34] │ 94│ 17│ 18.1 ───────────────┴────────┴────────┴──────── Footnote 34:

See note on page 45.

It is impossible to judge from statistics alone whether or not the work done by an individual woman, either her own housework or work for money, is so excessive as to affect her during pregnancy or while nursing to the extent of reacting on the health of the baby; but the fact is that the infant mortality rate is higher among the babies of wage-earning mothers than among others, being 188 as compared with a rate of 117.6 among the babies of nonwage-earning mothers. Wage-earning mothers and low-wage fathers are in practically the same groups, and it is difficult to secure an exact measurement of the comparative weight of the two factors in the production of a high infant mortality rate.

TABLE 33.—DISTRIBUTION OF LIVE BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE FOR BABIES OF WAGE-EARNING AND NONWAGE-EARNING MOTHERS, ACCORDING TO ANNUAL EARNINGS OF FATHER.

═════════════════╤═════════════════╤═════════════════╤═════════════════ ANNUAL EARNINGS │ MOTHER A WAGE │MOTHER NOT A WAGE│INFANT MORTALITY OF FATHER. │ EARNER. │ EARNER. │ RATE. ─────────────────┼────────┬────────┼────────┬────────┼────────┬──────── │ │ Number │ │ Number │ │ Mother │ Live │ of │ Live │ of │Mother a│ not a │births. │ deaths │births. │ deaths │ wage │ wage │ │in first│ │in first│earner. │earner. │ │ year. │ │ year. │ │ ─────────────────┼────────┼────────┼────────┼────────┼────────┼──────── Total │ 266│ 50│ 1,165│ 137│ 188.0│ 117.6 ═════════════════╪════════╪════════╪════════╪════════╪════════╪════════ Under $521 │ 105│ 26│ 114│ 30│ 247.6│ 263.2 $521 to $624 │ 53│ 8│ 112│ 18│ 150.9│ 160.7 $625 to $779 │ 48│ 6│ 176│ 18│ 127.1│ 102.3 $780 or over, or │ 60│ 10│ 763│ 71│ 166.7│ 93.1 “ample”[35] │ │ │ │ │ │ ─────────────────┴────────┴────────┴────────┴────────┴────────┴────────

Footnote 35:

See note on page 45.

ILLEGITIMACY

Of the 1,551 birth included in this investigation 34, or 2.2 per cent., occurred out of wedlock. Nine of the 32 illegitimate babies who were born alive died during their first year. It is recognized that these figures are a very small base from which to draw conclusions concerning the effect of illegitimacy on the infant mortality rate. It is of interest, nevertheless, to note that the findings for this small group are similar to those of countries which compute an infant mortality rate for legitimate and illegitimate children separately, that is, a rate for illegitimates more than twice as high as for children born in wedlock.

TABLE 34.—DISTRIBUTION OF BIRTHS AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE, ACCORDING TO LEGITIMACY.

════════════════════════╤═════════╤═════════╤══════════════════════════ LEGITIMACY. │ Total │ Live │DEATHS DURING FIRST YEAR. │ births. │ births. │ ────────────────────────┼─────────┼─────────┼─────────┬──────────────── │ │ │ Number. │Infant mortality │ │ │ │ rates. ────────────────────────┼─────────┼─────────┼─────────┼──────────────── Illegitimate │ 34│ 32│ 9│ 281.3 Legitimate │ 1,517│ 1,431│ 187│ 130.7 ────────────────────────┴─────────┴─────────┴─────────┴────────────────

Thirty-two, or 3.7 per cent., of the 860 native mothers, as compared with 2, or 0.3 per cent., of the 691 foreign mothers visited, had illegitimate children in 1911.

REPRODUCTIVE HISTORIES

In addition to the data relating exclusively to babies born in 1911, a statement was secured from each mother as to the number and duration of each of her pregnancies and the result thereof; that is, the number of children she had borne, alive or dead, the number of miscarriages she had had, and the age at death of each live-born child who had died. Although this information was secured for all mothers, tabulations are presented of the data furnished by married mothers only. Comparatively few single mothers reported more than one child, and information from them on this point is not believed to be as reliable as that from married mothers.

The 1,491 married mothers of babies born in 1911 had had an aggregate of 5,554 pregnancies, resulting in 5,617 births, the excess of 63 births over pregnancies being due to plural births. Eight hundred and four of these children died under 1 year of age, making an infant mortality rate of 149.9 for all their babies, as compared with the rate of 134 for those born in 1911. The stillbirths of these women numbered 194, or 4.5 per cent. of the total number of births; miscarriages reported numbered 191, but these were not added to the total reportable[36] pregnancies.

Footnote 36:

“Reportable” pregnancies are those terminating either in the birth of a live child or of a dead child when the period of gestation exceeds 28 weeks; that is, when its registration or report is required by law.

Details as to the infant mortality rates for all babies born to native and foreign mothers included in this study, not only in the year 1911 but at any other time, are presented in the next table, which classifies the babies according to the total number of reportable pregnancies that their mothers had had, to and including the pregnancy resulting in the 1911 birth.

TABLE 35.—DISTRIBUTION OF MOTHERS, OF LIVE BIRTHS, AND OF DEATHS DURING FIRST YEAR, AND INFANT MORTALITY RATE FOR BABIES OF NATIVE AND FOREIGN MARRIED MOTHERS, ACCORDING TO THE NUMBER OF REPORTABLE PREGNANCIES.

═════════════════╤════════╤═════════════════╤══════════════════════════ REPORTABLE │ Number │ │ PREGNANCIES FOR │ of │NUMBER OF BABIES.│ INFANT MORTALITY RATE MARRIED MOTHERS. │married │ │ AMONG BABIES OF— │mothers.│ │ ─────────────────┼────────┼────────┬────────┼────────┬────────┬──────── │ │ Born │Died in │ All │ Native │Foreign │ │ alive. │ first │mothers.│mothers.│mothers. │ │ │ year. │ │ │ ─────────────────┼────────┼────────┼────────┼────────┼────────┼──────── Total │ 1,491│ 5,363│ 804│ 149.9│ 113.1│ 184.6 ═════════════════╪════════╪════════╪════════╪════════╪════════╪════════ 1 │ 339│ 322│ 35│ 108.7│ 75.9│ 183.7 2 │ 283│ 544│ 59│ 108.5│ 76.5│ 156.7 3 │ 214│ 626│ 92│ 147.0│ 118.0│ 177.6 4 │ 186│ 723│ 78│ 107.9│ 99.4│ 116.3 5 │ 147│ 704│ 103│ 146.3│ 86.1│ 191.5 6 │ 94│ 546│ 88│ 161.2│ 157.4│ 163.6 7 │ 83│ 555│ 78│ 140.5│ 100.0│ 173.8 8 │ 54│ 426│ 95│ 223.0│ 157.6│ 272.7 9 │ 33│ 283│ 41│ 144.9│ 128.4│ 155.2 10 or more │ 58│ 634│ 135│ 212.9│ 164.5│ 257.6 ─────────────────┴────────┴────────┴────────┴────────┴────────┴────────

The statistics, based upon the results of all her reportable pregnancies, show a generally higher infant mortality rate where the mother has had many pregnancies, but there is not always an increase from one pregnancy to the next. This is more clearly shown when the pregnancies are grouped as in the next table.

TABLE 36.—INFANT MORTALITY RATE FOR ALL CHILDREN BORNE BY MARRIED MOTHERS, ACCORDING TO SPECIFIED NUMBER OF REPORTABLE PREGNANCIES.

════════════════════════════════════════════════╤══════════════════════ REPORTABLE PREGNANCIES FOR MARRIED MOTHERS. │Infant mortality rate. ────────────────────────────────────────────────┼────────────────────── Total │ 149.9 ════════════════════════════════════════════════╪══════════════════════ 1 and 2 │ 108.5 3 and 4 │ 126.0 5 and 6 │ 152.8 7 and 8 │ 176.4 9 or more │ 191.9 ────────────────────────────────────────────────┴──────────────────────

This tendency is shown in still another form of summary: Combinations of four or less pregnancies are, for convenience, considered as group 1, while the combinations of over four are designated group 2. The differences in rates in the two groups are notable. The infant mortality rate is much lower for the first than for the second group.

TABLE 37.—INFANT MORTALITY RATE FOR ALL CHILDREN BORNE BY MARRIED MOTHERS, ACCORDING TO SPECIFIED NUMBER OF REPORTABLE PREGNANCIES, BY GROUPS

════════════════════════════════════════════════╤══════════════════════ REPORTABLE PREGNANCIES FOR MARRIED MOTHERS. │Infant mortality rate. ────────────────────────────────────────────────┼────────────────────── │ GROUP 1. │ │ 2 or less │ 108.5 3 or less │ 124.7 4 or less │ 119.2 │ GROUP 2. │ │ Over 4 │ 171.5 Over 5 │ 178.8 Over 6 │ 183.9 ────────────────────────────────────────────────┴──────────────────────

This influence of the size of the family upon the infant mortality rate is shown in the computations giving the relative infant mortality rate for the different children borne by married mothers. The rate is most favorable for the second-born child, being 131.2. Among first born it is 143.6; for tenth or later born children 252.3.

TABLE 38.—INFANT MORTALITY RATE FOR ALL CHILDREN BORNE BY MARRIED MOTHERS, ACCORDING TO THE ORDER IN WHICH THE CHILD WAS BORN

════════════════════════════════════════════════╤══════════════════════ ORDER OF BIRTH. │Infant mortality rate. ────────────────────────────────────────────────┼────────────────────── First-born child │ 143.6 Second-born child │ 131.2 ────────────────────────────────────────────────┼────────────────────── First and second born children │ 138.3 ════════════════════════════════════════════════╪══════════════════════ Third-born child │ 144.2 Fourth-born child │ 142.0 ────────────────────────────────────────────────┼────────────────────── Third and fourth born children │ 143.2 ════════════════════════════════════════════════╪══════════════════════ Fifth-born child │ 178.1 Sixth-born child │ 175.5 ────────────────────────────────────────────────┼────────────────────── Fifth and sixth born children │ 177.0 ════════════════════════════════════════════════╪══════════════════════ Seventh-born child │ 192.1 Eighth-born child │ 165.4 ────────────────────────────────────────────────┼────────────────────── Seventh and eighth born children. │ 181.5 ════════════════════════════════════════════════╪══════════════════════ Ninth-born child │ 128.2 Tenth or later born child │ 252.3 ────────────────────────────────────────────────┼────────────────────── Ninth and later born children │ 201.1 ────────────────────────────────────────────────┴──────────────────────

The next table gives a further elaboration of the same data; that is, it shows the infant mortality rate where such rates are lowest and highest, respectively, according to the age of the mother at the child’s birth and the order in which the child was born. Attention is again directed to the fact that the statistics presented in this section on “Reproductive histories” are based upon the total number of reportable pregnancies; that is, in addition to the pregnancies resulting in births in 1911, all prior pregnancies of the women considered in the investigation have been included.

TABLE 39.—LOWEST AND HIGHEST INFANT MORTALITY RATES, ACCORDING TO AGE OF MOTHER AT BIRTH OF CHILD AND THE ORDER IN WHICH CHILD WAS BORN.

═══════════════════════╤═══════════════════════════════════════════════ ORDER OF BIRTH. │ INFANT MORTALITY RATES, ACCORDING TO MOTHER’S │ AGE. ───────────────────────┼───────────────────────┬─────────────────────── │ Lowest mortality. │ Highest mortality. ───────────────────────┼───────────┬───────────┼───────────┬─────────── │ Mother’s │ Mortality │ Mother’s │ Mortality │ age. │ rate. │ age. │ rate. ───────────────────────┼───────────┼───────────┼───────────┼─────────── All children │ 20–24│ 140.0│ Under 17│ 367.3 ═══════════════════════╪═══════════╪═══════════╪═══════════╪═══════════ First child │ 25–29│ 92.1│ 17–19│ 190.4 Second child │ 25–29│ 100.3│ 17–19│ 178.6 Third child │ 30–39│ 106.4│ 25–29│ 160.8 Fourth child │ 30–39│ 122.4│ 20–24│ 155.0 Fifth child │ 30–39│ 105.8│ 25–29│ 236.6 Sixth child │ 30–39│ 164.8│ 25–29│ 171.4 ───────────────────────┴───────────┴───────────┴───────────┴───────────

The difference in size of family for native and foreign mothers of different ages are indicated in the next table. The total and average number of live-born children, not reportable pregnancies, are given.

TABLE 40.—TOTAL AND AVERAGE NUMBER OF LIVE-BORN CHILDREN BORNE BY MARRIED MOTHERS HAVING EITHER A LIVE BIRTH OR A STILLBIRTH IN 1911, CLASSIFIED BY NATIVITY AND AGE OF MOTHER.

