| Year of life in which fathers died | At all ages | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| 16-25 | 26-35 | 36-45 | 46-55 | 56-65 | 66-75 | 76-85 | 86-up | ||
| No. of children. | 23 | 90 | 367 | 545 | 725 | 983 | 444 | 33 | 3210 |
| No. who died in first 5 years | 12 | 29 | 115 | 171 | 200 | 254 | 105 | 1 | 887 |
| Per cent. who died | 52.2 | 32.2 | 31.3 | 31.4 | 27.6 | 25.8 | 23.6 | 3.0 | 27.6 |
Allowing for the smallness of some of the groups, it is evident that the amount of correlation is about the same here as among the English Quakers of the Beeton-Pearson investigation, whose mortality was shown in the two preceding tables. In the healthiest group from the royal families—the cases in which the father lived to old age—the amount of child mortality is about the same as that of the Hyde family in America, which Alexander Graham Bell has studied—namely, somewhere around 250 per 1,000. One may infer that the royal families are rather below par in soundness of constitution.[193]
All these studies agree perfectly in showing that the amount of child mortality is determined primarily by the physical constitution of the parents, as measured by their longevity. In the light of these facts, the nature of the extraordinarily low child mortality shown in the 340 families from the Genealogical Record Office, with which we began the study of this point, can hardly be misunderstood. These families have the best inherited constitution possible and the other studies cited would make us certain of finding a low child mortality among them, even if we had not directly investigated the facts.
If the interpretation which we have given is correct, the conclusion is inevitable that child mortality is primarily a problem of eugenics, and that all other factors are secondary. There is found to be no warrant for the statement so often repeated in one form or another, that "the fundamental cause of the excessive rate of infant mortality in industrial communities is poverty, inadequate incomes, and low standards of living."[194] Royalty and its princely relatives are not characterized by a low standard of living, and yet the child mortality among them is very high—somewhere around 400 per 1,000, in cases where a parent died young. If poverty is responsible in the one case, it must be in the other—which is absurd. Or else the logical absurdity is involved of inventing one cause to explain an effect to-day and a wholly different cause to explain the same effect to-morrow. This is unjustifiable in any case, and it is particularly so when the single cause that explains both cases is so evident. If weak heredity causes high mortality in the royal families, why, similarly, can not weak heredity cause high infant mortality in the industrial communities? We believe it does account for much of it, and that the inadequate income and low standard of living are largely the consequences of inferior heredity, mental as well as physical. The parents in the Genealogical Record Office files had, many of them, inadequate incomes and low standards of living under frontier conditions, but their children grew up while those of the royal families were dying in spite of every attention that wealth could command and science could furnish.
If the infant mortality problem is to be solved on the basis of knowledge and reason, it must be recognized that sanitation and hygiene can not take the place of eugenics any more than eugenics can dispense with sanitation and hygiene. It must be recognized that the death-rate in childhood is largely selective, and that the most effective way to cut it down is to endow the children with better constitutions. This can not be done solely by any euthenic campaign; it can not be done by swatting the fly, abolishing the midwife, sterilizing the milk, nor by any of the other panaceas sometimes proposed.
But, it may be objected, this discussion ignores the actual facts. Statistics show that infant mortality campaigns have consistently produced reductions in the death-rate. The figures for New York, which could be matched in dozens of other cities, show that the number of deaths per 1,000 births, in the first year of life, has steadily declined since a determined campaign to "Save the Babies" was started:
| 1902 | 181 |
| 1903 | 152 |
| 1904 | 162 |
| 1905 | 159 |
| 1906 | 153 |
| 1907 | 144 |
| 1908 | 128 |
| 1909 | 129 |
| 1910 | 125 |
| 1911 | 112 |
| 1912 | 105 |
| 1913 | 102 |
| 1914 | 95 |
To one who can not see beyond the immediate consequences of an action, such figures as the above indeed give quite a different idea of the effects of an infant mortality campaign, than that which we have just tried to create. And it is a great misfortune that euthenics so often fails to look beyond the immediate effect, fails to see what may happen next year, or 10 years from now, or in the next generation.
We admit that it is possible to keep a lot of children alive who would otherwise have died in the first few months of life. It is being done, as the New York figures, and pages of others that could be cited, prove. The ultimate result is twofold: