In no less than twelve out of the Eighteen Counties, the death rate from tuberculosis is excessive. (See [Map 1] and [Table A], column 1.) Reports of the Ohio Bureau of Vital Statistics for the years 1909, 1910, and 1911 (the latest we could secure on this subject), give the average annual deaths from this disease for 100,000 persons, as 125 for the whole State. On Map 1, all counties are shaded whose rate exceeds not 125 only, but 145. Of the seventeen counties in the State whose death rate from tuberculosis is 145 or over, all but five are in this region, and of the five one is a bordering county.
Outside this area and the bordering counties, the highest rate is in Franklin, of which the city of Columbus is the county seat; but of the Eighteen Counties, seven have a higher rate than Franklin. In Clermont County it is 164, in Scioto 169, in Lawrence 172, in Ross 175, in Gallia 184, while in Pike it is no less than 216,—far larger than for any other rural county in the State. In Hamilton County, in which is the city of Cincinnati, and which is adjacent to Clermont County, the rate of 217 is probably due to the large colored population.
It will be observed, therefore, that in no less than two-thirds of the Eighteen Counties the rate of death from this preventable disease is excessively and indefensibly high.
The number of illegitimate births in the Eighteen Counties is likewise excessive. (See [Map 2] and [Table A], column 2, pages [28] and [37].) The rate per 100,000 population for the State is 43.9. Of the 28 counties whose rate is above the average, 19, or 68 per cent, are either in the Eighteen Counties or the counties bordering upon them. No less than thirteen, or more than two-thirds, of the Eighteen Counties have an excessive number of illegitimate births. Outside this area and the bordering counties the highest rate for any county is 61, but in ten of the Eighteen Counties it is greater than this. Whereas the rate for the State is less than 44, in Athens County it is 65, in Noble 67, in Scioto 73, in Gallia 76, in Hocking and Monroe 78, in Ross 87, in Pike 89, in Lawrence no less than 113, while in Jackson it is 123, or the highest rate in the State.
It will be noted that these figures cover the counties in which are the large cities as well as the rural counties. But in Hamilton, containing the city of Cincinnati, the rate is only 66, in Franklin, containing the city of Columbus, it is 56, and in Cuyahoga, containing the city of Cleveland, it is only 50.
Illiteracy also, in the Eighteen Counties, is excessive. (See [Map 3] and column 3 of [Table A].) The per cent of illiterate males of voting age for the State in 1910 was 4.2. There are 29 counties in which that number was exceeded. Of these, fourteen are among the Eighteen Counties, and five border upon them. In Brown County, the percentage is 4.3, in Washington and Noble 4.5, in Monroe 5.4, in Adams 6.9, in Athens and Ross 7.4, in Scioto 7.7, in Gallia 8.1, in Vinton 8.4, in Hocking 8.6, while in Pike it is 10.7, and in Lawrence 11.6.
Among the remaining ten counties whose percentage of illiteracy is above the average it appears (see [Map 4], page [30]) that in all but three, the percentage of foreign-born persons is large, and that among counties where the foreign born are few, there are, outside the Eighteen Counties, only six for which the percentage of illiteracy is greater than 4.2, and three of these are included in the counties which border upon them.
It will be noted that in this region the number of foreign-born persons is very small. The percentage for the State is 12.5, whereas in the Eighteen Counties it is only 2.3. No less than 53 counties out of the 70 outside of the Eighteen Counties, have a foreign population of more than 2.3 per cent.
In this region, therefore, where there is so high a percentage of illiteracy, of illegitimacy, and of deaths from preventable disease, the people are more nearly pure Americans than in the rest of the State. They compare unfavorably with the people of counties where a large proportion are foreigners. It is true that the cause does not lie in the origin of the population. But the fact that these things are true in the most American parts of Ohio, where we should naturally expect to find the best situation, greatly emphasizes the significance of the conditions disclosed.
It is an additional indictment against those who are responsible that in Mahoning County more than 28 per cent and in Cuyahoga County more than 33 per cent of the population in 1910 were foreign born, yet in these counties, containing the large cities of Youngstown and Cleveland, the moral and social conditions are better than in the Eighteen Counties—a rural section inhabited by our purest American stock.