the contamination of the entries and halls. Too little fresh air and sunlight brings lack of bodily vigor.

Data secured by the Children's Bureau in its study of infant mortality, in Johnstown, Pennsylvania, present further evidence of the ill health resulting from bad housing.1

An absolute measure of the importance of each housing defect in a high mortality rate cannot be secured from this study. But it is not without interest to note that in homes where water was piped into the house the infant mortality rate was 117.6 per thousand, as compared with a rate of 197.9 in homes where the water had to be carried in from outdoors. In the homes of 496 live-born babies the infant mortality rate where bathtubs were found was 72.6, while it was more than double, or 164.8, where there were no bathtubs. Desirable as a bathtub and bodily cleanliness may be, this does not prove that the lives of the babies were saved by the presence of the tub or the assumed cleanliness of the persons having them. In a city of Johnstown's low housing standards the tub is an index of a good home, a suitable house from a sanitary standpoint, a fairly comfortable income, and all the favorable conditions that go with such an income.

In homes of one, two, three, or four rooms, or where the number of occupants ranged from 4.42 to 1.58 persons per room, the infant mortality rate was 155, as compared with a rate of but 101.8 in larger homes, where the number ranged from 1.22 to 0.43 persons per room.

The 1910 census returns show that the greatest overcrowding was in ward 15, where the average number of persons per dwelling was 9.9. Wards 16, 11, and 14 came next, with averages of 8.3, 7.7, and 7.2, respectively. The infant mortality rate for these four wards is 190.2, which is over one third more than the rate for the whole city.

1 Emma Duke, "Infant Mortality, Johnstown, Pennsylvania,” Bulletin No. 9, Children's Bureau, United States Department of Labor, 1915.

The Manchester study, made by the same bureau in 1917, brought out similar points.1

Conditions in and. around alley and rear houses were found by the agents to be almost uniformly bad, and the infant mortality rate for babies in such houses was high. Live-born babies in these houses numbered 123, or 7.9 per cent of the whole number. These babies died at the rate of 227.6 per 1,000, while the death rate among babies in homes with a street frontage was only 159.4.

The infant mortality rate showed a steady increase according to the number of persons per room. It was 123.3 where the average was less than 1; 177.8 where the average was 1 but under 2; and 261.7 where the average was 2 but less than 3.

Such figures as these are convincing evidence of the serious menace which bad housing presents to the immigrant.

One of our health officers has thus explained why American housing is usually versus the immigrant's health:2

Congestion, the crowding of large numbers of persons upon a small area and of families into cramped dwelling quarters, favors communication of diseases, uncleanliness, and inadequate ventilation. . . . These influences show statistically in infant mortality and the death rates from tuberculosis and other diseases.

TESTIMONY OF HEALTH OFFICERS

The attitude of American health agencies toward the housing problems of the immigrant will be im

1 Beatrice Sheets Duncan and Emma Duke, "Infant Mortality, Manchester, New Hampshire, 1917," Children's Bureau, United States Department of Labor.

J. S. McNutt, A Manual for Health Officers, 1915, p. 512

portant in determining their solution. A series of questionnaires sent to 261 health departments in cities in the United States which had large foreign-born populations brought replies from 142 cities. The problems of housing and home sanitation were giving serious concern to 74 of these health officers-52 per cent of all who answered. In contrast to this the contagious-disease problem, which is usually of such paramount importance to health departments, was spoken of in only 37 questionnaires, or 26 per cent.

Some of the officers claimed that the immigrants deliberately seek out the worst housing locations so that they can annoy the officers of the law by violating all sanitary codes. Asked what problems had been met in his experience as health officer in dealing with the foreign born, one man answered, “Ignorance and willful violation of all health rules." Another writes:

The average Italian . . . lives in colonies in the old tumble-down districts of the city. [They] are clannish, following many of the old native country fashions, and, above all, cannot be made to appreciate the personal and economic value of a general clean-up and stay clean.

For others the immigrant seems to represent a race apart, quite different from all others when it comes to questions of sanitation and housing. One of this group -after referring to the "Dagoes" and "Polacks." in his community-said there was "great need of cleanliness," but that "very little had been accomplished.' One reason for this man's failure is apparent in the very tone of the reply. Another claims that "there are no laws of sanitation and living by the average foreign-born family." Another makes the sweeping ac

cusation that the immigrant is unable "to understand what constitutes sanitation." It is not unlikely that the immigrant's inability to understand is here due to the health officer's antagonizing those whom he wished to reach, instead of employing educational methods.

Some health officers have recognized the need of the foreign born for education in the sanitary care of houses.

Our foreign population is being instructed in sanitation through the Health Department, the District Nursing

Association, and the school nurse. These branches seem to me to be the best fitted for this work as they have direct access to the homes of the foreigner when called in cases of illness and contagious disease.

Another group whose attitude was investigated

was the industrial physicians. Of the 80 replies received, there were only 22 who spoke of the importance of housing in relation to the efficiency of the foreign-born employee. Many of these 22 felt