The Task of Social Hygiene

Chapter 12

Chapter 124,011 wordsPublic domain

This is now a familiar fact, and perhaps it should not excite very great surprise. England is an old and fairly stable country, and it may be said that it would be unreasonable to expect its population to retain indefinitely a high degree of fertility. Whether this is so or not, there is the further consideration to be borne in mind that, during nearly the whole of the Victorian period, emigration of the most vigorous stocks took place to a very marked extent. It is not difficult to see the influence of such emigration in connection with the greatly diminished population of Ireland, as compared with Scotland; and we may reasonably infer that it has had its part in the decreased fertility of the United Kingdom generally.

But we encounter the remarkable fact that this decreased fertility of the Anglo-Saxon populations is not confined to the United Kingdom. It is even more pronounced in those very lands to which so many thousand shiploads of our best people have been taken. In the United States the question has attracted much attention, and there is little disagreement among careful observers as to the main facts of the situation. The question is, indeed, somewhat difficult for two reasons: the registration of births is not generally compulsory in the United States, and, even when general facts are ascertained, it is still necessary to distinguish between the different classes of the population. Our conclusions must therefore be based, not on the course of a general birth-rate, but on the most reliable calculations, based on the census returns and on the average size of the family at different periods, and among different classes of the population. A bulletin of the Census Bureau of the United States since 1860 was prepared a few years ago by Walter F. Wilcox, of Cornell University. It determines from the data in the census office the proportion of children to the number of women of child-bearing age in the country at different periods, and shows that there has been, on the whole, a fall from the beginning to the end of the last century. Children under ten years of age constituted one-third of the population at the beginning of the century, and at the end less than one-fourth of the total population. Between 1850 and 1860 the proportion of children to women between fifteen and forty-nine years of age increased, but since 1860 it has constantly decreased. In 1860 the number of children under five years of age to one thousand women between fifteen and forty-nine years of age was 634; in 1900 it was only 474. The proportion of children to potential mothers in 1900 was only three-fourths as large as in 1860. In the north and west of the United States the decline has been regular, while in the south the change has been less regular and the decline less marked. A comparison is made between the proportion of children in the foreign-born population and in the American. The former was 710 to the latter's 462. In the coloured population the proportion of children is greater than in the corresponding white population.

There can be no doubt whatever that, from the eighteenth century to the twentieth, there has been a steady decrease in the size of the American family. Franklin, in the eighteenth century, estimated that the average number of children to a married couple was eight; genealogical records show that, while in the seventeenth century it was nearly seven, it was over six at the end of the eighteenth century. Since then, as Engelmann and others have shown, there has been a steady decrease in the size of the family; in the earlier years of the nineteenth century there were between four and five children to each marriage, while by the end of the century the number of children had fallen to between four and but little over one. Engelmann finds that there is but a very trifling difference in this respect between the upper and the lower social classes; the average for the labouring classes at St. Louis he finds to be about two, and for the higher classes a little less. It is among the foreign-born population, and among those of foreign parents, that the larger families are found; thus Kuczynski, by analysing the census, finds that in Massachusetts the average number of children to each married woman among the American-born of all social classes is 2.7, while among the foreign-born of all social classes it is 4.5. Moreover, sterility is much more frequent among American women than among foreign women in America. Among various groups in Boston, St. Louis, and elsewhere it varies between 20 and 23 per cent, and in some smaller groups is even considerably higher, while among the foreign-born it is only 13 per cent. The net result is that the general natality of the United States at the present day is about equal to that of France, but that, when we analyse the facts, the fertility of the old native-born American population of mainly Anglo-Saxon origin is found to be lower than that of France. This element, therefore, is rapidly dwindling away in the United States. The general level of the birth-rate is maintained by the foreign immigrants, who in many States (as in New York, Massachusetts, Michigan, and Minnesota) constitute the majority of the population, and altogether number considerably over ten millions. Among these immigrants the Anglo-Saxon element is now very small. Indeed, the whole North European contingent among the American immigrants, which was formerly nearly 90 per cent of the whole, has since 1890 steadily sunk, and the majority of the immigrants now belong to the Central, Southern, and Eastern European stocks. The racial, and, it is probable, the psychological characteristics of the people of the United States are thus beginning to undergo, not merely modification, but, it may almost be said, a revolution. If, as we may well believe, the influence of the original North-European racial elements--Anglo-Saxon, Dutch, and French--still continues to persist in the United States, it can only be the influence of a small aristocracy, maintained by intellect and character.

