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U. S. D EPARTM EN T O F LA B O R

CHILDREN’S BUREAU
JULIA C. LATHROP. Chief

INFANT MORTALITY
RESULTS OF A FIELD STUDY
IN JOHNSTOWN, PA., BASED ON
BIRTHS IN ONE CALENDAR YEAR

EMMA DUKE

I N F A N T M O R T A L I T Y S E R IE S N o . 3
Bureau Publication N o . 9

W ASHINGTON
GOVERNMENT PRINTING OFFICE

1915

ifca-1

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ADDITIONAL COPIES
OF THIS PUBLICATION MAY BE PROCURED FROM
THE SUPERINTENDENT OF DOCUMENTS
GOVERNMENT PRINTING OFFICE
WASHINGTON, D. C.
AT

20 CENTS PER COPY
V

3 C?^ *"f
ft *

CONTENTS.
Page.
Letter of transmittal................................................................. ......................................
5-9
Introduction...........................................................................
11-14
Relation of infant mortality to environment............................................................. 14-26
Neighborhood incidence...... ................................
14-20
Sanitary conditions—sewerage, pavements, and garbage collection s........... 20, 21
Housing..........................................................................................................
21-26
Nationality......................................................................................................
27-31
General nativity.....................................................................
27,28
Serbo-Croatian.................................................................................. ..................... '. 28, 29
Italian......................................................................................................................... 29, 30
Slovak, Polish, e tc ...................................................................................................
30
Other nationalities............ ........... .......................................................................... 30, 31
Stillbirths...........................................................................................................................
31
Attendant at birth .............................
32-34
Mothers.................................................................................................................
34-36
Literacy......................................................................................................................
34
A bility to speak English..............................................................................
34
Years in the United States.....................................................................................
35
Age.........................................................................................
35,36
Baby’ s age at death and cause (disease) of death................
36-38
Feeding................................................
38-42
Sex........................................................................ ....... ......................................................42,43
Mother’s household duties; cessationand resumption o f.......................................... 43-45
Economic factors.............................................................................................................. 45-49
Earnings of father...................................... .............................................................45-47
Gainful work of mother........................................................................................... 47-49
Illegitim acy........................................
49
Reproductive histories.................................................................................................... 50-53
G E N E R A L TABLES.
Table I.— Distribution of births according to nationality of mother, b y section
of city and ward............................................................................................................
Table II.— Distribution of births, live births, stillbirths, and deaths in first
year, according to nativity of mother, b y section of city and ward....................
Table I I I .— Distribution of births to native and foreign married mothers
and number and per cent of births in each group to those gainfully employed,
b y section of city ..........................................................................................................
Table IV .— Distribution of births to married mothers, according to attendant
at birth and to nativity of mother,b y section of city and ward..........................
Table V .— Distribution of live births and of deaths during first year, according
to number of persons and number of rooms per family ..........................................
Table V I.—Distribution of births, live births, stillbirths, and of deaths during
first year, according to nationality (detailed) of mother.......................................


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57
58

59
60
61
62

CONTENTS.

4

Page.

Table V II.—Distribution of births, live births, stillbirths, and of deaths during
first year, according to attendant at ba by’s birth and nationality of m other..
63
Table V III .—Distribution of deaths of infants at specified age, according to
cause of death of infant and nativity of mother.....................................................
64
Table I X .— Distribution of babies alive at beginning of each month from first
to ninth, according to type of feeding during each month; number continu­
ing such diet until following month; number changing to other specified
type of feeding; number of deaths in each group in first year and also deaths
at beginning of next month........................................................................................ 65, 66
Table X .— Distribution of births to married wage-earning mothers, according
to husband’s annual earnings and nativity and earnings of mother........ .........
67
Table X I .—Distribution of results of reportable pregnancies (live births and
stillbirths) and miscarriages, according to number per mother and nativity
of mother.............................................................................................................- ......... 68, 69
Table X I I .—Distribution of results of reportable pregnancies (live births and
stillbirths) and miscarriages, according to number per mother and age of
mother at each pregnancy................................................. - ...................................... 70, 71
Table X I I I .— Distribution of results of reportable pregnancies (live births and
stillbirths) and miscarriages, according to number per mother and husband’s
72-75
earnings...................
Table X IV .— Distribution according to number of pregnancies and age groups
of married mothers classified b y nativity.............................................................
76
Table X V .— Distribution of married mothers by losses sustained, according to
nativity of mother and number of possible losses.................................................
77
A PPE N D IXE S.
Appendix I.— Statements of m others........................................................................ 81-85
Appendix II.— Detailed description of method used for computing infant
mortality rate for this report and comparison with conventional m ethod----- 86-88
Appendix I I I .—The milk supply.............................
89-93
ILLU STRATION S.
Plates A to R


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LETTER OF TRANSMITTAL.
U. S.

D epartm ent

of

L abor,

C h il d r e n ’ s B u r e a u ,

Washington, August 24, 1914S i r : I transmit herewith a statement of the first study in the
field inquiry contemplated by the Children’s Bureau into the sub­
ject of infant mortality in the United States. This study was made
in Johnstown, Pa., during the first year of the bureau’s existence,
and is submitted as the first item in a proposed series of studies into
infant mortality to be made in a number of typical communities
throughout the country.
The city of Johnstown was selected because of its interest as a
type of town in which there are no large factories employing women
and because its size and its good birth registration permitted a study
by the staff which the bureau could at first assign to this work.
The subject of infant mortality was chosen, first, because of its
obvious importance as recognized by the fact that it is the first
subject mentioned in the law creating the bureau; second, because
of its fundamental value to further work of the bureau; and third,
because it was practicable to make a single study, complete in itself,
which would yet form part of an integral whole as it became possible
to extend the field inquiry.
The restricted and tentative character of this first study is
recognized. Its results will be constantly compared and collated
with those of following similar studies in other communities. Doubt­
less the method of the general field inquiry may be modified from
time to time, but the essential basal material of the schedules will
be comparable throughout.
Infant mortality is a subject of profound social importance. The
modern view has ceased to’ be fatalistic; infant mortality is now
regarded as a preventable waste, injurious to survivors as well as
destructive to infants, and cruelly increasing the burden of rearing
a family. Sir Arthur Newsholme, the great English authority, has
said,. “ Infant mortality is the most sensitive index we possess of
social welfare and of sanitary administration, especially under urban
conditions.” Nationally, the United States has as yet no means of
measuring the extent and significance of its infant mortality. If
it were practicable, it would be illuminating to visit each one of the


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6

LE TTE R OF T R A N S M IT T A L .

2,500,000 children who, it is estimated, are born in this country
yearly, and to take note of the varying social and economic condi­
tions under which some 300,000 of them die and the others survive.
As this is manifestly impossible, the nearest approach is to consider
certain communities typical of the whole, and it is believed that in
the course of a few years’ study such data can be presented as will
give the United States a fairly adequate measure of the conditions
under which American-born infants survive or perish, and of the
possibilities of modifying those conditions by local action.
Brilliant work for infant welfare has been done in many localities,
notably by the public-health authorities and volunteer organizations
of the larger cities, and incidental thereto much information regard­
ing infant mortality has been gathered; but in the greater part of
the country, especially in the smaller cities and rural communities,
it is as yet hardly recognized that the problems which confront the
crowded quarters of the great cities may also exist in less congested
areas.
In accordance with the plans for a general inquiry into infant
mortality, Mr. Ethelbert Stewart, the first statistical expert of the
Children’s Bureau, directed the preparation of the schedule and the
field work at Johnstown.
This study considers all the babies born in Johnstown within a
single calendar year. Since the work was begun in January, 1913,
it was necessary to select the year 1911 as the latest in which all
babies born could have attained a full year of life.
Mr. Stewart preceded the agents by a visit to Johnstown in which
he explained the purposes of the inquiry, and the courtesy with
which the agents were received by the general public—the press,
the clergy, civic and volunteer organizations, and especially by the
mothers themselves—was a valuable factor in making the inquiry
successful.
Above all, the bureau wishes to express its obligation to the mothers
of Johnstown, without whose generous understanding and help the
inquiry could not have been conducted. Their good will is evidenced
by the fact that, out of 1,553 mothers visited, only two refused
information. The readiness with which the information was given
undoubtedly depended upon the appeal to the mothers to cooperate
with the Government in the effort to learn how to save babies’ lives
and to the fact that the agents could show that the information
given was not to be used in any personal way.
The schedules were taken by Miss Emma Duke, Miss Sophia Vogt,
and Miss Emily Miladofsky, special agents of the bureau, while the
preliminary work of transferring to the schedules the information
contained on the State records of birth was done by Mr. A. V. Par-


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LE TTE R OF T R A N S M IT T A L .

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sons, special agent of the bureau, who also took the photographs
reproduced.
Just as the work of filling out the schedules was being completed
in Johnstown, Mr. Stewart was transferred to the Bureau of Labor
Statistics, and his loss, together with other bureau exigencies, delayed
the completion of the report. Miss Emma Duke has written the
text and she has had the assistance of Miss Sophia Yogt and Miss Ella
A. Merritt in making the tabulations. Mr. Lewis Meriam, Assistant
Chief of the Children’s Bureau, was interested in the inquiry from
the start, and on Mr. Stewart’s transfer was placed in charge of the
statistics. The bureau wishes to acknowledge its indebtedness to all
those who have aided in the preparation of this study by preliminary
advice and by criticism of the schedule or manuscript.
The method of the inquiry is in one respect unique, so far as we are
aware. Instead of taking as its point of departure the death records
of children who have not survived their first year, the birth records
are first secured for all children born within a certain calendar year,
and each child is then traced through the first 12 months of life, or as
much of that period as he survives, in order to obtain information
as to the conditions which surround all the children of the town born
during the given year. It is evident that this inquiry can be carried
on effectively only in communities which have birth registration,
and its extension to include typical units throughout the country
must depend largely upon the further extension of birth registration.
The law creating the bureau provided for no medical officer upon
the staff, and the inquiry was necessarily restricted to a consideration
of family, social, industrial, and civic factors. The original material
of the schedule was secured through personal interviews between
individual mothers and the women agents. As the text shows, cer­
tain facts regarding the civic surroundings of the families were
secured in addition to the interviews, but the chief value of the
inquiry lies in the information afforded by the mothers. It is plain,
however, that a study thus limited must omit certain important con­
siderations. It is not fair nor practicable to enter a home and ask
questions regarding conditions which, if they exist, are considered
personally humiliating. Hence it was necessary to omit questions
bearing on matters of personal character or behavior, and therefore
to omit all consideration of two recognized factors in infant mor­
tality— alcoholism and venereal disease. It is anticipated that the
bureau will be in a position later to consider these and other factors,
notably those connected with the employment of mothers and with
industrial diseases, by methods independent of family inquiry.
The emphasis of the inquiry, as shown throughout the text, was
upon certain of the more obvious economic, social, and civic factors
which have surrounded the lives of the children of Johnstown born


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8

L E TTE R OF T R A N S M IT T A L .

within the given year. Civic action can remedy defective sewerage
and scavenger systems and dirty unpaved streets which are instru­
mental in creating conditions that endanger the lives of infants.
The extension of city water to all houses; improved methods for
sewage disposal, garbage collections, and general scavenging; the
paving of streets and inhabited alleys; the widening of alleys; the
improved grading of streets and alleys; the relief of house and lot
congestion; the abolition of wells and yard privies; sewer connec­
tion for all houses; the abatement of the smoke nuisance— all of these
are needed improvements for the infant health and the general
health of Johnstown.
But the public’s responsibility does not end merely in remedying
such conditions as those just noted. There is a growing tendency
on the part of municipalities to accept responsibility for furnishing
information and instruction to its citizens. Some cities have reduced
their infant mortality rate by having expectant mothers instructed
in prenatal care; others by sending instructive visiting nurses, imme­
diately after the birth of a child, into homes that need them. Other
means which have been found effective in reducing excessive infant
mortality rates are baby welfare stations, consultation stations for
expectant and nursing mothers, and the distribution of sound litera­
ture on prenatal care, the care and feeding of infants, the care of milk,
and other hygienic matters.
The importance of a pure milk supply in reducing infant mortality
has been repeatedly demonstrated. The direct effects of impure
milk on the health of Johnstown babies could not be ascertained in
this investigation, but the careless handling of milk was obvious, and
at the request of the Johnstown Board of Health and the local health
officer the Children’s Bureau secured the cooperation of the Bureau
of Animal Industry of the Department of Agriculture in making
a comprehensive investigation of the milk supply in Johnstown.
The findings of the experts, L. B. Cook, C. E. Clement, and B. J.
Davis, printed in full on pages 89 to 93 of this report (Appendix III),
justify the citizens’ campaign for clean milk now under way in
Johnstown.
In many directions public spirit is active in Johnstown. The city is
awakening to its needs and to its responsibilities as well. It sup­
ports a strong civic club and other associations which are studying
ways and means to proceed. Its newspapers are virile and pro­
gressive and plans are being made to remedy insanitary conditions.
Through private effort a visiting nurse has been secured to instruct
mothers in the care of their homes and their children.
The Johnstown report shows a coincidence of underpaid fathers,
overworked and ignorant mothers, and those hazards to the life of
the offspring which individual parents can not avoid or control


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because they must be remedied by community action. All this
points toward the imperative need of ascertaining a standard of life
for the American family, a standard which must rest upon such
betterment of conditions of work and pay as will permit parents to
safeguard infants within the household. Toward the slow working
out of the essentials of such a standard it is hoped that the bureau’s
continued studies into infant mortality may contribute.
While the bureau has not yet determined upon all the units of the
inquiry, it is the purpose at present to study localities outside those
great urban areas whose spectacular needs have secured costly and
effective work by municipal and volunteer organizations. Such work
should be equally valuable and, on the whole, equally applicable in
smaller towns and even in rural communities. That similar prob­
lems and needs exist also in our less congested areas is proved by the
1913 report of the New York State Health Commission, which has
made plain the unfavorable health showing of the State as a whole
as compared with that of the city of New York. This report and
the studies upon which it is based have furnished the impetus for new
legislation which extends throughout the State certain measures for
improving the health of children which have already proved effective
in the largest city of the State. In various parts of the world the
history of intelligent efforts to surround babies with healthful con­
ditions shows a progressively lessening infant mortality rate and leads
to the belief that the problems of infant mortality can be solved.
Sir Arthur Newsholme, who has already been quoted above, says
in the Forty-Second Annual Report of the Local Government Board
(1912-13), “ It is obvious that the complex problems involved (ex­
cessive infant and child mortality) can not be effectively stated in a
single report, and that investigation is called for in nearly every
center of excessive mortality.”
It is therefore desired to pursue this inquiry in various typical
communities throughout the country so that the facts may secure
popular attention. Clearly the law creating the Children’s Bureau,
framed by experts in child welfare, embodies the conviction that if
the Government can “ investigate and report” upon infant mortality,
the conscience and power of local communities can be depended upon
for necessary action.
Respectfully submitted.
J u l i a C. L a t h r o p , Chief.
Hon. W i l l i a m B. W i l s o n ,
Secretary o f Labor.


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INFANT MORTALITY : JOHNSTOWN, PA.
INTRODUCTION.
The term infant mortality, used technically, applies to deaths of
habies under 1 year of age. An infant mortality rate is a statement
o f the number of deaths of such infants in a given year per 1,000
births in the same year. Some countries include stillbirths in making
the computations, but this method is not generally followed in this
•country nor has it been followed in this report.
Ordinary procedure is to compare the live births in a single calendar
year with the deaths of babies under 12 months of age occurring in
that same year, even though those who died may not have been born
within the calendar year of their death. The infant mortality
rates in this report, however, have not been computed on the usual
basis, but for the purpose of securing greater accuracy in measuring
the incidence of death this bureau has considered, in making the
computation, only so many of the babies born in the year 1911 as
could be located by its agents, and has compared with this number
the number of deaths within this group of babies who died within
one year of birth, even though some of these deaths may have oc­
curred during the calendar year 1912.1
Infant mortality can be accurately measured in no other way than
b y means of a system of completely registering all births as well
as all deaths. In 1911 the United States Bureau of the Census
regarded the registration of deaths as being “ fairly complete (at
least 90 per cent of the total) ” in 23 States, but the same degree of
completeness in the registration of births was found only in the New
England States, Pennsylvania, and Michigan, and in New York City
and Washington, D. C. An exact infant mortality rate for the United
States as a whole can not be computed owing to this generally incom­
plete registration. In the 1911 census report on mortality statistics,2
however, the infant mortality rate is estimated at 124 per 1,000 live
births. How this estimated rate compared with the computed rates
for other countries is shown in the following summary:
i For more detailed description of method see Appendix II, pp. 86 to 88.
a Bulletin 112, Bureau of the Census, p. 23.


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IN F A N T M O R T A L IT Y : J O H N S T O W N , PA.

D eaths

of

q u e n n ia l

Y

ears

Ch il d r e n
P e r io d s

1909

and

1 Y e a r of A ge
1901 t o 1910, a n d

under
from

per
also

1,000
for

L iv e
the

B ir t h s , b y Q u in ­
Sin g l e Ca l e n d a r .

1910.1

COUNTRY.

Chile...................................................
Russia (European)....................................
Austria..............................................
Hungary..............................
Prussia................................
Jamaica..........................................
Spain...................................
Ceylon.................................................
Italy..........................................
Japan...................................
Servia...........................
Belgium.......................................
Bulgaria..............................................
France..........................................
England and Wales.................................
The Netherlands.................................
Switzerland...................................................
Finland...................................................
Scotland................................................
Denmark..................................
Province of Ontario......................
Ireland..........................................................
Australian Commonwealth....................
Sweden.......................................................
Norway....................................
New Zealand...........................................

1901 to 1906 to
1905
1910
306
(8)
215
212
190
174
173
171
168
154
149
148
148
139
138
136
134
131
120
119
* 114
98
97
91
81
75

1909

1910

315

315

313

204
168
191

212
164
174

194
157
m

189

202
155
166

176-

137
117
114
117
127
94
78
70

120
109
99
115
111
108
98
131
92
72
72
72
62

105
108
118
123
95
75
68

1 From the Seventy-third Annual Report of the Registrar General of Births, Deaths, and Marriages in.
England and Wales (1910). London, 1912.
2 Available only for the period from 1896 to 1900, when it was 261.

When it had been decided by the Children’s Bureau to make infant
mortality the subject of its first field study and to include all babies
born in a given calendar year, regardless of whether they lived or died
during their first year, advice and cooperation were enlisted of moth­
ers, physicians, nurses, and others experienced in the care of chil­
dren, and also of trained investigators and statisticians, in the prep­
aration of a schedule which was submitted to them for criticism.
With its limited force and funds it was not possible for the Chil­
dren’s Bureau to extend its inquiries throughout the entire United
States. It was therefore decided to make intensive studies of babies
bom in a single calendar year in each of a number of typical areas
throughout the country that offered contrasts in climate and in
economic and social conditions, the results to be eventually combined
and correlated. It was necessary to restrict the choice of the first
area to a place of such size as could be covered thoroughly within a
reasonable time by the few agents available for the work.
Johnstown, Pa., was the first place selected. It is in a State
where birth registration prevails, and hence a record of practically
all babies could be secured; it is of such size that the work could
be done by a small force within a reasonable period, and it seemed
to present conditions that could with interest be contrasted with con­
ditions typical of other communities. Moreover, the State commis­
sioner of health and the State registrar of vital statistics were both


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13

working zealously to enforce birth-registration laws; both were ac­
tively interested in reducing infant mortality, and they welcomed a
study of the subject in their State. In Johnstown the mayor, the pres­
ident of the board of health, the health officer, and other local officials
all showed the same spirit of hearty cooperation and interest.
Inasmuch as the study was confined to babies born in a single cal­
endar year and work was begun in January, 1913, the latest year in
which the babies could have been born and still have attained at least
one full year of life was 1911.
Work was begun on January 15, 1913, with the transcription from
the original records at Harrisburg of the names and other essen­
tial facts entered on the birth certificates of babies born in 1911, and,
if the baby had died during its first year of life, items on the death
certificate were also copied.
In the meantime the people of Johnstown through the press, and
through the clergy in the foreign sections, had been informed of the
purpose and plan of the investigation. Without the friendly spirit
thus aroused and the interest manifested by the Civic Club and other
organizations the work could not have been brought to a successful
issue. The investigation was absolutely democratic; every mother
of a baby born in 1911, rich or poor, native or foreign, was sought,
and it is interesting to note refusals were met with in but two cases.
The original plan was to limit the investigation to those babies bom
in the calendar year selected whose births had been registered, the
purpose being to secure facts concerning a definite group and not to
measure the completeness of birth registration. Shortly after begin­
ning the work, however, agents of this bureau were told that the Ser­
vian women in Johnstown seldom had either a midwife or a physician
at childbirth; that they called in a neighbor or depended upon their
husbands for help at such times, or that they managed alone for them­
selves, and that therefore their babies usually escaped registration.
The omission of these babies meant the exclusion of a number of moth­
ers in a group that was too important racially to be omitted from an
investigation embracing all races and classes. Accordingly a list of
babies christened in the Servian Church and born in the year 1911 was
secured and an attempt made to locate them. In addition an agent
called at each house in the principal Servian quarter to inquire con­
cerning births in 1911. A number of unregistered babies of Servian
mothers were thus found and included in the investigation.
The agents were sometimes approached by mothers of babies born
in 1911 who resented being omitted from the investigation simply for
the reason that their babies’ births had not been registered. The
agents were therefore instructed to interview mothers thus accidentally
encountered and to include their babies in the investigation. But no


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additional baptismal records were copied nor was a house-to-house
canvass*made of the city; in fact, no further means were resorted to
to locate unregistered babies for the purpose of including them in the
investigation.
There were 1,763 certificates copied at Harrisburg, and 1,383 of the
babies named in them were reached by the agents. In addition, 168
babies for whom there were no birth certificates, but who were located
in the ways just noted, were included, making a total of 1,551 com­
pleted schedules secured.
Of the 380 not included in the investigation there were 149 who
could not be located at all; 220 others had moved out of reach— that
is, into another city or State; 6 of the mothers had died; 3 could not
be found at home after several calls, and 2 refused to be interviewed.
From the following summary of data recorded on the certificates
of the 380 unlocated babies just referred to it appears that the infant
mortality rate (134.3) among them is almost the same as that (134)
shown in Table 1 for babies included in the investigation. In reality,
however, it is perhaps a little higher, as some of these babies no doubt
died outside of Johnstown and their deaths were recorded elsewhere.
SEX OF BABY.

Still­
Live
Total
NATIONALITY OP MOTHER.
births. births. births.

Total....................

380

Physi­
cian.

Mid­
wife.

30

227

153

158

189

33

47

76
151

58
95

122
36

5
184

7
26

12
35»

27
10
1
6
26
3
3

16
3

4

2
6

2
15
4
4

2
3
3
5

37
7
1
5
36
4
2

73

50

19

89

15

Native.........................
Foreign.......................

134
246

118
232

Slovak, Polish, etc..............

43
13
1
8
41
7
7

41
11
1
8
39
6
7

2
2

123

116

7

Austrian (not otherwise
specified)............................

Fe­
male.

Certifi­
cate
showing:
deaths
Un­
during
known. first year.

350

16
14

Italian....................................
Syrian and Greek................

Male.

ATTENDANT AT BIRTH.

2
1

3
5

i

2

2

4
1

RELATION OF INFANT MORTALITY TO ENVIRONMENT.
NEIGHBORHOOD INCIDENCE.
The rate of in fant, mortality is regarded as a most reliable test of the sanitary condi­
tion of a district. (Sir Arthur Newsholme, Elements of Vital Statistics, p. 120. Lon­
don, 1899.)

Johnstown is a hilly, somewhat Y-shaped area of about 5 square
miles which spreads itself out into long, narrow, irregularly shaped
strips, detached by rivers and runs and steep hills. In some places
it is not over a quarter of a mile wide, but its extreme length is


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15

about 4 miles. The city is composed of 21 wards and is an aggrega­
tion of what were formerly separate unrelated boroughs or towns.
The names of these different sections, together with the numerical
designations of the wards included in or comprising them, are shown
in the following table. This table gives for each section not only the
total population according to the Federal census of 1910, but also
the number of live-born babies included in the investigation and the
number and proportion of deaths among such babies during their
first year.
T a b l e X . 'D i s t r i b u t io n o p P o p u l a t i o n , L i v e B i r t h s , a n d D e a t h s D u r i n g
F i r s t Y e a r , a n d I n f a n t M o r t a l it y R a t e A c c o r d in g t o S e c t io n o f J o h n s ­
t o w n , f o r A l l C h il d r e n I n c l u d e d i n t h is I n v e s t i g a t i o n .

SECTION OF CITY AND WARD.

Popu­
lation,
1910.1

The whole city.................................

55,482

Down-town section (wards 1. 2,3, 4) ..
Kernville (wards 5, 6)................ ' .
Hornerstown (ward 7 )..............
Roxbury (ward 8 ).........................
Conemaugh Borough (wards 9, 1 0 )....................
Woodvale (ward 11)....................... '___
Prospect (ward 12).................; .....................
Peelorville (ward 13).................................
Minersville (ward 14)......................................
Cambria City (wards 15, 16).................................
Moxham (ward 17)..............................................
Morrellvilie (wards 18,19, 20)................
Coopersdale (ward 21)..........................................

5,944
6,070
2’ 862
5,282
1,893
1,443
2,403
8,706
5,735
5,757
966

Deaths
during
Total
first
year Infant
live-bom
mortality
babies. of babies
rate.
born in
1911.

80
104
10Ö
85
136
107
55
18
72
310
157
194

16

156.0
117.6

(2)

16
8

89.2
82.5
(2)

1 Federal census of 1910.
* Total live births less than 50; base therefore considered too small to use in computing an infant mortality rate.

To learn where the babies die is perhaps the first step in solving
the infant mortality problem. The modem health officer recognizes
this and generally has in his office a wall map upon which are indi­
cated sections, wards, city blocks, and sometimes even houses. As
infant deaths are reported, pins are stuck in the map in the proper
places, a density of pins on any part of the map indicating, of course,
where deaths are most numerous, although the percentage of infant
deaths may not be the highest. The next table shows the compar­
ative frequency of infant deaths in each of the several sections of
Johnstown as well as the rate of infant mortality, total population,
proportion of foreign population, proportion of foreign mothers, and
total births in the year 1911 in each.


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16

INFANT M ORTALITY: JOHNSTOW N, PA.

T able 2 . — R elative R ank op S ections op J ohnstown , A ccording to I npant
Mortality R ate por all Childern I ncluded in T his I nvestigation , T otal
P opulation , T otal F oreign B orn , P ercentage op F oreign B orn in T otal
P opulation , N umber of B abies B orn A live in 1911, P roportion op F oreign B orn M others , and N umber op I nfant D eaths .
BANK OF THE SEVERAL SECTIONS OF THE CITY ACCORDING TO—

SECTION OF CITY AND WARD.