══════════════════╤══════════════════════════╤══════════════════════════ │ ALL MARRIED MOTHERS. │ NATIVE MARRIED MOTHERS. ──────────────────┼────────┬─────────────────┼────────┬───────────────── AGE OF MOTHER AT │ │ Live-born │ │ Live-born BIRTH OF CHILD IN │ Total. │ children. │ Total. │ children. 1911. │ │ │ │ ──────────────────┼────────┼────────┬────────┼────────┼────────┬──────── │ │Number. │Average.│ │Number. │Average. ──────────────────┼────────┼────────┼────────┼────────┼────────┼──────── All ages │ 1,465│ 5,363│ 3.7│ 801│ 2,600│ 3.2 ══════════════════╪════════╪════════╪════════╪════════╪════════╪════════ Under 20 years │ 81│ 96│ 1.2│ 62│ 70│ 1.1 20 to 24 years │ 456│ 908│ 2.0│ 258│ 483│ 1.9 25 to 29 years │ 389│ 1,261│ 3.2│ 196│ 536│ 2.7 30 to 39 years │ 459│ 2,480│ 5.4│ 240│ 1,188│ 5.0 40 years and over.│ 80│ 618│ 7.7│ 45│ 323│ 7.2 ──────────────────┴────────┴────────┴────────┴────────┴────────┴────────

══════════════════╤══════════════════════════ │ FOREIGN MARRIED MOTHERS. ──────────────────┼────────┬───────────────── AGE OF MOTHER AT │ │ Live-born BIRTH OF CHILD IN │ Total. │ children. 1911. │ │ ──────────────────┼────────┼────────┬──────── │ │Number. │Average. ──────────────────┼────────┼────────┼──────── All ages │ 664│ 2,763│ 4.2 ══════════════════╪════════╪════════╪════════ Under 20 years │ 19│ 26│ 1.4 20 to 24 years │ 198│ 425│ 2.1 25 to 29 years │ 193│ 725│ 3.8 30 to 39 years │ 219│ 1,292│ 5.9 40 years and over.│ 35│ 295│ 8.4 ──────────────────┴────────┴────────┴────────

The next table shows all losses of pregnancy sustained by 628 mothers and the rate of loss per 1,000 births for mothers having different numbers of births or reportable pregnancies. For all mothers it was 188.4. “Loss,” as here used, means the sum of infant deaths (or deaths in first year) and stillbirths.

TABLE 41.—AGGREGATE NUMBER OF BIRTHS, LOSSES, AND RATE OF LOSS PER 1,000 BIRTHS, ACCORDING TO NUMBER OF BIRTHS PER MOTHER.

══════════════════════════╤══════════════╤══════════════╤══════════════ NUMBER OF BIRTHS PER │ Aggregate │ Aggregate │ Rate of loss MOTHER. │ number of │ number of │ per 1,000 │ births. │ losses. │ births. ──────────────────────────┼──────────────┼──────────────┼────────────── Total │ 5,617│ 1,058│ 188.4 ══════════════════════════╪══════════════╪══════════════╪══════════════ 1 │ 335│ 53│ 158.6 2 │ 554│ 87│ 157.0 3 │ 648│ 113│ 174.4 4 │ 748│ 109│ 145.7 5 │ 740│ 133│ 179.7 6 │ 576│ 119│ 206.6 7 │ 574│ 104│ 181.2 8 │ 432│ 102│ 236.1 9 │ 324│ 65│ 200.6 10 or more │ 686│ 173│ 252.2 ──────────────────────────┴──────────────┴──────────────┴──────────────

The influence of the economic factor on infant mortality among the babies born prior to 1911 can not be determined with exactness, as no inquiry was made concerning earnings of the father when the other children were born. But it is believed that his earnings during the year following the birth of the 1911 baby can be regarded as an index of the economic standing of the family for some time past. In individual cases, of course, revolutionary changes in the family’s income may have occurred, but for the great mass of people in the group considered it is not likely that within such a short space of time as that covered by the child-bearing period of the women considered—most of whom had not had numerous pregnancies—marked changes had taken place. If these known earnings are accepted as an index, the following variations are found to occur in the infant mortality rate for all the babies of whom a record was secured:

TABLE 42.—INFANT MORTALITY RATE FOR ALL CHILDREN OF MARRIED MOTHERS INCLUDED IN THIS INVESTIGATION, DISTRIBUTED ACCORDING TO THE FATHER’S EARNINGS.

══════════════════════════════════════════╤════════════════════════════ FATHER’S ANNUAL EARNINGS. │ Infant mortality rate. ──────────────────────────────────────────┼──────────────────────────── Under $521 │ 197.3 $521 to $624 │ 193.1 $625 to $779 │ 163.1 $780 to $899 │ 168.4 $900 to $1,199 │ 142.2 $1,200 and over │ 102.2 ──────────────────────────────────────────┴────────────────────────────

The infant mortality rate for the babies whose fathers earn under $521 is almost twice as great as for those born into families in the most prosperous group. These figures strengthen the conclusion reached in the study of the babies born in 1911, namely that the economic factor is of far-reaching importance in determining the baby’s chance of life.

TABLE V.—DISTRIBUTION OF LIVE BIRTHS AND OF DEATHS DURING FIRST YEAR, ACCORDING TO NUMBER OF PERSONS AND NUMBER OF ROOMS PER FAMILY.

═════════════════╤═════════════════════════════════════ │NUMBER OF BABIES WHO WERE BORN ALIVE │AND NUMBER OF SUCH BABIES WHO DIED │DURING FIRST YEAR IN HOMES HAVING— ─────────────────┼───────┬─────┬─────┬─────┬─────┬───── PERSONS PER │ All │ │ │ │ │ FAMILY (NOT │ live │ 1 │ 2 │ 3 │ 4 │ 5 INCLUDING BABY). │ born │room │rooms│rooms│rooms│rooms │babies.│ │ │ │ │ ─────────────────┼───────┼─────┼─────┼─────┼─────┼───── {Births│ 1,463│ 33│ 165│ 147│ 526│ 222 Total {Deaths│ 196│ 3│ 29│ 24│ 79│ 20 ═════════════════╪═══════╪═════╪═════╪═════╪═════╪═════ {Births│ 24│ 3│ 7│ 4│ 6│ 2 2 {Deaths│ 19│ 1│ 5│ 4│ 6│ 1 │ │ │ │ │ │ {Births│ 275│ 14│ 46│ 35│ 96│ 29 3 {Deaths│ 31│ │ 5│ 4│ 12│ 2 │ │ │ │ │ │ {Births│ 234│ 7│ 44│ 20│ 83│ 40 4 {Deaths│ 30│ 1│ 12│ 5│ 9│ 2 │ │ │ │ │ │ {Births│ 229│ │ 27│ 24│ 88│ 31 5 {Deaths│ 22│ │ 1│ 6│ 9│ 1 │ │ │ │ │ │ {Births│ 182│ 2│ 21│ 17│ 56│ 37 6 {Deaths│ 18│ │ 4│ │ 8│ 2 │ │ │ │ │ │ {Births│ 164│ 2│ 10│ 20│ 50│ 32 7 {Deaths│ 15│ │ 1│ 2│ 6│ 1 │ │ │ │ │ │ {Births│ 107│ 2│ 5│ 14│ 37│ 16 8 {Deaths│ 17│ │ │ 2│ 6│ 3 │ │ │ │ │ │ {Births│ 79│ 2│ 2│ 6│ 27│ 13 9 {Deaths│ 8│ 1│ │ │ 2│ 2 │ │ │ │ │ │ {Births│ 58│ 1│ 1│ 2│ 26│ 7 10 {Deaths│ 15│ │ │ 1│ 11│ 2 │ │ │ │ │ │ {Births│ 36│ │ 1│ 1│ 16│ 3 11 {Deaths│ 4│ │ 1│ │ 1│ 1 │ │ │ │ │ │ {Births│ 21│ │ 1│ 1│ 10│ 2 12 {Deaths│ 5│ │ │ │ 2│ 1 │ │ │ │ │ │ {Births│ 20│ │ │ 1│ 13│ 4 13 {Deaths│ 4│ │ │ │ 3│ 1 │ │ │ │ │ │ {Births│ 8│ │ │ 1│ 5│ 2 14 {Deaths│ 2│ │ │ │ 1│ 1 │ │ │ │ │ │ {Births│ 6│ │ │ │ 3│ 2 15 {Deaths│ 1│ │ │ │ │ │ │ │ │ │ │ {Births│ 4│ │ │ │ 4│ 16 {Deaths│ 2│ │ │ │ 2│ │ │ │ │ │ │ {Births│ 3│ │ │ │ 1│ 17 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ 5│ │ │ 1│ 1│ 18 {Deaths│ 1│ │ │ │ 1│ │ │ │ │ │ │ {Births│ 2│ │ │ │ 2│ 19 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ 3│ │ │ │ 1│ 1 20 {Deaths│ 1│ │ │ │ │ │ │ │ │ │ │ {Births│ 1│ │ │ │ │ 22 {Deaths│ 1│ │ │ │ │ │ │ │ │ │ │ {Births│ 1│ │ │ │ 1│ 23 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ Not {Births│ 1│ │ │ │ │ 1 reported. {Deaths│ │ │ │ │ │ ─────────────────┴───────┴─────┴─────┴─────┴─────┴─────

═════════════════╤═════════════════════════════════════ │NUMBER OF BABIES WHO WERE BORN ALIVE │AND NUMBER OF SUCH BABIES WHO DIED │DURING FIRST YEAR IN HOMES HAVING— ─────────────────┼─────┬─────┬─────┬─────┬─────┬─────── PERSONS PER │ │ │ │ │ 10 │Unknown FAMILY (NOT │ 6 │ 7 │ 8 │ 9 │rooms│number INCLUDING BABY). │rooms│rooms│rooms│rooms│ and │ of │ │ │ │ │over.│rooms. ─────────────────┼─────┼─────┼─────┼─────┼─────┼─────── {Births│ 233│ 38│ 43│ 22│ 12│ 22 Total {Deaths│ 20│ 6│ 6│ 4│ 2│ 3 ═════════════════╪═════╪═════╪═════╪═════╪═════╪═══════ {Births│ │ │ │ │ │ 2 2 {Deaths│ │ │ │ │ │ 2 │ │ │ │ │ │ {Births│ 37│ 4│ 6│ 1│ │ 7 3 {Deaths│ 3│ 3│ 2│ │ │ │ │ │ │ │ │ {Births│ 23│ 4│ 5│ 2│ 2│ 4 4 {Deaths│ │ │ │ │ 1│ │ │ │ │ │ │ {Births│ 43│ 4│ 5│ 1│ 1│ 5 5 {Deaths│ 4│ │ 1│ │ │ │ │ │ │ │ │ {Births│ 34│ 5│ 7│ 2│ │ 1 6 {Deaths│ 3│ │ 1│ │ │ │ │ │ │ │ │ {Births│ 30│ 9│ 6│ 3│ 1│ 1 7 {Deaths│ 3│ 1│ │ 1│ │ │ │ │ │ │ │ {Births│ 18│ 4│ 6│ 2│ 3│ 8 {Deaths│ 1│ 2│ 1│ 1│ 1│ │ │ │ │ │ │ {Births│ 13│ 6│ 2│ 4│ 4│ 9 {Deaths│ 1│ │ │ 2│ │ │ │ │ │ │ │ {Births│ 15│ 1│ 1│ 3│ │ 1 10 {Deaths│ 1│ │ │ │ │ │ │ │ │ │ │ {Births│ 10│ │ 3│ 2│ │ 11 {Deaths│ 1│ │ │ │ │ │ │ │ │ │ │ {Births│ 6│ │ 1│ │ │ 12 {Deaths│ 1│ │ 1│ │ │ │ │ │ │ │ │ {Births│ │ │ 1│ 1│ │ 13 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ │ │ │ │ │ 14 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ │ │ │ │ │ 1 15 {Deaths│ │ │ │ │ │ 1 │ │ │ │ │ │ {Births│ │ │ │ │ │ 16 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ 1│ │ 1│ │ │ 17 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ 1│ 1│ │ 1│ │ 18 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ │ │ │ │ │ 19 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ {Births│ 1│ │ │ │ │ 20 {Deaths│ 1│ │ │ │ │ │ │ │ │ │ │ {Births│ 1│ │ │ │ │ 22 {Deaths│ 1│ │ │ │ │ │ │ │ │ │ │ {Births│ │ │ │ │ │ 23 {Deaths│ │ │ │ │ │ │ │ │ │ │ │ Not {Births│ │ │ │ │ │ reported. {Deaths│ │ │ │ │ │ ─────────────────┴─────┴─────┴─────┴─────┴─────┴───────

TABLE VIII.—DISTRIBUTION OF DEATHS OF INFANTS AT SPECIFIED AGE, ACCORDING TO CAUSE OF DEATH OF INFANT AND NATIVITY OF MOTHER.