When we turn to Canada, a land that is imposing, less by the actual size of the population than by the vast tracts it possesses for its development, the question has not yet been fully investigated; but such facts and official publications as I have been able to obtain all indicate that, in this matter, the English Canadians approximate to the native Americans. In the United States it is the European immigrants who maintain the general population at a productive level, and thus indirectly oust the Anglo-Saxon element. In Canada the chief dividing line is between the Anglo-Saxon element and the old French element in the population; and here it is the French Canadians who are gaining ground on the English elements in the population. Engelmann ascertained that an examination of one thousand families in the records of Quebec Life Assurance companies shows 9.2 children on the average to the French Canadian child-bearing woman. It is found also from the records of the French Canadian Society for Artisans that 500 families from town districts, taken at random, show 9.06 children per family, and 500 families from country districts show 9.33 children per family.[98] It must be remembered that this average, which is even higher than that found in Russia, the most prolific of European countries, is not quite the same as the number of children per marriage; but it indicates very great fertility, while it may be noted also that sterile marriages are comparatively rare among French Canadians, although among English Canadians the proportion of childless families is found to be almost exactly the same (nearly 20 per cent) as among the infertile Americans of Massachusetts. The annual Reports of the Registrar-General of Ontario, a province which is predominantly of Anglo-Saxon origin, show that the average birth-rate during the decade 1899-1908 has been 22.3 per 1000; it must be noted, however, that there has been a gradual rise from a rate of 19.4 in 1899 to one of 25.6 in 1908. The report of Mr. Prévost, the recorder of vital statistics for the predominantly French province of Quebec, shows much higher rates. The general birth-rate for the province for the year 1901 is high, being 35.2, much higher than that of England, and nearly as high as that of Germany. If, however, we consider the thirty-five counties of the province in which the population is almost exclusively French Canadian, we find that 35 represents almost the lowest average; as many as twenty-two of these counties show a rate of over forty, and one (Yamaska) reached 51.52. It is very evident that, in order to pull down these high birth-rates to the general level of 35.2, we have to assume a much lower birth-rate among the counties in which the English element is considerable. It must be remembered, however, that infant mortality is high among the French Canadians. The French Canadian Catholic, it has been said, would shrink in horror from such an unnatural crime as limiting his family before birth, but he sees nothing repugnant to God or man in allowing the surplus excess of children to die after birth. In this he is at one with the Chinese. Dr. E.P. La Chapelle, the President of the Provincial Conseil d'Hygiène, wrote some years ago to Professor Davidson, in answer to inquiries: "I do not believe it would be correct to ascribe the phenomenon to any single cause, and I am convinced it is the result of several factors. For one, the first cause of the heavy infant mortality among the French Canadians is their very heavy natality, each family being composed of an average of twelve children, and instances of families of fifteen, eighteen, and even twenty-four children being not uncommon. The super-abundance of children renders, I think, parents less careful about them."[99]

The net result is a slight increase on the part of the French Canadians, as compared with the English element in the province, as becomes clear when we compare the proportion of the population of English, Scotch, Irish, and all other nationalities with the total population of the province, now and thirty years ago. In 1871 it was 21 per cent; in 1901 it was only 19 per cent. The decrease of the Anglo-Saxons may here appear to be small, though it must be remembered that thirty years is but a short period in the history of a nation; but it is significant when we bear in mind that the English element has here been constantly reinforced by immigrants (who, as the experience of the United States shows, are by no means an infertile class), and that such reinforcement cannot be expected to continue in the future.

From Australia comes the same story of the decline of Anglo-Saxon fertility. In nearly all the Australian colonies the highest birth-rate was reached some twenty or thirty years ago. Since then there has been a more or less steady fall, accompanied by a marked decrease in the number of marriages, and a tendency to postpone the age of marriage. One colony, Western Australia, has a birth-rate which sometimes fluctuates above that of England; but it is the youngest of the colonies, and, at present, that with the smallest population, largely composed of recent immigrants. We may be quite sure that its comparatively high birth-rate is merely a temporary phenomenon. A very notable fact about the Australian birth-rate is the extreme rapidity with which the fall has taken place; thus Queensland, in 1890, had a birth-rate of 37, but by 1899 the rate had steadily fallen to 27, and the Victorian rate during the same period fell from 33 to 26 per thousand. In New South Wales, the state of things has been carefully studied by Mr. Coghlan, formerly Government statistician of New South Wales, who comes to the conclusion that the proportion of fertile marriages is declining, and that (as in the United States) it is the recent European immigrants only who show a comparatively high birth-rate. Until 1880, Coghlan states, the Australasian birth-rate was about 38 per thousand, and the average number of children to the family about 5.4. In 1901 the birth-rate had already fallen to 27.6 and the size of the family to 3.6 children.[100] It should be added that in all the Australasian colonies the birth-rate reached its lowest point some years ago, and may now be regarded as in a state of normal equipoise with a slight tendency to rise. The case of New Zealand is specially interesting. New Zealand once had the highest birth-rate of all the Australasian colonies; it is without doubt the most advanced of all in social and legislative matters; a variety of social reforms, which other countries are struggling for, are, in New Zealand, firmly established. Its prosperity is shown by the fact that it has the lowest death-rate of any country in the world, only 10.2 per thousand, as against 24 in Austria and 22 in France; it cannot even be said that the marriage-rate is very low, for it is scarcely lower than that of Austria, where the birth-rate is high. Yet the birth-rate in New Zealand fell as the social prosperity of the country rose, reaching its lowest point in 1899.