Babies included in investiga­
* Per
tion.
Total
cent
of
Infant Total foreignborn foreignmortal­ popu­
Propor­
bom
ity rate. lation.1 popu­
Number
tion of Number
lation.1 popu­ live born. foreign of infant
lation.1
mothers. deaths.
1
2

•3
4
5
6
7
8
9
10
11

(2)
(2)

8

2

1

6

2

2

11
1

8

5

7

7

10
4
3

2
11

11
1

5

1

10

6
9
5
4

12

5

3
4
13
8
9

10

12

4
8
3

3

6
7
9
5

12

11

7
6

7
9
13

13

13

10

12

2

2

1
11

3
4
12

1

3
9
4
8
6
5

7
6
13
9

11
12

10

13

8

10

1 According to Federal census of 1910.
2 Total live births less than 50; base therefore considered too small to use in computing an infant mor­
tality rate.

The highest infant mortality rate, 271, is found in the eleventh
ward, known as Woodvale, although this is neither the most populous
ward nor the one having the largest number of births. The infant
mortality rate here, however, is double the rate for the city as a
whole and more than five times as great as it is for the most favor­
able ward.
This is where the poorest, most lowly persons of the community
five—families of men employed to do the unskilled work in the steel
mills and the mines. They are for the most part foreigners, 78 per
cent of the mothers interviewed in this ward being foreign born.
Through Woodvale runs the main fine of the Pennsylvania Rail­
road. To the north of the tracks rises a steep hill, toward the top
of which is Woodvale Avenue, the principal street north of the rail­
road. (See plate A.) Sewer connection is possible for the houses
along this avenue, as a sewer main has recently been installed, but
the people have not in all cases gone to the expense of having the
connection made, and in other cases where they have done so some­
times only the sinks are connected with the sewer and the yard
privy is retained.
On the streets above Woodvale Avenue dwellings are more scat­
tered and the appearance is more rural. A few of the families still
have to depend upon more or less distant springs for their water,
although city water is quite generally available throughout W ood­
vale.


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17

The streets near the bottom of the hill, as Plum Street, for exam
pie, are so much below the level of the sewer mains that they can
not be properly drained into the sewer. Private drain pipes from
houses are buried a few feet below the surface and protrude from
the sides of the hills, dripping with house drainage which flows
slowly into ditches and forms slimy pools. (See Plates B and C.)
None of the streets on the north side of the railroad track are
paved; sidewalks and gutters are lacking. In cold weather the
streets are icy and slippery and even dangerous on account of the
grade. In warm weather they are frequently slippery and slimy
with mud.
Maple Avenue is the principal street of that part of W ood vale
lying to the south of the railroad tracks, and it is the only properly
paved and graded street in Woodvale. The streets on this side of
the tracks, however, are not in as bad a condition as those to the
north, nor are the drainage and general sewerage conditions as offen­
sive as north of the tracks, but many of the streets are nevertheless
muddy and filthy. (See Plate D.)
Prospect ranks next to Woodvale in infant mortality, having a
rate of 200. This section, lying along a steep hill and above one of
the big plants of the steel company, has not a single properly graded,
drained, and paved street. The sewers are of the open-ditch type,
and the natural slope of the land toward the river is depended upon
for carrying off the surface water that does not seep into the soil.
The closets are generally in the yard and are either dry privies or
they are situated over cesspools. Some of the people who live on
the lower part of the slope have wells sunk directly in the course of
the drainage from above. (See Plate E.)
Cambria City, which is composed of the two most populous wards
of Johnstown, has the third highest infant mortality rate, 177.4.
I t has a large foreign element, as is evidenced by the fact that 90.6
per cent of the mothers interviewed were foreign born. It is situated
along the river, between the hills of Minersville and Morrellville, and
somewhat to the north of Prospect. The sewage from other resi­
dential sections and from the steel mills above them empties into the
river at this point. In warm, dry seasons the river is low, flows
slowly, and forms foul-smelling pools.
Sewer connection is possible for most of the houses in Cambria City,
although all are not connected. Some, on the streets bordering the
river, have private drain pipes that empty out into the stream.
Others have their kitchen sinks connected with the sewer but still
retain yard privies, which, of course, are not sewer connected.
There is considerable crowding of houses on lots, rear houses being
commonly built on lots intended for but one house. Density of pop­
ulation and house congestion are greater here than elsewhere in the
city.
61112°— 15------2


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I N F A N T M O R T A L IT Y : J O H N S T O W N , P A .

The streets of Cambria City are somewhat better graded and more
generally paved than those of Woodvale, but muddy streets and
unpaved sidewalks nevertheless exist here. Broad Street, however,
which is the business thoroughfare and runs through the center of
the section, is the widest and best constructed street in Johnstown.
Bradley Alley, on the other hand, running the length of Cambria
City and parallel to Broad Street, is the most conspicuous example in
the city of a narrow lane or alley used as a residence street. A num­
ber of small dwellings, generally housing more than one family, have
their frontage on this alley, which is 19 feet 10 inches in width and
without sidewalks. It is unpaved and in bad condition, generally
being either muddy or dusty and littered with bottles, cans, and other
trash. (See Plates F and G.)
Homerstown has an infant mortality rate of 156, ranking fourth
among the several sections of Johnstown in this respect. It has a
fairly prosperous and somewhat suburban appearance, but its com­
paratively high infant mortality rate can perhaps be partly accounted
for by the bad street conditions and the fact that refuse of all sorts
is dumped into the shallow river at this point.
Minersville is a district where a high rate would be expected from
prevailing conditions. The rate is 125, or less than the average for
the city but more than double that for the most favorable sections.
This ward is built on a hill and so located that the rising clouds of
grit-laden smoke from the steel mills envelop it much of the time.
Only one street in this section is well paved, and this is seldom clean.
Houses on some of the streets near the top of the hill are not sewer
connected, and streams of waste water trickle down the hill and give
rise to unpleasant odors. (See Plates H and I.)
Conemaugh Borough, with an infant mortality rate of 117.6, ranks
sixth in this respect among the sections into which Johnstown has
been divided. It comprises wards 9 and 10 and begins at the edge
of the downtown section and spreads upward over the hills to the
southwest. Some of the houses on streets near the top of the hill are
not sewer connected, and streams of water constantly trickle down
the numerous alleys and streets that descend the hill. (See Plate J.)
This section makes a very unfavorable first impression because of the
open drainage and of the many dirty, badly paved streets. (See
Plate K .) Unlike some of the other wards, it has a rather evenly
distributed population and is without the vast uninhabited areas and
acutely congested spots found in some other sections. On the whole
there is little crowding on the lots and there are many good-sized
yards. One-third of the population is foreign born. Of these the
Italians are the most numerous. Despite certain ugly spots this sec­
tion has not the unwholesome atmosphere that characterizes Woodvale and to a lesser extent Prospect, Cambria City, and Minersville.


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19

The infant mortality rate of 117.6 per thousand in Roxbury is the
same as that of Conemaugh Borough. For reasons not plainly appar­
ent the rate here is higher than in Moxham, Morrellville, Kernville,
or the down-town section, although it appears to be as favorably con­
ditioned as these sections are from a social, economic, and sanitary
standpoint. Here, as in all these sections, however, are many con­
ditions not conducive to health. For example, parts of Franklin
Street are in bad repair. The roadway is full of ruts and holes; the
street, which is seldom sprinkled, is dusty in dry weather and muddy
in wet weather, and in front of good houses along one section of this
street runs an open ditch that receives house drainage.
Moxham has the eighth highest infant mortality rate, it being 89.2.
Conditions here are generally rather favorable, although there is some
complaint that at “ high water” the sewage received by one of the
runs in this section backs into some of the houses and then the sinks
and water-closets overflow. Some of the homes here, near the city
limits, are not supplied with city water but are still dependent upon
wells and springs.
One of the three wards constituting Morrellville (ward 18) has a
rural appearance; there is little house crowding on lots, big yards are
common, and the streets are not paved. It is, however, marred by
an offensive open-ditch sewer. Ward 19 of Morrellville has a moi:e
finished, less rural appearance. One of its objectionable features is
that house drainage and the bloody waste of slaughterhouses are
emptied into a shallow stream that flows through it. Ward 20
adjoins ward 19, and although it spreads out into a suburb it appears
for the most part to be a comfortable and busy little village. Strayer’s Run winds about here and receives sewage. The fact that it is
without a guardrail in some places and that the railing is inadequate
in others makes it a source of danger, and according to common
report such accidents as children falling into the stream have occurred.
The infant mortality rate for Morrellville is 82.5.
Kernville, a section with a considerable proportion of prosperous
people, has a very favorable infant mortality rate, it being 57.7.
Parts of this section, however, are on a hill stretching upward from
Stony Creek, which is both unsightly and offensive in warm weather
and when the water is low.
The down-town section, i. e., wards 1, 2, 3, and 4, where are to be
found many of the best conditioned houses, the homes of many of the
well-to-do people, has the lowest infant mortality rate in the city, it
being but 50.
No infant mortality rate is presented in the tables for Coopersdale
or for Peelorville. In the first-named section only 36 live-born
infants were considered, and 8 of them died in their first year. But
this high rate need not be considered as especially significant, as


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IN F A N T

M O R T A L IT Y : J O H N S T O W N , PA.

the base number is small for such a computation. Coopersdale, how­
ever, is a suburban-appearing community in which one would expect
the infant mortality rate to be low.
Peelorville is that part of the thirteenth ward which adjoins Pros­
pect. A number of company houses are located here in which sani­
tary conditions are f airly good. The ward seems to have good drainage
and no sewage nuisances. It is a community of wage earners and not
of prosperous homes. Only 18 babies are included in the report for
this district, one of whom died. With such a small base the infant
mortality rate is not significant. (See Plate L.)
SANITARY CONDITIONS— SEWERAGE, PAVEMENTS, GARBAGE
COLLECTIONS.

The general inadequacy of the sewerage system which has been
indicated for the city as a whole is due in part to the fact that the
city is largely an aggregation of sections, formerly independent of
Johnstown itself, which have been annexed at different periods.
Some of these boroughs had sewer systems more or less developed
when they were taken into Johnstown; others had none. Not only
the sewage of Johnstown but that of outlying boroughs pollutes the
two shallow rivers, the Conemaugh and the Stony Creek, that flow
through Johnstown. These are burdened with more waste than they
can properly carry away, and the deposits which are left on the rocks
in various sections of both rivers create nuisances that are the subject
of much complaint, especially during the warm summer months. (See
Plates M, N, O, and P.) At various times agitation has been started
to improve the rivers which, as they flow through Johnstown, are, at
the low-water stage, little better than swamps of reeking slime from
the waste matter emptied into them from the hundreds of sewers
along their banks. The pipes through which waste matter is emptied
into the streams go only to the river edge, leaving their mouths un­
covered and making the river beds at times pools of slowly flowing
filth. These unsightly, malodorous conditions could be remedied if
pipes were extended out into the middle of the streams, where the
water is deeper.
With the exception of sprinkling a few wagon loads of lime along
the banks of the streams each year, the city has done nothing to
abate the nuisances arising from the use of these rivers as sewers or
to restrain the coal and steel companies from allowing the drainage
from mines and mills to enter the streams.
The engineer’s records show that Johnstown had in 1911 a total of
41.1 miles of sewers and 36 sewer outlets, and 82 miles of streets, 52.7
miles being paved. The alleys in Johnstown are generally inhabited.
They are narrow and without sidewalks. Their length is 52.88 miles
and 47.35 miles are unpaved. The combined length of streets and


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I N F A N T M O R T A L IT Y : J O H N S T O W N , P A .

21

alleys is 134.88 miles. A comparison of this combined length of
streets and alleys with the 41.1 miles of sewers having 36 outlets
shows the inadequacy of the sewer system.
Not only is there an absence of paving, but the roadways are in
very bad condition. A protest by “ A Citizen” in the Democrat of
June 26, 1913, says that there are nine months in the year when it
would be impossible for the proposed fire-department automobile
engines to attend a fire in the seventh, eighth, eleventh, seventeenth,
eighteenth, nineteenth, twentieth, and twenty-first wards owing to
the condition of the streets.
The scavenger system is also very defective. Citizens are re­
quired to pay for the removal of their ashes, trash, and garbage.
Garbage collections are not made by the municipality, but by private
contractors, and any sort of receptacle, covered or uncovered, can or
box, is pressed into service by householders. It is by no means
uncommon to find streets and alleys littered with ashes, garbage,
bottles, tin cans, beer cases, and small kegs. Dirty streets are by
no means exceptional in Johnstown, even though the State of Penn­
sylvania has a law (act of Apr. 20, 1905) which provides for the pun­
ishment of any person who litters paved streets. It reads, in part, as
follows (sec. 7 of Pamphlet Laws, 227):
From and after the passage of this act, it shall be unlawful, and is hereby forbidden,
for any person or persons to throw waste paper, sweepings, ashes, household waste,
nails, or rubbish of any kind into any street in any city, borough, or township in this
Commonwealth, or to interfere with, scatter, or disturb the contents of any receptacle
or receptacles containing ashes, garbage, household waste, or rubbish which shall be
placed upon any of said paved streets or sidewalks for the collection of the contents
thereof.
Any person or persons who shall violate any of the provisions of this act shall, upon
conviction thereof before any magistrate, be sentenced to pay the cost of prosecution
and to forfeit and pay a fine not exceeding $10 for each offense, and in default of the
payment thereof shall be committed and imprisoned in the county jail of the proper
county for a period not exceeding ten days.

In a report on infant mortality to the registrar general of Ontario,
1910, Dr. Helen MacMurchy says: “ Improve the water supply, the
sewerage system, and the system of disposing of refuse; introduce
better pavements, such as asphalt, and at once there is a decline in
infantile mortality.” All these are sanitary features in need of great
improvement in Johnstown, and unquestionably a lowered infant
mortality rate would reward any efforts for their betterment.
HOUSING.

In Johnstown the so-called “ double” house predominates, usually
frame. The double house is in reality two semidetached houses built
upon a single lot. Rows of three or more houses of two, three, or


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M O R T A L IT Y : J O H N S T O W N , PA.

four rooms each are common, and they are known locally as threefamily, or six-family houses, as the case may be. Sometimes these
are “ rear houses/' that is, they are built behind other houses that
face the street, on the same lots and in fact are approached by way
of a narrow alley running alongside the house that has its frontage
directly on the street. For this type of house water-closets or
privies are often in rows in the yard or court that is used in common
by all families. (See Plates Q and R.) In some places they are too
few in number to permit each family to have the exclusive use of one.
Johnstown has three or four comparatively high-grade apartment
houses, and in several office buildings rooms are rented to families
for housekeeping. These are generally taken by native families.
In one of these office buildings the two lower floors are used for
business purposes and the two upper floors are given over entirely to
tenement purposes. From 40 to 50 families live here, many of whom
have but one room. To serve the 20 or 25 families on each floor
there is one bath and toilet room for men and another for women.
Adjoining the toilet rooms is a small room containing garbage cans
and trash receptacles for the use of the tenants.
The sanitary conditions in some of the best tenements or apart­
ments, however, are not up to the standards of other cities, and in
those occupied by the poorer people conditions are much worse than
are usually permitted to exist in cities having large tenement houses
in great numbers, where a tenement-house problem is recognized as
such and active efforts are made by the municipality to improve
conditions.
An absolute measure of the importance of each single housing defect
in a high mortality rate can not be secured from this study. But it is
not without interest to note that in homes where water is piped into
the house the infant mortality rate was 117.6 per thousand, as com­
pared with a rate of 197.9 in homes where the water had to be carried
in from outdoors. Or that in the homes of 496 live-born babies
where bathtubs were found the infant mortality rate 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 com­
fortable income, and all the favorable conditions that go with such an
income.
The same trend of a high infant mortality rate in connection with
other housing defects is noted in the next table.


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23

I N F A N T M O R T A L IT Y : J O H N S T O W N , PA.
T

able

B . — D i s t r i b u t io n o p L i v e B ir t h s a n d o p D e a t h s D u r i n g F i r s t Y
I n f a n t M o r t a l it y R a t e , A c c o r d in g t o H o u s i n g C o n d i t i o n s .

ear,

and

•

1

i

HOUSING CONDITIONS.

DEATHS DURING
FIRST YEAR.

Live
births.

Infant
Number. mortality
rate.

1,463

196

134.0

808
336
319

99
47
50

122.5
139.9
156.7

496
965
2

36
159
1

72.6
164.8
(*)

1,173
288
2

138
57
1

117.6
197.9
0)

1,333
128
2

176
19
1

132.0
148.4
0)

801
632
28
2

80
107
8
1

99.9
169.3

739
722
2

80
115
1

P>

(x)
108.3
159.3

0)

1 Total live births less than 50; base therefore considered too small to use in computing an infant mor­
tality rate.

The following summary may be of interest in indicating some rela­
tion between infant mortality and cleanhness or uncleanliness com­
bined with dryness or dampness of homes :
T

4 . — D i s t r i b u t io n o p L i v e B ir t h s a n d o p D e a t h s D u r i n g F i r s t Y e a r * a n d
I n f a n t M o r t a l it y R a t e , A c c o r d in g t o C l e a n l i n e s s a n d D r y n e s s o p H o m e .

able

DEATHS DURING
FIRST YEAR.
TYPE OF HOME.

•Clean:
Moderately clean:
j_/x y ...•••••••• *

Dirty:


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Live
births.

Infant
Number. mortality
rate.

1,463

196

134.0

943
354
166

107
58
31

113.5
163.8
186.7

807
656

99
97

122.7
147.9

581
362

61
46

105.0
127.1

158
196

27
31

170.9
158.2

68
98

11
20

161.8
204.1

24

IN F A N T M O R T A L IT Y : J O H N S T O W N , PA.

Dirt is doubtless unhealthful, but the amount of ill health or the
number of infant deaths caused by a home being dirty can hardly
be measured, when, as is usually the case, the dirt is accompanied
by so many other bad conditions arising from poverty. For example,
a home in close proximity to railroad tracks or mills whose stacks send
forth clouds of soot, smoke, and ashes is generally the poorly built
home of those who have neither time nor means to secure and retain
cleanliness under such difficulties.
Overcrowding in homes is another factor the relative importance of
which can not be exactly determined, because of its close connection
with other ills. But the degree of overcrowding is greatest in the small
cheaper houses, those of one, two, three, or four rooms. The average
number of persons per room in the homes of all live-bom babies for
whom the data were secured was found to be 1.38. Homes of four
rooms were more numerous than those of any other size and they
housed an average of 1.58 persons per room. The number of babies
in homes of various sizes with the number of persons per room for
homes of each size was as follows:
T a b l e 5 . — N u m b e r o p B a b ie s L i v i n g i n H o m e s op E a c h Sp e c if ie d Siz e
A v e r a g e N u m b e r o f P e r s o n s P e r R o o m i n H o m e s o p E a c h Si z e . ’

SIZE OF HOME.

Live-bom
babies.

All homes................

1,463

1 room...............................
2 rooms..............................
3 rooms..............................
4 rooms..............................
5 rooms..............................
6 rooms..............................
7 rooms..............................

33
165
147
526
222
233
38

Persons
per room.

SIZE OF HOME.

Live-bom
babies.
43

4.42
2.27
1.83
1.58
1.22
1.07
.96

Not reported.................

22

and-

Persons
per room.
0.88
.93
.88.64
.75
.69.43-

In homes of one, two, three, or four rooms or where the number o f
occupants ranged from 4.42 to 1.58 persons per room the infant mor­
tality 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 rates 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.
The mortality rate among infants who slept in a room with no
other person than their parents was much lower than among those
who slept in a room with more than two persons. The babies that
slept in separate beds also had a much lower infant mortality
rate than those who did not sleep alone, as shown in the next table.


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25

T a b l e 6 . — D is t r ib u t io n o p B ir t h s a n d o p D e a t h s
D u r in g F ir s t Y e a r
A m o n g B a b ie s Su r v iv in g a t L e a s t 1 M o n t h , a n d I n p a n t M o r t a l it y R a t e ,
A c c o r d in g t o C e r t a i n C o n d i t i o n s i n B a b y ’ s S l e e p i n g R o o m .

BABIES WHO LIVED AT LEAST
1 MONTH.

Deaths during first
year.
CONDITIONS IN BABY’ S SLEEPING BOOM.

Total.
Number.

1,389

122

600
725
57
7

40
71

575
810
4

32
88
2

Number of others sleeping in same room with baby:
3 t o 5 ............................ ............................................................. .................................

Rate per
1,000 of
those who
lived 1
month8 7 .8
66.7

97.9
122.8

7

4

0)

Baby sleeping alone in separate bed:
N o.....................................................................................................................

5 5 .7

108.6
<»)

1 Total number of babies less than 50; base therefore considered too small to use in computing rate.

In presenting statistics on sleeping and ventilation, only the babies,
who lived at least one month have been considered, for the reason that
so many deaths during the first month of life were due to prenatal
causes.
The incidence shown in the foregoing table is significant, even
though it can by no means be deduced therefrom that the health of a
large proportion of babies was so impaired by sleeping with older and
more or less unhealthy persons that death resulted. But irregular
night feeding and overfeeding are undoubtedly harmful, and the
mother is tempted to subject the baby to this when it sleeps with
her and disturbs her rest.
Of the 1,389 babies who lived at least one month, 600, or 43.2 per
cent, lived in homes where the baby slept in a room with not more
than two other persons. The fact that the baby slept in a room
with no more persons than its parents generally argues that the
family’s means permitted them to have one or more additional rooms
for other members of the family, but in other cases, of course,
merely that there were no other persons in the family.
Almost every home visited had means for good ventilation of the
baby’s room at night, yet but 604, or 43.5 per cent, of the 1,389
babies who lived at least, a month slept at night in well-ventilated
rooms— that is, in rooms where, according to the mother’s statement,
a window was open all night. Some mothers opened windows when
the weather was neither cold nor damp; or opened them in a hall or
room adjoining that where the baby slept; others emphatically stated


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that at night the windows were ‘ 1always shut tight.” The babies
subjected to differences of ventilation show corresponding variations
in infant mortality rates.
■Ta b l e 7 . — D i s t r i b u t io n o f B ir t h s a n d o f D e a t h s D u r i n g F i r s t Y e a r , a n d
I n f a n t M o r t a l it y R a t e a m o n g B a b i e s S u r v i v i n g a t L e a s t 1 M o n t h , A c c o r d ­
in g to V e n t il a t io n of B a b y ’ s R o o m .

BABIES WHO LIVED AT LEAST 1
MONTH.

Died during first year.
VENTILATION OP B AB Y’ S BOOM.

Total.
Number.

Total.
■Good.............
Fair...............
Poor..............
Not reported
i

Rate per
1,000 of
those who
lived 1
month.

1,389

122

87.8

604
392
390
3

17
36
66
3

28.1
91.8
169.2
(‘ )

Total number of babies less than 50; base therefore considered too small to use in computing rate.

A high death rate in badly ventilated homes can not be charged
wholly to bad air. The mother who did not, or could not, provide
proper ventilation was generally the mother without the means or
the knowledge necessary to enable her to care for her baby properly
in other respects, and yet the marked differences suggest that venti­
lation is itself a very important ally of the baby in its first year of
struggle for existence.
In many rooms that were poorly ventilated, windows were not
opened for the reason that the room was not properly heated and the
houses themselves were flimsy and drafty. The problem in such
houses is to keep warm. If the windows were frequently or con­
stantly opened, the houses would be too cold to live in. In some
localities the outside air is so laden with soot, ashes, dirt, and smoke
that every effort is made to keep it out of the house.
The foreigners, who generally have the most miserable homes, are
not dirty people who select bad living conditions through innate poor
judgment, low standards, and lack of taste. The squalid homes
which housed the natives and later the Germans and the Irish until the
present type of immigrants came to do the more poorly paid work
were the only homes available within the purchasing power of their
low wages. The new immigrants demanded practically nothing
and the owners did practically nothing in the matter of improving
these homes, which naturally became more and more squalid as time
went on. An excessive infant mortality rate and insanitary homes
in unhealthful sections were found to be coexistent.


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27

NATIONALITY.
GENERAL NATIVITY.

The investigation embraced 860 babies of native mothers (of whom
6 were negroes) and 691 babies of foreign mothers, making a total of
1,551. The infant mortality rate for the entire group was 134 per
1,000 live births; for the babies of native mothers 104.3, and for those
o f foreign mothers 171.3. The stillbirth rate for native mothers
having children in 1911 was less than that for foreign mothers, being
52.3, as compared with 62.2 per 1,000 total births.
The line between the natives and foreigners is very sharply drawn
in Johnstown. The native population as a rule knows scarcely
anything about the foreigners, except what appears in the news­
papers about misdemeanors committed in foreign sections. The
report of the Immigration Commission1 comments “ on the attitude
o f the police department toward foreigners * * * with regard
to Sunday desecration,” and states that “ the Croatians are accus­
tomed to spend Sunday in singing, drinking, and noisy demonstra­
tions. The police have been instructed to show no leniency on ac­
count of ignorance of the municipal regulations, and, without any
attempt at explaining the laws, they arrest the offenders in large
numbers.” Again, it states: “ They are arrested more often for
crimes that make them a nuisance to the native population than for
mere infractions of the law * * *. Few arrests are made for im­
morality among foreigners.” “ Sabbath desecration” is the crime
foreigners are most frequently charged with.
Foreigners are employed largely in the less skilled occupations of
the steel mills, which operate 24 hours a day, seven days a week. At
the time the investigation was made some of the men in the steel
mills worked for a period of two weeks on a night shift of 14 hours,
then two weeks on a day shift of 10 hours, and back again to the
night shift of 14 hours for another two weeks, and so on. When
shifts were changed, one group of men was required to work through­
out a period of 24 hours instead of for the usual 10 or 14 hour period
and another group had 24 hours off duty. Some departm ents^
the steel mills, however, shut down on Sundays, and in some de­
partments for certain occupations an eight-hour day prevails, but
these more favorable conditions do not prevail among thè majority
o f the unskilled foreign workers whose homes were visited.
The foreigners who work on a 24-hour shift in a mill on one Sunday
frequently “ desecrate” their alternate free Sabbath by “ singing,
drinking, and noisy demonstrations,” in spite of the known danger
i United States Immigration Commission Reports, Volume V in , “ Immigrants in Industries: Part 2,
iron and Steel Manufacturing in the East,” p. 387. Reference is to Johnstown and is a very true picture
of various immigrant institutions and of the comparative progress and assimilation of different races there.
Although the immigration report was made five years before our investigation, conditions remain practi­
cally the same.


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of arrest for “ crimes that make them a nuisance to the native popu­
lation” or for “ Sabbath desecration,” laws concerning which are
strictly enforced in Johnstown; for example, children are not permitted
to play in public playgrounds on Sunday and mercantile establish­
ments are required to be closed on that day. Also, it is “ unlawful for
any person or persons to deliver ice cream, or to sell or deliver milk
from wagon or by person carrying same, within the city on the Sab­
bath day, commonly called Sunday, after 12 o’clock m.” The ordi­
nance from which the foregoing sentence was quoted became a law on
January 25, 1914.
SERBO-CROATIAN.

