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U. S. DEPARTMENT OF LABOR JAMES J. DAVIS, Secretary CHILDREN’S BUREAU GRACE ABBOTT, Chie! INFANT M O RTALITY RESULTS OF A FIELD STUDY IN BALTIMORE, MD. BASED ON BIRTHS IN ONE YEAR By ANNA ROCHESTER « Bureau Publication N o . 119 WASHINGTON GOVERNMENT PRINTING OFFICE 1923 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis OWING TO LIMITED APPBOPEIATIONS FOB FEINTING, IT IS NOT POSSIBLE TO DISTBIBUTE THIS BULLETIN IN LABGE QUANTITIES. ADDITIONAL COPIES MAY BE PEOCUBED FEOM THE SUPEBINTENDENT OF DOCUMENTS GOVEENMENT PBINTING OFFICE WASHINGTON, D . C. AT 40 CENTS P E R COPY https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 3 ( * z , r] <% \ \ ^ CONTENTS. Page. Letter of transmittal.................................. . . . Introduction................................................. . Method and purpose of the study..................................... The babies’ surroundings.. . ______ . ______ Baltimore................ .............................................. Mothers’ color and nationality....... ................................ Foreign-bom white families............... .. _ . . . *l .* ___ _ Colored families................... .......................... M ___ 17 . . . . 19-21 .... 20 ----- 23-56 .... 23 . . . . 28-34 .... 28 32 Social questions arising from differences in color and nationality" 33 Fathers’ earnings and occupations............ .................... . . . . 34-42 Fathom’ earnings and fam ily incom e.......... ................... .... .35 Fathers’ occupations........... ................. . . . . ___ 36 Irregularity of fathers’ em ploym ent.... . . . . . . . ______ 39 Home conditions............................................ ,...4 2 -4 7 Rental and sanitation.......................... ............... .. .... 42 Space and size of household........................ ’ ____ _ -----45 Variations in size of fam ily................................. 46 |; ' Employment of mothers......................... .; ____. . . . . 47-53 ! f. Prevalence of em ploym ent................ ............. .... 48 Occupations.......... ............................................... ... 50 Care of the infant........................................ . . . . 53-54 Prevalence of artificial feeding...................................* 53 pi Sum m ary.. .................. . ........................ 54 The deaths.................. .......................................................... . . . 57-68 Age at death............................. ..................... ................ 58 Causes of death.......................................... ....................... . . . 59-67 Early infancy and malformations............................. 59 Gastric and intestinal diseases.................................... || 61 Respiratory diseases............................................. 63 Other communicable diseases........ ............ ......... ............ 64 Other cau ses................................................................. 66 Summary................. ................ .................................... 67 Feeding and infant m ortality............................................. 69 Social and economic factors in infant mortality............. .. 77-132 Nationality and mortality........... .................. . . . 77-93 Nationality and cause of death....................... ..... 78 Social factors in the variation of rates b y n ationality.......... ........... . . . 79-93 Native white and colored families................................... 80 Native white and foreign-born white fam ilies.. . . ...... ............... 85 Polish and foreign-bom Jewish fam ilies...................................* .. 88 Summary...... .... .................................................. ... ....... 93 Li Poverty and infant mortality..................... ................. ........... . 94-106 Fathers’ earnings and mortality rates............. ................. a J 94 Type of feeding and mortality in the several earnings grou ps.. . . . 97 Living conditions affecting mortality in the poorer fam ilies.. . . . . . . . 100 Poverty as a direct factor in infant mortality............ ... .......... .. 104 Sum m ary..... ............................... 105 3 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 4 CONTENTS. Social and econom ic factors in infant mortality— Continued. Page. Neighborhoods, dwellings, and infant mortality............................................ 106-114 Wards................................................ ........................................ - - ................... 106 Dwellings................................................................................................ ....... 111-114 Room congestion.. . . . . . . . . . . . . - . . . . - ................................... ....... ........... 1** Sanitary equipment............................................. %------ - - - - — - - - - - - IP Summary.......................- ..................... ........... -'......... .............. 114 Employment of mothers and infant mortality............ .- - ........ ............ - - - • 114-181 Employment during pregnancy of 1915................................................ . 115 Employment of mothers after birth occurring in 1915............................ 120 127 Employment away from home at any tim e. .....................‘ . . . rt f 10A Summary........................ ......... - ......... - - - - - . - - - - - ------- - - .................... xou Relation of infant mortality to the mother’s illiteracy or inability to speak English........... ........................- ......... ..........................- - ..................... ....... ....... 1^1 Physical factors in infant m orta lity..... . . . . . . . . . . . . . . ................................ . . . 133-152 Order of birth, age of mother, and interval between b irth s ......... ............. 133-146 Order of birth............. - - ............... - ...........................- ------- . . . . i . . . . ------133 Age of m oth er....'..... ........... ........... ....... ..................... .................... - ......... Interval between births...................................... 139 Summary.......................- .......... - - - - - - •- - - •— - * 145 Plural births................... ............. . - - - ....................................... ............................. Sex of infant.................................................................................................. . . . . . |pi§ Maternal deaths.......................................... - - - - - - - . . . - - - - - ............... - - - . . . . . . P® Stillbirths............................................... •............................................................... 153 Illegitimate births........... .............. - ...............................- - - ............. - - - - - - - - - - - - - 155-IM The mothers................. 155-Hw Color and nativity................... ............ .. II - . . . . . . . . . . . . . . . . . . . . . . . . — 1*P> Em ploym ent..........................................i . :.i . . 1«P Age. ......................... - .............................- - - - ......... -----------------------------------Civil condition at confinement— .......... .................. - - - - - - - - ........... - 157 Previous births — ......................W& - - -. . . - 157 Literacy.................................................- - - - - - - - - - - - - ............................ 158 The fathers............................... - - - ...............- - - - - - - - * - - - - - - - - - - - - - ------158 The births......................... .................... - ------- ------------------------ ------ - - -1»- -■• 159-160 Place of confinement and attendant at birth ..----- : . . ----- - - - — - - - - 159 Prenatal care.......................... - .......................- - - - - - - - - .................. ........ 159 Conditions during year after b i r t h . . . . ----- . . . . ------ -: 1- - - - - ............. - - - - 160-167 Relation of mothers and fathers - . . . . . . . . . . . . —. . A ................ ......... ... 160 Where the mothers liv ed ........... .............. ............ .......... - - - : ............ - - 161 Civil condition of mother at one year after confinement............... ......... 162 Maternal deaths............... ; . - ................... - ......... ............................ . - 1........ 164 Economic status of the mothers. r. .............. ............ .............................. . . . 164 Where the babies lived ...... .................... - - ........... ........................... ............. Mf> Summary of social background....................... ........ ............................................ i®7 Mortality among illegitimate infants.. . . . . . . . ----- . . . ........ ............. 168-175 White and colored infants......... .......................................... -; SB9* - - - - - W® Age at death and stated cause of death.......... ................... . - - - ........ 170 Employment of mother........... ................................ .— e»0 P ov erty .. . — ........ — —. . . . . . . t . . . . . . . . - *............ . 171 Conditions peculiar to illegitim acy............................... ...................... - - - 171 Infant feed in g ................ - — - ........... - - - - - ......... ........................ - - ............. 174 Stillbirths and miscarriages.. . . . . . . . . . ...... ........................ ....... . - J- - - - ------1*° General summary..................................................... ........................................................ *H| https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CONTENTS. 5 Page. Appendix I. Birth registration in B altim ore.. . . ___ . . . . . . ....... ..................... 185 Appendix II. The babies in families which could not b ^ ^ U d ied ...................... 189 ‘ Appendix I II. Infant mortality and stillbirth rates in this study and in Balti more City as a w hole............ ............................................................. ................... ..... 193 Appendix IV . Method b y which median earnings and median rentals are esti mated from data available in the present study....... ........................ .......... ...... 197 Appendix V. Method b y which infant mortality rate is computed for infants having a specified type of feeding; explanation of terms “ expected deaths” and “ expected rates” ............. ........... ........ ....... ............................................... 199-202 Computed rate by type of feeding..................... . . ................. .................... . 199 201 Expected deaths. .................. .............. ........... ......................................... . Appendix V I. Prevalence of prenatal care and extent to which the infants in the study were reached b y inf ant-welfare work............. .......................................... . 203-222 Organizations giving prenatal care................• . .. . .................. ................. . 203 Prevalence of prenatal care____ ________________ _______ __________A 204 Prenatal care and poverty..................... ................... ......... % .......................... 205 Prenatal care and color and n a tio n a lity ................. ......... ...................... 206 208 Prenatal care and wards...... ........... ........................... ............. ............... Grade of prenatal c a r e . . . . . ........ ................................ ......... ........................ 208 Confinement c a r e ......................... .......... ....... ........... ...................... ......... . 211-217 Hospital facilities..................................................................... . 211 Attendant at birth..................... ............ ..................... ..................... 211 Visits b y attendant during confinement p eriod ......................... ........ ..... 213 Nursing care....... ....................... .................................................. 213 Infant-welfare w o r k . . . . . ^...... ................ .............. .................. ......... . . . . 218-222 Organizations doing infant-welfare w o r k . . . . . . . . . . . . . . . ............................ 218 Infants reached b y infant-welfare work......................... . . . . . . . . . . . . . . 219 Appendix V II. Tables.............______ _____________ ________ __________ . .... 223-391 TABLES. Table 1. Infant mortality rates in the United States birth-registration area, in certain foreign countries, in Baltimore and certain foreign cities, and in cities (population 100,000 or more) in the United States birth-registration area, 1916. Table 2. Legitimacy of birth, inclusion in and exclusion from, and reason for exclusion from detailed study; total registered births in Baltimore in 1 9 1 5 .... Table 3. Ward of residence, b y color and nationality of mother; scheduled legitimate liv e births in Baltimore in 1915........................... .................. 1 . . . . . . Table 4. Sanitary condition of dwelling, b y ward of residence; infants bom in 1915 who lived at least two weeks in dwellings stu d ied .. _....... ................. . Table 5. Earnings of father, b y ward of residence and color of mother; live births in 1915............................................................. .................................................. Table 6. Monthly rental, b y ward of residence; infants bom in 1915 who lived at least two weeks in rented dwellings studied ........... ................................... . Table 7. Tenure of dwelling, b y ward of residence; infants bom in 1915 who lived at least two weeks in dwellings stu d ied..................................... ................ Table 8. Tenure of dwelling, b y color and nationality of mother; infants bom in 1915 who lived at least two weeks in dwellings studied................ ........ .. Table 9. Tenure of dwelling, b y earnings of father; infants b om in 1915 who lived at least two weeks in dwellings studied........ ......... .............................. Table 10. Dwellings in building; infants b om in 1915 who lived at least two weeks in dwellings studied......................................... . Table 11. Color, nativity, and mother tongue of population in Baltimore and ; in Continental United States, 1910............... ....... . . . ________ . . . . ______: . . . . https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 223 223 224 224 226 228 229 229 230 230 230 6 CONTENTS. Page. Table 12. Years of residence of mother in the United States, b y nationality of mother; births in 1915 t^B reign-born white m others----- - — — - .............. Table 13. A b ility to speak English, b y literacy and nationality of mother; births in 1915 to foreign-born white mothers of non-English-speaking nationalties................. ...........................- - ---------- v- - - - - - - ............. .......... ................. . ••-1 Table 14. A b ility to speak English, b y years in the United States and nation ality of mother; births in 1915 to foreign-born white mothers of non-Englishspeaking nationalities.............................................................- - *........ ......... .. Table 15. Literacy of mother, b y color and nationality of mother and earnings of father; births in 1915......................... .— ...................... ............... ........ . . . . . . . . Table 16. A b ility of mother to speak English, b y earnings of father and nation ality of mother; births in 1915 to foreign-bom white mothers of non-EnglishJ . speaking nationalities................................ - ................................ ............................... Table 17. Occupation group of father, b y color and nativity of mother; births in 1915.......................................................................... ....................................- ........... Table 18. Infant mortality and stillbirth rates, b y earnings of father, and color and nationality of mother; births in 1915 — <i............................................. .. Table 19. Earnings of father, b y occupation; births in 1915........... ............ . Table 20. Earnings of father, b y occupation group of father and color and nativity of mother; births in 1915................................................................. Table 21. Estimated median earnings of father, b y occupation group of father and color and nativity of mother; births in 1915........ - ............. — - ........... ......... Table 22. Earnings of father, b y regularity of his employment, and b y color and nativity of mother; births in 1915...............- ............................................................ Table 23. Duration of nonemployment, b y earnings of father, and by color and nativity of mother; births in 1915......................... .. - .................... - ..................... Table 24. Cause of nonemployment of father, b y color and nativity of mother; births in 1915.................................... ............................................... - - - ......... - ......... Table 25. Duration of unemployment of father, b y color and nativity of mother; births in 1915 in families with fathers unemployed because work was not available........ . - . ......... - . . . . . . . . . - - ........... v- i ■■y----- y........................ Table 26. Source of fam ily ineome, b y earnings of father; births in 1915.............. Table 27. Source of family income, b y fam ily earnings; births in 1915.............. -Table 28. Earnings of father as sole source of family income, b y amount of his earnings and color and nativity of mother; births in 1915.......... ...................... Table 29. Fam ily earnings, b y earnings of father; births in 1915. — ............ — Table 30. Earnings of mother, b y color and nativity; births in 1915 to mothers employed within year after birth of infant..............................- ............. .. Table 31. Monthly rental, b y color and nationality of mother; infants born in 1915 who lived at least two weeks in rented dwellings studied----- ------- Table 32. Monthly rental, b y earnings of father; infants born in 1915 who lived at least two weeks in rented dwellings studied................................ ......... ........... Table 33. Estimated median rental, b y estimated median earnings of father and b y color and nationality of mother; births in 1915.............. ................ . . . . . . . Table 34. Sanitary arrangements of dwelling, b y color and nationality of mother and earnings of father; infants born in 1915 who lived at least two weeks in dwellings studied........................... - ......... ...............................................................Table 35. Number of persons in household, b y number of rooms in dwelling, and b y color and nativity of mother; infants born in 1915 who lived at least two weeks in dwellings studied....... ............ ............................................. - -----* Table 36. Average number of persons per room, b y size of household and color and nationality of mother; infants born in 1915 who lived at least two weeks in dwellings studied........................................................... ..............................' ■ " * https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 23£J(v ¿oa 232 oqo 233 234 236 238 .^ ^ 242 243 243 245 ^ -Jjjj 246 CONTENTS. 7 Page. Table 37. Average number of persons per room, b y earnings of father and color and nativity of mother; infants bom in 1915 who lived'at least two weeks in dwellings studied.................................................... .................................................. Table 38. Total number of births to mother, b y earnings of father and color and nativity of mother; single births in 1915.......... ..................................................... Table 39. Total number of births to mother, b y nationality of mother; births in 1915 to foreign-bom white mothers..................... ...................... ........ .............. Table 40. Keeping of lodgers, b y color and nationality of mother; infants born in 1915 who lived at least two weeks in dwellings studied................................. Table 41. Mother pregnant within year after birth of infant, b y color and nationality of mother; live births in 1915.............. .................... ................ ......... Table 42. Type of feeding, b y month of life, and by earnings of father and color and nativity of mother; infants bom in 1915 to native white and colored mothers not employed within year after birth............................................... .. Table 43. Type of feeding, b y month of life of infant, ana b y literacy and color and nativity of mother; infants born in 1915....................... ................................. Table 44. Prevalence of artificial feeding, b y month of life of infant, and b y ability of mother to speak English and nationality of mother; infants bom in 1915 to Jewish, Polish, and Italian mothers.......................... ..................... . Table 45. Prevalence of artificial feeding, b y month of life of infant, and by literacy and nationality of mother; infants bom in 1915 to Jewish, Polish, and Italian m oth ers.................................................................... . . . ........... ............ Table 46. „Prevalence of mixed feeding and artificial feeding, b y month of life of infant, and b y place of employment and color and nationality of mother; infants bom in 1915 to mothers employed within year after birth___ ________ Table 47. Infant deaths per 1,000 live births, b y cause of death and age; legiti mate live births in 1915, Baltimore study, and total registered live births in 1915 in cities of 10,000 or more population in United States birth-registra tion area.............. ...................................................... ......... .......................................... Table 48. Infant deaths, b y cause of death, with reference to classification num bers in International List of Causes of Death; deaths among legitimate live births in 1915, Baltimore study, and total deaths in United States death-regis tration area in 1915............... ....... »j— ......... .................... ............................... Table 49. Infant mortality rates, b y cause of death, and b y color and nativity of mother; live births in 1915................................................................................... Table 50. Infant deaths, b y cause of death and month of life; live births in 1915......... ........................ ...................... . . . . . . ............. .. Table 51. Infant deaths, b y age at death, and b y color and nationality of mother; live births in 1915........................................ ................. ............................... Table 521 Infant deaths, b y calendar month of death and cause; live births in 1 9 1 5 . . . . . . . . . . . . . . . ........ ...................................... .. ........................................m Table 53. Infant mortality rates, b y calendar month of birth and cause of death; live births in 1915....... ............................................................................... . Table 54. Infant deaths from gastric and intestinal diseases per 1,000 live births, b y age at death; Baltimore City, 1915 and 1916, cities of birth-registration area, 1915, and legitimate group in Baltimore study.................................. ......... Table 55. Infant deaths from diarrhea and enteritis per 1,000 live births, by age at death; England and Wales, 1891 to 1917.................... ............................... Table 56. Mean temperature and precipitation, by calendar month; Baltimore, 1915 and 1 9 1 6 ............ ............ ...................... .............................. ..................... . Table 57. Infant deaths from epidemic and communicable diseases per 1,000 live births, b y age at death and cause of death; Baltimore City, 1915 and 1916, cities of birth-registration area, 1915, and legitimate group in Baltimore study................................................................................................................................ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 252 253 253 254 254 255 255 256 256 257 257 258 259 260 261 262 263 264 264 264 265 8 CONTENTS. Page. Table 58. Monthly death rates, b y type of feeding, and by color and nationality of mother; infants bom in 1915................. .............. . i .......... ............... ..... 266-'' Table 59. Monthly death rates, b y type of feeding, and by earnings of father and color and nativity of mother; in fa n tsb om in 1 9 1 5 . . . . . . . . . . . . . . . . . . . . . . ; 268 Table 60. Computed infant mortality rates, by type of feeding, and b y earn ings of father and color and nativity of mother; infants bom in 1915............ .. 1 276 *' Table 61. Computed infant mortality rates, b y type of feeding, and b y nation ality of mother; infants bom in 1915 to foreign-bom white m others.. . . . ___ 277 Table 62. Monthly death rates, by type of feeding, month of life and cause of ' 278 death; infants born in 1 9 1 5 . . . . . . . . . . . . . . . . . ........ . Table 63. Computed mortality rates for first 10 months of life, b y cause of death of infant and color of mother; infants bom in 1 9 1 5 ........... ........... . 278 Table 64. Death rates from each month to end of first year, b y month in which artificial feeding began; infants born in 1915 and artificially fed during some part of first year of l i f e . . . ....... ................................... ..: . . . . . . . . . . ..¿..i. . . . . . . . 278 Table 65. Computed (annual) infant mortality rates, by month in which arti ficial feeding began; infants born in 1915............. .................................. ....... 279 Table 66. Monthly death rates, b y month of life, and by month in which arti ficial feeding began; infants born in 1915, and artificially fe d ............... . 279 Table 67. Weaning before end of first year of life, b y color and nationality of mother; infants born in 1915 and surviving at one year. . . . . . . . . . ___. . . . 279 Table 68, Weaning before end of first year of life, by earnings of father; infants bom in 1915 and surviving at one year....... ........ . . . . . . . . . . . . . . . * ____ . 280 Table 69. Infant mortality and stillbirth .rates, b y color and nationality of mother; births in 1915................. ................. . . . ^ . . . . . . . . . . . . . . . i v i . . . ’ j . . . . . 280 Table 70. Infant mortality and stillbirth rates, b y color and nationality of mother; births, all pregnancies......... ................... . . . . . . . . . . . . . . . . . . . . . . . . . . . 281 Table 71. Infant mortality rates, b y cause of death, and b y color and nation ality of mother; live births in 1 9 1 5 . . . . . . . . . . . . . . . . . . . . ___________________jumi 281 Table 72. Excess mortality among infants of Polish mothers over that among infants of other foreign-born white mothers when the effect of greater propor tion of employed among Polish mothers is eliminated; infants of Polish mothers not employed away from home during infant’s lifetim ei ....... 282 Table 73. Stillbirth rates, by earnings of father and color and nativity of mother; births in 1915.......................................... ................ . . . - ............. . j . . . . . . . . . . . _. 282 Table 74. Infant mortality rates, b y earnings of father and color and nativity of mother; live births in 1915........................ .... . . . . . . . . . . . . . . . . . ; ..................... .. 283 Table 75. Infant mortality rates, b y earnings of father and color and nativity of mother; live births, all pregnancies........ .. 1.1____. . . . . . . . . . . . . 283 Table 76. Stillbirth rates, b y earnings of father and color and nativity of mother; births, all pregnancies............................... ......... .................. ............. .................... 284 Table 77. Neonatal infant mortality rates, earnings of father, and color and nationality of mother; live births in 1915. . . ^. . . . . . . . . . . . . . . . . . . . . . ____ . * 285 Table 78. Infant mortality rates, b y cause of death, earnings of father, and color and nationality of mother; live births in 1915................................. . . . . . 286 Table 79. Deaths before feeding per 1,000 live births, and infant death rates per 1,000 fed, by earnings of father and color and nativity of mother; live births in 1915........................................... ......... ......... ............... ......... .............. ....... 287 Table 80. Type of feeding, by month of life and earnings of father and color and nativity of mother; infants born in 1915................................ ; . . . ....... ......... ...... , 288 Table 81. Type of feeding, b y month of life and by nationality; infants bom in 1915 to foreign-born white mothers.............. ........................ . . . . . . . . . . . . . . 289 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CONTENTS. Table 82. Relative mortality among infants in families where the father earned - $450 to $549 in comparison with that among infants in families where the father earned $550 to $849, when effeet of differences in type of feeding is eliminated; infants bom in 1915 to foreign-born white m others.. ............ .. Table 83. Infant mortality rates in favored group, b y earnings of father and color and nativity of mother ; live births in 1915................................................. Table 84. Death rates in favored group per 100 (infants who lived at least two weeks), b y average number of persons per room and earnings of father; in fants born in 1915 to white mothers, who lived at least two weeks in dwell ings studied............................................. ....... : ............. ........... ............................. Table 85. Infant mortality rates, b y occupation group and earnings of father and color and nativity of mother; Hve births in 1915............................................. Table 86. Excess mortality in overcrowded dwellings, with effect of differences in father’s earnings eliminated; infants (born in 1915 to native white mothers) who lived at least two weeks in dwellings with one or more persons per room .. Table 87. Excess mortality, by ward of residence and cause of death, over mortality expected when differences due to color and nationality are elim i nated ; live births in 1915.............................................................. ............................ Table 88. Excess mortality in overcrowded dwellings, with effect of differences in father’s earnings eliminated; infants (born in 1915 to foreign-born white mothers) who lived at least two weeks in dwellings with less than one and with two or more persons per room.............. ............. .......... ......... ......................... Table 89. Excess mortality in overcrowded dwellings, with effect of differences . in nationality eliminated; infants (born in 1915 to foreign-bom white mothers) who lived at least two weeks in dwellings studied........................................... .. Table 90. Per cent of infant deaths, b y average number of persons per room, earnings of father, and color and nativity of mother; infants born in 1915 who lived at least two weeks in dwellings s t u d i e d . . . . . . . . . . . . ________ ________ __ Table 91. Percentage of infant deaths, b y cause of death, sanitary arrangements of dwelling, earnings of father, and color and nationality of mother; infants born in 1915 who lived at least two weeks in dwellings studied.......... ............ Table 92. Employment of mother at any time after marriage, during pregnancy of 1915, or during lifetime of infant bom in 1915,b y place of employment, earnings of father, and color and nativity of mother; mothers (maternal histo ries) and births in 1915........... ........................ ..................... ..... . . . . . . . . . . . . . . . Table 93. Employment of mother at any time after marriage, during pregnancy of 1915, or during lifetime of infant bom in 1915, b y place of employment and nationality; foreign-born white mothers (maternal histories) and births in 1915............... ....... .......... 1................................................. . i ................ 296 Table 94. Employment of mother away from home after marriage, b y number of births, earnings of father, and color and nativity of mother; mothers (maternal histories)............ ......... ...................... ."................................................. .. / Table 95. Employment of mother during pregnancy, or within 12 months after the birth, b y color of mother; live births in 1915...... ........................................... Table 96. Occupation of mother and employm ent away from home before and after marriage, b y color and nationality; mothers (maternal histories)... . . . . Table 97. Occupation, b y time of employment away from home and color and nationality of mother; mothers (maternal histories).... ....................................... Table 98. Occupation and place of employment of mother during pregnancy, b y color and nationality; births in 1915............. ........................................... . Table 99. Occupation of mother, b y place and tim e of employment; liv e births in 1915 to mothers em ployed.......... ........................................... . ....... ¿ . . . . . Table 100. Employment of mother during pregnancy of 1915 and during life time of infant, b y color and nationality; births in 1915..................................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 9 289 290 290 291 291 292 292 293 293 294 295 296 297 297 299 300 302 302 10 CONTENTS. Table 101. Employment of mother during pregnancy of 1915, by employment after the birth, at home and away from home, b y color of mother; live births in 1 9 1 5 ............................................ ................. . . . ........ ............................... Table 102. Infant mortality rates, b y mother’s employment away from home during pregnancy or within year after birth, earnings of father, and color and nativity of mother; live births in 1915........................................... . . . . . . . . . Table 103. Infant mortality rates (b y cause of death) and stillbirth rates, b y employment of mother dining pregnancy and color and nativity of mother; births in 1915.................................. ......... .............................................................._ Table 104. Excess infant mortality (by cause of death) and stillbirth rates among infants of mothers employed during pregnancy, over those expected when effect of differences in color and nationality and earnings of father is eliminated; births in 1 9 1 5 .,...................................................................................... Table 105. Prevalence of premature births, by employment during pregnancy and color and nativity of mother; live births in 1915................................. ......... Table 106. Infant mortality rates, b y cause of death and b y employment of mother during pregnancy and color and nativity; full-term live births in 1915. Table 107. Interval between cessation of work and confinement, b y occupation and color of mother; births in 1915 to mothers employed during pregnancy.. Table 108. Infant deaths under 1 month per 1,000 live births and stillbirth rates, b y interval between cessation of work and confinement, color of mother, and place of employment; births in 1915 to mothers employed during pregnancy.. Table 109. Age of infant when mother began work, b y place of mother’s em ployment and color and nationality of mother; infants born in 1915 to mothers employed during infant’ s first year of life, and subsequent infant deaths___ Table 110. Excess mortality among infants of mothers employed during infant’s lifetime, b y time of resumption of work, place of employment, and color and nationality of mother, over mortality expected when effect of differences in color and nationality of mother is eliminated; infants born in 1915 to mothers employed during infant’s lifetime. ^............ ........... .............................................. Table 111. Excess mortality among infants of mothers employed during infant’s lifetime, b y place of employment, over mortality expected when effect of differences in infants’ ages and in fathers’ earnings is eliminated; infants bom in 1915 to native white and to colored mothers............ ..................... ......... Table 112. Nationality of mother, b y place of her employment and age of infant when mother began work; infants born in 1915 to mothers employed during infant’s lifetime............... ............ ................ ........... .......................................... . Table 113. Earnings of father, b y mother’s place of employment, color and nativity, and age of infant when mother began work; infants of mothers employed during infant’s l i f e t i m e ; .................................... ............. ...; Table 114. Interval between cessation of work and confinement, b y interval between confinement and resumption of work; infants of mothers employed away both dining pregnancy and within year after the birth............ ...... ........ Table 115. Excess mortality among infants of mothers employed away from home during infant’s lifetime, b y mother’s employment during pregnancy and age of infant when mother resumed work, over mortality expected when effect of differences in mother’s color and nationality, and father’s paming« -is eliminated; infants of mothers employed away from home during infant’s lifetim e............................................................................................................ ............. Table 116. Infant survivors and infant deaths, b y type of feeding, month of life, place of mother’s employment, and color and nationality of mother; infants of mothers employed during infant’s lifetim e........................................ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 303 304 305 306 307 308 308 309 310 313 314 314 315 316 316 317 CONTENTS. 11 Page. Table 117. Excess mortality among infants of mothers em ployed dining infant’s lifetime, b y place of employment, over mortality expected when effect of differences in type feeding, in color and nationality and (in native white families) in earnings of father are eliminated; infants of mothers employed during infant’ s lifetim e............. ..................... ......................................................... Table 118. Infant mortality rates, b y time of mother’s employment away from home, color and nativity of mother, and earnings of father; live births, all pregnancies . .............. ....................... ............ - - .......................................................... Table 119. Stillbirth rates, b y time of mother’ s employment away from home, color and nativity of mother, and earnings of father; births, all pregnancies.. Table 120. Infant mortality rates, b y number of births to mother, her employ ment away from home, and color and nativity; live births, all pregnancies.. Table 121. Infant mortality rates (b y cause of death) and stillbirth rates, by employment of mother away from home, during pregnancy and after birth, and b y color and nativity of mother; births in 1915.............................................. Table 122. Excess mortality among infants of mothers employed away from home, b y time of mother’ s employment, over mortality expected when effect of differences in number of births to mother, color and nativity of mother, and earnings of father are eliminated; live births, all pregnancies................ ... Table 123. Employment of mother away from home, b y age of mother when she began work, and color and nativity; births (all pregnancies) to mothers em ployed away from home at some time prior to birth in 1915................... ........... Table 124. Employment of mother during pregnancy of 1915, b y place of em ployment, age when she began work away from home, and color and nativity; births in 1915 to mothers employed away from home at some time prior to the birth........... ................................................................... - - ........................ ............. * Table 125. Excess mortality and stillbirth rates among infants of mothers em ployed away from home, b y age of mother when she began work, over average rates after effect of differences of color and nativity is eliminated; births, all pregnancies..................... ..................... ...............................- * - - ............................. Table 126. Excess mortality (by cause of death) and stillbirth rates among in fants of mothers employed away from home, b y age of mother when she began work, over average rates after effect of differences of color and nativity is eliminated; births in 1915......... — ............................................- ............... .............. Table 127. Infant mortality rates, b y literacy of mother, earnings of father, and color and nationality of mother; live births in 1915....... -..............................— Table 128. Relative mortality among infants of illiterate mothers when effect of differences in mother’s color and nationality and father s earnings is eliminated; births in 1915 to illiterate mothers....... .....................- ............- - - - Table 129. Infant mortality rates, b y mother’ s ability to speak English, earnings of father, and nationality of mother; live births in 1915 to foreign-bom white mothers of non-English-speaking nationalities............ ......... ......... ....................... Table 130. Relative mortality among infants of mothers not able to speak English, as compared with mortality expected on the basis of average rates, when effect of differences in mother’s color and nationality and father s earnings is eliminated; live births in 1915 to foreign-bom white mothers unable to speak English....................................... — - - - - ........................................ Table 131. Prevalence of infant-welfare work, b y ability of mother to speak English and nationality; infants b o m to Jewish, Polish, and Italian mothers and surviving two w e e k s ....................... .................................................... ; ------Table 132. Infant mortality and stillbirth rates, b y order of birth; births in 1915, and births, all pregnancies............ .......... ............. ......................... - ............. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ^23 QOA 325 326 327 328 329 330 ^31 332 333 333 334 334 335 12 CONTENTS. Table 133. Infant mortality and stillbirth rates, b y order of birth and color of mother; single births in 1915, and single births, all pregnancies, to mothers who reported no plural births.................................................................................... Table 134. Stillbirth rates, b y number of births to mothers, order of pregnancy, and color of mother; single births, all pregnancies, to mothers who reported no plural births...... ....................................................................................................... Table 135. Infant mortality rates, b y number of births to mother, order of preg nancy, and color of mother; single live births, all pregnancies, to mothers who reported no plural births............ ........................................................................ Table 136. Excess mortality among infants of mothers reporting large numbers of births over mortality expected at average rates when effect of differences in color and nativity and father’s earnings is eliminated; live births, all pregnancies. ..................................................... .................................... Table 137. Infant mortality rates, b y order of birth and earnings of father; single live births in 1915 and all live births, all pregnancies.................... ................... Table 138. Infant mortality rates, b y order of birth, earnings of father, and color and nativity of mother; single live births in 1915................................................. Table 139. Infant mortality rates, b y order of birth, earnings of father (detailed groups), single live births in 1915 to native white mothers................................ Table 140. Premature birth, b y order of birth; live births in 1915....................... Table 141. Premature birth, b y interval since preceding birth; live births in 1915, second and later in order of birth................ ................................................... Table 142. Infant mortality (specified causes) and stillbirth rates, by order of birth; single births in 1 9 1 5 . ......................................................... ...................... Table 143. Infant mortality rates, b y age, color, and nativity of mother; live births in 1915 and live births, all pregnancies...................................................... Table 144. Stillbirth rates, b y age, color, and nativity of mother; births in 1915. Table 145. Stillbirth rates, b y age of mother and earnings of father; single births in 1915 and all births, all pregnancies....... ....................................................... . Table 146. Infant mortality rates, b y age of mother and earnings of father; sin gle live births in 1915 and all live births, all pregnancies............................... Table 147. Infant mortality rates from specified causes, b y age of mother; single live births in 1 9 1 5 ............ ..................... ................................................................ Table 148. Premature births, by age, color, and nativity of mother; live births in 1 9 1 5 . . . . . . . . . . . . . ........ .................................................................................. ............... Table 149. Stillbirth rates, b y order of birth and age of mother; births in 1915, and births, all pregnancies..................................................................................... .... Table 150. Infant mortality rates, b y order of birth and age of mother; live births in 1915, and live births, all pregnancies................................................... Table 151. Infant mortality rates, by order of birth and age and color of mother; single live births in 1915, and all live births, all pregnancies........ ... Table 152. Infant mortality rates, b y order of birth, age of mother, and earn ings of father; live births, all pregnancies.......... .................................................... Table 153. Infant mortality rates from specified causes, b y age of mother and order of birth; single live births in 1915........................... ..................................... Table 154. Stillbirth and infant mortality rates, b y interval since preceding birth, earnings of father, and color and nativity of mother; births in 1915, second and later in order of b irth ............ .............................................................. Table 155. Infant mortality and stillbirth rates, b y interval since preceding birth and period of gestation; births in 1915......................................................... Table 156. Interval since preceding birth, b y earnings of father and color and nativity of mother; live births in 1915, second and later in order of birth. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 335 336 337 338 338 339 339 340 340 340 341 341 342 343 343 344 344 345 346 347 347 348 350 351 CONTENTS. 13 Page. Table 157. Number of mother’s pregnancies, b y duration of mother’s married life and earnings of father; live births, all pregnancies.................................. . . 352 Table 158. Infant mortality rates, b y number of mother’s pregnancies, dura tion of married life and earnings of father; live births, all pregnancies.. . . i :. 353 Table 159. Infant mortality rates, b y interval between birth in 1915 and pre- ' ceding birth; live births in 1915, second and later in order of birth, and live births preceding single births in 1 9 1 5 . . . . — . — .............. ............. .. — 354 Table 160. Stillbirth rates, b y interval between birth in 1915 and preceding birth; births in 1915, second and later in order of birth, and births preceding single births in 1915......................................................... ..........................354 Table 161. Mother reported pregnant within first year after birth, b y age of infant when the pregnancy began, b y color and nationality of mother; live births in 1915 to mothers reported pregnant within year after the birth in 1915 and infant deaths subsequent to commencement of pregnancy. . . . . . . . . 355 Table 162. Infant deaths, b y age at death, relation of infant death to mother’s pregnancy after the birth, and color and nativity of mother; live births in 1915 to mothers pregnant within year after b ir t h ..................... . . . . . . . . . . . . . . 356 Table 163. Monthly death rates, b y month of life and by pregnancy of mother during infant’s first year of life; live births in 1 9 1 5 . . . . . . . . 357 Table 164. Computed infant mortality rates, b y mother’s pregnancy during infant’s lifetime; infants born in 1915..................................... . r ----- . . . . 357 Table 165. Prevalence of interval under two years between births, b y order of birth; single live births in 1915, second and later in order of birth and all live births, all pregnancies— .............. - ........... ........... - - ............... - - - - - - - v - • Table 166. Interval between births, b y age of mother; single live births in 1915, second and later in order of birth.................... ........................................... Table 167. Infant mortality rates from specified causes and stillbirth rates, by order of birth and interval since preceding birth; single births in 1915, second and later in order of birth.................................................................. .... ......... ...... Table 168. Infant mortality rates from specified causes and stillbirth rates, by age of mother and interval since preceding birth; single births in 1915, second and later in order of birth............................................ - - - - - - - - - ........... - - - -g - Table 169. Infant mortality rates from specified causes, by age of mother, order of birth, and interval since preceding birth ; single live births in 1915, 357 358 358 359 second and later in order of b irth ................................... ...........................r .v ; * .* ...360 Table 170. Prevalence of plural births, b y color and nativity of mother , births , in 1915 and births, all pregnancies........................................................ . ........ . - -r 361 Table 171. Infant mortality, stillbirth, and miscarriage rates, by color and ........ - - - - 1- - -T- - - - ; 3jBi nativity of mother; single and plural births in 1915. Table 172. Infant mortality, stillbirth, and miscarriage rates, b y color and nativity of mother; single and plural births, all pregnancies.. . . . . . . . . . . . . . 361 Table 173. Infant mortality, stillbirth, and miscarriage rates, b y character of plural birth; plural births in 1915 and all pregnanci es. . . . 3 6 2 Table 174. Prevalence of plural births, b y age of mother; births in 19,15 and births, all pregnancies----- . . . . . . . ------ .....................‘ ‘ ; Y ‘ *' Y ' ' ' ' ' ‘ ’ "j Table 175. Prevalence of plural births, b y order of birth; births in 1915 and 36^ births, all p r e g n a n c ie s ............ ............................. ................. -------------- r h . v r Table 176. Prevalence of plural births, b y age of mother and order of birth, 362 births in 1915.......................................- ••- - ..................... *....... ........... .." " * ' ' ' Table 177. Prevalence of plural births, b y occurrence of previous plural births-, . pregnancies....... . . .. i . all ................ ............... .....................— ------ . . . . . . . ______ .. 363 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 363 14 CONTENTS. Table 178. Prevalence of prematurity, b y single and plural births; births in I®15* * " ............................................. *..................................................................... . . . la b le 179. Infant mortality rates, b y single and plural births and prema turity; births in 1915.......................................................... .................. ... 363 364 Table 180. Type of feeding, b y month of life; infants bom of plural births in 1915..................................... .............. .................... ........' ................ Table 181. Infant mortality and stillbirth rates, b y period of gestation- births in 1915......................................... ............................................ 364 Table 182. Infant mortality rates, b y period of gestation and color and nativity of mother; live births in 1915...................................... ........... .' . . . . . ' . _ _ *7 Table 183. Infant mortality and stillbirth rates, b y sex of infant and color and nativity of mother; births in 1915................................. .......................... . . . Table 184. Masculinity, b y color and nationality of mother; births in 1915___ Table 185. Miscarriages, stillbirths, and infant deaths, b y interval between confinement and death of mother and b y period of gestation; births in 1915 to mothers who died within year following confinement........ ........................... Table 186. Death of mother, b y period elapsing after confinement and cause of mother’s death; births in 1915 to mothers who died within year following confinement.................................................................................... Table 187. Stillbirths, miscarriages, and infant deaths, b y color and nationality of mother; births in 1915 and births, all pregnancies.............................. ......... Table 188. Stillbirth and miscarriage rates, b y color and nationality of mother; births in 1915 and births, all pregnancies....................................................... . . . Table 189. Miscarriage rates, b y earnings of father and color and nativity of mother; births in 1915 and births, all pregnancies...................... 1..... ................. Table 190. Stillbirth and miscarriage rates, b y employment of mother away from home and color and nativity; births, all pregnancies........................... .. Table 191. Legitimacy of birth and scheduling of illegitimate births, b y color of mother; total registered births in 1 9 1 5 .. . .. . .. . .. . . . 1 : ___ V........ Table 192. Employment of mother during pregnancy, b y color of mother; scheduled legitimate and illegitimate births and total illegitimate births in 365 365 366 367 33^ 368 368 368 369 369 i9i5........................... ............... 