rates of 1900. Therefore, it is evident that these differences in the rates of various nationalities are not due to chance, but to actual differences in the peoples themselves, or in their occupations, or in their manner of living. Some of the factors causing the differences or affecting the order of national mortality rates may be brought to light by considering the causes of deaths. Material is available showing the nationalities affected by the degenerative diseases-pneumonia and the acute infections, and tuberculosis. DEATHS FROM DEGENERATIVE DISEASES In the 1900 census, death rates from the chief degenerative diseases are classified for the different nationalities.1 TABLE XIII DEATH RATE FROM CERTAIN DISEASES AMONG WHITES, CLASSIFIED ACCORDING TO BIRTHPLACE OF MOTHER. REGISTRATION AREA, 1900 1 Stomach, liver, and peritonitis. 2 Heart disease and dropsy, angina pectoris. 1 Twelfth Census of the U. S., 1900, Vital Statistics, vol. iii, p. lxxviii. The outstanding feature of this table is the high death rate that the Irish show from all four causes. Their death rate of 17.7 from alcoholism is the most conspicuous fact of the table. This figure is almost double the next nearest in rank and partially accounts, no doubt, for the high rank of the Irish in the other causes of death, which in every instance obtains. Disregarding the figure for the French because so small a unit of population was included, we find the Germans, English, and Scotch following the Irish closely in a high mortality rate. At the other end of the scale are the Russians and Poles, who have the lowest rate of all nations from all causes except alcoholism, from which they have next to the lowest rate. It must be borne in mind that a large proportion of the Russians, and many of the Poles, are not Slavs, but Jews. The ranks of the Italians remain comparatively low in the four columns, proving to be lower than the native born in every case. From these figures it is possible to prognosticate in a general way the causes of death in a community whose racial elements are dominantly any of those included in this table. This information again emphasizes the need of considering racial factors in practical attempts to lower mortality rates. Both Dublin and Guilfoy come to much the same conclusions in their study of the influence of nationality upon mortality. Guilfoy finds in New York City that:1 1 William H. Guilfoy, M.D., "The Influence of Nationality upon the Mortality of a Community," New York City Department of Health, Monograph Series No. 18, November, 1917, pp. 20–21. See The males of the four countries—United States, Ireland, Germany, and England-show excessive mortality from these causes [alcoholism and cirrhosis of the liver]. The deaths among the Italians, Russians, and Austro-Hungarians are so few as to be negligible. . . . Considering the degenerative diseases, we find that the Irish males lead the mortalities with a rate of 1,010 (per 100,000 population), followed by the German males with a rate of 965, and an English male rate of 635, all considerably above the rate for all males. Irish females, German females, and English females also show higher mortalities than that of all females. In conclusion it may be said that the foreign white stock suffer from a higher rate of premature deaths from the degenerative diseases than do the native born, and certain races, notably the Irish and Germans, show mortality rates from these diseases which far exceed those of any other group. PNEUMONIA AND THE ACUTE INFECTIONS Table IV in Chapter II, presented cases of pneumonia and other respiratory diseases attended by Henry Street nurses, as well as the number of deaths from these causes. There was a high per cent of deaths for Italians in all age groups, being 8.9 per cent, as contrasted with 2.6 per cent for the Hebrews. Especially notable is the high ratio (17.7) for Italian children under one year of age. The following table conclusively corroborates the evidence of their susceptibility to respiratory diseases and to acute infections as well: also Louis I. Dublin, "Increasing Mortality after Age Fortyfive," Quarterly Publication of American Statistical Association, March, 1917, pp. 514-518, 523. TABLE XIV DEATH RATE OF WHITES FROM CERTAIN RESPIRATORY DISEASES AND ACUTE INFECTIONS, CLASSIFIED BY BIRTHPLACES OF MOTHERS, PER 100,000 POPULATION OF REGISTRATION AREA, 1900 1 England and Wales.... 36.7 7.9 Scotland. Canada.. Scandinavia. France. Other foreign. 228.7 156.9 8.3 19.7 25.4 10.1 5.2 7.2 9.4 8.4 5.0 9.9 1 Tuberculosis excluded. The rates for the Italians from every cause of death are double those for almost every other race. Guilfoy says, in his report on mortality in New York City, that the death rate from respiratory diseases among infants of Italian mothers is from two to three and a half times that among children of mothers of all other nationalities. Dublin also was much struck by the high general death rate of the Italians in New York State, and sought to discover the causes. He found that in practically every age period the 1 Twelfth Census of the U. S., 1900, Vital Statistics, vol. iii, pp. lxvii, lxxxiii. pneumonia death rate for Italians is about twice that of native Americans-sometimes the proportion is even greater. The differences are especially marked among women. Like Abou Ben Adhem, Italy's name leads all the rest in this table. Since the fatal termination of many of the acute infections is due to some form of pneumonia, the high rates from these diseases may result from inaccuracy in reporting the immediate cause of death. In so far as this is the case, the rate from pneumonia is not nearly so high for the Italians as it should be. Dr. Antonio Stella, in a block study of mortality among the Italians in New York City in 1908, found the same conditions there. While the death rate from the acute respiratory diseases for the city was 12.7 per 1,000, for the Italians in the ten blocks studied it ranged from 17.9 to 49.0, and was usually over 30.0. From diphtheria, the city rate was 2.8, and the Italian 3.2 to 8.9, usually over 4.0. The broncho-pneumonia death rate for Italian children under five was two and one half times the American rate. The mortality from measles was five times the city death rate from that disease. There are no such outstanding figures for any other nationality. The Irish rank second to the Italians in all the respiratory diseases, but they hold a low rank in the acute infections. Contrary to expectation based on the general mortality tables previously quoted, the Russians and Poles come near the first rank in deaths 1 Antonio Stella, M.D., "The Effects of Urban Congestion on Italian Women and Children," New York Medical Record, May 2, 1908, pp. 722-732. |