The foreign group having the highest infant mortality rate is the
Serbo-Croatian1 where, as shown in the next table, infant deaths
numbered 263.9 per 1,000 live births.
T a b l e 8 . — D i s t r i b u t io n o p B i r t h s , L i v e B i r t h s ,
Y e a r , a n d I n f a n t M o r t a l it y R a t e , A c c o r d in g

D e a t h s D u r in g F ir s t
N a t io n a l it y op M o t h e r .

and
to

DEATHS DURING FIRST
YEAR.
NATIONALITY OF MOTHER.

Total
births.

Total
live
births.
Number.

All nationalities............................................................

Slovak, Polish, etc.........................................................................
Italian.................................................................................. ............

Infant
mortality
rate.

1,551

1,463

196

134.0

860
691

815
648

85

104.3
171.3

394
76
75
53
38
33

367
72
71
47
38
31

12
10

12
10

111

65
19
13

6
4
4

177.1
263.9
183.1
(l)

St
(l)

1 Total live births less than 60; base therefore considered too small to use in computing an infant mor­
tality rate.

The men of the Serbo-Croatian group are fine looking and powerful
and are employed in the heavy unskilled work of the steel mills and
the mines. They greatly outnumber the women of their race in
Johnstown, and a man with a wife frequently becomes a “ boarding
boss” ; that is, he fills his rooms with beds and rents out sleeping
space to his fellow countrymen at from $2.50 to $3 a month each.
1 A distinct and homogenous race, from a linguistic point of view, among Slavic peoples. They are
divided into the groups “ Croatian ” and “ Servian,” on political and religious grounds, the former being
Roman Catholics and the latter Greek Orthodox. Their spoken language is the same, but they can not
read each other’s publications, for the Croatians use the Roman alphabet, or sometimes the strange old
Slavic letters, while the Servians use the Russian characters fostered by the Greek Church.
Three Krainers have also, for convenience, been included in this group. Krainers are Slovenians from
the Austro-Hungarian Province of Carniola and are designated “ close cousins of the Croatians but with a
different though nearly related language” by Emily Greene Balch in her book entitled “ Our Slavic Fellow
Citizens.”


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29

The same bed and bedding is sometimes in service both night and
day to accommodate men on the night and the day shifts of the steel
mills.
The wife, without extra charge, makes up the beds, does the wash­
ing and ironing, and buys and prepares the food for all the lodgers.
Usually she gets everything on credit and the lodgers pay their respec­
tive shares biweekly. These conditions exist to some extent among
other foreigners, but are not as prevalent among other nationalities
in Johnstown as among the Serbo-Croatians.
In a workingman’s family, it is sometimes said, the woman’s work­
day is two hours longer than the man’s. But if this statement is
correct in general, the augmentation stated is insufficient in these
abnormal homes where the women are required to have many meals
and dinner buckets ready at irregular hours to accommodate men
working on different shifts.
The Serbo-Croatian women who, more than any of the others,
do all this work are big, handsome, and graceful, proud and reckless of
their strength. During the progress of the investigation, in. the
winter months, they were frequently seen walking about the yards
and courts, in bare feet, on the snow and ice-covered ground, hanging
up clothes or carrying water into the house from a yard hydrant.
Whether it harmed them to expend their force and vigor as they
did could not be determined in individual cases, but their babies
are the ones who died off with the greatest rapidity, their infant mor­
tality rate being 263.9, as compared with the rates of 171.3 for all
the foreign; 104.3 for the natives; and 134 for the entire group as
shown in Table 8. Excluding babies of Serbo-Croatian mothers, the
infant mortality rate for babies of foreign mothers is but 159.7.
ITALIAN.

The Italian mothers visited in Johnstown bore 75 children in 1911,
4 being stillborn. The infant mortality rate among the live born was
183.1, the highest of any racial group excepting the Serbo-Croatian,
where it was 263.9.
The Italians have been in Johnstown somewhat longer than the
Serbo-Croatians and they seem to have a little firmer grip on the
community life there. Their homes are a shade better, a trifle cleaner,
and somewhat less crowded than those of the Serbo-Croatians,
although their hygienic standards seem little if any higher and they
rank no better in literacy. The women do not perform the arduous
duties that are the lot of so many of the Serbo-Croatian women; they
have not the robust physique of the latter and the men are not found
in those branches of the steel industry which require the extraordinary
strength possessed by the Serbo-Croatians. The occupations of the
Italian fathers were found to be more diversified than those of the
Serbo-Croatians, some being fruit, grocery, or cheese merchants;


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steamship agents; bricklayers,
skilled and semiskilled trades.

carpenters,

or workers at other

SLOVAK, POLISH, ETC.

The infant mortality rate in the group designated “ Slovak, Polish,
etc.,” is 177.1. In this group are included all the Slavic races rep­
resented in the investigation excepting the Serbo-Croatian. The
babies of Slovak 1 mothers were found to be most numerous, there
being 276 of them. There were 108 babies of Polish,2 2 of Bohe­
mian,3 and 7 of Ruthenian4 mothers. In addition, one baby of a
Scandinavian (Danish) mother was -included, not because Scandina­
vians bear the least racial resemblance to the Slavic races, but
because the few Scandinavians in Johnstown happened to be on about
the same economic footing as the “ Slovak, Polish, etc.”
The rate for this group is lower than that for either the SerboCroatians or the Italians, hut it is nevertheless very high and one
exceeded by only a few European countries, as shown by the table
on page 12.
Some of the “ Slovaks, Poles, etc.,” live in the same squalid sections
as the Serbo-Croatians, and in the same type of inferior houses, hut
on the whole they have been in Johnstown longer, are more pros­
perous, and are therefore beginning to move from Cambria City and
Woodvale, where formerly practically all lived, into more desirable
sections. Those who have been in this country longest and intend
to stay here are buying homes with large yards in the less crowded
sections and are raising vegetables and flowers. Others, however,
still remain in poor neighborhoods and sometimes buy houses there
for from $300 to $600 each, built close together on rented ground.
Lodgers are by no means uncommon among the people in this
group, but usually their homes are cleaner, less crowded, and pos­
sessed of more comforts than those of the Serbo-Croatians and Italians.
OTHER NATIONALITIES.

The British5infant mortality rate in Johnstown is 129 and the
German 127.7. The British and Germans in Johnstown are more
prosperous than the Slavic, Magyar, Jewish, Italian, Syrian, and
Greek peoples, and regard the others as ‘ ‘foreigners.” It was strange
1 Slovaks occupy practically all except the Ruthenian territory of northern Hungary; also found in great
numbers in southeast Moravia. They are the Moravians conquered by Hungary. In physical type no
dividing line can be drawn between Slovaks and Moravians. It is often claimed that Slovak is a Bohemian
dialect.
2 The west Slavic race native to the former Kingdom of Poland. For the most part they adhere to the
Roman rather than the Greek Orthodox Catholic Church.
3 xhe westernmost division or dialect of the Czech and the principal people or language of Bohemia.
Czech is the westernmost race or linguistic division of the Slavic (except Wendish, in Germany), the race
or people residing mainly in Bohemia and Moravia.
4 Also known as Little Russians; live principally in southern Russia; also share Galicia with the Poles
but greatly surpassed by Poles in number. In language and physical type resemble Slovaks. Generally
Greek Orthodox, but a few are Greek Catholics of the Roman Catholic Church, whose priests marry, and
are separated from other Roman Catholics by marked religious differences.
6 English, Irish, Scotch, and Welsh included in the term British.


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to hear a man, one who could hardly speak English, say, "W e are notforeigners; we are Germans.” The British and Germans occupy
the same relative position economically that they occupy in tho
infant mortality scale with relation to other races.
In the Magyar 1 group, of 38 babies born alive 4 died in their first
year, making an infant mortality rate of 105.3, which is almost a»
low as that for babies of native mothers. The Magyars are little
if any better off than the other “ foreigners” among whom they live,
but they possess somewhat higher standards of living. They live in,
poor neighborhoods and have inferior houses, but their homes are
cleaner and they themselves somewhat more alert, personally cleaner,
and less illiterate than the other foreigners.
There were but 10 babies of Hebrew mothers and 12 of Syrian and
Greek mothers; among these there were no deaths. These groups
are too small numerically to be significant in a comparative race
study of infant mortality.
STILLBIRTHS.
In all there were but 88 stillbirths included in the investigationThey were more numerous proportionately among the Germans than
among the mothers of any of the other nationalities. No single
nationality group, however, has a very large representation, and
hence a comparison of the rate for one with that for another nation­
ality is not as significant as the difference in rate between native and
foreign mothers. Although a special study of the causes of still­
births was not made in connection with a study of deaths of infants
during their first year of life, nevertheless the incidence of these
births among the different nationality groups is believed to be o f
some interest, and therefore shown in the next table.
T able 9 .— D istribution of B irths and of Stillbirths , and R ate of Stillbirth ®
per 1,000 B irths , A ccording to N ationality of M other .
STILLE IRTHS.

NATIONALITY OF MOTHER.

Total
births.
Number.

All nationalities......................................................................................

Rate per
1,000
births.

1,551

88

56 . 7

860

45
43

52. 3
6 2 .2 '

691
394
76
75
53

27
4
4

6
2

60. &

38
33
12

68.5
52.6 5 3 .3
1 1 3 .2

10
i The race of Finno-Tatar origin that invaded Hungary about the ninth century and is now dominant
there; commonly called Hungarians.


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ATTENDANT AT BIRTH.
The native mother usually had a physician at childbirth; the
foreign-born, a midwife. The more prosperous of the foreign moth­
ers, however, departed from their traditions or customs and had
physicians, while the American-born mothers, when very poor, re­
sorted to midwives. The midwives usually charged $5, and some­
times only $3 ; they waited for payment or accepted it in installments,
and they performed many little household services that no physician
would think of rendering.
T

able

10 . — N u m b e r

and

P e r C e n t o f B ir t h s A c c o r d in g
a n d N a t iv it y o f M o t h e r .

to

A ttendant

at

B ir t h

M OTH ER ATTEN DED B Y —
A L L B IR T H S .

Physician.

N A T IV IT Y OF
M OTHER.

Num­
ber.

Per
cent.

Num­
ber.

Per
cent.

Midwife.

Num­
ber.

Per
cent.

Neighbor, rela­
tive, or friend.

No one.

Num­
ber.

Per
cent.

Num­
ber.

Per
cent.

All....................

1.551

100.0

928

59.8

588

37.9

14

0.9

21

1.4

Native mothers........
Foreign mothers___

860
691

100.0
100.0

774
154

90.0
22.3

84
504

9.8
72.9

2
12

0.2
1.7

21

3.0

Two-thirds of those having no attendant were Serbo-Croatians.
I t was a Polish woman, however, who gave the following account
o f the birth of her last child:
A t 5 o ’clock Monday evening went to sister’ s to return washboard, having just
finished day’s washing. Baby b om while there; sister too young to assist in any
w ay; woman not accustomed to midwife anyway, so she cut cord herself; washed
b a by at sister’ s house; walked home, cooked supper for boarders, and was in bed b y
8 o’clock. Got up and ironed next day and day following; it tired her, so she then
stayed in bed two days. She milked cows and sold milk day after b a by ’s birth,
b u t being tired hired some one to do it later in week.
This woman keeps cows, chickens, and lodgers; also earns money doing laundry
and char work. Husband deserts her at times; he makes $1.70 a day. A 15-year-old
son makes $1.10 a day in coal mine. Mother thin and wiry; looks tired and worn.
Frequent fights in home.

The infant mortality rate was lower for babies delivered by phy­
sicians than for those delivered by midwives or for those at whose
birth no properly qualified attendant was present. This is not neces­
sarily an indication of the quality of the care at birth, although in
some cases the inefficiency of the midwife may have directly or indi­
rectly caused deaths, just as in some instances a physician’s ineffi­
ciency may have caused them. The midwife, however, is resorted
to by the poor, and in their homes are found other conditions that
create a high infant mortality rate.


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33

T able 1 1 .— D istribution of B irths and of D eaths D uring F irst Y e a r , and
I nfant M ortality R ate , A ccording to A ttendant at B irth and N ativity
of M other .
DEATHS DURING
FIRST YEAR.

Total
live
births.

ATTENDANT AT BERTH AND NATIVITY OF MOTHER.

Infant
Number. mortality
rate.

1,463

196

134.0

866

87

100.5

730
136

68

93.2
139.7

562

101

179.7

83
479

15
86

180.7
179.5

35

8

C1)

2
33

2
6

0)
(i)

19

1 Total live births less than 50; base therefore considered too small to use in computing an infant mortality rate.

Frequently the Serbo-Croatian women dispense altogether with
any assistance at childbirth; sometimes not even the husband or a
neighbor assists. Over 30 per cent of the births among the women
of this race took place without a qualified attendant. More than
one-half of those delivered by midwives, less than one-fifteenth of
those delivered by physicians, and about one-fifth of those delivered
without a qualified attendant had babies who died in their first year
of life, as shown in the next tabulation:
T able 1 2 .— D istribution
A ccording to A ttendant

of
at

B irths and of D eaths D uring F irst Y e a r ,
B irth , for B abies of Serbo -C roatian M others .

ATTENDANT AT BIRTH.

ALL
BIRTHS
TO
SERBO-CROATIAN
MOTHERS.

Live
births.

Deaths
during
first
year.

Number. Per cent.
76

100.0

72

19

31
22
9
14

40.8
28.9
11.8
18.4

28
21
9
14

2
12
2
3

Fifteen of the 19 Serbo-Croatian women whose babies died under
1 year of age kept lodgers.
In Johnstown the midwife is resorted to principally by the poor.
Recent laws that the State is now trying to enforce require that the
standard for the practice of midwifery be raised. If this can be done
midwives might become definitely helpful persons in the community.
One or two of the intelligent graduate midwives in Johnstown have
6 1 1 1 2 ° — 1 5 ------- 3


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34

been an educational force among the foreign mothers for some years
past. On the other hand there were others who were so dirty and
so ignorant that they were a menace to the public health.
MOTHERS.
LIT E R A C Y .1

There are differences in the infant mortality rate between the
babies of literate and the babies of illiterate mothers; between
those with mothers who can speak English and those with mothers
who can not; and between babies of the mothers who have been in
this country for a considerable period and those of the newer arrivals.
Comparisons of this nature are confined to the foreign mothers, as
only three cases of illiteracy were found among native mothers, and
the other comparisons would not, of course, be applicable in any
case to native mothers.
The next table shows that the infant mortality rate among the
children of illiterate foreign mothers was 214, or 66 per thousand
greater than the rate among literate foreign mothers.
T able 1 3 .— D istribution of B irths and of D eaths D uring F irst Y e a r , I nfant
M ortality R a te , and N umber and P er Cent of Stillbirths , A ccording to
L iteracy of F oreign M others .
STILLBIRTHS.
LITERACY OF FOREIGN MOTHERS.

Total
births.

Live
births.

DEATHS DURING
FIRST YEAR.

Infant
Number. Per cent. Number. mortality
rate.

Foreign mothers...... ............................

691

648

43

6.2

I ll

171.3

Literate..............................................................
Illiterate............... J...........................................

445
246

419
229

26

5.8
6.9

62
49

148.0
214.0

17

ABILITY TO SPEAK ENGLISH.

The next table shows that babies whose mothers can not speak
English were characterized by a more unfavorable infant mortality
rate than other babies.
T able 1 4 .—D istribution of B irths and of D eaths D uring F irst Y e a r , I nfant
M ortality R a t e , and N umber and P er Cent of Stillbirths , A ccording to
A bility of F oreign M other to Speak E nglish .
STILLBIRTHS.
ABILITY TO SPEAK ENGLISH.

Total
births.

Live
births.

DEATHS DURING
f ir s t y e a r :

Infant
Number. Per cent. Number. mortality
rate.

Foreign mothers....................................

691

648

43

6.2

Ill

171.3

Speak English..................................................
Can not speak English...................................

263
428

247
401

16
27

6.1
6.3

36
75

145.7
187.0

‘ B y literacy is meant ability to read and write in any language and not simply in English.


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IN FAN T M O RTALITY: JO H N STO W N , PA.

35

YEARS IN THE UNITED STATES.

In addition to a consideration of the babies according to their
mothers’ ability to speak English, it is of interest to note the infant
mortality rates among babies whose mothers have been in this coun­
try for different periods of time.
T able 1 5 .— D istribution op B irths and op D eaths D uring F irst Y ear and
I nfant M ortality R a te , A ccording to L ength of R esidence op F oreign
M other in the U nited States .

DEATHS DURING
FIRST YEAR.

Total
live
births.

YEARS IN THE UNITED STATES.

Foreign mothers........................

.

5 years or less..............................
Over 5 years...................................

Infant
Number. mortality
rate.

648

Ill

171.3

168
480

36
75

214.3
156.3

The high infant mortality rate for the children of newer immi­
grants, illiterates, and those who can not speak English is perhaps
affected by the fact that they are at the same time generally of the
poorest families and are housed in the most insanitary and unhealthful
part of the city.
AGE.

The age of the mother is frequently believed to be a factor in the
health of the child. The highest infant mortality rate was found
to be that for the group of babies with mothers over 40 years of age,
and the lowest for babies of mothers from 20 to 24 years of age.
T able 1 6 .— D istribution op B irths and op D eaths D uring F irst Y ear I nfant
M ortality R ate , and N umber and P er Cent op Stillbirths , A ccording to A ge
op Mother .

STILLBIRTHS.

AGE OF MOTHER.

Total
births.

Live
births.
Number.

All mothers.................. .....................
Under 20.....................................................
20 to 24......................................................
25 to 29.........................................................
30 to 39..................... .......... ..............................
40 and over............................................

Infant
Per cent
of total. Number. mortality
rate.

1,551

1,463

88

5.7

105
476
410
480
83

95
454
391
449
74

10
22

9.5
4.6
4.6
6.5
7.5

19
31
6

D E A TH S.

196

ÎT

55
56
61
11

134.0
136.8
1 2 1 .1

143.2
135.9
148.6

The youngest mothers have a higher stillbirth rate than other
mothers, and the oldest group of mothers has the next highest rate.
In this connection not only the foregoing table is of interest, but


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IN FAN T M O RTALITY: J O H N STO W N , PA.

36

also Table X II on page 70, based upon the entire reproductive
histories of the mothers included in this study. As all the children
borne by these mothers are included, the base numbers in the latter
table are larger and the figures therefore somewhat more significant.
BABY’S AGE AT DEATH AND CAUSE (DISEASE) OF DEATH.
A baby who comes into the world has less chance to liv e one week than an old
man of 90, and less chance to liv e a year than one of 80.— B ergeron .

The most dangerous time of life is early infancy; even old age
seldom has greater risk. Death strikes most often in infancy. The
Johnstown babies died during their first year of life at the rate of
134 per 1,000 born alive, and they paid their heaviest toll in their
very earliest days. If the total of 196 deaths had been distributed
evenly throughout the 12 months, 8.3 per-cent of the babies would
have died each month and 25 per cent during each quarter. But
instead of that 37.8 per cent died in the first month; 9.2 per cent
in the second, and 8.2 per cent in the third, or over 55 per cent in
the first quarter.
T able

1 7 .—

N umber

and

P e r C e n t D i s t r i b u t io n
at D eath .

op

D eaths

op

B a b ie s ,

by

A ge

DEATHS OF BABIES
OF ALL MOTHERS.
AGE AT DEATH.

Number.

Per cent
distri­
bution.

Total deaths in first year.

196

100.0

First quarter...........................
First month..............................

108
74

55.1
37.8

45

23.0

30
4
11

15.3
2.0
5.6

Second week.
Third week..
Fourth week.

14
7
8

7.1
3.6
4.1

Second month.
Third month..

18
16

9.2
8.2

Seçond quarter.
Third quarter..
Fourth quarter.

42
31
15

21.4
15.8
7.7

First week.............. ..........

—

Less than 1 day and 1 day........
2 days................ ....................
3 to 6 days...................... ..............

The large number of deaths in the first few hours or days of life
indicates that many babies are born with some handicap and that in
many instances the mother has been subjected to some condition
which resulted in the birth of a child incapable of withstanding the
ordinary strain of life. Of the 45 babies who died in Johnstown less
than a week after birth, 38 died of prematurity, congenital debility
or malformations, or injuries received at birth. In one other case


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37

IN FAN T M O RTALITY: J O H N STO W N , PA.

the cause of death was given as “ bowel trouble” and in six other
cases it was not clearly defined. In addition to the 45 babies just
referred to as having died in their first week, 12 died later either from
prematurity or from congenital defects.
Of the deaths from causes arising after birth, 52 were attributed
by the attending physicians to diarrhea and enteritis, 50 to respira­
tory diseases, and 44 to some other or to some ill-defined cause.
T able 1 8 .— D istribution of D eaths D uring F irst Y ear and I nfant M ortality
R ate , A ccording to Cause of D eath and Nativity of M other .
D E A TH S D U R IN G FIRST Y E A R OF B A B IE S OF-

Native mothers.

All mothers.

Foreign mothers.

C A USE O F D E A T H .
,
Infant
Infant
Infant
Number. mortality Number. mortality Number. mortality
rate.
rate.
rate.

196
52
50
24
19
7
44

134.0

85

104.3

Ill

171.3

35.5
34.2
16.4
12.9
4.8
30.1

17
19
11
5
6
27

20.9
23.3
13.5
6.1
7.4
33.1

35
31
13
14
1
17

54.0
47.8
20.1
21.6
1.5
26.2

The latest census report on mortality statistics characterizes diar­
rhea and enteritis as the “ most important preventable cause of infant
mortality” in the United States, and numerically at least it proves
to be the most important cause of infant death in Johnstown.
H o lt1 says that one of the most striking facts about diarrheal dis­
eases in infants is their prevalence during the summer season. In
Johnstown the infant diarrheal deaths were least prevalent in the first
quarter of the year, next in the second, next prevalent in the fourth,
and most prevalent in the third or summer quarter.
T able 1 9 .— D istribution of Deaths , A ccording to Cause of D eath and Q uarter
of Calendar Y ear in which D eath O ccurred .
Q U A R T E R OF C A L E N D A R Y E A R IN W H ICH
D E A T H O CC U R R E D .
C A USE O F D E A T H .

All
deaths.
First.

All cau ses...___ *.............. .......
Diarrhea and enteritis.........................
Respiratory diseases............................
Premature births.................................
Congenital debility or malformation.
Injuries at birth...................................
Other causes or not reported.............

196

54

52
50
24
19
7
44

3
24
7
5
5
10

The Diseases of Infancy and Childhood, by L. Emmett Holt.


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Second.

Third.

29

74

p. 345.

Fourth.
39
12
11
3
4
1
8

New York, 1912.

38

IN FAN T M O RTALITY: JO H N STO W N , PA.

Our figures are too small to admit of broad generalizations or a
very full discussion of infant deaths according to the period of the
year.
This excess of infant deaths from diarrhea in the summer months
has been established by statistics in many countries, and the cause of
such an excess has been the subject of much discussion, but as yet
there is no general agreement. Liefmann and Lindemann1 conclude,
however, that in this field of controversy there are certain facts which
are at present well established, these being the dependence of the high
summer mortality on methods of feeding, on hot weather, and on the
living and social condition of the parents. The last factor mentioned
by these authors, including as it does housing conditions, economic
status, and degree of intelligence, is becoming more and more the
subject of study and investigation. It has been shown that the dis­
tinctly harmful effect of hot weather on the infant is increased when
the housing conditions are bad; in overcrowded homes with bad ven­
tilation the indoor temperature may be many degrees higher than
the outdoor temperature. The ignorance and carelessness of mothers
has also been shown to increase the bad effect of hot weather. With
hygienic care, including cool baths, much fresh air, and careful feed­
ing, many infants are able to pass through extremely hot weather
without diarrheal disturbances.
Respiratory diseases were reported as a cause of death with almost’
as great frequency as diarrheal diseases. As shown by Table 19,
these deaths occurred principally in the colder months of the first
and fourth quarters of the calendar year.
FEEDING.
Food is recognized as of such importance in relation to infant
mortality that studies of this subject frequently resolve themselves
into studies of feeding only. Invariably these demonstrate the truth
of the statement of Dr.G. F. McCleary2 that “ in human milk we have
a unique and wonderful food for which the ingenuity of man may
toil in vain to find a satisfactory substitute.” Many mothers, how­
ever, still fail to appreciate the risk their young babies face in being
given any except the natural infant food, and consequently babies
are in large numbers wholly or partly weaned from the breast in the
earliest months of their lives.
1 Liefmann, H ., and Lindemann, H ., Die Lokalization der Säuglingsterbliehkeit und ihre Beziehungen
zur Wohnungsfrage. Med. Klinik 1912, pp. 8, 1074.
2 Infantile Mortality and Infants’ Milk Depots. London.


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39

Breast feeding is far more general, comparatively, among the poorer
mothers than among the well to do, as shown by the following sum­
mary which gives the number and per cent of babies of mothers with
husbands earning varying incomes, who had been completely weaned
from the breast when they were 3, 6, or 9 months of age, respectively.
For each of the periods indicated the percentage completely weaned
from the breast is much greater in the groups where earnings are
highest.
T able 2 0 .— D istribution op B abies A live at 3, 6, and 9 M onths op A ge
T ype op F eeding at E ach op Said A ges , A ccording to A nnual E arnings
F ather and N ativity of M other .

by
of

B A B IE S LIV IN G A T AG E OF—

6 months.

3 months.
ANNUAL
E A R N IN G S
OF
F A T H E R A N D N A T IV IT Y
OF M O T H E R .

9 months.

Completely
weaned from
breast.

Completely
weaned from
breast.

Total.

Total.

Total.
Number.

. Number.

Per
cent.

Completely
weaned from
breast.
Number.

Per
cent.

Per
cent.

193

14.2

1,313

250

19.0

1,282

353

27.5

. 22
48
114
9

6.5
13.4
18.1
33.3

322
351
616
24

32
63
146
9

9.9
17.9
23.7
37.5

309
342
608
23

57
85
201
10

18.4
24.9
33.1
43.3

765

155

20.3

747

195

26.1

735

251

34.1

69
180
491
25

10
36.
100
9

14.5
20.0
20.4
36.0

66
177
482
22

13
46
127
9

19.7
26.0
26.3
40.9

65
173
476
21

18
55
168
10

27.7
31.8
35.3
47.6

Mother foreign..............

590

38

6.4

566

55

9.7

547

102

18.6

Under $624...............................
$625 to $899...............................
$900 and over1.........................
Not reported 2...............

272
178
• 138
2

12
12
14

4.4
6.7
10.1

256
174
134
2

19
17
19

7.4
9.8
14.2

244
169
132
2

39
30
33

16.0
17.8
25.0

Total.......................

1,355

Under $624........................
$625 to $899........................
$900 and over1..................
Not reported 2..................

341
358
629
27

Mother native.............
Under $624..............................
$625 to $899.........
$900 and over1.......................
Not reported2..........................