═══════════════╤══════╤═════════════════════════════════════════ │ │ AGE AT DEATH. ───────────────┼──────┼───────────────────────────┬───────────── │Total │ │ CAUSE OF DEATH │deaths│ │ 1 week but OF INFANT AND │under │ Less than 1 week. │ less than 1 NATIVITY OF │1 year│ │ month. MOTHER. │ of │ │ │ age. │ │ ───────────────┼──────┼──────┬──────┬──────┬──────┼──────┬────── │ │ │ │ │ │ │1 week │ │ │1 day │ │ │ │ but │ │Total.│ or │ 2 │3 to 6│Total.│ less │ │ │less. │days. │days. │ │ than │ │ │ │ │ │ │ 2. │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼────── All causes │ 196│ 45│ 30│ 4│ 11│ 29│ 14 ═══════════════╪══════╪══════╪══════╪══════╪══════╪══════╪══════ Native mothers │ 85│ 25│ 18│ 3│ 4│ 9│ 2 Foreign mothers│ 111│ 20│ 12│ 1│ 7│ 20│ 12 │ │ │ │ │ │ │ Diarrhea and │ 52│ 1│ │ │ 1│ 5│ enteritis │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ 17│ 1│ │ │ 1│ │ Foreign mothers│ 35│ │ │ │ │ 5│ │ │ │ │ │ │ │ Respiratory │ 50│ │ │ │ │ 3│ 3 diseases │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ 19│ │ │ │ │ │ Foreign mothers│ 31│ │ │ │ │ 3│ 3 │ │ │ │ │ │ │ Premature │ 24│ 21│ 19│ │ 2│ 3│ 3 births │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ 11│ 11│ 11│ │ │ │ Foreign mothers│ 13│ 10│ 8│ │ 2│ 3│ 3 │ │ │ │ │ │ │ Congenital │ │ │ │ │ │ │ debility or │ 19│ 10│ 7│ 1│ 2│ 6│ 2 malformation │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ 5│ 4│ 3│ │ 1│ 1│ Foreign mothers│ 14│ 6│ 4│ 1│ 1│ 5│ 2 │ │ │ │ │ │ │ Injuries at │ 7│ 7│ 3│ 2│ 2│ │ birth │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ 6│ 6│ 3│ 2│ 1│ │ Foreign mothers│ 1│ 1│ │ │ 1│ │ │ │ │ │ │ │ │ Other or not │ 44│ 6│ 1│ 1│ 4│ 12│ 6 reported │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ 27│ 3│ 1│ 1│ 1│ 8│ 2 Foreign mothers│ 17│ 3│ │ │ 3│ 4│ 4 ───────────────┴──────┴──────┴──────┴──────┴──────┴──────┴──────

═══════════════╤═══════════════════════════════════════════════════════ │ AGE AT DEATH. ───────────────┼─────────────┬───────────────────────────────────────── CAUSE OF DEATH │3 weeks but │ OF INFANT AND │less than 1 │ 1 week but less than 1 month. NATIVITY OF │month. │ MOTHER. │ │ ───────────────┼──────┬──────┼──────┬──────┬──────┬──────┬──────┬────── │ 2 │ 3 │ │ 1 │ 2 │ 3 │ 6 │ │weeks │weeks │ │month │months│months│months│ 9 │ but │ but │Total.│ but │ but │ but │ but │months │ less │ less │ │ less │ less │ less │ less │ and │ than │than 1│ │ than │ than │ than │ than │over. │ 3. │month.│ │ 2. │ 3. │ 6. │ 9. │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼──────┼────── All causes │ 7│ 8│ 122│ 18│ 16│ 42│ 31│ 15 ═══════════════╪══════╪══════╪══════╪══════╪══════╪══════╪══════╪══════ Native mothers │ 1│ 6│ 51│ 9│ 7│ 18│ 12│ 5 Foreign mothers│ 6│ 2│ 71│ 9│ 9│ 24│ 19│ 10 │ │ │ │ │ │ │ │ Diarrhea and │ 3│ 2│ 46│ 5│ 4│ 17│ 15│ 5 enteritis │ │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ │ │ 16│ 3│ 1│ 5│ 5│ 2 Foreign mothers│ 3│ 2│ 30│ 2│ 3│ 12│ 10│ 3 │ │ │ │ │ │ │ │ Respiratory │ │ │ 47│ 7│ 4│ 15│ 13│ 8 diseases │ │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ │ │ 19│ 2│ 2│ 8│ 5│ 2 Foreign mothers│ │ │ 28│ 5│ 2│ 7│ 8│ 6 │ │ │ │ │ │ │ │ Premature │ │ │ │ │ │ │ │ births │ │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ │ │ │ │ │ │ │ Foreign mothers│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ Congenital │ │ │ │ │ │ │ │ debility or │ 3│ 1│ 3│ 1│ 2│ │ │ malformation │ │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ │ 1│ │ │ │ │ │ Foreign mothers│ 3│ │ 3│ 1│ 2│ │ │ │ │ │ │ │ │ │ │ Injuries at │ │ │ │ │ │ │ │ birth │ │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ │ │ │ │ │ │ │ Foreign mothers│ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ Other or not │ 1│ 5│ 26│ 5│ 6│ 10│ 3│ 2 reported │ │ │ │ │ │ │ │ ───────────────┼──────┼──────┼──────┼──────┼──────┼──────┼──────┼────── Native mothers │ 1│ 5│ 16│ 4│ 4│ 5│ 2│ 1 Foreign mothers│ │ │ 10│ 1│ 2│ 5│ 1│ 1 ───────────────┴──────┴──────┴──────┴──────┴──────┴──────┴──────┴──────

TABLE X.—DISTRIBUTION OF BIRTHS TO MARRIED WAGE-EARNING MOTHERS, ACCORDING TO HUSBAND’S ANNUAL EARNINGS AND NATIVITY AND EARNINGS OF MOTHER.

═════════════════╤═══════╤═════════════════════════════════════════════ NATIVITY AND │ │ ANNUAL EARNINGS │ Total │ BIRTHS TO MARRIED WAGE-EARNING MOTHER WITH OF MARRIED │births.│ HUSBAND EARNING ANNUALLY— MOTHER. │ │ ─────────────────┼───────┼─────┬─────┬─────┬─────┬───────┬──────┬────── │ │Under│$521 │$625 │$780 │$900 to│$1,200│Ample. │ │$521.│ to │ to │ to │$1,199.│ and │ [37] │ │ │$624.│$779.│$899.│ │over. │ ─────────────────┼───────┼─────┼─────┼─────┼─────┼───────┼──────┼────── All wage-earning │ 281│ 112│ 57│ 51│ 25│ 14│ 1│ 21 mothers │ │ │ │ │ │ │ │ ═════════════════╪═══════╪═════╪═════╪═════╪═════╪═══════╪══════╪══════ Under $53 │ 20│ 6│ 5│ 1│ 4│ 1│ —│ 3 $53 to $103 │ 57│ 23│ 12│ 11│ 7│ 3│ —│ 1 $104 to $207 │ 89│ 46│ 16│ 19│ 3│ 3│ —│ 2 $208 to $311 │ 60│ 23│ 16│ 12│ 4│ 3│ 1│ 1 $312 and over │ 46│ 14│ 8│ 8│ 7│ 2│ —│ 7 Not reported │ 9│ —│ —│ —│ —│ —│ 2│ 7 │ │ │ │ │ │ │ │ Native │ │ │ │ │ │ │ │ wage-earning │ 26│ 9│ 3│ 4│ 6│ 1│ —│ 3 mothers │ │ │ │ │ │ │ │ ─────────────────┼───────┼─────┼─────┼─────┼─────┼───────┼──────┼────── Under $53 │ 6│ 2│ 1│ —│ 2│ 1│ —│ — $53 to $103 │ 5│ 2│ 1│ 2│ —│ —│ —│ — $104 to $207 │ 5│ 1│ 1│ 2│ 1│ —│ —│ — $208 to $311 │ 4│ 3│ —│ —│ 1│ —│ —│ — $312 and over │ 3│ 1│ —│ —│ 2│ —│ —│ — Not reported │ 3│ —│ —│ —│ —│ —│ —│ 3 │ │ │ │ │ │ │ │ Foreign │ │ │ │ │ │ │ │ wage-earning │ 255│ 103│ 54│ 47│ 19│ 13│ 1│ 18 mothers │ │ │ │ │ │ │ │ ─────────────────┼───────┼─────┼─────┼─────┼─────┼───────┼──────┼────── Under $53 │ 14│ 4│ 4│ 1│ 2│ —│ —│ 3 $53 to $103 │ 52│ 21│ 11│ 9│ 7│ 3│ —│ 1 $104 to $207 │ 84│ 45│ 15│ 17│ 2│ 3│ —│ 2 $208 to $311 │ 56│ 20│ 16│ 12│ 3│ 3│ 1│ 1 $312 and over │ 43│ 13│ 8│ 8│ 5│ 2│ —│ 7 Not reported │ 6│ —│ —│ —│ —│ 2│ —│ 4 ─────────────────┴───────┴─────┴─────┴─────┴─────┴───────┴──────┴──────

Footnote 37:

See note on page 45.

TABLE XI.—DISTRIBUTION OF RESULTS OF REPORTABLE PREGNANCIES (LIVE BIRTHS AND STILLBIRTHS) AND MISCARRIAGES, ACCORDING TO NUMBER PER MOTHER AND NATIVITY OF MOTHER.

═══════════╤═════════════════════════════════════════════════════ │ REPORTABLE PREGNANCIES AND RESULTS THEREOF. │ ───────────┼────────────┬───────┬───────┬────────┬─────────────── │ │ │ │ │ │ │ │ │ │ Live births. │ │ │ │ │ ───────────┼────────────┼───────┼───────┼────────┼───────┬─────── NUMBER OF │ │ │ │ │ │ REPORTABLE │ │ │ │ │ │ PREGNANCIES│ │ │ │ │ │ PER MOTHER │ │ │ │ │ │ AND │ │ │ │ │ │ NATIVITY OF│ │ │ │ │ │ MOTHER. │ │ │ │ │ │ ───────────┼────────────┼───────┼───────┼────────┼───────┼─────── │ │ │ │ │ │Number │ │ │Excess │ Number │ │ of │ Total │ Total │due to │ of │Number.│mothers │pregnancies.│births.│plural │mothers.│ │having │ │ │births.│ │ │ live │ │ │ │ │ │births. ───────────┼────────────┼───────┼───────┼────────┼───────┼─────── All married│ 5,554│ 5,617│ 63│ 1,491│ 5,363│ 1,465 mothers │ │ │ │ │ │ ═══════════╪════════════╪═══════╪═══════╪════════╪═══════╪═══════ 1 │ 339│ 343│ 4│ 339│ 322│ 318 2 │ 566│ 576│ 10│ 283│ 544│ 279 3 │ 642│ 650│ 8│ 214│ 626│ 214 4 │ 744│ 752│ 8│ 186│ 723│ 180 5 │ 735│ 740│ 5│ 147│ 704│ 147 6 │ 564│ 568│ 4│ 94│ 546│ 93 7 │ 581│ 586│ 5│ 83│ 555│ 83 8 │ 432│ 437│ 5│ 54│ 426│ 54 9 │ 297│ 299│ 2│ 33│ 283│ 33 10 or more │ 654│ 666│ 12│ 58│ 634│ 58 │ │ │ │ │ │ Native │ 2,717│ 2,744│ 27│ 816│ 2,600│ 801 ───────────┼────────────┼───────┼───────┼────────┼───────┼─────── 1 │ 234│ 236│ 2│ 234│ 224│ 222 2 │ 346│ 351│ 5│ 173│ 327│ 170 3 │ 333│ 338│ 5│ 111│ 322│ 111 4 │ 376│ 377│ 1│ 94│ 362│ 94 5 │ 325│ 326│ 1│ 65│ 302│ 65 6 │ 222│ 222│ │ 37│ 216│ 37 7 │ 266│ 267│ 1│ 38│ 250│ 38 8 │ 184│ 187│ 3│ 23│ 184│ 23 9 │ 117│ 118│ 1│ 13│ 109│ 13 10 or more │ 314│ 322│ 8│ 28│ 304│ 28 │ │ │ │ │ │ Foreign│ 2,837│ 2,873│ 36│ 675│ 2,763│ 664 ───────────┼────────────┼───────┼───────┼────────┼───────┼─────── 1 │ 105│ 107│ 2│ 105│ 98│ 96 2 │ 220│ 225│ 5│ 110│ 217│ 109 3 │ 309│ 312│ 3│ 103│ 304│ 103 4 │ 368│ 375│ 7│ 92│ 361│ 92 5 │ 410│ 414│ 4│ 82│ 402│ 82 6 │ 342│ 346│ 4│ 57│ 330│ 56 7 │ 315│ 319│ 4│ 45│ 305│ 45 8 │ 248│ 250│ 2│ 31│ 242│ 31 9 │ 180│ 181│ 1│ 20│ 174│ 20 10 or more │ 340│ 344│ 4│ 30│ 330│ 30 ───────────┴────────────┴───────┴───────┴────────┴───────┴───────

