[Footnote 22: British Medical Journal, July 23, 1921, p. 131.]
[Footnote 23: Quoted in Tablet, November 5, 1921, p. 598.]
[Footnote 24: Quoted from America, October 29, 1921, p. 31.]
CHAPTER III
HIGH BIRTH-RATES NOT THE CAUSE OF HIGH DEATH-RATES
Section 1. POVERTY AS NOW EXISTING
The second contention of birth controllers is that a high birth-rate, by increasing poverty, causes a high death-rate. In the first place, there is no doubt that poverty, necessary features of which are mal-nutrition or insufficient food and bad housing, is directly associated with a high death-rate, although this view was once shown by the Lancet to need important qualifications.
"With respect to the greater mortality amongst the poor than the rich, we have yet to learn that the only hope of lessening the death-rate lies in diminishing the birth-rate. We have no proof as yet that the majority of the evils at present surrounding the poor are necessarily attendant upon poverty. We have yet to see a poor population living in dry, well-drained, well-ventilated houses, properly supplied with pure water and the means of disposal of refuse. And we have yet to become acquainted with a poor population spending their scant earnings entirely, or in a very large proportion, upon the necessities of life; for such is not the case when half the earnings of a family are thrown away to provide adulterated alcoholic drinks for one member of it. Until reforms such as these and others have been carried out, and the poor are able and willing to conform to known physiological laws, it is premature to speak of taking measures to lessen the birth-rate—a proposal, be it said, which makes the humiliating confession of man's defeat in the battle of life." [25]
It will be seen that the qualifications practically remove the question from dispute. [26] If the conditions of the poor were thus altered, poverty, as it exists to-day, would of course disappear. As things are, we find that a high death-rate is related to poverty, as is proved, for example, by the death-rate from tuberculosis being four times greater in slums than in the best residential quarters of a city.
The correct answer to the birth controllers is that a high birth-rate is not the cause of a high death-rate, because high birth-rates, as shown in the previous chapter, are not the cause of poverty, but vice versa. Moreover, all the statistical evidence goes to prove that in this matter we are right and that Malthusians are wrong.