'

1 Includes those reported as earning “ ample.” “ Ample,” as used in this report has a somewhat techni­
cal meaning; when information concerning the father’s earnings was not available and the family showed
no evidences of poverty, the word “ ample” was used. When, however, the family was clearly in a state
of abject poverty, it was included in the group “ Under $521.”
2 Unmarried mothers’ babies also included.

Breast feeding, wholly or in part, is continued for a longer period
by foreign than by native mothers, as indicated in the precedhig
table, showing that 20.3, 26.1, and 34.1 per cent of the native
mothers’ babies as compared with 6.4, 9.7, and 18.6 per cent of the
foreign mothers’ babies had been weaned from the breast at the age
of 3, 6, and 9 months, respectively.
Some additional details concerning the type of feeding of babies
of native and foreign mothers are given in the next table.


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in f a n t

40

M o r t a l it y :

jöh n sto w n

,

pa.

T able 2 1 .— N umber and P er Cent op B abies A ged 3, 6, and 9 M onths W ho
R eceived Specified T ype op F eeding , A ccording to N ativity op M other .
AGE OF BABY.

TYPE OF FEEDING AND NATIVITY OF
MOTHER.

9 months.

6 months.

3 months.

Number. Per cent. Number. Per cent. Number. Per cent.
All babies........................................

1,355

100.0

1,313

100.0

1,282

100.0

. Exclusively breast fed............................
Partly breast fed......................................
Exclusively artificially fed.....................

987
175
193

72.8
12.9
14.2

616
447
250

46.9
34.0
19.0

220
709
353

17.2
55.3
27.5

Native mothers’ babies.......................

765

100.0

747

100.0

735

100.0

Exclusively breast fed....................................
Partly breast fed........... .................................
Exclusively artificially fed............................

512
98
155

66.9
- 12.8
20.3

307
245
195

41.1
32.8
26.1

87
397
251

11.8
54.0
34.1

Foreign mothers’ babies.....................

590

100.0

566

100.0

547

100.0

Exclusively breast fed....... ............................
Partly breast fed..............................................
Exclusively artificially fed............................

475
77
38

80.5
13.1
6.4

309
202
55

54.6
35.7
9.7

133
312
102

24.3
57.0
18.6

The following table shows that artificially fed babies die at a
much more rapid rate than breast-fed babies. In the very earliest
months exclusive breast feeding seems to be the only safe method.
After four months the danger of giving some other food in addition
to the breast milk does not seem to be so great.
T able 2 2 .— D istribution op B abies A live at E nd op E ach M onth , F rom S ec­
ond to T enth , I nclusive , A ccording to T ype op F eeding D uring E ach
M onth Specified , N umber op D eaths D uring F irst Y eah , and R ate per 1,000
A live in E ach G roup .
LIVE-BORN BABIES.

Deaths during first
year.
TYPE OF FEEDING AT TIME SPECIFIED.

Number
alive at
specified
Rate per
time.
Number. 1,000 alive
at specified
time.

Second month......................

1,389

122

87.8

Breast exclusively..........................
Mixed (i. e., breast and other). . .
Artificial (i. e., no breast m ilk)..

1,181
77
131

85
31

6

72.0
77.9
236.6

Third m onth..

1,371

104

75.9

Breast exclusively...
Mixed.........................
Artificial.....................

1,112
98
161

60
9
35

54.0
91.8
217.4

Fourth month

1,355

88

64.9

Breast exclusively.. .
Mixed.........................
Artificial.....................

987
175
193

46
10
32

46.6
57.1
165.8

Fifth month..

1,337

70

52.4

Breast exclusively...
Mixed.........................
Artificial....................

871
253
213

33
10
27

37.9
39.5
126.8


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IN F A N T M O RTALITY! JO H N STO W N , PA.
T

able

2 2 . — D i s t r i b u t io n
ond to

41

of B a b ie s A l iv e a t E n d of E a c h M o n t h , F ro m S ec­
T e n t h , I n c l u s i v e , e t c .— Continued.

LIVE BORN BABIES.

Deaths during first
year.
Number
alive at
Rate per
specified
time.
Number. 1,000 alive
at specified
time.

TYPE OF FEEDING AT TIME SPECIFIED.

Sixth month

1,318

51

38.7

Breast exclusively
Mixed....................
Artificial...............

780
310
228

20

10
21

25.6
32.3
92.1

Seventh month

1,313

46

35.0

Breast exclusively___
Mixed...........................
Artificial.....................

616
447
250

18
10
18

29.2
22.4
72.0

Eighth month.

1,305

38

Breast exclusively..,
Mixed.........................
Artificial................... .

502
541
262

13
11
14

Ninth month.

1,291

24

18.6

Breast exclusively.,
Mixed...................... .
Artificial..................

395
611
285

7
10
7

17.7
16.4
24.6

1,282

15

11.7

220
709
353

3
8
4

13.6
11.3
11.3

Tenth month
Breast exclusively..
Mixed...................... .
Artificial...................

25.9
20.3
53.4

The next table differentiates between babies of native and foreign
mothers, giving the statistics by three-month periods instead of by
single months.
T able 2 3 .— D istribution of B abies A live at the E nd of 3, 6, and 9 M onths,
R espectively , A ccording to T ype of F eed ing , N umber of D eaths D uring
F irst Y e a r , and R ate per 1,000 A live in E ach G roup , b y N ativity of
M other .
BREAST FED EXCLU­
SIVELY.

AGE OP BABY
AND
NATIVITY
OF MOTHER.

Babies
alive at
age indi­
cated.

MIXED f o o d : BREAST
AND OTHER.

Deaths in first
year.

Deaths in first
year.

Rate per
1,000
alive at
specified
age.

Total.

Num­
ber.

Total.

ARTIFICIAL FOOD: NO
BREAST MILK.

Deaths in first
year.

Rate per
1,000
alive at
specified
age.

Total.

Num­
ber.

Num­
ber.

Rate per
1,000
alive at
specified
age.

ALL

3 months___
6 inonths___
9 months___

1,355
1,313
1,282

987
616
220

46
18
3

46.6
29.2
13.6

175
447
709

10
10
8

57.1
22.4
11.3

193
250
353

32
18
4

165.8
72.0
11.3

765
747
735

512
307
87

12
2
1

23.4
6.5
11.5

98
245
397

2
1
1

20.4
4.1
2.5

155
195
251

21
14
3

135.5
71.8
12.0

590
566
547

475
309
133

34
16
2

71.6
' 51.8
15.'0

77
202
312

8
9
7

103.9
44.6
22.4

38
55
102

11
4

289.5
72.7
9.8

NATIVE.

3 months___
6 months___
9 months___
FOREIGN.

3 months___
6 months___
9 months___


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42

IN FAN T M O RTALITY: JO H N STO W N , PA.

These statistics show that the manner of feeding is one of the most
important considerations in the life and health of a baby. But a
comparison of the number of deaths among babies whose fathers
earn specified sums (Table 31) shows that the influence of poverty
reaches even the breast-fed baby. When the fathers’ earnings are
small a larger proportion of babies die despite breast feeding.
SEX.
The Johnstown investigation comprehended 1,551 births in the year
1911, male births numbering 813 and female 738, the proportion
being as 1,101.6 male to 1,000 female births; or, stated inversely, 907.7
female to 1,000 male births. Newsholme1 says that “ male infants
always suffer from a higher infant mortality rate than female infants,”
and in Johnstown we find this true for the group as a whole, the
rates being as shown in the next table:
T a b l e 24.—D i s t r i b u t io n o f L i v e B ir t h s a n d S t il l b ir t h s a n d
D u r i n g F i r s t Y e a r , a n d I n f a n t M o r t a l it y R a t e , A c c o r d in g
Bab y.

STILLBIRTHS.
SEX OF BABY.

All
births.

Live
births.
Total.

Total babies....................
Male...................................
Female................................

'

Rate
per 1,000
births.

of
to

D eaths
Se x of

DEATHS IN FIRST
YEAR.

Total.

Infant
mortality
rate.

1,551

1,463

88

56.7

196

134.0

813
738

761
702

52
36

64.0
48.8

105
91

138.0
129.6

Among foreign mothers male births were considerably in excess of
female births; among native mothers the reverse was true. The
more favorable mortality rate for female infants does not prevail
among the children of foreign mothers, as can be seen in the next table,
which shows an infant mortality rate of 177.5 for girls as compared
with one of 166.2 for-boys.
1 Thirty-ninth Annual Report of the Local Government Board.


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London 1910.

IN FAN T M O RTALITY: JO H N STO W N , PA.

43

T able 2 5 .— D istribution of A ll B irths , L ive B irths , and Stillbirths
D eaths D uring F irst Y e a r , and I nfant M ortality R ate , A ccording
of B aby and N ativity of M other .
STILLBIRTH S.

S E X O F B A B Y A N D N A T IV IT Y OF M O T H E R .

,

All
births.

Live births.
Total.

Rate per
1,000
births.

and of
to Sex

D E A T H S D U R IN G
F IR ST Y E A R .

Total.

Infant
mortality
rate.

B A B IE S OF N A T IV E M O TH ERS.

Total number................................................
Male:
Female:

860

815

45

52.3

85

104.3

433
50.3

406
49.8

27
60.0

62.4

46
54.1

113.3

427
49.7

409
50.2

18
40.0

42.2

39
45.9

95.4

691

648

43

62.2

111

171.3

380
55.0

355
54.8

25
58.1

65.8

59
53.2

166.2

311
45.0

293
45.2

18
41.9

57.9

52
46.8

177.5

B A B IE S OF F O R E IG N M O TH E R S .

Male:
Number.............................................................
Female:
Number.............................................................

,

MOTHER’S HOUSEHOLD DUTIES, CESSATION AND
RESUMPTION OF.
The extent to which the native and foreign mothers in Johnstown
relinquished a part of their household duties as the time for their
confinement approached is shown below:
T able

2 6 . — D i s t r i b u t io n

q u is h m e n t of
of

Part

of

of

H

B ir t h s A

o useh old

c c o r d in g t o T im e o f t h e M o t h e r ’ s R e l i n ­
D u t ie s B e f o r e C o n f in e m e n t , b y N a t iv it y

M other.

TIM E O F R E L IN Q U IS H M E N T O F P A R T OF H O U SEH O LD D U TIES B E F O R E
CON FIN E M E N T.

No household duties relinquished to day of confinement...............................
Part of duties relinquished:
Less than 7 days before confinement............................................................
7 to 13 days before confinement....................................................................
2 weeks to 1 month before confinement.......................................................
1 month or more before confinement............. '........... ..................................

All
births.

To native To foreign
mothers. mothers.

1,551

860

691

1,350

695

655

3
7
16
174
1

1
5
12
146
1

2
2
4
28

Among the 174 babies of mothers who relinquished part of their
household duties a month before confinement, the infant mortality
rate was 112.5, as compared with 136.7 for those of other mothers.
T able 2 7 .—D istribution of B irths and of D eaths D uring F irst Y ear , and
I nfant M ortality R ate , A ccording to T ime of R elinquishment of P art of
H ousehold D uties of Mother B efore Confinement .
TIM E O F R E L IN Q U IS H M E N T OF P A R T O F H O U SEH O LD D U TIES
B E F O R E CON FIN E M E N T.

All mothers...........................
No cessation or less than 1 month
I month or more..............................
No housework............................... .


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All
births.

Live
births.

Infant
Deaths
during
mortal­
first year. ity rate.

1,551

1,463

196

134.0

1,376
174
1

1,302
160
1

178
18

136.7
112.5

IN FAN T M O RTALITY: JO H N STO W N , PA.

44

To what extent the relinquishment of household duties at a given
time directly affected the health of the child can not be definitely
shown. A relation may exist, but on the other hand the difference
in the mortality rate may be due to the fact that the mothers could
afford to give consideration to their condition and escape some of
their heaviest tasks as their pregnancy approached its end, and were
members of families who were thoughtful of them and relieved them
of these tasks or employed extra household assistance at such times.
Another indication of intelligence and of comfortable surroundings
is the care given a mother in the early days of her baby’s life, par­
ticularly if she is a nursing mother. The duration of her rest period
before the resumption of part of her household duties is one measure
of this. The foreign mothers, with less education, more numerous
and arduous tasks, less opportunity for leisure, and smaller incomes,
begin to resume their housework sooner than the native mothers
with young babies.
T able 2 8 .— D istribution of L ive B irths and of D eaths D uring F irst Y e a r ,
and I nfant M ortality R ate , A ccording to T ime of M other R esuming P art
of H ousehold D uties A fter Confinement , b y N ativity of M other .

DEATHS DURING
FIRST Y E AR.

LIVE BERTHS TO—
TIME OP RESUMING PART OF HOUSEHOLD DUTIES
AFTER CONFINEMENT.

All
Foreign
Native
mothers. mothers. mothers.

Total.

Infant
mortality
rate.

Total...........................................................................

1,463

815

648

196

134.0

8 days or less................................. .....................................
9 to 13 days..........................................................................
14 days or more...................................................................
Mother died or not reported............................................

467
560
427
9

44
446
318
7

423
114
109
2

79
70
41
6

169.2
125.0
96.0
P)

1 Total Humber of live births less than 50; base therefore considered too small to use in computing an
infant mortality rate.

The fact that a mother takes up her housework in the early days of
her baby’s life does not necessarily increase the danger of its death.
In some cases, however, mothers stated that the quantity of their
breast milk was noticeably impaired when they got up and resumed
their work too soon. Naturally this would affect the baby’s nutri­
tion. In other cases a mother’s cares and duties may be so absorbing
that she can not give the baby full attention*. Whatever the exact
explanation, attention should be called to the greater frequency of
infant deaths when the mother resumed household duties very soon
after childbirth.
A statement of the time of the mother’s resumption of household
duties in full, like that giving the time of resumption in part, shows
that the native mothers have the longer period of rest.


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T a b l e 2 9 . — D is t r ib u t io n op L iv e B ir t h s a n d op D e a t h s D u r in g F ir s t Y e a r ,
a n d I n p a n t M o r t a l it y R a t e , A c c o r d in g t o T i m e o p M o t h e r R e s u m i n g a l l
H o u s e h o l d D u t ie s A fte r C o n f in e m e n t , b y N a t iv it y op M o t h e r .

D E A TH S D U R IN G
FIRST YJ£a R .

L IV E B IR TH S TO —
T IM E OF R E S U M IN G ALL H O USEHOLD D U TIES A FTE R
C O N FIN E M E N T.

Foreign
Native
AH
mothers. mothers. mothers.

Total.

Infant
mortality
rate.

Total.....................................................- ...................

1,463

815

648

196

134.0

8 days or less................................. ......................................
9 to 13 days................................................. - .......................
14 days or more.. . : ............................- - - - .........................
Mother died or not reported............. .............. - ..........

219
182
1,053
9

13
132
663
7

206
50
390
2

37
30
123
6

168.9
164.8
116.8
(*)

1 Total live births less than 50; base therefore considered too small to use in computing an infant mor­
tality rate.

The infant mortality rates for all mothers in the group just re­
ferred to, according to the time of resuming housework in full after
childbirth, show fewer infant deaths proportionately when the mother
has had a longer rest; that is, a rest of two weeks or more.
ECONOMIC FACTORS.
EARNINGS OF FATHER.

A grouping of babies according to the income of the father shows
the greatest incidence of infant deaths where wages are lowest, and
the smallest incidence where they are highest, indicating clearly the
relation between low wages and ill health and infant deaths.
For all live babies born in wedlock the infant mortality rate is
130.7. It rises to 255.7 when the father earns less than $521 a year or
less than $10 a week, and falls to 84 when he earns $1,200 or more or
if his earnings are “ ample.” 1 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 consecutive groups are combined
an invariable lowering of the infant mortality rate from one such
combined group to that next higher results.
i “ Ample” as used in this report has a somewhat arbitrary meaning. When information concerning
the father’s earnings was not available and the family showed no evidences of actual poverty, the word
“ ample” was used. If no information concerning earnings was available when, on the other hand, the
family was clearly in a state of abject poverty, then the income was tabulated as “ Under 5521.”


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IN FAN T M O RTALITY: JO H N STO W N . PA.

46

3 0 . — D i s t r i b u t io n o p L i v e B ir t h s a n d o p D e a t h s D u r i n g F i r s t Y
I n p a n t M o r t a l it y R a t e , A c c o r d in g t o A n n u a l E a r n i n g s o p F a t h e r
N a t i v i t y o p M o t h e r , f o r L e g it im a t e L i v e - B o r n B a b i e s .

T able

ear,

and

and

ANN UAL

E A R N IN G S

OF

FA T H E R

Total...............................

ACCORDING

TO

N A T IV IT Y

OF

W IF E .

Total
live
birtbs.

Deaths
Infant
during mortality
first year.
rate.

1,431

187

130.7

Under $625................................

384

82

213.5

Under $521..........................
$521 to $624.....................

219
165

56
26

255.7
157.6

$625 to $899...............................

385

47

122.1

$625 to $779............. - .........
$780 to $899.........................

224
161

24
23

107.1
142.9

$900 or more..... ........................

186

18

96.8

$900 to $1,199.......................
$1,200 or more....................

138
48

14
4

101.4
83.3

Ample1 .............................. ......

476

40

84.0

Husbands with native wives -

785

76

96.8

Under $625..........................-............

80

16

200.0

Under $521................................
$521 to $624...............................

32
48

9
7

(2)
145.8

$625 to $899....................: ................

193

20

103.6

86
107

6
14

69.8
130.8

$625 to $779...............................
$780 to $899............................... .
$900 or more.................................

129

10

77.5

$900 to $1,199........................
$1,200 or more............ ..............

92
37

7
3

76.1
1 (2)

Ample1 ............................................

383

30

78.3

Husbands with foreign wives

646

111

171.8

Under $625.........................*............

304

66

217.1

187
117

47
19

251.3
162.4

Under $521.................................
$521 to $624...............................
$625 to $899.....................................

192

27

140.6

$625 to $779.................................
$780 to $899.................................

138
54

18
9

130.4
166.7

$900 or more.................: ..................

57

8

140.6

$900 to $1,199..............................
$1,200 or more............................

46
11

7
1

152.2
(2)

Ample1............................................

93

10

107.5-

1 See note on page 45.
2Total live births less than 50; base therefore considered too small to use in computing an infant
mortality rate.

In considering the babies of native and of foreign mothers separately
in the foregoing table, similar variations in mortality rates according
to earnings of father are found, although the foreign infant death rate
is higher in each group. The foreign are less numerous both actually
and relatively in the higher wage groups.
The foreigners of a given wage group almost always live in a poorer
neighborhood than the natives earning the same amount. The
foreigners go where they find their own countrymen, most of whom
are poor, and hence even those who earn a fair wage find themselves,


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47

IN FAN T M O RTALITY: JO H N STO W N , PA.

until they become Americanized, surrounded by poor conditions and
an ignorant class of people.
It is of interest to note what per cent of the native and what per
cent of the foreign are in the several earnings groups. The next table
shows this for all married mothers and not simply for those of liveborn babies as in the foregoing table.
T able

3 1 .—

N umber

and
th e

P e r C e n t o p M o t h e r s b y N a t i v i t y , A c c o r d in g
A n n u a l E a r n in g s op H u s b a n d .

ALL MOTHERS.

NATIVE MOTHERS.

to

FOREIGN MOTHERS.

ANNUAL EARNING OF
HUSBAND.

Number. Per cent. Number. Per cent. Number.
Total......................................................
Under $521.............................................
$521 to $624...........................
$625 to $779 ...........................................
$780 to $899..................................................
$900 to $1,199.....................................
$ 1 ,2 0 0 and over............................................
Ample1.......................................................

1,491

1 0 0 .0

816

1 0 0 .0

233
174
229
166
146
50
493

15.6
11.7
15.4

36
50

4.4

1 1 .1

108
98
39
399

9.8
3.4
33.1

86

6 .1

10.5
13.2
1 2 .0

4.8
48.9

675
197 I
124’
143
58
48

Per cent.

1 0 0 .0

29.2
18.4
2 1 .2
8 .6

7.1

11

1 .6

«

13.9

1 See note on page 45.

The 1,491 married mothers included in the foregoing table bore
1,517 babies in 1911, the excess being due to plural births. The
33 unmarried mothers and their 34 babies (one mother had twins),
although included in some of the general tables, are not included in
those relative to the earnings of the husband.
GAINFUL WORK OF MOTHER.

In localities where large numbers of women are engaged in indus­
trial work, comparisons are frequently made of the death rates among
their babies with those of the babies of mothers not so engaged. In
Johnstown, however, industrial occupations are not open to women,
and but 3.1 per cent of the mothers visited went outside their homes to
earn money. All mothers who gained money by keeping lodgers or
in any other way are, for convenience, designated 1‘ wage-earning ’ ’
mothers, even though their earnings were not in the form of a
definite wage at stated periods.
Although not industrially engaged, nearly one-fifth of the mothers
did resort to some means of supplementing the earnings of their hus­
bands. Usually they kept lodgers. This was done by the foreign
mothers principally, exactly one-third of whom had lodgers, as com­
pared with less than 1 per cent of the native women. Usually work
done outside the home consisted either of char work or of assisting
husbands in their stores. Generally these stores were in the same
building with the home.
When a mother of a young baby does not give her full time to her
duties within the home but resorts to means of earning money, it


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48

generally indicates poverty. This is true to a greater degree in
Johnstown than in places which have many inducements for women
to work. In Johnstown, with its excess of males, especially in the
foreign population, the woman’s services are particularly needed to
make the home.
In the group where the husband earns $10 a week or less— that is,
under $521 a year— many of the women are wage earners. In each
group showing better earnings for the husband the number and percent­
age of wage-earning wives decline. Such a tabulation as the following
almost automatically fixes the minimum wage on which a man, wife,
and a child or two can live with any degree of comfort in Johnstown
at about $780 a year. When the husband’s wage is less than $780.
a year, it is shown that the wives, in considerable number, must be
wage earners. As shown in the next table, in nearly half of the
families where the husband earns $10 a week or less (less than $521
a year), the wife resorted to some means of earning money; when
he earned as much as $900 a year, only 8.9 per cent of the wives
worked, and in the small group where the man earns as much as $1,200
a year, only 1 in 50.
T able 3 2 .—N umber and P er Cent of H usbands with W age -E arning W iv e s ,
b y N ativity of W ife and A nnual E arnings of H u sband .
HUSBANDS HAVING
NATIVE WIVES.

TOTAL HUSBANDS.

Husbands with
wage-earning
wives.

Husbands with
wage-earning
wives.

ANNUAL EARNINGS
OF HUSBAND.

Number.
A

HUSBANDS HAVING
FOREIGN WIVES.

Number.

Number.
Num­
ber.

Num­
ber.

Per
cent.

Husbands with
wage-earning
wives.

Per
cent.

Num­
ber.

Per
cent.

Total....................

1,491

278

18.6

816

26

3.2

675

252

37.3

Under «521.....................
«521 to «624....................
#625 to #779.....................
#780 to $899....................
$900 to $1,199.................

233
174
229
166
146
50
493

111
57
51
25
13

47.6
32.8
22.3
15.1
8.9
2.0
4.1

36
50
86
108
98
39
399

9
3
4
6
1

25.0
6.0
4.7
5.6

3

.8

197
124
143
58
48
11
94

102
54
47
19
12
1
17

51.8
43.5
32.9
32.8
25.0
9.1
18.1

“ Am ple"1......................

1

20

1.0

1See note on page 45.

It is impossible to judge from statistics alone whether or not
the work done by an individual woman, either her own housework
or work for money, is so excessive as to affect her during pregnancy
or while nursing to the extent of reacting on the health of the baby;
but the fact is that the infant mortality rate is higher among the
babies of wage-earning mothers than among others, being 188
as compared with a rate of 117.6 among the babies of nonwageearning mothers.
Wage-earning mothers and low-wage fathers


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49

are in practically the same groups, and it is difficult to secure an
exact measurement of the comparative weight of the two factors in
the production of a high infant mortality rate.
T able 3 3 .— D istribution op L ive B irths and op D eaths D uring F irst Y e a r ,
and I nfant M ortality R ate for B abies op W age - earning and N onwage earning M others , A ccording to A nnual E arnings op F ath er .
MOTHER NOT A
WAGE EARNER.

MOTHER A "WAGE
EARNER«
ANNUAL EARNINGS OF FATHER.

Live
births.

Number
of deaths
in first
year.

Live
births.

INFANT MORTAL­
ITY RATE.

Number . Mother
of deaths a wage
in first
earner.
year.

Mother
not a
wage
earner.

Total........................................................

266

50

1,165

137

188.0

117.6

Under $521........................................................
$521 to $624........................................................
$625 to $779........................................................
$780 or over, or “ ample ’ ’ 1............................

105
53
48
60

26
8
6
10

114
112
176
763

30
18
18
71

247.6
150.9
127.1
166.7

263.2
160.7
102.3
93.1

1 See note on page 45.

ILLEGITIMACY.
Of the 1,551 births included in this investigation 34, or 2.2 per cent,
occurred out of wedlock. Nine of the 32 illegitimate babies who were
born alive died during their first year. It is recognized that these
figures are a very small base from which to draw conclusions con­
cerning the effect of illegitimacy on the infant mortality rate. It
is of interest, nevertheless, to note that the findings for this small
group are similar to those of countries which compute an infant
mortality rate for legitimate and illegitimate children separately,
that is, a rate for illegitimates more than twice as high as for children
bom in wedlock.
T able 3 4 .— D istribution op B irths and op D eaths D uring F irst Y e a r ,
I nfant M ortality R ate , A ccording to L egitimacy .

and

DEATHS DURING
FIRST YE AR.
LEGITIMACY.

Illegitimate.....................................................................................
Legitimate.............................................................................................

Total
births.

34
1,517

Live
births.

32
1,431

Infant
Number. mortality
rates.
9
187

281.3
130.7

Thirty-two, or 3.7 per cent, of the 860 native mothers, as com­
pared with 2, or 0.3 per cent, of the 691 foreign mothers visited,
had illegitimate children in 1911,
61112°— 15------ i


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REPRODUCTIVE HISTORIES.
In addition to the data relating exclusively to babies born in 1911,
a statement was secured from each mother as to the number and
duration of each of her pregnancies and the result thereof; that is, the
number of children she had borne, alive or dead, the number of mis­
carriages she had had, and the age at death of each live-born child
who had died. Although this information was secured for all mothers,
tabulations are presented of the data furnished by married mothers
only. Comparatively few single mothers reported more than one
child, and information from them on this point is not believed to be
as reliable as that from married mothers.
The 1,491 married mothers of babies born in 1911 had had an aggre- \
gate of 5,554 pregnancies, resulting in 5,617 births, the excess of 63
births over pregnancies being due to plural births. Eight hundred and
four of these children died under 1 year of age, making an infant
mortality rate of 149.9 for all their babies, as compared with the rate
of 134 for those born in 1911. The stillbirths of these women num­
bered 194, or 4.5 per cent of the total number of births; miscarriages
reported numbered 191, but these were not added to the total reportable 1 pregnancies.
Details as to the infant mortality rates for all babies born to native
and foreign mothers included in this study, not only in the year 1911
but at any other time, are presented in the next table, which classifies
the babies according to the total number of reportable pregnancies
that their mothers had had, to and including the pregnancy resulting
in the 1911 birth.
T able 3 5 .— D istribution of M others , of L ive B irths , and of D eaths D uring
F irst Y e a r ,.and I nfant M ortality R ate for B abies of N ative and F oreign
Married M others , A ccording to the N umber of R eportable P regnancies .
NUMBER OF BABIES.

