those of native mothers, is a fact of no slight import. Exposure to urban conditions for many generations, and consequent elimination of stocks unable to resist the prevalent urban infections, is a probable factor in this low rate among the Jews.

ITALIAN DEATH RATE NOT UNIFORM

The Italian death rate varies more than the Russian. For the degenerative diseases it is lower than that of the native born. In the consumption table we find the Italian death rate about equal to the native, a figure which is low compared to the other races. But for the other respiratory diseases and the acute infections, the Italians have the highest rate, with one exception, of any racial group, varying from over five times that of the native group to slightly less than it.

This range in mortality rate, from less than the native to over five times it, is analogous to what is commonly considered the volatility of the Italian temperament. Perhaps the return of the Italian to Italy, when he knows he has tuberculosis, fully explains the low figure for that disease. The causes affecting death rates, with this race as with all, must be widely sought in general attitudes and aptitudes, as well as in physical conditions of living and working. The present brief outline of available data has served its purpose if it has indicated racial variations and the possibility of further inquiries.

INFANT MORTALITY

The final group of mortality statistics to be discussed here is that relating to infants. The first question to

be answered is whether or not babies of the foreign born show a higher death rate than those of the natives.

According to the 1900 census the children born of native parents had 135.3 deaths to every 1,000 births; those born of parents, either one or both of whom were foreign born, had 149.2; those born abroad had 141.1.1 The figure for the foreign-born babies need not be considered, as the number of children under one year brought to the United States and dying here is small, only about 400 for the whole registration area as against 37,000 deaths among native-born babies of foreign parents. The other two figures are comparable, and indicate clearly that infants of foreign parentage suffer from a higher mortality rate than those of native parentage.

In 1919, Eastman, of the New York State Department of Health, made an analysis of the infant mortality statistics for that state, in order to see whether or not there was any connection between race and infant mortality rates. The report is full of tables, with careful interpretations by the author, which are too long for reproduction here. Certain of Eastman's observations and conclusions will be quoted.2

It appears [he says] that the mortality of babies under one month old is higher among those born to native mothers than among children born of women of foreign nativity. Although the mortality of children less than one year of age born of native women was only 87 per 1,000 births,

1 Twelfth Census of the U. S., 1900, Vital Statistics, vol. iii, pp. lxxxviii and 286.

P. R. Eastman, The Relation of Parental Nativity to the Infant Mortality of New York State, American Medical Association, 1919.

compared with 108.4 for children of foreign-born mothers, the rate under one month for the former was 47.4 as against 45.2 for the latter. Attention is also directed to the fact that the infant mortality of the children of native mothers more than one month of age and less than one year old, was only 39.6 contrasted with 63.2 for babies born to foreign mothers..

...

The infant mortality from communicable diseases was almost 75 per cent greater among children of foreign mothers than among the babies of native mothers; from respiratory diseases it was more than 100 per cent greater, and from gastro-intestinal diseases the excess was about 78 per cent; but the rate from prenatal and other causes peculiar to early childhood was higher among the native element by more than 20 per cent.

There is further analysis of the New York State figures, but the main fact is this, there is a measurable difference in resistance between children of native and of foreign parents for both age periods under one month and between one month and one year. Examination of these differences leads to the conclusion "that the chief causes of infant mortality among the native population originate for the most part in adverse prenatal conditions, but that among the foreign element the most frequent causes of deaths are communicable, respiratory, and gastrointestinal diseases."

Turning again to Guilfoy's figures for New York City, we find the same wide variation among the races that appeared in his total mortality data. The following table sums up his findings:1

1 William H. Guilfoy, M.D., "Influence of Nationality upon Mortality of a Community," New York City Department of Health, Monograph Series No. 18, November, 1917, p. 24.

TABLE XVI

MORTALITY OF CHILDREN UNDER FIVE YEARS OF AGE AND UNDER ONE YEAR, IN NEW YORK CITY IN 1915, CLASSIFIED BY BIRTHPLACE OF MOTHER

Here the rank of Italians and the low rank of Russians, with their preponderant numbers of Jews, corresponds with the total death-rate tables quoted earlier in the chapter.

The most intensive studies in the field of infant mortality, from a social rather than a medical point of view, have been made by the Children's Bureau. Racial differences are apparent in these, as the briefest reference to the findings of the studies made in Manchester, Johnstown, and Brockton will indicate. The following table compares the death rate for the children under one year of age, of native and foreign-born mothers, in these three places. We find here wide variation among the three towns, especially for the rate of children with foreign-born mothers, which is twice as high in Manchester as in Brockton. The range is not so great in the three towns between those of native mothers. The rates

of the different cities are not exactly comparable, since the surveys were made in three different years.

TABLE XVII

MORTALITY RATES OF INFANTS UNDER ONE YEAR CLASSIFIED BY NATIONALITY OF MOTHERS IN THREE CITIES, STUDIED BY CHILDREN'S BUREAU1

It is common to find the death rates of the native born lower than those of the foreign born. This is true in two of the places listed, but not in Brockton. At the same time, stillbirths were twice as numerous among the foreign born as among the native born. More detailed analysis would be needed fully to explain this variation. Brockton is a prosperous shoemanufacturing town where almost half the foreign born come from English-speaking countries. This might explain the lower foreign-born rate.

The high figure for Manchester is largely due to the high death rate (224.7) of French-Canadian mothers. The single race that brings up the figures for Johnstown is that for the Serbo-Croatian mothers, who have a rate of 263.9. In the case of Manchester the French-Canadians are "generally thrifty, selfrespecting people, ambitious to own their homes and to accumulate property.... On the whole, they occupy

1 Beatrice Sheets Duncan and Emma Duke, "Infant Mortality, Manchester, New Hampshire, 1917"; Mary V. Dempsey, "Infant Mortality, Brockton, Massachusetts, 1918"; Emma Duke, "Infant Mortality, Johnstown, Pennsylvania, 1915"; Children's Bureau, United States Department of Labor.