Infant mortality rate

“ In the civilised countries of Europe, at the end of the nineteenth and the beginning of the twentieth century, of every 1000 infants, from 100 to 300 die, on the average, every year. The attainable minimum of infant mortality, under conditions practically realisable to-day, may be regarded as about 70 per 1000. In families in which exceptionally favourable conditions prevail, the infant mortality rate is even lower than the figure just stated ”

“ The reports on infant mortality published under the direction of the Children's Bureau substantiate for the United States of America the findings of the Galton Laboratory for Great Britain, showing that an abnormally high rate of fertility is usually associated with poverty, filth, disease, feeblemindedness and a high infant mortality rate. It is a commonplace truism that a high birth-rate is accompanied by a high infant-mortality rate. No longer is it necessary to dissociate cause and effect, to try to determine whether the high birth rate is the cause of the high infant mortality rate. ”

“ The increase in life expectancy since World War II has been brought about by a drop in the death rate from 12.2 per 1,000 in 1939 to seven per 1,000 in 1970 for the urban population and from 13.7 per 1,000 in 1939 to 11.4 per 1,000 in 1970 for the rural population. During the same period, infant mortality dropped from 139 per 1,000 live births to twenty-seven per 1,000 live births. In the late 1960s the incidence of infant mortality was 39 percent higher among rural infants than among urban ones. ”

“ The rate of infant mortality has been defined by experts as the ratio of deaths during the first year to the total number of births, and not, as sometimes figured, the ratio of deaths during the first year to the number of living infants under one year of age. For the group of registration states as a whole, the infant death rate calculated under the latter plan was about eight times the death rate at all ages. The death rate of children in the first five years of life was about ten times that of children in the second five years. ”

“ A LOW BIRTH-RATE NO GUARANTEE OF A LOW DEATH-RATE Again, birth controllers claim that a low birthrate leads to a low infant mortality rate. Now, it is really a very extraordinary thing that, whatever be the statement made by a Malthusian on the subject of birth-control, the very opposite is found to be the truth. During the last quarter of last century a falling birth-rate in England was actually accompanied by a rising infant mortality rate! ”

“ Thus we are brought face to face with another problem of infant mortality. Are we to check the infant mortality rate among the feeble-minded and aid the unfortunate offspring to grow up, a menace to the civilized community even when not actually certifiable as mentally defective or not obviously imbecile? ”

“ JOHNSTOWN, PA. INTRODUCTION The term infant mortality, used technically, applies to deaths of babies under 1 year of age. An infant mortality rate is a statement of the number of deaths of such infants in a given year per 1,000 births in the same year. ”

“ High infant mortality is at once a symptom and a means of natural-selection. Years characterised by high infant mortality necessarily follow years in which the infantile death-rate has been low. In countries with high infant mortality the population is stronger, because the badly-equipped new-born infants die in greater proportion than the well-equipped; in subsequent years the mortality is consequently lower, the fitness for military service is greater, and tuberculosis is less common. To diminish infant mortality would lead to a more rapid increase of population ”

“ The effect of this is not yet fully apparent in a decreased death-rate, but there can be little doubt that within a very few years it will have its result. For instance, one third of the infant mortality is due to prenatal conditions, congenital diseases which afflict the child at birth, and which mean either speedy death or a lingering, crippled life. ”

“ Thus the average infant mortality for 1896 to 1905 among eight "textile towns," where on the average 43 per cent, of married women below the age of 35 were employed, was 182 per thousand; whereas the average rate among eight "non-textile" towns, where only 3.1 per cent, of this class of women were employed, was 150, that is, over one sixth less. The average infant death rate for all England then was 152. ”

“ In the case of infants, there is no question of the struggle for existence. For their death-rate depends upon two factors—first, upon their inborn capacity; secondly, upon the conditions in which they are reared. The former factor is of far less importance in relation to infant mortality than it is in relation to child mortality. Only in an extremely limited sense is it possible, with regard to infants, to speak of a struggle for existence, in virtue of which the fittest survive. The infant is exposed to numerous dangers, in coping with which its inborn capacity hardly counts at all. ”

“ Now persons who are conversant with mortality statistics, either at first hand or through the columns of the newspapers, know that while it is true that "we hear so much about" infant mortality, what we hear is not that it is increasing but that it is declining—declining in the City of New York especially, at a rate so steady and so rapid as would have been pronounced incredible a quarter of a century ago. But the mothers who were drinking in the lecturer's words were led to believe that our modern society is responsible for an ever-increasing slaughter of the innocents. ”

“ The variation in the infant mortality rate from one earnings group to another is not perfectly regular and consistent, but if any two or more 129consecutive groups are combined an invariable lowering of the infant mortality rate from one such combined group to that next higher results. ”