Number
REPORTABLE PREGNANCIES FOR MARRIED
of married
MOTHERS.
mothers.

Bom
alive.

Total........................................................

1,491

5,363

1
..................................................................
2
............................................................
3
.....................................................................
4
............................................................
5
..........................................................
6
...........................................................
7
.................... .......................................
8.
................................................................
9
........... ...........................................
10 or more.........................................................

339
283
214
186
147
94
83
54
33
58

322
544
626
723
704
546
555
426
283
-634

INFANT MORTALITY RATE
AMONG BABIES OF—

Foreign
Native
All
Died in
first year. mothers. mothers. mothers.
804

149.9

113.1

184.6

35~
59
92
78
103
88
78
95
41
135

108.7
108.5
147.0
107.9
146.3
161.2
140.5
223.0
144.9
212.9

75.9
76.5
118.0
99.4
86.1
157.4
100.0
157.6
128. 4
164.5

183.7
156.7
177.6
116.3
191.5
163.6
173.8
272.7
155.2
257.6

The statistics, based upon the results of all her reportable pregnan­
cies, show a generally higher infant mortality rate where the mother
has had many pregnancies, but there is not always an increase from
i “ Reportable” pregnancies are those terminating either in the birth of a live child or of a dead child
when the period of gestation exceeds 28 weeks; that is, when its registration or report is required by law.


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one pregnancy to the next. This is more clearly shown when the
pregnancies are grouped as in the next table,.
T able 3 6 .— I nfant M ortality R ate for all Children B orne b y Married
M others , A ccording to Specified N umber of R eportable P regnancies .

REPORTABLE PREGNANCIES FOR MARRIED MOTHERS.

Total

Infant
mortality
rate,
149.9

land 2 ..
3 and 4 ..
5 and 6 ..
7 and 8 ..,
9 or more

108.5
126.0
152.8
176.4
191.9

This tendency is shown in still another form of summary: Combi­
nations of four or less pregnancies are, for convenience, considered
as group 1, while the combinations of over four are designated group
2. The differences in rates in the two groups are notable. The
infant mortality rate is much lower for the first than for the second
group.
T able 3 7 .— I nfant M ortality R ate for A ll Children B orne b y Married
Mothers , A ccording to Specified N umber of R eportable P regnancies ,
b y G roups .
REPORTABLE PREGNANCIES FOR MARRIED
MOTHERS.

Infant
mortality
rate.

GROUP 1.

REPORTABLE PREGNANCIES FOR MARRIED
MOTHERS.

Infant
mortality
rate.

GROUP 2.

108.5
124.7
119.2

171.5
178.8
183.9

This influence of the size of the family upon the infant mortality
rate is shown in the computations giving the relative infant mor­
tality rate for the different children borne by married mothers. The
rate is most favorable for the second-born child, being 131.2. Among
first born it is 143.6; for tenth or later born children 252.3.
T able 3 8 .— I nfant M ortality R ate for A ll Children B orne by Married
M others , A ccording to the O rder in which the Child was B orn .

order

o f b ir t h .

Infant
mortality
rate.
143.6
131.2

First and second bom children___

138.3

ORDER OF BIRTH.

Seventh-born child................................
Eighth-born child........................ i ............
Seventh and eighth born children.

144.2
142.0
Third and fourth born children___

143.2
178.1
175.5

Fifth and sixth born children.......


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Federal Reserve Bank of St. Louis

177.0

Infant
mortality
rate.
192.1
165.4
181.5
128.2
252.3

Ninth and later born children___

201.1

IN F A N T M O RTALITY: JO H N STO W N , PA.

52

The next table gives a further elaboration of the same data; that
is, it shows the infant mortality rate where such rates are lowest and
highest, respectively, according to the age of the mother at the child’s
birth and the order in which the child was born. Attention is again
directed to the fact that the statistics presented in this section on
“ Reproductive histories” are based upon the total number of reportable pregnancies; that is, in addition to the pregnancies resulting in
births in 1911, all prior pregnancies of the women considered in the
investigation have been included.
T able 3 9 .—'Lowest and H ighest I nfant M ortality R ates , A ccording to A ge
of M other at B irth of Child and the O rder in which Child w as B orn .

INFANT MORTALITY RATES, ACCORDING
TO MOTHER’ S AGE.

ORDER

Lowest mortality.

o f b ir t h .

Highest mortality.

Mother’s Mortality Mother’s Mortality
age.
rate.
age.
rate.

Second child...................... ....................................................................
Fourth child.......................................................................................

20-24

140.0 Under 17

367.3

25-29
25-29
30-39
30-39
30-39
30-39

92.1
100.3
106.4
122.4
105.8
164.8

190.4
178.6
160.8
155.0
236.6
171.4

17-19
17-19
25-29
20-24
25-29
25-29

The differences in size of family for native and foreign mothers of
different ages are indicated in the next table. The total and average
number of live-born children, not reportable pregnancies, are given.
T able 4 0 .— T otal and A verage N umber of L iv e -B orn Children B orne b y
Married Mothers H avin g E ither a L ive B irth or a Stillbirth in 1911,
Classified b y N ativity and A ge of Mother .
ALL MARRIED MOTHERS.
AGE OF MOTHER
AT BIRTH OF
CHILD IN 1911.

NATIVE MARRIED MOTHERS. FOREIGN MARRIED MOTHERS.

Live-bom chil­
dren.
Total.

Live-bom chil­
dren.
Total.

Number. Average.

Live-born chil­
dren.
Total.

Number. Average.

Number. Average.

All ages___

1,465

5,363

3.7

801

2,600

3.2

664

2,763

4.2

Under 20years..
20 to 24 years___
25 to 29 years___
30 to 39 years___
40 years and over.

81
456
389
459
80

96
908
1,261
2,480
618

1.2
2.0
3.2
5.4
7.7

62
258
196
240
45

70
483
536
1,188
323

1.1
1.9
2.7
5.0
7.2

19
198
193
219
35

26
425
725
1,292
295

1.4
2.1
3.8
5.9
8.4

The next table shows all losses of pregnancy sustained by 628
mothers and the rate of loss per 1,000 births for mothers having
different numbers of births or reportable pregnancies. For all
mothers it was 188.4. “ Loss,” as here used, means the sum of infant
deaths (or deaths in first year) and stillbirths,


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Federal Reserve Bank of St. Louis

IN FAN T M O RTALITY: JO H N STO W N , PA.

53

T able 4 1 , —A ggregate N umber op B irths , L osses , and R ate op L oss
B irths , A ccording to N umber op B irths per M other .

NUMBER OF BIRTHS PER MOTHER.

per

Aggregate Aggregate
number
number
of births. oflossesl

1,000

Rate of
loss per
1,000
births.

5,617

1,058

188.4

335
554
648
748
740
576
574
432
324
686

53
87
113
109
133
119
104
102
65
173

158.6
157.0
174.4
145.7
179.7
206.6
181.2
236.1
200.6
252.2
'

The influence of the economic factor on infant mortality among
the babies born prior to 1911 can not be determined with exact­
ness, as no inquiry was made concerning earnings of the father when
the other children were born. But it is believed that his earnings
during the year following the birth of the 1911 baby can be re­
garded as an index of the economic standing of the family for some
time past. In individual cases, of course, revolutionary changes in
the family’s income may have occurred, but for the great mass of
people in the group considered it is not likely that within such a
short space of time as that covered by the child-bearing period of
the women considered— most of whom had not had numerous preg­
nancies:—marked changes had taken place. If these known earn­
ings are accepted as an index, the following variations are found to
occur in the infant mortality rate for all the babies of whom a record
was secured:
T able 4 2 .— I nfant M ortality R ate por all Children op Married M others
I ncluded in this I nvestigation , D istributed A ccording to the F ather ’ s
E arnings .

FATHER’ S

a n n u a l e a r n in g s .

Infant
mortal­
ity rate.
197.3
193.1
163.1

f a t h e r ’ s a n n u a l e a r n in g s .

$780 to $899..................................... .............
$900 to $1,199.................................................
$1,200 and over.............................................

Infant
mortal­
ity rate.
168.4
142.3
102.2

The infant mortality rate for the babies whose fathers earn under
$521 is almost twice as great as for those born into families in the
most prosperous group. These figures strengthen the conclusion
reached in the study of the babies born in 1911, namely that the
economic factor is of far-reaching importance in determining the
baby’s chance of life.


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Federal Reserve Bank of St. Louis


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Federal Reserve Bank of St. Louis

GENERAL TABLES.


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Federal Reserve Bank of St. Louis

GENERAL TABLES,

B ir t h s A c c o r d in g t o N a t i o n a l i t y
S e c t io n o f C i t y a n d W a r d .

op

M other,

by

Births to native
mothers.

op

Births to all moth­
ers.1

T a b l e I . — D i s t r i b u t io n

All sections............................. 1,551

860

691

87

69

18

42
20
li
14

36
14
6
13

6
6
5
1

2

106

100

6

1

34
72

33
67

1
5

1

- 118
90

107
83

11
7

5
4

142

78

64

18

41

3

24
17

1
2

6

6

1
4

52

14
3
1
3

204

59

5

21

4

4

2

22

1
4

6

2

15

4

2
2

1

• 4

4

4

2

1

11

5

3

1

Ward ft

Cambria C ity ..................................
W a r d IS
W a r d 16


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Federal Reserve Bank of St. Louis

75
67

48
30

27
37

1
17

Ì13
57
20
77

25
33
18
18

88
24
2
59

49

330

31

299

11

7
24

98
201

• 65
139

169

133

36

21

204

135

69

42

89
55
60

44
45
46

45
10
14

30
4
8

38

30

8

4

6

6

Hebrew.

Syrians a n d
Greeks.

53

33

12

10

2

3

.7

4

2

2

3

1

4

2

2

1

2

2

1

3

2

1

38

1
1
2
1

1

3

37

V

British.

75

17

105
225

Magyars.

76

Germans.

Croatians, Ser­
vians, etc.

394

Italians.

Slovaks,Boles,
etc.

Total.

SECTION OF CITY AND W ARD.

BIRTHS TO FOREIGN MOTHERS.

1
1

1

2

2

2

2
3

1

2

2

1

2

7
1

1
1

1
1

1 Includes both legitimate and illegitimate births.
57

INFANT. MORTALITY : JO H N STO W N , PA,

58

T a b l e I I . — D i s t r i b u t io n o f B i r t h s , L i v e B i r t h s , S t i l l b i r t h s , a n d D e a t h s i n
F i r s t Y e a r , A c c o r d in g t o N a t i v i t y o f M o t h e r , b y S e c t io n o f C i t y a n d
W ard.

Live births.

45

85

691

648

43

4

69

63

6

4

18

17

1

Ward 1............................

42

40
17

2

2
1

36
14

34

2
1

6
6

6

3

6

5

20
11

Kernville................................

14

13

1
1

106

104

2

10

1

13

12

2
2
1
1

6

100

98

2

Ward 5 ...................................
Ward 6 . ...........................

34
72

34
70

2

Hornerstown—Ward 7 ..........
Roxbury—Ward 8 ...................

118
90

109
85

9
5

10

Conemaugh Borough...........

142

136

6

■ 16

Ward 9 ...................................
Ward 1 0 .................................

75
67

72
64

3
3

10
6

Woodvale—Ward 1 1 ..............

113
57

6
2
2

29

12

3
3

33
67

33
65

17

107
83

100

Stillbirths.

All births.

Deaths in
first year.

815

7

Stillbirths.

Live births.

860

80

All sections................. 1,551 1,463

Stillbirths.

196

87

-

Live births.

88

Down town...........................

SECTION OF CITY AND
W ARD.

All births.

All births.

Deaths in
first year.

FOREIGN MOTHERS .1

NATIVE MOTHERS.1

Deaths in
first year.

ALL MOTHERS.1

1

I ll

5

5
5

1

1

1

5

6

6

1

2

1

1

1

5

X

2

3

5

16

11

9

79

7
4

8

7

6

2
1

1
2

78

75

3

6

64

61

3

10

48
30

46
29

2
1

3
3

27
37

26
35

1
2

7
3

24
33
16
17

1

6
8
1

88

83

5

24

22
2

2

23
3

2
1

Minersville—Ward 1 4 ............

77

107
55
18
72

- 5

9

25
33
18
18

3

59

55

4

6

Cambria C ity .......................

330

310

20

55

31

29

2

4

299

281

18

51

Ward 1 5 .......................... —
Ward 1 6 .................................

105
225

98

7
13

20

98

23.

1
1

1

35

7
24

6

212

3

201

92
189

6
12

19
32

Moxham—Ward 1 7 .................

169

157

12

14

133

124

9

10

36

33

3

4

Morrellville............................

204

194

10

16

135

129

6

10

69

65

4

6

Ward 1 8 .................................
Ward 1 9 ........................
Ward 2 0 ................. .

89
55
60

85
52
57

4
3
3

8

44
45
46

43
42
44

1

42

3

3

10

10

2

4
3
3

45

5
3

14

13

38

36

2

8

30

28

2

4

8

8

20

Coopersdale—Ward

21 ' : . .


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Federal Reserve Bank of St. Louis

11
1

•

1 Includes both married and unmarried mothers.

2

4
2

1

4-

IN F A N T M O RTALITY: JO H N STO W N , PA.
T able

59

I I I .—

D i s t r i b u t io n o f B ir t h s t o N a t i v e a n d F o r e i g n M a r r i e d M o t h e r s
a n d P e r C e n t o f B ir t h s i n E a c h 'G r o u p t o T h o s e G a i n f u l l y
E m p l o y e d , b y S e c t io n o f C i t y .

and

N

umber

B IR T H S TO M A R R IE D M O T H E R S .

SECTIO N O F C ITY.

Per
cent.1

1,517

281

18.5

86
104

4
3

4.7
2.9
.9

112

Conemaugh Borough..............

85
143
110

Morrellville........................... ..


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Federal Reserve Bank of St. Louis

52
19
75
329
167
197
38

Total.

Total.
Num­
ber.

1
1

40
50
6

1 .2

28.0
45.5
11.5

1
121

30.7
36.8

18

1 0 .8

11

5.6

23

2

Gainfully em­
ployed.

Gainfully em­
ployed.

Gainfully em­
ployed.
Total.

All sections....................

Foreign.

Native.

All.

Num­
ber.

Num­
ber.

Per
cent.1

828

26

3.1

689

255

68
98

2
3

2.9
3.1

18
6

2

101

78
78
23
28
17
17
31
131
128
30

1
1

4
2
2
1
1
1
2

6

1 Not shown when base is less than 50.

1 .0

11

1.3
5.1

. 7
65
87
24

Per
cent.1
37.0

36
48
4

55.4
55.2

22
120

37.9
40.3

16
5

7.2

2

1.5
4.7

58
298
36
69
8

2

60

IN FAN T MORTALITY : JO H N STO W N , PA,

T a b l e I V . — D i s t r i b u t io n o f B i r t h s
to
M a r r i e d M o t h e r s A c c o r d in g to
A t t e n d a n t a t B i r t h a n d t o N a t i v i t y o f M o t h e r , b y S e c t io n o f C i t y a n d
W ard.

A TTE N D A N T AT B IR T H .

All married mothers.

2

Ward 1 ............................
Ward 2 ...................................
Ward 3 ...................................
Ward 4 ............................

42

41
19

1
1
2
2

36
14
5
13

36
14
5

14

8
12

11

2

1

1

Kemville................................

104

94

10

98

91

7

6

3

Ward 5 ...................................
Ward 6 ................. .................

34
70

32
62

2
8

33
65

32
59

1
6

5

3

Homerstown—Ward 7........
Roxbury—Ward 8 ...................

112'

93
78

18
7

1

101

89
73

11

il

4
5

Conemaugh Borough...........

143

72

70

1

78

66

11

Ward 9 ...................................
Ward 1 0 ............................

75

47
25

28
42

44

1

48
30

22

4
7

71

7

4
47

4

23
28
17
17

18
23
13
13

5
4
4

20
10

85

68

78

2

Midwife.

689

134

522

18

14

6
6

5
5
3

5

1

1

7

5

3
1

7
2

1

65

6

59

3
3

24

1

27
38
87
24

14

110

52
19
75

32
31
15
24

Cambria City.........................

329

53

255

21

31

26

Ward 1 5 ................................
Ward 16................................

105
224

11

88

6

4

42

167

15

7
24

22

2

200

Moxham—Ward 1 7 .................

167

140

26

1

131

123

8

20

17

18

Morrellville............................

197

133

64

128

113

15

69

20

49

Ward 1 8 ................................
Ward 1 9 ................................
Ward 2 0 ................................

87
55
55

46
48
39

41
7
16

42
45
41

36
42
35

6

45
10

10
6

35

3
6

14

4

4
19

Coopersdale—Ward 2 1 ______

38

32

6

30

29

1

8

3

5


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Federal Reserve Bank of St. Louis

33

1
1

Woodvale—Ward 1 1 ..............
Prospect—Ward 12.................
Peelorville—Ward 13..............
Minersville—Ward 1 4 ............

21

Other or
none.

66

Midwife.

83

68

35

Physician.

743

6

All births.

Physician.

828

80

Other or
none.

All births.

605

86

All sections................. 1,517

Other or
none.

877

Down town...........................

All births.

Midwife.

Native married mothers. Foreign married mothers.

Physician.

SECTION OF CITY AND
W ARD.

2

8
2

58

U

5

298

27

3

Qft

16

250

20

21

61

IN FA N T M O RTALITY: JO H N STO W N , PA,

165
29

147
24

526
79

222
20

233
20

fBirths...

24
19

3
1

7
5

4
4

6
6

2
1

(Births...

275
31

14

46
5

35
4

96
12

29
2

37
3

4
3

6
2

1

fBirths...

234
30

7
1

44
12

20
5

83
9

40
2

23

4

5

2

2
1

4

fBirths...

229
22

27
1

24
6

88
9

31
1

43
4

4

5
1

1

1

5

fBirths...

182
18

2

21
4

17

56
8

37
2

34
3

5

7
1

2

fBirths...

164
15

2

10
1

20
2

50
6

32
1

30
3

9
1

6

3
1

1

fBirths...

107
17

2

5

14
2

37
6

16
3

18
1

4
2

6
1

2
1

3
1

fBirths...

79
8

. 2
1

2

6

27
2

13
2

13
1

6

2

4
2

4

fBirths...

58
15

1

1

2
1

26
11

7
2

15
1

1

1

3
2

..........

A

4 ...................

--

6 ...........................
6....................
...........

Unknown
number
of rooms.

6 rooms.

33
3

38
6

9 rooms.

5 rooms.

1,463
196

8 rooms.

4 rooms.

mirths...
[Deaths..

7 rooms.

3 rooms.

3......... -

2 rooms.

2....................

10 rooms
and over.

f a m il y

N U M B E R O F B A B IE S "WHO W E R E B O R N A L IV E A N D N U M B E R OF SUCH
B A B IE S W H O D IE D D U R IN G FIRST Y E A R IN H O M E S H A V IN G —

1 room.

person s pe r

(N O T IN C L U D IN G B A B Y ).

All live-bom ba­
bies.

T a b l e V . — D i s t r i b u t io n o f L i v e B ir t h s a n d o f D e a t h s D u r i n g F i r s t Y e a r ,
A c c o r d in g t o N u m b e r o f P e r s o n s a n d N u m b e r o f R o o m s p e r F a m i l y .

43
6

36
4

1
1

1

16
1

3
1

10
1

3

12....................

21
5

1

1

10
2

2
i

6
1

1
1

13------------

-

20
4

1

13
3

4
1

14....................

8
2

1

5
1

2
1

15....................

6
1

3

2

16....................

4
2

4
2

3

1

1

1
1

1

18....................

5
1

1

2

2

20....................

3
1

1

22.................

1
1

19....................

23....... ............
Not reported.


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Federal Reserve Bank of St. Louis

1

1

1

i

.........
1'

1

1

22
3

7

1
1

. 1

1

1
1

1
1
1
1

1

12
2

2
2

11....................

17....................

22
4

1
1

1

62
T

IN FAN T M O RTALITY: JO H N STO W N , PA,

V I . — D i s t r i b u t io n o f B i r t h s , L i v e B i r t h s , S t i l l b i r t h s ,
D u r i n g F i r s t Y e a r , A c c o r d in g t o N a t i o n a l i t y ( D e t a i l e d )

able

N A T IO N A L IT Y OF M O T H E R .

Welsh...............................................................................................


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Federal Reserve Bank of St. Louis

All
births.

Live
births.

and
of

of D e a th s
M o t h e r .'

Still­
births.

Deaths
during
first year.

1,551

1,463

88

860

815

45

85

691

648

43

111

394

367

27

65

276
108
2
7
1

258
100
2
6
1

18
8

48
14

1

3

196

76

72

4

19

34
39
3

32
37
3

2
2

8
10
1

75
53
38
33
12
13
4
4

71
47
38
31
12
13
3
3

4
6

13
6
4
4
2
2

12

12

10
2

10
2

10

10

2
i
1

IN F A N T M O RTALITY: JO H N STO W N , PA,

63

T a b l e V I I . — D i s t r i b u t io n o f B i r t h s , L i v e B i r t h s , S t il l b i r t h s , a n d o f D e a t h s
D u r i n g F i r s t Y e a r , A c c o r d in g t o A t t e n d a n t a t B a b y ’ s B i r t h a n d N a t i o n ­
a l it y of M o t h e r .

A T T E N D A N T A T B A B Y ’ S B IR T H A N D N A T IO N A L IT Y OF M O T H E R .

All mothers......................................
Physician...............................
Midwife......................................
Other..............................................
None.......................................
Native mothers.......................................
Physician.................................................
Midwife..........................................
Other.....................................................
Foreign mothers.........................................

All
births.

Live
births.

1,551

1,463

928
* 588
14
21

866
562
14
21

860

815

774
84
2

730
83
2

Still­
births.

Deaths
in first
year.

62

85
i

691

Physician..............................................
Midwife.....................................................
Other.....................................................
None......................................................

154
504
12
21

Slovak, Polish, etc........... ............................... .. .

394

Physician......................................................... ;
Midwife........................................................
Other.........................................................
None.............................................................

45
340

12
21

1

7

Croatian, Servian, etc.......................................

76

Physician....................................................
Midwife........................................................
Other.......................................................
None...........................................................

31
22
14

_
9
14

2

Italian..............................................................
Physician.......................................... .
Midwife.......................................................

X

71

German........................................................
Physician.........................................................
Midwife.................................................
Magyar.......................................................................
Physician..........................................
Midwife....................................... •...........

6
27
26
38

38

7
31

31

British............. .....................................
Physician..............................................
Midwife..............................................
Other............................................
Syrian and Greek...............................
Physician.................................................
Midwife..............................................
Hebrew.....................................................
Physician.
Midwife...


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

1
12

i

12

3
9
10

10

8

8

2

2

64

INFANT, MORTALITY : JO H N STO W N . PA,

Table

V I I I .—
in g

to

D i s t r i b u t i o n o f D e a t h s o f I n f a n t s a t S p e c if ie d A g e , A c c o r d ­
Ca u s e o f D e a t h of I n f a n t a n d N a t iv it y of M o t h e r .

AG E AT DEATH.

ai

L ess

08

th an
w eek .

1

1 w eek b u t less
th a n 1 m on th .

1 m on th b u t less th a n 1
year.

o
u

<
m’

9

&

¡g

P
P

©

CO

A

©

a

©

©

eh

13
o

>>

03

P

!>»

U

CO

P
A

* ft
<N CO

o
H

£
rH

©

©

•

CO

CO

9
A
43
CO

I
.a
4-3
CO

c3
rP
CO

d-3
4
CO

43

43

P

,©

P

rO

P

A
4
-a

,P

P

P

»43
P

a
CO

a
co

a>

P

©

©

P
rO

.d-3
4
P
O

A

o

a

a
<N

Eh

,h

O

9

©

p

A

co

M

CO
43
CO

13

. ©

A

<N

>>
cS

CO
a
c3
A
43
CO

b u t less th an
m on th .

c3
C A U SE OF D E A T H OF IN F A N T A N D
N A T IV IT Y O F M O T H E R ?

>>

p-

©
>

o
C9

a

All causes..........................

196

45

30

4

11

29

14

7'

8

122

18

16

42

31

15

Native mothers...........................
Foreign mothers.........................

85
111

25
20

18

3
1

4
7

9
20

2
12

1
6

6
2

51
71

9
9

7
9

18
24

12
19

5
10

5

3

2

46

5

4

17

15

5

3
2

i

2

16
30

3

5
12

5
10

2
3

12

Diarrhea and enteritis...........

52

1

1

Native mothers.................................
Foreign mothers.................................

17
35

1

1
5

Respiratory diseases...............

50

Native mothers..................................
Foreign mothers.................................

19
31

Premature births....................

24

21

19

Native mothers..................................
Foreign mothers................................

11

11

11

13

10

8

Congenital debility or mal­
formation .............................

19

10

7

Native mothers..................................
Foreign mothers........... .....................

5
14

4

3

6

Injuries at birth......................

7

7

Native mothers..................................
Foreign mothers.................................

6

G

1

1

Other or not reported............

44

Native mothers..................................
Foreign mothers............................... .


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

27
17

3

3
3

47

7

4

15

13

8

19
28

2

5

2
2

8
7

5
8

2
6

3

i

2

3

i

2

3

3

2

3

3

2

3

3

1

2

6

2

1

4

1

1
1

3

2

2

3

2

1
1

6

1

1

3
3

1

1

3

1
1

5

2

3

4

12

6

1

5

26

5

6

10

3

2

1
3

8
4

2

1

5

16
10

4

4
2

5

2

1
1

4

1

1

T a b l e IX.— D i s t r i b u t io n 1 o f B a b i e s A l i v e a t B e g i n n i n g o f E a c h M o n t h f r o m F i r s t t o N i n t h , A c c o r d in g t o T y p e o f F e e d i n g D u r i n g
E a c h M o n t h ; N u m b e r C o n t i n u i n g S u c h D i e t U n t i l F o l l o w in g M o n t h ; N u m b e r C h a n g i n g t o O t h e r S p e c i f i e d T y p e o f F e e d i n g ;
N u m b e r o f D e a t h s in E a c h G r o u p in F ir s t Y e a r a n d a l s o D e a t h s a t B e g in n in g o f N e x t M o n t h .

61112

A L IV E A T B E G IN N IN G OF
SPECIFIED M O N T H .

O N S A M E D IE T A T B E ­
G IN N IN G
OF
NEXT
M ONTH.