370 Table 193. Occupation of mother during pregnancy, b y color of mother; ille gitimate births in 1915................................. ......................... Table 194. Occupation of mother during pregnancy, b y occupation during year after birth; scheduled illegitimate births in 1915....... ................... ... . \ Table 195. Occupation during pregnancy, b y age of mother; illegitimate births in 1915................... ......................................... .. Table 196. Age of mother, b y color; illegitimate births in 1915................... Table 197. Marital condition at confinement and one year later, b y color of mother; scheduled illegitimate births in 1915................ .............. .................. Table 198. Order of birth, b y color of mother; total and scheduled illegitimate births in 1915............................. ...................... j ____^ _ Table 199. Order of birth, by color of mother and legitimacy; scheduled illegitimate births in 1915, and previous births to mothers of scheduled illegitimate births in 1915.................... ............................. . . . . . . . . Table 200. Legitimacy of-previous births, b y order o f birth; scheduled ille gitimate births in 1 9 1 5 ..................... . . . . . . . . . . . . . . . . . . . . . . . v . i . . Table 201. Occupation of father, b y color of mother; illegitimate births in 1915. ................................................................ . . . . . . . . . . . . . . . . l . . . . . . . i . . . i Table 202. Age of mother, b y age of father and color of mother; illegitimate, births in 1915.......................................................................................... Table 203. Place of confinement, b y legitimacy of birth; total an d’scheduled births in 1915....................................... ........................................ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 370 374 371 372 372 3^3 374 375 375 376 377 CONTENTS. Table 204. Attendant at birth, b y color of mother; scheduled legitimate and illegitimate births in 1915.................................... .......................... . ............ ^ Table 205. Prenatal care, b y color of mother; mothers of scheduled legitimate and illegitimate births in 1915.................................... ............................................. Table 206. Mother’s mode of living during whole or greater part of year after confinement, b y color of mother; scheduled illegitimate births in 1 9 1 5 ...... Table 207. Earnings of father or contributions to the support of mother or child during year following birth of infant, and mode of living, b y color of mother; scheduled illegitimate births in 1915.............................. . ...................... ............. j Table 208. Contribution of father to the support of mother or child during year following birth of infant, b y mode of living, and b y color of mother; scheduled illegitimate births in 1915................................ ................ ‘...................... ........... . Table 209. Mortality among mothers during year after confinement, b y cause of death and color; mothers of scheduled legitimate and illegitimate births in 1915...............* ; ............... .................................... ................. ................... .................... Table 210. Earnings of mother, b y period worked during year after confine ment and type of remuneration; scheduled illegitimate births in 1915___ __ Table 211. Mother’s and infant’s mode of living during year after birth, by color of mother; scheduled illegitimate infants born in 1915 and surviving at least 2 w eeks................................................. .......... . . . . . . . . . . . . . . . Table 212. Infant mortality and stillbirth rates, by employment of mother away from home during pregnancy, and color of mother; scheduled legiti mate and illegitimate births and total illegitimate births in 1 9 1 5 .... I . . . . . Table 213. Age at death, b y color of mother; deaths among illegitimate live births in 1915............... ..................... .................................. ......... ... ; _ Table 214. Deaths per 1,000 live births, by age at death and color of mother; total illegitimate and scheduled legitimate live births in 1915....................... . Table 215. Cause of death, b y color of mother; deaths among illegitimate live births in 1915................................................ _................................ Table 216. Infant mortality rates, b y cause of death and color of mother; total illegitimate and scheduled legitimate live births in 1915........................... . Table 217. Cause of death, b y age at death; infant deaths among illegitimate live birthsin 1 9 1 5 . . . . . . . . ............ ................................ . " Table 218. Age of infant when mother began work, b y color of mother; scheduled legitimate and illegitimate infants born in 1915........... ...................... . Table 219. Per cent of premature births and stillbirths and infant mortality rates among full-term births, b y employment of mother during pregnancy; scheduled legitimate and illegitimate births in 1915.......... ........ ................. ’ Table 220. Infant mortality and stillbirth rates, b y literacy and color of mother; scheduled illegitimate births in 1915.......................... ...___ . . . . ___ , _____ _ Table 221. Infant mortality rates, b y mode of living and earnings of father or contributions to the support of mother or child during year following birth of infant; scheduled illegitimate live births in 1915.............. ......................... . . Table 222. Per cent of infant deaths, b y separation of infant from mother, and color of mother; illegitimate infants born in 1915 and surviving at 3 months and at 6 months of a g e ............... ..................... ......... ............. 5 ................................ Table 223. Infant mortality rates, b y place of confinement; total and scheduled illegitimate live births in 1 9 1 5 . . . . . . .................... .................... .. Table 224. Infant mortality rates, b y infant’s place of residence and color of mother; scheduled illegitimate live births in 1915........................... f . . . . . p | Table 225. Death rate per 1,000 infants, b y removals of infant; scheduled illegitimate infants bom in 1915 and surviving at 3 months and at 6 months o fa Se ................ ............ ................... ...................................................................... Table 226. Type of feeding, b y month of life, and.by color of mother; scheduled legitimate and illegitimate infants bom in 1 9 1 5 . . . . . . . . . . . . . . . . . . . . . . . . . . https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 15 377 373 378 379 380 381 382 383 384 3gc 385 3gg 386 386 387 387 ggg 3gg 389 389 399 390 391 16 CONTENTS. Page. Table 227. Computed mortality rates for first 10 months of life, b y type of feeding and color of mother; scheduled legitimate and illegitimate live b irth sin l9 1 5 ....................— .............. ..................................... ............................ 39i CHARTS. Chart L Rental and sanitary condition of dwellings.......... — - ........................ -.Chart II. Per cent of mothers gainfully employed away from home, b y fathers’ earnings............................ ......... — - - - ................. .................................................., Chart III. Per cent of mothers gainfully employed at home and away from home, b y color and n a t i v i t y . — ......... ............. - - ......... 52 Chart IV . Infant mortality rates, b y cause of death................... . Chart V. Infant deaths, b y calendar month........................... ........................- - - Chart V I. Monthly death rates, b y type of feeding.. . . . . . . . . . . . . . . . . . ------- . . . . Chart V II. Computed infant mortality rates during first 10 months of life per 1,000 infants fed, by type of feeding and cause of death..................... ............ . Chart V III. Infant mortality rates, b y month of life in which artificial feeding began......... . ....................................... ........ .................... . Chart I X . Infant mortality rates, b y color and nationality........................... j-----Chart X . Infant mortality rates from all causes, b y fathers’ earnings, for infants of native white, foreign-bom white, and colored mothers................. .............. Chart X I . Infant mortality rates from early infancy, b y fathers’ earnings, for infants of native white, foreign-bom white, and colored mothers. . . . . . . . ----- Chart X I I . Infant mortality rates from gastric and intestinal diseases, by fathers’ earnings, for infants of native white, foreign-bom white, and colored mothers.............. ................. - - .............................- ......... ............. ...................... , 87 Chart X I I I . Infant mortality rates from respiratory and other communicable diseases, b y fathers’ earnings, for infants of native white, fordign-bom white, and colored mothers............... ............................. - ............................ - ■* - - - — -... Chart X IV . Infant mortality rates, b y fathers’ earnings among infants of “ favored group” and all other in fa n ts ....! — ................ ............... . - * ......... . , Chart X V . Death rates among infants surviving two weeks, b y fathers’ earn ings and room congestion...............................................- - - ------------------------ - - - Chart X V I. Infant mortality rates, b y mothers’ employment during pregnancy; actual rates compared with rates expected on the basis of the fathers’ earnings and the mothers’ color and nationality...................- - ......... - - - ---------............. - Chart X V II. Infant mortality rates under 1 month of age and stillbirth rates, b y interval between the mothers’ cessation of work and confinement of mothers employed away from home during pregnancy....... . — . ----Chart X V III. Infant mortality rates from early infancy and from all other 1 causes, b y order o f birth; single births in 1915........ — . . . i . . . . . . . . . . . . . . . Chart X I X . Infant mortality rates from all causes for each order of birth group, according to age of mother; all single births and single births following pre ceding births by.tw o years or longer, 1915..................- ......... .. . ........ . . - ....... Chart X X . Infant mortality rates from early infancy for each order of birth group, according to age of mother; all single births and single births following . preceding hirths b y two years or longer, 1915----...... ..............................138 Chart X X I . Infant mortality rates from early infancy and from all causes for certain order of birth groups, b y interval since preceding birth; single births in 1915. . . .. ............. ........................................... . - . . . . ----- - -,.. . . . . . . . - Chart X X I I . Per cent of deaths before end of first year of life among illegiti mate infants surviving at 3 months of age, according to separation from mother............ ......................... ......... .............................- ......... .................................MAP. Infant mortality in Baltimore b y w a r d s . . . . . . - - - - - - - - - - - ........ ....... ........... - ........ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 44 48 57 58 70 71 73 77 80 86 87 102 HO 115 119 135 137 144 172 24 LETTER OF TRANSMITTAL. U n it e d States D epartm ent of L abor, C h il d r e n ’s B ureau , Washington, February 2 1 , 1922. Si r : There is transmitted herewith a study of infant mortality in Baltimore, Md. It is the eighth and in many respects the most important of the unique and valuable series of infant mortality studies which the Children’s Bureau made while Julia C. Lathrop was its chief. Because Baltimore is the largest city studied by the bureau, the number of births is larger, and a more detailed comparison has been possible than in other studies. Dr. Grace Meigs Crowder was medical adviser during this investi gation; Estelle B. Hunter was in charge of the field work; Emma Duke and Dr. Robert M. Woodbury planned the statistical tabulation; and Anna Rochester organized the material and wrote the report. In the analysis, the “ method of expected deaths” developed by Prof. Harald Westergaard was applied under the direction of Doctor Woodbury to isolate the effects of the several causal factors. It is a pleasure to record that conditions have improved in Balti more since the investigation was made. The city now has a bureau of child hygiene, and the opportunities for prenatal care have been increased; and, as everywhere, the corollary has been a downward trend in the infant mortality rate. The evidence which this report adds to those already made as to conditions which affect the mor tality rate among infants under 1 year of age, will, it is believed, be of value to all communities that are at work on this problem. Respectfully submitted. Grace A bbott, Chief. Hon. James J. D avis , Secretary o f Labor , 101351°—23-----2 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 17 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis INFANT M ORTALITY, BALTIMORE, M D. INTRODUCTION. Baltimore is tlie eighth, city in which the Children’s Bureau has made an intensive field study of infant mortality. Not only do the Baltimore findings strengthen conclusions indicated in the earlier studies, but they have also a unique significance because of the detailed analysis made possible by the large number of births included in the study and because Baltimore differs in certain ways from the seven other cities. Baltimore is the largest of the cities studied by the bureau. The population, shown by the Federal census of 1910 to be 558,485, is estimated to have been 599,817 on July 1, 1915, the middle of the calendar year covered by the study.1 It is the first city studied in which the negro population was large enough to permit analysis of the high infant mortality rate among negro babies. In fact, the composite of native white, foreign-born white, and negro elements in Baltimore was similar to that in the United States as a whole. In the cities previously studied, some one industry predominated, but not so in Baltimore. It is not only a shipping center but also a manufacturing city producing a great variety of wares. Baltimore is also the first city studied in which extensive infantwelfare work, including opportunity for prenatal instruction and supervision, had been carried on for several years. Hospital pro vision for maternity care was also relatively well developed. In Baltimore the mortality was not markedly higher than the mortality in the birth-registration area of the United States. But this in turn is definitely higher than the mortality in certain other countries. Even when the negro births— which showed uniformly higher mortality than white births— are eliminated from considera tion, the Baltimore infant mortality rate in 1916 was not only twice as high as the rate for New Zealand (and markedly higher than the rates for the cities of New Zealand) but also higher than the rates in a number of European and American cities, including London and New York. On the other hand, a number of American cities showed approximately the same mortality as Baltimore and others a higher mortality than Baltimore.2 In its population, the variety of its industries, and the rate of infant mortality prevailing, Baltimore may be regarded as a typical American city with a typical problem in relation to infant mortality. i U. S. Bureau of the Census, Bulletin No. 133, p. 22. » See Table 1, Appendix VU , p. 223. 19 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 20 IN F A N T MORTALITY, BALTIMORE, MD. METHOD AND PURPOSE OF THE STUDY. The study is based primarily on the registered births (including stillbirths and miscarriages) occurring in Baltimore during the year 1915 3 and the deaths among these infants within 12 months after birth (in 1915 or 1916). The information was secured in part from the birth certificates and death certificates on file with the Baltimore Department of Public Safety, subdepartment of health, and in larger measure from the mothers who were visited by women agents of the bureau as soon as possible after the first anniversary of the baby’s birth.4 In addition, information was secured from the mothers about all their babies and the deaths (or stillbirths or miscarriages) among these earlier births. The babies bom in 1915 fall into two main groups— the 13,484 legitimate and the 1,124 illegitimate.5 As the study progressed, each of these two groups had to be further divided. A m on g the legitimate it was found that the families of 1,466 could not be located in Baltimore or were known to have moved away; the families of 381 were omitted as nonresidents; and for 24 babies whose families were found, and who were residents of Balti more, detailed information was not available. Such facts as are known about these 1,871 excluded births have been analyzed and are discussed in Appendix II.5a Therefore the normal group of legiti mate births whose home surroundings were studied in detail and whose infant mortality rate is given with precision includes 11,613, or 86 per cent, of the registered legitimate births.6 More difficult to trace were the 1,124 illegitimate births. Only 679 or 60.4 per cent of these could be located and information secured about their surroundings and care. Such items as were given on the birth certificates and the known deaths in Baltimore or elsewhere are, however, analyzed for the larger group, of all illegiti mate births. The material on illegitimate infants is presented in a special section of the report. The infant mortality rate among the legitimate babies whose his tories were traced throughout the year was 103.5 per 1,000 live births. The rates for the other groups were unsatisfactory, but the known deaths among the illegitimate babies indicate a rate about three times as high as the rate in the normal group.7 3 For discussion of birth registration in Baltimore, see Appendix I, p. 185. 4 Tbe father provided he was able and willing to give the information, might be interviewed if the mother was not at home or if it was otherwise inexpedient to seethe mother; others (as custodians or rela tives living with the baby’s family) might be interviewed ( 1 ) when the parents were dead or it was impos sible to see them; ( 2) when the relation of such persons to the family and their information were such that there was no question as to their knowledge of facts; and (3) when their reliability was otherwise unques tioned. „ ..... ¿i.y 6 In addition there were 28 stillbirths or miscarriages whose legitimacy was not reported and for whom no information could be secured. 6» See p. 189. « See Table 2, Appendix V II, p. 223. 7 see Table V II, p. 170. For mortality among excluded legitimate births, see Appendix II, p. 189. For mortality among illegitimate infants,seep. 168. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis INTRODUCTION. 21 No rate is offered as exact for Baltimore as a whole.8 Even the rate for the group of families studied in detail can not be considered an exact rate for all legitimate babies in Baltimore. While all the nationalities living in Baltimore, all grades of economic status, and mothers working and not working for wages are represented in the large group on which the main body of the study is based, their dis tribution in the group may not be identical with their distribution in the families about which information was not secured. But the study is directly related to the city. Certain items were noted about the houses in which the babies born in 1915 lived and civic conditions affecting their health. Families in which either mother or baby was away from Baltimore surroundings four months or more during the year were excluded from the detailed study, even when the facts about them were clear. The facts about earlier births or “ maternal histories” are not, however, so directly related to Baltimore. Many known social factors in infant mortality were present in Baltimore— poverty, gainful employment for married women, imper fect sanitation, room congestion, and artificial feeding of young babies. Whether these were more or less prevalent in Baltimore than elsewhere is a question outside the scope of the present study, the aim of which is, rather, to show how these factors, and others, were related to infant mortality among the Baltimore babies about whom detailed information was available. Statements of nationality or color are uniformly based on the color or nationality (mother tongue) of the mother. For example, in the discussion of fathers’ occupations and earnings, the fathers are some times referred to as native white, foreign-born white, Jewish, etc. to avoid constant repetition of some such cumbersome phrase as “ fathers of babies born to native white mothers.” 9 In the distribution of certain factors— the percentage of “ mothers” or “ fathers ” or “ families ” of whom one or another statement is made in the text— the presence of plural births is disregarded. It is as sumed that the number of births and the number of mothers, etc., are identical. The actual error involved is slight, but it should be remembered that data are based, for example, not on “ mothers employed” but on “ births to mothers employed.” 8 The relation of the rates given in this study to rates for the city as a whole is discussed in Appendix III, p. 193. s Intermarriage between white and colored is forbidden in Maryland. In the study of infant mortality in Waterbury, Conn., an analysis was made of the nationality of the mother in relation to that of the father. In 87 per cent (1,911 ases) of the total 2,197 cases, the nationality of the fathers was the same as that of the mothers. Infant Mortality: Results of a Field Study in Waterbury, Conn., Based on Births in One Year, b y Estelle B. Hunter, Children’s Bureau publication No. 29, p. 116. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES’ SURROUNDINGS. BALTIMORE. In 1729 the inhabitants of Baltimore County addressed a petition to the general assembly for the erection of a town upon the Patapsco River. About 70 years later (in 1797) the town was incorporated as Baltimore City with a population of 20,000 persons. The settlement centered about the water front, and many houses of the shipbuilders, merchants, and sea captains of these early days still stand in the district east of the Fallsway. With the growth of the last century, the uold families” have moved away from the water front, wharves and warehouses have been extended, and the homes of the leaders in former days have passed to the immigrants of yesterday. Commercially the water front has remained of primary importance to Baltimore, The city has spread far to the north and west of the original settlement, and freight yards and factories have carried business into other parts of the city, but the center of business life is still near the river. In the fourth ward, which lies at the head of the basin, just south and east of the physical center of the 30 square miles of Baltimore City,10 are the city hall and the customhouse, the newspapers, banks, and business offices, and, along the water front, docks, warehouses, and factories. East and south of the fourth ward docks and warehouses extend along the entire shore; and the irregular contour, especially marked in the southern districts, increases enormously the water front available to a comparatively srna.ll and compact territory. But at the time of this study business did not monopolize the eight wards of the water front.11 The more prosperous residents had moved to the north, but the poorest native white families and colonies of the foreign bom remained. The negroes lived mainly in other sec tions of the city, but in the fourth ward and the twenty-second ward (directly south of the fourth) a considerable percentage of the births were colored. In the eight water-front wards were bom more than one-third of the Baltimore babies of 1915.12 The foreign neighborhoods extended into two other wards— the eighteenth ward, just west of the fourth, and the fifth ward, just east of the fourth and north of the third. In these two small adja10 Before the annexation of additional territory on January 1 , 1919. 11 Wards 1,2,3,4,21,22,23,24. For the t abulations on which following statements are based see Tables 3,4,5, 6, and 7, Appendix V II, pp. 224 to 229. « “ Baltimore” in this study refers to the 24 wards of Baltimore City as it was before the annexation of surrounding territory, January 1,1919. 23 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 24 IN F A N T MORTALITY, BALTIMORE, MD. cent wards and the eight wards of the water front were more than two-thirds of the Baltimore births to foreign-born white mothers and all the foreign neighborhoods except the Bohemian colony near the Johns Hopkins Hospital. In these 10 wards, also, were nearly two-thirds (65.8 per cent) of the white babies whose fathers earned less than $550 during the year after the birth in 1915. Live births. Class. The 10 wards.1 Baltimore City (24 wards). Number. 10,797 4,581 42.4 2,753 2,130 1,899 1,402 69.0 65.8 Per cent. 1 Wards 1, 2, 3,4, 5, 18, 21, 22, 23, and 24. The largest distinctively foreign neighborhoods lay east of the fourth ward. Crossing the Fallsway eastward on Baltimore Street, one stepped from the business of the fourth ward into a district of dwellings and small shops from which the main currents of city life seemed singularly remote. In the fifth ward and the third ward which lay north and south of East Baltimore Street at this point, only 13 per cent of the babies were born to native white mothers. Almost half were foreign-bom Jewish and one-fifth were Italian. Just south of East Baltimore Street, in the third ward, were the blocks described in detail as the Albemarle Street district in the 1907 study of housing conditions in Baltimore.13 Except that between 1907 and 1915 the sewer had been built and many, though not all, of the toilets in the third ward had been connected, that report gives a true picture of the neighborhood when the babies studied were born— one-family dwellings used as tenements; extensions crowding the lots and reducing light and air to a minimum; poorly paved yards reeking with waste water (the gutters in many streets still ran with surface drainage); and live stock in congested sheds or cellars, chicken slaughterhouses, stables, and manure piles adding their odors to the general stench. Farther south and east in the third ward the neighborhood shifted; the Jewish signs were less frequent and the Polish colony began. The Polish colony was nearer the water front in the third ward, and in the second ward and the first which follow on the east. A typical neighborhood in the Polish colony is described in the 1907 housing report referred to above. Here also the one-family is Housing Conditions in Baltimore, a study under direction of Association for the Improvement of the Condition of the Poor and Charity Organization Society, Baltimore, 1907. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 15 8 0 .3 INFANT MORTALITY IN BALTIM ORE. BY W A R D S I I Infant -mortal ity less th a n 8 5 In fan t m o r ta lity 85 to m t! Infant m o r ta lity 101351°—23. (To face p. 24.) https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 125 125 a n d o v e r ««*> https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES’ SURROUNDINGS. m house of an earlier day was the prevailing type of tenement. In lot congestion and in neglect of necessary repairs, the report found this neighborhood slightly better than the Albemarle district, and there were no chicken slaughterhouses. Dampness, however, in cellars and yards was no less prevalent. A much smaller Polish colony lived across the Basin, in the eastern part of the twenty-fourth ward in the district known as Locust Point. Behind the railroad piers, the dry docks,. and the grain elevators which line the water front, and separated from the western part of the ward by railroad tracks and, at the time of this study, by a wide stretch of unbuilt land, lived this isolated community, made up largely of Poles and other foreigners working on the water front and in the big industrial plants of the districts.14 The lack of sanitation and the filthy condition of the streets in this district were conspicuous. In the twenty-fourth ward as a whole considerably more than half the babies were in homes which had no sewer con nection.16 In the foreign neighborhoods west and south of the business center of the fourth ward,16 the largest single group of foreign-born families was the Lithuanian, and 91 of the 100 babies of Lithuanian mothers in Baltimore lived in the fourth or the twenty-second ward or just west of these in the eighteenth or the twenty-first ward. Almost no Polish families lived in the wards west and south of the central business district, and foreign-bom Jewish families were slightly less numerous than Italian families. In the twenty-second ward, also, were the blocks selected in the 1907 housing study to show the worst conditions in negro dwellings in Baltimore. But there were fewer births to colored mothers than to foreign-born white mothers in this ward. The largest negro neighborhood lay northwest of the downtown business district. More than half the births in the seventeenth ward (which adjoined to the north the western part of the fourth ward) were colored; and this ward, with the fourteenth which lay beyond it to the north and the eleventh ward which adjoined them both on the east, included almost one-third of the total number of negro births in Baltimore. n The tabulations do not show how the 447 live births to native white mothers and the 158 live births to foreign-born white mothers were divided between the Locust Point district and the western part of the ward. But the Locust Point district was popularly supposed to be chiefly foreign and the western part of the ward chiefly native born. . See Table 4, Appendix VH, p. 224. is Wards 4,18,21,22,23, and 24 except Locust Point. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 26 IN F A N T MORTALITY, BALTIMORE, MD. T able I.—-Ward o f residence; live births to colored mothers in 1915. Live births to col ored mothers. Ward group. Number. Wards 11,14,17.................................................. ............................................................. Wards 15' 16j 18, 22............................................ : ............................................................. Per cent distrib ution. 1,305 100.00 414 338 553 31.7 25.9 42.4 1 Wards in which less than one-fifth of the births were to colored mothers. Certain alleys in the seventeenth ward were described in the 1907 study of housing conditions in Baltimore as typical of negro alley dwellings in the city. This study showed space to be less congested in the Negro alleys than in the Jewish and Polish districts east of the Fallsway. But it found a higher percentage of dwellings seriously out of repair, and it referred especially to the lack of decent toilet facilities and to the filthy dampness of the alleyways. A t the time of this study the percentage of babies born into homes which lacked sewer connection was more than twice as high in the seventeenth ward as that in any one of the four poorest white wards.17 Around these districts, where the poorest homes predominated and where native white families were in the minority, the city stretched out to the east, to the north, and to the west. The small downtown district of fashion and wealth lay directly north of the fourth ward— a narrow belt in the eleventh ward— between the negro district on the west and the steep slope that dropped to the factories and rail road tracks along the Fallsway on the east. The other choice resi dential districts were to the north and northwest of this, about Druid Hill Park and toward the Johns Hopkins University and beyond.18 In no ward, however, did births among the well-to-do predominate, and no ward was without a quota of foreign-born and negro families.19 Baltimore has been called a city of homes. The present study offers no basis for comparing Baltimore with other cities in respect to the prevalence of one-family houses, but it was found that slightly more than two-thirds (68 per cent) of the infants whose dwellings were studied lived in one-dwelling buildings and only 3 per cent lived in buildings of five or more dwellings.20 Twenty-eight per cent of « Wards 2, 3, 5, and 22 showed median earnings of the fathers under $650. For exact percentages of dwellings with sewer connection in the several wards, see Table 4, Appendix V II, p. 225. is Of the 197 live births in families where the father earned $2,850 and over, 134, or 68 per cent, lived in the eleventh ward, or in the twelfth, thirteenth, fourteenth, or fifteenth wards to the north or northwest of the eleventh ward. Of the 44 infants surviving at least two weeks who lived in rented dwellings with rental of $50 or more a month, 42 lived in these five wards. See Tables 5 and 6, Appendix VII, pp. 226 and 228. u See Tables 3 and 5, Appendix VII, pp. 224 and 226. *<>See Table 10, Appendix VII, p. 230. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES’ SURROUNDIN'GS. 27 the families owned the dwellings in which they lived, but behind this average percentage there were wide variations in the different wards and in the different earnings groups. Speaking generally, the higher the fathers’ earnings and the higher the economic level within a ward the higher was the percentage of families owning the dwelling in which they lived. This percentage rose to 50 per cent and 56 per cent, respectively, among the families throughout the city where the fathers earned $1,250 to $1,849, and $1,850 and over. Wards 1, 6, 7, 9, 15, and 16 also showed more than one-third of the infants in fa m i lies who owned their dwellings. But these should be contrasted with the seven wards (4, 5, 11, 17, 18, 22, and 23) where only 15 per cent or less owned their dwellings, and the very small percentages of homes owned by families in the lower earnings groups.21 Baltimore is built on the alley plan, and in these narrow back streets lived a considerable percentage of the population, especially of the negroes. The evils of unpaved and dirty alleys were recog nized by the city officials, and in 1916, during the epidemic of polio myelitis, a systematic flushing of the alleys was attempted. Paving of the alleys was gradually being pushed, but the Municipal Journal stated in February, 1917, that 800 alleys were then under contract to be paved and in addition 1,279 alleys had not yet been paved nor contracted for. Alley dwellings have not been tabulated separately in the present study, but they unquestionably housed many of the colored babies and many of the babies in the poorest white families. The sewerage system of Baltimore was opened in 1911. Of the 10,336 infants whose dwellings are included in the present study, 2,364, or 23 per cent, had toilets not connected with the sewer. The great majority of these dwellings were in wards which included open blocks and outlying districts. The tabulations do not show how many of the dwellings without sewer connection were in open blocks and how many in thickly settled parts of these wards. It was found, however, that in 13 wards having no outlying districts, 598 infants lived in dwellings without sewer connection, and the per centage having no sewer connection varied in these 13 wards from 1 per cent in the fourth ward to 35 per cent in the nineteenth ward and 37 per cent in the first ward.22 During 1916 a vigorous clean-up campaign was inaugurated, the Women’s Civic League and the Women’s Cooperative Civic League working with the city departments to secure the cooperation of householders throughout the city in more efficient handling of garbage and other refuse. In 1916 a city ordinance was enacted requiring householders to use covered metal cans for garbage awaiting col lection. 21 See Tables 7 and 9, Appendix V II, pp. 229 and 230. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 22 See Table 4, Appendix VII, p. 225. 28 IN F A N T MORTALITY, BALTIMORE, MD. M O TH E RS’ COLOR AND NATIONALITY. The group of Baltimore births includes nearly 7,000 native white, families, nearly 3,000 white families in which the mother was of for eign birth, and more than 1,000 negro families. Or, in exact per centages^ 62 per cent of the births were to native white mothers, 25 per cent to foreign-born white mothers, and 13 per cent to negro mothers.33 T able II .— Color and nativity o f mother; births in 1915. Births in 1015. Color and nativity of mother. Per cent Number. distribu tion. 11,195 100.0 6,937 2,837 1,421 62.0 25.3 12.6 Foreign-born white families. The tabulations do not show how many of the native white mothers were of foreign parentage and what foreign stocks predominated; but in 1910, according to the Federal census, more than one-third (34 per cent) of the native white population of all ages and both sexes was of foreign or mixed parentage. The principal groups were, in the order named, German, English and Celtic (chiefly Irish), Jewish, and Polish. Together these groups comprised almost 90 per cent of the total number of native white persons of foreign or mixed parentage and about 30 per cent of the total native white popu lation.24 In 1910 the same four groups predominated among the foreignborn population in Baltimore that have been noted among the native white population of foreign or mixed parentage. The order of numeri cal importance was somewhat different, however, with the Jewish and Polish groups each larger than the English and Celtic (chiefly Irish) group. The German group was both actually and relatively smaller among the foreign-born white population than among the native white population of foreign or mixed parentage. In the present study, based on births in Baltimore during the year 1915, the group of foreign-born German mothers was smaller than the groups of foreign-born Jewish, Polish, or Italian mothers. Certain important elements in the foreign-bom population of the United States were not sufficiently represented in Baltimore to appear in the present study. For example, the detailed study of legitimate ** See Tablé 69, Appendix VH , p. 280. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ft See Table 11, Appendix V II, p. 230. 29 TH E BABIES’ SURROUNDINGS. births includes 21 births to foreign-born mothers of western European nationalities other than German or English and Celtic, and 77 to mothers of eastern European nationalities other than Polish, Bo hemian, and Lithuanian. In the analysis of conditions and mor tality rates in the foreign-bom families— that is, among infants of foreign-bom white mothers— discussion will coyer mainly the Jewish, Polish, and Italian groups. T able I II. i— Nationality o f mother; births in 1915 to foreign-born white mothers. Births i to foreignbom white mothers. Births i to foreignbom white mothers. Nationality of mother. Nationality of mother. Irish............................................ English, Scotch, and EnglishCanadian................................. Num ber. Per cent distri bution. 2,894 100.0 1 Oil '655 440 331 101 34.9 22.6 15.2 11.4 3.5 37 1.3 Num ber. 112 105 24 21 53 4 Other western European2......... Othereastem European3.......... Percent distri bution. 3.9 3.6 .8 .7 1.8 .1 1 Includes miscarriages. 2 8 Norwegian, 5 French, 3 Dutch, 2 Swedish, 2 Spanish, 1 Danish. * 19 Greek, 13 Magyar, 6 Serbian, 5 Slovak, 4 Rumanian, 4 Ruthenian, 2 Slavic (not otherwise specified). * 3 French-Canadian, 1 Arabian. The length of time these different groups had been in the United States reflects the general shifts in the tide of immigration. More than 25 per cent of the German, Bohemian, and English and Celtic mothers had been here 20 years or longer,25 and less than half had come during the last 10 years. Per cent distribution of births a in 1915. Length of residence of mother in the United States. German mothers. English and Celtic mothers. Bohemian mothers. 100.0 100.0 100.0 34.7 24.7 39.3 1.3 28.3 41.3 29.0 1.4 39.3 29.5 30.4 0.8 a Includes miscarriages. Among the Lithuanians and Italians and the 102 mothers of various nationalities (Russians, other eastern Europeans, “ other western Europeans,” and “ all other” ) more than half had come to the United States within 10 years and, except among the Lithuanians, more 25The difference between these three groups should be noted. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 30 IN F A N T MORTALITY, BALTIMORE, MD. than one-third had come within 5 years. The Jewish and Polish immigration had been more evenly distributed over a long period of years than any other, with more mothers who had come during the last 10 years than during the 10 years next preceding, but also with a high percentage who had been in the United States 20 years or more.29 The groups which had been longest in the United States were least separated from the life of the community. Their economic status approached that of the native white American; the mothers more generally spoke English; and the families lived not in the poorest neighborhoods where the foreign born predominate, but in wards of average prosperity, where more than half the births w;ere to native white mothers. T able IV .— Median earnings o f fathers and 'percentage o f mothers unable to speak English, by color ana nationality o f mother; live births in 1915. Color and nationality of mother. Native white........................... Median earnings of fathers.« $796 619 781 718 703 664 Per cent of mothers unable to speak English. 6 Color and nationality of mother. Percent Median of ’ earnings mothers of unable fathers.« to speak English.^ Foreign-born white—Contd. $555 525 540 671 474 37.3 14.4 17.9 18.4 63.5 71.4 66.0 43.1 0.1 a Based on births, not including miscarriages except for English and Celtic, Bohemian, Lithuanian, and "a ll other foreign.” For method by which median earnings are computed, see Appendix IV , p. 197. 6 Based on births, not including miscarriages except for Bohemian, Lithuanian, "all other foreign,” and colored. Nationality of mother. Births a in 1915. Estimated median residenceof motherin United States. Years. 138 331 112 1 on 655 105 440 102 14 14 12 10 9 8 7 5 Months. 6 2 6 5 8 5 5 « Includes miscarriages. The median conceals, however, the important fact that 20 per cent of the Poles and only 6 per cent of the Lithuanians had been in this country 20 years or longer. For detailed tabulation see Table 12, Appendix VII, p. 231. 26 The median residence in the United States reported by the several groups offers a convenient summary of their relation on this point. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES STIKKOUNDINGS. 31 While, on the whole, the nationality groups varied in these respects according to the median periods that they had been in the United States, three exceptions appear— among the Italians, the Bohemians, and the mixed group of “ all other foreign.” The Italian families, among whom relatively more had come within the last five years than the Lithuanians, reported higher median earnings than the Lithuanians and a slightly smaller percentage of mothers unable to speak English. The Italians were also more widely scattered through the city than the Lithuanians.27 The Bohemian families, who belonged to the older immigration and whose economic status was far above that of the recent immi grants, had stayed mainly in one district. Of the 107 live births to Bohemian mothers, 93, or 87 per cent, were in the three wards about Johns Hopkins Hospital, a distinct colony in wards where, on the whole, native white families predominated.28 On the other hand, the Bohemian families had a higher percentage owning their homes than any other group in Baltimore—not only higher than any other foreign-bom group, but also more than twice as high as the native white group: Bohemians, 73 per cent; native white families, 31 per cent. The mixed group of “ all other foreign” families, in spite of the shortest median period in the United States, had higher median earnings than any other foreign group except the English and Celtic, German, and Bohemian, and fewer mothers unable to speak English than the Poles, Italians, and Lithuanians. It will be remembered that about one-fifth of the “ all other foreign” families were western Europeans of the older immigration, but in the main this group con sisted of Russians and southeastern Europeans. In this group, also the percentage of families owning their homes (33 per cent) was about equal to the percentage among the native white families (31 per cent) and higher than that among any other foreign group except the Bohemians (73 per cent) and the Germans (47 per cent).29 Furthermore, while the variations in the extent to which foreignbom mothers had learned English correspond roughly with the variations in the length of time that the groups had been in the United States, certain marked differences persist when a comparison is made of the mothers in each nationality who had been in the United States less than 5 years, or those who had been here 10 years and ” 0 f the 100 Lithuanians, 91 were in a compact neighborhood made up of parts of 4 contiguous wards, while 16 wards reported no birth to a Lithuanian mother. Of the 412 Italians, 50 per cent were in the 2 wards just east of the Fallsway (the third and the fifth), 26 percent w erem the other wards of the water front (wards 1 ,2,4,21,22,23, and 24), and the remainder were distributed throughout the city. Only 3 wards (the ninth, eleventh, and the thirteenth) reported no live birth to an Italian mother. See Table 3 Appendix VII, p . 224. 28 Wards 6, 7, and 8. See Table 3, Appendix VII, p. 224. » F o r percentages of homes owned in the several groups, see Table 8, Appendix VII, p. 229. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 32 IN F A N T MORTALITY, BALTIMORE, MD. over. In each, comparison, a relatively high, percentage of the Poles and of the Italians and a relatively low percentage of the Jews spoke no English.30 The fact that illiteracy was far more prevalent among ‘ the Poles and Italians than among the other foreign bom may account in part for their failure to learn English. For within each nationality3 a higher percentage of mothers spoke English among those who could read and write than among the illiterate. Illiteracy, inability to speak English, and poverty seemed to go hand in hand. Not only were there more mothers who could not read and write, more mothers who could not speak English, and more very poor families among the recent immigrants (especially the Ital ians and the Poles) than among the Jews and the older immigration, but within each nationality, also, the poorer the fathers the higher the percentages of mothers who were cut off from the community by inability to speak English or by inability to read in any language.32 Colored families. The proportion of negroes in the population of Baltimore at the census of 1910 was somewhat greater than that in the United States as a whole and decidedly above the average for the cities of 500,000 or more population— 15 per cent in Baltimore, 11 per cent in the United States, and 3 per cent in the large cities. In actual number^ of negroes Baltimore ranked in 1910 as the fourth city of the United States.33 Practically all the negroes in Baltimore were of native birth,’ and most of them were born in Maryland. Nine per cent of the negroes in Maryland in 1910 had come from Virginia f 87 per cent were native in Maryland; and less than 1 per cent had come from any other State. What proportion of the negroes had been born in Baltimore is not known. The increase in negro population in Baltimore from 1900 to 1910 accompanying a decrease in negro population in the State of Maryland as a whole indicates a drift from the country to the city.34 Shifting of the colored population within the city was limited at the time of this study by a segregation ordinance, which prohibited any colored person from moving into a block occupied wholly by white persons (and vice versa). This ordinance had been passed in 1913 and was in force until it became invalid through the decision s# See Table 14, Appendix VII, p. 232. :, si Based on data for Jewish, Polish, Italian, German and “ all other foreign” (including Lithuanian). See Table 13, Appendix V II, p. 231. 32 See Tables 15 and 16, Appendix VII, p. 232. 33 Negro population: Washington, 94,446; New York, 91,709; New Orleans, 89,262; Baltimore, 84,749; Philadelphia, 84,459; Memphis, 52,441. See IT. S. Bureau of the Census, Vol. I, Population statistics 1910, p p .207-213. ¿L • ^ ... 34 u . S. Bureau of the Census, Thirteenth Census of the United States, 1910, Vol. II, Population statistics, p. 837; Bulletin 129, Negroes in the United States, 1915, pp. 14 and 58. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES* SURROUNDINGS. 33 of the United States Supreme Court in the Louisville segregation case.35 The rentals paid by colored families were excessively high. Only 6 per cent of the colored families included in the study owned the dwellings in which they lived. This percentage was smaller than the corresponding figure in the poorest families, all nationalities combined, and smaller than in any one of the foreign groups.36 Illiteracy was more prevalent among the negroes in Baltimore— 13 per cent illiterate—than among the negroes in any other city having 500,000 population or over at the 1910 census. Only St. Louis approached it, with 12 per cent of the negroes illiterate.37 A com-, parison of the negro mothers and the native white mothers in cluded in the detailed study also indicates the neglect of education for the negroes. Thus, 12 per cent of the negro mothers as against 2 per cent of the native white mothers were unable to read and write. In the poorest native white families, where the percentage of illiteracy rose above the average (to 6 per cent in families with fathers earning less than $450, and 5 per cent in families with fathers earning $450 but less than $550), it was much lower than the percentage in the negro families. In Baltimore separate schools and playgrounds were provided Tor white and colored children, but the colored leaders interviewed by the agents of the bureau referred to the fact that provision for their children was inferior to that for white children. They pointed out the lack of a colored industrial school in Baltimore and the absence of provision for mental defectives. Negroes in Baltimore had political representation; the seventeenth ward had for some years been represented by a negro in the city council. Several organizations of colored people were found working for improvement of education, of civic conditions, and of health conditions. The Federated Charities had enlisted the cooperation of colored leaders. . Such agencies as the hospitals, the Babies’ Milk Fund Association, and the Children’s Aid Society were serving both the white and the colored population. Social questions arising from differences in color and nationality. Isolation of a group from the life of the community as a whole may or may not affect the physical welfare of the babies of the group. If it deprives men of economic opportunity, because they can not pass barriers of language or of color, the babies born into their homes will pay with a high mortality the pride of the fathers’ poverty. If it cuts off women from the services of nurses and hosw Buchanan v. Warley, 245 U. S. 60, reversing Harris v. City of Louisville, 165 Ky. 539. Decided Nov. 5,1917. 86 See Tables 8 and 9, Appendix V II, pp. 229 and 230. s7 u. S. Bureau of the Census, Bulletin 129, p. 102. 101351°— 23------3 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 34 IN F A N T MORTALITY, BALTIMORE, MD. pitals and from opportunities to learn fundamental principles of the hygiene of maternity and infancy, the babies of the isolated group will suffer from their mothers’ ignorance and lack of care. If, o n ” the other hand, the foreign mother steps outside of her colony merely to exchange the traditions of the Old World for the habits of her American neighbors, without guidance from a trained adviser, her contact with the community will be of doubtful value to her baby. Several items in the data collected throw light on the contacts with the community established by the groups of foreign born and by the negroes in Baltimore. It is possible to examine the occupa tions in which the fathers in foreign and negro families were en gaged and their earnings, as compared with the earnings of fathers in the native white families in the same occupations; to compare the dwellings which, whether from choice or necessity, were occu pied by the several groups, and the home conditions into which the babies were born; and to note how white and colored mothers were supplementing the fathers’ earnings and the extent to which they were going out into the community to work. It has already been noted how many mothers were unable to read and write, and how many of the foreign-born white mothers spoke no English. It is interesting to see how the knowledge of English had reacted upon— the customs of the foreign born in regard to infant feeding; and to what extent the community agencies for instruction in hygiene and for medical care were serving the mothers in the several groups. FATHERS’ EARNINGS AND OCCUPATIONS. The native white families were the most well-to-do and the negro families were the poorest in the city, while the foreign-born groups varied in economic status from English and Celtic,38 whose earn ings were only a little lower than the earnings in the native white fami lies, to the Lithuanians, whose earnings were considerably above the earnings of the colored fathers. In the native white group, however, less than half the fathers earned as much as $850. The percentage of fathers earning at least $850 ranged from 42 per cent (based on total births) of all in the native white families to 4 per cent of all in the colored families.39 It may be fairly assumed that at the time of this study the difference between $850 and $1,850 marked the difference between a minimum of subsistence and a fair standard of comfort. Four per cent of the families (total births) lived at the comfort level; among the native white families, 6 per cent; and among the colored families, two-tenths of 1 per cent. That is to say, of the 10,797 livebom babies only 431 were in families where the father earned so much as $1,850. 88 Including Irish, Scotch, and Welsh. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 39 See Table 20, Appendix VII, pp. 238-239. THE BABIES SURROUNDINGS. 