II
In England the high infantile mortality has occasioned much alarm and called forth much agitation. There is a world of pathos and rebuke in the grim truth that the knowledge that it is becoming increasingly difficult to get suitable recruits for the army and navy has stirred the nation in a way that the fate of the children themselves and their inability to become good and useful citizens could not do.[[11]] Alarmed by the decline of its industrial and commercial supremacy, and the physical inferiority of its soldiers so manifest in the South African war, a most rigorous investigation of the causes of physical deterioration has been made, with the result that on all sides it is agreed that poverty in childhood is the main cause. Greater attention than ever before has been directed to the excessive mortality of infants and young children. Of a total of 587,830 deaths in England and Wales in 1900 no less than 142,912, or more than 24 per cent of the whole, were infants under one year, and 35.76 per cent were under five years of age. That this death-rate is excessive and that the excess is due to essentially preventable causes is admitted, many of the leading medical authorities contending that under proper social conditions it might be reduced by at least one-half. If that be true, and there is no good reason for doubting it, the present death-rate means that more than 70,000 little baby lives are needlessly sacrificed each year.
No figures can adequately represent the meaning of this phase of the problem which has been so picturesquely named “race suicide.” Only by gathering them all into one vast throng would it be possible to conceive vividly the immensity of this annual slaughter of the babies of a Christian land. If some awful great child plague came and swept away every child under a year old in the states of Massachusetts, Idaho, and New Mexico, not a babe escaping, the loss would be less than those that are believed to be needlessly lost each year in England and Wales. Or, to put it in another form, the total number of these infants believed to have died from causes essentially preventable in the year 1900 was greater than the total number of infants of the same age living in the following six states,—Connecticut, Maine, Delaware, Florida, Colorado, and Idaho. Even if the estimate of the sacrifice be regarded as being excessive, and we reduce it by half, it still remains an awful sum.
Unfortunately, there is no reason to suppose that the infantile death-rate in the United States is nearly so far below that of England as is generally supposed. The general death-rate is given in the census returns as 16.3 per thousand, or about two per thousand less than in England. But owing to a variety of causes, chief of which is the defective system of registration in several states, these figures are not very reliable, and it is generally agreed that the mortality for the whole country cannot be less than for the “Registration Area,” 17.8 per thousand. Similarly, the difference in the infantile death-rate of the two countries is much less than the following crude figures contained in the census reports appear at first to indicate:—
| United States | England and Wales | ||
|---|---|---|---|
| Deaths at all ages, | 1,039,094 | Deaths at all ages, | 587,830 |
| Deaths under 1 year, | 199,325 | Deaths under 1 year, | 142,912 |
| Deaths under 5 years, | 317,532 | Deaths under 5 years, | 209,960 |
In the English returns the death of every child having had a separate existence is counted, even though it lived only a few seconds, but in this country there is no uniform rule in this respect. In Chicago, for instance, “no account is taken of deaths occurring within twenty-four hours after birth,”[[12]] and in Philadelphia a similar custom prevailed until 1904.[[13]] Such facts seriously vitiate comparisons of the infantile death-rates of the two countries which are based upon the crude statistics of census returns.
But while the difference is much less than the figures given would indicate, it is still safe to assume that the infantile death-rate is lower in this country than in England. Such a condition might reasonably be expected for numerous reasons. We have a larger rural population with a higher economic status; new virile blood is being constantly infused by the immigration of the strongest and most aggressive elements of the population of other lands; our people, especially our women, are more temperate. All these factors would tend naturally to a lower death-rate at all ages, but especially of infants.
Danny’s Best Smile
Rickety, Ill fed, and Neglected
RACHITIC TYPES
That with all these favorable conditions our infantile mortality should so nearly approximate that of England, that of every thousand deaths 307.8 should be of children under five years of age—according to the crude figures of the census, more if a correct registration upon the same basis as the English figures could be had—is a matter of grave national concern. If we make an arbitrary allowance of 20 per cent, to account for the slight improvement shown by the death-rates and for other differences, and regard 30 per cent of the infantile death-rate as being due to socially preventable causes, instead of 50 per cent, as in the case of England, we have an appalling total of more than 95,000 unnecessary deaths in a single year.
And of these “socially preventable” causes there can be no doubt that the various phases of poverty represent fully 85 per cent, giving an annual sacrifice to poverty of practically 80,000 baby lives. If some modern Herod had caused the death of every male child under twelve months of age in the state of New York in the year 1900, not a single child escaping, the number thus brutally slaughtered would have been practically identical with this sacrifice. Poverty is the Herod of modern civilization, and Justice the warning angel calling upon society to “arise and take the young child” out of the reach of the monster’s wrath.