CHANGED
TO
M IX E D
DIET A T B E G IN N IN G
OF N E X T M O N T H .

C H A N G E D TO A R TIFICIAL
D IE T A T B E G IN N IN G
OF N E X T M ONTH .

C H A N G E D TO B R E A S T
E X C L U S IV E L Y A T B E ­
G IN N IN G
OF
NEXT
M ONTH.

Total.

Lived
first
year.

First month...................... .

1,463

1,267

Breast exclusively..................... .
Mixed..................... , .....................
Artificial exclusively..................
No feeding, infant died at once

1,333
43
55
32

1,193
36
38

Died
in first
year.

140
7
17
32

Total.

1,180
34
53

Lived
first
year.

Died
in first
year.

1,164

103

Second month...... .............

1,389

1,267

1,306

1,213

1,181
. 77
131

1,096
71

1,111

1,051
68
94

74

121

Third month.................... .

1,371

1,267

Breast exclusively......................
Mixed............................................
Artificial exclusively..................

1,112
98
161

1,052
89
126

92
150

Fourth month................. .

1,355

1,267

1,211

1,148

Breast exclusively.....................
Mixed...........................; .............. .
Artificial exclusively............. .

987
175
193

941
165
161

166
177

835
159
. 154

Fifth month..................... .

1,337

1,267.

1,203

1,159

871
253
213

838
243
186

780
227
196

760
220
179

Breast exclusively.. .
Mixed......................... .
Artificial exclusively.


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

104

Lived
first
year.

Died
in first
, year.

Total.

39

78

84

36

1,095
32
37

Breast exclusively..................... .
Mixed.......................................... .
Artificial exclusively..................

100

Total.

1,145

24

83

940
84

121
87

Lived
first
year.

Died
in first, Total.
year.

Lived
first
year.

Died
in first
year.

Dead at
beginning
oi next
month.

IN F A N T M O RTALITY: JOH N STO W N

T Y P E O F FEEDING-.

32

05

cn

T

IX.— D i s t r i b u t i o n o p B a b i e s A l i v e a t B e g i n n i n g o f E a c h M o n t h p r o m F i r s t t o N i n t h , A c c o r d in g t o T y p e o p F e e d i n g D u r i n g
E a c h M o n t h ; N u m b e r C o n t i n u i n g S u c h D i e t U n t i l F o l l o w i n g M o n t h ; N u m b e r C h a n g i n g t o O t h e r S p e c if ie d T y p e o p F e e d i n g ;
N u m b e r o p D e a t h s i n E a c h G r o u p i n F i r s t Y e a r a n d a l s o D e a t h s a t B e g i n n i n g o p N e x t M o n t h — Continued.

able

A L IV E A T B E G IN N IN G OF
SPECIFIED M O N TH .

O N S A M E D IE T A T B E NEXT
G IN N IN G
OF
M O N TH .

CHANGED
TO
M IX E D
D IE T A T B E G IN N IN G
OF N E X T M O N T H .

C H A N G E D TO ARTIFICIAL
D IE T A T B E G IN N IN G
OF N E X T M ONTH.

C H A N G E D TO B fiE A S T
E X C L U S IV E L Y A T B E ­
G IN N IN G
OF
NEXT
M O N TH .

Sixth month......................................

Total.

Lived
first
year.

Died
in first
year.

Total.

Lived
first
year.

Died
in first
year.

Total.

Lived
first
year.

Died
in first
year.

Total.

Lived
first
year.

Died
in first
year.

Total.

Lived
first
year.

Died
in first
year.

Dead at
beginning
of next
month.

1,318

1,267

51

1,108

1,064

44

160

158

2

45

45

Breast exclusively.........................................
Mixed.......................................
Artificial exclusively........................

780
310
228

760
300
207

20
10
21

616
287
205

598
279
187

18

148

147

1

15

15

8

12

11

1

10
20

10
20

Seventh month...................................

1,313

1,267

46

1,166

1,130

36

112

110

2

27

27

616
447
250

598
437
232

18

502
429
235

489
420

98
14

96
14

13
3

13
3

3

221

13
9
14

2

18

11

11

4

1,305

1,267

38

1,141

1,119

22

95

94

i

55

54

502
541
262

489
530
248

13

388
507
224

7

90
4

1

11

11

9

91
4

14

395
516
230

19
25

Ninth month.......................................

.1,291

1,267

24

1,003

989

14

158

158

Breast exclusively.........................................
Mixed...........................................
Artificial exclusively.....................................

395
611
285

388
601
278

7

220

551
232

217
543
229

3

10

140
18

3

140
18

Breast exclusively.....................................
Mixed..................................................
Artificial exclusively...............................
Eighth month.....................................
Breast exclusively.......................... ...........
Mixed.......................................
Artificial exclusively.................................


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

10

11

7

18

6

8

5

3

1

14

19
24

1

7

121

120

1.

32
40
49

31
40
49

1

IN FAN T M O RTALITY: JO H N STO W N , PA,

T Y P E OF F E E D IN G .

os

IN F A N T MORTALITY

JO H N STO W N - PA,

67

T a b l e X . — D i s t r i b u t io n o p B ir t h s t o M a r r i e d W a g e - e a r n i n g M o t h e r s ,
A c c o r d in g t o H u s b a n d ’ s A n n u a l E a r n i n g s a n d N a t i v i t y a n d E a r n i n g s o p
M other.

B IR TH S TO M A R R IE D W A G E -E A R N IN G M O T H E R W IT H
B A N D E A R N IN G A N N U A L L Y —
N A T IV IT Y A N D A N N U A L E A R N IN G S OF
M A R R IE D M O T H E R .

Total
births.
Under
$521.

$521
to
$624.

$625
to
$779.

$780
to
$899.

$900
to
$1,199.

All wage-earning mothers..

281

112

57

51

25

14

Under $53..-......................................
$53 to $103.........................................
$104 to $207........................................
$208 to $311........................................
$312 and over....................................
Not reported...................................

20

6

5

23
46
23
14

16
16
8

12
8

4
7
3
4
7

1

57
89
60
46
9

1
11

4

12

19

3
i
i

2
1

6

1

3

1

9

3

6

5
5
4
3
3

2
2
1

1
1
1

2
2

Foreign wage-earning mothers..

255

54

47

19

Under $53....... .................... ...................
$53 to $103.................................................
$104 tò $207...............................................
$208 to $311.............................................
$312 and over..........................................
Not reported..........................................

14
52
84
56
43


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

21

2

26

1
1
2

3
103

4

1

2

21

11

20

15
16

9
17

7

45

4

13

8

12
8

3
5

6

1

i

7
7

Native wage-earning mothers...

1

$1 ,2 0 0
and Ample.1
over.

2
2

Under $53.................................................
$53 to $103.................................................
$104 to $207...............................................
$208 to $311...............................................
$312 and over................................ ..........
Not reported..........................................

3

3
3
3

H US­

See note on page 45,

2

13

i

18
3

3
3
3
2
2

i

1
2
1

7
4

T

able

XI.—

D is t r ib u t io n

op

R esults

op

R e p o r t a b l e P r e g n a n c ie s ( L i v e B ir t h s a n d St il l b ir t h s )
N u m b e r p e r M o t h e r a n d N a t iv it y op M o t h e r .

and

M i s c a r r i a g e s , A c c o r d in g

to

M IS C A R R IA G E S I N A D D IT IO N TO
R E P O R T A B L E P R E G N A N C IE S .

R E P O R T A B L E P R E G N A N C IE S A N D R E S U L T S T H E R E O F .

Live births.

All married mothers..

Total
Total
preg­ births.
nancies.

Excess
due to
plural
births.

Stillbirths.

Number of mothers
reporting miscarnages.

Deaths in first year.
Number
of
mothers.

Num­
ber.

Number
of
mothers
having
live
births.

Num­
ber.

Num­
Number
ber of
of
Infant
mothers mortality still­
births.
having
rate.
babies
die.

N umber
of
mothers
having
still­
births.

Number
of miscar­
Per cent riages re­
ported.
of all
births.

Total
mothers.

Per cent
of all
mothers.

5,654

5,617

63

1,491

5,363

1,465

804

509

149.9

254

194

4.5

191

130

8.7

343
576
650
752
740
568
586
437
299

4

318
279
214
186
147
93
83
54
33
58

6 .1

8

8

32
24
29
36

28
23

23
27
15
13
14

16
18
18
14
14
15
9

,45

5.6
3.7
3.9
4.9
3.9
5.3
2.5
5.4
4.8

23
26

20

108.7
108.5
147.0
107.9
146.3
161.2
140.5
223.0
144.9

21

78
95
41
135

34
54
75
64
67
60
48
42

666

322
544
626
723
704
546
555
426
283
634

35
59
92
78
103

2
12

339
283
214
186
147
94
83
54
33
58

21

3.................................................
4.................................................
5.................................................
6 .................................................
7.................................................
8 .................................................
9...............................................
1 0 or more...............................

339
566
642
744
735
564
581
432
297
654

8
10

2.4
5.7
8.4
9.7
9.5
14.9
18.1
16.7
(i)
17.2

Native.................................

2,717

2,744

27

816

2,600

801

294

1 .......... ........................................ ..
2 ..........................................................................
3 ..........................................................................

234
346
333
376
325

236
351
338
377
326

2

234
173

222

222

222

266
184
117
314

267
187
118
322

224
327
322
362
302
216
250
184
109
304

17
25
38
36
26
34
25
29
14
50

1 ................................................
2 ................................................

4 ........................................................
5 ..........................................................................
6 ........................................................

7........................................................
8 ........................................................
9 ..........................................................................
1 0 or more .....................................


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

10
8
8

5
4
5
5

5
5
1
1
1

3
1
8

111

94
65
37
38
23
13
28

170
111

94
65
37
38
>23
13
28

88

22

31
11

21

31
13
22

7

22
20

2 1 2 .9

16
32

17

206

113.1

144

115

5.2

136

92

11.3

17
23
31
31

75.9
76.5
118.0
99.4

12

5.1

7
18

8 6 .1

10
10

15.4

6

18
17
7
19

1 0 0 .0

157.6
128.4
164.5

17
3
9
18

4.7
4.0
7.4
• 2J7
6.4

3.0
7.5
13.5

157. 4

16
13
19
5
ii

7
13
15

21
22

24
16
15
24

12
21

2
6
10

1 .6

8

7.6
5.6

4

11

6 .8

21

13
13
17
25
10

13
5
3
7

10. 6

m
m
l 1)

(*)

IN FAN T M O RTALITY: JO H N STO W N , PA.

NUMBER o p r e p o r t a b l e p r e g ­
n a n c ie s
PER M OTHER AND
N A T IV IT Y O F M O T H E R .

05
00

Foreign............. .................

2,837
105
220

or more.......................................


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

107
225
312
375
414
346
• 319
250
181
344

36

675

2

105

5
3
7
4
4
4

110

2
1

4

103
92
82
57
45
31
20

30

2,763
98
217
304
361
402
330
305
242
174
330

664
96
109
103
92
82
56
45
31
20

30

510
18
34
54
42
77
54
53
66

27
85

303
17
31
44
33
46
38
30
25
13
26

iNot shown when base is less than 50.

184.6
183.7
156.7
177.6
116.3
191.5
163.6
173.8
272.7
155.2
257.6

110

9
8
8

14
12

16
14
8

7
14

79

3 .8 '

9
7
7

8.4
3. 6

8
12
8
11

5
5
7

<

2 .6

3.7
2.9
4. 6
4.4
3. 2
3.9
4.1

55

38

5.6

1

1

1 .0

5
5
7
6
2

7
9
4

(*)
lit
0 )
0 )

IN FA N T M O RTALITY: JO H N STO W N , PA.

10

309
368
410
342
315
248
180
340

2,873

O

CO

T able

XII.— 'D i s t r i b u t i o n

op

R

esults
to

op

N umber

R e p o r t a b l e P r e g n a n c i e s ( L i v e B ir t h s a n d S t i l l b i r t h s )
p e r M o t h e r a n d A g e op M o t h e r a t E a c h P r e g n a n c y .

R E P O R T A B L E P R E G N A N C IE S .

N U M B E R OF R E P O R T A B L E P R E G ­
N A N C IE S A N D A G E OF M O T H E R
A T B IR T H OF B A B Y B O R N IN 1911.

L IV E B IR TH S.

B A B IE S D Y IN G IN FIRST Y E A R .

and

M i s c a r r i a g e s , A c c o r d in g

STILLBIRTHS.

M ISC A R R IA G E S .

Resulting births.
Total.

Mothers reporting.
Number
of
mothers.

Num­
ber.

Number
of
mothers.

Num­
ber.

Number
of
mothers.

Infant
mortal­
ity rate.

Num­
ber.

Number
of
mothers.

Per cent Num­
of all
ber re­
births. ported.

Number.

Per cent
of all
mothers.

191

130

8.7

All married mothers___

5,554

5,617

63

1,491

5,363

1,465

804

509

149.9

254

194

4.5

Under 20 years..........................
20 to 24 years..............................
25 to 29 years..............................
30 to 39 years..............................
40 years and over.....................
Average age: 28 years.

107
933
1,316
2,570
628

108
946
1,329
2,595
639

1

96
908
1,261
2,480
618

81
456
389
459
80

12

11

12

1 1 .1

140
185
382
85

115
132
207
44

125.0
154.2
146.7
154.0
137.5

12

38

4.0
5.1
4.4
3.3

19
46
95
31

3.9

66

21

29
55
84
14

18
27

11

89
461
395
466
80

19

14.2
23.8

6 .1

8

8

2.4

13
13
25

68

115

reportable pregnancy........

339

343

4

339

322

318

35

34

108.7

21

21

Under 20 years..................................
20 to 24 years.....................................
25to29yeafs.....................................
30 to 39 years.....................................
Average age: 23 years.

74
178
57
30

75
179j
58
31

1
1
1
1

74
178
57
30

67
176
54
25

66

8

8

18
4
5

119.4
102.3
74.1
(2)

8

175
53
24

7
18
4
5

3
4

3
4

6

10

283

544

279

59

54

108.5

12

21

12

156
74
39

154
73
38

3
37
9
5

(2)
139.1
63.8
65.8

2

302
141
76
4

3
42
9
5

214

626

214

92

75

3
77
95
36
3

8

3
77
95
36
3

1

1

40
41

31
33

8
2

8
2

1

reportable pregnancies___

566

576

Under 20 years..................................
20 to 24 years.....................................
25 to 29 years................................... .
30 to 39 years.....................................
40 years and over........................ .
Average age: 25 years.

24
312
148
78
4

24
317
151
80
4

3 reportable pregnancies___

642

650

Under 20 years..................................
20 to 24 years.....................................
25 to 29 years....................................
30 to 39 years...........*.........................
40 years and over.............................
Average age: 26 years.

9
231
285
108
9

9
234
288

3
3

110

2

2


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

9

5
3
2

8

1

227
277
105
9

3
3

3
3

6

10.7
1.7
6.9
(2)

2

2

32

28

5.6

23

16

3
15

(2)
4.7

4

3
13
9
3

147.0

24

(2)
176.2
148.0
76.2
(2)

1

7
11

6
11

5

5

10

6

6

6 .6

5

5.0

12

3
7

23

3.7

26

18

1

(2)
3.0
3.8
4.5

7
14
4

6

1

1

2

7
4

6 .8

1.7
5.3
(2)
5.7
3.8
4.1
(2)

8.4
7.8
7.4
(2)
(2)

IN FAN T M O RTALITY: JO H N STO W N , PA.

Num­ Excess
ber. over preg­
nancies.1

“3
®

4 reportable pregnancies. . . .

30 to 39 years.....................................
40 years and over.............................
Average age: 29 years.
5

reportable pregnancies-----

744

752

8

160
301
255
36

4

735

740

5

50
280
375
30

50
283
377
30

' 564

568

6

6

1

3

21

3.9

22

18

12
11
6

~6
10

7.5

3

3

3

3

20

14

723

186

78

64

107.9

39
75
63
9

148
290
249

39
75
63

28

21

26
21

23
17
3

189.2
89.7
84.3
(2)

147

704

147

103

67

146.3

36

31

4.9

10

10

183.7
191.7

1

1

17
16

15
14

2 .0
6 .0

6

9
51
40
3

7
31
27

6

49
266
361
28

94

546

93

88

60

161.2

22

13

3.9

23

14

1

21

6

4.5
4.1
1.5

6

3

15

13

56
75

3
2

56
75

2

.

1 1 0 .8
(S )

'

2

9.7
(2)
8 .0

9.5
(2)
9.5
7.1
10.7
(2)

4.2
(2)

Average age: 30 years.
6

reportable pregnancies-----

4

14.9

1
2
1

60

1271
347

60

17
36

(s)
181.1
155.6

66

133
362
67

3
23
54

11

66

11

8

6

1 2 1 .2

1

1
11
1

581

586

5

83

555

83

78

48

140.5

31

22

5.3

27

15

255.6
119.4
113.6

9
18
4

5
15

1 0 .0

2

1

4.6
4.3

19

2

223.0

ii

7

2.5

15

.9

16.7

215.9

10
1

6
1

2.4
(2)

15

9

17.6

132
360

22

(2)
(2)

Average age: 33 years.
7 reportable pregnancies-----

98
* 392
91

99
395
92

14
56
13

90
377
88

14
56
13

23
45

1

10

13
28
7

432

437

5

54

426

54

95

42
2

51

3
87

1

3

18.1
(2)
(2)

6

“ Averageage: 3 4 years.
8

reportable pregnancies----i

30 to 39 years.....................................
40 years and. over..............................
Average age: 35 years.
9 reportable pregnancies-----

16
408

16
413

8

8

297

299

207
90

208
91

654

666

12

360
294

364
302

4

40

(2 )

1

403
7

2

33

283

33

41

20

144.9

16

11

5.4

13

8

1
1

23

195

23

13
3

6.3
3.3

4

10

164.1
1 0 2 .3

5

88

15
5

8

10

32
9

5

51

1

3

24.2
(2)
(2)

“ Average age: 37 years.
10

or more reportable preg­
nancies----- ----------------------

8

8

58

634

58

135

45

212.9

32

17

4.8

14

10

33
25

342
292

33
25

85
50

26
19

248.5
171.2

22
10

11
6

6 .0

7

6

3.3

“ Average age: 39 years.
1 Excess of births over pregnancies due to plural births.
Rate not computed because of small base.

2


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

8

Includes 21 having 10 pregnancies; 16 having 11; 11 having 12;

6

having 13; 3 having 14; 1 having 16.

17.2
(*)
(2)

IN F A N T M O RTALITY: JOH N STO W N

156
300
252
36

29

186

T a b l e X I I I . — D is t r ib u t io n

op

R esults

op

to

R e p o r t a b l e P r e g n a n c i e s (L i v e B i r t h s a n d S t i l l b i r t h s )
N u m b e r per M o th er a n d H u s b a n d ’ s E a r n in g s .

L IV E B IR T H S .

R E P O R T A B L E P R E G N A N C IE S .

Mothers reporting.

Resulting births.
Total.

Number
Infant
Num­
Num­ mortality
of
mothers.
ber.
ber.
rate.1

Num­
ber.

Number
of
mothers.

63

1,491

5,363

1,465

804

149.9

509'

8

902

227
173
227
163
143
49
483

178
129
130
99
78
30
160

197.3
193.1
163.1
168.4
142.3
161.3
95.6

110

797
588
548
186
1,674

108.7

Excess
Number. over preg­
nancies.
5,617

Husband earns:
Under $521..............................
$521 to $ 6 2 4 ..,...................1..
$625 to $779...............................
$780 to $899.............................
$900 to $1,199..........................
$ 1 ,2 0 0 and over.......................
Ample 2 ....................................

938
691
816
611
574
196
1,728

946
700
826
616
581
199
1,749

21

233
174
229
166
146
50
493

reportable pregnancy.. .

339

343

4

339

322

318

35

48

48
23
48
35

43

43

22

22

46
. 32
36
13
130

44
32
35
13
129

11
2
6

544
62

Husband earns:

reportable pregnancies. .

Husband earns:
$625 to $ 7 7 9 ...........................
$780 t.r> $R9Q
Ample 2 ...................... ............ 1


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

5
7
3

39

1

136

13
137

1

48
23
46
35
38
13
136

566

576

10

283

2
2
1

31
36
55
28
23

23
46
35
38

2

9
10

62
72

64
74

110

111

56
46
16
204

56
46
16
209

2

5

8
102

668

68

108
53
41
14
198

254

194

4.5

31
25

61
48
18
109

44
32
29
28
33
13
75

23
24
9
61

4.7
4.6
3.5
4.5
5.7
6.5
4.3

34

21

21

6 .1

75
88

11
2

5
3
4

3
4
1

Number Per cent Num­
ber re­
of all
of
Per cent
mothers. births.1 ported. Number.
of all
mothers.

21

191

130

8.7

27

17
14
15
19
18

7.31

1 2 .0

22
21

30
25

8 .0
6 .6

11.4
12.3

8

6

58

41

8.3

8

8

2.4

1
2

1
2

5
1
2

1
2

3
3

3
3

1

8

61.5

8

7

7

5.1

5

5

279

59

108.5

54

32

28

5.6

23

16

5.7

31
36
55
28
23
7
99

11
8

176.4
177.6
157.4
169.8

11
6

2
6

2
6

8 .1

3

16
7

3
3
5

2.7
5.4

2

1
2
2

4.4

55.6

2
1
11

3
3
5
2
11

1
8

17
9
2
1
11

(

3.1
4
4
1

5.3

9

4
1
6

5.9

M O RTALITY: JO H N STO W N , PA.

Number
of
mothers.

5,554

1

M ISC A R R IA G E S .

STILLBIRTH S.

B A B IE S D Y IN G IN FIRST Y E A R .

pregnancies..

A 11 reporta ble

M i s c a r r i a g e s , A c c o r d in g

IN F A N T

SPECIFIED N U M B E R O F P R E G ­
N A N C IE S F O R A L L M A R R IE D
M OTH ERS A N D A N N U A L E A R N ­
IN G S O F H U S B A N D .

and

3

reportable pregnancies..

Husband earns:
Under $621...... ......................
$521 to $624..............................
$625 to $779............................
$780 to $899..............................
$900 to $1,199...........................
$1 ,2 0 0 and over.......................
Ample2. . . ............. ................

5

reportable pregnancies.

Husband earns:
Under $521............................
$521 to $624............................
$625 to $779........ ....................
$780 to $899............................
$900 to $1,199.........................
$1 ,2 0 0 and over.................
Ample2. . . ............................
6

reportable pregnancies. .

Husband earns:
Under $521..............................
$521 to $624..............................
$625 to $779..............................
$780 to $899......................
$900 to $1.199................... .
$1 ,2 0 0 and over.......................
Ample 2 ....................................


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

650

8

214

626

214

114

115
104
84
87
58
7
195

1
2

38
34
28
29
19

110
101

84
87
57
6
192

38
34
28
29
19

1

2

T

2

3

64

188

64

744

752

8

186

723

186

104

104
89
137
97
58
41
226

26

101
86

26

1
1
1
2
1
2

34
24
14

56

129
95
55
39
218

147

704

147

26
18

26
18

102

88
136
96
56
40
224

i

735

740

5

130
90

131
91

1
1

22

34
24
14
10

82
83
55

22

10

56

210

212

2

42

125
85
99
106
60
26
203

564

568

4

94

546

93

132
60
114
48
72

132
60
115
48
74
12
127

22
10

124
59

21
10

19

110

19

8
12
2
21

48
70

8
12
2
21

100
110

100
110

66
30

65
30

12

126

20
22
1

13
6

1
2
1

'

11

124

iNot shown when base is less than 50.

20
22

13
6

42

IN F A N T M O RTALITY: JO H N STO W N , PA.

4 reportable pregnancies. .
Husband earns:
Under $521............... »............
$521 to $624............................ $625 to $779..............................
$780 to $899.................... .........
$900 to $1,199........ .................
$1 ,2 0 0 and over.......................
Ample 2 ....................................

642

T able

XIII.— D i s t r i b u t i o n

op

R

to

reportable

7 reportable pregnancies. .

p r e g n a n c ie s .

$ 7 8 0 t o $890
$ 9 0 0 t o $1 1 9 9

8

reportable pregnancies. .

B A B IE S D Y IN G IN FIR ST Y E A R -

Number
Num­
of
ber.
■mothers.

Number
Infant
Num­ mortality
of
ber.
rate.1 mothers.

Total.

Excess
Number. over preg­
nancies.

.

• 9 reportable pregnancies. .

$780 t o $899
.
* 9 0 0 t o $1 1 9 9

Amnles....................................


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

M ISC A R R IA G E S .

STILLBIRTH S.

Num­
ber.

Number
of
mothers.

Per cent Num­
ber re­
of all
Per cent
births.1 ported. Number.
of all
mothers.

581

586

5

83

555

83

78

140.5

48

31

22

5.3

27

15

91
56
98
35
84

92
56
101
35
84

1

13
g
14
5

88
51
97
32
79

13
8
14

13
15
16

147.7
294.1
164.9

4
5
4
3
5

4
4
3

4.3
8.9
4.0

2
1

2
2

6 .0

3
5

3

21

22

1

22

5
12
3

8
6
9
5
5

4
1

3

1

1

196

196

8
2

186

28

20

107.5

14

10

7

5.1

2
12

432

' 437

5

54

426

54

95

223.0

42

11

7

2.5

15

9

120

120

15

31

2
1
1

12
5
6

12
5
6

12
10

3
4

2
2

2.5
4.1

2
1

4
5
3

3

2

3

22
11
11
6

265.0
234.0

5

88

98
41
49
24
16
89

1

2
11

117
94
41
46
24
16

15

96
• 40
48
24
16

88

2
11

11

125.0

2
6

1

1

1 .1

297

299

2

33

283

33

41

144.9

20

16

11

81
72
18
18
18
18
72

82
72
18
19
18
18
72

1

9
8
2
2
2
2
8

80
70
15
17
18
16
67

9
8
2
2
2
2
8

15

187.5
142.9

6
6

2
2

2
1
1
2

Husband earns:
$521 to $624. .
$625 to $779 .

c c o r d in g

'

Mothers reporting.
Number
of
mothers.

12
3

Husband earns:
$521 t o $024
$025 t o $779
$780 t o $899
$ 9 0 0 t o $1 19 9

M is c a r r ia g e s , A

Resulting births.

Husband earns:
$521 t o $fi24

L IV E B IR T H S .

and

3

1

6

7

8 8 .6

1

3

10

3
5

2
2

2

9

134.3

4

2
2

1

5

4

/
/

1
2

1

7

5

i
3

1
1

1
1

5.4

13

8

2.4

3
3

2

1

1

6

2

2 .8

6.9

78.1

3

16.7

IN FAN T M O RTALITY: JO H N STO W N , PA.

SPECIFIED N U M B E R OF P R E G ­
N A N C IE S F O R A L L M A R R IE D
M OTHERS A N D A N N U A L E A R N ­
IN G S O F H U S B A N D ,

R e p o r t a b l e P r e g n a n c ie s (L i v e B ir t h s a n d S t il l b ir t h s )
N u m b e r p e r M o t h e r a n d H u s b a n d ’ s E a r n i n g s — Continued.

e su l t s op

10

or more reportable
pregnancies......................