35 Fathers’ earnings and family income. The father’s earnings are used as the index to the family’s economic status because they are the normal source of the f a m ily income, and the assumption in the United States is that a man’s earnings will be sufficient to meet the needs of wife and children. In Baltimore, the father’s earnings were in fact the main source of income and usually determined the family’s economic status. Fifty-five per cent of the births were in families without income from any source except the father’s earnings, and 23 per cent in families where the father’s earnings were supplemented only by earnings of wife or children; 4 per cent, where the family’s earnings were supplemented by earnings of other relatives living in the household, or by money from pensions, or compensation allowances, and 10 per cent, where the cash earnings of the family were supplemented by gifts or by meals given in part payment for services rendered. Only 7 per cent were in families with any income from insurance, investments, or rents from tenants outside the family’s dwellings.40 Where the father’s earnings were below the level of decent sub sistence (reckoned at $850 at pre-war prices), the family income also was usually below $850. In this study 7,171 births were in families where the father earned less than $850; of these, 3,672 had no other source of income except the father’s earnings, and 2,753 reported earnings from other members of the household 41 in such amounts that the aggregate earnings of the family remained below $850. Only 109 of the families where the father earned under $850 had total earnings from all wage earners in the family amounting to $1,250 or more, and four-fifths of the families whose total earnings were under $850 had no other source of income. In all, then, 7,171 births, or 64 per cent of all studied, were in families where the fathers earned less than $850; and at least 5,249 births, or 47 per cent of all, were in families where the total family income was also less than $850. In addition, 1,336 births, or 12 per cent, were in families where the aggregate earnings were under $850, but were supplemented by meals, gifts, or income from other sources. The amount of income received from insurance, investments, or rents was not asked, but simply whether the family received income from such sources. It should be noted, however, that in no fathers’ earnings group under $1,250 did so many as 10 per cent of the families report income from such sources. Where the fathers earned $1,250 but less than $1,850, 11 per cent reported income from insurance, investments, or rents, and where the fathers earned $1,850 or over, 21 per cent.42 <o See Tables 26,27, and 28, Appendix VII, pp. 243-244. « Including, besides earnings, pensions, compensation allowances, and alimony, where these wero reported. 42 Tables 26,27, and 28, Appendix VU , pp. 243-244. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 36 IN F A N T MORTALITY, BALTIMORE, MD. The exact amounts received from family earnings apart from the father’s earnings are not tabulated in detail. It is known, however, that more than half the mothers who worked within the year after the baby’s birth earned less than $150.43 And considering only families where fathers’ earnings were supplemented by earnings of other members of the family, when earnings are classified in five groups (under $550, $550 to $840, $850 to $1,249, $1,250 to $1,849, and $1,850 and over), it is found that about one-third of the families fell in a higher earnings group on the basis of aggregate earnings than that in which they belonged on the basis of fathers’ earnings.44 Except where the father’s earnings by themselves approached the level of comfort, the great majority of the families (93 per cent) were dependent on their own exertions for support. And the amounts earned by wife and children, when these were employed, were usually too small to lift the family to a definitely higher economic level than that provided by the father’s earnings. Fathers’ occupations. The differences in the earnings of the fathers in the native white, foreign-born white, and the colored groups reflect differences in the kinds of work the fathers did and in the regularity of their employ ment. It was commonly stated that negro workers were paid lower wages than white workers in the same occupations. The tabula tions do not furnish exact evidence on this point, but they do show unmistakably that the annual earnings of negro workers were lower than the annual earnings of white workers in the same occupations. Occasional striking instances of difference in pay for white men and colored men doing the same work were noted by the bureau agents. The census classification of occupations according to subdivisions of the great fields of manufacturing, trade, transportation, clerical occupations, domestic and personal service, public service, agri culture and animal husbandry, extraction of minerals, and pro fessional and semiprofessional pursuits, throws little light on the economic status of the persons engaged in them. In the present study, therefore, the occupations of the fathers have first been classi fied according to this method and then regrouped according to the median earnings of the fathers in each occupation. This further grouping gives five classes of occupations in which median earnings were: I, under $550; II, $550 to $649; III, $650 to $849; IV, $850 to $1,049; and V, $1,050 and over.45 48 See Table 30, Appendix VII, p. 245. « Four thousand seven hundred and thirty-six births were in families where fathers’ earnings were sup plemented by family earnings and the amounts of the fathers’ earnings and the aggregate earnings were known. Sixty-five per cent fellin the same earnings group on both bases. See Tables 26 and 29, Appendix VII, pp. 243 and 244. <5 For the method by which median earnings are computed, see Appendix IV, p. 197. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES’ SURROUNDINGS. 37 In Group I (under $550)° were cannery operatives; laborers, except those employed in public service; janitors and elevator men; serv ants, except waiters; and the small number engaged in “ agriculture, animal husbandry, and extraction of minerals.” In Group II ($550 to $649)° were all factory operatives, except cannery workers; shoe makers and tailors; deliverymen and chauffeurs, teamsters, and expressmen; waiters; and laborers employed in public service. The total number of births with fathers in these two groups of occupa tions was 5,292, or 47 per cent of all births studied. Groups III ($650 to $849)“ and IV ($850 to $1,049)“ included all the other types of skilled manual labor—blacksmiths, boilermakers, skilled mechanics in the building trades, engineers and firemen in industrial establishments, and barbers, with median earnings $650 to $849; compositors, electricians, machinists, conductors and rail way trainmen, and express, telegraph and telephone employees, with median earnings $850 to $1,049. (No type of manual labor showed median earnings so high as $1,050.) In Group III (median earnings $650 to $849) were included also men engaged in clerical occupations, saloon keepers and bartenders, and unclassified em ployees designated as “ others” in manufacturing and mechanical occupations, in trade, in transportation, and in public service. Group IV (median earnings $850 to $1,049) included in addition to the more highly paid manual workers, salesmen and commercial travelers, firemen and policemen, proprietors and managers of hotels, pool rooms, etc., and retail and wholesale dealers, together with officials and managers in retail and wholesale trade. The number of births in families representing these two groups of occupations was a trifle smaller than the number in the more poorly paid occupations, and totaled 4,972, or 44 per cent, of all the births studied. Group V (median earnings $1,050 and over) was made up of men in six types of occupations— builders and contractors; manufac turers, proprietors, officials, etc., in manufacturing and mechanical industries; bankers, brokers, and real estate and insurance agents; proprietors, officials, and managers of transportation; public-service officials and inspectors; and men engaged in professional and semiprofessional pursuits. Six per cent of the births in the study were in families of this group. Two hundred and eight, or 2 per cent, of the births were in families where the father had no occupation (including seven births in families living on own income). Seventeen births, or less than 1 per cent, were in families where the occupation of the father was not reported.46 The most poorly paid occupations— with median earnings under $550— included more than half the fathers in the colored group, a Median earnings. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6 See Table 17, Appendix VII, p. 233. 38 IN F A N T MORTALITY, BALTIMORE, MD. almost one-fifth of the fathers in the foreign-born white, and almost one-twelfth of the fathers in the native white.47 In the next occupa tion group— with median earnings between $550 and $650—were approximately one-third of the fathers in the colored group, more than two-fifths of the fathers in the foreign-born white, and more than one-fourth of the fathers in the native white. Together these two groups of occupations, where more than half the fathers earned less than $650 and very few individual workers earned so much as $1,250, included 84.7 per cent of the fathers in the colored group, 59.2 per cent of the fathers in the foreign-born white, and 34.7 per cent of the fathers in the native white.48 More than half the fathers in the native white group and more than one-third of the fathers in the foreign-born white were in occunation Groups III and IV, mainly skilled manual occupations, with median earnings between $650 and $1,050. Only 8.1 per cent of the colored fathers were in this group. The supervisory and professional occupations— Group V, with median earnings above $1,050— included less than 10 per cent of the fathers in the native white group; 4.7 per cent of the fathers in the foreign-born white, and 1.6 per cent of the fathers in the colored. The earnings of all fathers engaged in each occupation are included in the computation of these medians, but when the earnings of the three color and nativity groups are considered separately a marked difference in median earnings appears even within each group of occupations. The earnings were highest in the native white and lowest in the colored group. For example, in the poorly paid and mainly unskilled occupations of Group I, the median earnings of the native white were approximately $560, the median earnings of the foreign-born white approximately $483, and the median earnings of the colored group were approximately $452. Again, in the occupa tions of Group II, with median earnings for all workers studied, falling between $550 and $650, the median earnings of the native white group were approximately $654, of the foreign-born white, $585, and of the colored, $489.49 It appears, therefore, that relatively more of the fathers in the negro than of the fathers in the white group, and relatively more of the fathers in the foreign-born white than of the fathers in the native white group, were employed in the most unskilled and poorly paid occupations. And, among men doing the same type of work, the earnings of the native white were higher and the earnings of the negro were lower than the earnings of the foreign born. « The reader is reminded that the groups are based on the color and nativity of mother. « See Table 17, Appendix V II, p. 233. 49 see Tables 20 and 21, Appendix VII, pp. 238 and 240. Median earnings are estimated from known distribution in earnings groups under $450, $450 to $549, $550 to $649, $650 to $849, etc. For method, see Appendix IV, p.'197. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 39 THE BABIES’ SURROUNDINGS. The actual difference in economic level comes out even more strongly when the earnings are compared without reference to the fathers’ occupations. For all occupations combined, the median earnings in the native white group were $796; in the foreign-bom white, $618; in the colored, $474. In the native white group, 55.3 per cent of the fathers earned less than $850 (in addition to 1.4 per cent who earned nothing); in the foreign-bom white group, 73.9 per cent of the fathers earned less than $850 (besides 1.9 per cent who earn ed nothing); and in the colored group, 87.3 per cent of the fathers earned less than $850 (besides 5.2 per cent who earned nothing). Or, comparing the earnings in the several groups with the amount which the infant mortality rates seem to indicate as the minimum for providing the necessities of health and well-being, it appears that in the native white group 5.5 per cent earned at least $1,850; in the foreign-born white group 2.2 per cent earned at least $1,850; and in the colored group 0.2 per cent earned at least $1,850.50 T able V .— Earnings o f father by color and nativity o f mother; per cent distribution o f births in 1915. Per cent distribution. Births to— Earnings of father. Total births. Native ForeignColored bom . white mothers. white mothers. mothers. Total........................... ...................................... ................... 100.0 100.0 100.0 100.0 Under $650................................ ..................................................... S650-S849 ....................................................................................... $850-81,849...................................................... ........... ..................... $1,850 and over.............................................................................. No earnings..................................................................................... Not reported......................... .......................................................... 41.8 22.2 27.9 4.0 2.0 2.0 29.7 25.6 36.0 5.5 1.4 1.9 53.1 20.8 20.2 2.2 1.9 1.8 78.5 8.8 4.2 0.2 5.2 3.1 Irregularity of fathers’ employment. The fathers in the native white group were more steadily em ployed than the fathers in the foreign-born or the colored groups, 66 per cent reporting employment throughout the year, as against 47 per cent among the foreign bom and 46 per cent among the negroes.51 Nonemployment is discussed in the present study from the point of view of the family and includes not only the father’s unemployment from lack of work or from illness but also any period .during which he was not contributing to the support of the family because of desertion or death. Irregularity of employment has been consid ered in computing the father’s earnings, and earnings refer in every so The reader is again reminded that these figures refer to pre-war prices and earnings. For more detailed tabulation of father’s earnings by color and nationality, see Table 18, Appendix VII, p. 234. oi See Table 23, Appendix VII, p. 241. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 40 IN F A N T MORTALITY, BALTIMORE, MD. case to amounts actually received during the year following the birth of the infant in 1915.52 Relatively more nonemployment was ascribed to lack of work and to illness among the fathers in the foreign-born white than among the fathers in the negro group; and among the fathers in the negro group the number unonemployed” for other reasons, including desertion of the family, was relatively high. T a b l e V I . — P er cent o f fath ers iCnonem ploy ed’ ’ by cause o f nonem ploym ent and color and n ativity o f mother; births in 1915.1 Per cent of fathers nonemployed. Cause of nonemployment. Color and nativity of mother. Work not avail able. Illness. Other causes (includ ing de sertion). 32.4 6.4 2.6 26.0 44.0 40.5 6.1 7.9 5.2 2.0 1.6 7.6 1 See Table 24, Appendix VII, p. 242. Comparing those in each group whose nonemployment was ascribed to lack of work and for whom the period of nonemployment was definitely stated, it is found that relatively more of the foreign born than of the native, whether white or colored, were out of work for six months or more— 12 per cent of the unemployed foreign born,, 6 per cent of the unemployed native white, and 5 per cent of the unemployed negroes.53 The nonemployment from other causes, including illness and desertion, was, in each group, of somewhat longer duration than the nonemployment from lack of work, and when all nonemploy ment, from whatever cause, is considered together it appears that the period of nonemployment was at least six months for 12.5 per cent of the irregularly employed fathers in the native white group, for 16.2 per cent of the irregularly employed fathers in the foreignborn white group, and for 21.7 per cent of the irregularly employed fathers in the colored group. 62In the majority of cases the computations were based on reports made by the mothers of the weekly or the monthly wages and the time out of work. In the study of infant mortality in Manchester, N. H., similar reports of fathers’ earnings were -tested with pay-roll data; it was found that on the whole the mothers’ statements were substantially correct, with perhaps a slight tendency to overstatement. See Infant Mortality. Results of a Field Study in Manchester, N. H ., Based on Births in One Year, by Beatrice Sheets Duncan and Emma Duke, Children’s Bureau publication No. 20, pp. 15 and 16. 58 See Table 25, Appendix VII, p. 242. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 41 THE BABIES7 SURROUNDINGS. T able V I I .—Duration o f nonemployment o f father by color and nativity o f mother; births in 1915 with fathers reporting duration o f nonemployment. Per cent distribution of fathers nonemployed.1 Duration of nonemployment of father. Native white group. Foreignborn white group. Colored group. Total............................................. ............ 100.0 100.0 100.0 Under 3 months.................... .................................... 3-6 months......................................... 6 months and over....................................................... 69.4 18.1 12.5 54.3 29.5 16.2 59.0 19.4 21.7 1 Based on births. The extent to which nonemployment was responsible for low earnings among the fathers in the native white, the foreign-bom white, and the colored groups is indicated by the following figures. Among all the fathers in the native white group earning less than $450 during the year, 10 per cent were steadily employed and 27.2 per cent were nonemployed for at least six months; in the foreignborn white group earning less than $450 during the year, 12.2 per cent were steadily employed and 19.4 per cent were nonemployed for at least 6 months; but in the colored group, 32.2 per cent of those earning less than $450 were steadily employed throughout the year and only 7.9 per cent were nonemployed for six months or more. (In each color and nativity group there were also a considerable number reported as nonemployed but with no report as to the period of nonemployment. This number was 14.8 per cent of the native white, 19.7 per cent of the foreign-born white, and 18.2 per cent of the colored fathers, respectively, in the group earning less than $450.) In the next earnings'groups, where the fathers earned from $450 to $549 or from $550 to $649, relatively more of the fathers in the colored than of the fathers in the white group were steadily em ployed, and fewer of the fathers in the colored than of the fathers in the white group were without employment for three months or more. But in these earnings groups there was far more nonemployment among the fathers in the foreign-born group than among those in the native white group. In the higher earnings groups, where more steady employment was reported among all types of families, the total number of colored fathers was small. Again, it is possible to compare, roughly, the median earnings of all fathers in the native white, the foreign-born white, and the colored groups with the median earnings of those fathers in the same groups who were steadily employed. The smallest difference appears in the colored group and the largest difference in the foreign-born white group, in spite of the fact, already noted, that on the whole https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 42 IN FAN T MORTALITY, BALTIMORE, MD. in these two groups the percentage of fathers irregularly employed was practically identical. T a b l e V I I I .— Median earnings o f fathers steadily employed compared with all fathers, by color and nativity o f mother; births in 1915. Median earnings.1 Color and nativity of mother. Fathers steadily em ployed. All fathers. $825 $705 888 785 511 796 618 474 1 Estimated from distribution of births in earnings groups “ under $450,” “ $450 to $549,” “ $550 to $649,” “ $650 to $849,” “ $850 to $1,049,” etc. See Tables 22 and 23, Appendix V II, pp. 240 and 241. Two things seem apparent, even from this unsatisfactory analysis: First, that in the pre-war days to which the data refer the foreignborn white man and the colored man were less regularly employed than the native white man; and, second, that from the nature of the occupations in which he was engaged and the rate at which he was paid, the colored man who was steadily employed remained in the same low earnings class with the colored man who was not steadily employed. HOM E CONDITIONS. Many of the most important phases of home conditions do not lend themselves to tabulation, and yet a rough index for the compari son of the babies’ homes among the native white families, the larger groups of foreign white families, and the negro families is afforded by such items as the rental paid, the sanitary arrangements of the dwellings, and the relative sizes of dwellings and households. Rental and sanitation. The lowest median rental, $5.83 per month, was found among the Polish families; the highest, $13.25 per month, among the English and Celtic.54 In the three other groups it ran from $8.42 among the Italian families to $11.83 among the native white families. Three hundred and fifty babies, or 5 per cent of those living in dwellings for which cash rent of a known amount was paid, were in dwellings rented at less than $5 a month. The proportion rose to 39 per cent among the Poles and dropped to 2 per cent among the Jews and the Negroes. 64The Lithuanians paid a rental slightly higher than the Poles, and the English and Celtic paid a rental slightly higher than the Negroes. For all other housing items these two nationalities are included in the group of “ all other foreign,” and this group, as a whole, paid a rental lower than the negroes and higher than the Poles. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES’ SURROUNDINGS. 43 The 350 dwellings rented at less than $5 a month were scattered ^throughout the city. A t least 1 was reported for every ward, but only in seven wards were there as many as 10 such dwellings. Almost three-fourths were in wards 1, 2, and 3, and in these wards they formed a considerable percentage of all the dwellings. Taking the city as a whole, one-half of all the families studied reported a rental of less than $15 a month. Differences in rental usually reflect a difference in economic status, but a comparison of the median rental with the median earnings of the fathers in each of the color and nationality groups reveals two variations: Among the Negroes, the group with the lowest earnings, is found next to the highest median rental, amounting to 33 per cent of their median earnings; among the Poles, with earnings lower than any other group except the Lithuanians, Italians, and Negroes, was found a median rental so low that it amounted to only 13 per cent of their median earnings. The native white families, the Jewish families, and the Italians were paying in median rental 18 per cent, 17 per cent, and 19 per cent, respectively, of their median earnings.55 But the amount of rental is less important than the dwelling it procures. Considering the three items, sewer connection, a toilet for the exclusive use of the family, and a bath tub, as roughly indicating a fair standard of convenience and sanitation, it is found that the Polish families had by far the poorest dwellings, 12 per cent possess ing none and only 6 per cent possessing all these arrangements. Of the native white families, 51 per cent lived in dwellings provided with these three arrangements, 42 per cent of the Jewish families had them, and only 20 per cent of the Italian families lived in such dwellings. That this reflected in part the relative prosperity of the native white families and was not due wholly to their insistence on a certain standard of living was indicated by the dwellings occu pied by families in which the father earned under $650 during the year. The percentage of native white homes with the three con veniences dropped to 29, the Jewish to 25, and the Italian to 12. And in this economic group relatively more of the native white homes than of the Jewish, Italian, or Negro homes had none of these conveniences, the exact percentages being 6 among the native white families, 3 among the Italians and Negroes, and 2 among the Jews.56 Among the Negroes, as a whole, in spite of their paying a higher median rental than any other group except the English and Celtic, the percentage of dwellings provided with the three stated sanitary arrangements was lower than among the native white or the Jewish families. It has been commonly believed that a negro tenant pays more than a white tenant for similar accommodations. These find66 See Tables 31, 32, and 33, Appendix VII, pp. 245 and 246. « See Table 34, Appendix VII, p. 247. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis IN F A N T M O E T A U T Y , BALTIMOEE, MD. 44 ings confirm this belief so far as the city of Baltimore is concerned. Among the native white families living in rented dwellings, 24 per cent paid $15 or more per month, and 51 per cent of all native white f a.m ilip.fi lived in dwellings having bathtub, sewer connection, and a C h a r t I . — R e n t a l a n d s a n it a r y c o n d it i o n o f d w e llin g s . Per cent. 100 t. P e rce n ta g e p a y in g 15 or m o r e •monthly r e n ta l. 342 23.7 14.3 8.9 — so 0.9 _ 5.9 20.3 32.5 42.9 50.6 Native white.. P ercen tage living indw ellings with all s a n ita ry accom m odations. Jewish. Polish. Italian. Other foreign. Negro. toilet for the exclusive use of the family; among the negro families 34 per cent of those living in rented dwellings paid $15 or more per month, but only 33 per cent of all the negro families lived in dwell ings provided with these arrangements.57 w See Tables 31 and 34, Appendix VII, pp. 245 and 247. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES SURROUNDINGS. 45 Space and size of household. So far as space is concerned, the native white families, as the most prosperous, fared better than any others. In actual number of rooms per dwelling, the median negro home, with six rooms, was the same as the median dwelling among native white families, but the median negro household numbered six persons, and the median native white household numbered only four persons, so the margin of space in negro homes was considerably less than in the native white homes. More cramped than either of these groups were the households of the foreign bom , where the median dwelling of four rooms accommodated a median household of four persons. (The kitchen was counted as a room,' hut the bathroom was not.) Within the foreign group itself, variations were found both in the size of the dwelling and in the number of persons it accommodated. The medians in the Jewish families were the same as those for the entire foreign group; in the Italian families the number of rooms was the same but the median household numbered five instead of four. The Polish families had the smallest and most congested dwellings, with a median of three rooms and four persons. The “ other for eign” — including the German, Bohemian, English and Celtic, and all -oth er families— reported the same median space in their dwellings as the native white families— six rooms and four persons. Further analysis shows that the percentage of families who reported one or more persons per room, exclusive of the baby born during 1915, ranged from 36 per cent among the native white families to 89 per cent among the Polish families. The Italians stood nearest to the Polish in their room congestion, with 72 per cent reporting one or more persons per room; then the Jewish families with 63 per cent, the Negroes with 54 per cent, and the group of “ other foreign” with 49 per cent. Thirty-one per cent of the babies in Polish families were housed in dwellings with two or more persons per room; among the Italians 14 per cent, and among the Jewish families 9 per cent, were housed in such congested quarters. In each group, the percentage of families reporting one or more persons per room increased with the size of the household, but it was not only large households that had no margin of space. The households of four persons or less showed similar variations in the native white, the foreign white, and the negro f a m ilies — 18 per cent of such native white families, 31 per cent of such negro fa m i l i es, and 50 per cent of such foreign families were living one or more persons per room. And for each size of household, there were markedly higher percentages reporting two or more persons per room among the foreign families, and especially among the Poles, than among other groups. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 46 IN F A N T MORTALITY, BALTIMORE, MD. In each race and nativity group room congestion was greatest in the poorest households; but, again, at each economic level the native white and the negro families had relatively more rooms in their dwell ings than the foreign families.58 Variations in size o f family. Closely related to the variations in the size of household are the variations in the numbers of children born to the mothers of the several nationalities. But they do not correspond exactly, because of differences in the stillbirth and infant mortality rates, and differ ences in custom regarding the presence in the household of relatives and lodgers. Thus the Polish and Italian mothers reported on the average more births and (in spite of high mortality among the Polish) more children surviving the first year of life than any other nation ality. But the average households of the Jewish, the Polish, and the “ other foreign” groups were approximately the same; and of all the foreign born, only the Italians with their high percentage of families keeping lodgers showed a definitely larger average household.59 The negro mothers also reported a large average number of births but relatively fewer children surviving their first year. The negro house holds, however, were larger, on the average, than any others. T a b l e I X .—Size offam ily by nationality o f mother; births 1 in 1915. Color and nationality of mother. Average number of births1 to mother.2 3.08 4.11 3.89 4.51 4.35 3.39 4.13 Average Average number number of child of per ren sur sons per viving 1 dwell ing.8 year.2 2.48 3.36 3.35 3.54 3.49 3.18 2.88 4.48 4.77 4.70 4.66 5.19 4.73 5.79 1 Includes miscarriages. „ ,,. • . .. , TTT aIncluding 1915 birth. Average derived from Table 70, Appendix VII, p. 281. V 'lA j 8 Excluding 1915 infant, but including parents. Average derived from data shown in Table 35, Appen dix VII, p. 248. Analyzing the average number of births to the mothers, the extent to which the groups vary from one another is more clearly seen. The number of mothers who had borne seven or more children ranged from 10 per cent of all in the native white group to 26 per cent of all in the Polish group. MSee Tables 35,36, and 37, Appendix VII, pp. 248 to 252. ss Two nationality groups—the Lithuanians and the small unclassified group of “ all other foreign” made up mainly of immigrants who had recently arrived from southeastern Europe—showed a higher percentage of families keeping lodgers than the Italian showed. But the housing data for these two groups wioh 191 infants have not been separately analyzed. In comparison with every other group the Italians had the highest percentages keeping any lodgers (18.3 per cent) or keeping 3 or more lodgers (4.8 per cent). See Table 40. Appendix V II; p. 254. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES’ SURROUNDH'TGS. 47 The mothers in the poorest families bore more children than the prosperous mothers. This difference was more marked among the —native white mothers, who had an average o f -3.1 children in families in which the fathers earned less than $550 a year and 2.5 in families in which the fathers earned $1,250 or over, than among the foreignbom mothers, who had an average of 4 children in families having earnings of less than $550 a year and 3.8 in families having namings of $1,250 or over.60 Associated with this question of the size of the family is a variation in the length of the interval between births. From the three sets of data on this point included in the tabulations, it appears that the average interval between births was shorter in the poorer families than in the well-to-do, and shorter among the colored families than among native white families of the same economic level. The Polish and Italian mothers— the groups with the largest families— seem to have had the shortest interval and the Jewish mothers the longest interval between births. But it appears also that the intervals between the first birth and the second and between the second birth and the third tended to be somewhat shorter than those between births later than the third, except that the intervals between births -4n very large'families (of 10 or more) were the shortest of all.61 EMPLOYMENT OF MOTHERS. In Baltimore, as in other cities studied by the Children’s Bureau, it was mainly the wives of men whose earnings were insufficient for the family’s needs who were gainfully employed away from home during the critical time of pregnancy or the normal nursing period. Tracing the mother’s record back for the entire period of her marriage, as the Baltimore tabulations for the first time allow, it is found that for the large number of women who had worked away from home at some time after marriage the same relation holds: The lower the earnings 62 of the men, the higher the proportion of women going out to work. 80 Considering live births, stillbirths, and miscarriages, the averages in the native white famiiiog were 5 under 8550 and 2.8 at $1,250 or over and in the foreign white families 4.7 under $550 and 4.1 at $1,250 or over. See Tables 38 and 39, Appendix VII, p. 253. 81 See Tables 41, 156, 157, and 165, Appendix V II, pp. 254,351, and 357. 81 This statement is based on the assumption that, in general, the earnings of the father during the year following the birth of a baby in 1915 correctly indicate the family’s economic status in-previous years also. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 48 IN FAN T MORTALITY, BALTIMORE, MD. T able X .—Employment o f mother away from home, by earnings offather and color and nativity o f mother; births1 in 1915. Per cent2 of mothers em ployed away from home during pregnancy. Earnings of father. Native Foreignbom Colored white white mothers. mothers. mothers. $450-$549........................................................................................................... $550-$649........................................................................................................... $650-$849........................................................................................................... $850-$1,049........................................................................................................ $1,050-$1,249...................................................................................................... 5.5 11.4 44.9 15.5 12.5 7.6 4.1 2.0 1.2 1.1 20.4 18.5 14.6 14.7 7.8 2.8 2.9 .9 24.5 50.9 41.3 36.5 34.8 69.6 1Includes miscarriages. * Based on births, including miscarriages. Not shown where base is less than 50. Ch a r t II.—Per cent of mothers gainfully em ployed away from hom e, b y fathers’ earnings. DURING PREGNANCY. AFTER BIRTH. Per cent. 70 Per cent. 60 50 40 30 20 10 $450. to $549. to $649. $450. to to and $849. $1,049. over. Native white mothers Foreign-bom white mothers Colored mothers to $549. to to to and :l,049. over. Prevalence of employment. Relatively more colored women than white women, and relatively more foreign-born women than native women, worked outside their homes. But in each of these three groups separately it is found that in descending the scale of fathers’ earnings, there was a steady increase in the percentage of mothers gainfully employed away from home at any time after marriage, or during the pregnancy of 1915, or during the first 12 months of the baby’s life time.63 63For detailed tabulation see Table 92, Appendix VII, p. 295. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES 49 SURROUNDINGS. Another indication of the economic pressure that is usually present when married women go to work outside their homes is given b y the fact that the percentage of women reporting such employment rose steadily with the number of children in the family. At each economic level within each of the three race and nativity groups, the percentage of mothers who had worked outside their homes since their marriage was higher among those who had borne seven or more children than among others. And in families where the father earned less than $850, the percentage of mothers who had worked outside their homes since marriage was higher among those who had borne from four to six children than among those who had borne less than four.64 T able X I .— Time o f employment o f mother away from home; live births in 1915. Live births. Time of employment of mother. Per cent Number. distribu tion. 1 10,797 100.0 2,284 8,507 6.011 945 1.551 6 21.1 78.8 55.7 8.8 14.4 1 Not shown when less than one-tenth of 1 per cent. In all, 8,507 live-born babies, or 79 per cent of those studied, were bom to mothers who had been at some time gainfully employed out side their homes. Over one-half of all the mothers had gone out to work before they were 16 years old, and over one-fourth before they were 14. But many of these mothers had had no outside employment after marriage, and others did not go out to work during the preg nancy of 1915 nor within 12 months after the birth of a baby in that year. Of the 10,797 babies studied, 1,229, or 11 per cent, were born to mothers who worked outside their homes during pregnancy; more •than one-half., of these mothers resumed work outside the home after the baby’s birth— 594 during the baby’s lifetime and 104 after the baby’s death. The mothers of 322 babies, or 3 per cent of all, went out to work within 12 months of the baby’s birth, although they had not been so employed during pregnancy— 261 during the baby’s lifetime, and 61 after the baby’s death.65 All but 22 of these 322 mothers had been gainfully employed away from home at some previous time. m See Table 94, Appendix VII, p. 296. 101351°—23----- 4 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 50 IN FAN T MORTALITY, BALTIMORE, MD. Occupations. The white mothers working away from home were mainly factory operatives; the negro mothers were mainly domestic servants, char women, and laundresses.86 T a b l e X I I .— Occupation o f Toother, by color; births in 1915 to mothers employed away from home during pregnancy.1 Occupation of mother during 1915 pregnancy. Births to mothers em ployed away from home. White. A ll.................................. Factory operatives: Canning, shucking............ Clothing............................ Other factory.................... 688 315 99 121 Occupation of mother during 1915 pregnancy. Colored. 629 6 23 12 Births to mothers em ployed away from home. White. Charwork, laundering, etc___ Other occupations................... Colored. 49 22 82 363 194 31 1 The statements that follow in text are based on births, Table 98, Appendix V II, p. 300. Among the cannery workers Polish women predominated, and almost one-third were native white women; the other cannery workers, a very small number in all, represented every nationality group except the Jewish. Approximately two-fifths of the clothing workers were native white women and the remainder were about evenly divided among the Negroes, the Lithuanians, and a scattered group representing every nationality except the English and Celtic. Of the workers in “ other factories,” four-fifths were native white women. These numbers represent widely varying percentages of mothers employed away from home in the several race and nationality groups, as custom and economic status within the group sent more mothers or fewer out to work. At one extreme, with the largest numbers going out to work, were the Negroes and Poles; at the other extreme, the Jewish and Italian women. Of the native white mothers, 14 per cent had worked away from home after marriage, 6 per cent during their pregnancy of 1915, and 4 per cent during the first 12 months of the infant’s life. Among the Jewish mothers, these percentages dropped to 7 per cent, 1 per cent, and less than 1 per cent; among the Negroes they rose to 67 per cent, 45 per cent, and 32 per cent.67 For the period of the 1915 pregnancy and the 12 months after the birth of a baby in that year, the gainful employment of mothers within their own homes has also been tabulated. Except among See Table 101, Appendix VII, p. 303. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis MSee Tables 96, 97, and 98, Appendix VII, pp. 297-300. 51 THE BABIES ’ SURROUNDINGS. the Poles and the Negroes, more mothers worked at home than away from home. And considering together employment at home and away it is found that the native white mothers, instead of the Jewish mothers, reported the least employment during the pregnancy of 1915. The percentage employed among the Jews rose to a point just above the average for the city, and among the Italians con siderably higher. The Negroes and Poles still headed the list with the highest proportions of mothers gainfully employed.68 Relatively few mothers reported doing “ home work” given out by a factory. The 174 mothers 69 (just 2 per cent of all) who reported having sewed at home on work given out by a factory during the 1915 pregnancy were Italians (69), native white women (37), Poles (22), Lithuanians (17), Jews (15), and others (14). Only among the Italians and the Lithuanians did these numbers represent more than 4 per cent of the mothers, but here they rose to 16 per cent of all. Of the 124 mothers employed at “ other home work,” 3 mothers—native white—were working for a factory and 12 were probably doing factory work. These 12 included 2 Italian mothers making lace and embroidering, one Jewish mother “ making crab cakes at home,” one colored mother mending feed bags, and 8 native white mothers •making Christmas ornaments, flowers, brushes, etc. The principal home occupations among the white mothers were keeping lodgers and helping in the husband’s business; among the negro mothers, laundering. T a b l e X I I I .— Occupation o f mother, by color; births in 1915 to mothers employed at home during pregnancy. Occupation of mother during 1915 pregnancy. Births to mothers employed at home. White. Colored mothers. mothers. Keeping lodgers....................... Sewing (for factory)................ 1,397 355 670 167 46 1 Occupation of mother during 1915 pregnancy. Helping in husbands5business. Doing other home work......... Births to mothers employed at home. White Colored mothers. mothers. 55 22 333 104 3 14 Keeping lodgers was most prevalent among four of the foreign groups. In the small mixed group of “ other foreign,” 19 per cent of the mothers were so engaged; of the English and Celtic mothers, 15 per cent; and of the Lithuanian mothers and the Italian mothers, 14 per cent. But these groups were small, and together they reported only 115 of the 732 mothers who kept lodgers. In actual numbers, the « See Tables 92 and 93, Appendix V II, pp. 295 and 296. MSee Table 100, Appendix VII, p. 302. m Births. Table 98, Appendix V U , p. 300. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 52 IN F A N T MORTALITY, BALTIMORE, MD. native white mothers led, with 422 keeping lodgers— a large number but a small percentage (6 per cent) of the total number of native white mothers. The other 195 mothers keeping lodgers were scat tered among the other nationalities, with percentages in each group varying from 3 per cent of the Negro mothers to 9 per cent of the German mothers. Helping the husband’s business was the chief occupation reported by Jewish mothers, of whom 163, or 16 per cent, were so engaged. These Jewish mothers and 107 native white mothers constituted more than three-fourths of all the women helping in the husband s business. Both actually and relatively the numbers were small in the other groups, ranging from less than 1 per cent of the negroes to 10 per cent of the mixed group of “ other foreign.” Ch a r t n i . _Per cent of mothers gainfully employed at home and away from home, by color and nativity. 40 r 30 i NATIVE WHITE. During pregnancy. .During life of infant. 255 FOREIGN-BORN WHITE During pregnancy. During life of infant. | C l .l | 24.8 N E GR O. During pregnancy. During life of infant. . an| ¿Q.U I It has been noted that fewer mothers were employed outside their homes after the birth of the baby than during the pregnancy of 1915. This decrease accompanies an increase in the number gain fully employed within their homes. Even omitting from consider ation the mothers who resumed or began work only after the death of the baby born in 1915, this increase in work at home persists.70 T able X I V .— Time and place o f employment o f mother; live "births in 1915 to mothers employed. Live births to mothers em ployed. Place of employment. During preg nancy. Within the first year after birth. At any time. During lifetime of infant. 2,911 3,036 2,784 1,229 1,682 1,020 2,016 855 1,929 70 For details of shifting from employment to nonemployment and from employment away to employ ment at home and vice versa, see Table 101, Appendix VII, p. 303. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES’ SURROUNDINGS. 53 In each nationality without exception 71 this change in the distri bution of working mothers is found— relatively more working at home and relatively fewer working away during the lifetime of the infant than during pregnancy. Among the Negroes and the Poles, however, in spite of this increase in employment at home, work away continued to be more prevalent than work at home. Whether the mother works at home or away is a matter of great importance to her baby’s welfare. From the infant mortality rates, which will be discussed in detail in a later section,72 it appears that the work away from home increased the hazard to the baby, while work at home, so far as the Baltimore figures show, was accompanied by no excess in the infant mortality rate. Whether the mother at home regulated her own conditions of work so that strain during pregnancy was avoided, and ill effects were not too serious to be outweighed by the benefit of addition to the family income, is an open question. It does appear that the mothers who worked at home breast fed their babies to about the same ex tent as mothers at the same economic level who were not gainfully employed. The high percentage o f Negro mothers and Polish mothers employed away from home and the very low percentages of Jewish and Italian mothers so employed may reasonably be considered one factor in the high infant mortality rates among Negro and Polish babies and the low infant mortality rates among Jewish and Italian babies. CARE OF THE INFANT. Prevalence of artificial feeding. One baby in 11 was deprived of breast milk during the first month of life; 1 baby in 5 had been weaned before the end of the third month; and by the ninth month, 1 baby in 3 was having only artificial food. Behind these average percentages for all babies born in 1915 were certain marked variations among the several groups. More babies were artificially fed in the prosperous families than among the less well-to-do, and more babies were artificially fed in the native white families than in the foreign-born white or the negro families. On the other hand, mixed feeding— that is, the supplementing of the mother’s milk with cow’s milk or other food— was less common during the early months of infancy among the native white families than elsewhere. But even with the relatively high percentages of babies mixed fed in the other groups, there were also higher percentages having only breast feeding among the babies of foreign-born white mothers than among the babies of native white mothers and, omitting n Native white, Negro, Jewish, Polish, Italian, and all other foreign (German, Bohemian, English and Celtic, Lithuanian, and “ other foreign” combined). >*See page 114. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 54 IN FA N T MORTALITY, BALTIMORE, MD. the babies of mothers gainfully employed, higher percentages having only breast feeding among the babies of colored mothers than among the babies of native white mothers. These comparisons hold true not^ only for the several groups as a whole, but also for native white, foreign-born white, and colored families of the same economic levels. The feeding was tabulated separately for the three largest foreignborn groups. The Polish and Italian babies showed approximately the same distribution among the three types of feeding, with a slight difference in favor of the Italian babies. Among the babies of Jewish mothers, on the other hand, during the third month and later, the percentages having mixed feeding were markedly high. As com pared with the Polish babies, the Jewish babies showed slightly less artificial feeding at the first, third, and sixth months of life and markedly less breast feeding during the sixth month and later. As compared with the Italian babies, the Jewish babies showed prac tically no difference in the extent of artificial feeding, but markedly less breast feeding from the third month onward.73 It is worth noting that the Italian and Polish mothers who had learned to speak English were more likely to wean their babies during the early months than the Italian and Polish mothers who had not learned to speak English, while exactly the reverse was true of the ~ Jewish mothers. And more of the Polish mothers who could read and write than of the illiterate Polish mothers were weaning their babies during the early months, while among the Italian mothers as well as the Jewish mothers there was less artificial feeding when the mothers could read and write than when they were illiterate. Among the native mothers, both white and colored, the illiterate women were less likely than the others to give their babies breast milk and no other food during the early months. In both groups the illiterate mothers showed a high percentage of babies whose nursing by their mothers was supplemented by other food. And among the illiterate native white mothers the percentage of babies weaned in the early months was also above the average.74 Within each race and nationality group the greatest prevalence of artificial feeding occurred in families where the mother was gainfully employed away from home.75 SUMMARY. The Baltimore group included considerable numbers of colored births and of births to foreign-born Jewish, Polish, and Italian mothers. Other foreign groups were also represented, but their numbers were too few to permit a separate detailed analysis. 73 See Tables 42,80, and 81, Appendix VII, pp. 255,288, and 289. 74 See Tables 43, 44, and 45, Appendix V U , p p. 255 and 256. 76 See Table 46, Appendix VII, p. 257. Therelation of the mother’s employment to her way of feeding her baby is discussed in detail in the section on Employment of Mothers and infant Mortality, p. 124. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE BABIES7 SURROUNDINGS. 55 Artificial feeding of young babies, poverty, poor bousing, and employment of mothers away from home are four important factors in infant mortality the relation of which to mortality rates will be discussed in detail in the later sections of the report. In Baltimore artificial feeding was more prevalent among the native white mothers than among the foreign-bom mothers or the colored mothers. It was more prevalent among the Avell-to-do than among the very poor white mothers, although it was greatly increased in certain poor groups by the mothers7 employment away from home. Except among the foreign-born Jewish families, the foreign-born mother who spoke English was more likely to wean her baby during the early months than the foreign-born mother who spoke no English. In spite of the relatively high percentage of mothers employed in the Polish group there was no marked differ ence in the prevalence of artificial feeding among the Poles, the Italians, and the foreign-born Jewish mothers when these groups are considered as a whole. Almost two-thirds of the births studied were in families where the fathers earned less than $850 a year. Four per cent were in families where the fathers earned $1,850 or over. Economic conditions were -w orst among the colored families. These fathers were employed mainly in unskilled and poorly paid occupations and their annual earnings were lower than the earnings of white fathers in similar kinds of work. On the. other hand, the colored families paid higher rentals than white families for houses with corresponding type of sanitation. In the colored group the median rental was approxi mately one-third of the median earnings of the fathers; in the white groups it was less than one-fifth. The foreign-born fathers also earned less than the native white fathers, because of difference in type of occupation and lower earn ings from similar types of occupations. But no foreign-born group (except the small group of Lithuanians) was so poor as the colored group. The foreign-born families lived in poorer dwellings and had greater room congestion than thé native white families. But when native and foreign-born families of corresponding economic levels are com pared, it appears that the foreign-bom families had approximately the same sanitary equipment as native white families with similar earnings. The greatest room congestion and the lowest rentals were found in the Polish group. More than one-fifth of the families lived in dwellings without sewer connections, and a considerable number of these were in wards with no outlying, thinly settled districts. The percentage of dwell ings having no sewer connection was higher in the seventeenth https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 56 INFANT MORTALITY, BALTIMORE, MD. and eighteenth wards than in any other ward with no outlying district. About one mother in seven worked away from home during preg nancy or during the lifetime of the baby within 12 months after the birth. Such employment was most prevalent among the Negro and Polish mothers and in these groups 45 per cent and 33 per cent, respectively, worked away from home during pregnancy. In every group the percentage of mothers employed away was greatest in the poorest families and decreased steadily with increase in the fathers’ earnings. The principal occupation among white mothers employed away from home was factory work— chiefly in canneries for the Poles, and for others chiefly in clothing factories. Domestic service was the principal occupation among colored mothers. The interplay of these social conditions in relation to variations in the infant mortality rates in the several groups offers the main subject for the following sections. Even this brief survey of the field suggests certain reasons for the excessive mortality among babies of Polish mothers and babies of colored mothers. