(f) Tuberculosis. Tuberculosis is very general among the foreigners and seems to be increasing. The crowded conditions of life, entire ignorance of sanitary precautions, and poor food are regarded as especially conducive to the spread of the infection. One physician, however, states that there is no more tuberculosis among the immigrants than among the Americans, and that it is not increasing any more rapidly among the alien than among the native population. Furthermore, all authorities agree that the second generation, as they understand proper hygienic measures and escape the present congestion, will be no more susceptible to the disease than are Americans. VITALITY OF ALIENS. On this subject two views are expressed by the local physicians. It is said that the vitality and physical stamina of the southern and eastern European is below that of the native; that in consequence he contracts diseases more readily, resists their ravages less successfully, and succumbs to disease and accident more easily. One illustration cited to prove this is the fact that in the majority of cases fractures require a longer time to heal if the patient is a foreigner than if he is an American. On the other hand, it is stated by physicians with wide acquaintance among the recent immigrants that the fears on this head are much exaggerated. They say the fact alleged may be true, but urge that, if true, it argues no inherent weakness or physical inferiority. They believe the alien, when he arrives here, is physically the equal of the American and that the decline in vitality and stamina is due to the insanitary conditions of life, the ignorance of hygienic measures, the great increase in the consumption of alcoholic liquors and general dissipation of these people under conditions of life here. It is their opinion that the second generation, with a better knowledge of how to care for themselves, are in no way inferior to the natives. ALIENS AS INMATES OF HOSPITALS. The following tables, compiled from the records of the local city hospital, together with those from the steel company hospital, show the foreign patronage of the hospitals of Community A. TABLE 318.-Number and per cent of patients in the local hospital and the steel company's hospital, by general nativity, August 1, 1904, to July 31, 1908. [Compiled from records of local hospital and steel company's hospital.] Per Per Per Per Per Num- cent Num- cent Num- cent Num- cent Num- cent TABLE 318.-Number and per cent of patients in the local hospital and the steel company's hospital, by general nativity, August 1, 1904, to July 31, 1908—Continued. STEEL COMPANY'S HOSPITAL. August 1. 1904. August 1, 1905, August 1, 1906, August 1, 1907, August 1, 1904, to July 31, 1905. to July 31, 1906. to July 31, 1907. to July 31, 1908. to July 31, 1908. The following table shows the foreign patients of the city hospital, by race, for each successive year from 1904 to 1908. TABLE 319.---Number and per cent of foreign-born patients in the local hospital, by race, August 1, 1904, to July 31, 1908. OBEDIENCE TO MUNICIPAL HEALTH REGULATIONS. The regulations of the municipal board of health cover in a fairly complete way such subjects as conduct of hotels and boarding houses; meat markets and slaughter houses; grocery and provision stores, and dairies; wells and water, sewer and house drains; privy vaults, cesspools, etc.; quarantine in case of specified communicable diseases; funerals, etc.; spitting on sidewalks and in public places; disposition of refuse and garbage; specified regulations as to barbers, bakers, butchers, plumbers, and milk dealers. The machinery for the execution of these laws consists of a city health officer, a sanitary inspector, and the police, with the cooperation of physicians. As a general rule, it may be stated that in the foreign sections of the city the regulations are continually violated in every particular. The frank confession on the part of the health officials of the impossibility of enforcing them among the immigrants on account of the lack of sufficient force, the testimony of physicians whose practice is largely in the foreign sections, and the undeniable evidences of failure to observe health regulations afford ample evidence of the truth of this statement. Just in what particulars immigrants are most guilty of violations could not be ascertained at the office of the city board of health. No records are kept except those of deaths and of the diseases causing death, these giving country of birth, but not the race of the deceased. Very vague ideas as to the diseases common among immigrants and as to the violations of laws governing health were the only information on the situation that the city officers had. Their attitude seemed to be that if epidemics could be kept down in the foreign sections, and the spread of dangerous diseases to native sections could be prevented, their duty was done. Interviews with physicians practicing among the immigrants of the foreign sections indicate that in general only about half of the population of these sections make any effort to obey health laws in whole or in part, and that the southern European races may be graded, according to their observance of the laws, in the following order: Poles, Magyars, Croatians, Slovaks, Macedonians, Servians, and Italians. This order, however, is due not so much to a knowledge of or a willingness to obey health regulations as to habits already formed. A very small percentage know anything about the regulations, and the general attitude of the immigrants toward them is one of contempt, since the purpose of the rules is misunderstood. Possibly the best observed regulation is the one requiring the placing of garbage in barrels for removal to the city garbage plant. The explanation of this lies chiefly in the fact that little animal or vegetable food is allowed to go to waste, and that the removal of garbage is regarded as a convenience more than a sanitary measure. The milk supply of the whole city is in the hands of a few large dairies, and the immigrants thereby enjoy to a large extent the same benefits as the natives. On the other hand, violations of other sanitary laws are everywhere plain among the immigrant population. In the opinion of physicians, much of the disease prevalent among immigrants is due to bad meat, which can be bought more cheaply than fresh meat. The butcher shops, as well as grocery and provision stores, are kept in a dirty condition, and the regulations as to the cleanliness of the persons who handle these foods have probably never been heard of. The cleansing of dry closets, which prevail among immigrants in the foreign_sections, is irregular, and in frequent instances filthy conditions have been found, especially in the cases where they are used by large groups or several groups of people. The proximity of wells to privy vaults and cesspools is common, a fact which is rarely taken into account by city health officers when there is cause for examination into the water supply. Quarantine is maintained in the case of no communicable disease except smallpox, and frequently no placards are placed on houses wherein communicable diseases exist, both of which are in express violation of the very complete regulations on these points. The regulations as to expectoration on sidewalks in the foreign sections have been unknown until recently, when notices were posted in all parts of the city; the presence of a policeman in the foreign sections is so rare, however, except on call, that it is doubtful whether any improvement in enforcing the law will result. The regulations as to cleanliness in barber shops, bakeries, etc., are unknown and quite evidently not enforced. The most glaring example of unsanitary sewerage is seen in the Italian quarter. The houses here are built on a steep slope. All of the closets are either dry or situated over cesspools, and the natural drainage is toward the river. The residents in the houses below obtain their water from wells which are sunk immediately in the course of this drainage. Open sewers on both sides of the principal street run into the river. During the summer months the odors are very perceptible. The foreign section is situated below the other sections of the city and below where the two rivers join." The people in that section, who are chiefly immigrants, thus get the full benefit of the filth that is emptied into the two rivers for several miles above. In the dry seasons of the year, during the warm weather, the water is quite low and forms in standing pools or flows very slowly. Frequently the odor from the river is offensively evident. a See map facing page 329. In what follows, the term "the foreign section" refers to this part of the community. 48296°-VOL 8—11- -29 THE NATIVE AND THE FOREIGN DEATH RATE. Although no exact data as to the death rate by races is available, the following statistics from the report of the local board of health will indicate by nationalities the proportion of deaths among immigrants to deaths among natives: TABLE 320.-Nativity of deceased in Community A, 1903 to 1907.a a In studying the table the following points should be noted: (1) No distinctions are made according to race except in the case of Poland, by which is meant " Polish," the country of birth not being indicated. (2) It is probable that foreign races are included to some extent in "Not reported." (3) All children born in the United States, irrespective of the race or country of birth of parents, are included under "Community A" and "United States (other)." The table also includes children born in foreign countries. |