Husband earns:
Under $521..............................
$521 to $624.............................
$625 to $779..............................
$780 to $899..............................
$900 to $1 199


https://fraser.stlouisfed.org
Federal Reserve Bank of St. Louis

666

56
32
70
78
114
24
280

58
33
71
80
114
24
286
1

12

58

634

58

2
1
1
2

5
,3

5
3

7

52
32
70
76

10
2

110
22

10
2

25

272

25

6

•
6

Not shown when base is less than 50.

6

7

IN F A N T M O RTALITY: JO H N STO W N , PA.

Ample 2 .............. .....................

654

IN FAN T M O RTALITY: J O H N STO W N , PA,

76

T a b l e X I V . — D i s t r i b u t i o n A c c o r d in g t o N u m b e r
G r o u p s o p M a r r ie d M o t h e r s Cl a s s if ie d

ALL M OTH ERS.
m o t h e r ’s a g e a n d
able

n um ber

of

report

op
by

P r e g n a n c ie s
N a t iv it y .

N A T IV E M O T H E R S .

and

A

ge

F O R E IG N m o t h e r s .

-

P R E G N A N C IE S .

Number. Per cent. Number. Per cent. Number. Per cent.
Total pregnancies..........................

1,491

1 0 0 .0

816

675

1 0 0 .0

1 ...................................................................
2 ........................................ ..........................

22.7
19.0
14.4
12.5
9.8
6.3
5.6
3.6

234
173

28.7

105

2 1 .2

110

3...................................................................
4...................................................................
5...................................................................
6 ...................................................................
7...................................................................
8 ...................................................................
9 ...................................................................
1 0 and over.................................................

339
283
214
186
147
94
83
54
33
58

111

103
92
82
57
45
31

15.6
16.3
15.3
13.6

3.9

94
65
37
38
23
13
28

13.6
11.5

Under 20 years, total pregnancies___

89

1 0 0 .0

66

1 0 0 .0

1 ..........................................................................
2 ...........................................................................

74

55

3

10
1

83.3
15.2
1.5

19

3......................................... ...............................

83.1
13.5
3.4

2
2

82.6
8.7
8.7

20 to 24 years, total pregnancies.......

461

1 0 0 .0

261

1 0 0 .0

200

1 0 0 .0

1 ...........................................................................
2 ...........................................................................

178
156
77
39

38.6
33.8
16.7
8.5

64
70
35
25

10
1

2 .2
.2

6

32.0
35.0
17.5
12.5
3.0

1

43.7
33.0
16.1
5.4
1.5
0.4

25 to 29 years, total pregnancies.......

395

1 0 0 .0

199

1 0 0 .0

196

1 0 0 .0

1 . . .......................................................................
2 ..........................................................................

.57
74
95
75
56

45
46
40
40
17
7
4

2 2 .6

12

6 .1

23.1

28
55
35
39
15

14.3
28.1
17.9
19.9
7.7
5.1

2

14.5
18.7
24.1
19.0
14.2
5.6
3.5
.4

30 to 39 years, total pregnancies........

466

1 0 0 .0

1 ...........................................................................
2 ...........................................................................

3......... .................................................................
4...........................................................................
5 ...........................................................................
6 ...........................................................................
7...........................................................................
8 ...........................................................................
9 ...........................................................................
10 and over........................................................

30
39
36
63
75
60
56
51
23
33

6.4
8.4
7.7
13.5
16.1
12.9
10.9
4.9
7.1

40 years and over, total pregnancies.

80

1 0 0 .0

2 ...........................................................................

2

3...........................................................................
4..........................................................................
5...........................................................................
6 ...........................................................................

3...........................................................................
4...........................................................................
5...........................................................................
6 ..........................................................................
7...................... ....................................................
8 ...........................................................................

3..........................................................................
4...........................................................................
5 ..........................................................................
6 ..........................................................................
7...........................................................................
8 ..........................................................................
9 ...........................................................................
1 0 and over........................................................


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12

22

14

3
9
6
11

13
1
10

25

2 .2

1 2 .0

2.5
3.8
11.3
7.5
13.8,
16.3
1.3
12.5
31.3

U4r
86

42
14
4

1 0 0 .0

8 .0

4.5
4.7
2 .8
1 .6

3.4

2 0 .1
2 0 .1

8.5
3.6

20

30
23'

1 2 .1

8.4
6.7
4.6
3:0
4.4
1 0 0 .0

2 .0

10
2

245

1 0 0 .0

221

1 0 0 .0

20

8 .2
1 1 .8
1 0 .2

10
10
11

4.5
4.5
5.0
13.6
15.8
16.3
12.7
12.7

29
25
33
40
24
28
23

1 .0

8

13.5
16.3
9.8
11.4
9.4
3.3

15

6 .1

30
35
36
28
28
15
18

45

1 0 0 .0

35

1 0 0 .0

2

3
7
4

4.4
6.7
15.6
8.9

5

1 1 .1

2
2
6

5.7
5.7
17.1

6

13.3

7

2 0 .0

5
13

1 1 .1

5

28.9

12

1

6 .8
8 .1

2.9
14.3
34.3

IN F A N T M O RTALITY: JO H N STO W N , PA.
T able

XY.— D i s t r i b u t io n
in g

to

N a t iv it y

77

M a r r ie d M o t h e r s b y L o s s e s S u s t a in e d , A cco r d ­
M o t h e r a n d N u m b e r o p P o s s ib l e L o s s e s .

op

op

D ISTR IB U TIO N O F M O T H E R S A CCO RD IN G TO N U M B E R OF LOSSES.
N U M B E R OP B IR T H S O R POS­
S IB L E LO SSE S
AND N A­
T IV IT Y O F M O T H E R .

Number
of
mothers.

2

3
losses.

4
losses.

5
losses.

6

8

losses.

losses.

losses.

121

60

24

13

8

1

2

1
1
2
2

2
1

4

2

1

i

1

2

i

1

All mothers.............

1,491

399

birth................................
births...............................
3 births...............................
4 births...............................
5 births...............................
J 6 births...............................
/
7 births...............................
7
8 births...............................
9 births...............................
1 0 or more births..............

335
277
216
187
148
96
82
54
36
60

53
67
73
55
48
44

Native mothers.............

1
2

22

18
9

8
10

10

15

5
4

13

i
7

816

199

59

19

5

6

1 b irth .....................................
2 births......................................
3 births......................................
4 births......................................
5 births....... .............................
6 births......................................
7 births......................................
8 births......................................
9 births......................................
1 0 or more births.....................

232
170

29
36
35
33
19
19

15
29

4
6

5
4
7

Foreign mothers...........

675

200

62

b ir th ...,.................................
births......................................
3 births........... .-.........................
4 births......................................
5 births......................................
6 births......................................
7 births......................................
8 births......................................
9 births......................................
1 0 or more births.....................

103
107
105
89
83
58
45
33

24
31
38

1
2


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98
65
38
37
21

21

31

10
8

22

29
25
12
10

5
4

.

10

14
13
19
13
19

111

10 or
more
losses.

1

loss.

4
8
11
8
10
10

5
7

1

6
10

3
4

7

1

8

3
3
3

1
1
1

1

4

5

41

19

7

1
1
2
2

3

3
5
7
7
7
7

6
8

3

5
7
7
9
6
11

2
1
2
2

7

2
2

4

2
1

2

9

2

i

2

2

2


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APPENDIX I.

STATEMENTS OF MOTHERS.

The statements appended herewith are taken from the testimony
of the mothers whose babies were included in the investigation.
They, like photographs of random spots, illustrate instances where
hard work and a limited income are coexistent with marked loss of
infant life. They are offered not as medical or scientific testimony,
but because of the natural interest in the mother’s viewpoint on
these intimate matters. A closer contact with a few individual
cases can not but serve to humanize and make more realistic a mass
of figures on similar and related topics.
Mother aged 34 years; 9 pregnancies in 17 years; 7 live born; 2 stillborn; no miscar­
riages reported; 3 deaths in first year, viz, aged 9 weeks, strangled on milk; aged 1
year, pneumonia; aged 6 months, pneumonia; 3 children living at time of agent’s
visit. In poor health. Has had sunstroke. Worries. Torn at birth of one child.
Has lacked medical attention. Father has miner’s consumption.
Mother aged 36 years; 10 pregnancies in 12 years; 6 live bom ; 1 stillborn; 3 miscar­
riages reported; one death in first year, viz, 4 hours, hemorrhage; 5 children living at
time of agent’s visit. Formerly toll keeper and had to lift heavy gate during earlier
pregnancies. Housework since marriage excessive. Always has instrument deliv­
eries. Home fair. Father skilled mill hand.
Mother aged 38 years; 12 pregnancies in 17 years; 11 live born; 1 miscarriage reported;
3 deaths the first year? viz, 3 weeks, prematurity; 3 months, pneumonia; 3 weeks,
unknown; 7 children living at time of agent’s visit. During pregnancy resulting in
premature birth, in a state of worry and excitement owing to frequent fights in
neighborhood. During pregnancy resulting in miscarriage she overexerted self doing
heavy laundry work, lifting boilers, etc. Home fair.
Mother aged 35 years; 11 pregnancies in 15 years; 8 live born; 3 miscarriages reported;
3 deaths in first year, viz, aged 10 days, yellow jaundice; 10 days, cause unknown;
6 months, spinal meningitis; 4_ children alive at time of agent’s visit. Had to do
excessive work during pregnancies, as sweeping, washing, lifting tubs, carrying water,
etc.
Mother aged 25 years; 7 pregnancies in 6 years; 3 live born; 4 stillborn; 2 deaths the
first year, viz, aged 11 days, cause unknown; aged 2 days, cause unknown; 1 child
alive at time of agent’s visit. Physician stated mother was overworked during preg­
nancies, therefore during pregnancy resulting in birth of healthy baby in 1911 she
was extra careful of self. Fair home. Father skilled mill worker.
Mother aged 34 years; 4 pregnancies in 5 years; all live born; 1 death the first year,
■viz, aged 11 months, spinal meningitis; 3 children alive at time of agent’ s visit. D oc­
tor stated period of gestation only 8£ months for each p r e g n a n c y A lw a y s mis­
erable during pregnancies. Can not eat. Feet and legs swell. Children fed and
cared for intelligently. Home good.
Mother aged 41 years; 12 pregnancies in 22 years; 12 live bom ; 1 death the first year,
viz, aged 3 weeks, spasms; 11 children alive at time of agent’s visit. Baby of 1911
poorly developed and in poor health at 1 year of age. When 6 months old was given
soup, milk, coffee, and crackers; at 9 months, sauerkraut, cabbage, pie, and every­
thing. Dirty house. Father machinist in mill.
Mother aged 37 years; 12 pregnancies in 15 years; 8 live bom ; 4 miscarriages
reported; 1 death the first year, viz, aged 1 month, cause unknown; 6 children alive
6 1 1 1 2 ° — 1 5 ------- 6


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81

82

IN FAN T M O RTALITY: J O H N STO W N , PA.

at time of agent’s visit. Hard worked and worried during pregnancies. Laundry
and char work in addition to home duties, but manages to give babies only breast
milk during first year.
Mother aged 31 years; 10 pregnancies in 10 years- 8 live bom ; 2 stillborn; 4 deaths
the first year, viz, aged 7 days, 2 days, 1 day, 12 hours, cause unknown; 4 children
alive at time of agent’s visit. Doctor says not strong enough to bear babies to term
or to have healthy children.
Mother aged 32 years; 7 pregnancies in 11 years; 5 live born; 2 stillborn; one
death the first year, viz, aged 2 months, mother says from nervous shock and fright
from passing trains. Baby died a day or so after family moved to house along railroad
track; 3 children alive at time of agent’s visit.
Mother aged 27 years; 6 pregnancies in 10 years; 6 live bom ; 3 deaths the first
year, viz, all aged few weeks, cause unknown; 3 children alive at time of agent’s visit.
Babies who died all born before marriage, when mother was a servant and had to
leave them to be artificially fed and poorly cared for when she went to work.
Mother aged 30 years; 9 pregnancies in 14 years; 6 live bom ; 3 stillborn; nfc
deaths the first year; 3 children alive at time of agent’s visit During one pregnancyv'
resulting in stillbirth felt strain of struggle she made to separate fighting lodgers; dur­
ing another resulting in stillbirth she had fall on ice; and during the third her work
had been excessive.
Mother aged 41 years; 13 pregnancies in 22 years; 13 live bom ; 7 deaths the first
year, viz, aged 1 year, 1 year, 2 days, 1 month, few minutes, 6 weeks, 8 weeks, causes
unknown; 4 children alive at time of -agent’s visit. No member of family has ever
attended school. They own a lot in a miserable unpaved alley, on which they
have built houses 3 deep. They have a dirty cow shed there and sell m ilk in open
receptacles. No sewer connection; yard privy; but they have city water. Save
father’s earnings and live on milk sales. Never has a doctor or midwife at child
birth—manages alone. Began to do her housework two days after birth of 1911 baby.
Mother aged 26 years; 6 pregnancies in 5 years; 5 live bom ; 1 stillborn; 3 deaths
m first year, viz, aged 15 minutes, one-half day, 3 days; 1 child alive at time of agent’s
visit.^ The 1911 baby alive and in poor health at 1 year of age. Was given table
food in addition to breast milk from 4 months of age.
Mother aged 31 years; 6 pregnancies in 9 years; 6 live bom ; 2 deaths the first year
viz, aged a few months, croup; a few months, bronchitis and pneumonia; two others
at 14 months, each of bronchitis and pneumonia; 2 children alive at time of agent’s
visit. Father has tuberculosis. Poor, insanitary home. Total income, $500 a year.
Mother aged 33 years; 4 pregnancies in 8 years; 3 live bom - 1 miscarriage reported;
1 death the first year, viz, aged 4 months, pneumonia; 2 children alive at time of
agent’s visit. Does excessive work in own home in addition to char work. The 1911
baby was only one to die in first year. Deserted b y husband early in that pregnancy.
This pregnancy period was one of worry and mental and physical strain to support
her family, and when baby was bom she had no milk and gave him condensed milk
from birth.
Mother aged 30 years; 11 pregnancies in 12 years; all live bom ; 5 deaths the first
year, of which 2 were from pneumonia; 6 children alive at time of agent’s visit.
Frail, hard worked, and worried over money matters. Kitchen is living room and
a dark h o le in basement.” Ventilation of home bad; sleeping-room window al­
ways shut “ tight.” Baby bom in 1911 died of pneumonia at age of 9 months.
Mother aged 34 years; 6 pregnancies in 10 years; 6 live bom ; 5 deaths in first y e a r
causes thereof unknown. The 1911 baby was aged 2 months at death; 1 child alive
at time of agent’s visit. Says she has never had enough to eat since marriage and
that breast milk always leaves her two weeks after childbirth. Poor, dirty close
house. Father a teamster who spends considerable portion of wages in arink. ’
Mother aged 20 years; 1 pregnancy, resulting in a live-bom child who died at the
SLg©of 9 months of cholera infantum. Hor only child bom ovor one year after hus­
band s desertion; latter claims she is syphilitic. She comes from feeble-minded
family whose history is matter of State record. Her grandfather acquitted of killing
his son on account of mental condition. Her mother and sister and latter’s 18months-old baby all officially pronounced feeble-minded. Family of loose morals.
The baby bom in 1911 weaned from breast at age of 4 months and died of cholera in­
fantum at age of 9 months.


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IN F A N T M O RTALITY: JO H N STO W N , PA.

83

Mother aged 30 years; 9 pregnancies in 11 years; 8 live births; 1 miscarriage re­
ported; 3 deaths in first year, viz, aged 3 months, pneumonia; aged 8 months, m a l a r i a l
fever and rheumatism; and the baby bom in 1911 Weaned from breast when 6 weeks
of age, died at age of 9£ months of gastroenteritis; 5 children alive at time of agent’s
visit. During pregnancy resulting in miscarriage two months after conception, lived
on second floor and had to carry heavy wash up and down from yard.
Mother aged 27 years; 3 pregnancies in 3 years, all live births; 2 died in first year,
viz, aged 15 days of cause unknown to mother, and other bom in 1911, of hereditary
syphilis, according to death certificate. Poor, dirty home. Father a steel-mill la­
borer at $10 a week. One child alive at time of agent’s visit.
Mother aged 35 years; 6 births in 12 years; 4 live births and 2 stillbirths. A ll live
bom died in first year, viz, aged 6 weeks, bronchitis; aged 13 days, bronchitis; aged 2
days, weak from birth; aged 4 hours, inanition, the last being the 1911 baby. Had
another child the following year and she and her husband were so anxious that at
least one child should live that she consulted physician concerning its care. Upon
his advice she gave up her 20 boarders immediately after child’s birth and devoted all
her time to it.- Thinks she did not stop her hard work soon enough; says she has
always worked too hard, keeping boarders in this country and cutting wood and
carrying it and water on her back in the old country. Also says the carrying of water,
coal, and cases of beer in this country is great strain on her. Father furious be­
cause all babies die; wore red necktie to funeral of last to show his disrespect for wife
who can only produce children that die. A type of woman who would follow, and
profit by, instruction in prenatal care.
Mother aged 25 years; 3 pregnancies in 3 years; all live births; 2 died in first year,
viz, aged 1 day, cause unknown; aged 11 months (bom in 1911), pneumonia; 1 child
alive at time of agent’s visit.
Father a steel-mill hand. Damp, badly ventilated
home, outside toilet.
Mother aged 27 years; 8 children; 1 before marriage and 7 in the 11-year period
since marriage at the age of 16. A ll live births; 3 deaths under 1 year of age,
viz, aged 8 months, unknown cause, “ stomach turned b la ck ” ; 3-months old, same
statement as for 8; months old child; aged 11 months, ileocolitis. This last born
in 1911, was breast fed only three months and then given condensed milk to supple­
ment breast-milk feeding. Four children alive at time of agent’s visit. Boarders.
Fairly good home. Father a steel-mill hand.
Mother aged 25 years; 2 pregnancies in 8 years; both live-bom children, of whom
one died, aged 2 days, cause unknown. Mother says neither doctor nor midwife
present at birth; that husband “ caught” baby at 3 a. m., and she was up and doing
regular work at 6 a. m. One child alive at time of agent’s visit. Thirteen boarders.
Family sleeps in kitchen, which is also used as dining and living room for boarders.
Water supply in yard, and privy in yard used b y several families. Father works in
coal mine.
Mother aged 34 years; 8 pregnancies in 16 years; all live-bom children, all but 2
of whom died in first 2 weeks of life from unknown causes, except the last, whose
death was certified as from ileocolitis; 2 children alive at time of agent’s visit. Never
has doctor or midwife at childbirth. Very ignorant. Father a laborer in steel mill.
Mother aged 28 years; 3 pregnancies in 3 years, resulting in 4 live births; 2 (twins)
died in their first year, aged 1 month and 4 months, of inanition and malnutrition,
respectively; they were never breast fed ; condensed milk from birth ; 2 children alive
at time of agent’s visit. Six boarders. Poor, dirty home. City water in yard, also
dry privy. Father a steel-mill hand.
Mother aged 36 years; 12 pregnancies in 17 years; all live births; 3 died first year,
viz, aged 9 days, born sickly with big head; 9 months, bowel trouble; 10 months,
bowel trouble; 9 children alive at time of agent’s visit. Began to feed the 1911 baby,
who died last, on raw cows’ milk from the age of 2 months because she went out to do
laundry work and cleaning in the home of a physician and the baby had to be fed in
her absence. Bought milk from neighboring cow shed. Combined housework for
her large fam ily and outside work a great strain on mother. Dirty home. Father
works in mine.
Mother aged 31 years; 10 births in 14 years, 1 being stillbirth. Every live-born
child of this woman died in 1 year or less, as follows: Age 4 months, cough; 3 months,
cough; 1 year, unknown; 1 year, unknown (the last two Were insured for $26 each;


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84

IN FAN T M O RTALITY l ; JO H N STO W N , PA.

one baby died before company delivered policy); the others died at ages of 3 months,
4 months, 1 year, 3 months, and 10 weeks, respectively, of causes unknown to mother,
who said all had ‘ ‘ sores on body. ’ ’ Certificate gives scrofula as cause of death of baby
born in 1911. The first 2 children were born and died in Europe. Attending m id­
wife in Johnstown says father has syphilis. Both parents, however, claim to be
healthy; father drinks, came to United States 2 years ahead of wife. Had worked
in cigar factory from age of 13 until she came to United States. Her own mother had
worked in same place 30 years. She never stays in bed over 3 days when a child is
born. Father a car-shop rigger.
Mother aged 25 years; only 1 pregnancy; mother married 2 years. Baby born
alive with “ sores on b o d y ” ; died aged 4 months; she says “ wasted aw ay” ; certifi­
cate states ileocolitis. Weaned from breast when 3 weeks old because she had typhoid.
Hard worker, bu t has dirty home and never opens a window. Water and privy in
yard. Father a steel-mill hand.
Mother aged 20 years. First and only pregnancy resulted in live-bom child who
died, aged 6 months, of convulsions. Weaned from breast, aged 4 months, because
her milk left her on accoun t of hard work. Baby on condensed milk till 5 months old,
then given bread, cakes, apples, etc. Five boarders. Home neither clean nor well'
ventilated. Father a steel-mill worker.
Mother aged 22 years; only 1 pregnancy; a live-bom child that died in July, aged
7 months, of cholera infantum. Milk and crackers added to breast feeding at age of
5 months. Again pregnant when baby was 6 months old, but continued nursing
baby until its death, 1 month later. Unclean 1-room home; yard hydrant and privy
for use of this and other families. Father works in coal mine.
Mother aged 38; 13 pregnancies in 17 years, 11 live births and 2 premature stillbirths.
Only 2 children living at time of agent’s visit. The second to eighth, the eleventh, and
the thirteenth children died of bowel trouble at ages ranging from 3 weeks to 4 months.
Only cause of death she can give is that “ food did not agree with them. ’ ’ Believed in
feeding babies and gave them everything anybody told her to give them; begins at 1
month to give them bread, potatoes, egg, crackers, etc. For last baby that died she
got a goat and gave the baby its milk; goat got sick, but she persisted in g i v i n g the
baby its milk until the goat went dry. Directed the feeding of her daughter’ s baby
until its death at 3 months of age. On account of many children she has had, the
neighbors consider her an authority on baby care. Slovenly home. Dry privy in
yard. Father a stable hand.
MOTHERS WHO HAD STILLBORN CHILDREN IN 1911.

Mother aged 23 years; 2 live births and 1 stillbirth in 4 years. Stillbirth followed
a fall down cellar steps while carrying coal when 6 months pregnant; 2 children alive
at time of agent’s visit. Father works in coal mine.
Mother aged 24 years; 3 pregnancies in 5 years, 2 live births and 1 stillbirth, which
physician said was due to excessive work on sewing machine during pregnancy. Both
live-bom children alive at time of agent’s visit. Father a steel-mill hand. Good
home.
Mother aged 30 years; no live births; 2 miscarriages and 1 stillbirth from August, 1910,
to November, 1911; periods of gestation 5, 4, and 6 months, respectively. Cause of
losses unknown. When 21 years old had operation for prolapsis. Always tired and
weak during pregnancies. Father a steel-mill worker. Home good.
Mother aged 39 years; 9 pregnancies in 19 years; 5 live births; 2 stillbirths; 2 miscar­
riages reported. Gives overwork and worry as cause of miscarriages and 1 stillbirth
and a fall as cause in the other stillbirth; 4 children alive at time of agent’s visit.
Father laborer in steel mill. Home good.
Mother aged 27 years; 3 pregnancies in 8 years; 2 live births (in 1903 and 1905)
and 1 stillbirth (in 1911); 2 children alive at time of agent’s visit. In 1908 had fall
which caused internal misplacements; never had treatment for same; during 1911
pregnancy had convulsions from uremic poisoning. She has kidney trouble. Fair
living conditions. Father a mill hand.
Mother aged 30 years; 2 pregnancies in 2 years; no live births. First a miscarriage
after 4$ months’ gestation, said to be due to fall; second, after 7 months’ gestation, attrib­
uted to indigestion. Father a machinist in steel mill. Home clean. Dry privy
and well are in yard.


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in f a n t

M o r t a l i t y : .t o h n s t o w N ,

pa.

85

Mother aged 37 years; 10 pregnancies in 16 years; first, seventh, eighth, and ninth
children were live bom ; the others stillborn. All the live born died, as follows:
Age 3 months, scarlet fever; 2 months, scarlet fever; 6 months, “ boils on stomach” ;
6 weeks, cause unknown. Has no idea of causes of stillbirths; very ignorant. Keeps
boarders. Father a laborer in steel mill.
Mother aged 31 years; 5 pregnancies in 8 years; 4 live bom ; 1 (the last) premature
stillborn from an unknown cause. All the live-bom children died under 6 months
of age, viz, 6 months old, summer complaint; 2 months, summer complaint; 2 weeks,
unknown cause, but was half black and had sores on stomach; 1 day old, cause
unknown. Keeps boarders. Home bad. Father a laborer in steel mill.
Mother aged 28 years; 5 pregnancies in 3 years; 4 live births, the last a stillbirth;
all live bom died of unknown causes at ages of 10 months, 3 weeks, 2 weeks, and 2
weeks, respectively. First baby bottle fed from birth; could not nurse him on
account of having ‘ ‘neck full of boils. ’ ’ Has had hospital treatment for womb trouble.
Father a steel-mill worker. Insanitary home.
./Mother aged 23 years; 4 pregnancies in 3 years; 1 live birth and 3 stillbirths. The
liv e-b om baby, who died at age of 3 months of unknown cause, had “ scabs on face.”
She is a charwoman, who thinks that “ possibly” she works too hard. While preg­
nant always has fear babies will be born dead. Does not feel good after big day’s
work done during pregnancy. Father a steel-mill hand. Poor home conditions.


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APPENDIX II.

DETAILED DESCRIPTION OF METHOD USED FOR COMPUTING INFANT
MORTALITY RATE FOR THIS REPORT, AND COMPARISON WITH CON­
VENTIONAL METHOD.