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE DEATHS. Of the 10,797 live-born babies in the normal Baltimore group, 1,117, or approximately 1 in 10, died during the first year of life; 477 died during the first month, 337 between the second month and the sixth, and 303 between the seventh month and the twelfth. Seven-eighths of all the deaths were ascribed to the three main Ch ar t IV .—Infant m ortality rates, b y cause of death. Infant m ortality rate. 50 - 41.3 Early infancy and malfor mations. Gastric and intestinal diseases. Respiratory diseases. 67 67 Other communicable diseases. All other causes, groups of infant diseases, and the total infant mortality rate, 103.5 per 1,000 live births, is made up as follows: T a b l e I . — In f Hint mortality rates, by cause o f death; live births in 1915.1 Cause of death. Infant .m or tality rate. 103.5 Malformations........................................... 29.1 19.7 3.6 Cause of death. Infant mor tality rate. 37.7 Epidemic and other communicable disAll other causes....................................... 6.7 6.7 1 For detailed tabulation, see Table 48, Appendix V II, p. 258. More babies died during the hot months from July to September and during the month of March than at any other season. Omitting the seasonal deaths (from gastric and intestinal diseases and from 57 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 58 IN FA N T MORTALITY, BALTIMORE, MD. respiratory diseases), it is found that in March there were 71 deaths from other causes, while in the other months the number of deaths from other causes ranged from 56 in April to 39 in January. AGE AT DEATH. In the Baltimore group, as in the death-registration area of the United States and in the cities of the birth-registration area, slightly over two-fifths of all infant deaths occurred in the first month of life. Roughly, one may say that in Baltimore of every 1,000 babies Ch ar t V .—Infant deaths, b y calendar month. Number. Gastric and intestinal diseases Respiratory diseases born alive, 103 died during the first year; 56 died during the first three months (37 of these failed to survive the first two weeks); 19 died during the fourth, fifth, or sixth month; 15, during the seventh, eighth, or ninth month, and 13, during the last three months of the first year. A glance at the deaths by single months reveals the fact that although, in general, the number of deaths decreased month by month, more babies died in the fifth month and in the sixth month than in the second, third, or fourth. In the seventh month the number of deaths was strikingly less than in any preceding month.76 « See Table 50, Appendix VII, p. 260. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 59 TH E DEATHS. T a b l e I I .— Deaths per 1,000 live births, by age at death; comparison o f Baltim ore and cities in the birth-registration area. Deaths per 1,000 live births. Deaths per 1,000 live births. Cities in the birthregistra tion area (1915). Age at death. Balti more. 2 weeks, under 1 month......... Cities in the birthregistra tion area (1915). Age at death. Balti more. 103.5 103.3 1 month, under 2.................... 56.0 37.0 7.1 60.4 35.4 8.0 3 months, under 6................... 6 months) under 9................... 9 months) under 12................. 6.0 5.8 19.4 15.1 13.0 9.2 7.8 18.1 14.0 10.9 In the cities of the birth-registration area in 1915 the total infant mortality rate (103.3 per 1,000 live births) was practically identical with the rate for the Baltimore group (103. 5 per 1,000 live births). But the Baltimore rate was higher than that for the other cities dur ing the first two weeks of life and during each three-month period after the first three months.77 CAUSES OF DEATH. Early infancy and malformations. In Baltimore, as in the cities of the birth-registration area, the causes of death peculiar to early infancy were responsible for more babies’ deaths than any other group of diseases. Among the Balti more babies 407 deaths were assigned to premature birth, congenital debility, or injuries at birth, and in addition 39 babies born with malformations died early in their first year.78 These causes together showed an infant mortality rate of 41.3 per 1,000 live births. More than three-fourths (78.5 per cent) of these deaths occurred within 2 weeks of birth, many of them within 24 hours; 40 deaths assigned to early infancy or malformations, or 9 per cent of all deaths from these causes, occurred after the second month. The deaths after the second month included none of those due to injuries at birth, and 77 For detailed tabulation see Table 47, Appendix v n , p. 257. re So far as information could be secured, a list of defects of infants bom alive is shown in the following tabular statement: Nature of defect. Rate per Number. 1,000 live births. Cleft palate.................... Harelip.......... ............... Additional finger or toe. Missing finger or toe— Club foot........................ Paralysis of lim b........... Hydrocephalus............. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6 9 13 3 3 1 4 0.6 .8 1.2 .3 .3 .1 .4 Nature of defect. Imperfectly developed head. Spinabifiaa....... .......... . Monster....... ....................... .. Lack of opening of rectum. .. Congenital disease of heart... Blind........ ............................. Rate per Number. 1,000live births. 7 4 2 1 38 1 0.6 .4 .2 .1 3.5 .1 60 IN F A N T MORTALITY, BALTIMORE, MD. only 2 of those due to prematurity. But 9 of the 39 babies who died from malformations and 29 of the 138 who died from congenital debility had struggled safely through the first two months and died"~> later in the year.79 The death rate from malformations (3.6 per 1,000) was lower than the corresponding rate (6.1 per 1,000) in the cities of the birthregistration area. For the causes peculiar to early infancy the Baltimore rate was higher than that in the birth-registration cities. Even omitting from the Baltimore group the colored babies with their specially high death rate from these diseases, the Baltimore rate was still somewhat above the rate for the other cities. T a b l e I I I .—Infant mortality rates from causes 'peculiar to early infancy, by color and nativity o f mother; comparison o f Baltimore and cities o f the birth-reqistration area (1915). Color and nativity of mother, and area. Cities of birth-registration area (1915)............................................................ Baltimore study................................................. .................................. White mothers.................... ................................................................. Native................................................................................ Foreign-born..... ................................................................... Colored mothers................................................................. ._____ Live births. 1481,496 10,797 9,492 6,739 2,753 1,305 Infant mortal ity rate from early infancy. 35.0 37.7 36.0 38.1' 30.9 49.8 1 Includes 471,144 white and 10,352 colored infants. U. S. Bureau of the Census, Birth Statistics, 1915. First annual report, p. 10. Only for the babies of foreign-bom mothers did the Baltimore rate from early infancy drop below that for all the cities of the birth-reg istration area combined. The deaths from causes peculiar to early infancy were more evenly distributed through the different seasons than deaths from gastric and intestinal diseases or deaths from respiratory diseases; and yet in the Baltimore group it was found that more babies died from causes peculiar to early infancy in March, April, and November than in other months and noticeably few in January. The variations in the numbers of births occurring in the several months do not ac count for these differences, for the infant mortality rate from this group of causes was exceptionally high among babies born in March, April, or November and exceptionally low among babies born in January.80 In discussing these diseases, Dr. Grace L. Meigs says: “ No more than a guess can be made as to the degree to which these diseases can be prevented. * * * Two problems are here involved: (1) The ignorance of the prospective mother in the care of 79 See Table 50, Appendix V II, p. 260. 80 See Tables 52 and 53, Appendix VII, pp. 262 and 263. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 61 TH E DEATHS. herself during pregnancy; (2) improper care by physician and mid wife during pregnancy and at birth.” 81 The present study will show the extent to which in the Baltimore group the death rate from causes peculiar to early infancy varied not only with the color and nativity of the mother, but also with the family’s means, with the work the mother did, and the number of children she had borne. Gastric and intestinal diseases. Second in importance as a cause of death were the diarrheal dis eases, from which 308 babies in the Baltimore families died under 1 year of age. The six deaths from diseases of the stomach were included with these in the group of gastric and intestinal diseases, and the combined infant mortality rate was 29.1 per 1,000 live births. In the deaths from these causes there was the least variation in rates between the native, foreign-bom, and colored groups as a whole.82 Each of the three in the Baltimore study showed a rate somewhat higher than the rate in the cities of the birth-registration area. , Color and nativity of mother, and area. Infant mortality rate from gastric and intestinal diseases. Cities of birth-registration area (1915)..................... ............. |........... ....... ................ altimore study................................. ............................................... ............................. Native white mothers.............................................................................................. Foreign-horn white mothers.......................................... ....... ......................... ....... Colored mothers...................................................................................... ................ 26. 6 29.1 28. 8 29.1 30. 7 These deaths occurred at every month of age within the first year of life. The hazard was less during the first two months than later and for these early months the rate in the Baltimore group was below the rate in the cities of the birth-registration area. The monthly death rate from gastric and intestinal diseases, in the Baltimore group reached its maximum during the sixth month. Or, if the four three-month periods of the first year of life are considered, the lowest infant mortality rate from gastric and intestinal diseases is found during the first quarter and the highest rate during the second quarter.83 Quite different was the distribution of such infant deaths among all babies under 1 year of age in all cities of the birthregistration area during 1915. There the rate from gastric and intes tinal diseases was highest during the first three months of life and decreased steadily and markedly through the remainder of the first year.. For each age period except the first three months the Baltimore group had a higher rate than the babies in these other cities, and it may be noted that the highest rate reached b y the Baltimore group « Grace L. Meigs, M. D.: Other Factors in Infant Mortality than the Milk Supply and Their Control, in American Journal of Public Health, Vol. V I, No. 8. 83 Table 49, Appendix VII, p, 259. Important variations in rate occur within the foreign group, which will be discussed in the comparison of the several nationalities. Compare page 78. 88 See Tables 50 and 54, Appendix VII, pp. 260 and 264. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 62 IN FA N T MORTALITY, BALTIMORE, MD. (during the second three months) was higher than the maximum reached in the other cities (during the first three months). A com parison with the death rate under 1 year from gastric and intestinal diseases in Baltimore City during the calendar year 1915 shows a distribution of deaths similar to that in the group studied in detail and unlike that in the cities of the birth-registration area. Gastric and intestinal diseases are, of course, largely seasonal. Disregarding for. a moment differences between the two summers, it appears that for the Baltimore group, while no calendar month was without infant deaths assigned to these diseases, the months from July to October had 243 such deaths, or 77.4 per cent of them all. August had the highest number of deaths, 89, and July followed with 78.84 The summer of 1916, which was the period of special exposure for most of the older babies in the Baltimore group, was exceptionally dry,85 and the city death records showed more deaths under 2 years of age from diarrhea and enteritis during 1916 than during 1945, when the younger babies in the Baltimore group were especially exposed to gastric and intestinal disorders. This might account for an exceptionally high percentage of such deaths occurring during the later months of life. It could have no bearing upon the high mortality during the months from the third to the sixth. Deaths from these causes are considered the most immediately preventable of all infant deaths, since the disorders from which they result are directly related to wrong feeding and improper care. That these di£orders are gradually being controlled and prevented through out the country is indicated by the mortality statistics for the deathregistration area. The total number of infant deaths in the death registration States as of 1910 (exclusive of North Carolina) decreased from 135,020 in 1910 to 119,349 in 1917. There is no reason to assume a corre sponding decrease in the annual number of births within the same area, since a possible decrease in birth rate would have been more than offset by an increase in population. Therefore, the shift in per cent distribution of deaths by cause of death indicates, primarily, a decrease in the mortality from the causes which show a decreasing percentage of the total infant deaths. On the other hand, whether the mortality from causes-which show an increasing percentage of the total deaths has actually increased or merely remained constant while the deaths from other causes have decreased can not be determined without a comparison of deaths and births.86 84 See Chart V , p. 58, and Table 52, Appendix Vn, p. 262 . 86 See Table 56, Appendix VII, p. 264. 86A comparison of infant births and deaths is possible for the birth-registration area as of 1915, exclusive of Rhode Island. The infant mortality rate from gastric and intestinal diseases was 24.6 in 1915,25.1 in 1916, and then fell to 23.4 in 1917, 23.2 in 1918, and 19.0 in 1919. Compiled from U. S. Bureau of the Census, Birth Statistics, 1915 to 1919. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 63 TH E DEATHS. T a b l e IY .— Changes in per cent o f infant deathsfrom certain causes in the death-registration area, as o f 1910 (exclusive o f North Carolina), 1910 to 1917. Per cent of infant deaths from specified causes! Years. 1917 ...................... 1916......................... 1915......................... 1914......................... Gastric Early in and in fancy and All other testinal malfor causes. diseases. mations. 23.7 24.3 23.4 24.5 41.4 41.2 41.9 41.4 34.8 34.6 34.6 34.2 Per cent of infant deaths from specified causes. Years. 1913......................... 1912......................... 1911......................... 1910.................... . Gastric Early in and in fancy and All other testinal malfor causes. diseases. mations. 26.1 25.3 27.0 30.6 39.8 39.5 37.1 30.7 34.2 35.0 35.7 38.7 ■ (U. S. Bureau of the Census, Mortality Statistics, 1917, p. 64.) Marked variations in the rates from gastric and intestinal diseases occurred within the native white group and among the several nationalities in the Baltimore study. How these variations were related to methods of feeding and to home conditions will be discussed in later sections of this report. The very low rates prevailing in certain groups tend to confirm the belief that these disorders can be largely prevented by breast feeding, and by good care and sur1 roundings. Respiratory diseases. To the third important group of infant diseases— pneumonia, bronchitis, and broncho-pneumonia— were assigned 213 deaths among the Baltimore infants, an infant mortality rate of 19.7 per 1,000 live births. The hazard from these diseases persists throughout the first year of life, but the rate was highest (3.5) during the first month and decreased slightly as the year progressed. More than one-sixth of the babies who died of respiratory diseases were less than 1 month old, and more than three-fifths of them were less than 6 months old. In the cities of the birth-registration area there was a similar slight decrease in these deaths as babies grew older, but the proportions of the deaths from respiratory diseases occurring in the early months of age were not quite so high as in the Baltimore group. During each three-month period except the last the rate was higher in Baltimore than in the cities of the birth-registration area.87 As in the deaths from gastric and intestinal diseases, there was a seasonal variation, but the greatest numbers of deaths from respira tory diseases were in February (33) and March (32), and the least were in August (7). The five calendar months, January, February, March, April, and December, had 129 such deaths, two and one-third times as many as the five months from July to November. These deaths were very unevenly distributed among the different families studied. Relatively more than three times as many occurred 87 See Table 47, Appendix V U , p. 257. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 64 IN FA N T MORTALITY, BALTIMORE, MD. among the colored babies as among the white babies. Or, specifically, of the 1,305 babies born to colored mothers, 64 died from respiratory diseases— 49 per 1,000 live births; of the 9,492 babies born to white mothers, 149 died from respiratory diseases— 15.7 per 1,000 live births. Among the babies of foreign-born mothers the rate (20.7) was higher than among the babies of native white mothers. It should be men tioned that respiratory diseases are often complications of acute contagious diseases, especially of whooping cough and measles, and as shown later, whooping cough was more prevalent among colored than among white babies.88 This element of the infant death rate has been considered difficult to touch; the definite attempt to reach it is the development of only the last few years. But, again, the low rates found in certain groups suggest that many of the deaths from respiratory diseases might be prevented.89 Here, too, the chief weapons are improve ment in the standard of living and the education of the mother. She must learn that breast milk and plenty of fresh air increase the baby’s power of resistance; that the baby must not be exposed to infection from a person suffering from a cold; and that respiratory infections in the baby must receive early treatment. Other communicable diseases. About 1 in 15 of the infant deaths were ascribed to the other com municable diseases, which included whooping cough, with 18 deaths, tuberculosis, 15 deaths, and syphilis, 14 deaths. The other 25 deaths in this classification were scattered among several causes— measles 8, influenza 7, erysipelas 4, diphtheria and croup 4, and scarlet fever and dysentery each 1. Altogether these diseases showed an infant mortality rate of 6.7 per 1,000 live births, which was somewhat less than the corresponding rate (8.5 per 1,000) in cities in the birth-registration area in 1915.90 The 14 deaths assigned to syphilis occurred in the earliest months of life— 10 in the first month and only 1 after the third month.91 Deaths from this cause, like those assigned to early infancy, are directly related to the condition of the mother and the condition of the infant at birth. Their prevention depends directly upon the care and treatment of the mother during pregnancy* and confinement. s8 But if both causes are stated on the death certificate the death is ascribed to the epidemic rather than to the respiratory cause. See U. S. Bureau of the Census, Manual of International Causes of Death, pp. 18-20; also U. S. Bureau of the Census, List of Joint Causes of Death. 8» A marked reduction in infant mortality from respiratory diseases in New Zealand during the past 15 years from 10 per 1,000 births in 1905-1909 to 4.6 in 1915-1918, has accompanied the development of infantwelfare work in that country. 90 See Tables 47,48,49, and 50, Appendix VII, pp. 257 to 260. 91 In addition to these deaths assigned to syphilis, an unknown number due to syphilis or other venereal infection are probably included in the early deaths assigned to “ prematurity,” “ congenital debility,” “ diseases ill defined and unknown,” and other causes. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis TH E DEATHS. 65 The deaths assigned to other communicable diseases increased in the later months of life, and 24, or almost two-fifths of all, occurred '-"among babies more than 9 months old.92 Among babies from 6 to 12 months old the death rate was practically the same in the Balti more group and in the cities of the birth-registration area for other communicable diseases. While it is necessary to guard against using the rates for the group studied as true and complete for the city of Baltimore, it is found nevertheless that on this point the experience of the group was similar to that shown by all registered infant deaths in Baltimore during 1915 and 1916— low death rates for communicable diseases other than syphilis, with a diminishing difference between Baltimore and the other cities as babies passed from early infancy to the later months of their first year. Variations in rates from these diseases were found within the Baltimore group. Except for the three diseases— whooping cough, tuberculosis, and syphilis— the total numbers of deaths were too small to justify analysis, and, even for these three causes, slight variations in rates would not be significant. But when it is found that the babies of colored mothers died from whooping cough at the ^rate of 5.4 per 1,000 five births and that this rate was 3 times as high as the rate (1.8) among babies of foreign-born white mothers and 6 times as high as the rate (0.9) among babies of native white mothers, it becomes apparent that this difference in rate reflects a real difference in conditions and care. Again, the rate from deaths assigned to syphilis was 11 times as high among babies of colored mothers (7.7 per 1.000) as among babies of foreign-born white mothers (0.7), and 26 times as high as the rate (0.3) among babies of native white mothers.93 For tuberculosis the babies of foreign-born mothers had the most favorable rate (0.4 per 1,000). The colored babies had a rate (3.1 per 1.000) more than twice as high as the babies of native white mothers (1.4 per 1,000). This indication that relatively more colored babies than white babies died from tuberculosis was confirmed by the much « This cannot be ascribed to the fact that measles and whooping cough were more prevalent in Baltimore during 1916 than during 1915. While 17 of the 26 babies in this group who died from one of these diseases had passed the sixth month of life, more than half the infant deaths from measles and whooping cough recorded for the year 1915 in the cities of the birth-registration area were in this same age period. See Table 50, Appendix V U , p. 260. M This may in part reflect a difference in the extent to which deaths from syphilis were assigned to other causes in registering deaths of white persons and deaths of colored persons. It has been shown in other studies that venereal infection is more prevalent among the negroes in Baltimore than among the white population. J. Whitridge Williams: The Limitations and Possibilities of Prenatal Care based upon the study of 705 foetal deaths occurring in 10,000 consecutive admissions to the obstetrical department of the Johns Hopkins Hospital, pp. 32-48, especially pp. 33-35, American Association for Study and Prevention of Infant Mortality, fifth annual meeting, Boston, 1914; J. Whitridge Williams: The Significance of Syphilis in Prenatal Care andin the Causation of Foetal Deaths, in New York State Journal of Medicine, 1920, Vol. X X , pp. 252-259. 101351°— 23------5 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 66 IN F A N T MORTALITY, BALTIMORE, MD. greater difference between the white and colored death rates from tuberculosis at all ages in Baltimore.94 The prevention of communicable diseases in infancy is not only a general community health problem but another challenge to all efforts to insure babies breast feeding and good home care. It is also, in large part, a problem of the sound condition and good care of the mother during pregnancy and confinement. The deaths from such diseases, even where the rate was highest, were few in relation to infant deaths from all causes, and yet they did increase the total infant mortality rate in the group. If no babies had died from these diseases the rate for babies of white mothers would have been 90.6 per 1,000 instead of 95.9 and for babies of colored mothers 141. 7 instead of 158.6. Other causes. Of the remaining 72 scattered deaths which completed the toll within the group, 10 were assigned to external causes, 7 to causes entered as ill defined or unknown, 10 to meningitis, and 15 to “ con vulsions.” Little variation within the group was found in relation to these deaths. The colored babies had more than their share of deaths from external causes, with a rate of 2.3 per 1,000, as against. 94N ote .— Year, and color of mother. White: 1915 1916.. Estimated population of Balti more, July l.o 496,682 501,155 Deaths from tubercu losis.* Number. 798 812 N Per 1,000 population. 1.60 1.62 Estimated population of Balti more, July I.® Year, and color of mother. Colored: 1915......... 1916......... Deaths from tubercu losis.* Number. 87,923 88,466 Per 1,000 population. 489 509 5.56 5.75 a U. S. Bureau of the Census, Bulletin 133, p. 37. * U. S. Bureau of the Census, Mortality Statistics, 1915, p. 570; 1916, p. 420. Information was secured from various agencies in Baltimore about the mothers shown by their record to have had tuberculosis, either at the time of the birth during 1915 or at some earlier time. This was undoubtedly an incomplete s+a+ement of *he total number of cases, but it offers a bit of evidence about the increase in hazard to infants whose mothers had had tuberculosis. Infanc deaths. Condition of mothers. Live births. From tubercu losis. From all other . causes. Infant Infant Num mortality Number. mortality ber. rate. rate. Mothers with tuberculosis................................................. Mothers without tuberculosis............................................ 96 10,701 3 12 31.3 1.1 23 1,079 239-6 100.8 Note that while infant mortality from “ all other causes” was higher when the mother had tuberculosis than when she did not have tuberculosis, the difference was especially marked in the mortality from tuberculosis. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis THE DEATHS. 67 0.7 per 1,000 among-the white babies, but the whole number of such deaths (10) was too small to be significant. Plainly, however, deaths from external causes usually reflect lack of proper care of the baby. Of the other 62 deaths, 24, or about two-fifths, occurred in the first month of life, and 50, or nearly four-fifths, occurred during the first six months of life. It seems likely that many of these early deaths were closely related to the deaths classified as due to causes peculiar to early infancy and could have been prevented only by better care of the mother before her baby’s birth. SUMMARY. The total infant mortality in the Baltimore group was approxi mately equal to the mortality reported for the cities of the birthregistration area during 1915. The Baltimore group had a rate some what higher than this general rate for deaths during the first two weeks and after the first three months of infancy, and lower than this general rate for deaths among infants 2 weeks but less than 3 months o ld .95 The Baltimore rate for causes peculiar to early infancy, which was slightly above that for the birth-registration cities, was relatively high during the first two weeks of life and relatively low thereafter. The Baltimore rate for gastric and intestinal diseases, which for the year as a whole was above the rate in the birth-registration cities, was lower than the rate elsewhere during the first two months and higher than the rate elsewhere during the remainder of the year. It was especially high among babies in their fourth, fifth, and sixth months of life. The Baltimore rate for respiratory diseases was relatively high for the year as a whole and was not at any period lower than the rate in the birth-registration cities. The excess in the Baltimore rate ap peared chiefly among babies 3 months but less than 9 months old, but also for the relatively few deaths from these diseases among babies under 2 weeks of age the Baltimore rate was higher than the rate elsewhere. The Baltimore rates for communicable diseases and for the illdefined and “ all other” causes were below the rates for the birthregistration cities. In each group of deaths, except those from malformations, the rates among colored babies were higher than the rates among white babies. Other variations that accompanied differences in economic and social conditions will appear in the development of the discussion. »s The reader is again reminded that in comparing the rates in the Baltimore group with the cities of the birth-registration area, the rates used as a standard of comparison were almost twice as high as the rates which had prevailed during recent years in the cities of New Zealand. And even where the rate for the Baltimore group as a whole was “ relatively low,” it was still above the New Zealand rate. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 68 IN F A N T MORTALITY, BALTIMORE, MD. The total infant mortality in the Baltimore group was higher than that in the groups studied b y the bureau in Brockton, Akron, and Saginaw, and lower than that in the groups studied by the bureau hr~ Waterbury, New Bedford, Johnstown, and Manchester. The Balti more rate from gastric and intestinal diseases was markedly higher than the rates in the three other cities with a lower total mortality. The Baltimore rate from the causes peculiar to early infancy was higher than the corresponding rates in New Bedford and in Akron. Saginaw and Brockton showed lower mortality from respiratory and other communicable diseases. T able V.—Infant mortality rates from specified causes; cities studied by the Children's Bureau. Infant mortality rate. City. Respiratory Gastric and and other Early All causes. intestinal communi infancy. cable diseases. diseases. 134.0 165.0 130.3 96.7 122.7 85.7 84.6 103.5 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 32.8 63.3 48.3 12.4 41.0 20.4 8.2 29.1 38.3 29.4 36.7 21.5 26.6 16.0 15.3 26.4 39.6 39.6 29.0 37.2 38.7 28.9 37.7 37.7 FEEDING AND INFANT MORTALITY. It has become a truism that babies who are nursed through the greater part of the first year have a lower mortality than babies who are weaned prematurely or are never nursed at all, and that babies who are given during their early months other food in addition to breast milk face a greater hazard than babies who have breast milk only. The extent of the variation is greatly modified by the condi tions under which artificial feeding is given and the nature of the food. It is true, also, as shown in later sections of the report, that breast fed babies in the poorest families have a higher mortality than arti ficially-fed babies in the most prosperous families, but within each group, distinct and homogeneous in race or nationality and in eco nomic status, an excessive hazard persists among artificially-fed babies as compared with breast-fed babies in the same group. In these studies “ breast feeding” refers to those babies who at the specified age were receiving breast milk and no artificial food what ever. “ Artificial feeding” refers to those babies who were receiving no breast milk at all. “ Mixed feeding” refers to babies who were being nursed but were having other food besides. No attempt has been made to distinguish among the various kinds of artificial food such as cow’s milk (raw or Pasteurized), condensed or evaporated milk, proprietary foods, bread or other solid foods, etc.96 The feeding of each baby was recorded and classified separately for each of the 12 months of the first year.97 Any comparison of mortality must, therefore, be based primarily on the monthly death rates of the three groups of babies— the breast-fed group, which diminished from month to month as babies were given other food, and the mixed-fed and artificially-fed groups, which in creased correspondingly. But from the monthly death rates an annual rate, per 1,000 babies fed, may be computed in order to compare the total hazards to breast-fed and other babies.98 96 The milk situation in B altimore during 1915 and 1916 was generally recognized as unsatisfactory. Raw milk, inadequately safeguarded by regulation and inspection of dairies, and “ loose milk” were sold under insanitary conditions. Pasteurization was voluntarily carried on by certain large dairies but without standardization of the process. The sale of milk from diseased cows was prohibited, but city health au thorities found, year b y year, a considerable number of herds which had not been tuberculin tested. A new ordinance intended to remedy these conditions was passed in 1917, to become effective June 1 of that year. (Municipal Journal, Feb. 9,1917, p. 7.) 9? When a shift from one type of feeding to another occurred within the month the month was assigned to the type of feeding which predominated. In most of the tabulations of feeding and mortality, however, the feeding after the ninth month was disregarded; infants surviving at the beginning of the tenth month and deaths among them were classified according to the feeding recorded for the ninth month. 98 For the method of computation of annual rate per 1,000 babies fed, see Appendix V, p. 199. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis *70 T able IN FAN T MORTALITY, BALTIMORE, MD. I .— Monthly death rates, by type o f feeding and month o f life; infants bom in 1916. Month of life. Deaths per 1,000 infants fed in Deaths per specified way. 1,000 infants surviving at beginning of month. Breastfed. Mixed fed. Artificially fed. First................................................................................ Second............................................................................. Third............................................................................... Fourth............................................................................ Fifth..................... . Sixth............................................................................... Seventh..................... .................................................... 144.2 6.3 6.1 6.1 7.0 7.6 5.6 5.6 5.2 4.8 15.0 3.9 2.4 2.3 3.4 2.2 1.7 2.2 2.8 2.7 42.7 6.6 9.5 ' 5.4 5.6 4.0 3.2 3.3 3.1 2.3 i The rate per 1,000 infants fed was 19.3; 269, or 24.9 per 1,000 live births, died not fed. Chart V I.—Monthly death rates, b y type of feeding. R ate per 1, 000. Breast-fed babies Artificially-fed babies Babies having mixed feeding https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 55.3 18.9 18.4 16.5 15.7 20.6 13.7 11.8 9.8 9.6 71 FÈEd ING AND IN FA N T MORTALITY. Comparing, first, the monthly death rates, it is found that at each month up to the ninth the babies artificially fed had the highest mortality, and that during the last three months of the first year the babies who'had been artificially fed in the earlier months con tinued to show a higher mortality than the babies who had had breast feeding or mixed feeding through the ninth month. The breast-fed babies showed a monthly death rate of 15 per 1,000 babies fed in the first month, 3.9 per 1,000 babies fed in the second month, and thereafter a fairly constant rate ranging from 1.7 to 3.4 per Ch art VII.—Computed infant mortality rates during first 10 months of life per 1,000 infants fed, by type of feeding and cause of death. Rate per 1,000 fed. 120 108.8 100 Breast feeding. Artificial feeding. Gastric and intestinal diseases. Breastfeeding. Artificial feeding. All other causes. 1,000 in each month to the end of the year. The artificially-fed babies showed a monthly death rate of 55.3 per 1,000 babies fed in the first month, 18.9 per 1,000 babies fed in the second month, and a slowly diminishing rate in the succeeding months which touched 9.6 per 1,000 in the tenth to twelfth month. A break in the fall occurred, however, in the sixth month, when the mortality among artificially-fed babies rose to 20.6 per 1,000. The babies having mixed feeding showed the greatest difference between the first and later months. Their rate in the first month, 42.7 per 1,000, approaches the rate for artificially-fed babies; from the second month to the ninth it continued higher than the rate for breast-fed babies https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 7â ï t f M T MORTALITY, BALTIMORE, MD. though with a diminishing difference. From the tenth month to the end of the year the babies who had had mixed feeding during the ninth month or earlier had approximately the same mortality as1 the babies who had been breast fed throughout that period." Or, comparing the computed annual rates per 1,000 infants fed, it appears that, on the whole, the hazard to babies having mixed feeding was twice as great, and the hazard to babies artificially fed was more than four times as great, as the hazard to babies who were breast fed. The excess hazard to artificially-fed babies as compared with breast-fed babies in the same group rose to a still higher point in the poorest families and dropped somewhat in the most prosperous families, but in no group did the excess hazard among artificially-fed babies disappear.1 The greatest difference appeared in the mortality from gastric and intestinal diseases. Considering the deaths during the first 10 months (computed rates per 1,000 infants fed), it is found that the rate from gastric and intestinal diseases varied from 75.1 among artificially-fed babies to 6.3 among breast-fed babies, while the rate from all other causes combined varied from 108.8 to 32.9.2 The age at which a baby is weaned bears directly upon the hazard he must encounter. At each month, the percentage of subsequent deaths was highest among babies who had been artificially fed during the first month. And, in general, the later the artificial feeding was begun the smaller the percentage of subsequent deaths among the survivors at the beginrung of any specified month. There was an apparent exception to this in a relatively high percentage of subse quent deaths among babies whose artificial feeding began in the sixth or the seventh month. But they were few in number, and the rates, apparently higher than the corresponding rates among babies weaned in the fourth or the fifth month, may easily be due to chance varia tion.3 Another method of comparing the relative hazard of weaning at different ages is shown in Chart VIII, in which yearly rates are com puted for infants weaned at different ages. In computing the rates, it has been arbitrarily assumed that infants were mixed-fed during 99 See Tables 58 and 59, Appendix V II, pp. 266 and 268. 1 The average excess hazard among artificially-fed babies as compared with breast-fed babies is probably a slight understatement of the true average excess. The artificially-fed babies included a relatively large proportion of babies in the most prosperous families and relatively more of the babies in native white families and fewer of the babies in foreign-born white families than are included in the breast-fed group. The average hazard to artificially-fed babies was based, therefore, on a group weighted a little more favor ably than the breast-fed group, in relation to nationality and fathers’ earn in gs. But whether the average hazard to artificially-fed babies was four times as great or more than five times as great is, after all, of little moment. See Table 60, Appendix V II, p. 276. * See Table 63, Appendix VII, p. 278. 8 See Table 64, Appendix VII, p. 278. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Y3 FEEDING AND INFANT MORTALITY. the month preceding the month in which artificial feeding began, and breast fed during the earlier months.4 The infant mortality rate per 1,000 for babies artificially fed from birth was 251.1. For infants mixed fed during the first, and artificially fed from the second to the Ch ar t VIII.—Infant mortality rates, by month of life in which artificial feeding began. Rate per 1,000 red. 280 . 251.1 1st. 2d. 3ft. 4th. 5th. 6th. 7th. 8th. 9th. 10th or 11th. Month in which artificial feeding began. twelfth month, the rate per 1,000 fed was 170.5; while for those breast fed the first eight or nine months and artificially fed only from the tenth or eleventh months, the rate per 1,000 fed was only 48.2. The rates descend with two slight breaks in the regularity— the * In the computation, average monthly death rates by type of feeding and, for those artificially fed,b£ the month in which feeding began, have been used as the basis of computation. For further explanation o f method, see Appendix V , p. 199. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 74 IN FAN T MORTALITY, BALTIMORE!, MO. babies weaned in the sixth seem to have a slightly higher rate than those weaned in the fifth month, but the number of cases upon which the monthly rates are based are small; and the differences are slight among the babies weaned in the eighth, ninth, and later months (eighth month, 49.8; ninth, 53.6; tenth or eleventh, 48.2).5 Furthermore, analysis of the monthly death rates among arti ficially fed babies, grouped according to the month in which artificial feeding began, shows that except among babies artificially fed from the first month, the highest monthly death rate within each group occurred after the babies had been artificially fed for at least a month.6 Moreover, there was no consistent decrease in the hazard during the latter months of the first year among babies artificially fed during the early months. And the decrease in monthly death rate, from month to month, among all babies artificially fed during each specified month reflects in considerable part the shifting into the artificially-fed group of babies who had had breast feeding, or mixed feeding, during their early months and the consequent lower ing of the average mortality among artificially-fed babies by the more favorable rates among these later-weaned babies. Practically, this lends great importance to the fact that of the 4,025 babies who were artificially fed within 12 months after birth, 24 per cent were artificially fed from the first month, and 2,082, or 52 per cent, were artificially fed before the fourth month. Only 850, or 21 per cent, were weaned during the eighth month or later.7 On the other hand, of all the 9,680 babies surviving at 1 year of age, considerably less than one-half (37 per cent) had been completely weaned. But this percentage varied markedly in the several nation alities and the several earnings groups— ranging from 23 per cent among the Poles to 46 per cent among the Lithuanians, and from 30 per cent in families where the fathers earned from $450 to $549 to 63 per cent in families where the fathers earned $2,850 or over.8 The present study does not attempt to follow the babies into their second year nor to draw conclusions about the relation between a too long continuance of nursing and the welfare of the infants after the first year of life. The Baltimore findings, therefore, conform to the accepted theory that artificial food given during the early months increases the hazards of infancy, and that babies having in the early months breast milk and other food besides, face a greater hazard than babies who are breast fed only, but a lesser hazard than babies who are artificially fed only. They show that the effect of artificial feeding was most marked in gastric and intestinal diseases, but that for 6 See Table 65, Appendix VII, p. 279. « See Table 66, Appendix VII, p. 279. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis i See Table 65, Appendix VII, p. 279. s See Tables 67 and 68, Appendix V II, pp. 279and 280. FEEDING AND IN FA N T MORTALITY. 75 other causes of death, also, the artificially-fed babies had a higher mortality during each month of life than the breast-fed babies. The effect of artificial feeding appeared most markedly after the baby had been deprived of breast milk for at least a month. Artificial feeding, as it was practiced in Baltimore, meant in large measure artificial feeding during the early months. More than half the babies weaned during their first year had been weaned before the end of their third month, and more than three-fourths before the end of the seventh month. The earlier the baby was weaned the greater the hazard he encountered during his first year. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN INFANT MORTALITY. NATIONALITY AND MORTALITY. It has been noted that the mortality from all causes and from each cause separately except the gastric and intestinal diseases and malformations was markedly higher among the colored babies than among the white babies in the Baltimore group. Differences quite as marked appear within the white families studied, when „ . Infant mortality rate. 180 * Ch ar t IX .—Infant mortality rates, by color and nationality. - Native white (6,739). Jewish (961). Polish (625). Italian (412). German English' Bohem- Lithu- Other Colored, (318). and ian anian foreign (1,305). Celtic (107). (100). (98). (132). they are divided according to the nationality of the mother. It is true that the foreign-born white families, considered as a single group, showed the same mortality as the native white families— 95.9 per 1,000. But the babies of Jewish mothers had the lowest mortality in Baltimore— 51 per 1,000— and the Polish babies the highest— 163.2 per 1,000. (The rate among colored babies, it will be remembered was 158.6 per 1,000.) The other nationality groups— 77 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 78 IN F A N T MORTALITY, BALTIMORE, MD. Italian, German, English and Celtic, Bohemian, Lithuanian, and ah other foreign bom —had rates ranging from 120 per 1,000 among the Lithuanians to 87.4 per 1,000 among the Itahans, but the num bers of live births within each of these other nationality groups were smah and the variations shown may not be significant. T able I.— Infant mortality rates, by color and nationality o f mother; live births in 1915 and live births, all pregnancies. Live births in 1915. Color and nationality of mother. Infant mortality rate. Infant mortality rate. Number. 10,797 103.5 34,844 119.3 9,492 6,739 2,753 961 625 412 318 437 132 107 100 98 1,305 95.9 95.9 95.9 51.0 163.2 87.4 94.3 107.6 113.6 93.5 120.0 102.0 158.6 30,440 19,696 10,744 3,561 2,681 1,701 1,313 1,488 529 387 252 320 4,404 111.9 110.9 113.7 65.2 163.7 111.1 125.7 132.4 132.3 124.0 162.7 118.7 170.5 ’| Number. ................................................... Live births, all preg nancies. Infant mortality rates based on ah live births from ah pregnancies, to these mothers, showed the same general relation: The Polish and Negro babies had the highest rates; the Jewish babies had the lowest rates; the foreign bom as a whole had approximately the same rate as the native white.9 Nationality and-cause of death. Behind the equal total rates for babies of native white mothers and babies of all foreign-bom white mothers, there were two marked differences between these groups. For causes peculiar to early infancy, the babies of native white mothers had a rate higher than the babies of the foreign born as a whole and higher than the babies in any single group of the* foreign born except the Polish. But for respiratory and other communicable diseases the babies of the. native white mothers had a rate lower than the babies of the foreign bom as a whole and lower than the babies in any single group of the foreign born except the Jewish. s For tabulations see Tables 69 and 70, Appendix V II, pp. 280 and 281. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AÍTD ECONOMIC FACTORS IN IN F A N T MORTALITY. 79 T able I I .— Infant mortality rates from specified causes, by nationality o f mother; live births in 1915. Infant mortality rate. Color and nationality of mother. Total.................................................... Native white........................................... Foreign-born white..................................... Jewish.............................................. Polish............................................... Italian................ ....................... All other.............................................. Colored......................................... Respira Gastric tory and All causes. andintes- other com tinal diseases. municable diseases. Early in fancy. All other causes. 103.5 29.1 26.4 37.7 10.3 95.9 95.9 51.0 163.2 87.4 102.2 158.6 28.8 29.1 9.4 68.8 9.7 31.9 30.7 18.4 27.2 15.6 33.6 31.6 34.6 65.9 38.1 30.9 22.9 43.2 34.0 29.1 49.8 10.5 8.7 3.1 17.6 12.1 6.6 12.3 Again, behind the excessively high rates which were approxi mately the same for Polish babies and Negro babies were marked differences in the rates from the principal causes of death. The high rate among the Polish babies was chiefly due to an excessive rate (68.8) from gastric and intestinal diseases, but their deaths from early infancy (43.2 per 1,000) and from respiratory and communi cable diseases (33.6 per 1,000) were also above the average. Among the colored babies, on the other hand, the rate from gastric and intestinal diseases (30.7) was practically the same as the average for all Baltimore babies studied, but the rate from respiratory and other communicable diseases (65.9) was excessively high and the rate from early infancy (49.8) was higher than the corresponding rate in the Polish group. The very low rate among babies of Jewish mothers appears in each group of causes. At one point only was it equaled by the rate in any other group: The babies of Italian mothers, whose total mortality was considerably higher than the mortality among babies of Jewish mothers, had the same low rate as the Jewish babies from gastric and intestinal diseases. The deaths from scattered and unspecified causes (which make up the rates shown in the sixth column of Table II) were too few in the several foreign-born groups to justify detailed comparison. It may be noted, however, that again the Polish babies show the highest rate and the babies of Jewish mothers the lowest rate. Social factors in the variation o f rates by nationality. Do the differences in social and economic conditions under which the several groups were living account for these variations ? Or are the variations related to other differences in home life or in physical vigor which can not be analyzed in a study like the present one ? https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 80 IN FA N T MORTALITY, BALTIMORE, MD. The relation which thé several social factors seem to bear in them selves to infant mortality will he discussed in later sections. The present section will merely review briefly the items, already noted about the distribution of these factors within each of the principal race and nationality groups, and indicate the points at which variaCh art X .—Infant m ortality rates from all causes, b y fathers’ earnings, for infants of native white, foreignb o m white, and colored mothers. Infant m ortality rate. Under $450. . $650 $450 $550 to to to $849. $649. $549. Native white ---------------Foreign-bom white ---------------- $1,250 $850 to to $1,849. $1,249. C o lo r e d -------------Average x—x—x—x $1,850 and over. tions in rate seem to coincide with or to run counter to the differences in social condition. Native white and colored fa m ilies.— T h e most obvious differences in social conditions in native white and colored families were the ex cessively high percentages of colored fathers earning the lowest wages and of colored mothers gainfully employed, and the greater preva lence in colored families of many births to a mother and of births following a preceding birth by an interval of less than two years. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 81 SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. As a corollary to the poverty in colored families, their dwellings were poorer than those occupied by native white families. But in relation to room congestion and sanitary equipment of the dwelling— the main points on housing which in the present study have been exactly tabulated— the percentage of colored babies living in unfa vorable dwellings was not quite so high as the percentage of native white babies, when families at the same economic level are compared. Housing as a factor distinct from poverty is therefore omitted from this comparison of infant mortality rates in native white and colored families.10 Six aspects of the relative rates among babies of natiye white mothers and babies of colored mothers will be considered: (a) Were the higher rates among colored babies due wholly or partly to the greater poverty of their families ? (6) Were they due to the larger families and the shorter intervals between births in the colored group ? (c) Were they due to a combination of poverty and preva lence of mothers’ employment away from home ? id) Were they due to poverty and artificial feeding? (e) Were they due to a lack of trained care for mothers and babies? if) Is there a difference in mortality that persists when all these factors have been considered ? (a) So far as rates can be computed for colored babies whose fathers earned more than the very lowest wages (that is, at least $450), the rates were somewhat higher for colored babies than for babies in native white families of the same earnings groups, but these differ ences were far less than the difference between the native white and colored groups as a whole. And in the families where the father earned less than $450 the difference disappeared, the babies of native white mothers showing a rate of 164.8 and the babies of colored mothers a rate of 163.7. T a b l e I I I . — Infant mortality rates, by father's earnings; infants born in 1915 to native white and colored mothers. Native white mothers. Earnings of father. Live births. Total................................................... Under $450..................................... $450-$549......................... $550-1649.............................. $650-$849........................... $850 and over.................................. No earnings.............................. Not reported.................................. Infant mortality rate.« Infant mortality rate.® 95.9 1,305 158.6 449 644 908 1,726 2,797 88 127 164.8 128.9 107.9 95.6 69.0 507 356 152 121 59 69 41 163.7 168.5 138.2 115.7 10 On housing conditions among the negroes in Baltimore, see p. 42 £E. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Live births. 6,739 a Not shown where base is less than 100. 101351°—23- Colored mothers. 