═══════════╤═════════════════════════════════════════════════════ │ REPORTABLE PREGNANCIES AND RESULTS THEREOF. │ ───────────┼─────────────────────────┬─────────────────────────── │ │ │ Live births. │ Stillbirths. │ │ ───────────┼─────────────────────────┼─────────────┬───────────── NUMBER OF │ │ │ REPORTABLE │ │ │ PREGNANCIES│ │ │ PER MOTHER │ Deaths in first year. │ │ AND │ │ │ NATIVITY OF│ │ │ MOTHER. │ │ │ ───────────┼───────┬───────┬─────────┼─────────────┼───────────── │ │Number │ │ │ │ │ of │ Infant │ │ Number of │Number.│mothers│mortality│ Number of │ mothers │ │having │ rate. │still-births.│ having │ │babies │ │ │still-births. │ │ die. │ │ │ ───────────┼───────┼───────┼─────────┼─────────────┼───────────── All married│ 804│ 509│ 149.9│ 254│ 194 mothers │ │ │ │ │ ═══════════╪═══════╪═══════╪═════════╪═════════════╪═════════════ 1 │ 35│ 34│ 108.7│ 21│ 21 2 │ 59│ 54│ 108.5│ 32│ 28 3 │ 92│ 75│ 147.0│ 24│ 23 4 │ 78│ 64│ 107.9│ 29│ 21 5 │ 103│ 67│ 146.3│ 36│ 31 6 │ 88│ 60│ 161.2│ 22│ 13 7 │ 78│ 48│ 140.5│ 31│ 22 8 │ 95│ 42│ 223.0│ 11│ 7 9 │ 41│ 20│ 144.9│ 16│ 11 10 or more │ 135│ 45│ 212.9│ 32│ 17 │ │ │ │ │ Native │ 294│ 206│ 113.1│ 144│ 115 ───────────┼───────┼───────┼─────────┼─────────────┼───────────── 1 │ 17│ 17│ 75.9│ 12│ 12 2 │ 25│ 23│ 76.5│ 24│ 21 3 │ 38│ 31│ 118.0│ 16│ 16 4 │ 36│ 31│ 99.4│ 15│ 13 5 │ 26│ 21│ 86.1│ 24│ 19 6 │ 34│ 22│ 157.4│ 6│ 5 7 │ 25│ 18│ 100.0│ 17│ 11 8 │ 29│ 17│ 157.6│ 3│ 2 9 │ 14│ 7│ 128.4│ 9│ 6 10 or more │ 50│ 19│ 164.5│ 18│ 10 │ │ │ │ │ Foreign│ 510│ 303│ 184.6│ 110│ 79 ───────────┼───────┼───────┼─────────┼─────────────┼───────────── 1 │ 18│ 17│ 183.7│ 9│ 9 2 │ 34│ 31│ 156.7│ 8│ 7 3 │ 54│ 44│ 177.6│ 8│ 7 4 │ 42│ 33│ 116.3│ 14│ 8 5 │ 77│ 46│ 191.5│ 12│ 12 6 │ 54│ 38│ 163.6│ 16│ 8 7 │ 53│ 30│ 173.8│ 14│ 11 8 │ 66│ 25│ 272.7│ 8│ 5 9 │ 27│ 13│ 155.2│ 7│ 5 10 or more │ 85│ 26│ 257.6│ 14│ 7 ───────────┴───────┴───────┴─────────┴─────────────┴─────────────

═══════════════════╤══════════════════════════════ REPORTABLE│ MISCARRIAGES IN ADDITION TO PREGNANCIES AND│ REPORTABLE PREGNANCIES. RESULTS THEREOF.│ ───────────┬───────┼────────────┬───────────────── │Still- │ │Number of mothers │births.│ │ reporting │ │ │ miscarriages. ───────────┼───────┼────────────┼────────┬──────── NUMBER OF │ │ │ │ REPORTABLE │ │ │ │ PREGNANCIES│ │ │ │ PER MOTHER │ │ │ │ AND │ │ │ │ NATIVITY OF│ │ │ │ MOTHER. │ │ │ │ ───────────┼───────┼────────────┼────────┼──────── │ │ │ │ │ Per │ Number of │ │ Per │ cent. │miscarriages│ Total │cent. of │of all │ reported. │mothers.│ all │births.│ │ │mothers. │ │ │ │ ───────────┼───────┼────────────┼────────┼──────── All married│ 4.5│ 191│ 130│ 8.7 mothers │ │ │ │ ═══════════╪═══════╪════════════╪════════╪════════ 1 │ 6.1│ 8│ 8│ 2.4 2 │ 5.6│ 23│ 16│ 5.7 3 │ 3.7│ 26│ 18│ 8.4 4 │ 3.9│ 22│ 18│ 9.7 5 │ 4.9│ 20│ 14│ 9.5 6 │ 3.9│ 23│ 14│ 14.9 7 │ 5.3│ 27│ 15│ 18.1 8 │ 2.5│ 15│ 9│ 16.7 9 │ 5.4│ 13│ 8│ ([38]) 10 or more │ 4.8│ 14│ 10│ 17.2 │ │ │ │ Native │ 5.2│ 136│ 92│ 11.3 ───────────┼───────┼────────────┼────────┼──────── 1 │ 5.1│ 7│ 7│ 3.0 2 │ 6.8│ 18│ 13│ 7.5 3 │ 4.7│ 21│ 15│ 13.5 4 │ 4.0│ 13│ 10│ 10.6 5 │ 7.4│ 13│ 10│ 15.4 6 │ 2.7│ 17│ 9│ ([38]) 7 │ 6.4│ 25│ 13│ ([38]) 8 │ 1.6│ 8│ 5│ ([38]) 9 │ 7.6│ 4│ 3│ ([38]) 10 or more │ 5.6│ 10│ 7│ ([38]) │ │ │ │ Foreign│ 3.8│ 55│ 38│ 5.6 ───────────┼───────┼────────────┼────────┼──────── 1 │ 8.4│ 1│ 1│ 1.0 2 │ 3.6│ 5│ 3│ 2.7 3 │ 2.6│ 5│ 3│ 2.9 4 │ 3.7│ 9│ 8│ 8.7 5 │ 2.9│ 7│ 4│ 4.9 6 │ 4.6│ 6│ 5│ 8.3 7 │ 4.4│ 2│ 2│ ([38]) 8 │ 3.2│ 7│ 4│ ([38]) 9 │ 3.9│ 9│ 5│ ([38]) 10 or more │ 4.1│ 4│ 3│ ([38]) ───────────┴───────┴────────────┴────────┴──────── Footnote 38:

Not shown when base is less than 50.

TABLE XII.—DISTRIBUTION OF RESULTS OF REPORTABLE PREGNANCIES (LIVE BIRTHS AND STILLBIRTHS) AND MISCARRIAGES, ACCORDING TO NUMBER PER MOTHER AND AGE OF MOTHER AT EACH PREGNANCY.

═════════════╤════════════════════════════════════╤════════════════ NUMBER OF │ │ REPORTABLE │ │ PREGNANCIES │ │ AND AGE OF │ REPORTABLE PREGNANCIES. │ LIVE BIRTHS. MOTHER AT │ │ BIRTH OF BABY│ │ BORN IN 1911.│ │ ─────────────┼──────┬────────────────────┬────────┼───────┬──────── │ │ Resulting births. │ │ │ │ │ │ │ │ ─────────────┼──────┼───────┬────────────┼────────┼───────┼──────── │ │ │Excess over │ Number │ │ Number │Total.│Number.│pregnancies.│ of │Number.│ of │ │ │ [39] │mothers.│ │mothers. │ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── All married │ 5,554│ 5,617│ 63│ 1,491│ 5,363│ 1,465 mothers │ │ │ │ │ │ ═════════════╪══════╪═══════╪════════════╪════════╪═══════╪════════ Under 20 │ 107│ 108│ 1│ 89│ 96│ 81 years │ │ │ │ │ │ 20 to 24 │ 933│ 946│ 13│ 461│ 908│ 456 years │ │ │ │ │ │ 25 to 29 │ 1,316│ 1,329│ 13│ 395│ 1,261│ 389 years │ │ │ │ │ │ 30 to 39 │ 2,570│ 2,595│ 25│ 466│ 2,480│ 459 years │ │ │ │ │ │ 40 years │ 628│ 639│ 11│ 80│ 618│ 80 and over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 28 years. │ │ │ │ │ │ │ │ │ │ │ │ 1 reportable │ 339│ 343│ 4│ 339│ 322│ 318 pregnancy │ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Under 20 │ 74│ 75│ 1│ 74│ 67│ 66 years │ │ │ │ │ │ 20 to 24 │ 178│ 179│ 1│ 178│ 176│ 175 years │ │ │ │ │ │ 25 to 29 │ 57│ 58│ 1│ 57│ 54│ 53 years │ │ │ │ │ │ 30 to 39 │ 30│ 31│ 1│ 30│ 25│ 24 years │ │ │ │ │ │ Average age: │ │ │ │ │ │ 23 years. │ │ │ │ │ │ │ │ │ │ │ │ 2 reportable │ 566│ 576│ 10│ 283│ 544│ 279 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Under 20 │ 24│ 24│ │ 12│ 21│ 12 years │ │ │ │ │ │ 20 to 24 │ 312│ 317│ 5│ 156│ 302│ 154 years │ │ │ │ │ │ 25 to 29 │ 148│ 151│ 3│ 74│ 141│ 73 years │ │ │ │ │ │ 30 to 39 │ 78│ 80│ 2│ 39│ 76│ 38 years │ │ │ │ │ │ 40 years and │ 4│ 4│ │ 2│ 4│ 2 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 25 years. │ │ │ │ │ │ │ │ │ │ │ │ 3 reportable │ 642│ 650│ 8│ 214│ 626│ 214 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Under 20 │ 9│ 9│ │ 3│ 8│ 3 years │ │ │ │ │ │ 20 to 24 │ 231│ 234│ 3│ 77│ 227│ 77 years │ │ │ │ │ │ 25 to 29 │ 285│ 288│ 3│ 95│ 277│ 95 years │ │ │ │ │ │ 30 to 39 │ 108│ 110│ 2│ 36│ 105│ 36 years │ │ │ │ │ │ 40 years and │ 9│ 9│ │ 3│ 9│ 3 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 26 years. │ │ │ │ │ │ │ │ │ │ │ │ 4 reportable │ 744│ 752│ 8│ 186│ 723│ 186 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── 20 to 24 │ 156│ 160│ 4│ 39│ 148│ 39 years │ │ │ │ │ │ 25 to 29 │ 300│ 301│ 1│ 75│ 290│ 75 years │ │ │ │ │ │ 30 to 39 │ 252│ 255│ 3│ 63│ 249│ 63 years │ │ │ │ │ │ 40 years and │ 36│ 36│ │ 9│ 36│ 9 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 29 years. │ │ │ │ │ │ │ │ │ │ │ │ 5 reportable │ 735│ 740│ 5│ 147│ 704│ 147 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── 20 to 24 │ 50│ 50│ │ 10│ 49│ 10 years │ │ │ │ │ │ 25 to 29 │ 280│ 283│ 3│ 56│ 266│ 56 years │ │ │ │ │ │ 30 to 39 │ 375│ 377│ 2│ 75│ 361│ 75 years │ │ │ │ │ │ 40 years and │ 30│ 30│ │ 6│ 28│ 6 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 30 years. │ │ │ │ │ │ │ │ │ │ │ │ 6 reportable │ 564│ 568│ 4│ 94│ 546│ 93 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── 20 to 24 │ 6│ 6│ │ 1│ 6│ 1 years │ │ │ │ │ │ 25 to 29 │ 132│ 133│ 1│ 22│ 127│ 21 years │ │ │ │ │ │ 30 to 39 │ 360│ 362│ 2│ 60│ 347│ 60 years │ │ │ │ │ │ 40 years and │ 66│ 67│ 1│ 11│ 66│ 11 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 33 years. │ │ │ │ │ │ │ │ │ │ │ │ 7 reportable │ 581│ 586│ 5│ 83│ 555│ 83 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── 25 to 29 │ 98│ 99│ 1│ 14│ 90│ 14 years │ │ │ │ │ │ 30 to 39 │ 392│ 395│ 3│ 56│ 377│ 56 years │ │ │ │ │ │ 40 years and │ 91│ 92│ 1│ 13│ 88│ 13 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 34 years. │ │ │ │ │ │ │ │ │ │ │ │ 8 reportable │ 432│ 437│ 5│ 54│ 426│ 54 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── 25 to 29 │ 16│ 16│ │ 2│ 16│ 2 years │ │ │ │ │ │ 30 to 39 │ 408│ 413│ 5│ 51│ 403│ 51 years │ │ │ │ │ │ 40 years and │ 8│ 8│ │ 1│ 7│ 1 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 35 years. │ │ │ │ │ │ │ │ │ │ │ │ 9 reportable │ 297│ 299│ 2│ 33│ 283│ 33 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── 30 to 39 │ 207│ 208│ 1│ 23│ 195│ 23 years │ │ │ │ │ │ 40 years and │ 90│ 91│ 1│ 10│ 88│ 10 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 37 years. │ │ │ │ │ │ │ │ │ │ │ │ 10 or more │ 654│ 666│ 12│([41])58│ 634│ 58 reportable │ │ │ │ │ │ pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── 30 to 39 │ 360│ 364│ 4│ 33│ 342│ 33 years │ │ │ │ │ │ 40 years and │ 294│ 302│ 8│ 25│ 292│ 25 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 39 years. │ │ │ │ │ │ ─────────────┴──────┴───────┴────────────┴────────┴───────┴────────

