The economic situation in Porto Rico is giving rise to the formation of classes based on wealth. With the introduction of available markets and modern methods of commerce and industry which followed the American occupation, the land values rapidly increased. The small landholder, seeing the increase in price which came about and believing that it was to his best advantage to sell his land, disposed of it to the representatives of large landholding concerns for what, to him, was a fabulous price. As soon as the money from this sale was expended, the original landholder found himself absolutely dependent upon the mercy of a wage-paying employer. In this way a great part of small landholdings passed into the hands of representatives of large landholdings and caused the formation of the two groups, the capitalistic group, which is limited to a comparatively small number of people, and the wage-earning group, which comprises probably 90 per cent of the population of Porto Rico. As a result we lack in Porto Rico the great middle class of financially independent farmers which constitutes the strength of the United States and the more prosperous European countries. A serious and systematic effort to build up a prosperous and independent middle class, either by encouraging small-farm or other industries, is necessary if the majority of the people are to attain the advantages which they should enjoy, and if the social and economic status of the Island is to be made equitable and stable.
The reduced wage system and the absolute dependence of the wage-earning group has given rise to a great many labor disturbances within the last few years. These labor disturbances have included both city and country groups and have in nearly all cases been caused by an effort to better the working conditions and to secure an increase of wages. In the great majority of the cases there is no doubt but that the laborers were justified in asking for better conditions than those which actually existed. That the disturbances sometimes ended in riots and led to the destruction of property is the fault of the educational condition of the people, who are easily excited and led to believe that only by the use of violence can they secure the things which they demand.
The relation between poverty and health and poverty and morals is very close. The poverty-stricken family cannot be led to take any great amount of interest in society or health betterment until means have been produced by which the economic situation of the family group can be bettered. The expense of living uses up the daily wage of the ordinary unskilled laborer in Porto Rico, who averages fifty or sixty cents per day for the time that the weather and his physical condition permit him to work. There is also a close relation between sickness and poverty, the average countryman of Porto Rico being only partly as efficient a worker as he should be, due to physical weakness caused by anemia or malaria. Poverty is closely related to degeneration and crime, especially when it descends into pauperism and absolute dependence upon charity.
The climate and geographical conditions of Porto Rico have never provided the laborer with any incentive to economize, inasmuch as he has no need for providing against a period of cold, and Nature produces some form of plant or vegetable food throughout the entire year. Clothing and lodging may be of the simplest and still prevent much suffering under such conditions, and with physical weakness caused by disease, the tendency is to live for the present, and to take little care for the future through a system of saving and economy. The average manual laborer saves nothing and makes little effort to accumulate property. Incentive must be provided through education which will accustom the countryman to the idea of accumulation of property in a small way, so that dependence upon charity will not be necessary in the case of a financial or economic crisis. That there is a movement toward saving is evident from the fact that on June 30, 1915, there were savings accounts to the amount of $1,909,969.34 in the various banks in the Island. This, however, is a comparatively small amount, and the younger generation should be given definite instruction and incentives along the line of savings. The introduction of the Postal Savings Bank has been of great value in this respect, and the school savings banks have also done their share in inculcating the principles of economy.
SICKNESS AND DISEASE
The Island of Porto Rico is more free from disease than the average tropical or semi-tropical country, due to the active efforts of the medical profession and of the special commissions and departments created for the elimination of disease within the last few years. Nevertheless, a great deal of sickness which might be avoided, part of which is responsible for death, and part of which merely incapacitates the sufferers or renders them less useful citizens, is to be found. The elimination of such diseases as smallpox and yellow fever, which formerly were responsible for a great number of deaths and which descended upon the Island as epidemics with considerable regularity, has been accomplished, and if similar care were taken in the case of less dreaded diseases, there is reason to believe that they could also be wiped out of existence in the Island.
For the year 1915-16 there was a total of 26,572 deaths in Porto Rico. Most of these deaths were from diseases classified as transmissible, and, consequently, from diseases which could be prevented by complete quarantine. Following is a list of the number of deaths from the diseases which took the heaviest toll in the Island:
| Rickets | 1,271 |
| Tuberculosis (lungs) | 2,125 |
| Malaria | 1,290 |
| Typhoid fever | 94 |
| Whooping cough | 167 |
| Tetanus | 109 |
| Cancer | 365 |
| Meningitis | 344 |
| Epilepsy | 57 |
| Acute bronchitis | 1,015 |
| Chronic bronchitis | 309 |
| Bronco-pneumonia | 822 |
| Pneumonia | 569 |
| Diarrhea and enteritis under two years | 3,485 |
| Diarrhea and enteritis two years and over | 870 |
| Infantile tetanus | 729 |
| Lack of care in infancy | 117 |
| Congenital debility in children | 1,145 |
| Uncinariasis | 479 |
| Smallpox | 9 |
| Diphtheria | 26 |
The two diseases which are of most vital importance to the people of Porto Rico at present are undoubtedly tuberculosis and anemia. The ravages of tuberculosis are more noticeable in the cities, and it has been stated that in 1912, on one street in San Juan, 12 out of every 100 residents died of this disease. Anemia is prevalent throughout the Island, but is more noticeable in the country districts than in the cities, and while the death rate for anemia is not so high as the death rate of some other diseases, yet by reason of weakening the vitality of the sufferers it tends to offer a fertile spot for the incubation of germs of other diseases, and the working and producing power of the individual is lessened with the acuteness of the disease.