133.9 82 IN F A N T MORTALITY, BALTIMORE, MD. A large part of the difference in mortality, but not all, is evidently due to the greater poverty of the colored families. (b) In every group a short interval since the preceding birth was accompanied by a relatively high mortality. The percentage of short-interval births was considerably higher among the colored families, but when all short-interval births are eliminated and native white and colored families in which the fathers earned under $550 are compared, it appears that the colored babies had a somewhat higher mortality than the white babies. The short-interval births, considered by themselves, on the other hand, showed approximately the same mortality in white and colored families of this low-eamings level. In general, it would seem, therefore, that the greater preva lence of short intervals between births in colored families contributed to the high mortality among colored infants, but that in the lowest earnings group the mortality in native white families was greater from other causes, which counterbalanced the longer intervals in white families. T a b l e IY .— Excess mortality among infants o f colored mothers, when effect o f greater prevalence o f short intervals between births is eliminated; infants o f native white and colored mothers. Color and nativity of mother and earnings of father. Total: Native white........................................................................ Colored................................................................... Under $550: Native white.......................................................................... Colored........................................................................... Infant mortality rater' Per cent of live births with Live births Live births interval of with inter with inter less than val of less val of 2 than 2 2 years. years or years. over. 25.5 33.5 138.0 188.9 88.6 141.4 27.9 35.7 205.6 207.0 134.1 142.2 Again, considering all earnings groups together, more than twice as high a percentage of colored babies as of babies in native white families were seventh or later in order of birth. But the distinctive hazards to these babies of the later orders of birth evidently com bined with other factors to raise the total mortality among colored babies and themselves played a minor part in the total rate. The difference in rates between the later born and the earlier bom was less among the colored babies than among the babies of native white mothers, the colored rate remaining high, even when babies seventh or later in order of birth were eliminated from the comparison. The part played by large families and short intervals between births in the total mortality among the colored infants seems to have been, therefore, of small importance. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 83 T able V .—Excess mortality among infants o f colored mothers, when effect o f greater prevalence o f births o f late orders is eliminated; infants born in 1915 to native white and colored mothers. Infant mortality rate. Per cent of live births, seventh or later.1 Color and nativity of mother and earnings of father. Total: Under $550: 1 Based on single issues only. Births, seventn or later. Births, sixth or earlier.1 9.8 20.0 132.6 152.3 84.3 146.9 14.5 20.8 163.4 170.5 127.5 150.3 See Table 138, Appendix VII, p. 339. (c) It is plain that in some way the mothers’ employment was a factor in the excessive mortality of colored babies, for when all mothers employed away from home during pregnancy or within 12 months after the birth in 1915 are eliminated from the comparison, the total mortality rates among the colored babies and the babies in native white families of the same earnings groups become almost identical, with a slight difference in favor of the colored babies.11 —. T able V I.— Relative mortality among in f amts o f white and colored mothers, when effect o f greater prevalence o f employment is eliminated; infants born in 1915 to native white ana colored mothers not employed away from home. Live births to mothers not employed away from home.1 Earnings of father. Native white mothers. Live births. Under $450.......................................................................... $450-$549...:...................................................................... $550-$849............................................................................. 329 548 2,467 Infant mortality rate. 130.7 131.4 94.4 Colored mothers. Live births. 217 184 160 Infant mortality rate. 124.4 108.7 93.8 1 During pregnancy or within 12 months after the birth of a baby in 1915. Compare Table 102, Appendix VII, p. 304. (d) More colored babies than babies of native white mothers were nursed b y their mothers. The higher mortality among colored babies as compared with white babies (when working mothers are included) can not be attributed to an excess of artificial feeding in the colored group; and the equivalent rates among colored babies and babies of native white mothers (when working mothers are not included) occur in spite of markedly more favorable feeding among the colored babies than among the babies of native white mothers. 11 The relation of mothers’ employment to mortality is discussed in detail in another section of the report, pp. 114 to 131. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 84 IN F A N T MORTALITY, BALTIMORE, MD. Throughout, whether working mothers are included or not in the comparison, the hazard to breast-fed colored babies or to artificiallyfed colored babies, was greater than the hazard to babies of native white mothers reporting the same type of feeding. T a b l e V I I .—Excess mortality among infants o f colored mothers, when effect o f differ ences in type o f feeding and mother's employment is eliminated; infqnts o f native white and o f colored mothers in fam ilies where the father earned under $550. Computed mortality rates among infants bom in 1915 in families where the father earned un der $550. Type of feeding and nonemployment of mother. For first 10 months per 1,000 infants fed. Native white mothers. All mothers: Breast.......................................................................... Mixed........................................................................... Artificial...................................................................... Mothers not employed: Colored mothers. 36.7 100.3 268.8 73.3 127.9 375.7 32.2 107.1 259.3 79.3 131.4 448.9 For second to tenth months per 1,000 in fants surviving at be ginning of second month.i Native white. 11.8 107.1 196.8 Colored. 53.2 13.8 204.5- 1 B y eliminating deaths during the first month— the period in which most of the deaths from prenatal causes occur—the effect of the greater prevalence of employment during pregnancy among the colored mothers is, at least in part, neutralized. Rate not computed for all mothers. (e) The infant-welfare agencies in Baltimore reached during the period of this study more of the colored mothers than of the native white mothers in Baltimore. This subject is discussed in detail in Appendix V I,lla but it should be noted here that comparison of native white and colored families at the same economic level showed a higher percentage of colored mothers than of white mothers receiv ing prenatal care of Grades A and B and trained nursing care at confinement, and a larger percentage of colored babies than of white babies receiving supervision from infant-welfare agencies. The per centage of cases dropped by the infant-welfare agencies because the mother failed to cooperate was smaller in the colored group than in any other. (/) Among the colored babies, then, the greater poverty of the fathers (with the attendant evil of poor housing), the more general employment of the mothers, the tendency toward larger families and shorter intervals between births, and the wider prevalence of venereal disease indicated by the high mortality assigned to syphilis, were increasing mortality, while mothers’ nursing of their babies, prenatal care, and instruction and supervision received from infant-welfare il» See p. 203. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 85 social and economic factors in infant mortality. agencies were tending to reduce mortality. As the net result, the mortality from gastric and intestinal diseases— which responds most readily to breast feeding and intelligent care— was relatively low; the mortality from early infancy—which was especially increased by mothers’ employment away from home during pregnancy and by the prevalence of venereal disease— was checked by prenatal care from rising to the excessively high rate found in the poorest native white families; and thè mortality from respiratory diseases and other communicable diseases, which tends always to rise with poverty, was almost twice as high among the colored babies in the poorest families, as among babies in native white families of the same economic level, suggesting a less protection from exposure to contagious diseases or a lower resistance in the colored families. T a b l e V I I I .— Infant mortality rates, by cause o f death, earnings o f father, and color o f mother; live births in 1915.1 Infant mortality rate.2 Earnings of father. Gastric and intes tinal diseases. Respiratory and other communi cable diseases. Early infancy. Native Native Native Colored Colored Colored white white white mothers. mothers. mothers. mothers. mothers. mothers. Total...................................... Under $450............................. $450-$849......................... $850 and over..................... 1 See Table 78, Appendix VII, p. 286. 28.9 30.7 18.4 65.9 38.1 49.8 51.2 34.2 14.7 33.5 28.6 37.9 21.0 11.4 71.0 55.6 62.4 41.5 31.1 47.3 54.1 2 Not shown where base is less than 100. In relation to each group of causes, the greater poverty of the colored families was by itself a factor in their high average mortality. The average mortality in the native white families represented throughout a balance between a high rate in the poor families and a low rate in the prosperous families; but the average in the colored families was not tempered by lower rates in some favored group, since there were almost no “ prosperous” colored families.12 Native white and foreign-born white fa m ilies .— The foreign-bom group itself presents so wide a diversity in rates that the social and economic differences between the foreign-born group as a whole and the native white group may be discussed briefly. Three points stand ou t: The fathers’ earnings were much lower among the foreign born than the native white; the percentage of mothers employed away from home was slightly higher among the foreign born than the native white, whether a comparison is made of families at all economic levels 12 Three live births to colored mothers were in families where the father earned $1,860 or over; 11, where the father earned $1,260 to $1,819. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 86 ixfant Mortality, Baltimore, M£>. combined or only of those in both groups in which fathers’ earnings were identical; and room congestion was more common in the foreign-born families than in native white families having the same economic status. In addition, relatively more of the foreign-born white mothers than of the native white mothers had borne seven or more children; but the difference on this point is reduced when cor responding earning groups are compared; and the foreign-bom white mothers as a whole, seem not to have had shorter intervals between births than the native white mothers. Chart X I.—Infant mortality rates from early infancy, by fathers’ earnings, for infants of native white, foreign-bom white, and colored mothers. Infant mortality Under $450. $450 $550 $650 to to to $649. $549. $849. Native white ---------------Foreign-bom w h i t e ---------------- $1,250 $850 to to $1,849. $1,249. C o l o r e d ----------- —• Average x—x—x—x $1,850 and over. Except for the relatively high mortality from respiratory and other communicable diseases among the babies of the foreign-bom mothers, the comparative rates in the foreign-bom and native white families ran counter to that which might have been expected from these social conditions if no other factors had been present. For example, comparing only those families in which the fathers earned under $650, it is found that there was among the babies of native white mothers the higher mortality from early infancy, in spite of a relatively low percentage of employment away from home, and the higher mortality from gastric and intestinal diseases, in spite of less congested dwellings. The total mortality, in families with earnings https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL ANO ECONOMIC FACTORS IN IN FA N T MORTALITY. 87 Ch ar t X II.—Infant mortality rates from gastric and intestinal diseases, by fathers’ earnings, for infants of native white, foreign-bom white, and colored mothers. i— -Infant mortality rate. $450. to to to $549. $649. $849. Native white ---------------Foreign-bom w h i t e ---------------- to $1,249. Colored — •— •— • Average x—x—x—x to $1,849. and over. Ch art X III.—Infant mortality rates from respiratory and other communicable diseases, by fathers’ earnings, for infants of native white, foreign-bom white, and colored mothers. Infant mortality rate. Under $450. $550 $650 $450 to to to $849. $649. $549. Native white ---------------Foreign-bom w h i t e ---------------- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis $1,250 $850 to to $1,249. $1,849. Colored — — |— • Average x—x—x—x . $1,850 and over. 88 IN FA N T MORTALITY, BALTIMORE, MB. under $650, was definitely higher among the babies of native white mothers than among the babies of the foreign bom .13 T a b l e I X .— Infant mortality rates, by cause o f death, nativity o f mother, and earnings of father; live births in 1915 to white mothers. Infant mortality rate. Nativity of mother and earnings of father. Total: Under $650: All causes. Eespirar Gastric tory and Early and in other testinal commu infancy. diseases. nicable diseases. All other diseases. 95.9 95.9 28.8 29.1 18.4 27.2 38.1 30.9 10.5 8.7 127.4 106.4 45.5 36.2 24.0 30.7 48.5 28.6 9.5 10.9 But another factor was present in the variations in method of feeding. More babies had only breast milk and fewer babies had only artificial feeding in the foreign-bom families than in the native white families. And the general prevalence of breast feeding seems to have been the chief reason for the more favorable rates among the babies of the foreign bom. Comparing breast-fed babies with breast fed babies, and artificially-fed babies with artificially-fed babies, the differences in favor of the foreign-born disappeared; and for the breast-fed babies the total mortality was higher among the babies of the foreign-born than among the others. But the greater proportion of babies having breast feeding among the foreign born, and facing the lesser hazards of breast-fed babies, reduced the total hazard in the foreign-born group below the hazard in native white families at the same economic level.14 Poverty, then, with its attendant evils of mothers’ employment and poor housing, tended to increase mortality among the babies of foreign-born mothers, while the greater prevalence of breast feeding among the foreign born tended to reduce the mortality of their babies. Considering together all types of feeding the native white families showed a higher mortality than the foreign-born white families in corresponding earnings groups; but for all earnings groups the average mortality was reduced in the native white families by the very low mortality in well-to-do homes. If the foreign-born group had included a similar proportion of well-to-do families their average mortality would have fallen below instead of equaling the mortality in the native white families. Polish and foreign -bom Jewish fa m ilies — On five points the con ditions reported among the Polish families were less favorable to js gee Table 78, Appendix V II, p. 286. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 14 See Tables 60 and 80, Appendix VII, pp. 276 and 288. SOCIAL AND ECONOMIC FACTORS IN IN FA N T MORTALITY. 89 the welfare of their babies than the conditions reported among the Jewish families: (1) father’s earnings; (2) housing; (3) mothers’ employment; (4) interval between births; (5) care and instruction of the mother. In respect to feeding, so far as it can be judged in the present study by the rough classifications of breast feeding, mixed feeding and artificial feeding, practically no difference ap peared.15 T a b l e X .— Relative prevalence o f certain conditions influencing infant mortality, by nationality o f mother; births in 1915 to Jewish, Italian, and Polish mothers. Per cent of births in 1915. Condition. Mother employed away from home: Mother reporting: Italian. Jewish Polish mothers. mothers. mothers. 46.3 70.5 62.1 1.3 .9 8.9 58.2 32.8 23.4 30.7 94.1 3.9 1.7 13.9 79.7 17.6 3.8 7.9 53.4 35.3 64.8 37.2 45.1 24.5 25.5 8.2 17.0 13.9 7.9 22.6 6.0 22.4 5.7 19.5 7.3 25.2 22.1 9.2 54.8 8.5 32.3 13.6 (1) The greater poverty of the Polish families was only a partial factor in the excessive mortality among their babies as compared with the Jewish babies; for when Polish and Jewish families in which the father earned under $650 are compared, the differences in their total rates and in their rates from each of the groups of causes show little if any variation from the differences that appear when the average rates for all earnings groups are compared.16 It is plain, however, that the most unfavorable circumstances accompanying poverty were more prevalent among the Poles than among the Jews. (2) It has been noted that the median annual rental paid by Polish families ($70) was lower than the median rental paid by Jewish fam ilies ($114); that the dwellings of the Polish families were more con gested than the dwellings of the Jewish families; and that fewer of the dwellings were equipped with sanitary conveniences. The greater congestion and poorer sanitation among the Poles appeared not only in all earnings groups combined but also in the families in which the is The Jewish families reported very little more breast feeding than the Polish families during the first month; after the second month this was reversed and the Polish had slightly more breast feeding than the Jewish. A t each month, excepting the ninth, the percentage artificially fed was slightly higher among the Poles than among the Jews. The quality of the mixed feeding and of the artificial feeding may have been better in the Jewish group than in the Polish group because of the greater prevalence of infant-welfare work in the Jewish group. See Table 81, Appendix VII, p. 289. is See Table 78, Appendix VII, p. 286. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 90 IN FA N T MORTALITY, BALTIMORE, MD. father earned under $650. It is known that overcrowding and lack of conveniences within the dwelling react disastrously on the baby. Rates in relation to room congestion can not be computed for Jewish and Polish babies separately; but a comparison of the actual deaths among Jewish and Polish babies who had survived the first two weeks with the expected deaths (computed from the numbers in each group living in congested dwellings and the average death rate for all foreignborn nationalities in similar dwellings) shows actual deaths far below the expected number among the Jews and far above the expected number among the Poles (Jewish, 54 expected, 25 actual; Polish, 45 expected, 75 actual. T a b l e X I .—Relative mortality in Jewish and Polish fam ilies, when effect o f differences in room congestion is eliminated; infants, horn in 1915 to Jewish and Polish mothers, who survived two weeks. Infants (of foreign-bom white mothers) surviving 2 weeks. Jewish mothers. Persons per room. Deaths per 100. Deaths. Infants. 931 Total.................................. 3.9 6.4 10.6 66.6 Polish mothers. 342 506 83 Deaths. Infants. Actual. Ex pected.1 25 54.4 597 13.3 32.4 8.7 68 345 183 1 Actual. Ex pected.1 75 44.7 2.7 22.1 19.2 .7 1 Expected deaths in each nationality are computed by multiplying number of infants in each group by death rate (all nationalities combined) for infants in dwellings with stated number of persons. For detailed discussion of method, see Appendix V , p. 201. Rates computed in relation to the sanitary equipment of the dwell ing indicate that while the greater prevalence of bad housing among the Poles may accentuate the difference, part of the excess mor tality among the Poles must be traced to some further cause. In dwellings lacking one or all of three specified items of sanitation and in families where the father earned less than $650, the Polish mor tality was 12.6 per 100 infants surviving the first two weeks, the Jewish mortality 2.2.17 (3) Employment of the mother away from home was far more prevalent among the Poles than among the foreign-born Jews. This employment increased the mortality among the Polish babies. (See p. 114 ff.) It accounts, however, for only part of the difference in rates in these two nationalities. Comparing families in which the mother was not employed away either during pregnancy or at any time within 12 months after the birth in 1915, a persistently higher mor tality was found among Polish babies than among Jewish babies. w See Table 91, Appendix V II, p. 294. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 91 SOCIAL AND ECONOMIC FACTORS IN IN FA N T MORTALITY. (4) More than twice as many of the Polish mothers as of the foreign-bom Jewish mothers became pregnant during the infant’s lifetime and within a year after the birth in 1915; Polish, 17 per cent, and Jewish, 7.9 per cent. (For discussion of the effect of short interval between births, see p. 139.) But comparing only the infants of mothers who did not become pregnant within a year, a mortality still markedly higher was found among the Poles than among the Jews, with a Polish rate of 153.7 per 1,000 live births and a Jewish rate of 50.6 per 1,000 live births.18 (5) Relatively few of the Polish mothers were reached by the infant-welfare activities in Baltimore, and the contrast between the Polish families and the Jewish families on this point was marked. T a b l e X I I .—-Relative prevalence o f types o f prenatal and confinement care and super vision from infant-welfare agencies in Jewish and Polish fam ilies. Per cent having specified kind of care.1 Kind of care. Jewish Polish mothers. mothers. Any prenatal care from physician.................................................................................... Prenatal care of Grades A ànd B ............................................... Physician attendant at confinement......................................................... Trained nursing care, confinement................................................................................... Any supervision from infant-welfare agencies.................................. Regular supervision from infant-welfare agencies............................................ 53.4 35.3 64.8 37.2 45.1 24.5 13.9 7.9 22.6 6.0 22.4 5.7 1 Percentages for prenatal and confinement care based on mothers who had had births in 1915; per centages of supervision from infant-welfare agencies based on infants bom in 1915 who survived 2 weeks. Whether these factors together account for the differences in mor tality among Polish and Jewish babies, or whether other factors existed which did not appear in the present study, can not be deter mined. Unfortunately, the groups were too small to permit a com18 The mortality rates are not materially altered by eliminating the time lived by infants of mothers who became pregnant during the infant’s lifetime and the deaths among these infants, as shown in the following table. For a discussion of the excess mortality among infants of mothers who became preg nant during the infant’s first year of life, see p. 140. Infant mortality rate. Nationality of mother. All mothers. Mothers not pregnant within, year after birth. Total............................................................................................................ 103.5 101.6 Native white......................................................................................................... 95.9 51.0 163.2 87.4 102.0 158.6 93.8 50.6 153.7 89.9 101.8 160.8 Other foreign-born white...................................................................... ............... Colored.. . ” ........................................................................................ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 92 in f a n t m o r t a l it y , Ba l t i m o re , m ix parison of Jewish and Polish families in which no one of these un favorable factors was present and in which the fathers’ earnings and the grade of prenatal care, etc., were identical.19 A word must be added about the difference between the Polish and Jewish rates and the rates among babies of native white mothers. An excess in mortality among Polish babies as compared with ba bies of native white mothers follows naturally from the conditions surrounding them. Just as we have noted in our comparison of Polish and Jewish babies the conditions among the Poles involving excess hazard to their babies, so, point by point, the comparison might be repeated with equal force as between the Polish babies and the babies of native white mothers. The fact that more Polish babies than babies of native white mothers were breast fed is the only item more favorable to the Polish babies than to the others. But the rate for breast-fed Polish babies— 83.7 per 1,000 babies fed— is itself so excessive that the somewhat greater prevalence of breast feeding still leaves the total Polish mortality far in excess of the mortality in native white families. On the other hand, poverty and poor housing are more prevalent among the Jews than among the native white families, and more Jewish mothers than native white mothers reported having had seven or more births.20 If these conditions were not balanced by others, more favorable in the Jewish families than in the native white fam ilies, the Jewish rate would fall, not below the rate in native white families, but between the rates for native white and for Polish families. Actually, the Jewish rate is almost twice as favorable as the rate among babies of native white mothers.21 Four of these more favorable factors in the Jewish homes are clear from the tabulations: (I) Fewer mothers were employed away from home; (2) fewer babies followed a preceding birth by an interval under two years; (3) more babies were breast fed ; (4) more mothers had Grade A or Grade B prenatal care, trained nursing care at con finement, and more babies had regular supervision from infantwelfare agencies. Apart from the prevalence of one or another type of feeding, these factors, favorable and unfavorable, seem approxi mately to balance among the native white and the Jewish families. m The Italians had a mortality falling between the mortality of the Jews and the Poles. In each of the factors presented in this section, except interva jbetween births, the Italians had conditions less favorable than the Jews and more favorable than the Poles. The percentage of Italian mothers pregnant within a year was, however, higher than the corresponding percentage in any other group. See Table 161, Appendix V II, p.355. 20 Note, however, the small percentage of Jewish mothers who had 10 or more births: Polish, 8.3; Jewish, 3.8; native white, 2.9. si In families where the fathers earned less than $550, the Jewish rate is quite as definitely more favorable than the rate in native white families as it was in the whole group, all grades of earnings combined. This was true for the total mortality and for each group of causes separately. Also, in families where the fathers earned less than $550 and the dwelling lacked one or more of three selected items of sanitation, the Jewish rates from all causes and from gastric and intestinal diseases fell further below the rates for native white families than when the average rates for all earnings groups and all dwellings are compared. See Tables 78 and 91, Appendix VII, pp. 286 and 294. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 93 The mortality of breast-fed babies was almost identical in both groups— 32.7 per 1,000 fed in the native white families and 31.4 in _the Jewish families. But the scales tip slightly in favor of the Jewish babies, for the artificially-fed babies had a rate of 160.5 per 1,000 fed in the native white families and 137.2 in the Jewish families. With the greater prevalence of breast feeding among the Jewish mothers, the total mortality in their families naturally fell definitely below the total mortality in the native white families. Summary. The highest rates b y color and nationality were found among the Polish and the Negro babies. They seem to have been due in part to the fact that these two groups had the largest percentage of fathers earning very low wages and of mothers gainfully employed away from home. In addition, the Polish families had more congested dwellings and more dwellings lacking in sanitary equipment than any other group, even when compared with other families at the same earnings level; and the Polish mothers had received less trained care and instruction during pregnancy, confinement, and the year after the birth than any others in Baltimore. Among the Polish babies the computed annual rates from all causes, per 1,000 babies fed, were "excessive even for breast-fed babies; and, in spite of the relatively high percentage of breast feeding among them, their excess mortality appeared chiefly in gastric and intestinal diseases. The negro families had the poor housing that accompanies poverty, but in comparison with other families at the same economic level their room congestion and lack of sanitary equipment were not excessive; on general conditions, such as dampness and ill repair, the present study furnishes no information. The negro mothers more generally than any others received trained care and instruction in maternal and infant hygiene. The high mortality among colored babies was not due to a high rate from gastric and intestinal dis eases; and their rate from early infancy was above the average, but below the corresponding rate in the poorest native white families. Their greatest excess appeared in the deaths from respiratory and from other communicable diseases. The lowest rate, b y nationality, was found among the babies of foreign-born Jewish mothers. The rate for these babies was much lower than the rate among babies of native white mothers, in spite of the greater poverty in the Jewish families with its attendant evil of poorer housing. But in the employment of mothers away from home, the interval between births, the prevalence of breast feeding, an.d the receiving of trained care and instruction by the mothers, conditions were more favorable among the Jewish mothers than among the native white mothers. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 94 IN F A N T MORTALITY, BALTIMORE, MD. POVERTY AND INFANT MORTALITY. Fathers’ earnings and mortality rates. In Baltimore, as elsewhere, the babies in poor families had the_ greatest hazards to face. Among the 1,544 babies whose fathers earned less than $450 during the year after the baby’s birth, more than 1 in 7 died within the year; among the 431 babies whose fathers earned $1,850 or more, 1 in 27 died within the year. Eliminating differences in race and nationality and considering only the babies born to native white mothers, the same extremes are found— 1 in 26 dying in the most prosperous homes and about 1 in 6 dying in the poorest homes.22 T a b l e X I I I . — Infant m ortality rates, by earnings o f father and color and nationality o f m other; live births in 1915. Infant mortality rate.1 Earnings of father. Under $450-$549 ..................................................................................... ...................................................................................................... S650-S849 .................................................................................................... Native ForeignColored bom white white mothers. mothers. mothers. 95.9 95.9 158.6 164.8 128.9 107.9 95.6 69.9 84.3 38.3 144.6 62.4 100.2 93.0 61.1 46.7 163.7 168.5 138-.-2 115.7 1 Not shown where base is less than 100. The very low infant mortality in families where the fathers earned at least $1,850 (a sum which at that time was held to be sufficient to maintain a family at the comfort level) suggests that the differences in mortality in the several earnings groups below $1,850 may be less sig nificant than the difference between this u $1,850 and over” group and all poorer families. Unfortunately, the numbers are too small to permit the clear analysis of higher earnings groups above $1,850 (and above $2,850) which would be of interest. Except among the native white families, however, this comparison of the “ $1,850 and over” group with all poorer families is impossible, because the general level of earnings was low. (See Chart X , p. 80.) In the foreign white families, all nationalities combined, only 62 births occurred where the fathers earned as much as $1,850, and in no single foreign nationality except the Jewish were there 100 or more live births in families where the fathers earned even as much as $850, so that no comparison of rates by detailed grouping of fathers’ earn ings can be made within each nationality. But if each nationality is divided into two earnings groups— under $650 and $650 and over— it is found that in both groups the Jewish rate was low and the Polish 33F or detailed tabulation see Tables 18 and 74, A ppen dix V II, p p . 234 and 283. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 95 SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. rate was high, while the Italians and “ all other foreign” families showed markedly higher rates below this dividing line than above it.23 T a b l e X IV . Infant mortality rates, ^by earnings o f father, selected nationalities,* live births in 1915. Infant mortality rate. Nationality of mother. Foreign-bom white mothers.................. Jewish................................ Polish.............................. Italian.................... All other.................................. Earnings of father under 8650. 106.4 49.3 160.3 105.5 112.1 Earnings of father $650 and over. 73.0 40.5 153.4 48.6 86.7 In the colored families only 3 babies were born whose fathers earned $1,850 or more, and only 59 babies whose fathers earned as much as $850; in fact, nearly two-thirds of all were in families where the fathers earned less than $550, so that the comparison of infant mortality by fathers’ earnings in the colored families is especially limited. It is plain, however, that the colored babies whose fathers earned less than $550 had a higher rate than those whose fathers earned $550 or more. (See Charts X I, X II, and X III, pp. 86 and 87.) In ascending the scale of fathers’ earnings, the decrease in infant mortality in the more well-to-do families represents, in the main, a decrease in deaths from gastric and intestinal disorders and from respiratory and other communicable diseases; but among the babies of native white mothers there was also a definite decrease in deaths from causes peculiar to early infancy.24 Or, separating the deaths of babies who died immediately after birth, before they had been fed at all, and all other deaths during the first year of life, it is found that the decrease in the infant death rate appears chiefly in the later deaths— although, again, among the babies of native white mothers, there was the lowest rate for deaths immediately after birth in the families of the highest earnings group.25 The total infant mortality decreased steadily from one earnings group to the next among the white babies of both native and foreign mothers, except for one break in the downward curve of rates in each group. (1) The babies of native white mothers in families where the fathers earned $1,250 but less than $1,850 had a total infant mortality rate higher than the babies whose fathers earned $850 but less than $1,250. But their rate— 84.3 per 1,000—was lower than the rate for babies whose fathers earned less than $850, and above $1,850 the rate dropped sharply again. 23 For detailed tabulation see Table 78, Appendix VU, p. 286. 24 See Table 78, Appendix VII, p. 286. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 86 See Table 79, Appendix VII, p. 287. 96 IN F A N T MORTALITY, BALTIMORE, MD. T able X V .— Infant mortality rates, by came o f death and earnings o f father; infants o f native white mothers. Infant mortality rate; infants of native white mothers. Earnings of father. All causes. TTp^fir $4fiO ............................................................................. $1,860 anil over............................................................................- .......... Early infancy. All other causes. 95.9 38.1 57.7 164.8 128.9 107.9 95.6 69.9 84.3 38.3 62.4 43.5 45.2 38.8 28.3 44.5 21.9 102.4 85.4 62.7 56.8 41.6 39.7 16.4 This break in the downward curve appeared only in the rates from early infancy. That is to say, the mortality related to the care and condition of the mother was unfavorable in this group which lay between the poor and the well to do, but the mortality related to the care of the baby after birth and the home surroundings was more favorable here than in any poorer homes. It should be noted, how ever, that even for the causes peculiar to early infancy the highest rate was found in the families where the father earned less than $450 and the lowest rate where the father earned $1,850 or more.26 (2) In the foreign-born white families, all nationalities combined, the families where the father earned under $450 had the highest total infant mortality rate and the families where the fathers earned $1,250 or over had the lowest total infant mortality rate, and these extremes fell definitely above and below the rates for any earnings groups between $450 and $1,250. But a break in the curve between these two extremes occurred at $450 to $549, where the rate was lower than in the two earnings groups next above and practically identical with the rate at $850 to $1,249. T able X V I — Infant m ortality rates, by came o f death and earnings o f father; infants o f foreign-born white mothers. Infant mortality rate; infants of foreign-born white mothers. Earnings of father. Total.................................................... TJndftr $450 ................................................. ^,50-4549 _ _ ................................ - ............. %k^O to $1,249.......................................... Respiratory Gastric and and other All causes. intestinal communi cable diseases. diseases. 95.9 144.6 62.4 110.2 93.0 54.8 61.1 42.5 29.1 56.1 26.7 18.6 17.5 16.1 24.4 26 For detailed tabulation see Table 78, Appendix V II, p. 286. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Early infancy. Other causes. 27.2 30.9 8.7 35.7 15.6 39.6 31.6 9.7 • 11.9 4.8 40.8 8.9 32.6 33.3 27.4 24.4 33.0 11.9 11.1 9.4 10.5 1.6 4.8 SOCIAL, AND ECONOMIC FACTORS IN 'IN F A N T MORTALITY. 97 This comparatively low rate in so poor an earnings group appeared in the rates from early infancy and from respiratory and other com—municable diseases, but not in the rate from gastric and intestinal diseases. For deaths assigned to early infancy this earnings group— $450 to $549— showed the lowest rate of all among the foreign born.27 Among the foreign-born white families, more babies in this wage group were breast fed through the earlier months and fewer were artificially fed throughout the first nine months than in the group under $450 or in the groups between $550 and $849.28 This more favorable feeding would, apart from other factors, reduce the infant death rate for babies fed somewhat below the death rate for babies fed in the earnings groups between $550 and $849. It does not, however, account for the whole difference that appears, and, obviously, it has no relation whatever to the very low death rate for babies dying immediately after birth.29 T able X V I I .— Comparison o f infant mortality in fathers' earnings group, $450 to $549 with that in the group $550 to $849, elim inating differences due to type o f feeding; infants in foreign-horn white fam ilies in the $450 to $549 group. Type of feeding. Actual deaths. Expected deaths.! 28 39.7 5 23 9.9 29.8 Type of feeding. Infants fed: Artificially........................ Actual Expected deaths. deaths.i 12 3 8 15.0 6.0 8.8 i The "expected deaths” are computed from rates in $550 to $849 group for babies not fed, breast fed, mixed fed, and artificially fed. Type of feeding and mortality in the several earnings groups. In general, such variations as occurred in the prevalence of breast feeding or of artificial feeding in the several groups do not account for high rates in the poorer families and low rates among the well to do, but tend, on the contrary, to obscure the actual differences in hazard. For example, in the native white families of the “ under $450” group, where the rates were highest, there were during the early months, which are the period of greatest hazard, a higher per centage of babies breast fed and a lower percentage artificially fed than in the native white families of any other earnings group. Only after the sixth month did the percentage breast fed in this earnings group drop below the average for all earnings groups combined. And the fewest babies were breast fed and the greatest number were artificially fed in the highest earnings group— $2,250 to $2,849, and $2,850 and over— where the rates were very low.28 w For detailed tabulation see Table 78, Appendix VII, p. 286. m See Table 80, Appendix V II, p . 288. » See Tables 79 and 82, Appendix V II, pp. 287 and 289* 101351°—$3-----7 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 98 IN F A N T MORTALITY, BALTIMORE, MD. Again, dividing all the native white families into two approxi mately equal groups, with fathers earning under $850 and fathers earning $850 and over, the infant mortality rate in the poorer group (112.7 per 1,000) was considerably above the rate (69.0 per 1,000) in the group with higher earnings. But the percentages breast fed, month by month, were almost identical in the two groups. The one difference, that there was more artificial feeding in the “ $850 and over” group and more mixed feedings in the “ under $850” group, would reduce the rate in the poorer families below the rate among the more well to do if other factors were not involved. What, then, of the commonly held opinion that if all babies received the mother’s milk and no other food through the first nine months of infancy the excessive mortality among the babies in the poorest families would disappear? In the Baltimore study, the Children’s Bureau is, for the first time, discussing numbers large enough to permit a detailed analysis of rates in relation to the earn ings of the father, the race and nativity of the mother, and the type of feeding given to the infant. This analysis confirms the theory that the rates for breast-fed babies at each economic level are below the rates for artificially-fed babies in homes of the same economic level; but it shows that while the rates for breast-fed babies in thepoorest homes (61.8 per 1,000 fed) were below the average rates for all babies studied in Baltimore (80.5 per 1,000 fed) they were far above the rates for breast-fed babies in families that were well to do (13.3 per 1,000 fed).31 T a b l e X Y I I I .— In fa n t, m ortality rates, by earnings o f fath er and color and n ativity o f m other; infan ts a rtificia lly fed .a Computed annual rates « for artificiallyfed infants. Earnings of father. $550-8849.......................................................................................... $850-81,249....................................................................................... $i,250-41,849..................................................................................... Native Foreignbom Colored All white white mothers. mothers. mothers. mothers. 191.4 160.8 232.1 310.1 185.4 117.3 130.1 27.5 289.9 178.8 109.6 104.2 | 26.0 274.1 196.9 347.3 387.9 169.7 | 252.4 a The method by which an annual rate per 1,000 infants fed is computed from the monthly rates for babies artifleally fed, mixed fed, or breast fed during the first month, the second month, etc., is shown in Appendix V, p. 199. « Sea Table 60, Appendix VII, p. 276. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 99 SOCIAL, AND ECONOMIC FACTORS IN IN F A N T MORTALITY. T a b l e X V I X .— Infant mortality rates, by earnings o f father and color and nativity o f mother; breast-fed infants-1 Computed annual rates1 for breast-fed infants. Earnings of father. Native Foreignborn Colored All white mothers. mothers. white mothers. mothers. Total___ 43.3 32.7 50.2 Under $550....... $550-5849.......... $850-11,249........ $1,250-51,849__ $1,850 and over. 61.8 46.1 22.5 23.2 13.3 39.0 39.6 20.2 Ì 29.2 1 15.6 63.8 51.1 J 90.2 91.4 Ì 20.9 | 88.0 I 1 The method by which an annual rate per 1,000 infants fed is computed from the monthly rates for babies artificially fed, mixed fed, or breast fed during the first month, the second month, etc., is shown in Appendix V, p. 199. The variations in rates between the poorest and the most prosperous were greater among the artificially-fed babies than among the breast fed babies, and the rates for artificially-fed babies descended in an unbroken line from one earnings group to the next in each of the three race and nativity groups. But the contrasts in rates between the poorest and the most prosperous were quite definite even among the breast-fed babies. In the native white families, the rate for breast-fed babies was more than twice as high in the families “ under $550” as in the f amilies “ $1,850 and over,” but the downward curve in the rate was broken by a slight rise in the group $1,250 to $1,849. How do these rates compare with the rates for all babies having, all types of feeding? The total death rate in Baltimore for the 10,528 babies living long enough to be fed at all was 80.5 per 1,000 infants fed. The rates for breast-fed babies in the poorest homes— except in the colored families— were below this average rate for the community but also above the rates for breast-fed babies in the most prosperous homes; and, it should be noted, the artificiallyfed babies in the most prosperous homes showed a far more favorable rate than the breast-fed babies in the poorest homes. Three simple computations of what the infant mortality in Baltimore might have been if all the babies had been exposed only to such hazards as the more favored babies had to meet, illustrate the interplay of infant feeding and economic conditions as factors in preventable mortality. (1) If the infant death rate of 43.3 per 1,000 infants fed, which was the average for all breast-fed babies in Baltimore, had been the death rate among all the 10,528 babies who lived long enough to be fed, the total number of deaths among babies fed would have been approximately 456 instead of 848, and the total number of deaths in the entire group (including the 269 who died immediately after birth without being fed at all) would have been approximately 725 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 100 IN F A N T MORTALITY, BALTIMORE, MD. instead of 1,117; and 392, or 35 per cent of those who died, would have been saved. (2) If the infant mortality rate (including all types of feeding a n d "' babies not fed at all) among the 431 babies born in families where the father earned at least $1,850 had been the rate for the entire group of 10,797 babies, the total number of infant deaths would have been approximately 401 instead of 1,117; and 716 babies, or 64 per cent of those who died, would have been saved. (3) But if the rate, lower than either of these, for breast-fed babies in the most prosperous families, and the rate in these families of deaths immediately after birth before the infant was fed at all, had been true for the entire group in Baltimore, then 175 instead of 269 babies would have died immediately after birth; and among the 10,622 who would have survived long enough to be fed 141 would have died during the year. The total deaths would have been 316 instead of 1,117; and 801 babies, or 72 per cent of those who died, would have been saved. T able X X .—Potential saving in infant m ortality in Baltim ore; live births in 1915. I. IF A L L BABIES HAD BEEN BREAST FED THROUGH THE FIRST NINE MONTHS (OR UNTIL DEATH W ITHIN TH AT PERIOD). Potential. Infants. Rate. Fed ............................................................................................... Deaths. Actual deaths. 10,797 725 1,117 269 10,528 269 456 269 848 43.3 II. IF A L L BABIES HAD FACED THE H AZARDS TO BABIES (TY PE OF FEEDING DIS R E G A R D E D ) WHOSE FATHERS EARNED $1,850 OR OVER. 10,797 37.1 401 1,117 III. IF A L L BABIES HAD FACED THE HAZARDS FACED A T B IR TH AND B Y BREAST FED BABIES A F TE R BIRTH , IN FAMILIES W HERE FATH ERS EARNED $1,850 OR OVER. 10,797 Live births and deaths at birth..................................................... Infants fed and subsequent deaths............................................... 10,797 10,622 16.2 13.3 316 1,117 175 141 269 848 Living conditions affecting mortality in the poorer families. The higher mortality among babies living in the poorest families, even when exclusively breast fed, is not easily explained. It is doubtless due in part to social conditions associated with but not due to poverty and in part to conditions for which poverty is itself a cause. It is not easy to separate these two classes of conditions nor https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 101 to determine the extent to which poverty itself may be a direct factor in increasing the hazards to babies. Certain social conditions that raise the infant mortality rate were more commonly present in the poorest families than elsewhere, but even here they were not universal.32 In the poorest families, where the fathers earned under $450 during the year, the most prevalent unfavorable social factors were room congestion and employment of mothers away from home; but more than one-half of the poorest mothers were not so employed during pregnancy or within 12 months after the birth of a baby in 1915, and more than one-fourth of these babies who lived at least two weeks were in dwellings having more rooms than there were persons in the household. Large families and short intervals between births were slightly more prevalent in poor homes than in prosperous homes, but less than one in four of the babies whose fathers earned under $450 was seventh or later in order of birth and less than one in four followed a brother or sister born less than two years before. Poverty may also be associated with lack of intelligence or with ignorance on the part of the mother of the best methods of caring for her baby. Perhaps the most serious aspect of ignorance in caring for the baby is that it may lead to the early substitution of artificial for natural feeding. But in this respect the mothers in the poorer groups, as already discussed, are not handicapped, since the propor tion of infants breast fed is greater in the low earnings groups than in the higher. In other respects, however, ignorance of the proper intervals between feedings, ignorance of the importance of cleanli ness, of the importance, if artificial feeding is adopted, of adapting it to the needs of the baby, ignorance of when it is advisable to consult a physician— ignorance of these things may prove disastrous to the baby’s life. Such ignorance is doubtless more prevalent among the poorer mothers; the old theory.that all mothers know b y instinct the best methods of caring for their babies is no longer held; and it is obvious that the more well-to-do mothers have access to facilities for education in respect to the best methods of infant care and may secure competent medical advice and nursing c&re to supplement their own efforts which the poor mother can not secure. In one important point, in respect to the illiteracy of the mother, the data of the study offer definite information. While illiteracy may not always be associated with ignorance in regard to infant care, yet it is probable that it usually is so associated, since the illiterate mother is wholly dependent upon oral tradition and advice. In the poorest families, those in which the fathers earned under $450, 23 per cent of the mothers were illiterate as compared with less than 1 per cent in families where the fathers earned $1,850 or over. « Compare Tables 90,102, 127, 137, and 154, Appendix V II, p. 293, 304, 332, 338, and 349. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 102 Ch abt IN F A N T M O R T A L I T Y , B A L T IM O R E , M D , X IV .—Infant mortality rates, by fathers’ earnings among infants of “ favored group” and all other infants. NATIVE "WHITE MOTHEES. FOEEIGN-BOEN "WHITE MOTHEES. Infant mortality rate. Infant mortality rate. $450. to $549. to $649. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis to to and $1,249. $1,849. over. Favored group All others Average $450. to to to $1,249. and SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 103 The effects upon infant mortality of these conditions associated with poverty— illiteracy of the mother, her employment away from —home, large families, and short intervals between births— can be eliminated to a large extent by examining the mortality rates in a favored group in which none of the most unfavorable conditions are present, and in which therefore the influence of poverty as dis tinct from these conditions is revealed. Eliminating all families where the mother was employed away from home or was illiterate, or where the 1915 baby was seventh or later in order of birth or followed a preceding birth by an interval of less than two years, a “ favored group” is formed which includes 22 per cent of the live births in families where the father earned under $450 and 40 per cent of the live births in families where the father earned under $850. In this favored group, the contrast in rates between the poorest and the most prosperous families is slightly less sharp than in all the families combined, but the same general trend persists— the infant mortality falls as the fathers ’ earnings rise.33 T a b l e X X I . — I n f ant m ortality in first favored group by earnings o f father; infants o f native white mothers. Favored group,1 Total. Earnings of father. mor Infant mor Live births. Infant tality rate. Live births. tality rate. Under $450.......................................................................... $450-1549............................................................................. $550-$649............................................................................. $650-$849............................................................................. $850-$l, 249.......................................................................... $1,250-$l, 849...................................................................... $1,850 and over................................... ................................ 