═════════════╤══════════════════════════╤══════════════════════════ NUMBER OF │ │ REPORTABLE │ │ PREGNANCIES │ BABIES DYING IN FIRST │ AND AGE OF │ YEAR. │ STILLBIRTHS. MOTHER AT │ │ BIRTH OF BABY│ │ BORN IN 1911.│ │ ─────────────┼───────┬────────┬─────────┼───────┬────────┬───────── │ │ │ │ │ │ │ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── │ │ Number │ Infant │ │ Number │Per cent. │Number.│ of │mortality│Number.│ of │ of all │ │mothers.│ rate. │ │mothers.│ births │ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── All married │ 804│ 509│ 149.9│ 254│ 194│ 4.5 mothers │ │ │ │ │ │ ═════════════╪═══════╪════════╪═════════╪═══════╪════════╪═════════ Under 20 │ 12│ 11│ 125.0│ 12│ 12│ 11.1 years │ │ │ │ │ │ 20 to 24 │ 140│ 115│ 154.2│ 38│ 29│ 4.0 years │ │ │ │ │ │ 25 to 29 │ 185│ 132│ 146.7│ 68│ 55│ 5.1 years │ │ │ │ │ │ 30 to 39 │ 382│ 207│ 154.0│ 115│ 84│ 4.4 years │ │ │ │ │ │ 40 years │ 85│ 44│ 137.5│ 21│ 14│ 3.3 and over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 28 years. │ │ │ │ │ │ │ │ │ │ │ │ 1 reportable │ 35│ 34│ 108.7│ 21│ 21│ 6.1 pregnancy │ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Under 20 │ 8│ 7│ 119.4│ 8│ 8│ 10.7 years │ │ │ │ │ │ 20 to 24 │ 18│ 18│ 102.3│ 3│ 3│ 1.7 years │ │ │ │ │ │ 25 to 29 │ 4│ 4│ 74.1│ 4│ 4│ 6.9 years │ │ │ │ │ │ 30 to 39 │ 5│ 5│ ([40]) │ 6│ 6│ ([40]) years │ │ │ │ │ │ Average age: │ │ │ │ │ │ 23 years. │ │ │ │ │ │ │ │ │ │ │ │ 2 reportable │ 59│ 54│ 108.5│ 3│ 28│ 5.6 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Under 20 │ 3│ 3│ ([40]) │ 3│ 3│ ([40]) years │ │ │ │ │ │ 20 to 24 │ 42│ 37│ 139.1│ 15│ 13│ 4.7 years │ │ │ │ │ │ 25 to 29 │ 9│ 9│ 63.8│ 10│ 9│ 6.6 years │ │ │ │ │ │ 30 to 39 │ 5│ 5│ 65.8│ 4│ 3│ 5.0 years │ │ │ │ │ │ 40 years and │ │ │ │ ...│ │ over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 25 years. │ │ │ │ │ │ │ │ │ │ │ │ 3 reportable │ 92│ 75│ 147.0│ 24│ 23│ 3.7 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Under 20 │ 1│ 1│ ([40]) │ 1│ 1│ ([40]) years │ │ │ │ │ │ 20 to 24 │ 40│ 31│ 176.2│ 7│ 6│ 3.0 years │ │ │ │ │ │ 25 to 29 │ 41│ 33│ 148.0│ 11│ 11│ 3.8 years │ │ │ │ │ │ 30 to 39 │ 8│ 8│ 76.2│ 5│ 5│ 4.5 years │ │ │ │ │ │ 40 years and │ 2│ 2│ ([40]) │ │ │ over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 26 years. │ │ │ │ │ │ │ │ │ │ │ │ 4 reportable │ 78│ 64│ 107.9│ 29│ 21│ 3.9 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── 20 to 24 │ 28│ 21│ 189.2│ 12│ 6│ 7.5 years │ │ │ │ │ │ 25 to 29 │ 26│ 23│ 89.7│ 11│ 10│ 3.7 years │ │ │ │ │ │ 30 to 39 │ 21│ 17│ 84.3│ 6│ 5│ 2.4 years │ │ │ │ │ │ 40 years and │ 3│ 3│ ([40]) │ │ │ over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 29 years. │ │ │ │ │ │ │ │ │ │ │ │ 5 reportable │ 103│ 67│ 146.3│ 36│ 31│ 4.9 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── 20 to 24 │ 9│ 7│ 183.7│ 1│ 1│ 2.0 years │ │ │ │ │ │ 25 to 29 │ 51│ 31│ 191.7│ 17│ 15│ 6.0 years │ │ │ │ │ │ 30 to 39 │ 40│ 27│ 110.8│ 16│ 14│ 4.2 years │ │ │ │ │ │ 40 years and │ 3│ 2│ ([40]) │ 2│ 1│ ([40]) over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 30 years. │ │ │ │ │ │ │ │ │ │ │ │ 6 reportable │ 88│ 60│ 161.2│ 22│ 13│ 3.9 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── 20 to 24 │ 3│ 1│ ([40]) │ │ │ years │ │ │ │ │ │ 25 to 29 │ 23│ 17│ 181.1│ 6│ 1│ 4.5 years │ │ │ │ │ │ 30 to 39 │ 54│ 36│ 155.6│ 15│ 11│ 4.1 years │ │ │ │ │ │ 40 years and │ 8│ 6│ 121.2│ 1│ 1│ 1.5 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 33 years. │ │ │ │ │ │ │ │ │ │ │ │ 7 reportable │ 78│ 48│ 140.5│ 31│ 22│ 5.3 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── 25 to 29 │ 23│ 13│ 255.6│ 9│ 5│ 10.0 years │ │ │ │ │ │ 30 to 39 │ 45│ 28│ 119.4│ 18│ 15│ 4.6 years │ │ │ │ │ │ 40 years and │ 10│ 7│ 113.6│ 4│ 2│ 4.3 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 34 years. │ │ │ │ │ │ │ │ │ │ │ │ 8 reportable │ 95│ 42│ 223.0│ 11│ 7│ 2.5 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── 25 to 29 │ 8│ 2│ ([40]) │ │ │ years │ │ │ │ │ │ 30 to 39 │ 87│ 40│ 215.9│ 10│ 6│ 2.4 years │ │ │ │ │ │ 40 years and │ │ │ │ 1│ 1│ ([40]) over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 35 years. │ │ │ │ │ │ │ │ │ │ │ │ 9 reportable │ 41│ 20│ 144.9│ 16│ 11│ 5.4 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── 30 to 39 │ 32│ 15│ 164.1│ 13│ 8│ 6.3 years │ │ │ │ │ │ 40 years and │ 9│ 5│ 102.3│ 3│ 3│ 3.3 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 37 years. │ │ │ │ │ │ │ │ │ │ │ │ 10 or more │ 135│ 45│ 212.9│ 32│ 17│ 4.8 reportable │ │ │ │ │ │ pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── 30 to 39 │ 85│ 26│ 248.5│ 22│ 11│ 6.0 years │ │ │ │ │ │ 40 years and │ 50│ 19│ 171.2│ 10│ 6│ 3.3 over │ │ │ │ │ │ Average age: │ │ │ │ │ │ 39 years. │ │ │ │ │ │ ─────────────┴───────┴────────┴─────────┴───────┴────────┴─────────

═════════════╤═══════════════════════════ NUMBER OF │ REPORTABLE │ PREGNANCIES │ AND AGE OF │ MISCARRIAGES. MOTHER AT │ BIRTH OF BABY│ BORN IN 1911.│ ─────────────┼─────────┬───────────────── │ │ Mothers │ │ reporting. ─────────────┼─────────┼────────┬──────── │ │ │ Per │ Number │Number. │cent. of │reported.│ │ all │ │ │mothers. ─────────────┼─────────┼────────┼──────── All married │ 191│ 130│ 8.7 mothers │ │ │ ═════════════╪═════════╪════════╪════════ Under 20 │ │ │ years │ │ │ 20 to 24 │ 19│ 18│ 3.9 years │ │ │ 25 to 29 │ 46│ 27│ 6.8 years │ │ │ 30 to 39 │ 95│ 66│ 14.2 years │ │ │ 40 years │ 31│ 19│ 23.8 and over │ │ │ Average age: │ │ │ 28 years. │ │ │ │ │ │ 1 reportable │ 8│ 8│ 2.4 pregnancy │ │ │ ─────────────┼─────────┼────────┼──────── Under 20 │ │ │ years │ │ │ 20 to 24 │ 3│ 3│ 1.7 years │ │ │ 25 to 29 │ 3│ 3│ 5.3 years │ │ │ 30 to 39 │ 2│ 2│ ([40]) years │ │ │ Average age: │ │ │ 23 years. │ │ │ │ │ │ 2 reportable │ 23│ 16│ 5.7 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Under 20 │ │ │ years │ │ │ 20 to 24 │ 6│ 6│ 3.8 years │ │ │ 25 to 29 │ 5│ 3│ 4.1 years │ │ │ 30 to 39 │ 12│ 7│ ([40]) years │ │ │ 40 years and │ │ │ over │ │ │ Average age: │ │ │ 25 years. │ │ │ │ │ │ 3 reportable │ 26│ 18│ 8.4 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Under 20 │ │ │ years │ │ │ 20 to 24 │ 7│ 6│ 7.8 years │ │ │ 25 to 29 │ 14│ 7│ 7.4 years │ │ │ 30 to 39 │ 4│ 4│ ([40]) years │ │ │ 40 years and │ 1│ 1│ ([40]) over │ │ │ Average age: │ │ │ 26 years. │ │ │ │ │ │ 4 reportable │ 22│ 18│ 9.7 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── 20 to 24 │ 3│ 3│ ([40]) years │ │ │ 25 to 29 │ 10│ 6│ 8.0 years │ │ │ 30 to 39 │ 6│ 6│ 9.5 years │ │ │ 40 years and │ 3│ 3│ ([40]) over │ │ │ Average age: │ │ │ 29 years. │ │ │ │ │ │ 5 reportable │ 20│ 14│ 9.5 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── 20 to 24 │ │ │ years │ │ │ 25 to 29 │ 6│ 4│ 7.1 years │ │ │ 30 to 39 │ 12│ 8│ 10.7 years │ │ │ 40 years and │ 2│ 2│ ([40]) over │ │ │ Average age: │ │ │ 30 years. │ │ │ │ │ │ 6 reportable │ 23│ 14│ 14.9 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── 20 to 24 │ │ │ years │ │ │ 25 to 29 │ 6│ 3│ ([40]) years │ │ │ 30 to 39 │ 13│ 9│ 15.0 years │ │ │ 40 years and │ 4│ 2│ ([40]) over │ │ │ Average age: │ │ │ 33 years. │ │ │ │ │ │ 7 reportable │ 27│ 15│ 18.1 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── 25 to 29 │ 2│ 1│ ([40]) years │ │ │ 30 to 39 │ 19│ 11│ 19.6 years │ │ │ 40 years and │ 6│ 3│ ([40]) over │ │ │ Average age: │ │ │ 34 years. │ │ │ │ │ │ 8 reportable │ 15│ 9│ 16.7 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── 25 to 29 │ │ │ years │ │ │ 30 to 39 │ 15│ 9│ 17.6 years │ │ │ 40 years and │ │ │ over │ │ │ Average age: │ │ │ 35 years. │ │ │ │ │ │ 9 reportable │ 13│ 8│ 24.2 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── 30 to 39 │ 5│ 4│ ([40]) years │ │ │ 40 years and │ 8│ 4│ ([40]) over │ │ │ Average age: │ │ │ 37 years. │ │ │ │ │ │ 10 or more │ 14│ 10│ 17.2 reportable │ │ │ pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── 30 to 39 │ 7│ 6│ ([40]) years │ │ │ 40 years and │ 7│ 4│ ([40]) over │ │ │ Average age: │ │ │ 39 years. │ │ │ ─────────────┴─────────┴────────┴──────── Footnote 39:

Excess of births over pregnancies due to plural births.

Footnote 40:

Rate not computed because of small base.

Footnote 41:

Includes 21 having 10 pregnancies; 16 having 11; 11 having 12; 6 having 13; 3 having 14; 1 having 16.

TABLE XIII.—DISTRIBUTION OF RESULTS OF REPORTABLE PREGNANCIES (LIVE BIRTHS AND STILLBIRTHS) AND MISCARRIAGES, ACCORDING TO NUMBER PER MOTHER AND HUSBAND’S EARNINGS.