We thus find that from the three great Anglo-Saxon centres of the world--north, west, and south--the same story comes. We need not consider the case of South Africa, for it is well recognized that there the English constitute a comparatively infertile fringe, mostly confined to the towns, while the earlier Dutch element is far more prolific and firmly rooted in the soil. The position of the Dutch there is much the same as that of the French in Canada.

Thus we find that among highly civilized races generally, and not least among the English-speaking peoples who were once regarded as peculiarly prolific, a great diminution of reproductive activity has taken place during the past forty years, and is in some countries still taking place. But before we proceed to consider its significance it may be well to look a little more closely at our facts.

We have seen that the "crude" birth-rate is not an altogether reliable index of the reproductive energy of a nation. Various circumstances may cause an excess or a defect of persons of reproductive age in a community, and unless we allow for these variations, we cannot estimate whether that community is exercising its reproductive powers in a fairly normal manner. But there is another and still more important consideration always to be borne in mind before we can attach any far-reaching significance even to the corrected birth-rate. We have, that is, to bear in mind that a high or a low birth-rate has no meaning, so far as the growth of a nation is concerned, unless it is considered in relation to the death-rate. The natural increase of a nation is not the result of its birth-rate, but of its birth-rate minus its death-rate. A low birth-rate with a low death-rate (as in Australasia) produces a far greater natural increase than a low birth-rate with a rather high death-rate (as in France), and may even produce as great an increase as a very high birth-rate with a very high death-rate (as in Russia). Many worthy people might have been spared the utterance of foolish and mischievous jeremiads, if, instead of being content with a hasty glance at the crude birth-rate, they had paused to consider this fairly obvious fact.

There is an intimate connection between a high birth-rate and a high death-rate, between a low birth-rate and a low death-rate. It may not, indeed, be an absolutely necessary connection, and is not the outcome of any mysterious "law." But it usually exists, and the reasons are fairly obvious. We have already encountered the statement from an official Canadian source that the large infantile mortality of French Canadian families is due to parental carelessness, consequent, no doubt, not only on the dimly felt consciousness that children are cheap, but much more on inability to cope with the manifold cares involved by a large family. Among the English working class every doctor knows the thinly veiled indifference or even repulsion with which women view the seemingly endless stream of babies they give birth to. Among the Berlin working class, also, Hamburger's important investigation has indicated how serious a cause of infantile mortality this may be. By taking 374 working-class women, who had been married twenty years and conceived 3183 times, he found that the net result in surviving children was relatively more than twice as great among the women who had only had one child when compared to the women who had had fifteen children. The women with only one child brought 76.47 per cent of these children to maturity; the women who had produced fifteen children could only bring 30.66 of them to maturity; the intermediate groups showed a gradual fall to this low level, the only exception being that the mothers of three children were somewhat more successful than the mothers of two children. Among well-to-do mothers Hamburger found no such marked contrast between the net product of large families as compared to small families.[101]

It we look at the matter from a wider standpoint we can have no difficulty in realizing that a community which is reproducing itself rapidly must always be in an unstable state of disorganization highly unfavourable to the welfare of its members, and especially of the new-comers; a community which is reproducing itself slowly is in a stable and organized condition which permits it to undertake adequately the guardianship of its new members. The high infantile mortality of the community with a high birth-rate merely means that that community is unconsciously making a violent and murderous effort to attain to the more stable and organized level of the country with a low birth-rate.