In this study the infant mortality rate is obtained by comparing
the number of babies born alive in Johnstown in 1911 with the num­
ber of those same babies who died before they were a year old, omit-v
ting, as was necessary in a detailed study where approximations were
not allowed, those babies whose parents could not be located by the
bureau’s agents. This method gives an exact and absolute infant
mortality rate of 134 per thousand for this limited group of babies.
Obviously, this method can not practically be used to obtain the
infant mortality rate for large groups of population, year by year.
Where there is a constant flow of population, cities, States, or com­
munities can not trace the place of birth of infants dying within their
respective areas or follow each child born within their boundaries
if it moves away. It is impossible to know the life history of each
child born in the area considered in a given year and to determine,
as has been done for this intensive study of a small and definite group,
how many babies per 1,000 live born in a given area actually do die
under 1 year of age.
The established method of obtaining an infant mortality rate is
to compare the live births in a given area during a single calendar
year wdth the infant deaths (that is, deaths of babies under 1 year
of age) occurring during that same year. Of course, the babies
dying in that year are not all born in tne same year nor in that same
area, and of »those born in the given calendar year not all who die
under 12 months of age die in the calendar year of their birth. But
this is the only feasible method as yet discovered for approximating
an infant mortality rate for large areas, and it is sufficiently accurate
for practical and comparative purposes; that is, for approximating
the relative rank of different cities, States, and countries with respect
to infant mortality.
The infant mortality rates of the various States and also of cities of
at least 50,000 population within the régistration area 1 of the United
States for the year 1910 are shown in the following table, taken from
a bulletin of the Federal Census Bureau.2 All the rates in this table
are computed by the established method.
1 The Bureau of the Census designates as the registration area the area comprising States in which the
registration laws are of suitable character and sufficiently well enforced to insure at least approximately
complete (i. e., at least 90 per cent) returns of births and deaths. In addition to such States it includes
certain cities in nonregistration States in which the returns are made with equal effectiveness under local

* Bulletin

109, Mortality Statistics: 1910.


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Government Printing Office, Washington, 1912.

IN FAN T M ORTALITY: JOHNSTOW N, PA.

87

P o p u l a t io n , R e g is t e r e d B ir t h s , D e a t h s of I n f a n t s u n d e r 1 Y e a r o f A g e ,
a n d I n f a n t M o r t a l it y R a t e s f o r R e g i s t r a t i o n
St a t e s a n d R e g is t r a t io n
C i t i e s h a y i n g a P o p u l a t i o n o f a t L e a s t 50,000 i n 1910.

Popula­
tion in
1910.

DEATHS 2 OF
INFANTS UNDER 1
YEAR CF AGE.

Births. 1
Number. Per 1,000
births.8

R E G IST R A T IO N STATES.

Connecticut............................... ................... . ................................
Maine...............................................................................................
Massachusetts.............................................. . . » ............................ .
Michigan..... ......................................................................................
New Hampshire........................................................................... .
Pennsylvania..................................................................................
-Rhode Island........................................................ '.......................
Vermont........................................ ..................................................

1,114,756
742,371
3,366,416
2,810,173
430,572
7,665,111
542,610
355,956

27,291
15,578
86,765
63,566
9,385
202,631
4 6 ,595
7,343

Connecticut:
Bridgeport...............................................................................
Hartford....................................................................................
New Haven........................... ; ......................................... .......
Waterbury...................................................................... ..........

102,054
68,915
133,605
73,141

Washington, D. C..........................................................................
Portland, Me................................................................................... .

331,069
58,571 •

Massachusetts:
Boston................................................................................... .
Brockton..................................................................................
Cambridge................................................................................
Fall River.................................................................................
Holyoke...............................................................................
Lawrence................................................................ .................
Lowell......................................................................... ........... .
Lynn.........................................................................................
New Bedford............................................................................
Somerville,...............................................................................
Springfield...............................................................................
Worcester..................................................................................

3,476
2,108
11,377
7,912
1,373
28,377
791

127
135
131
124
146
140
4 168
168

2,976
2,411
3,772
2,150

367
286
406
320

123
119
108
149

7,016
1,163

1,068
167

152
144

670,585
56,878
104,839
119,295
57,730
85,892
106,294
89,336
96,652
77,236
88,926
145,986

17,760
1,359
2,462
4,591
1,702
3,165
2,630
2,218
3,873
1,728
2,438
3,918

2,246
134
293
854
362
529
607
216
685
174
302
536

126
99
119
186
213
167
231
97
177

Michigan:
Detroit.......................................................................................
Grand Rapids.........................................................................
Saginaw...... ................................... .........................................

465,766
112,571
50,510

11,960
2,693
897

2,138
329
130

179

Manchester, N . H ...........................................................................

70,063

1,939

375

193

New York, N . Y ...........................................................................
Bronx Borough...... ................................ ............................... .
Brooklyn Borough.................................................................
Manhattan Borough......................................................... ......
Queens Borough......................................................................
Richmond Borough................................................................

4,766,883
430,980
1,634,351
2,331,542
284,041
85,969

129,316
10,926
43,128

6,1'59
11,047
5,063
8,900
865
284

125
96
117
135

Pennsylvania:
Allentown.................................................................................
Altoona......................................................................................
Erie...........................................................................................
Harrisburg............................................................................... .
Johnstown.................. .............................................................
Philadelphia.............................................................................
Pittsburgh................................................................................
Reading......................................................... ..........................
Scranton....................................................................................
Wilkes-Barre............................................................................

51,913
52,127
66,525
64,186
55,482
1,549,008
533,905
96,071
129,867
67,105

1,406
1,392
1,713
1,308
1,628
38,666
15,059
2,370
3,512
1,840

202

144
119
115
129
165
138
150
142
148
146

4 1 ,1 1 1

R E G IST R A T IO N CITIES OF 50,000 PO PU LATIO N O R O V E R IN 1910.

Rhode Island:
Pawtucket...............................................................................
Providence..................... .........................................................
1
2
8
8
5

51,622
224,326

6 6 ,1 1 2

7,095
2,055

124
137

122

145

122

138

166
197
169
268
5,334
2,259
336
520
269

(*)
(6)

Provisional figures; exclusive of stillbirths.
Exclusive of stillbirths.
Based on provisional figures for births.
The figures for Rhode Island are exclusive of Providence and Pawtucket.
Returns of births not received from State board in time for inclusion.


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101

191
827

(6)
(*)

88

INFANT M ORTALITY: JOHNSTOW N, PA.

It will be seen by this table that Johnstown is among the 10 cities
of more than 50,000 population which had an infant mortality rate
for 1910 in excess of 150 per 1,000 births. These 10 cities and their
respective rates are as follows: Lowell, Mass., 231; Holyoke, Mass.,
213; Manchester, N. H., 193; Fall River, Mass., 186; Detroit, Mich.,
179; New Bedford, Mass., 177; Lawrence, Mass., 167; Johnstown,
Pa., 165; Washington, D. C., 152; and Pittsburgh, Pa., 150.
It should be borne in mind that the absolute infant mortality rate
of 134, computed for the group of babies included in this investi­
gation, that is, for those born in Johnstown in 1911, can not be com­
pared wifi1 any of the approximate rates in the foregoing table, since
the basis of computation is entirely different. But the method used
in this report seemed to be the only practicable one for our purpose,
namely, to measure the infant mortality rate in different districts m
the city where the babies are subjected to varying conditions.


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APPENDIX III.

THE MILK SUPPLY.
[A study by the Dairy Division, United States Department of Agriculture, May 23 to June 16,1913.
■
Conducted by L. B. Cook, C. E. Clement, and B. J. Davis.]

Between the dates of May 23 and June 16, 1913, the Dairy Divi­
sion, United States Department of Agriculture, made a study and
survey of the milk supply of Johnstown, Pa. This study consisted
of a chemical and bacteriological examination of samples and an
inspection of the sources of supply. The Government score card
was used for all inspection work. This work showed that about
4,000 gallons of milk were consumed daily in the city, or an average
of a little over one-half pint per capita. About two-thirds of this
milk is shipped over the Baltimore & Ohio and the Pennsylvania
Railroads, but by far the most over the Baltimore & Ohio. The
sources of the milk supply may easily be divided into city cow
dairies, farmer milk dealers, dairy farms, city milk plants, and stores.
Each of these will be discussed separately.
CITY COW DAIRIES.

About 150 cows are kept within the city limits. Most of these dairies are owned
by foreigners and consist of two or three cows. The city dairies produced about 150
to 200 gallons of the city ’s milk supply. These dairies are very filthy and the sani­
tary conditions bad. The health of the cows is somewhat questionable, because the
majority are stabled in small stables throughout the year. These stables are so small
and the cows so crowded in that in some stables they have to take turns in lying
down. The stables frequently have no means of ventilation or lighting except one
or two small openings in the sides of the building. Most of the stables were located
near contaminating surroundings, such as manure piles and outside closets.
The food for the cows in many of these dairies was fermented and in a bad condi­
tion, due to its being a wet mixture which was prepared far in advance of feeding.
The utensils were very poor in construction, most of them having open seams and
in a condition impossible to clean properly. The pails were of the common cheap
open type. In nearly all cases city water was used for all purposes.
The cows were not in as bad a condition as they might have been with regard to
cleanliness, although very little bedding was used, but the manure as a rule was not
left standing in the stable, which accounts partly for the condition of the cows.
The uncleanliness of the stable was marked, and usually no credit was given under
this heading. Very few whitewashed stables were found, while cobwebs, dirt, and
dust abounded nearly everywhere.
The manure was removed to a box or pile near the stable. Some of these boxes
were covered, but many were not.
These city dairies had no milk houses. As soon as the milk was milked it was
taken to the house, strained, and delivered to the customers, who were usually the
neighbors.
The milk utensils were often found dirty and being used for many other purposes.
It is very doubtful if many of these milk pails are ever thoroughly scalded. After
being washed they were kept almost any place, but were seldom put in a good place
free from contaminating surroundings.
The milking was usually done b y the women, who wore very dirty clothes and often
milked with wet and filthy hands.' No pretense was made to clean the cows or
use a damp cloth.


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89

90

INFANT M ORTALITY: JOHNSTOW N, PA.

The milk was not cooled, but sold while warm at 8 cents per quart. Most of the
consumers who bought this milk had no ice or refrigerators, therefore i t remained
warm for some time or until consumed. Sometimes the milk was placed in earthen
jars and set on the cellar bottom, but as a rule no effort was made at cooling. The
milk was sold twice a day.
. .
. . . _
The average score for the 48 city dairies visited was 26.34 points. The highest was
43.50 and the lowest 16.75— 12 scored below 20, 23 between 20 and 30, and 12 in the
thirties, with 1 above 40.
PARMER MILK DEALERS.

B y farmer milk dealers is meant those farmers who retail their own m ilk and pos
sibly bu y a little from other farms. There are about 26 such dealers in the city and
they handle about 1,000 gallons of the city ’s m ilk supply. Some of these dairies
were the source of the city ’s best milk. The average score of these dairies was 39.43.
Most of this m ilk is hauled from 3 to 5 miles to the city, then peddled upon the
street. These dealers bottle very little milk, and most of it is drawn from a faucet.
They use covered wagons and some peddle garden truck— like flowers, onions, etc.—
on the same wagon.
,,
. , ,
.
, ,
.
. ■£
The cows, as a rule, seemed to be in good health, but very few had ever been tuber­
culin tested. The bams were of the sort typical of that section of the country, with
a stone wall on one side and an overhanging shed on the other, which meant that the
stables were dark, as light could only enter at the ends. The basement was used
for all the farm animals, as horses, pigs, cows, chickens, etc., and the cow stable was
not separated from the rest. The general construction was only fair. A few cement
floors, tightw alls, ceilings, etc., were found.
The ventilation was poor and conditions as to the cleanliness oi the stable very
bad. In many of the stables at this time of the year the manure was not removed
daily and oftentimes it was piled near the stable. In general the cows could be
well rated as to cleanliness, as they were outdoors both day and night.
A t some of these farms milk houses were found, but many used the cellar of the
house for handling and cooling the milk. These m ilk rooms were often used for the
storage of other things and were not as clean as they should be. Some strained the
milk at the stable, but many removed it to the m ilk room for straining.
Many of the utensils were of poor construction and were not thoroughly washed.
The m ilk dealers usually scalded the pails and had a place to keep them after being
washed. No covered pails or special milking suits were found and only one milk
cooler Most of the milkers m ilk with a dry hand, but do not clean the cows or use
a damp cloth. Most of these farms had excellent water facilities, having running
water at a temperature of from 50° to 55° F. This was used for washing utensils
and cooling the milk.
;
, ,
., , .
The cooling was done b y setting the 5-gallon cans in a trough of running water, but
oftentimes the milk was not stirred, therefore the cooling was delayed; Some of
these dairymen used ice on the farms and on the wagons.
The lowest score of these farmer m ilk dealers was 22.40 and the highest was 53.50.
There were 4 farms scoring in the twenties, 8 in the thirties, 13 in the forties, and 1
above 50. .
DAIRY FARMS.

Under this heading is meant the farms that ship or draw milk to the dealers. Some
of these farms sold cream in the summer and m ilk in the winter. Two hundred and
twenty-one of such farms were visited and their average score was 36.06, which was
a little lower than the farmer dealer. Some of these farms were fairly good, but
most of them were poor in their facilities and methods of handling milk. In gen­
eral these farms were like the farm dealers, but many were much worse. Very few
had’ any milk houses, but handled the milk in the cellar or set the cans in some
trough of running water. These farmers oftentimes had to carry their m ilk several
miles over very bad roads to the railroad station where it was shipped to Johnstown.
Very few covered pails or m ilk coolers were being used.
The lowest score for these farms was 22.50, while the highest was 70.6. Of these
farms 52.9 per cent scored between 30 and 40.
_
T ransportation .—Most of this m ilk was shipped over the Baltimore & Ohio Rail­
road from points between Somerset, Pa., and Johnstown. The m ilk was placed on
the uncovered platform at the receiving station, then placed in baggage cars for trans­
portation. No refrigerator cars were used. The total railroad haul on this line is
about 40 miles. When the m ilk reaches Johnstown it is at a temperature of about
65° F., depending on the outside temperature. It is then unloaded onto an uncov­
ered platform, and if the dealer does not take it away at once it is left in the sun to


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INFANT Mortality : joh Nst6WN, Fa .

91

get still warmer. One day after taking temperatures on arrival of the train,- the in­
spectors returned in one and one-half hours and found about one-half of the milk still
in the sun and the temperature of the m ilk was then about 15° warmer, or at a tem­
perature of about 85° to 90° F.
Some of the m ilk shipped over the Pennsylvania Railroad comes a longer distance,
but no refrigerator cars are used for the Johnstown supply and about the same con­
ditions exist.
CITY MILE PLANTS.

There are about 15 city m ilk dealers. These dealers have their milk shipped in
or hauled on wagons. The two large dealers in Johnstown handle about one-half of
the city ’s m ilk supply.
The small dealers have no milk plant, as they take the m ilk as delivered from the
farm and peddle it direct. Most of them have a refrigerator for storage of any milk
left over. They bottle very little, and a few use ice.
The two large milk companies pasteurize and bottle all of their retail trade. One of
these dairies has four creameries outside of Johnstown from which it draws some of its
/u p p ly when needed. These plants are located at Indiana, Martinsburg, Woodbury,
and New Enterprise, Pa. These plants do a considerable cream and ice cream busi­
ness; some of them also pasteurize the milk before it is shipped to Johnstown, where it
may be repasteurized and is bottled.
The sanitary conditions in these plants were found to be poor and no ice was used
on the wagons. Apparently, from the bacterial results, the pasteurizing did very
little, if any, good. The flash method was used at a temperature of about 165° F.,
and after pasteurizing the milk was exposed to much contamination.
The average score of all of these plants was 39.37. Some of the plants received a
higher score than they really deserved, because they had no real plant but only a
refrigerator and a place to wash the utensils, the milk not being brought to the plant.
The milk cans as returned to the farmer were in a very bad condition, as these
plants do not properly wash them. Some of them rinse the cans, while others do not
even do that; consequently when the farmer receives the cans they have sour milk in
them and very bad odors. W ith a farmer’s lim ited means at hand it is nearly impos­
sible to get these cans in proper condition to again ship sweet milk in them.
One creamery at Friedens, Pa., ships about 100 gallons of milk direct to some of the
small city dealers and stores.
STORES HANDLING MILK.

A great many of the stores sell milk. Some of these buy bottled milk, while others
buy direct from the farmer and sell dipped or faucet milk. Most of this milk is
sold as an accommodation to customers. Many of these stores have ice boxes or refrig­
erators to keep the milk cold. However, some of the stores have no facilities for keep­
ing the milk at a low temperature and the cans or bottles are allowed to sit on the floor
until all the m ilk is sold. These stores do not wash the cans or bottles. Much of this
store milk is open to considerable contamination from dust, dirt, and flies.
The average score of the stores handling bulk milk was 46.11. The highest was
72.75, and the lowest 12.30.
BACTERIOLOGICAL AND CHEMICAL RESULTS.

Samples for this work were taken at as many sources as possible. The samples taken
at the city cow dairies gave a low bacteria count, due to the sample being taken imme­
diately after milking. In all, 163 samples of milk were examined, 115 being from
producers and 48 from dealers. The maximum bacteria count was 319 million per
cubic centimeter, and the minimum count was 3,650 bacteria per cubic centimeter.
This sample was taken from one of the city cow dairies and it was fresh milk direct
from the cow.
The average count of all samples was 1,699,587 bacteria per cubic centimeter. Two
samples were sour when taken at the railroad station.
7 samples, or 4.2 per cent, were under 50,000 bacteria per cubic centimeter.
6
samples, or 3.6 per cent, were between 50,000 and 100,000 bacteria per cubic centi­
meter.
31 samples, or 19 per cent, were between 100,000 and 500,000 bacteria per cubic centi­
meter.
22 samples, or 13.5 per cent, were between 500,000 and 1,000,000 bacteria per cu b ic
centimeter.


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92

IK FAK T M ORTALITY: JOHNSTOW N,

PA.

45 samples, or 27.6 per cent, were between 1,000,000 and 10,000,000 bacteria per
cubic centimeter.
44 samples, or 27 per cent, were between 10,000,000 and 50,000,000 bacteria per cubic
centimeter.
8 samples, or 4.9 per cent, were over 50,000,000 bacteria per cubic centimeter.
This table shows that 59.5 per cent of the samples contained over 1,000,000 bacteria
per cubic centimeter.
The fat was only determined on 161 samples, and the average per cent was found to
be 3.58. The minimum per cent was 1.2 and the mavimirm 5.
14 samples, or 8.7 per cent, contained below 3 per cent fat.
108 samples, or 66.1 per cent, contained between 3 and 4 per cent fat.
39 samples, or 25.1 per cent, contained 4 per cent fat or above.
The total solids was determined on 93 samples with an average of 11.68.
GENERAL SUMMARY.

The bacterial results and the inspection work show that the milk sold in JohnstovVn,
Pa., is very poor. The scores are low and most of the milk has a bacteria count in
the millions. This is easily explained b y the fact that the city does no milk in­
spection work, therefore the general methods and ideas in use do not tend for clean
milk. The general idea is that if milk is not sour it must be all right; then where
the milk is pasteurized no particular pains are taken with its care. Our results show
that pasteurizing did very little if any good. On the farms and in the city no par­
ticular methods or care are used to keep the bacteria count low.
. 1. There are 48 dairies in the city with an average score of only 26.84 out of a pos­
sible 100. On the whole, the, city dairies were vile from a sanitary standpoint.
While the bacteria counts taken on this milk were fairly low it must be remembered
that milk produced at these places is delivered warm to the consumer; this milk
is sold in the poorer sections, where there is usually no way to keep it cold until it
is tlsed, so that before it is finally consumed the bacteria count is probably extremely
high.
2. The dairymen who operated farms and sold the milk from their own farms were
in average condition for uninspected dairies. Their average score was 39.43 out of a
possible 100.
3. Transportation facilities are very crude and there is an entire lack of care in
handling the milk from the farm to the city.
4. The facilities for handling the milk in the city are very poor; many dealers
have ho equipment or means of refrigerating the milk or handling it properly. The
average score of the city dairies was 39.37 out of a possible 100. There were only
two plants inspected which were in fairly presentable condition. Pasteurization as
carried on at the present time in Johnstown is a farce. This is shown b y the fact
that 52 farmers shipping milk to one of the dairies averaged 1,419,961 bacteria
per cubic centimeter when the milk arrived at Johnstown, while samples taken from
the milk supply handled b y this dairy showed an average count of 18,337,500 bacteria
per cubic centimeter, indicating that the milk was much worse after it had been
pasteurized” than it was before. Another large dairy did a little better, but the
results obtained there showed a very incomplete pasteurizing process. Twenty-eight
dairymen supplying milk to the latter dairy averaged 30,410,071 bacteria per cubic
centimeter when the milk arrived at Johnstown, while the finished product as put
out b y the dairy averaged 3,150,083-bacteria per cubic centimeter.
5. A large amount of dipped milk is sold both from the wagons and from stores in
Johnstown at the present time. Such a practice is at best insanitary, but carried on
as it is in Johnstown it is a positive menace.
6. Bacteria counts showed that the milk averaged 1,699,587 and that 59.5 per cent
of the samples showed over a million bacteria per cubic centimeter.
7. Aside from the bacteriological condition of the milk it was found to be in many
cases lacking in the required food elements. Of 44 samples taken from milk dealers
29.5 per cent were found to be below the State standard for butter fat, while of 118
samples taken from producers, 22.9 per cent were found to be below the State standard
for butter fat.


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93

IN F A N T M O RTALITY: JO H N STO W N , PA.
R

esults

op th e

I n s p e c t io n W

D one

ork

City
cow
dairies.

Score.

0to 10
. ................................................................
10to 20....................................................................... .........
20 to 30
.................... ........................ .........................
20

to 4 0

12
12
1

23

.........................................................................................

40 to 50...................... .......................................... ................
50 to 60..............................................- ..................................
60

to 7 0

¿0to 9 0
90

to

100

in

Jo h n s t o w n , P a .

Farm
milk
dealers.

Dairy
farms.

City
milk
plants.

1
4

8
13

1

...........................................................................

43
117
55
3

4
4

2

1
2

Stores.

2
1

4

1

...........................................................................
.................................................................

Total1.........................................................................

48

26

Average score.......................................................................

26.34

39.43


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11

221
36.06

39.37

i In all, 314.

o

\

8
46.11


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Infant Mortality: Johnstown, Pa., 1913.

PLATE A

OPEN D ITC H

ALONG W OODVALE AVENUE, W H IC H
HOUSE DRAINAGE.

RECEIVES ALL K IN D S OF

This ditch Is cleaned out by heavy rains, but within a few days becomes offensive again.
important street in Woodvale is unpaved and without sidewalks.

PLATE B

This

Infant Mortality: Johnstown, Pa., 1913.

V IE W OF AN OPEN D ITC H ON PLUM STREET, W H IC H
AGE OF ALL K IN D S.

RECEIVES HOUSE D R A IN ­

This waste flows along for a distance of about an eighth of a mile before emptying intothe
sewer. Ducks and geese are frequently seen in the ditch. Children wade here.


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Infant Mortality: Johnstown, Pa., 1913.

PLATE C

AN O TH ER V IE W OF PLUM STREET.
Open sewer ditch, a convenient dumping place for empty beer kegs, etc.

Infant Mortality: Johnstown, Pa., 1913.

PLATE D


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SIX TH STREET, OFF MAPLE AVENUE.
One type of tenement.

Littered street.

PLATE E

Infant Mortality: Johnstown, Pa., 1913.

AN OPEN D ITC H ALONG NEW STREET, PROSPECT.
Private pipes into this ditch are numerous. Here the waste flows along until it enters a sewer
at the right of the fence near the center of the background.

PLATE F

Infant Mortality: Johnstown, Pa., 1913.

LOWER PART OF BRADLEY ALLEY, W H IC H RUNS A LM OST
T H E E N TIR E LENGTH OF CAMBRIA CITY.
Main orfront entrancesto abuttinghousesshown.
19 feet 10 inches.


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Unpaved. Width,

PLATE G

Infant Mortality: -Johnstown, Pa., 1913.

UPPER END OF BRADLEY ALLEY, CAM BRIA C ITY.
(See preceding picture.)

PLATE H

Infant Mortality: Johnstown, Pa., 1913.

A FRONT YARD ON CONNELLY AVENUE, M INER SVILLE.


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PLATE I

Infant Mortality: Johnstown, Pa., 1913.

A VIE W OF KELLEY ALLEY OR GARVEY PLACE IN M IN E R S V IL LE .
Houses to the left of the'picture are of flimsy construction.
flows into the street.

PLATE J

Drainage from the large house

Infant Mortality: Johnstown, Pa., 1913.

ONE OF SEVERAL LITTL E ALLEYS OF CONEM A U G H
BOROUGH LEADING DOW N T H E H IL L FROM HUBER
STREET.

Waste water from the houses not absorbed by the soil trickles down
the depression noted in the center.


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PLATE K

Infant Mortality: Johnstown, Pa., 1913.

H O R R IC K STREET, CO N EM A U G H BOROUGH, NEAR C ITY L IM IT S ;
BOARDED W ALK OVER A NATURAL BROOK.

LOOSELY

The brook has a considerable fall and carries off with fair rapidity the house sewage it receives.

PLATE L

Infant Mortality: Johnstown, Pa., 1913.

AN ASH AND RUBBISH HEAP BELOW PEELORVILLE, LO O K IN G UP FROM T H E
PENNSYLVANIA DEPOT.


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Company houses shown in the picture.

PLATE M

T H E CO N EM A U G H

Infant Mortality: Johnstown, Pa., 1913.

RIVER, TAK EN FROM W ALN U T STREET B RIDGE
T H E PEN NSYLVANIA RAILROAD DEPOT.

NEAR

Because of the low stage of water usual in the warm months, sewage is exposed on the
stones and rocks.

PLATE N

Infant Mortality: Johnstown, Pa., 1913.

V IE W OF STONY CREEK, LO O K IN G WEST, TAK EN FROM FR A N K LIN STREET
BRIDGE.
Discharge of sewage through some of the outlets In the wall trickles down the wall for
a distance of perhaps 6 feet before reaching the water. At low stage of the river the
deposits on the stones below become very offensive.


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PLATE O

Infant Mortality: Johnstown, Pa., 1913.

T H E C O N EM A U G H RIVER.
View from foot of bridge at end of Johns Street, just above the point where the Conemaugh
and Stony Creek meet. The sewer drainage settles in the ditch alongside the retaining
wall for perhaps 150 feet before reaching the sluggish current of the river itself. When
the ditch becomes clogged it is dugout, and the contents thrown on the dry bed between
the ditch and the river must remain there until washed into the middle of the stream
by high water.

PLATE P

Infant Mortality: Johnstown, Pa., 1913.

A CLOSER V IE W OF T H E D ISCHARGE FROM A SEWER O U TLET SET IN T H E
R E TA IN IN G W ALL ALONG STONY CREEK.
Taken at extreme east end of the Haynes Street footbridge, where odors from the stream
are especially offensive. Note that the sewage does not enter the water directly but in a
way liable to promote nuisance.


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PLATE Q

T E N -F A M IL Y

Infant Mortality: Johnstown, Pa., 1913.

T E N E M E N T , PLUM STREET, W OODVALE.
O P PO SITE FRONT DOORS.

PLATE R

OUTDOOR TO ILE TS

Infant Mortality: Johnstown, Pa., 1913.

A CLOSER V IE W OF T H E SAME PLUM STREET, W OODVALE, TE N E M E N T S AND
TO ILE TS .
The steep hill toward the back leads to Woodvale Avenue.


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