═════════════╤════════════════════════════════════╤════════════════ SPECIFIED │ │ NUMBER OF │ │ PREGNANCIES │ │ FOR ALL │ │ MARRIED │ REPORTABLE PREGNANCIES. │ LIVE BIRTHS. MOTHERS AND │ │ ANNUAL │ │ EARNINGS OF │ │ HUSBAND. │ │ ─────────────┼──────┬────────────────────┬────────┼───────┬──────── │ │ Resulting births. │ │ │ │ │ │ │ │ ─────────────┼──────┼───────┬────────────┼────────┼───────┼──────── │ │ │Excess over │ Number │ │ Number │Total.│Number.│pregnancies.│ of │Number.│ of │ │ │ [42] │mothers.│ │mothers. │ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── All │ │ │ │ │ │ reportable │ 5,554│ 5,617│ 63│ 1,491│ 5,363│ 1,465 pregnancies │ │ │ │ │ │ ═════════════╪══════╪═══════╪════════════╪════════╪═══════╪════════ Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 938│ 946│ 8│ 233│ 902│ 227 $521 to $624│ 691│ 700│ 9│ 174│ 668│ 173 $625 to $779│ 816│ 826│ 10│ 229│ 797│ 227 $780 to $899│ 611│ 616│ 5│ 166│ 588│ 163 $900 to │ 574│ 581│ 7│ 146│ 548│ 143 $1,199 │ │ │ │ │ │ $1,200 and │ 196│ 199│ 3│ 50│ 186│ 49 over │ │ │ │ │ │ Ample[43] │ 1,728│ 1,749│ 21│ 493│ 1,674│ 483 │ │ │ │ │ │ 1 reportable │ 339│ 343│ 4│ 339│ 322│ 318 pregnancy │ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 48│ 48│ │ 48│ 43│ 43 $521 to $624│ 23│ 23│ │ 23│ 22│ 22 $625 to $779│ 46│ 48│ 2│ 46│ 46│ 44 $780 to $899│ 35│ 35│ │ 35│ 32│ 32 $900 to │ 38│ 39│ 1│ 38│ 36│ 35 $1,199 │ │ │ │ │ │ $1,200 and │ 13│ 13│ │ 13│ 13│ 13 over │ │ │ │ │ │ Ample[43] │ 136│ 137│ 1│ 136│ 130│ 129 │ │ │ │ │ │ 2 reportable │ 566│ 576│ 10│ 283│ 544│ 279 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 62│ 64│ 2│ 31│ 62│ 31 $521 to $624│ 72│ 74│ 2│ 36│ 68│ 36 $625 to $779│ 110│ 111│ 1│ 55│ 108│ 55 $780 to $899│ 56│ 56│ │ 28│ 53│ 28 $900 to │ 46│ 46│ │ 23│ 41│ 23 $1,199 │ │ │ │ │ │ $1,200 and │ 16│ 16│ │ 8│ 14│ 7 over │ │ │ │ │ │ Ample[43] │ 204│ 209│ 5│ 102│ 198│ 99 │ │ │ │ │ │ 3 reportable │ 642│ 650│ 8│ 214│ 626│ 214 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 114│ 115│ 1│ 38│ 110│ 38 $521 to $624│ 102│ 104│ 2│ 34│ 101│ 34 $625 to $779│ 84│ 84│ │ 28│ 82│ 28 $780 to $899│ 87│ 87│ │ 29│ 83│ 29 $900 to │ 57│ 58│ 1│ 19│ 55│ 19 $1,199 │ │ │ │ │ │ $1,200 and │ 6│ 7│ 1│ 2│ 7│ 2 over │ │ │ │ │ │ Ample[43] │ 192│ 195│ 3│ 64│ 188│ 64 │ │ │ │ │ │ 4 reportable │ 744│ 752│ 8│ 186│ 723│ 186 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 104│ 104│ │ 26│ 101│ 26 $521 to $624│ 88│ 89│ 1│ 22│ 86│ 22 $625 to $779│ 136│ 137│ 1│ 34│ 129│ 34 $780 to $899│ 96│ 97│ 1│ 24│ 95│ 24 $900 to │ 56│ 58│ 2│ 14│ 55│ 14 $1,199 │ │ │ │ │ │ $1,200 and │ 40│ 41│ 1│ 10│ 39│ 10 over │ │ │ │ │ │ Ample[43] │ 224│ 226│ 2│ 56│ 218│ 56 │ │ │ │ │ │ 5 reportable │ 735│ 740│ 5│ 147│ 704│ 147 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 130│ 131│ 1│ 26│ 125│ 26 $521 to $624│ 90│ 91│ 1│ 18│ 85│ 18 $625 to $779│ 100│ 100│ │ 20│ 99│ 20 $780 to $899│ 110│ 110│ │ 22│ 106│ 22 $900 to │ 65│ 66│ 1│ 13│ 60│ 13 $1,199 │ │ │ │ │ │ $1,200 and │ 30│ 30│ │ 6│ 26│ 6 over │ │ │ │ │ │ Ample[43] │ 210│ 212│ 2│ 42│ 203│ 42 │ │ │ │ │ │ 6 reportable │ 564│ 568│ 4│ 94│ 546│ 93 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 132│ 132│ │ 22│ 124│ 21 $521 to $624│ 60│ 60│ │ 10│ 59│ 10 $625 to $779│ 114│ 115│ 1│ 19│ 110│ 19 $780 to $899│ 48│ 48│ │ 8│ 48│ 8 $900 to │ 72│ 74│ 2│ 12│ 70│ 12 $1,199 │ │ │ │ │ │ $1,200 and │ 12│ 12│ │ 2│ 11│ 2 over │ │ │ │ │ │ Ample[43] │ 126│ 127│ 1│ 21│ 124│ 21 │ │ │ │ │ │ 7 reportable │ 581│ 586│ 5│ 83│ 555│ 83 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 91│ 92│ 1│ 13│ 88│ 13 $521 to $624│ 56│ 56│ │ 8│ 51│ 8 $625 to $779│ 98│ 101│ 3│ 14│ 97│ 14 $780 to $899│ 35│ 35│ │ 5│ 32│ 5 $900 to │ 84│ 84│ │ 12│ 79│ 12 $1,199 │ │ │ │ │ │ $1,200 and │ 21│ 22│ 1│ 3│ 22│ 3 over │ │ │ │ │ │ Ample[43] │ 196│ 196│ │ 8│ 186│ 28 │ │ │ │ │ │ 8 reportable │ 432│ 437│ 5│ 54│ 426│ 54 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 120│ 120│ │ 15│ 117│ 15 $521 to $624│ 96│ 98│ 2│ 12│ 94│ 12 $625 to $779│ 40│ 41│ 1│ 5│ 41│ 5 $780 to $899│ 48│ 49│ 1│ 6│ 46│ 6 $900 to │ 24│ 24│ │ 3│ 24│ 3 $1,199 │ │ │ │ │ │ $1,200 and │ 16│ 16│ │ 2│ 16│ 2 over │ │ │ │ │ │ Ample[43] │ 88│ 89│ 1│ 11│ 88│ 11 │ │ │ │ │ │ 9 reportable │ 297│ 299│ 2│ 33│ 283│ 33 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 81│ 82│ 1│ 9│ 80│ 9 $521 to $624│ 72│ 72│ │ 8│ 70│ 8 $625 to $779│ 18│ 18│ │ 2│ 15│ 2 $780 to $899│ 18│ 19│ 1│ 2│ 17│ 2 $900 to │ 18│ 18│ │ 2│ 18│ 2 $1,199 │ │ │ │ │ │ $1,200 and │ 18│ 18│ │ 2│ 16│ 2 over │ │ │ │ │ │ Ample[43] │ 72│ 72│ │ 8│ 67│ 8 │ │ │ │ │ │ 10 or more │ │ │ │ │ │ reportable │ 654│ 666│ 12│ 58│ 634│ 58 pregnancies│ │ │ │ │ │ ─────────────┼──────┼───────┼────────────┼────────┼───────┼──────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 56│ 58│ 2│ 5│ 52│ 5 $521 to $624│ 32│ 33│ 1│ 3│ 32│ 3 $625 to $779│ 70│ 71│ 1│ 6│ 70│ 6 $780 to $899│ 78│ 80│ 2│ 7│ 76│ 7 $900 to │ 114│ 114│ │ 10│ 110│ 10 $1,199 │ │ │ │ │ │ $1,200 and │ 24│ 24│ │ 2│ 22│ 2 over │ │ │ │ │ │ Ample[43] │ 280│ 286│ 6│ 25│ 272│ 25 ─────────────┴──────┴───────┴────────────┴────────┴───────┴────────

═════════════╤══════════════════════════╤══════════════════════════ SPECIFIED │ │ NUMBER OF │ │ PREGNANCIES │ │ FOR ALL │ BABIES DYING IN FIRST │ MARRIED │ YEAR. │ STILLBIRTHS. MOTHERS AND │ │ ANNUAL │ │ EARNINGS OF │ │ HUSBAND. │ │ ─────────────┼───────┬────────┬─────────┼───────┬────────┬───────── │ │ │ │ │ │ │ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── │ │ Number │ Infant │ │ Number │Per cent. │Number.│ of │mortality│Number.│ of │ of all │ │mothers.│ rate. │ │mothers.│ births │ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── All │ │ │ │ │ │ reportable │ 804│ 149.9│ 509│ 254│ 194│ 4.5 pregnancies │ │ │ │ │ │ ═════════════╪═══════╪════════╪═════════╪═══════╪════════╪═════════ Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 178│ 197.3│ 110│ 44│ 31│ 4.7 $521 to $624│ 129│ 193.1│ 75│ 32│ 25│ 4.6 $625 to $779│ 130│ 163.1│ 88│ 29│ 21│ 3.5 $780 to $899│ 99│ 168.4│ 61│ 28│ 23│ 4.5 $900 to │ 78│ 142.3│ 48│ 33│ 24│ 5.7 $1,199 │ │ │ │ │ │ $1,200 and │ 30│ 161.3│ 18│ 13│ 9│ 6.5 over │ │ │ │ │ │ Ample[43] │ 160│ 95.6│ 109│ 75│ 61│ 4.3 │ │ │ │ │ │ 1 reportable │ 35│ 108.7│ 34│ 21│ 21│ 6.1 pregnancy │ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 11│ │ 11│ 5│ 5│ $521 to $624│ 2│ │ 2│ 1│ 1│ $625 to $779│ 6│ │ 5│ 2│ 2│ $780 to $899│ 3│ │ 3│ 3│ 3│ $900 to │ 4│ │ 4│ 3│ 3│ $1,199 │ │ │ │ │ │ $1,200 and │ 1│ │ 1│ │ │ over │ │ │ │ │ │ Ample[43] │ 8│ 61.5│ 8│ 7│ 7│ 5.1 │ │ │ │ │ │ 2 reportable │ 59│ 108.5│ 54│ 32│ 28│ 5.6 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 11│ 176.4│ 11│ 2│ 2│ 3.1 $521 to $624│ 8│ 177.6│ 6│ 6│ 6│ 8.1 $625 to $779│ 17│ 157.4│ 16│ 3│ 3│ 2.7 $780 to $899│ 9│ 169.8│ 7│ 3│ 3│ 5.4 $900 to │ 2│ │ 2│ 5│ 5│ $1,199 │ │ │ │ │ │ $1,200 and │ 1│ │ 1│ 2│ 1│ over │ │ │ │ │ │ Ample[43] │ 11│ 55.6│ 11│ 11│ 8│ 5.3 │ │ │ │ │ │ 3 reportable │ 92│ 147.0│ 75│ 24│ 23│ 3.7 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 27│ 245.5│ 23│ 5│ 4│ 4.3 $521 to $624│ 16│ 158.4│ 13│ 3│ 3│ 1.9 $625 to $779│ 13│ 158.5│ 11│ 2│ 2│ 2.4 $780 to $899│ 6│ 72.3│ 6│ 4│ 4│ 4.6 $900 to │ 11│ 200.0│ 8│ 3│ 3│ 5.2 $1,199 │ │ │ │ │ │ $1,200 and │ 1│ │ 1│ │ │ over │ │ │ │ │ │ Ample[43] │ 18│ 95.7│ 13│ 7│ 7│ 3.6 │ │ │ │ │ │ 4 reportable │ 78│ 107.9│ 64│ 29│ 21│ 3.9 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 13│ 128.7│ 9│ 3│ 2│ 1.9 $521 to $624│ 10│ 116.3│ 9│ 3│ 1│ 3.4 $625 to $779│ 19│ 147.3│ 15│ 8│ 6│ 5.8 $780 to $899│ 13│ 136.8│ 12│ 2│ 1│ 2.1 $900 to │ 4│ 72.7│ 2│ 3│ 1│ 5.2 $1,199 │ │ │ │ │ │ $1,200 and │ 5│ │ 4│ 2│ 2│ over │ │ │ │ │ │ Ample[43] │ 14│ 64.2│ 13│ 8│ 8│ 3.5 │ │ │ │ │ │ 5 reportable │ 103│ 146.3│ 67│ 36│ 31│ 4.9 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 21│ 168.0│ 12│ 6│ 6│ 4.6 $521 to $624│ 20│ 235.3│ 12│ 6│ 5│ 6.6 $625 to $779│ 18│ 181.8│ 13│ 1│ 1│ 1.0 $780 to $899│ 13│ 122.6│ 8│ 4│ 4│ 3.6 $900 to │ 6│ 100.0│ 5│ 6│ 4│ 10.0 $1,199 │ │ │ │ │ │ $1,200 and │ 10│ │ 6│ 4│ 3│ over │ │ │ │ │ │ Ample[43] │ 15│ 73.9│ 11│ 9│ 8│ 4.2 │ │ │ │ │ │ 6 reportable │ 88│ 161.2│ 60│ 22│ 13│ 3.9 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 26│ 209.7│ 14│ 8│ 3│ 6.1 $521 to $624│ 9│ 152.5│ 8│ 1│ 1│ 1.7 $625 to $779│ 14│ 127.3│ 11│ 5│ 2│ 4.3 $780 to $899│ 7│ │ 6│ │ │ $900 to │ 12│ 171.4│ 9│ 4│ 3│ 5.4 $1,199 │ │ │ │ │ │ $1,200 and │ 3│ │ 1│ 1│ 1│ over │ │ │ │ │ │ Ample[43] │ 17│ 137.1│ 11│ 3│ 3│ 2.4 │ │ │ │ │ │ 7 reportable │ 78│ 140.5│ 48│ 31│ 22│ 5.3 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 13│ 147.7│ 8│ 4│ 4│ 4.3 $521 to $624│ 15│ 294.1│ 6│ 5│ 4│ 8.9 $625 to $779│ 16│ 164.9│ 9│ 4│ 3│ 4.0 $780 to $899│ 6│ │ 5│ 3│ 2│ $900 to │ 7│ 88.6│ 5│ 5│ 2│ 6.0 $1,199 │ │ │ │ │ │ $1,200 and │ 1│ │ 1│ │ │ over │ │ │ │ │ │ Ample[43] │ 20│ 107.5│ 14│ 10│ 7│ 5.1 │ │ │ │ │ │ 8 reportable │ 95│ 223.0│ 42│ 11│ 7│ 2.5 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 31│ 265.0│ 12│ 3│ 2│ 2.5 $521 to $624│ 22│ 234.0│ 10│ 4│ 2│ 4.1 $625 to $779│ 11│ │ 4│ │ │ $780 to $899│ 11│ │ 5│ 3│ 2│ $900 to │ 6│ │ 3│ │ │ $1,199 │ │ │ │ │ │ $1,200 and │ 3│ │ 2│ │ │ over │ │ │ │ │ │ Ample[43] │ 11│ 125.0│ 6│ 1│ 1│ 1.1 │ │ │ │ │ │ 9 reportable │ 41│ 144.9│ 20│ 16│ 11│ 5.4 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 15│ 187.5│ 6│ 2│ 2│ 2.4 $521 to $624│ 10│ 142.9│ 6│ 2│ 1│ 2.8 $625 to $779│ │ │ │ 3│ 1│ $780 to $899│ 5│ │ 2│ 2│ 2│ $900 to │ 2│ │ 2│ │ │ $1,199 │ │ │ │ │ │ $1,200 and │ │ │ │ 2│ 1│ over │ │ │ │ │ │ Ample[43] │ 9│ 134.3│ 4│ 5│ 4│ 6.9 │ │ │ │ │ │ 10 or more │ │ │ │ │ │ reportable │ 135│ 212.9│ 45│ 32│ 17│ 4.8 pregnancies│ │ │ │ │ │ ─────────────┼───────┼────────┼─────────┼───────┼────────┼───────── Husband │ │ │ │ │ │ earns: │ │ │ │ │ │ Under $521 │ 10│ 192.3│ 4│ 6│ 1│ 10.3 $521 to $624│ 17│ │ 3│ 1│ 1│ $625 to $779│ 16│ 228.6│ 4│ 1│ 1│ 1.4 $780 to $899│ 26│ 342.1│ 7│ 4│ 2│ 5.0 $900 to │ 24│ 218.2│ 8│ 4│ 3│ 3.5 $1,199 │ │ │ │ │ │ $1,200 and │ 5│ │ 1│ 2│ 1│ 8.3 over │ │ │ │ │ │ Ample[43] │ 37│ 136.0│ 18│ 14│ 8│ 4.9 ─────────────┴───────┴────────┴─────────┴───────┴────────┴─────────