449 644 908 1,726 1,802 629 366 164.8 128.9 107.9 95.6 69.9 84.3 38.3 185 301 492 1,063 1,175 453 281 113.5 119.6 87.4 72.4 54.5 83.9 46.3 1 From this group have been eliminated mothers employed away from home and illiterate mothers,„ and infants who were seventh or later in order of birth or who had followed a preceding birth by an inter val of less than two years. Eliminating not only these social factors but room congestion as well, the favored group is further reduced and includes only 11.5 per cent of the infants surviving two weeks whose fathers earned under $450 and 26.3 per cent of the infants surviving two weeks whose fathers earned under $8^0. But the favored group is still large enough to permit a comparison of infant death rates by fathers’ earnings, and again the same trend persists— the death rate falls as the fathers’ earnings rise.34 88 To eliminate complications arising from differences in race, figures are shown in the table for infants of native white mothers only. For detailed tabulations see Tables 78 and 83, Appendix VII, pp. 286 and 290. 84 To eliminate complications arising from difference in race, figures are shown in the table for infants of white mothers only. For detailed tabulation see Tables 84 and 90, Appendix VII, pp. 290 and 293. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 104 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e X X I I . — Infant m ortality in second favored group by father’s earnings; infants o f white mothers who lived at least two weeks in dwelling o f residence. Favored group.1 Total. Earnings of father. Infants. $450-$549........................................ .................................... $550-8849. ............................................................ $850-11,249.......................................................................... 984 1,052 3,490 2,142 1,156 Deaths per 100. 11.1 6.8 6.4 4.1 2.4 Infants. 113 193 1,146 1,025 704 Deaths per 100. 7.1 5.2 4.0 2.6 2.0 1 From this group have been eliminated mothers employed away from home and illiterate mothers and infants who were seventh or later in order of birth or who had followed a preceding birth by an interval of less than two years, and infants in dwellings with one or more persons per room. Poverty as a direct factor in infant mortality. Evidently there are other unmeasured factors which make pov erty— or lack of means— a hazard to infant life apart from the size of the dwelling, the size of the family, the interval between births, and the illiteracy or the gainful employment of the mother. Low income may itself be a factor in infant mortality. An important way in which lack of means handicaps mothers in caring for their babies is in the purchase of competent medical care and* supervision and nursing service. Such medical care and super vision is necessary not only during the mother’s pregnancy but also during the infant’s first year of life. The disadvantages of poverty in this respect, however, are to a certain degree removed by provision of infant-welfare stations and free consultation centers which are open to the poor as well as to the well to do. But the highest per centages of mothers reporting examination and instruction" by phy sicians during pregnancy and medical and trained nursing care at confinement were found in families where the fathers earned at least $1,850, and the lowest percentages were found in one or another of the earnings groups under $850. The extent to which the poorest mothers took advantage of free medical supervision and care is shown by the fact that the lowest percentages receiving care were in no case found among the families in which the fathers earned the least (under $450). But the provision of free care does not solve the problem for the poorer mothers since throughout the study the highest mortality rates were found in this lowest earnings group. Lack of means is a further handicap in an attempt to fortify and maintain health through good food, fresh air, rest, and recreation, as recommended by health authorities. During pregnancy and the nursing period the mother should have plenty of nourishing food, including a generous proportion of fresh fruits and vegetables, and should drink plenty of good milk. But the mother who is constantly striving to make ends meet on a meager income may be forced to stint herself or her children in order to provide food to maintain the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 105 physical efficiency of the breadwinner of the family. She should have her teeth cared for by a good dentist; but she is probably unable to pay for such care. She should have pleasant exercise and recre ation and spend at least two hours of each day in the open air; she should avoid worry and fatigue; she should sleep at least 8 hours out of the 24. But her day may be filled with worries of making ends meet, and with busy work patching up clothing for the different members of the family that they may appear at least respectable, preparing meals, caring for the children, besides trying to do all the housework; it may be physically impossible for her so to arrange her time and work— and the household conveniences which lighten the toil and shorten the hours of housework can not be obtained without money— that she may carry out these excellent recipes for her own health and that of her baby. For the baby the house should be sunny, well ventilated, and dry; his room should be not too hot nor too cold, not too light nor too noisy. On a limited income it will be difficult to rent a dwelling which meets all these requirements. The baby should have clean, comfortable clothing, a good bed, and suitable coverings. Even the cleverest and most diligent mother can not provide all these things from an empty purse. Poverty, therefore, through lack of means to provide the physical essentials for health, as well as to procure medical and nursing assistance when needed, appears to have a direct influence upon the infant mortality rate. Summary. It appears, then, that the highest infant mortality was found in the families where the father’s earnings were lowest, and the lowest infant mortality where the fathers’ earnings were highest, and in gen eral the rates for the several causes of death decreased, with the total rate, as the father’s earnings rose. Two minor exceptions to this general rule appear in the Baltimore material— a low rate (especially from diseases of early infancy) in the $450 to $549 group among the foreign born, and a break in the downward curve from diseases of early infancy in the $1,250 to $1,849 group among the native white. The importance of breast feeding in reducing mortality was appar ent in the differences between the rates for breast-fed babies and for artificially-fed babies in the poorest homes. But the rates for breast fed babies also varied with the father’s earnings, and it is to be noted that the artificially-fed babies in the most well-to-do homes had a lower mortality than the breast-fed babies in the poorest homes. Certain unfavorable living conditions were more commonly present in the homes where the father’s earnings were low than elsewhere, but a “ favored group” from which had been eliminated all babies https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 106 IN FA N T MORTALITY, BALTIMORE, MD. whose mothers were employed or were illiterate, all babies who were seventh or later in order of birth or who had followed a preceding birth-by less than two years, and all babies living in congested dwellings, showed a marked decrease in mortality from the lower earnings groups to the higher. Prenatal instruction and supervision of the mother and medical and nursing care at confinement were not universal in any earnings group, but they were reported b y more mothers in the most pros perous families than at any lower economic level. That the absence of care and instruction was not the chief cause of high mortality in the poorer homes is evident, however, from the fact that relatively more mothers reported trained care and instruction in the lowest earnings group than in the groups slightly higher in the scale. But, uniformly, the mortality was highest in these poorest homes. The sheer absence of means with which to supply the necessities of wholesome living seemed to be itself a factor in mortality. NEIGHBORHOODS, DWELLINGS, AND INFANT MORTALITY. The physical environment into which the babies were born is difficult of measurement and tabulation. The babies can be grouped according to the ward in which their families lived and the room con gestion and sanitary equipment of the dwelling, but such important items as dryness, ventilation, and cleanliness of the dwelling, and the condition of the street and yard, can not be touched upon in the present study. Moreover, in every community the condition of neighborhoods and dwellings is primarily determined by the means of the families and, to a slighter degree, by their traditions and habits. It has been noted, for example, that overcrowding in the homes was directly related to the fathers’ earnings but that the foreign-born families reported more room congestion than the native white families, even when groups with identical earnings are com pared.35 So far, therefore, as environment can be measured, the effect of environment upon mortality must be considered as secondary to the relation of poverty and of nationality to mortality. Wards.36 In discussing the relation of wards to infant mortality, two separate questions are involved: First, Where in Baltimore were the babies living who faced the greatest hazards ? and, second, What was the effect of neighborhood conditions on infant mortality apart from other factors such as poverty and differences in conditions within the home ? 35See Table 37, Appendix VII, p. 252. 36 The classification by wards is based on the dwelling in which the infant spent the greater part of his life up to 1 year of age. If a period was equally divided between two dwellings, the dwelling occupied dur ing the time nearer the birth is used. In the ease of babies dying under 2 weeks of age (or stillbirths), the ward refers to the house in which the mother spent the greater part of her pregnancy. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 107 Four wards in Baltimore had infant mortality rates above 130 per 1,000. The second ward, a low-lying district on the water front, - where the foreign born predominated and more than two-fifths of the births were to Polish mothers, had a total infant mortality of 140.3 per 1,000, chiefly due to an excessive mortality from gastric and in testinal diseases. The seventeenth ward, lying on higher ground to the northwest of the business center, where about three-fourths of the births were to colored mothers, had a total infant mortality of 146.8 per 1,000, chiefly due to an excessive mortality from the dis eases of early infancy. The twenty-first ward, the most western of the wards bordering the river, with congested blocks and less settled blocks, foreign-born and native families, very poor families and fami lies of average means, had a mortality rate of 136.5 per 1,000, chiefly due to a high mortality from gastric and intestinal diseases. The twenty-second ward, a very poor ward on the water front, with crowded blocks of the foreign bom toward the west and a negro colony toward the east, had an excessive mortality from gastric and intestinal diseases and from respiratory diseases, but a relatively low mortality from the diseases of early infancy. The total rate in the twenty-second ward (134.1) was practically the same as the rate in 4he twenty-first ward. Ward rates do not offer a satisfactory index to the neighborhoods in which babies were facing excessive hazards. In many parts of Balti more the limits of a single ward included a marked variety of neigh borhoods, with alleys and streets, the homes of the rich and the homes of the poor, grouped together in the ward unit. The high mortality of a neglected neighborhood may have been balanced by the low mor tality of a well-conditioned neighborhood within the same ward. The average for a ward may, therefore, conceal a genuine contrast which it is impossible to trace from the data in the present study.37 37 See the general discussion of this in the section on “ Baltimore,” p. 23ff. The most obvious exam ple of contrasting conditions within the wards was found in the six wards in which 5 per cent or more of the babies were bom in families where the father earned at least $1,850. In each of these six wards the relatively high percentage of well to do families was balanced by a higher percentage of families in which the father earned less than $650. And in four of these six wards the percentage of colored births was con siderably above the percentage of colored births in the city as a whole, and more of the babies in the ward were bom into colored families than into well to do white families—see especially p. 26. Live births in specified ward of residence. Color of mother and earnings of father. Total........................................... $1,850 and over: White mothers.............................. Colored mothers............................ Under $650: White mothers.............................. Colored mothers............................ All other: White mothers.............................. Colored mothers............. .............. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis The six. 11 12 13 14 15 16 Num ber. Per cent. 2,307 100.0 145 409 449 289 598 417 284 2 12.3 0.1 28 70 42 26 1 89 1 29 326 378 14.1 16.4 8 60 66 43 117 5 26 107 64 98 45 65 1,185 132 51.4 5.7 38 11 212 18 284 1 78 51 315 31 258 20 108 IN F A N T MORTALITY, BALTIMORE, MD. That there were undoubtedly blocks, or districts, outside of wards 2, 17, 21, and 22 where mortality was also far above the average for all is indicated b y the extent to which the three groups in the popu-' lation whose mortality was especially high were gathered in other wards. Fifty-four per cent of the Polish babies, 78 per cent of the Negro babies, and 77 per cent of all babies in white families where the father earned less than $450 lived outside these four wards, but the total mortality among these babies was excessive not only in the four wards with high mortality rates but also in the remainder of the city. T a b l e X X I I I .—Relative m ortality, by ward groups, in selected nationality and earnings groups; live births in 1915. The four wards (2,17, 21, 22). The other wards. Earnings of father, color and nationality of mother. Live births. Polish mothers................................................................... Colored mothers................................................................. White mothers in families where father earned under $450 288 293 242 Infant mortality rates. 180.6 170.6 165.3 Live births. 337 r 1,012 795 Infant mortality rates. 148.4 155.1 149.7 Is there, then, no distinctive relation between neighborhood con ditions and mortality, apart from the economic status of the family and living conditions within the home ? The ward rates in the present study illustrate the difficulty of demonstrating the relation which many students of infant mortality have thought to exist between infant mortality and lack of drainage and sanitation and dirty streets— in other words, the city house keeping in any given district and the lot congestion and absence of sunlight and open spaces. The families living in ill-favored neigh borhoods are usually the poorest, whose babies suffer from other known hazards of poverty. Or, if they have a small margin of in come, they accept an ill-favored neighborhood because they con sider other things more essential than an improvement in living con ditions either within or without the home. And, vice versa, most of the very poor families live in ill-favored neighborhoods. In Balti more, at least, there was no basis for comparing families in ill-favored neighborhoods with families of the same nationality and similar poverty in well-conditioned neighborhoods. No evidence can be of fered as to whether in Baltimore neighborhood conditions were an independent factor in mortality, apart from the influence of poverty, racial customs, and conditions within the dwelling. For example, only two of the four wards— the twenty-first and the twenty-second—with a mortality above 130, markedly above the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 109 average for all wards, had an excess that is not accounted for by the inclusion within the'Ward of nationality and earnings groups with high mortality rates.38 But keeping in mind the difficulties of analysis stated above, it is apparent that this fact offers no evidence either for or against the independent effect of neighborhood. The apparent absence of high mortality in certain other conspicuously unfavorable districts also proves nothing. For example, the Locust Point dis trict is merged in the tabulation with the western part of the twentyfourth ward. The third ward had an average rate, although it closely resembled the second ward in housing and the condition of the streets and yards; but the third ward had a considerable per centage of births to Jewish mothers who managed, always, to pro tect their babies to an amazing degree. The seventeenth and eight eenth wards had a higher percentage of dwellings that lacked sewer connection than any other wards in the center of the city; but in neither ward was the mortality from gastric and intestinal diseases exceptionally high. Another element in mortality according to wards is infant-welfare work, which should tend to reduce the mortality in districts where the work is well developed. The fifth ward, for example, which was one of the poorest in the city, had the lowest infant mortality rate in any ward. The large Jewish population in this ward accounts for part, but only for part, of the difference between the fifth ward and the average for all. The chief factor seems to have been the exception ally high percentage of mothers having fairly good prenatal care and of infants having supervision.39 In the seventeenth and eighteenth wards and in the twenty-fourth ward the percentage having regular supervision from infant-welfare agencies was also above the average for the city, and in the third ward more mothers and babies had such care and supervision than in the second ward. But in none of these wards except the fifth did more than one baby in five have regular supervision from infant-welfare agencies. The essential facts in the present study seem to be that (1) while only four wards showed, as a whole, excessively high mortality either from all causes or from one or more specified groups of causes, the same excessive hazard was present in all districts representing the same standard of living; (2) the Jewish families had a low rate even in unfavorable surroundings; (3) the effect of neighborhood as dis tinct from economic status can not be either proved or disproved from the present data; (4) certain of the wards in which surround ings were unfavorable showed a relatively high development of inf ant88See Table 87, Appendix V II, p . 292. 39Grades A and B,prenatal care, 38.1 per cent; regular supervision from infant-welfare agencies,34.6 per cent. For grades of care, see pp. 208 to 210. But note that the rate in the fifth ward (65.7) is almost twice as high as the rate in families where the fathers earned $1,850 or over. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 110 ENTA N T MORTALITY, BALTIMORE, MD. welfare work and an average mortality, instead of excessive mor tality, from gastric and intestinal diseases; (5) but not even the fifth ward with its high percentage of Jewish mothers and except Ch ar t X V .—Death rates among infants surviving two weeks, by fathers’ earnings and room congestion. Per cent of Under $450. $450 to $549. $550 $650 to to $649. $849. Less than one person per room One or more persons per room $850 to $1,049. $1,050 to $1,249. $1,250 and over. tional development of infant-welfare work had a rate approaching the very low rate among babies in the most prosperous families throughout the city. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. I ll Dwellings. In relation to room congestion and lack of sanitation there was more definite evidence that low standards reacted unfavorably upon the baby.40 These conditions were,, of course, chiefly prevalent in poor homes, but a comparison of the infants in crowded and poorly equipped dwellings with other infants in families at the same economic level showed a higher mortality in the crowded and poorly equipped dwellings than elsewhere. Room congestion .— Of the infants in native white families who lived at least two weeks, 2,344 were in dwellings with one or more persons per room— 107 of these in dwellings with two or more per sons per room. The death rate among the infants whose families lived in dwellings with more rooms than persons in the household was 4.6 per 100 infants surviving two weeks; in dwellings with one person but less than two persons per room, the death rate was 8.6 per 100 infants, and in dwellings with two or more persons per room it was 14 per 100.41 T a b l e X X I V .— Excess m ortality in overcrowded dw ellings, when effect o f differences in fa th ers’ earnings is elim inated; in fan ts horn in 1915 to native white m others, who lived at least tw o weeks in dw ellings with specified num ber o f persons per room . Earnings of father. Deaths per 100 infants (native white mothers) who lived at least 2 weeks in dwellings with specified number of persons per room.1 Less than 1. Under $450........................................................................................................ $450-3549............................................................................................................ $550-3649............................................................................................................ $650-$849............................................................................................................ $850-SI,249......................................................................................................... $1,250 and over................................................................................................. 1 but less than 2. 4.6 8.6 7.5 7.1 6.9 4.5 3.8 2.7 15.1 9.6 8.3 7.8 5.8 3.4 2 or more. 14.0 1 Not shown where base is less than 100. At each earnings level, the death rate was lowest in the least crowded dwellings. The families of the 107 infants in dwellings with two or more persons per room were so distributed among the several earnings groups that even in the lowest group their number was too small to justify the computation of a death rate according to father’s earnings. It may be noted, however, that the average death rate among these 107 infants, for all earnings groups combined, was higher than the death rate in any earnings group except the 10 The housing tables are based on infants who had survived the first 2 weeks of life and the dwellings in which each lived the greater part of his life. The possible effect of housing on the condition of the mothers or infants immediately after birth is not considered. Of the infant deaths in Baltimore 35.8 per cent oc curred within 2 weeks after birth, and such deaths are almost entirely assigned to natal and prenatal causes. 41 For detailed tabulation see Table 90, Appendix VII, p. 293. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 112 IN F A N T MORTALITY, BALTIMORE, MD. poorest among the infants in dwellings with one person but less than two persons per room. A fair measure of the effect of room congestion upon mortality in ^ the native white families is afforded by comparing the actual number of deaths— 208— among the 2,344 infants of native white mothers liv ing in dwellings with one or more persons per room, with the number of deaths that would have occurred among them— approximately 133 — if they had been exposed to the hazards indicated by the rates in families at the same economic levels in dwellings with more rooms than persons in the household.42 The total mortality among babies in native white families was 6.1 per 100 infants surviving the first two weeks and 95.9 per 1,000 live births. If the excess deaths among babies in dwellings with one or more persons per room had been eliminated, the total mortality would have been reduced to 4.9 per 100 infants surviving the first two weeks and 84.7 per 1,000 live births. * In the same way among the colored babies the death rate in fam ilies living with less than one person per room was 8.1 per 100 infants surviving the first two weeks and 12.4 in families living with one or more persons per room. That is to say, 82 deaths occurred in the congested dwellings instead of the 54 deaths which would have,, occurred if these babies had faced the hazards of babies in other dwellings.43 The total colored mortality was 10.7 per 100 infants surviving the first two weeks and 158.6 per 1,000 live births. If the excess deaths among babies in dwellings with one or more persons per room had been eliminated, the total rates would have been 8.4 per 100 infants surviving the first two weeks and 137.2 per 1,000 live births. Among the foreign-born families, the difference in mortality ac cording to the room congestion was less than among the native white families, ranging from 4 per 100 infants surviving two weeks in house holds with less than one person per room to 10.5 per 100 infants in households with two or more persons per room. In this group of most congested households, more than half were Polish, and the dif ferences in nationality distribution within the least congested and the most congested groups would by themselves, apart from the room congestion, account for the part of the difference in mortality, but the actual difference (from 4 to 10.5). is somewhat greater than the expected difference (from 5.5 to 8.6). Again, part of this excess may be accounted for by the higher earnings in the families living with 42 See Table 86, Appendix VII, p. 291. 43Variations in distribution by earnings were disregarded in this comparison, since the general level was low in both groups of colored families, and “ 2 or more per room” were combined with “ 1 but less than 2,” since their number (48) was too small to serve as the base for a rate. See Table 90, Appendix VII, p. 293, https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 113 less than one person per room, where the median was between $650 and $850, while the median in the families living with two or more -^persons per room was between $450 and $550. Disregarding the differences in nationality distribution, computations of the deaths expected in these two groups from the earnings of the fathers show that, apart from room congestion, a somewhat higher mortality would be expected in the congested households from the greater poverty of the families. Again, however, the actual difference be tween the families with less than one person per room and the fam ilies with two or more persons per, room (from 4 to 10.5) was greater than the expected difference (from 5.4 to 7.6). Even if the difference due to variations in nationality and the difference due to poverty had been entirely distinct— and they were not— and the total ex pected variations in death rate might be fairly indicated by the sum of the two expected variations in rate, there would still be a margin of actual difference in rate unrelated to nationality and poverty.44 Moreover, the rates for all Polish babieg, all Jewish babies, etc., and the rates for all foreign-bom families with the fathers4 earnings under $450, $450 to $549, etc., used in the computation of expected deaths are themselves weighted somewhat by the relatively high percentage of congested dwellings among the Polish families and in the lowest ^ earnings groups, and, therefore, overstate the differences which can be attributed to poverty or to nationality apart from room con gestion. It may be concluded that the babies of foreign-born mothers also met a greater hazard in congested dwellings than else where, although the excess was far less marked (and more difficult to demonstrate) than the excess accompanying congestion in the native households. Sanitary equipment.— The native families, both white and colored, showed a marked difference in the death rates among*infants two weeks old and over according to the sanitary equipment of the dwell ings. Three items were taken as index to the condition of the dwell ing; a toilet connected with the sewer, a toilet for the exclusive use of the baby’s household, and a bathtub. Dividing the babies into two groups, with the dwellings equipped with all three items in one group, and the dwellings lacking one or more of the three items in the other group, and comparing the families where the fathers’ earn ings were the same, it is found throughout, for the native white and the colored families, that the babies in well-equipped dwellings had a lower death rate than the babies in other dwellings. The difference appeared mainly in the deaths from gastric and intestinal diseases. « Actual difference is 10.5 minus 4, or 6.5. Expected difference on basis of nationality is 8.6 minus 5.5, or 3.1, and expected difference on basis of fathers’ earnings is 7.6 minus 5.4, or 2.2. 3.1 plus 2.2 is less than 6.5. See Tables 88 and 89, Appendix VII, pp. 292 and 293, 101351°—23----- 8 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 114 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . Only 35 Polish babies in a total of 597, and 80 Italian babies in a total of 394, lived in well-equipped dwellings, but the Jewish families and the “ other foreign” group had a large enough number living inwell-equipped dwellings to permit the computation of a death rate for the babies in these families separately. Among the Jewish babies, no difference appeared in the rate from gastric and intestinal diseases, but there was a slight excess in deaths from other causes in the poorer dwellings. Among the “ other foreign” babies, the death rate was higher in the poorer dwellings than in the well-equipped dwellings, from gastric and intestinal diseases and from other causes also.45 Summary. It seems clear that physical surroundings do affect the welfare of the baby. The Baltimore data give new evidence that the crowded and insanitary home adds to the hazards of poverty and affects especially the mortality from gastric and intestinal diseases. The Baltimore data afforded no satisfactory classification of neigh borhoods and no clear evidence that neighborhood conditions are an independent factor in mortality apart from poverty and conditions within the home. The low mortality in one poor ward, the fifth, with its exceptionally^ large percentage of mothers receiving trained care and instruction in maternal and infant hygiene, illustrates how mortality can be re duced in spite of unfavorable surroundings, but the rate in the fifth ward (65.7) was markedly higher than the rate (37.1) among the babies throughout the city whose fathers earned $1,850 and over. EMPLOYMENT OF MOTHERS AND INFANT MORTALITY. The infant mortality rates among babies of mothers who worked outside their homes were higher than the rates among other babies. The working mothers represented, in the main, poorer homes, and the proportion of Polish and Negro mothers was higher; but even after due allowance was made for the higher infant mortality expected in a group so constituted, there remained an excessive mortality which seemed to be related to the fact of the mother’s employment away from home. In the present study, there are three sets of data on infant mortality and the mothers’ employment: First, concerning employment at home and outside the home dur ing the pregnancy of 1915. Second, concerning employment at home and outside the home dur ing the first 12 months after the birth of 1915. Third, concerning employment outside the home at any time dur ing the mother’s life-. <6 See Table 91, Appendix VII, p. 294, https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN F A N T MORTALITY. 115 From the first two sets of tables are derived infant mortality rates based on the births of 1915. From the third set of tables are derived rates based on all births to the mothers studied. Employment during pregnancy of 1915. It is difficult to disentangle the effect of employment during preg nancy and of employment during the first year of the baby’s life, since three-fourths (76.3 per cent) of the mothers who worked during Ch ar t X V I.—Infant mortality rates, by mothers’ employment during pregnancy; actual rates compared with rates expected on the basis of the fathers’ earnings and the mothers’ color and nationality. Infant mortality rates. 200 - 173.8 Not employed. Employed Employed away. at home. Actual variations. Not employed. Employed Employed at away, home. Expected variations on basis of earnings, race, and nationality. pregnancy resumed work during the first year of the baby’s life. But it is known that deaths assigned to “ early infancy” always are related to the condition of the mother and the care she has received during pregnancy and confinement; therefore, such deaths may fairly be related to the mothers’ employment or nonemployment during pregnancy. The total infant mortality among the 7,883 babies of mothers not employed during pregnancy was 93.4 per 1,000— 37.2 from the causes peculiar to early infancy and 56.2 from all other causes com bined. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 116 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . The total infant mortality among the 1,682 babies of mothers em ployed at home during pregnancy was 94.5 per 1,000— 26.2 from the causes peculiar to early infancy and 68.4 from all other causes com- ^ bined. The total infant mortality among the 1,22946 babies of mothers employed away from home during pregnancy was 179.8 per 1,000— 57 from the causes peculiar to early infancy and 122.9 from all other causes combined. Similar differences appear when each of the three race and nativity groups are considered separately. The rates from causes peculiar to early infancy were highest among the babies of mothers employed outside their homes during pregnancy and lowest among the babies of mothers employed at home; the rates from all other causes were also highest among the babies of mothers employed outside their homes during pregnancy. But these were lowest among the babies of moth ers not gainfully employed. T able X X V .— Infant mortality rates, by cause o f death, employment o f mother during pregnancy, and color and nativity; live births in 1915.1 Infant mortality rates. Employment, color, and nativity of mother. AH causes. Native white: Foreign-born white: Colored: Early infancy. All other causes. 94.3 85.4 140.8 38.9 27.4 46.0 55.5 57.9 94.8 82.9 88.2 183.3 28.8 21.3 64.3 54.1 66.9 119.0 124.1 126.9 201.8 48.7 34.1 59.6 74.5 92.9 142.1 1 For detailed table, see Table 103, Appendix VII, p. 305. The differences between the rates from causes peculiar to early infancy for the babies of mothers employed at home and the babies of mothers employed outside fell beyond the differences which might have been expected because of the economic and racial com position of the two groups and indicate a definite variation due to the fact and circumstances of employment.47 Among the white mothers the predominating types of work done at home and away were quite different; and a marked difference in infant mortality rates would be expected, since the monotony and unbroken strain of a factory day are not comparable with the variety « For the mothers of three babies no report as to employment during pregnancy was secured. « See discussion of employment of mothers in section on Nationality and Mortality: Social Factors, pp. 83 and 89, and Table 104, Appendix V II, p. 306. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis s o c ia l An d e c o n o m ic factors in iNfaNt m o r t a l it y . 117 of work and the adjustable hours of the woman who is keeping lodgers. But among the negro women, for whom laundering was the chief occupation at home, and doing laundry work and char work was the chief occupation away from home, the differences in rates persist. This seems to indicate that it is not so much the fact of muscular exertion as the uninterrupted hours of a full day’s work required in outside employment that is injurious during pregnancy. W hy the rates from causes peculiar to early infancy were lower among the babies of mothers employed at home than among babies of mothers not employed at all during pregnancy is not so clear. In the native white families the variations in rate according to the fathers’ earnings were more marked than in other groups both in the deaths ascribed to early infancy and in deaths from all other causes. It may well be that, when the mother worked at home during pregnancy, her addition to the family income was of direct and immediate benefit and tended to lessen the hazards to her baby. When she worked outside her home during pregnancy the benefit of her earnings was outweighed by the greater physical strain involved. In the foreign-born white families the most marked variations in rate followed the differences in nationality rather than the differ ences in fathers’ earnings. The rate from early infancy among babies of mothers not employed during pregnancy was a trifle lower than the rate expected on the basis of the nationality distribution within the group. In the negro families the economic factor may have been of im portance, since the general level of fathers’ earnings was low, and yet there is no indication that the rate from early infancy was highest in the poorest negro families. One fact remains quite clear, however: The rates from early in fancy were definitely higher when the mothers worked away from home during pregnancy than when the mothers worked at home or did not work at all. Premature births were more prevalent among the mothers who worked away during pregnancy than among those who worked at home. And in this respect as in others the mothers who were not gainfully employed fell between the other two groups. But the differences in the prevalence of premature births do not account for the differences in rates. Considering only the full-term live births, there were throughout— that is, for native white mothers, foreignbom white mothers, and colored mothers separately— the same differences in rates from early infancy— that is, the highest rates when the mothers were employed away from home and the lowest when they were employed at home.48 48 See Tables 105 and 106, Appendix V II, pp. 307 and 308. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 118 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . The stillbirth rate varied also with employment and nonemploy ment during pregnancy except among the foreign-bom white mothers. The native white mothers who worked away from home and the colored mothers who worked either at home or away from home had definitely higher stillbirth rates than the other native white and colored mothers. But in no group was the stillbirth rate materially lower when the mothers worked at home than when they did not work at all.49 The mortality rates from all causes other than those peculiar to early infancy were excessive among the babies of mothers working away from home during pregnancy, and only in part was this excess accounted for by the greater poverty in these families. It seems to have been due in part, also, to the mothers’ resumption of work during the first 12 months of the babies’ lifetime. Of the mothers who worked outside their homes during pregnancy, 39 per cent of the white and 59 per cent of the negro resumed such work within 12 months of the birth. There may be, however, some further relation between mothers’ employment away from home during pregnancy and the deaths during later infancy, but this can not be clearly determined. It is commonly believed that if the working mother secures an interval of release from employment before confinement the work has a less harmful effect or no effect at all upon her own physical condition and upon the health of her child. In Baltimore 74 per cent of the mothers employed outside their homes during pregnancy had stopped work at least two weeks before confinement, and most of these, or 60 per cent of the total number of mothers so employed, had stopped two months or more before confinement. Relatively more of the colored mothers than of the white mothers employed away from home continued working until less than two weeks before the birth.50 In the white group there was a definitely higher stillbirth rate, and in the colored group a definitely higher mortality rate for deaths under 1 month of age, when the mothers worked away with no interval of rest from employment before the birth or with only a short interval than when the mothers had stopped work at least two weeks before confinement. The same tendency, though less marked, appears in the stillbirth rates in the colored group, and the mortality rates under 1 month of age in the white group. It should be remembered that the group who had stopped work before the last two weeks probably included far more than its propor tionate share of the mothers who had suffered from some special dis ability or unfavorable symptom during pregnancy, and this would 49 See Tables 103 and 104, Appendix V II, pp. 305 and 306. so See Table 107, Appendix VII, p. 308. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis S O C IA L A N D E C O N O M IC F A C T O R S I N I N F A N T M O R T A L I T Y . 119 tend to increase the losses in this group above the losses in the group who continued work. When, therefore, the losses in the group who stopped work are found to be either equal to or definitely lower than the losses in the group who continued until less than two weeks before confinement, it may fairly be concluded that the experience of the Baltimore mothers confirms the belief that a fair interval of rest Ch art X V II.—Infant mortality rates under 1 month of age and stillbirth rates, by interval between the mothers’ cessation of work and confinement of mothers employed away from home during pregnancy. COLORED MOTHERS. WHITE MOTHERS. Stillbirth rates per 1,000 births. 120 - 100 — Infant mortality rates under 1 month of age. Infant mortality rates under 1 month of age. 1131 968 826 80 Stillbirth rates per 1,000 births. - 917 76! 657 60.3 60 - 375 40 20 0 - -1 Interval. Under . 2 weeks. 2 weeks and over. Under 2 weeks. 2 weeks and over. Under 2 weeks. 2 weeks and over. Under 2 weeks. 2 weeks and over. from employment outside the home during the latter weeks of preg nancy is of great importance. This unfavorable weighting of the group who stopped work ap pears plainly among the mothers employed at home. These mothers commonly continued work until less than two weeks before confine ment, and 71 per cent of the white mothers and 54 per cent of the colored mothers working at home reported no interval whatever. Such work as the Baltimore mothers were doing at home seems not to have been physically injurious to the mother or the child, and, as has been noted, the babies born to mothers employed at home had lower infant mortality and stillbirth rates than the babies of mothers not gainfully employed. In the relatively small group of white https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 120 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . mothers who had been employed at home during pregnancy but had ceased their employment two weeks or more before their confinement, the stillbirth rate and the mortality rate under 1 month of age were' relatively high. In the colored group the total number of mothers working at home during pregnancy was small, and the slight differ ences in rates between those who stopped work and those who con tinued are without significance.51 For gainful employment outside the home, a definite interval of rest before confinement is evidently important. For work within the home the figures are inconclusive. Employment of mothers after birth occurring in 1915. In a discussion of mothers’ employment after the infant’s birth the question of interval, not before but after confinement, becomes of paramount importance. It will be remembered that 43 per cent of all infant deaths occurred within four weeks after birth, and the mortality rates decreased steadily through the later months of life. But less than one-third of the working mothers took up their wage earning before this first month, with its high mortality, was passed. Naturally, therefore, a large proportion of the deaths among infants of mothers employed after the birth occurred before the_ mother began, or resumed, her employment. These deaths must be eliminated before a discussion of mortality in relation to employ ment during the first year of an infant’s life is attempted. T a b l e X X V I .—Deaths o f infants by age at death in relation to mother's employment; infants o f mothers employed away from home within year after the birth. Age at death. Mother employed only after death of infant. Mother employed during life of infant. 250 161 142 40 43 25 2 18 54 87 From the 161 deaths occurring among the 2,784 babies of mothers who began, or resumed, employment during the infant’s life, no single infant mortality rate can be computed to compare with a single infant mortality rate among the babies of mothers who did not work during the infant’s life. Instead, since the hazard for all babies surviving at the beginning of the second month, for example, was greater than the hazard for all babies surviving at the beginning of the seventh month, the 61 See Table 108, Appendix VII, p. 309. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis S O C IA L A N D E C O N O M IC F A C T O R S I N I N F A N T M O R T A L I T Y . 121 hazards to babies of working mothers must be compared with those to all babies according to the month of age of the infant when the mother began, or resumed, her employment. Roughly, such a com parison is indicated in Table X X V II. T able X X V I I .— Excess mortality among infants o f mothers employed during infant's lifetime, when effect o f differences in infants' ages is eliminated. Mothers employed at home. Mothers employed away from home. Age of infant when mother began to work. Infants. 693 465 194 297 326 12 Death rate.1 6.5 4.4 6.2 2.4 1.5 Infants. 60 132 99 255 308 1 Death rate.1 21.7 14.4 9.1 9.4 2.9 Death rate 2 all infants surviving at speci fied age. 6.9 6.2 5.6 5.0 (4.4) 3.0 (2.2) 1 Subsequent deaths in year per 100 infants. 2 Death rate per 100 is based on total number surviving at beginning of specified period (except m “ under 1 month” group, when it is based on number surviving the first 2 weeks) and total subsequent deaths in the group. But the two rates shown in parentheses are based on sum of survivors at beginning of each month in the period and the sum of the subsequent deaths in each of these monthly groups. From this it appears that employment away during the infant’s life was disastrous and employment at home was beneficial. But marked variations may have been due to some special weighting of the working group in relation to the father’s earnings and the mother’s nationality, and the extent to which these babies were breast fed. The question of the infant’s age when the mother went to work also demands further analysis. (1) How do the death rates among babies whose mothers worked during the first 12 months of their lifetime compare with rates cor rected to the special distribution of nationalities and incomes within the group where the mothers worked ? 52 Two-thirds of the mothers who worked away from home were Polish or Negro women whose babies showed high infant mortality rates throughout. Among these Polish and Negro babies there occurred 54 deaths, 16 more than the 38 deaths that would have occurred if these babies had faced only the average hazards to Negro and Polish babies of corresponding ages in Baltimore. The white mothers, other than Polish, who went out to work were mainly native born and the 20 babies who died in these families were more than twice as many as the number who would have died if they had been facing only the average hazards to white babies, other than. Polish, in Baltimore. More than twp-thirds (70.6) of the babies whose mothers worked away from home during their lifetime were in families where the father earned less than $550 during the year; barely 4 per cent were in the k See Tables 109,110, and 111, Appendix VII, pp. 310-314. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 122 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . families where the father earned as much as $850. On this point no complete comparison with rates corrected for distribution of incomes is possible, but it is found that the actual deaths among babies of native white mothers and babies of negro mothers, where the fathers earned under $850 and the mothers went out to work during the babies’ lifetime, were more numerous than the deaths expected on the basis of the rates for all babies in all native white and negro families of corresponding earnings groups. Among the mothers who worked at home during the baby’s life time the percentage of Negro and .Polish mothers was markedly lower than among the mothers who worked away, and about the same as the percentage of Negro and Polish women among those who were not employed at all during the baby’s lifetime. The Jewish and Italian mothers, on the other hand, whose babies had relatively low mortality under all circumstances and who were almost entirely absent from the group which worked away during the baby’s lifetime, constituted about 24 per cent of those who were employed at home. (In the group of mothers not employed at all during the baby’s lifetime, the Jewish and Italian mothers formed about 11 per cent of all.) A com parison of the deaths which might be expected, on the basis of this favorable nationality distribution with those actually occurring, among babies of mothers employed at home during the baby’s lifetime reveals but little difference for the group as a whole— 92 deaths expected and 87 deaths occurring. These mothers employed at home represented in general a higher economic level than the mothers employed outside. A t least 25 per cent, instead of barely 4 per cent, had husbands earning $850 or over. But they were still far below the economic level of mothers not gainfully employed. Again, on this point, no complete comparison is possible, but it is found that for all native white mothers employed at home whose husbands’ earnings were known, the actual infant deaths, 30, were approximately the number expected, 32, on the basis of fathers’ earnings. For colored mothers employed at home, the actual infant deaths, 16, were fewer than the number expected, 24, on the basis of the fathers’ earnings. Evidently, the mother’s employment outside the home during her baby’s lifetime involved some hazard which was distinct from the general conditions of poverty and which was not operative when the mother’s work was done at home. Infant mortality seems to have been even a trifle lower when the mother worked at home during the baby’s lifetime than when she was not employed. (2) What is the relation between the age of the baby when the mother took up her employment and excessive or favorable death rates? https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis S O C IA L A N D E C O N O M IC F A C T O R S I N I N F A N T M O R T A L I T Y . 123 From the foregoing comparison, it appears that the earlier the mother had begun her work the greater was the excess of infant 'deaths among the babies of mothers employed away from home. This might result, quite apart from, the effect of the mothers’ employ ment, if the group of mothers going out to work before the baby was 3 months old represented families in which other conditions were more unfavorable to the baby than in the families where the mother took up her outside employment after 3 months. On three points the conditions in these groups can be compared: Race and nationality, fathers’ earnings, and the extent to which the mothers were employed away during pregnancy. And this reveals in the “ under 3 months” group a slightly higher percentage of babies of Polish mothers and Negro mothers; a higher percentage of fathers with the lowest earn ings or none at all; and a markedly higher percentage of mothers employed away from home during pregnancy, than in the “ 3 months or over” group.53 That the high percentage of mothers who worked away from home during pregnancy does not account for the greater excess in rate in the “ under 3 months” group is plain, since this excess was approxi mately equal among the babies whose mothers had worked away from home during pregnancy and the babies whose mothers had not worked away during pregnancy. (It will be remembered that even among the mothers who went out to work within three months after the birth, comparatively few began their work during the first month, and most of the deaths from prenatal causes occur before the baby has completed a month of life.) But the unfavorable weighting of the “ under 3 months group” in the two other respects might account in part for the greater excess of infant deaths in this group. This excess, however, when the mother went out to work within three months did not appear uni formly throughout. Among the babies of white mothers other than Polish the number of deaths was more than twice the number ex pected, whether the mother began work within three months, or between three months and six months, or after the baby was 6 months old. In the Polish families the greatest excess of deaths occurred when the mothers went out to work after the baby’s third month but before he was 6 months old. In the Negro group the excess appeared only among the babies whose mothers went to work during the first three months.54 Where the mothers worked at home, the comparison of infant death rates with the death rates for all infants surviving at each month of life showed rates more favorable for the babies of working mothers than for others in the “ 3 months or over” group and not » See Tables 112,113,114, and 115, Appendix VII, pp. 314-316. MSee Table 110, Appendix VH, p. 313. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 124 I N F A N T M O R T A L I T Y , B A L T IM O R E , M O . in the “ under 3 months” group. But in these families there was no such favorable weighting in the “ 3 months or over” group as in the' families where the mothers worked outside their homes.55 So, when'" the number of deaths in one group or the other was below or above the number expected, it reflects clearly some relation between the age of the infant when the mother began her work at home and the benefit or the hazard of the work. Turning to each of the race and nation ality groups separately, it appears that in the native white, the Italian, and the “ other foreign” families there was a slight excess over the expected number of deaths among the babies whose mothers took up their employment within three months. In the native white families this excess yielded to a number smaller than the expected number of deaths, when the mothers took up their employment after three months. In the negro families the number of deaths is below the expected number for each period.56 From these variations, it may reasonably be inferred that, especially if the mother works away from home, she serves her baby’s interests better if she delays her employment at least three months or six months after the baby’s birth, and longer if possible. (3) Did the babies of mothers working away from home have less breast feeding than other babies, and did those whose mothers worked at home have more breast feeding than other babies? Do such variations in methods of feeding account for the high death rates in the one group and the low death rates in the other ? The ways in which working mothers fed their babies were different in the three principal race and nativity groups, just as the methods of nonworking mothers varied in these groups. In each group, employment away decreased breast feeding and increased both mixed feeding and artificial feeding throughout the first nine months. But in the native white families, after the third month, the increase in artificial feeding was much greater than the increase in mixed feeding ; in the foreign white and the colored fam ilies, the increase in artificial feeding was not greater than the increase in mixed feeding until after the sixth month. Throughout the nine months, however, the foreign-born white mothers and the negro mothers who went out to work were more likely to give their babies mixed feeding than to wean them entirely; exactly th6 reverse appeared among the native white mothers. It has been frequently assumed that few, if any, babies of mothers working away from home had breast milk and no other food. The statements of the mothers interviewed in Baltimore showed that of the 470 babies surviving at the beginning of the sixth month whose as See Tables 112 and 113, Appendix V II, pp. 314 and 315. 66 See Tables 109 and 110, Appendix VII, pp. 310 and 313. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN FA N T MORTALITY. 125 mothers had been employed away during the preceding month, 118, or 25 per cent, were entirely breast fed during the sixth month.57 So far as employment either at home or away increases early weaning it will inevitably raise the infant death rate. And the earlier the baby is deprived of breast milk the greater will be the hazard he must face throughout the year.58 A comparison of the deaths among babies of mothers employed away during the babies’ lifetime with the number expected on the basis of the rates, month by month, for breast-fed, mixed-fed, and artificially-fed babies in the race and nationality and fathers’ earnings groups represented, showed an excess of deaths among babies of mothers employed away. The greater prevalence of mixed and artificial feeding leads one to expect a relatively large number of deaths. The actual number was even higher. T a b l e X X V I I I .— Excess mortality among infants o f mothers employed awayfrom home during infant’s lifetim e, when effect o f differences in type o f feeding, color, and nation ality o f mothers and earnings o f father is eliminated. Type of feeding. Infants of mothers e m p lo y e d a w a y from home during infant’ s lifetime.1 Actual deaths. Expected deaths. 68 53.8 6 20 42 4.4 13.2 36.2 i Excludes 46 infants (6 deaths) of native white mothers in father’s earnings groups “ No earnings” and “ Not reported.” See Table 117, Appendix VII, p. 323. Some excess in the number of deaths among babies of working mothers over the number expected on the basis of the feeding reported appeared in each race and nativity group except in the very small group of foreign families other than Polish. It was highest in the Polish families. « See Table 116, Appendix V II, p. 317. ss The effect of artificial feeding in relation to the age at which the infant is weaned is discussed in section on Feeding and Infant Mortality, p. 69. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 126 IN FA N T MORTALITY, BALTIMORE, MD. T able X X I X .— Excess mortality, by color and nationality o f mother, among infants o f mothers employed away from home during infant’s lifetim e, when effect o f differences in color and nationality o f mother, earnings o f father, type o f feeding, and infants’ ages is eliminated. Color and nationality of mother. Infants of mothers e m p lo y e d a w a y from home during infant’s lifetime.1 Actual deaths. i See footnote 1, Table 117, p. 323. Expected deaths.2 68 53.8 15 14 2 37 8.3 8.8 2.1 34.6 2 See footnote 2, Table 117, p. 323. When the mothers worked at home the effect of their employment upon their way of feeding their babies was much less marked. In the native white families the mothers employed at home had an even higher percentage of babies breast fed at each month of life and a slightly lower percentage artificially fed than the mothers not employed. In the foreign-born white families, the mothers em ployed at home showed a greater tendency to give their babies^ either mixed or artificial feeding after the second month than the mothers not employed. In the negro families this tendency appeared from the beginning. The infant deaths in these families where the mother worked at home were slightly fewer than those expected on the basis of the feeding reported, but the difference occurred chiefly among the babies having breast milk at the time of death. These showed 23 deaths instead of the 36 deaths expected. The numbers of actual deaths and expected deaths among babies artificially fed were practically identical. T a b l e X X X .—Relative m ortality among infants o f mothers employed at home during infant’s lifetim e, when effect o f differences m color and nationality o f mother, earnings o f father, type o f feeding, and infants ’ ages is eliminated. Infants of mothers em ployed at home dur ing infant’slifetime.1 Type of feeding. Actual deaths. See Table 117, Appendix V II, p. 323. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Expected deaths. 83 95.7 14 10 59 20.7 15.9 59.1 SOCIAL AND ECONOMIC FACTORS IN INFANT MORTALITY. 127 Interference with breast feeding when the mother worked outside her home and continuation of breast feeding when she worked at home seem to account in part for the excessive number of deaths in the one group and the relatively few deaths in the other group. But even after the effect of the different methods of feeding is allowed for, there was still a definite hazard in employment of the mother away from home during her infant’s lifetime. Employment away from home at any time. In studying the deaths among all babies bom to the mothers, not only during 1915 but at any previous time, no data are available about methods of feeding, cause of death, or the baby’s age at death. 0nly total infant mortality and stillbirth rates for babies of moth ers never gainfully employed outside their homes, for babies of moth ers so employed before marriage only, and for babies of mothers so employed after marriage can be compared. The 8,169 babies born to 2,371 mothers never gainfully employed outside their homes showed an infant mortality rate of 99.2 per 1,000. The 17,491 babies born to 6,229 mothers gainfully employed out side their homes before marriage but not so employed after marriage showed an infant mortality rate of 104.3 per 1,000. The 9,172 babies born to 2,562 mothers gainfully employed out side their homes after marriage showed an infant mortality rate of 165.8 per 1,000. In each of these groups, as elsewhere, the infant mortality was higher among negro babies than white babies, the general tendency was for rates to decline as the fathers’ earnings increased; and the babies in large families, showed higher rates than others. From the presence of more negro babies, more babies of fathers with very low earnings, and more babies of mothers who had borne several children in the families where the mothers worked away from home after marriage than in the other families, a high infant mor tality among the babies whose mothers worked after marriage was to be expected. But the rate expected from the presence of these unfavorable factors— approximately 143 per 1,000— was considerably below the actual rate of 165.8 per 1,000.59 This difference was present in each of the three race and nativity groups considered separately, and it seems to be plainly indicated that the mothers’ employment after marriage or some undefined factor related to it was unfavorable to the babies’ welfare. The stillbirth rates were uniformly higher among mothers employed away after marriage than among those employed away before mar riage only. But in the native white and the colored families, the mothers who were never gainfully employed away from home had 69 See Tables 118, 120, 122, 123, and 124, Appendix VII, pp. 324,326,328,329, and 330, https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 128 IN FA N T MORTALITY, BALTIMORE, MD. stillbirth rates higher than the mothers who worked before marriage only, and in the colored families this rose to a point higher than the rate among mothers who worked away after marriage.60 It may be noted that in this grouping, no distinction is made between mothers who had worked habitually since marriage and mothers who had worked irregularly or for some one short period since marriage. Mothers who may have worked during each preg nancy are grouped with mothers who may have ceased work before the first pregnancy. The figures may conceal further variations of rates within this general group of working mothers, but they do serve to sum up the general fact that, in actual practice under existing conditions, employment of married women, outside thenhomes involves danger to their babies.61 T a b l e X X X I .— Stillbirth rates, by employment o f mother away from home previous to 1915 birth, by color and nativity o f mother. Stillbirth rate. Mother employed away, from home. Color and nativity of mother. After mar riage but During during pregnancy not pregnancy ofl915birtn. of 1915 birth. 49.2 34.2 93.8 21.6 25.8 78.2 Among the live born babies of 1915, there was also in the foreignborn and the colored families a higher mortality from the diseases of early infancy in the group where the mothers worked away from home during pregnancy than in the group where they had worked away after marriage but not during the pregnancy of 1915. In the native white families this difference does not appear, but the rates are approximately equal in the two groups. It should be noted that in the colored families, but not in the white families, stillbirth and early infancy rates were as high among the few babies whose mothers had never been employed outside the home as among the mothers who worked outside the home during pregnancy. (Detailed tabulations are shown in Table 121, Appendix V II, p. 327.) From the data for all pregnancies it appears that the age at which the mother had commenced gainful employment away from home 60 See Table 119, Appendix VII, p. 325. «1 Among the births during 1915, the stillbirth rates were uniformly higher in the group where the mothers worked away dining pregnancy than in the group where the mothers had worked away after marriage but did not work during the pregnancy of 1915. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN FA N T MORTALITY. 129 affected the well-being of her children. Among all mothers employed away at any time previous to the birth occurring during 1915, the lowest infant mortality rate, 106.9 per 1,000, was when the mother had been from 16 to 19 years of age at beginning work. The highest rate, 161.7 per 1,000, appeared in the group of 699 babies whose mothers had begun work after the twenty-fifth year, and the next highest rate, 139.6 per 1,000, in the group of 8,983 babies whose mothers had begun work before they were 14. But each of these two groups with rates above the average for all babies of mothers employed away were so constituted as to lead to an unfavorable infant mortality rate apart from the mothers’ age at first employment. In the “ 25 years and over” group 91 per cent of the babies were bom to mothers employed away from home after marriage— a percentage more than twice as large as that in any earlier age group. In the “ under 14 years” group an economic level below the average for all working mothers may be assumed, and this group is known to include a relatively high percentage of negro babies (20 per cent, as against an average of 14 per cent in other age groups). The only check afforded by the tabulations on the variations in economic level in the families where the mothers had begun work at the various ages is the fact of the mothers’ employment or nonem ployment away from home after marriage. But on the basis of the mothers’ employment and of color and nativity, “ expected rates” may fairly be computed for comparison with the actual rates in the several age groups. From these it appears that the relatively low rate among babies whose mothers had begun work at from 16 to 19 years of age was lower than the expected rate for this age group, and the relatively high rate among babies whose mothers had begun work under 14 years was higher than the expected rate. In the other data, based on births during 1915, there was a similar trend in the rates— the lowest among babies whose mothers had begun work between 16 and 19 years, and the highest among babies whose mothers had begun work at 25 or over, with a rate also slightly above the average for all mothers who had ever been employed away from home in the “ under 14 years” group. But comparing these actual rates with rates expected from the distribution in the several groups of mothers employed and mothers not employed during the pregnancy of 1915, and of native white, foreign-bom white, and colored mothers, the variation in the several age groups are so little greater than the expected variation that with the relatively small numbers involved it can not fairly be related to the mother’s age at beginning work. Even when the total mortality is divided into the two big groups of causes, there is no clear indication of a 101351°— 23----- 9 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 130 IN FA N T MORTALITY, BALTIMORE, MD. relation between excess mortality from either group of causes and the mother’s age at beginning work.®2 Summary. The babies of women who had been employed outside their homes since their marriage faced a greater hazard than other babies, and this hazard appears to have been especially emphasized when the mothers had been employed away during pregnancy or during the first 12 months after the baby’s birth. That employment outside the home during pregnancy had reacted harmfully upon the condition of the mother and through her upon the health of her baby is indicated b y a high percentage of premature births to mothers employed away from home during pregnancy, high stillbirth rates to native white and colored mothers so employed, and high mortality from early infancy causes even among the fullterm live births of mothers employed away from home during pregnancy. The babies of mothers who worked away during preg nancy also showed a high mortality from causes other than those peculiar to early infancy. This may have been due in part to the mother’s resumption of work during the first year of the baby’s lifetime. The variations in stillbirth rates and the mortality from early infancy in relation to the interval of rest before confinement indicate the importance of the mother’s ceasing her employment outside the home at least two weeks before her confinement. Employment away from home during the baby’s first year increased the hazard to the baby. This increase in the hazard was especially marked when the mother took up her work before the baby was 6 months old. The mothers employed away from home resorted largely to artificial feeding for their babies, but the greater prevalence of artificial feeding accounts only in part for the special hazard. The actual number of deaths was greater than the number that would have occurred among them if these babies had faced the average hazards to all babies of their nationalities and their economic status who had the same high percentage of artificial feeding. In general, then, the baby whose mother works away from home during pregnancy or during the baby’s first year pays dearly for the physical strain to the mother and for the lack of a mother’s care. The mothers’ employment at home, on the other hand, in the occupations and under the conditions prevailing in the families studied seems to have no ill effect upon the mothers or their babies. The one rate indicating an exception to this general statement was a stillbirth rate among colored mothers employed at home during 98 See Tables 123,124,125, and 126, Appendix V II, pp. 329-331. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis SOCIAL AND ECONOMIC FACTORS IN IN FA N T MORTALITY. 131 pregnancy greatly in excess of the stillbirth rate among colored mothers not employed during pregnancy. RELATION OF INFANT M ORTALITY TO THE M O TH E R ’S ILLITERACY O R INABILITY TO SPEAK ENGLISH. The babies of illiterate mothers and the babies of mothers who spoke no English had a higher mortality than others, but outside the small group of native white families in which the mother was illit erate the data collected offer no evidence that the differences in mortality were directly related to the fact of illiteracy or the fact that a foreign-bom mother had not learned to speak English.63 I t has already been noted 64 that the illiterate mothers and the mothers who spoke no English represented, on the whole, families poorer than the average in their several color and nationality groups; and, when due allowance is made in the comparison of rates for the low economic level in these families, it is found that except among the illiterate native white mothers the excess in mortality which seemed to be related to illiteracy or to inability to speak English practically disappears. And among the Polish babies there was, on either basis, a somewhat higher mortality in the families where the mother spoke English and in the families where the mother could read and write than in other Polish families.65 Although the higher mortality- in certain foreign families where the mother spoke no English coincides with greater poverty and seems to be traceable to it, another question at once arises: Was not lack of English a barrier cutting off certain mothers from the benefit of infantwelfare work ? In one sense it might seem so, for, it will be remem bered, fewer of the Polish and Italian women than of the Jewish women had learned to speak English and fewer in these two groups than in the Jewish group had care from the infant-welfare agencies. But the lack of English does not account for the lack of care. Within the Polish group 7 per cent of the 210 infants of mothers who spoke English and 5 per cent of the 388 of mothers who did not speak English had regular supervision from an inf ant-welfare agency. Within the Jewish group, 23 per cent of the 768 infants of mothers who spoke English had such supervision, and 31 per cent of the 169 of mothers who did not speak English. Only in the Italian group was the percentage having such regular supervision markedly higher 63 See Tables 127,128,129, and 130, Appendix V E , pp. 332-334. « S e e p . 32. 65 The differences in the prevalence of artificial feeding or of mixed feeding previously noted in connec tion with the illiteracy and inability to speak English (see p . 54) were too slight materially to affect the relative mortality, and can not account for the high mortality among babies of illiterate native white mothers or the relatively low mortality among babies of Polish mothers who were illiterate or who could not speak English. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 132 INFAiTT MORTALITY, BALTIMORE, MD. among the infants of mothers who spoke English (22 per cent) than among those of mothers who did not speak English (9 per cent) .66 The chief measureable difference, then, between the families where the foreign-bom mother had not learned English, or the mother, whether native or foreign, had not learned to read and write, and all other families, is a difference in economic status, and this is, as has been seen, a real factor in infant mortality. So far as illiteracy on the part of the parents or their inability to speak English is respon sible for the greater poverty of the families in which the parents have these limitations, the limitations become, themselves, a factor in the infant mortality rate. ««See Table 131, Appendix VU, p. 334. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis PHYSICAL FACTORS IN INFANT MORTALITY. ORDER OF BIRTH, AGE OF MOTHER, AND INTERVAL BETWEEN BIRTHS It is commonly said that mortality among first-born children is higher than among second- or third-born, but lower than among the later-bom children. And babies born to mothers more than 35 years old are supposed to face a special hazard. . References to the high mortality among fourth-, fifth-, and later-born children are frequently countered by the statement that the largest families are the poorest and that poverty rather than any essential condition in the bearing and rearing of many children is the cause of the excessive hazard. On these points one set of data is available based on the births during 1915, and a second set of data based on these and all previous births to the same mothers. Order of birth. The data based on births during 1915 showed a rate for the 2,868 ~ first-born children slightly higher than the rates for second- and thirdborn children, and the rates rose steadily with each order of birth after the third.67 The curve in the rates rose most sharply among the later births in large families, and an excess in rates in the group of babies seventh to ninth in order of birth as compared with babies of earlier orders of birth persisted in the subdivisions of both groups when the white and colored mothers and the families at different economic levels are considered separately.68 In the larger group the first-born babies showed an infant mortality rate higher than the rate for babies second in order of birth and approximately equal to the rate for babies third in order of birth. For later births the rate rose steadily and touched- its highest point among the 883 babies tenth or later in order of birth.67 In the larger numbers considered, the births in this group of all pregnancies would presumably give a better basis for discussion of order of birth than the births in 1915, but there are certain qualifi cations which should be noted. For example, if this large group— all births— is subdivided according to the total numbers of births reported by the mothers, it appears that within each subdivision of the group the first-born babies showed a higher mortality than the later-born babies in the same families.69 Even in the families of seven 67 See Tables 132 and 133, Appendix V II, p. 335. 68 See Tables 137,138, and 139, Appendix VII, pp. 338-339. 69 See Table 135, Appendix VII, pp. 337. 133 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 134 INFANT MORTALITY, BALTIMORE, MD. or more births the first-born babies had higher infant mortality rates than the babies born seventh or later in the same families. This apparent contradiction of the relative rates shown among the births during 1915 should be weighed against the fact that these births of all pregnancies had extended over a number of years during which the development of work for infant welfare and the improvement of sanitary conditions had been tending steadily to reduce mortality. The importance of this latter qualification is further suggested b y the differences between the rates for babies of corresponding orders of birth in the small families and in the large families, and again b y the differences in mortality among all babies in small families and all babies in large families, differences which fall far beyond the variation expected from the relatively unfavorable economic conditions in the larger families.70 In both sets of data we have stillbirth rates in addition to the infant mortality rates for the several orders of birth. The stillbirth rates for the several orders of birth showed almost identical curves in the two sets of data, with a greater loss among first births than among any later births except those tenth or over in order of birth. The rates dropped sharply from the first birth to the second and thereafter rose slowly without a break in the upward curve.71 In the data based on births during 1915, but not in the other set of data, are found analyses of the infant mortality rates b y causes peculiar to early infancy and all other causes, and statements of the relative prevalence of premature births among the several orders of birth. The first child was more likely than later children to come to birth prematurely. Of the 2,999 first births in 1915, 9 per cent were premature; of the 8,196 later births, 5.9 per cent were premature. Or, considering only the live-bom babies, 8 per cent were premature among the first births and 4.6 per cent were premature among the later births. The percentage of prematurity was lowest among the births fourth to seventh in order of birth and rose thereafter, but only among the babies twelfth and later in order of birth was it higher than among the first bom .72 to That is, owmwing that earnings during the year after the birth in 1915 were a fair index to the family’s economic status throughout married life. It may be questioned whether the fathers who in 1915 were em ployed in manual labor, either skilled or unskilled, would have had during their married life any general improvement in rate of wages (in relation to the cost of living) comparable to the salary increases that commonly occur among those doing administrative or professional work. The majority of the fathers were wage earners doing manual labor. 7» See Tables 132,133,134, and 142, Appendix VII, pp. 335,336, and 340. 7* See Table 140, Appendix V II, p. 340. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis PHYSICAL FACTORS IN' IN F A N T MORTALITY. Ch a r t 135 X V III.—Infant mortality rates from early infancy and from all other causes, by order of birth; single births in 1915. Infant mortahty rate. All causes -------------------------------Early infancy All other causes — . — --------- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 136 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e I. — In fa n t m orta lity and stillb irth rates, by order o f birth and term ; births in 1915. Order of birth and term. Total: First....................................■.............................. |............................ ' Second....................................................... ....... ............................. Third.................................................................. ............................. Fourth and later............................................................................. Full term: Second............................................................................................. Third................................................................................................ Premature: First................................................................................................. Births. Infant Stillbirth mortality rates (per rate (per 100 births).1 1,000 five births).1 2,999 2,471 : 1,525 4,200 4.4 2.5 2.9 3.8 94.8 92.6 91.8 120.3 2,726 2,312 1,429 3,963 3.3 1.4 1.3 2.3 65.6 62.7 68.8 97.9 271 158 94 232 10 15.1 19.0 426.1 625.0 29.3 640.2 1 Not shown where hase is less than 100. Since the mortality among premature births is exceptionally heavy, as will be shown later, the high proportion of premature among first births tends to raise the mortality rate among first as compared with later births. Considering only the full-term births, all the rates for the several orders of birth fall very considerably below those when the full-term and the premature births are grouped together, the differ ence being greatest for the first births. The rate for the first births is still above that for second, but falls below the rate for third births, in contrast to its position when the births of all terms are grouped. It should be noted further that among the premature births the rate among first births was lowest of all; likewise among this group the first births had the lowest stillbirth rate. Reverting to the consideration of the entire group and analyzing the total infant mortality rates according to the cause of death, and con sidering separately the rate from causes peculiar to early infancy— which are most closely related to the care and condition of the mother— and the rate of deaths from all other causes, it is found that for each type of causes the rates were slightly higher for first-born babies than for babies second or third in order of birth, while the steady increase in total rate among babies fourth and later in order of birth was due to a marked increase in the rate from causes other than those peculiar to early infancy. For, although the rate from causes peculiar to early infancy touched its highest point among babies tenth or later in order of birth, the variation was slight, and for the intermediate orders of birth— the fourth to the ninth— the rate from early infancy was some what lower than the corresponding rate for babies first to third in order of birth.73 '3 See Table 142, Appendix VII, p. 340. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis PHYSICAL FACTORS IFF IN F A N T MORTALITY. Age of mother. 137 * Closely related to the variations in mortality for the several orders of birth were the variations for the several age periods of the mothers. Ch ar t X IX .—Infant mortality rates from all causes for each order of birth group, according to age of mother; all single births and single births following preceding births b y two years or longer, 1915. All single births. Single births following preceding births by two years or more. Infant mortality rate. Infant mortality rate. 150 125 100 75 50 25 Second and third b i r t h s ---------------Fourth to sixth births ------ -------- Tenth and later births Average . --------------x—x—x—x Both among the 1915 births and the larger group of all births to these mothers the same curve in the rates was found, touching the lowest point among mothers from 25 to 29 years of age and rising to high https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 138 IN F A N T MORTALITY, BALTIMORE, MD. points among mothers under 20 and 35 or over. The same general curve appeared in the rates from early infancy and in the rates from all other causes when these were considered separately, with this difference— that the rates from early infancy were practically identical for the three age periods between 20 and 35, but the rates from all Ch art X X .—Infant m ortality rates from early infancy for each order of birth group, according to age of mother; all single births and single births following preceding births b y tw o years or Ringer, 1915. All single births. Infant mortality rate. Single births following preceding births by two years or more. Infant mortality rate. 100 75 50 25 Second and third births Fourth to sixth births .................... Tenth and later births Average other causes touched their lowest point among mothers 25 to 29 years old.74 Premature births were most prevalent among the youngest mothers. In each group— native white, foreign-born white, and colored moth ers— considered separately, the percentage of premature births was above the average among mothers under 20 and below the average among mothers 35 years old or older.75 Stillbirths, on the other « See Tables 143, 146, and 147, Appendix VII, pp. 341 and 343. » See Table 148, Appendix VII, p. 344. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis PHYSICAL FACTORS IN IN F A N T MORTALITY. 139 hand, were most prevalent among the oldest mothers, although the stillbirth rate among mothers under 20 was also above the average.76 One might assume that the mortality rates for older mothers, were high because among their babies the later births in large families predominated, or that the rate for later births in large families was high because older mothers predominated, and the limited volume of the available data makes it impossible to separate entirely these two interdependent factors. But it does reveal the fact that among the babies of the oldest mothers the first born as well as the seventh and later bom had excessively high rates, while for births other than the first, and the seventh or later, the highest rates were not found among the oldest mothers. Thus for babies second and third in order of birth the highest rate appeared when the mothers were under 20 years old; for babies fourth to sixth in order of birth, when the mothers were from 20 to 24 years old; and for babies seventh to ninth in order of birth, when the mothers were from 25 to 29 years old.77 These excessive mortality rates for babies of certain orders of birth bom to mothers of certain ages appear in both types of causes. The mortality from causes peculiar to early infancy was highest (83.3 per 1,000) among first-born infants of mothers 35 years old or older, but the babies second to sixth in order of birth bom to such mothers also had rates above the average for all age groups. And babies of all orders of birth born to exceptionally young mothers had rates above the averages for all age groups. With one exception the highest mortality from all other causes was among the babies bom to very young mothers; only among babies tenth or later in order of birth did this relation to the age of the mother disappear, and in this group the mortality from all causes other than early infancy was high throughout. The age of the older mothers seems to have offered a real hazard (involving a high mortality from prenatal causes) which was inde pendent of large families; and the large family seems to have suffered from a lack of care (showing an especially high mortality from post natal causes) which was accentuated if the mother had begun her child-bearing too young or had borne her children in too quick suc cession. The interval between births appears to have been, in fact, a third element in the problem of the variations of hazard according to the age of the mother and the number of children she had borne. 76 See Tables 144 and 145, Appendix VII, p. 341. This variation was true for native and foreign-bom white mothers; it did not appear among the colored mothers, but the colored groups were too small to afford basis for any deductions. 77 In the data based on all pregnancies, the highest rate for babies tenth or later in order of birth appeared when the mothers were 30 to 34 years old; but in the data based on 1915 births, the rate for babies tenth or later in order of birth is identical at this age period and among older mothers. See Tables 150, 151, 152, and 153, Appendix VII, pp. 345-347. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 140 IN F A N T MORTALITY, BALTIMORE, MD. Interval between births. In general the babies who followed a preceding birth by an interval, of less than two years had a definitely higher mortality than those for whom the interval was longer, with a rate of 146.7 per 1,000 among the 2,072 babies born after an interval of less than 2 years since a preceding birth and a rate of 92.3 per 1,000 among the 5,810 babies born after an interval of 2 years or longer. (Compare the rate of 94.8 among the 2,868 first-born babies.) It is, of course, true that among these short-interval babies the percentage of negro families and, in the white group, the percentage of poor families were some what higher than among the babies following a preceding birth by two years or longer. But these differences were too slight to account for the difference in rates.78 Moreover, if the native white families in the several earnings groups are considered separately, and the variations due to race or nationality and to economic status are thus eliminated, there appears in each earnings group except the highest a markedly higher infant mortality among the short-interval babies than among the others. The tabulations permit a comparison of infant mortality rates by interval from another angle— that is, in relation to the mother’s pregnancy within 12 months after the birth of the baby in 1915. T able IT.— Infant deaths in relation to succeeding pregnancies commencing within 1 year after birth o f 1915 infant; live births in 1915. Live births. Mother pregnant within 1 year after birth. Relation of infant death to pregnancy of mother. Total. Num ber. Total live births.................................................................................... Infont deaths......................................................... Preceding month in which pregnancy began.......................................... Following month in which pregnancy began.......................................... During month in which pregnancy began........... .................................. Relation to pregnancy not reported...“ .................................................. Per cent. 10,797 1,563 14.5 1,117 406 299 74 28 5 36.3 26.8 6.6 2.5 .4 The percentage of mothers pregnant within 12 months after the birth in 1915 was more than twice as high among the babies who died within the year as in the entire group; and among those babies who died and whose mothers became pregnant within the year, approxi mately three-fourths died before and one-fourth after the pregnancy had begun.79 78 See Tables 154,155, and 156, Appendix VII, pp. 348-351. » See Tables 161 and 162, Appendix VII, pp. 355 and 356. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 141 PHYSICAL FACTORS IN IN FAN T MORTALITY. Of the 1,231 babies whose mothers became pregnant during their first year of lifetime, 74 babies died within 10 months after birth; whereas only 34 babies would have died if they had been facing the average hazards of all who were born in 1915. Most of them were deprived of mother’s milk; but the deaths were also in excess of the deaths which might have been expected because of the greater prev alence of artificial feeding. T a b l e I I I .— Excess mortality among infants o f mothers becoming pregnant during first year o f infant’s lifetim e, when effect o f differences in type offeeding and infants’ ages is eliminated. Infants of mothers becoming pregnant during first year of infant’s lifetime. Type of feeding. Expected deaths. Actual deaths.1 On basis On basis of average of feeding mortality. reported. Total................. ...................................................................................... 74 Breast............................................................................................................ Mixed................................................................................................................ Artificial.................................. ......................... ...................... . . . ; ................ 2 5 67 33.8 60.3 1.2 2.8 56.3 1 See Table 163, Appendix VII, p. 357. The births of all pregnancies can be classified only according to the total number of births to the same mother and the number of years she had been married.80 They indicate the same general tendency— the shorter the average interval between births the higher the mor tality. It is possible, however, that the high infant mortality accompany ing the births in families with short average intervals between births was in part a cause, as well as a result, of the short interval and the circumstances under which it occurred. For it appears that the mother whose baby had died was more likely to become pregnant within a short period than the mother whose baby was living, and hence in classifying the births for mothers who had had short intervals between births, the fact that the death of the infant was correlated with short interval following the death exaggerated the relation be tween infant mortality and short interval. so See Tables 157 and 158, Appendix VII, pp. 352 and 353. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 142 IN F A N T MORTALITY, BALTIMORE, MD. T able IV .—Per cent o f short intervals follow ing birth 1 preceding 1915 birth according to survival or death o f preceding birth; * single births in 1915 second and later in order o f birth.1 Single births in 1915. Type of loss. Total.2 With interval under t w o . years since preceding birth.1 Number. Per cent/ 7,959 2,101 26.4 1,650 897 753 365 157 225 6 1,016 252 764 776 440 336 184 66 85 1 354 75 279 47.0 49.1 44.6 50.4 42.0 37.8 34.8 29.8 36.5 1 Includes miscarriages. * Excludes first births. * The Corresponding percentage for all births in 1915, 26.2; for all lire births, 26.1; for single live births 26.3. It has been noted that among the mothers who became pregnant within the year after the birth in 1915 and whose babies died within the year three-fourths became pregnant after the death of the baby and not before. From the data about births in 1915 and the preced ing birth it appears that the percentage of short intervals was con siderably higher in the groups where the preceding birth was a still birth or miscarriage or a live-born baby who died within 12 months than in the group as a whole. Some such difference would appear if short interval was a cause of infant mortality. But the actual percentage of short intervals in the group where the preceding birth did not survive (47 per cent) was not only higher than in the group as a whole (26 per cent) but also higher than in the group of losses among the 1915 births (35 per cent). And, significantly, the dif ference was greatest where the preceding birth had been a stillbirth or miscarriage or a death occuring within three months after birth. This seems to indicate that the short interval was in part a result of the death of the preceding infant. It does not, however, do away with all the excess mortality, for among the babies who died in 1915 the percentage who had followed the preceding birth by an interval of less than two years was still considerably higher than the corresponding percentage among all babies bom in 1915— or, as has been noted, 35 per cent instead of 26 per cent. Evidently, the mothers whose babies had died were a little more likely than other mothers to bear another child after a short interval; the babies whose mothers became pregnant during the first year of https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis PHYSICAL FACTORS IN IN FA N T MORTALITY. 143 the babies lifetime met a special hazard; and, except in the most prosperous families, the babies who followed a preceding birth by an interval of less than two years had a higher infant mortality than other babies. It is generally assumed that short intervals between births are more prevalent in large families than in small families, and this seems to have been true for the few exceptional families where the mother had borne 15'or more children. In these families, more than half the births during 1915 followed the preceding birth by an interval of less than two years. But in the much larger number of families where the mother had borne from 10 to 14 children, the percentage reporting intervals of less than two years was less than in the families where the mother had borne only 2 children and only a trifle higher than in the families where the mother had borne 3 children. A similar tendency appears among the births of all pregnancies. The interval in this group of data refers not to the period between births but the period between one birth and the beginning of the following pregnancy. The percentage with average interval under two years is therefore higher, on this basis, throughout. But the relation of the several orders of birth to short interval is identical with that shown in "--the births during 1915 and the interval since the preceding birth.81 It is not surprising, therefore, to find also that the percentage of births during 1915 following the preceding birth by an interval of less than two years was greatest among the youngest mothers and decreased steadily as the age of the mothers increased. At all age periods there was a practically constant proportion reporting an interval of two or three years; only the percentage reporting an interval of four years or more increased among the older mothers as the percentage of very short intervals declined.82 The excess mortality among babies bom in 1915 who followed a preceding birth by an interval of less than two years appeared especially in deaths from causes other than early infancy. For example, the babies following a previous birth by two years or longer had a mortality from these “ other causes” which increased with the later orders of birth, but for each order of birth the short interval babies showed a higher rate from “ other causes” than the rates in the other group. For the causes peculiar to early infancy, on the other hand, the short interval babies earlier than seventh in order of birth had rates definitely higher than the babies who followed a previous birth b y two or three years; and. the babies seventh or later in order of birth showed no differences in rates according to interval.83 It would seem, therefore, that short intervals between births affect 81 See Table 165, Appendix VII, p. 357. 82 See Table 166, Appendix VII, p. 358. 88See-Table 167, Appendix VII, p. 358. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis IN FAN T MORTALITY, BALTIMORE, MD. :.—Infant mortality rates from early infancy and from all causes for each order of birth, by interval since preceding birth; single births in 1915. ] j Early infancy. All other causes. mi talit; te. 40 120 LOO 80 00 40 20 0 rs. ---------------Fourth, fifth, and sixth births to mothers 25-34 years old Seventh, eighth, and ninth births to mothers 30-39 years old — •— •— •— https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis y 145 PHYSICAL FACTORS IN IN F A N T MORTALITY. the care the mother is able to give the baby more than they affect the physical condition of the mother herself. Again, at each age period of the mother, except among mothers less than 20 years old, there was a relatively high mortality from “ other causes” among the short interval babies but no clear dif ference b y interval in the mortality from early infancy. Under 20, however, the mortality from early infancy rose markedly among the short interval babies, while for all babies alike the mortality from “ other causes” was high.84 Variations in mortality according to the age of the mother and the order of the baby’s birth can not, therefore, except in this group of babies born to mothers less than 20 years old, be ascribed to the preva lence in certain groups of short intervals between births. In fact, when all the babies who followed the preceding birth by an interval of less than two years are eliminated, the characteristic curves in the rates persist, except that the rise in the curve for causes peculiar to early infancy among babies of mothers under 20 years of age disap pears. But while the curves have the same general outlines they are at several points lower when the short interval babies have been eliminated than they are for the entire group, and most notably so in the rates for causes other than early infancy among babies fourth to ninth in order of birth born to mothers 25 years old or older.840 T able V .— Infant mortality rate,1 by interval since preceding birth,2 order o f birth 2 and age o f mother; live births in 1915. Infant mortality rate.1 Age of mother and order of birth.* Second and third births: Fourth to sixth births: Seventh and later births: x Not shown where base is less than 100. Interval under 2 years. Interval 2 years and over. 160.6 113.0 70.4 107.3 142.3 81.2 82.9 166.7 185.0 110.4 122.6 * Includes miscarriages. Summary. 't It may fairly be concluded that although these three factors are closely bound together, yet each makes its own contribution to the general problem. In grouping the births according to the order of birth, it is found that, independently of age and interval, the births 8<gee Table 168, Appendix VII, p. 359. 101351°—23-----10 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Ma See Table 169, Appendix VU, p. 360. 146 IN F A N T MORTALITY, BALTIMORE, MD. seventh and later in order had a mortality higher than earlier births. The babies of mothers under 20 or over 35 years of age in general faced a greater hazard than other babies, although to this general rule there were certain exceptions And the short-interval babies had throughout higher rates than other babies of the same orders of birth born to mothers of the same age periods. Variations in rate with the different age periods of the mother appeared in the deaths from early infancy and also in the deaths from all other causes. But variations with the different orders of birth and the different intervals between births appeared more markedly in the mortality from other causes than in the mortality from early infancy. Large families and short intervals were especially a problem in the poorer homes, where they were somewhat more prevalent than in prosperous homes. In the small group of prosperous homes the excess mortality that accompanied them elsewhere was greatly diminished or seemed to disappear entirely. PLURAL BIRTHS. Plural births show an infant mortality from two to four times as high as thé infant mortality among single births, but the number of plural births is small and they are not, therefore, an important factor in the total mortality of a community. For example, if no plural births had occurred in the Baltimore group of births during 1915 the infant mortality rate would have been 97.1 per 1,000 in stead of 103.5 per 1,000.846 Just over 1 per cent of the pregnancies studied resulted in plural births. Of all the births during 1915, 2.5 per cent were plural. But the losses among plural births were so great that, among the infants born in 1915 and surviving their first year of life, the number of twins or triplets was 1.7 per cent of the total survivors. The three color and nativity groups showed practically no varia tion in the percentage of plural births. But there was a slight variation according to the age of the mother and the number of children she had borne. The younger mothers showed fewer plural births than the older mothers, the percentage of plural births increas ing steadily from approximately 1 per cent among the mothers under 20 years of age to approximately 4 per cent among the mothers 35 years of age or over. A similar increase appears when the first, second, third, and later births are compared. Analysis of the births during 1915 seems to indicate that order of birth and age of mother are independent factors in the prevalence of plural births.85 8<J> See Tables 170,171, 172, and 173, Appendix VII, pp. 361-362. 85 See Tables 174,175,176, and 177, Appendix VII, pp. 362-363. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 147 PHYSICAL FACTORS IN IN FA N T MORTALITY. It is clear, also, that the mother who has once had a plural birth is more likely than other mothers to have plural births. Of the 38,211 pregnancies studied, 1.1 per cent resulted in plural births; of the 734 pregnancies subsequent to a plural birth, 3.7 per cent resulted in plural births. This simply indicates that thé second occurrence of a plural birth is correlated with the occurrence of a first plural birth. T a b l e V I. — L oss rates— C om p a rison o f sin g le and p lu ra l births 1 in 1915. Loss rates. Type of loss.. Single birtns. 3.6 3.6 97.1 33.9 63.2 Plural births. • 5.4 7.1 361.5 192.3 169.2 1Includes miscarriages. In every sense the losses were high among plural births. Mis carriages, stillbirths, and infant deaths %ere all more numerous among plural than among single births. The infant mortality among plural births showed its greatest excess in deaths from early infancy, but it was also high from all other causes Combined. There was among the plural births a high percentage of premature births, but it was also found that among the full-term plural births the mortality rate (266 per 1,000) was more than three times the mor tality rate (73.9 per 1,000) among the full-term single births.86 T a b l e V II.— C om p u ted 'a n n u a l in fa n t m orta lity rates, by ty p e o f fe e d in g ; com p a rison o f p lu ra l an d a ll liv e births in 1915. Computed infant mortality rate. Type of feeding. All births. 24.1 43.3 87.4 191.4 Plural births. 88.5 132.2 256.2 399.0 Among the plural births,87 the percentage of infants artificially fed was high at each month from the first to the tenth; but, again, for each type of feeding considered separately, the computed rate per 1,000 infants fed was markedly higher among the plural-bom than among the single-bom children. 8« See Tables 178 and 179, Appendix VII, pp. 363 and 364. 87 See Table 180, Appendix V II, p . 364. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 148 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . Of the 403 pregnancies 88 resulting in twin births, 40, or 9.9 per cent, ended in miscarriage of both fetuses and 3, or 0.7 per cent, ended in miscarriage of one fetus and live birth of the other. Among the pregnancies resulting in single births, on the other hand, 6.6 per cent ended in miscarriage. Again, of these 403 pregnancies resulting in twin births, 9, or 2.2 per cent, ended in the stillbirths of both infants and 34, or 8.4 per cent, ended in the stillbirth of one infant and the live birth of the other. But among the pregnancies resulting in single births, only 3.3 per cent ended in stillbirth. In 317 cases the twins were both bom alive, and 150 pairs of twins, or 47 per cent of these plural live births, survived the first year; 90 pairs of twins, or 28 per cent of these plural live births died; and for each of 77 pairs of twins, or 24 per cent, there were one survivor and one infant death. T a b l e V I I I .— S u rv iv a l or death o f tw in s in p a irs; birth s,1 a ll pregn a n cies. Total pairs of twins............................... 403 Both miscarriages.................................... Both stillbirths..................................... Both live births................. Both deaths........... .................................. 1 survival and 1 death.............................. Both survivals.................. 40 9 317 90 77 150 1 stillbirth and 1 live birth (survivals, 23; deaths, 11).................................................... 1 miscarriage and 1 live birth (survival, 1; deaths, 2 )................ .................................... 34 3 1 Includes miscarriages. The infant mortality rate among these 634 twins who were both born alive was 405.4 per 1,000. But note the distribution of deaths and survivals. The twins tended both to survive or both to die. If the average mortality rate for the whole group of 634 twin-born infants had applied to them as individuals, the probable distribution of deaths would have doubled the number of cases where one twin survived and one twin died and reduced, correspondingly, the num bers of cases where both died or both survived.89 88 Among the total pregnancies the mothers had had. 89 N ote .