“ Realizing the importance of the principles which our vital statistics establish, society can insist more strenuously upon preventive reforms. It can reduce the waste of infant lives, and conserve our potential population. Let us ascertain whether our population is sufficiently fecund by giving every new-born babe a fair opportunity for life. Whether 'race suicide' will then have a national aspect, society will be better able to judge. Certain classes are indeed chargeable with a low birth rate, but for the masses the more important problem is a diminishing infant mortality. ”

“ It is not enough to make our civilisation good. It must also be made strong; and for strength, numbers are not indeed enough without other elements, but they are none the less essential. Under existing conditions we waste, before birth and in infancy, a large part of our possible population.
How quickly some social evils will yield to treatment is seen in the fact that in ten years the campaign against infant mortality has reduced the death-rate among infants under one year of age by nearly a third. But it is still very excessive. ”

“ The physiological advantage of contributing to a growing population by means of lowering the death rate rather than by increasing the rate of birth. Mental anguish, physical and economic cost, would thus be reduced to a minimum. It is the method of enlightened civilization. The burden of our mothers is not lightly borne, let them enjoy the fruits of their suffering.
Second: The marvelous reduction in the former rate of infant mortality indicates what social reform may accomplish, and what a saving of lives may follow. ”

“ It may be that discouragements from unhappy family conditions or worry over economic disabilities sap the mother's vitality. It may be that taints of blood doom the child and the mother. Whatever the cause, it is reason for deep concern that a great state, like New York, for example, has a rate of infant mortality nearly twice as high as that of New Zealand and ranking eleventh in the twenty-three states of the registration area in which the death of babies is set down with care. ”

“ According to Dr Farr, the northern countries of Europe show a much lower infant death-rate than the southern ones. Infant mortality is lowest in Norway, and highest in High Bavaria, where 404 infants per 1000 die in their first year. In New York, in 1869, the mortality amongst infants under one year old was 27·4 per cent. ”

“ 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." ”

“ BUT the really remarkable work in the reduction of the death-rate within the last few years has been done among the children. It is here that the war worth waging has been carried on most effectively. If, as Ellen Key says, this is the century of the child, New York proved it in its first decade by concentrating the health battalions on infant mortality.
“A baby that comes into the world has less chance to live one week than an old man of ninety, and less chance to live a year than a man of eighty,” Bergeron, the French authority on children’s diseases, said ten years ago. ”

“ When we examine into the infant mortality prevailing amongst different classes, we find the proportion existing between the death-rate of the children of the nobility, and the general death-rate up to one year, to be as 3 to 8. ”

“ The decline of the birth-rate is a more serious problem. A large infant mortality prevails the world over and no effective means have been found to prevent this great sacrifice of life. Indeed the decrease of the birth-rate is comparatively small when compared with the waste of life by infantile diseases. ”

“ But we must recognize that the minimum so obtained is nevertheless still too large, because among the consorts of the long-lived fathers and mothers, some died early with the result of increasing the infant mortality. The infant mortality with the 85-year-old fathers and mothers is found to be 11.2%-15.4%, average about 13%. The total child-mortality reaches 31-32%, of which the 13% make about 40%. ”

“ The first direct steps towards the reduction of infant mortality were directed against epidemic or summer diarrhœa. Medical officers of health have always been required in their annual reports to summarize the vital statistics in their districts; and since 1905 a more detailed statement of infant mortality during each part of infancy has been required. ”

“ Of those children that remain in Paris, and that are so rarely suckled by their mothers, no less than 8250 die from 0-1 year, which gives a death-rate of 243 per 1000 births. As to the mortality of the unfortunate infants, 20,049 in number, sent off to nurse, this amounts to 500 or 700 per 1000 in the first year of life. ”

“ About 10 per cent, of all who die within the year live less than one day, and nearly one third perish before the end of the first month, showing that prominent among the causes of infant mortality is the mother's condition before and during the birth, as affected by alcoholism, social disease and maternal overwork. These same evils tend to produce stillborn and defective children. There is also extended lack of proper care during confinement. In American cities, it is said that about one half of all births are attended by midwives, 90 per cent. ”

“ The only country in which the fall in the birth rate has not produced a fall in the death rate, and which is not therefore over-populated. The infantile mortality is the lowest in the world, and the death rate less than 10 per 1,000, which gives us an ideal which we can reach in all countries by lowering the birth rate sufficiently. ”

“ Grace L. Meigs, head of the hygiene division of this bureau, has been undertaken as a direct corollary to the infant mortality inquiry. The sickness or death of the mother inevitably lessens the chances of the baby for life and health. A large proportion of the deaths of babies occur in the first days and weeks of life, and these early deaths can be prevented only through proper care of the mother before and at the birth of her baby. ”