═════════════╤═══════════════════════════ SPECIFIED │ NUMBER OF │ PREGNANCIES │ FOR ALL │ MARRIED │ MISCARRIAGES. MOTHERS AND │ ANNUAL │ EARNINGS OF │ HUSBAND. │ ─────────────┼─────────┬───────────────── │ │ Mothers │ │ reporting. ─────────────┼─────────┼────────┬──────── │ │ │ Per │ Number │Number. │cent. of │reported.│ │ all │ │ │mothers. ─────────────┼─────────┼────────┼──────── All │ │ │ reportable │ 191│ 130│ 8.7 pregnancies │ │ │ ═════════════╪═════════╪════════╪════════ Husband │ │ │ earns: │ │ │ Under $521 │ 27│ 17│ 7.31 $521 to $624│ 22│ 14│ 8.0 $625 to $779│ 21│ 15│ 6.6 $780 to $899│ 30│ 19│ 11.4 $900 to │ 25│ 18│ 12.3 $1,199 │ │ │ $1,200 and │ 8│ 6│ 12.0 over │ │ │ Ample[43] │ 58│ 41│ 8.3 │ │ │ 1 reportable │ 8│ 8│ 2.4 pregnancy │ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ │ │ $521 to $624│ 1│ 1│ $625 to $779│ 2│ 2│ $780 to $899│ │ │ $900 to │ │ │ $1,199 │ │ │ $1,200 and │ │ │ over │ │ │ Ample[43] │ 5│ 5│ │ │ │ 2 reportable │ 23│ 16│ 5.7 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ │ │ $521 to $624│ 3│ 1│ $625 to $779│ 2│ 2│ 4.4 $780 to $899│ 4│ 2│ $900 to │ 4│ 4│ $1,199 │ │ │ $1,200 and │ 1│ 1│ over │ │ │ Ample[43] │ 9│ 6│ 5.9 │ │ │ 3 reportable │ 26│ 18│ 8.4 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 5│ 3│ $521 to $624│ 1│ 1│ $625 to $779│ 3│ 2│ $780 to $899│ 5│ 4│ $900 to │ 7│ 3│ $1,199 │ │ │ $1,200 and │ │ │ over │ │ │ Ample[43] │ 5│ 5│ 7.8 │ │ │ 4 reportable │ 22│ 18│ 9.7 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 4│ 2│ $521 to $624│ 2│ 2│ $625 to $779│ 3│ 2│ $780 to $899│ 3│ 3│ $900 to │ 2│ 2│ $1,199 │ │ │ $1,200 and │ 2│ 2│ over │ │ │ Ample[43] │ 6│ 5│ 8.9 │ │ │ 5 reportable │ 20│ 14│ 9.5 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 3│ 3│ $521 to $624│ 3│ 1│ $625 to $779│ 3│ 2│ $780 to $899│ 3│ 2│ $900 to │ │ │ $1,199 │ │ │ $1,200 and │ 2│ 1│ over │ │ │ Ample[43] │ 6│ 5│ │ │ │ 6 reportable │ 23│ 14│ 14.9 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 2│ 2│ $521 to $624│ 6│ 2│ $625 to $779│ 3│ 2│ $780 to $899│ 4│ 2│ $900 to │ 4│ 3│ $1,199 │ │ │ $1,200 and │ │ │ over │ │ │ Ample[43] │ 4│ 3│ │ │ │ 7 reportable │ 27│ 15│ 78.1 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 4│ 2│ $521 to $624│ 1│ 1│ $625 to $779│ │ │ $780 to $899│ 3│ 1│ $900 to │ 5│ 3│ $1,199 │ │ │ $1,200 and │ 2│ 1│ over │ │ │ Ample[43] │ 12│ 7│ │ │ │ 8 reportable │ 15│ 9│ 16.7 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 5│ 2│ $521 to $624│ 1│ 1│ $625 to $779│ 2│ 1│ $780 to $899│ 5│ 3│ $900 to │ 1│ 1│ $1,199 │ │ │ $1,200 and │ 1│ 1│ over │ │ │ Ample[43] │ │ │ │ │ │ 9 reportable │ 13│ 8│ pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 3│ 2│ $521 to $624│ 3│ 3│ $625 to $779│ 1│ 1│ $780 to $899│ │ │ $900 to │ │ │ $1,199 │ │ │ $1,200 and │ │ │ over │ │ │ Ample[43] │ 6│ 2│ │ │ │ 10 or more │ │ │ reportable │ 14│ 10│ 17.2 pregnancies│ │ │ ─────────────┼─────────┼────────┼──────── Husband │ │ │ earns: │ │ │ Under $521 │ 1│ 1│ $521 to $624│ 1│ 1│ $625 to $779│ 2│ 1│ $780 to $899│ 3│ 2│ $900 to │ 2│ 2│ $1,199 │ │ │ $1,200 and │ │ │ over │ │ │ Ample[43] │ 5│ 3│ ─────────────┴─────────┴────────┴──────── Footnote 42:

Excess of births over pregnancies due to plural births.

Footnote 43:

See note on page 45.

TABLE XIV.—DISTRIBUTION ACCORDING TO NUMBER OF PREGNANCIES AND AGE GROUPS OF MARRIED MOTHERS CLASSIFIED BY NATIVITY.

═══════════════════════╤═══════════════╤═══════════════╤═══════════════ MOTHER’S AGE AND NUMBER│ │ │ FOREIGN OF REPORTABLE │ ALL MOTHERS. │NATIVE MOTHERS.│ MOTHERS. PREGNANCIES. │ │ │ ───────────────────────┼───────┬───────┼───────┬───────┼───────┬─────── │Number.│ Per │Number.│ Per │Number.│ Per │ │ cent. │ │ cent. │ │ cent. ───────────────────────┼───────┼───────┼───────┼───────┼───────┼─────── Total pregnancies │ 1,491│ 100.0│ 816│ 100.0│ 675│ 100.0 ═══════════════════════╪═══════╪═══════╪═══════╪═══════╪═══════╪═══════ 1 │ 339│ 22.7│ 234│ 28.7│ 105│ 15.6 2 │ 283│ 19.0│ 173│ 21.2│ 110│ 16.3 3 │ 214│ 14.4│ 111│ 13.6│ 103│ 15.3 4 │ 186│ 12.5│ 94│ 11.5│ 92│ 13.6 5 │ 147│ 9.8│ 65│ 8.0│ 82│ 12.1 6 │ 94│ 6.3│ 37│ 4.5│ 57│ 8.4 7 │ 83│ 5.6│ 38│ 4.7│ 45│ 6.7 8 │ 54│ 3.6│ 23│ 2.8│ 31│ 4.6 9 │ 33│ 2.2│ 13│ 1.6│ 20│ 3.0 10 and over │ 58│ 3.9│ 28│ 3.4│ 30│ 4.4 │ │ │ │ │ │ Under 20 years, total│ 89│ 100.0│ 66│ 100.0│ 23│ 100.0 pregnancies │ │ │ │ │ │ ───────────────────────┼───────┼───────┼───────┼───────┼───────┼─────── 1 │ 74│ 83.1│ 55│ 83.3│ 19│ 82.6 2 │ 12│ 13.5│ 10│ 15.2│ 2│ 8.7 3 │ 3│ 3.4│ 1│ 1.5│ 2│ 8.7 │ │ │ │ │ │ 20 to 24 years, total│ 461│ 100.0│ 261│ 100.0│ 200│ 100.0 pregnancies │ │ │ │ │ │ ───────────────────────┼───────┼───────┼───────┼───────┼───────┼─────── 1 │ 178│ 38.6│ 114│ 43.7│ 64│ 32.0 2 │ 156│ 33.8│ 86│ 33.0│ 70│ 35.0 3 │ 77│ 16.7│ 42│ 16.1│ 35│ 17.5 4 │ 39│ 8.5│ 14│ 5.4│ 25│ 12.5 5 │ 10│ 2.2│ 4│ 1.5│ 6│ 3.0 6 │ 1│ .2│ 1│ 0.4│ │ │ │ │ │ │ │ 25 to 29 years, total│ 395│ 100.0│ 199│ 100.0│ 196│ 100.0 pregnancies │ │ │ │ │ │ ───────────────────────┼───────┼───────┼───────┼───────┼───────┼─────── 1 │ 57│ 14.5│ 45│ 22.6│ 12│ 6.1 2 │ 74│ 18.7│ 46│ 23.1│ 28│ 14.3 3 │ 95│ 24.1│ 40│ 20.1│ 55│ 28.1 4 │ 75│ 19.0│ 40│ 20.1│ 35│ 17.9 5 │ 56│ 14.2│ 17│ 8.5│ 39│ 19.9 6 │ 22│ 5.6│ 7│ 3.6│ 15│ 7.7 7 │ 14│ 3.5│ 4│ 2.0│ 10│ 5.1 8 │ 2│ .4│ │ │ 2│ 1.0 │ │ │ │ │ │ 30 to 39 years, total│ 466│ 100.0│ 245│ 100.0│ 221│ 100.0 pregnancies │ │ │ │ │ │ ───────────────────────┼───────┼───────┼───────┼───────┼───────┼─────── 1 │ 30│ 6.4│ 20│ 8.2│ 10│ 4.5 2 │ 39│ 8.4│ 29│ 11.8│ 10│ 4.5 3 │ 36│ 7.7│ 25│ 10.2│ 11│ 5.0 4 │ 63│ 13.5│ 33│ 13.5│ 30│ 13.6 5 │ 75│ 16.1│ 40│ 16.3│ 35│ 15.8 6 │ 60│ 12.9│ 24│ 9.8│ 36│ 16.3 7 │ 56│ 12.0│ 28│ 11.4│ 28│ 12.7 8 │ 51│ 10.9│ 23│ 9.4│ 28│ 12.7 9 │ 23│ 4.9│ 8│ 3.3│ 15│ 6.8 10 and over │ 33│ 7.1│ 15│ 6.1│ 18│ 8.1 │ │ │ │ │ │ 40 years and over, │ 80│ 100.0│ 45│ 100.0│ 35│ 100.0 total pregnancies │ │ │ │ │ │ ───────────────────────┼───────┼───────┼───────┼───────┼───────┼─────── 2 │ 2│ 2.5│ 2│ 4.4│ │ 3 │ 3│ 3.8│ 3│ 6.7│ │ 4 │ 9│ 11.3│ 7│ 15.6│ 2│ 5.7 5 │ 6│ 7.5│ 4│ 8.9│ 2│ 5.7 6 │ 11│ 13.8│ 5│ 11.1│ 6│ 17.1 7 │ 13│ 16.3│ 6│ 13.3│ 7│ 20.0 8 │ 1│ 1.3│ │ │ 1│ 2.9 9 │ 10│ 12.5│ 5│ 11.1│ 5│ 14.3 10 and over │ 25│ 31.3│ 13│ 28.9│ 12│ 34.3 ───────────────────────┴───────┴───────┴───────┴───────┴───────┴───────

TABLE XV.—DISTRIBUTION OF MARRIED MOTHERS BY LOSSES SUSTAINED, ACCORDING TO NATIVITY OF MOTHER AND NUMBER OF POSSIBLE LOSSES.