The English Registrar-General in 1907 estimated the natural increase by excess of births over deaths as exceptionally high (higher than that of England) in several Australian Colonies, in the Balkan States, in Russia, the Netherlands, the German Empire, Denmark, and Norway, though in the majority of these lands the birth-rate is very low. On the other hand, the natural increase by excess of births over deaths is below the English rate in Austria, in Hungary, in Japan, in Italy, in Sweden, Switzerland, Spain, Belgium, and Ontario, though in the majority of these lands the birth-rate is high, and in some very high.[102] In most cases it is the high death-rate in infancy and childhood which exercises the counterbalancing influence against a high birth-rate; the death-rate in adult life may be quite moderate. And with few exceptions we find that a high infantile mortality accompanies a high birth-rate, while a low infantile mortality accompanies a low birth-rate. It is evident, however, that even an extremely high infantile mortality is no impediment to a large natural increase provided the birth-rate is extremely high to a more than corresponding extent. But a natural increase thus achieved seems to be accompanied by far more disastrous social conditions than when an equally large increase is achieved by a low infantile death-rate working in association with a low birth-rate. Thus in Norway on one side of the world and in Australasia on the opposite side we see a large natural increase effected not by a profuse expenditure of mostly wasted births but by an economy in deaths, and the increase thus effected is accompanied by highly favourable social conditions, and great national vigour. Norway appears to have the lowest infantile death-rate in Europe.[103]

Rubin has suggested that the fairest measure of a country's well-being, as regards its actual vitality--without direct regard, of course, to the country's economic prosperity--is the square of the death-rate divided by the birth-rate.[104] Sir J.A. Baines, who accepts this test, states that Argentina with its high birth-rate and low death-rate stands even above Norway, and Australia still higher, while the climax for the world is attained by New Zealand, which has attained "the nearest approach to immortality yet on record."[105] The order of descending well-being in Europe is thus represented (at the year 1900) by Norway, Sweden, Denmark, Holland, England, Scotland, Finland, Belgium, Switzerland, Germany, Ireland, Portugal, Italy, Austria, France, and Spain.

On the other hand, in all the countries, probably without exception, in which a large natural increase is effected by the efforts of an immense birth-rate to overcome an enormous death-rate the end is only effected with much friction and misery, and the process is accompanied by a general retardation of civilization.

"The greater the number of children," as Hamburger puts it, "the greater the cost of each survivor to the family and to the State."

Russia presents not only the most typical but the most stupendous and appalling example of this process. Thirty years ago the mortality of infants under one year was three times that of Norway, nearly double that of England. More recently (1896-1900) the infantile mortality in Russia has fallen from 313 to 261, but as that of the other countries has also fallen it still preserves nearly the same relative position, remaining the highest in Europe, while if we compare it with countries outside Europe we find it is considerably more than four times greater than that of South Australia. In one town in the government of Perm, some years ago if not still, the mortality of infants under one year regularly reached 45 per cent, and the deaths of children under five years constituted half the total mortality. This is abnormally high even for Russia, but for all Russia it was found that of the boys born in a single year during the second half of the last century only 50 per cent reached their twenty-first year, and even of these only 37.6 per cent were fit for military service. It is estimated that there die in Russia 15 per thousand more individuals than among the same number in England; this excess mortality represents a loss of 1,650,000 lives to the State every year.[106]

Thus Russia has the highest birth-rate and at the same time the highest death-rate. The large countries which, after Russia, have the highest infantile mortality are Austria, Hungary, Prussia, Spain, Italy, and Japan; all these, as we should expect, have a somewhat high birth-rate.

The case of Japan is interesting as that of a vigorous young Eastern nation, which has assimilated Western ways and is encountering the evils which come of those ways. Japan is certainly worthy of all our admiration for the skill and vigour with which it has affirmed its young nationality along Western lines. But when the vital statistics of Japan are vaguely referred to either as a model for our imitation or as a threatening peril to us, we may do well to look into the matter a little more closely. The infantile mortality of Japan (1908) is 157, a very high figure, 50 per cent higher than that of England, much more than double that of New Zealand, or South Australia. Moreover, it has rapidly risen during the last ten years. The birth-rate of Japan in 1901-2 was high (36), though it has since fallen to the level of ten years ago. But the death-rate has risen concomitantly (to over 24 per 1000), and has continued to rise notwithstanding the slight decline in the birth-rate. We see here a tendency to the sinister combination of a falling birth-rate with a rising death-rate.[107] It is obvious that such a tendency, if continued, will furnish a serious problem to Japanese social reformers, and at the same time make it impossible for Western alarmists to regard the rise of Japan as a menace to the world.