═════════╤════════╤══════════════════════════════════════════════ NUMBER OF│ │ BIRTHS OR│ │ POSSIBLE │ │ LOSSES │ │DISTRIBUTION OF MOTHERS ACCORDING TO NUMBER OF AND │ │ LOSSES. NATIVITY │ │ OF │ │ MOTHER. │ │ ─────────┼────────┼──────┬───────┬───────┬───────┬───────┬─────── │ Number │ 1 │ 2 │ 3 │ 4 │ 5 │ 6 │ of │loss. │losses.│losses.│losses.│losses.│losses. │mothers.│ │ │ │ │ │ ─────────┼────────┼──────┼───────┼───────┼───────┼───────┼─────── All │ 1,491│ 399│ 121│ 60│ 24│ 13│ 8 mothers │ │ │ │ │ │ │ ═════════╪════════╪══════╪═══════╪═══════╪═══════╪═══════╪═══════ 1 birth │ 335│ 53│ │ │ │ │ 2 births│ 277│ 67│ 10│ │ │ │ 3 births│ 216│ 73│ 14│ 4│ │ │ 4 births│ 187│ 55│ 13│ 8│ 1│ │ 5 births│ 148│ 48│ 19│ 11│ 1│ 2│ 6 births│ 96│ 44│ 13│ 8│ 2│ 1│ 2 7 births│ 82│ 22│ 19│ 10│ 2│ │ 1 8 births│ 54│ 18│ 8│ 10│ 4│ 2│ 2 9 births│ 36│ 9│ 10│ 5│ 1│ 1│ 2 10 or │ │ │ │ │ │ │ more │ 60│ 10│ 15│ 4│ 13│ 7│ 1 births │ │ │ │ │ │ │ │ │ │ │ │ │ │ Native │ 816│ 199│ 59│ 19│ 5│ 6│ 1 mothers│ │ │ │ │ │ │ ─────────┼────────┼──────┼───────┼───────┼───────┼───────┼─────── 1 birth │ 232│ 29│ │ │ │ │ 2 births │ 170│ 36│ 5│ │ │ │ 3 births │ 111│ 35│ 7│ 1│ │ │ 4 births │ 98│ 33│ 6│ 3│ │ │ 5 births │ 65│ 19│ 10│ 4│ │ │ 6 births │ 38│ 19│ 7│ 1│ │ 1│ 7 births │ 37│ 10│ 8│ 3│ │ │ 1 8 births │ 21│ 8│ 5│ 3│ │ │ 9 births │ 15│ 4│ 4│ 3│ 1│ │ 10 or │ │ │ │ │ │ │ more │ 29│ 6│ 7│ 1│ 4│ 5│ births │ │ │ │ │ │ │ │ │ │ │ │ │ │ Foreign│ 675│ 200│ 62│ 41│ 19│ 7│ 7 mothers│ │ │ │ │ │ │ ─────────┼────────┼──────┼───────┼───────┼───────┼───────┼─────── 1 birth │ 103│ 24│ │ │ │ │ 2 births │ 107│ 31│ 5│ │ │ │ 3 births │ 105│ 38│ 7│ 3│ │ │ 4 births │ 89│ 22│ 7│ 5│ 1│ │ 5 births │ 83│ 29│ 9│ 7│ 1│ 2│ 6 births │ 58│ 25│ 6│ 7│ 2│ │ 2 7 births │ 45│ 12│ 11│ 7│ 2│ │ 8 births │ 33│ 10│ 3│ 7│ 4│ 2│ 2 9 births │ 21│ 5│ 6│ 2│ │ 1│ 2 10 or │ │ │ │ │ │ │ more │ 31│ 4│ 8│ 3│ 9│ 2│ 1 births │ │ │ │ │ │ │ ─────────┴────────┴──────┴───────┴───────┴───────┴───────┴───────

═════════╤═══════════════ NUMBER OF│ BIRTHS OR│DISTRIBUTION OF POSSIBLE │ MOTHERS LOSSES │ ACCORDING TO AND │ NUMBER OF NATIVITY │ LOSSES. OF │ MOTHER. │ ─────────┼───────┬─────── │ 8 │ 10 or │losses.│ more │ │losses. ─────────┼───────┼─────── All │ 1│ 2 mothers │ │ ═════════╪═══════╪═══════ 1 birth │ │ 2 births│ │ 3 births│ │ 4 births│ │ 5 births│ │ 6 births│ │ 7 births│ │ 8 births│ │ 9 births│ │ 10 or │ │ more │ 1│ 2 births │ │ │ │ Native │ 1│ mothers│ │ ─────────┼───────┼─────── 1 birth │ │ 2 births │ │ 3 births │ │ 4 births │ │ 5 births │ │ 6 births │ │ 7 births │ │ 8 births │ │ 9 births │ │ 10 or │ │ more │ 1│ births │ │ │ │ Foreign│ │ 2 mothers│ │ ─────────┼───────┼─────── 1 birth │ │ 2 births │ │ 3 births │ │ 4 births │ │ 5 births │ │ 6 births │ │ 7 births │ │ 8 births │ │ 9 births │ │ 10 or │ │ more │ │ 2 births │ │ ─────────┴───────┴───────

POPULATION, REGISTERED BIRTHS, DEATHS OF INFANTS UNDER 1 YEAR OF AGE, AND INFANT MORTALITY RATES FOR REGISTRATION STATES AND REGISTRATION CITIES HAVING A POPULATION OF AT LEAST 50,000 IN 1910.

═══════════════════════╤═══════════╤═══════════╤═══════════════════════ AREA. │ │ │ DEATHS[44] OF INFANTS │ │ │ UNDER 1 YEAR OF AGE. ───────────────────────┼───────────┼───────────┼───────────┬─────────── │Population │Births.[45]│ Number. │ Per 1000 │ in 1910. │ │ │births.[46] ───────────────────────┼───────────┼───────────┼───────────┼─────────── REGISTRATION STATES. │ │ │ │ │ │ │ │ Connecticut │ 1,114,756│ 27,291│ 3,476│ 127 Maine │ 742,371│ 15,578│ 2,108│ 135 Massachusetts │ 3,366,416│ 86,765│ 11,377│ 131 Michigan │ 2,810,173│ 63,566│ 7,912│ 124 New Hampshire │ 430,572│ 9,385│ 1,373│ 146 Pennsylvania │ 7,665,111│ 202,631│ 28,377│ 140 Rhode Island │ 542,610│([47])6,595│([47])1,111│ ([47])168 Vermont │ 355,956│ 7,343│ 791│ 168 │ │ │ │ REGISTRATION CITIES OF │ │ │ │ 50,000 POPULATION OR │ │ │ │ OVER IN 1910. │ │ │ │ │ │ │ │ Connecticut: │ │ │ │ Bridgeport │ 102,054│ 2,976│ 367│ 123 Hartford │ 98,915│ 2,411│ 286│ 119 New Haven │ 133,605│ 3,772│ 406│ 108 Waterbury │ 73,141│ 2,150│ 320│ 149 │ │ │ │ Washington, D. C. │ 331,069│ 7,016│ 1,068│ 152 Portland, Me. │ 58,571│ 1,163│ 167│ 144 │ │ │ │ Massachusetts: │ │ │ │ Boston │ 670,585│ 17,760│ 2,246│ 126 Brockton │ 56,878│ 1,359│ 134│ 99 Cambridge │ 104,839│ 2,462│ 293│ 119 Fall River │ 119,295│ 4,591│ 854│ 186 Holyoke │ 57,730│ 1,702│ 362│ 213 Lawrence │ 85,892│ 3,165│ 529│ 167 Lowell │ 106,294│ 2,630│ 607│ 231 Lynn │ 89,336│ 2,218│ 216│ 97 New Bedford │ 96,652│ 3,873│ 685│ 177 Somerville │ 77,236│ 1,728│ 174│ 101 Springfield │ 88,926│ 2,438│ 302│ 124 Worcester │ 145,986│ 3,918│ 536│ 137 │ │ │ │ Michigan: │ │ │ │ Detroit │ 465,766│ 11,960│ 2,138│ 179 Grand Rapids │ 112,571│ 2,693│ 329│ 122 Saginaw │ 50,510│ 897│ 130│ 145 │ │ │ │ Manchester, N. H. │ 70,063│ 1,939│ 375│ 193 │ │ │ │ New York, N. Y. │ 4,766,883│ 129,316│ 6,159│ 125 Bronx Borough │ 430,980│ 10,926│ 11,047│ 96 Brooklyn Borough │ 1,634,351│ 43,128│ 5,063│ 117 Manhattan Borough │ 2,331,542│ 66,112│ 8,900│ 135 Queens Borough │ 284,041│ 7,095│ 865│ 122 Richmond Borough │ 85,969│ 2,055│ 284│ 138 │ │ │ │ Pennsylvania: │ │ │ │ Allentown │ 51,913│ 1,406│ 202│ 144 Altoona │ 52,127│ 1,392│ 166│ 119 Erie │ 66,525│ 1,713│ 197│ 116 Harrisburg │ 64,186│ 1,308│ 169│ 129 Johnstown │ 55,482│ 1,628│ 268│ 165 Philadelphia │ 1,549,008│ 38,666│ 5,334│ 138 Pittsburgh │ 533,905│ 15,059│ 2,259│ 150 Reading │ 96,071│ 2,370│ 336│ 142 Scranton │ 129,867│ 3,512│ 520│ 148 Wilkes-Barre │ 67,105│ 1,840│ 269│ 146 │ │ │ │ Rhode Island: │ │ │ │ Pawtucket │ 51,622│ ([48]) │ 191│ ([48]) Providence │ 224,326│ ([48]) │ 827│ ([48]) ───────────────────────┴───────────┴───────────┴───────────┴───────────

Footnote 44:

Exclusive of stillbirths.

Footnote 45:

Provisional figures; exclusive of stillbirths.

Footnote 46:

Based on provisional figures for births.

Footnote 47:

The figures for Rhode Island are exclusive of Providence and Pawtucket.

Footnote 48:

Returns of births not received from State board in time for inclusion.

It will be seen by this table that Johnstown is among the 10 cities of more than 50,000 population which had an infant mortality rate of 1910 in excess of 150 per 1,000 births. These 10 cities and their respective rates are as follows: Lowell, Mass., 231; Holyoke, Mass., 213; Manchester, N. H., 193; Fall River, Mass., 186; Detroit, Mich., 179; New Bedford, Mass., 177; Lawrence, Mass., 167; Johnstown, Pa., 165; Washington, D. C., 152; and Pittsburgh, Pa., 150.

It should be borne in mind that the absolute infant mortality rate of 134, computed for the group of babies included in this investigation, that is, for those born in Johnstown in 1911, can not be compared with any of the approximate rates in the foregoing table, since the basis of computation is entirely different. But the method used in this report seemed to be the only practicable one for our purpose, namely, to measure the infant mortality rate in different districts of the city where the babies are subjected to varying conditions.

Conditions similar to those existing in Johnstown were found in Chicago by Dr. Alice Hamilton, Bacteriologist in the Memorial Institute for Infectious Diseases, Hull House. The results of a study made of 1,600 families in the neighborhood was published in 1910. The investigation was undertaken to find out the truth or falsity of a general feeling among the district nurses that a high birth rate was accompanied by a high death rate. It was found that a high birth rate was not so much accompanied as outrun by a high death rate. The number of children live-born was compared with the number of children who reached the age of three, so it is a study of child mortality, rather than of infant mortality. The child mortality rate rises and falls very much as does the infant mortality rate in Johnstown. A table calculated from the data of all the families shows an ascending mortality rate:

No. in Family Child Mortality Rate 4 children and less 118 6 children and more 267 7 children and more 280 8 children and more 291 9 children and more 303

Expressed in words this table says that child mortality increases as the number of children per family increases, until we have a death rate in families of eight and more, which is two and a half times as great as that in families of four children and under.

FOURTH ANNUAL REPORT OF THE CHIEF, CHILDREN’S BUREAU, U. S. DEPARTMENT OF LABOR, Washington, October 7, 1916

INFANT MORTALITY—MANCHESTER

The findings of the bureau’s earlier study in Johnstown, Pa., are confirmed in many respects by the findings in Manchester—the coincidence of a high infant mortality rate with low earnings, poor housing, mother’s work, and large families.

The mortality rate among the 1,564 live-born babies studied in Manchester was 165 per 1,000 births, which is considerably higher than the estimated rate for the whole country.

Manchester is primarily a textile town, and the textile mills employed 36.3 per cent. of all the fathers of babies born in Manchester during the 12 months covered by the study. Of the fathers, 13.7 per cent. were earning less than $450 per year; 48.5 per cent. less than $650; 22.9 per cent. $850 or more; 6.4 per cent. $1,250 or more.

Of the babies with fathers earning less than $450, about 1 in 4 died before it was 12 months old. The great majority of the babies had fathers in the wage group from $450 to $849, and of these about 1 in 6 died. Of the babies whose fathers earned $850 but less than $1,050, 1 in 8 failed to survive. Where the fathers earned $1,050 or more, 1 baby in 16 died in the first year.

Where families lived two or more persons per room, the infant death rate was twice as high as where they lived less than one person per room. The babies living in houses occupied by a single family died at the rate of 86.1 per 1,000, but those in tenements occupied by more than six families died at the rate of 236.6 per 1,000.

When the mother was a wage earner the baby’s chances of living were less than when she was not. Babies of mothers who had worked at some time during the year before the baby’s birth died at the rate of 199.2 per 1,000, while babies of nonworking mothers died at the rate of 133.9. Babies of mothers employed away from home some time during the year after childbirth while the baby was still alive and under four months old had a rate of 277.3, while babies of mothers not employed during that time had a rate of 122.

Babies of foreign-born mothers did not fare so well as babies of native mothers. The differences of rates, however, are only partly accounted for by their lower earnings. The largest foreign element in Manchester is Canadian French, and among them the infant mortality rate, 224 per 1,000 live births, is greater than that among any other group of the population, although their earnings are in general higher than those of other foreigners.

Sheer size of family appears to be one factor in this high Canadian-French rate, one-third of their babies being sixth or later in order of birth, while over one-sixth of these mothers had had from 9 to 18 children. These Canadian-French babies in families of 6 or more children died at the rate of 246.2 per 1,000 and the rate rises to 277.2 per 1,000 when only babies ninth or later in order of birth are considered.