— Pairs of twins. Actual dis Computed distribu tribution. tion. 317 317 90 77 150 52.1 152.8 112.1 *‘Computed distribution ’ ’ is derived from chance of death and chance of survival indicated in the average rate for the 634 infants—405.4 deaths per 1,000 live births. p=chance of death, or 0.4054; ?=chance of sur vival, or 1 minus 0.4054, which is 0.5946. The formula pl+2 ps+ff2 gives the following expected distribu tions: Both deaths =317X(0.4054)*=52.1. One died, one survived =317X2(0.4054) (0.5946) =152.8. Both survived=317X(0.5946)i =112.1 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis PHYSICAL FACTORS IN IN FA N T MORTALITY. 149 PREMATURE BIRTHS. Premature birth resulted in excessive mortality, especially during the first month of life, and in excessive losses from stillbirth and miscarriage. If the mortality rates among infants bom at full term had been applicable to the entire group, the losses from stillbirth and miscarriage would have been 2.2 instead of 7 per 100 births, and the infant mortality rate would have been 77.7 instead of 103.5 per 1,00Q five births. These differences indicate fairly the part played by premature birth in the total mortality. They do not reveal clearly the very great difference in hazard to infants bom at full term and infants born prematurely. Among the 11,613 births in 1915 and included in the study, 1,173 or 1 in 10 were born prematurely. Of these premature births, approximately one-half were stillborn; and of the live born premature infants, less than one-half survived 12 months. Five hundred and seven were born after less than seven months gestation, and in this group only 89 were live born and only 3 survived the year. Six hundred and sixty-four were bom after seven months but less than nine months gestation, and in this group 500 were live born and 266 survived the year. Comparing these losses with the losses among the full-term births, it appears that among the premature births 49.6 per cent of the births were stillborn (or miscarried) instead of 2.2 per cent stillborn, and 544.8 per 1,000 instead of 77.7 per 1,000 live births died within the year. Even when the births of less than seven months gestation are eliminated there was among the premature births a stillbirth rate of 24.7 per 100 births and an infant mortality rate of 468 per 1,000 live births. The difference in mortality rates among premature and full-term births was greatest during the first month— 453.5 per 1,000 live births in one group and 20.4 per 1,000 live births in the other group; after the third month the .mortality among the prematurely born was still higher than among the others but the difference then was slight.90 It has been noted in the analysis of the infant deaths in the Balti more group that 477, or 43 per cent of the total, occurred within one month after birth. Of these deaths during the first month, 56 per cent occurred among infants prematurely born, although premature births were less than 6 per cent of the total live births. It would seem, therefore, that the prevention of deaths in early infancy and the prevention of premature births are closely related to each other and alike depend on protection of the mother. The relatively high percentages of premature births which have been MSee Tables 181 and 182, Appendix VU , pp. 364 and 365. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 150 IN T A N T M O R T A L I T Y , B A L T IM O R E , M D . noted among the first-born children and among all children of young mothers emphasize the great importance of adequate care and instruction for young mothers and for all mothers during their first pregnancy. The high percentage of premature births previously noted, also, among mothers gainfully employed away from home during pregnancy emphasizes the importance of freedom from physical strain.91 In all groups the percentage of premature births could doubtless have been greatly reduced b y the general applica tion of known principles of hygiene and medical care. SEX OF INFANT. The Baltimore group offered no exception to the general fact that male infants have a higher mortality than female infants. This appeared in a higher percentage of miscarriages, a higher stillbirth rate, a higher percentage of premature births, and a higher mortality among the full-term live-born infants. T a b l e I X . — L oss rates, by s e x ; births 1 in 1915. Loss rates. Type of loss. Male. Premature Births (per lOOlive births)...................................................................... ...... 3.4 3.8 5.9 115.1 87.3 553.5 Female. 1.6 3.3 5.0 91.3 67.7 534.1 1 Includes miscarriages. The total number of male births #as higher than the total number of female births in the native and foreign-born white families, and, in spite of the higher mortality among male infants, the number of males surviving the first year was also slightly higher than the number of females surviving the first year in these two groups. Among the colored births, on the other hand, there were more female births than male births and markedly more female survivors than male sur vivors.92 MATERNAL DEATHS. When a mother dies from childbirth or from any other cause within 12 months after a birth, her baby faces a special hazard. In the Baltimore group 106 births, including 72 live births, were to mothers who died during the following year. Among these liveborn infants the mortality rate from all causes was 486.1 per 1,000, with a mortality from early infancy alone of 250 per 1,000. Among M See p. 117. MSee Tables 183 and 184, Appendix VTI, pp. 365 and 366. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 151 PHYSICAL FACTORS IN IN FA N T MORTALITY. the 32 live-born infants whose mothers died within 2 months after childbirth, or later in the year from a cause known to be connected with childbirth, the mortality rate from all causes rose to 625 per 1,000 and the mortality from early infancy to 375 per 1,000 live births. Even in so small a group, these rates indicate an excess hazard far beyond the range of a chance variation from the rates for infants whose mothers lived throughout the year— 100.9 from all causes and 36.3 from the diseases of early infancy. T a b l e X .— In fa n t m orta lity rates fr o m sp ecified causes, by su rviva l or death o f m oth er; liv e births in 1915. Infant mortality rate. Survival or death of mother. Mothers surviving.................................................. . From childbirth or within 2 months.................... Live births. 10,725 . 72 32 40 All causes. 100.9 486.1 625.0 375.0 Gastric Early and in testinal infancy. diseases. 28.6 97.2 93.8 100.0 36.3 250.0 375.0 150.0 All other causes. 36.0 138.9 156.3 125.0 The excess in mortality from gastric and intestinal diseases and from all other causes was less than the excess in mortality from early infancy and showed no such marked variation between the infants of mothers who died within 2 months after childbirth and the infants of mothers who died later in the year. Among the births (whether miscarriages, stillbirths, or live births) to mothers who died within the year after the baby’s birth a markedly high percentage of premature births was found, but this accounts only in part for the excessive infant mortality among infants whose mothers died. When the premature births and the full-term births are considered separately it appears that in each group the live-born infants whose mothers died within the year had a higher mortality than other live-born infants in the same group; but it is noted that the high mortality among premature infants whose mothers died was assigned wholly to early infancy while the high mortality among full-term infants whose mothers died was due to other causes.93 Of the 106 births to the mothers who died, 34 were stillborn (or miscarried)— a total of 32.1 per cent. Of the 11,507 births to mothers who lived, 782 were stillborn (or miscarried)— a total rate of 6.8 per cent. Among the premature births the difference in loss was less marked in the two groups— 54 per cent where the mother died and 49.5 per cent where the mother lived. But among the full-term births, the still-birth rate (20.3 per cent) was about 10 times higher when the mother died than when the mother lived (2.1 per cent). »» See Table 185, Appendix VII, p . 367. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 152 IN FAN T MORTALITY, BALTIMORE, MD. Evidently the relation is close between hazard to the mother and hazard to her child. The live-bom baby whose mother dies may suffer from the prenatal effect of the condition which leads to the mother’s death; it may suffer from the lack of the mother’s nursing and care. Premature birth and stillbirth or miscarriage may also result from a condition which leads afterwards to the mother’s death. The data show unmistakably that a high infant mortality, a high percentage of prematurity, and high losses from stillbirth and miscarriage accompany the mothers’ deaths. Perhaps this relation appears even more clearly if the mortality rates among the mothers are considered. In the group as a whole 105 maternal deaths occurred within one year after the birth, or 9.7 per 1,000 live births. Fifty of these deaths were assigned to causes connected with childbirth; 18, or 1.7 per 1,000 live births, to puer peral septicemia; 14, or 1.3 per 1,000 live births, to puerperal albuminuria and convulsions; and 18, or 1.7 per 1,000 live births, to all other causes related to childbirth. But in addition to these 50 mothers whose deaths were ascribed to childbirth, 7 others died within one month, 4 after one month but in less than two months, and 7 after two months but within three months after confinement. If the confinement was a contributing cause of the mother’s death in these 18 cases the actual loss from deaths related to childbirth would be approximately 6.3 per 1,000 live births. But these rates vary with the nature of the birth. Among the 798 confinements resulting in stillbirths and mis carriages, 29 mothers died from causes related to childbirth or from other stated cause within three months* after the birth— a death rate within the year of 36.3 per 1,000 confinements. But among the 10,665 resulting in live births, 39 mothers died from causes related to childbirth or from other stated cause within three months after the birth— a death rate within the year of 3.7 per 1,000 confinements. Again, among the 1,131 mothers prematurely confined (whether with miscarriage, stillbirth, or live birth), 28 mothers died from such cause— a death rate of 24.8 per 1,000 confinements. And among the 562 mothers prematurely delivered of live-born children, considered by themselves, 13 mothers died from such causes— a death rate of 23.1 per 1,000 confinements. On the other hand, among the 10,322 mothers delivered at full term, 40 maternal deaths occurred from such causes, or a death rate of 3.9 per 1,000 confinements. Behind this average, again, there was an excessive maternal death rate of 61.7 per 1,000 confinements among the 227 mothers delivered at term of stillborn infants, and a rate lower than the average for the entire group only among the mothers delivered at term of live-born infants. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis STILLBIRTHS. • From the mothers’ statements about all their pregnancies, it appears that in the group as a whole the total number of stillbirths and miscarriages, among the 38,630 births reported, was equal to 91 per cent of the total number of infant deaths occurring among their live-born infants— 3,786 stillbirths and miscarriages and 4,158 infants deaths. In the Jewish families, with their exceptionally low infant mortality, the number of stillbirths and miscarriages— 309— was greater than the number of infant deaths— 232. And in the colored families, with their exceptionally high miscarriage and still birth rates (as well as high infant mortality), the number of still births and miscarriages— 842—was also greater than the number of infant deaths— 751. Only among the Polish families and the foreign other than Jewish, Polish, or Italian, were the total stillbirths and miscarriages markedly fewer than the infant deaths. The Poles, 'with an excessive infant mortality (chiefly from gastric and intestinal diseases) had an average stillbirth rate and a miscarriage rate below the average. The group of “ other foreign” families showed an average mortality and average stillbirth rate but, like the Poles, a miscarriage rate below the average.94 In the present study the word “ stillbirth” refers to dead births of at least seven months gestation and “ miscarriage” to dead births of a shorter term. The substantial agreement in stillbirth rates shown in the two sets of data suggests a fairly complete reporting of still births, both in the registration of births during 1915 and in the mothers’ statements about their previous pregnancies. On the other hand, registration of miscarriages seems to have been far from complete, since the miscarriage rates based on births during 1915 were in every nationality group markedly lower than the miscarriage rates based on all pregnancies. Whether the mothers’ reporting of miscarriages was itself complete is a question that can not be deter mined. It may be noted, however, that the variations in miscarriage rate b y nationality were approximately the same in the two sets of data— the colored rate above the average for all and the Polish and “ other foreign” rates below the average for all. The average loss from miscarriages (all pregnancies) was 67 per 1,000 births and the average loss from stillbirths (all pregnancies) was 33 per 1,000 births. »«See Tables 187 and 188, Appendix V II, p . 368. 153 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 154 IN FA N T MORTALITY, BALTIMORE, MD. Certain variations in stillbirth rates have been noted in earlier sections of the report: The rate rises with the mothers’ employment away from home during pregnancy, with the mother’s advancing years, and with the bearing of very large families.95 What relation is there between stillbirth and infant mortality? Medical authorities agree that many of the causes of stillbirth and of deaths from causes peculiar to early infancy are identical. One would expect, therefore, to find the variations in stillbirth rates and in mortality from early infancy following the same general trend in the several groups. And it is true that the colored families, with a high infant mortality, especially high from early infancy, had the highest stillbirth rate in the Baltimore group. But the foreign-bom Jewish families, with a low infant mortality, including a low rate from the causes peculiar to early infancy, the Polish families, with a high inf ant mortality and a rate above the average from early infancy, and the Italian families, with an average infant mortality and a rate somewhat below the average from early infancy, had approximately equal stillbirth rates, with such difference as there was tending toward a high stillbirth rate in the Italian families and a low still birth rate in the Polish families. Again, the foreign-bom white group as a whole had a lower mortality from early infancy than the' native-white group, but the stillbirth rates in the two groups were practically identical. Except in the colored group, therefore, the data show no coinci dence of stillbirths and infant deaths. 96 See Tables 73, 103, 104, 132,133,144, 145, 149, 154, 189, and 190, Appendix VII, pp. 282, 305, 306, 335, 341,342, 344, 348. 368. and 369. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ILLEGITIMATE BIRTHS. It lias been noted that certain families were excluded from the study of the normal group because of temporary absence from Balti more or removal from the city. In studying the babies bom out of wedlock a different method was followed. Information was secured about every baby of illegitimate birth for whom the facts could be ascertained, whether the baby and mother were still living in Baltimore or had left the city. One source of information was the birth and death certificates, and (since none but registered births were included) information was available from the birth certificates for all infants. This method of study, however, offered a complica tion in computing an infant mortality rate, since only deaths that occurred within the city were registered in Baltimore.96 Besides securing this information, every effort was made to obtain an interview with the mother and to add detailed information on points not covered in the birth or death- certificates. Shifting of residence of mother and baby was so frequent an occurrence that it was difficult to locate the mothers. A special effort was made, there fore, to secure information in regard to this shifting of residence and separation of mother and baby that are so characteristic of the life of the illegitimate baby. THE M OTHERS. Color and nativity. Of the 12,045 births to white mothers registered as occurring during 1915 in Baltimore, 420, or 3.5 per cent, were illegitimate. Of the 2,555 births to colored mothers, 704, or 27.6 per cent, were illegitimate. In the illegitimate white group, less than half (192, or 45.7 per cent) were scheduled; in the illegitimate colored group, more than two-thirds (487, or 69.2 per cent) were scheduled.96® T a b l e I.— Color, nativity, and -parentage o f mother, by legitimacy o f birth; scheduled legitimate and illegitimate births in 1915. Legitimate births. Illegitimate births. Color, nativity, and parentage of m oth «. One or both parents foreign........................................... Parentage not reported................... .. — 1..................... Per cent Per cent Number. distribu Number. distribu tion. tion. 11,613 100.0 679 100.0 10,104 7,210 (a) («) (“ ) 2,894 1,509 87.0 62.1 («) («) (a) 24.9 13.0 192 174 111 43 20 18 487 28.3 25.6 16.3 6.3 2.9 2.7 71.7 a Parentage of mothers of legitimate children not reported, hut compare census figures shown on p. 28. b Foreign-horn white mothers of illegitimate children include 8 Polish, 3 German, 1 English, I Irish, 1 Scotch, 1 Lettish, 2 Russian Jewish, and 1 other Jewish. For nationalities of legitimate mothers see p . 29. »« Seep. 168. »to See Table 191, Appendix V II, p. 369. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 155 156 IN FA N T MORTALITY, BALTIMORE, MD. The nativity of the white mothers was tabulated only for the scheduled group, and among these 192 white mothers were 18 women of foreign birth, a percentage about one-third of the percentage of foreign-bom women in the group of legitimate births to white women. It is not known whether the larger group of unscheduled illegitimate white births included also a low percentage of foreign-bom women. Employment. Women employed outside their homes predominated, both among the white and colored mothers of children bom out of wedlock. In the large group (total registered illegitimate births), the fact of the mother’s employment or nonemployment during pregnancy was not reported for 31 per cent of the white women and 14 per cent of the colored women, but 53 per cent of the white women and 70 per cent of the colored women were stated to have been employed outside their homes. Twelve per cent of the white women and 10 per cent of the colored women were reported as not employed during pregnancy.97 Domestic service was the chief - occupation among the colored women and ranked second to factory work in importance among the white women. The mothers of 491, or 70 per cent, of the colored births and 88, or 21 per cent, of the white births were in domestic service and kindred occupations, which included those of laundress, waitress, cook, or kitchen girl, charwoman, nursemaid, and chamber maid. Of the white women 102, or 24 per cent, were factory oper atives and of the colored women 40, or 6 per cent. The other white women who were employed were stenographers or clerks (13), sales women (6), nurses (4), school teachers (3), seamstresses (10), and telephone operators (3). Eight white women and 4 colored women were scattered among the following occupations: Chorus girl, com panion, hairdresser, demonstrator, peddler, florist’s helper, proprietor of grocery store, farm worker, maid in hospital, maid in department store, lady’s maid, and prostitute.98 Age. The extreme youth of most of the mothers of children bom out of wedlock is noteworthy. Fifty-five of them (5 per cent) were under 16 years of age, 180 (16 per cent) were 16 and 17 years of age, and 274 (24 per cent) were 18 but less than 20 years of age. Six of the girls under 16 and 9 of the girls between 16 and 20 years old were school girls. In all, 87 (17 per cent) of these mothers under 20 years of age are known not to have been gainfully employed, while among the 97 In the scheduled group, with a smaller percentage of mothers whose employment or nonemployment was not reported, there were relatively more employed away and more not employed. Only the percentage employed at home remained approximately the same as in the entire group. For exact figures, see Table 192, Appendix VII, p. 370. »8 See Tables 193 and 194, Appendix VII, pp. 370 and 371. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ILLEGITIMATE BIKTHS. 157 mothers 20 years or older the number known not to have been gainfully employed was only 6 per cent of the total. The colored mothers were somewhat younger than the white mothers— with 26 per cent under 18 years of age among the colored mothers and 13 per cent under 18 years of age among the white mothers. But, on the other hand, fewer of the colored mothers than of the white mothers were between 20 and 25 years of age, and among the colored mothers 12 per cent, but among the white mothers 9 per cent, were 30 years of age or older." Civil condition at confinement. The civil condition of the mother at the time of the birth is known only for the scheduled group, and even here it is not known for seven, or 4 per cent, of the white mothers and four, or 0.8 per cent, of the colored mothers. Of the white women, 78 per cent were single, 15 per cent were widowed, divorced, or separated from a husband, and 4 per cent were married. Of the colored women, 88 per cent were single, 11 per cent were widowed, divorced, or separated from a hus band, and 1 per cent were married.1 Previous births. The illegitimate birth in 1915 was, in the majority of cases, the first the mother had borne, but one in four of the white mothers and about two in five of the colored mothers (scheduled group) had »previously had at least one illegitimate birth. Among both the white and the colored women were a few, also, who had borne one or more legitimate children but no illegitimate child previous to the 1915 birth. The order of birth of the illegitimate birth in 1915 is known for the entire group, with the exception of one white child and four colored children for whom it was not reported on the birth certificate. Eightytwo per cent of the white births and 58 per cent of the colored births were first-born children; 5 per cent of the white births and 15 per cent of the colored births were fourth or later-borne children. Cases other than the first birth proved slightly easier to trace, so in the scheduled group the percentage of first-born children dropped to 73 per cent of the white births and 55 per cent of the colored births. Only for the scheduled group is the legitimacy of the previous births known. In this group (192 white and 487 colored) there were 52 white women and 219 colored women who had borne other children. For 4 white women and 9 colored women the legitimacy of the previous births was not reported; for 16 white women, or 8.3 per cent of the total scheduled, and for 21 colored women, or 4.3 per cent of the total scheduled, the previous births had all been legitimate. The white women had borne from 1 to 6 legitimate children and the colored 99 See Tables 195 and 196, Appendix VU, pp. 371 and 372. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis i See Table 197, Appendix V n , p . 372. 158 IN F A N T MORTALITY, BALTIMORE, MD. women from 1 to 9 legitimate children. Twenty-four white women (or 12.5 per cent of the total scheduled) and 165 colored women (or 33.9 per cent of the total scheduled) had borne only illegitimate children, the white women from 1 to 3 children previous to the birth of 1915 and the colored women from 1 to 12 children previous to the birth of 1915. In all, including the birth of 1915, these 24 white women had borne 57 illegitimate children and these 165 colored women had borne 531 illegitimate children. In addition, 8 white women and 24 colored women (4.2 per cent and 4.9 per cent, respec tively, of the totals scheduled) had borne at least 1 illegitimate and 1 legitimate child previous to the birth of 1915, or a total, including the birth of 1915, of 59 white children and 162 colored children.2 Literacy. One other item is known about the scheduled mothers of illegiti mate children. A slightly higher percentage of these women than of the mothers in the legitimate group were illiterate— 10.9 per cent of the white women, instead of 9.3 per cent, and 16.2 per cent of the colored women, instead of 12.4 per cent. THE FATHERS. ^ Information about the fathers is comparatively meager. The birth certificates supposedly state the father’s color, age, and occu pation, but the age was not reported for 29.5 per cent of the fathers of white children and 9.5 per cent of the fathers of colored children,3 and the occupation was not reported for 35.5 per cent of the fathers of white children and 11.8 per cent of the fathers of colored children. The father’s color was stated, however, for all except the fathers of 15, or 2.1 per cent, of the births to colored women. Two of the 420 white women had births b y colored fathers. About these colored fathers nothing is stated except that one had died before the birth. Two of the 704 colored mothers are stated to have had births by white fathers, one classed as “ teamster, chauffeur, or delivery man,” and one as “ clerk.” But there may have been other white fathers in the group of 15 cases where the mother was colored and the color of the father was not reported. The occupations of these 15 fathers were not reported. Unfortunately, the occupations of the fathers as stated on the birth certificates do not lend themselves to exact classification or comparison with the occupations of the fathers of legitimate children. The fathers were so scattered through the various types of occu pations that, except for the 277 colored laborers and the 88 colored teamsters, chauffeurs, and delivery men,” the number of white or a See Tables 198,199, and 200, Appendix V II, pp. 373, 374, and 375. s See Tables 201 and 202, Appendix VH , pp. 375 and 376. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ILLEGITIMATE BIRTHS. 159 colored fathers of children born out of wedlock in any 1 of the 19 occupations given was less than 40 and frequently less than 10. Moreover, any conclusions as to the prevalence of certain types of occupations among the fathers of illegitimate children based on less than two-thirds of the white group and less than nine-tenths of the colored group would, in any case, be subject to serious error. Inexact registration of occupation is also an important factor. The number of colored “ laborers,” for example, in the illegitimate group, repre sented 45.6 per cent of the colored fathers in that group having a stated occupation, while in the colored legitimate group 34.5 per cent of the fathers having a stated occupation were classified as laborers. This apparent excess of laborers in the illegitimate group might indi cate nothing but a tendency on the part of physicians and midwives to classify all unskilled workers as laborers.4 Both the white and colored fathers seem to have been older than the mothers. Omitting the 124 white fathers and the 67 colored fathers whose ages were not reported, in the white group 6 per cent were under 20 years of age and 20 per cent 30 years *of age or older; in the colored group, 14 per cent were under 20 years of age and 25 per cent 30 years of age or older.5 . THE BIRTHS. Place o f confinement and attendant at birth. Far more of the illegitimate births than of the others occurred in hospitals. In the total group of illegitimate births, 46 per cent were hospital births as against 13 per cent in the total group of legitimate births and 10 per cent in the scheduled group of legitimate births. Fifty-six illegitimate births, or 5 per cent of the total, occurred in institutions, including two infants bom in jail. The illegitimate births in hospitals and institutions were more difficult to trace than those in private houses. Less than half the hospital births were scheduled and only 10 of the 56 births in institutions, while of the 551 births in private houses 424 were studied in detail. But even with the relatively small number of hospital births included in the scheduled group there still was in that group a percentage of hospital births (36 per cent of the total number scheduled) far in excess of the percentage of hospital births in the legitimate groups. A relatively high percentage of births attended by physicians accompanied, of course, the high percentage of hospital births in the illegitimate group.6 Prenatal care. For the scheduled illegitimate births, information was secured about the mother’s prenatal care. Of the white women the per4 See Table 201, Appendix VII, p. 375. 6 See Table 202, Appendix VII, p. 376. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6 See Tables 203 and 204, Appendix VII, p. 377. 160 INFANT MORTALITY, BALTIMORE, MD. centage reporting no prenatal care by a physician was the same among the legitimate and the illegitimate births, but a slightly smaller percentage of the mothers of children bom out of wedlock than of the others reported prenatal care of grade A or B. Among the colored mothers of children bom out of wedlock, however, a smaller percentage reported no prenatal care and a slightly higher percent age reported prenatal care of grade A or B than among the legiti mate colored mothers.6“ CONDITIONS DURING YEAR AFTER BIRTH.7 Relation of mothers and fathers. Thirteen per cent (25) of the white mothers of children bom out of wedlock and 18 per cent (86) of the colored mothers lived with the men b y whom they had borne children in 1915 during the whole or the greater part of the year following the birth. But although more of the colored mothers than of the white mothers lived with the fathers of their children, slightly more of the white mothers than of the colored-mothers were married to them during the year— 10 per cent of the white mothers and 8 per cent of the colored mothers. These marriages include in the white group 2 women (or 1 per cent^ of all the white mothers) and in the colored group 9 women (or 2 per cent of all the colored mothers) who did not live with the fathers of their children during the greater part of the year following the 1915 birth.8 In addition to these 25 white women and 86 colored women who lived with the men by whom they had borne illegitimate children in 1915, there were 50 white women, or 26 per cent of the total, and 171 colored women, or 35 per cent of the total, who reported that the fathers of their children had contributed something to their own or their child’s support. For 12 per cent of the white women and 4 per cent of the colored women, no report was made as to whether or not the father contributed to the support of mother or child. The median amounts contributed by both the white and the colored fathers were between $50 and $100. In the colored group, however, there were relatively more contributing under $5— I per cent (17) instead of 0.5 per cent (1) of the white group— and also relatively more contributing $100 and over— 9 per cent (45) instead of 6 per cent (13). The number of fathers who did not live with the mothers and con tributed nothing to the support of mother or child was relatively greater in the white group than in the colored group— white, 49 per cent (94); colored, 43 per cent (211). so See Table 205, A p pen d ix V II, p . 378. The statements about conditions during the year following the birth are based entirely on the scheduled group—192'white issues and 487 colored issues. 8 See Tables 197 and 206, Appendix VII, pp. 372 and 378. 7 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 161 ILLEGITIMATE BIRTHS. In both groups the percentage who contributed nothing to the mother’s support was higher where the birth was a stillbirth or mis carriage than where it was a live-bom infant. The difference was especially marked in the white group. But even where the infants were live-born, more of the white fathers than of the colored fathers contributed nothing to the support of mother or child.9 Where the mothers lived. Two-fifths of the mothers in both groups lived in their parental homes during the year after the birth. And these women, together with the women who lived with the child’s father, were considerably more than half of the mothers, both white and colored. It has been noted that more of the colored mothers than of the white mothers lived with the fathers of their children. It was found also that more of the colored mothers than of the white mothers lived with relatives or friends other than their parents or the fathers of their children. On the other hand, 10 per cent (19) of the white mothers but none of the colored mothers lived in an institution or hospital. T a b l e II.— M other's mode o f living during whole or greater part o f year after confinem ent; . scheduled illegitimate births 1 in 1915. Mother’s mode of living during whole or greater part of year after confinement. Per cent distribu tion: scheduled illegitimate births in 1915. White Colored mothers. mothers. Witlv other relatives or friends...................................................... .................................. With father of child........................................................................................................... Own establishment pr boarding.............................. ........................................................ 100.0 100.0 41.1 6.3 13.0 12.6 3.1 9.9 2.6 1.6 10.4 40.2 11.5 17.7 12.3 3.1 2.3 2.3 10.7 1Includes miscarriages. The white group studied in detail includes 39 stillbirths, miscar riages, and infant deaths under 2 weeks of age and 153 infants who lived at least two weeks. The colored group includes 112 stillbirths, miscarriages, and infant deaths under 2 weeks of age and 375 infants who lived at least two weeks. A comparison of the mode of living of the mothers whose babies lived two weeks and of the others reveals certain differences which can not be pressed to definite con clusions but which should be noted. Among the women whose in» See Tables 207 and 208, Appendix VII, pp. 379 and 380. 101351°— 23----- 11 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 162 IN FA N T MORTALITY, BALTIMORE, MD. fants had survived the first two weeks certain types of living arrange- . ments were reported by relatively more than among the mothers of dead births or of infants dying within two weeks after birth. ^Thus, in the white and in the colored group, more mothers were living in dependently, more mothers were living at service, and more mothers were living with friends or relatives other than their parents. And among the white mothers, also, a higher percentage were in an insti tution or a hospital and among the colored mothers a higher percent age lived in their parental homes. On the other hand, fewer, both of the white and of the colored women, were living with the father of the child or with some other man, and among the white women fewer were living in their parental homes. T a b l e I I I .— M other’s mode o f living during whole or greater part o f year after confinement, by color o f mother; scheduled illegitimate births m 1915. Per cent distribution;2 scheduled illegitimate births1in 1915. White mothers. Mother’s mode of living during whole or greater part of year after confinement. Colored mothers. Stillbirths, miscar Infants riages, or ■ surviving deaths 2 weeks. under 2 weeks. Stillbirths, miscar riages, or deaths under 2 weeks. Infants surviving 2 weeks. 100.0 100.0 100.0 100.0 40.5 6.5 12.4 12.4 3.9 11.1 1.3 ,7 11.1 35.7 6.3 21.4 9.8 2.7 41.6 13.1 16.5 13.1 3.2 4.5 3.6 16.1 1.6 1.9 9.1 With other relatives or friends......................................... In institution or hospital— . . . . . . . . . — i t .......... With husband or other man (not father of child j .......... is less than 100. See Table 206, Appendix VII, pp. 378-379. Civil condition of mother at one year after confinement. It has been noted that 4 per cent (7) of the white mothers of children bom out of wedlock and 1 per cent (5) of the colored mothers were married women; and, further, that 3 per cent (5) of the white mothers and 2 per cent (11) of the colored mothers in this group lived during the whole or the greater part of the year following the confinement with a husband or some other man, not the father of the illegitimate child bom in 1915. Comparing the civil condition of the mother at confinement with her civil condition one year later, it is found that these women who spent the whole or the greater part of the year with a husband or some other man were'only part of the total number who definitely reported marriage during the year to a man other than the father of the illegitimate child. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ILLEGITIMATE BIRTHS. 163 Thus, among the white mothers 9 single women and 3 who had been widowed or divorced, were married to a man other than the father of the child, and of the 7 white mothers of children bom out of wedlock who were married women, 6 were living at the end of the year. Apart, therefore, from the 15 white women whose civil condition at the end of the year was not reported, there were at least 13 white women, or 7 per cent of the total, who lived with a man other than the father of the illegitimate child at some time during the year after the birth, in addition to the 5 women (3 per cent of the total) who reported spending the whole or the greater part of the year with such a man. Among the colored mothers 16 single women were married during the year to a man other than the father of the child and 5 had been married women at the time of the birth. Hence, apart from the 16 colored women whose civil condition at the end of the year was not reported, there were at least 17, or 4 per cent of the total, who lived with a man other than the father of the illegitimate child at some time during the year after the birth, in addition to the 11 women (2 per cent of the total) who reported spending the whole or the greater part of the year with such a man. To what extent, if at all, the mothers of children born out of wed lock in either the white or the colored group lived with the fathers of their children or with other men for short periods during the year the data do not indicate. Of the 149 single women among the white mothers of children bom out of wedlock, 79 per cent were single at the end of the year, 11 per cent had been married to the father of the child, and 6 per cent had been married to another man. Of the 29 white mothers who had been widowed, divorced, or separated at the time of the birth, 69 per cent reported their civil condition as unchanged, 10 per cent had been married to the father of the child, and 10 per cent had been married to another man. Of the 426 single women among the colored mothers of children bom out of wedlock, 82 per cent were single at the end of the year, 9 per cent had been married to the father of the child, and 4 per cent had been married to another man. Of the 52 colored mothers who had been widowed, divorced, or separated at the time of the birth, 96 per cent reported their civil condition as unchanged a year later. Two per cent (1 mother) had been married, but whether to the father of the child or to another man is not known. For 8 per cent of the white women and 3 per cent of the colored women the civil condition at the end of the year was not reported. These 15 white women included not only the 7 whose civil condition at the time of the birth was not reported but also 6 who were single https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis IN FAN T MORTALITY, BALTIMORE, MD. 164 and 2 who were “ widowed, divorced, or separated” at the time of the birth. And these 16 colored women included not only the 4 whose civil condition at the time of the birth was not reported but also 12 who were then single.10 Maternal deaths. A relatively high percentage of these mothers are known to have died during the year. Classifying the maternal deaths according to the stated cause of death, it is found that among this group of mothers the deaths assigned to causes directly related to childbirth numbered 9 per 1,000 confinements, while among the mothers of children born in wedlock they numbered 4.4 per 1,000. Deaths occurring within the year but assigned to other causes numbered among these mothers 11.9 per 1,000 confinements, but among the mothers in the legiti mate group 4.8 per 1,000. That the high maternal death rate in the illegitimate group is not due wholly to the large proportion of colored women, whose hazard in childbirth is usually greater than the hazard to white women, is suggested by the fact that m the legiti mate group as a whole the maternal deaths from all stated causes were 9.2 per 1,000 confinements; in the illegitimate group the maternal deaths from all stated causes among white women totaled 15.7 per 1,000 confinements and among colored women 22.9 per 1,000. Evidently the death- rate among mothers of children born out of wedlock is excessive, not only among the white mothers but also among the colored mothers, as compared with the rates among mothers in the legitimate group.11 Economic status of the mothers. Of the economic status of the mothers during the year after the birth of an illegitimate child in 1915 there is little exact information. Such data as there are indicate extreme poverty. It has been noted that 49 per cent (94) of the white mothers and 43 per cent (211) of the colored mothers did not live with the fathers of their children and received no support from them, and that the amounts paid toward the support of the mother and child by those fathers who did not live with them but made some contribution were in most cases very small. Fifty white fathers (26 per cent) and 171 colored fathers (35 per cent) made contributions, but only 13 of these white fathers and 45 of these colored fathers contributed $100 or more. The median earnings of the white fathers and of the colored fathers who lived with the mother and whose earnings were stated were lower than the median earnings of white and of colored fathers in the normal 10 See Table 197, Appendix V II, p. 372. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis u see Table 209, Appendix VII, p. 381. ILLEGITIMATE BIRTHS. 165 group. Part of the difference may have been due to the relatively high percentage in the illegitimate groups whose earnings were not reported, and, furthermore, a difference appearing in a group so small as that of the fathers of children bom out of wedlock who lived with the mothers during the year after the birth can not be pressed to definite conclusions.13 No information was obtained regarding the economic status of the mother’s parents, or the extent to which the material needs of the mothers were provided for in the large number of cases where the women lived in their parental homes during the year after the birth. But 80 per cent of the women in the scheduled group were gainfully employed during the year before the birth and at least 77 per cent during the year after the birth. The actual percentages may have been even higher, since the fact of employment or nonemployment was not reported for 3 per cent during pregnancy and for 4 per cent during the year following. The earnings of the mothers were utterly inadequate for their support. Only 12 mothers of the 501 who worked during the year earned as much as $350. Or, considering separately the 297 mothers who worked at least nine months of the year, it is found that more than half this group earned less than $250, with 7 mothers earning less than $50 in cash (although 4 of these received meals in addition) and 2 mothers working for room and board with no cash wages whatever.13 More than two-thirds (68 per cent) of the women who had been employed during pregnancy returned to their former occupations or to other occupations included in the same group; 20 per cent shifted to a new occupation; 11 per cent did not resume gainful employment; and for 2 per cent of those employed during pregnancy employment during the year following was not reported. Of the mothers who had not been employed during pregnancy, 40 per cent were employed during the year after the birth. Comparing the total numbers en gaged in the five principal occupations during pregnancy and during the year following, it appears that the numbers working in domestic service and in factory work decreased while the numbers working in the occupations akin to domestic service— as laundress, waitress, cook, or kitchen girl, or as charwoman— increased.14 Where the babies lived. One in three of the white babies and one in six of the colored babies were, at some time during the year, in an institution or a boarding home or boarding with a private family. The white babies were chiefly in institutions and the colored babies chiefly in boarding homes or boarding in private homes. 12 See Table 207, Appendix V II, p. 379. J4 See Table 194, Appendix VII, p. 371. n See Tables 192, 194, and 210, Appendix VII, pp. 370,371, and 382. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 166 IN FA N T MORTALITY, BALTIMORE, MD. T a b l e IV. In fan t’s place o f residence, by color o f mother; scheduled illegitimate live births in 1915. Scheduled illegitimate live births in 1915. Infant’s place of residence. White mothers. Colored mothers. Per cent Per cent Number. distribu Number. distribu tion. tion. Total................... ...... Institution...................... Institution and boarded....... Boarding home............. Boarded in private home... Boarding home and private hom e.. Never inmate of institution or boarded. Not reported.......... 163 100.0 409 100.0 29 6 15 3 1 108 1 17.8 3.7 9.2 1.8 .6 66.3 .6 4 1 39 23 3 339 1.0 .2 9.5 5.6 .7 82.9 But not all these infants spent the whole, or even the greater part, of the year, or of their lives, in an institution or boarding. Among those who survived the first two weeks of life, approximately fourfifths of the infants (78 per cent of the white infants and 82 per cent of the colored infants) spent more than half of the year (or of their fives) with their mothers. In addition, 4 per cent of the white infants and 1 per cent of the colored infants lived more than half the time with foster parents, and 4 per cent of the colored infants (but none of the white infants) with the mother’s relatives. Among the remainder— the 18 per cent of the white infants and the 13 per cent of the colored infants who had survived the first two weeks of fife and spent the greater part of the year in an institution or boarding— it appears again that institutions predominated for the white infants and boarding homes or boarding in private homes predominated for the colored infants. T a b l e Y — Infant’s place o f residence during greater part o f first year o f life, by color o j mother; scheduled illegitimate infants surviving the first two weeks. Scheduled illegitimate infants surviving first 2 weeks. Infant’s place of residence during greater part of first year. White mothers. Colored mothers. Per cent Per cent Number. distribu Number. distribu tion. tion. Total........................ 375 1_ With mother’ s relatives............ With foster parents.............. In institution or hospital........ In boarding home. . . . . Inerivate home.......... With others.............. Never separated from mother Away part of time................ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis o# y . 120 97 78.4 4 1 31 15 2 309 100.0 3.5 1.1 •3 8.3 4.0 J5 82.4 74.4 8.0 167 ILLEGITIMATE BIRTHS. Of the 33 white infants away from the mother more than half the year 16 were among the 17 whose mothers’ mode of living was not reported. And of the 66 colored infants away from the mother 30 were among the 34 whose mothers’ mode of living was not re ported. For the others, a smaller percentage of the infants in both the white and colored groups were away from the mother when she lived with the father or with another man than under any other circumstances. In the colored group, the next smallest percentage of infants away from the mother appeared in the group whose mothers lived in their parental homes. But this was not so in the white group. There the mothers living in an institution, the mothers having their own establishments or boarding, and the mothers living with relatives (other than parents) or with friends all showed a smaller percentage whose infants were separated from them than the mothers living in their parental homes.15 * T able Y I.— M oth er's m ode o f liv in g , by co lo r and sep a ra tion o f in fa n t fr o m m oth er; scheduled illeg itim a te in fa n ts su rv ivin g fir s t tw o w eeks. Scheduled illegitimate infants surviving the first 2 weeks. White mothers. Mother’s mode of living. Colored mothers. Away from mother.1 Away from mother.i Total. Total. Number. Per cent. Number. Per cent. Total................................................... 1.53 33 21.6 375 66 17.6 Parental home............................................. With other relatives or friends................... 62 10 19 19 6 10 1 16.1 10.0 2 3 1 10.5 50.0 5.9 156 49 62 49 12 7 10 2 4 9 4.5 20.4 3.2 8.2 75.0 16 94.1 6 7 34 4 30 57.1 88.2 Own establishment or boarding................. At service..................................................... With husband or other man (not father Not reported................................................ 2 1 17 1 During whole or greater part of year, or of life. SU M M ARY OF SOCIAL BACKGROUND. In so far, therefore, as the scheduled group, including 46 per cent of the total white illegitimate births and 69 per cent of the total colored illegitimate births occurring during 1915, offers a fair picture of the condition of these mothers and their babies, it indicates certain differences in the status of mothers of children born but of wedlock among the colored population and the white population which may account for the greater excess in mortality among white illegitimate infants, which is revealed in the discussion below of deaths and mortality rates. is For more detailed figures, see Table 211, Appendix V U , p. 383. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 168 IN FA N T MORTALITY, BALTIMORE, MD. Births out of wedlock were more common among colored women than among white women. Not only was there a high percentage of illegitimate births in the total births during the year, but also among the colored mothers a relatively high percentage reported having borne several illegitimate children previously. More of the colored than of the white mothers were single women; fewer had been widowed, divorced, or separated, fewer were married women at the time of the birth, and fewer were married either to the father of the child or to another man during the year following the birth. But, on the other hand, a higher percentage of the colored women than of the white women lived with the father of the child during the whole or the greater part of the year after the birth, and a higher percentage of the colored women than of the white women who did not live with the father of the child received some contribution from him toward their support, including a higher per centage in the colored group who received at least $100 from the* father of the child. More of the colored mothers than of the white mothers kept their babies with them throughout the year (or until the baby’s death within the year). And 20 per cent of the colored babies who were separated from their mothers— but none of the white babies who were separated from their mothers— were cared for by the mother’srelatives. The difference in the white and colored mothers’ relation to their parental homes was most marked. The percentage who lived in their parental homes during the year after the birth was practically identical in the two groups as a whole. But in the colored group more mothers (instead of fewer) lived in their parental homes when the baby had survived the first two weeks than when the baby had died within two weeks or had been stillborn. And of all the mothers whose babies had survived two weeks and who lived in their parental homes, only 5 per cent in the colored group (instead of 16 per cent as in the white group) had their babies cared for elsewhere. M ORTALITY AM ONG ILLEGITIM ATE INFANTS. The group of 1,124 illegitimate births registered as occurring in Baltimore during the year 1915, faced excessive hazards, but the mortality rates which can be computed for the illegitimate babies can not be pressed to exact comparisons with the legitimate group for two reasons: (1) The large-number of illegitimate infants whose condition at the end of the year is not known (256 in a total of 955 five births) involves a wide margin of probable error in the rates based on the total illegitimate group; (2) in the scheduled group of illegitimate infants the basis of inclusion is broader than the basis of inclusion in the scheduled group of legitimate births, but the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ILLEGITIMATE BIRTHS. 169 difficulties of tracing the babies were so great that the scheduled group is relatively smaller among the illegitimate births than among the legitimate births and probably less representative of the entire number 16 in social conditions and in mortabty rates. The true infant mortality rates for the illegitimate group as a whole were probably higher than the rates which may be computed from all known infant deaths, whether scheduled or unscheduled, and the total (955) live births, since among the 256 cases which could not be traced and whose condition at 1 year of age was unknown some deaths under one year doubtless occurred. The rate of 294.2, based upon the total illegitimate births and the known infant deaths, is therefore an understatement of the true rate. The scheduled group, however, including those infants who could be located and traced to the end of the year, or, in other wofds, including roughly the group of infants whose mothers remained in Baltimore at or near the places from which births were registered, showed a rate of 300.7, slightly higher than the rate based on the total births. It can not be assumed, however, that this rate indicates the true rate for all illegitimate infants. In any case it is clear that the illegitimate in fants had a mortality markedly higher than the legitimate infants. White and colored infants. The live-born colored illegitimate infants (581 in number) had a mortality rate of 280.6, based upon births and known infant deaths per 1,000 births. The live-born white infants (374 in number) had a mortabty rate of 315.5 on the same basis.17 In the scheduled group of illegitimate infants, the rate among the colored babies was 293.4 per 1,000 and among the white babies 319 per 1,000. It will be noted, therefore, that among the colored births the mortality of illegitimate infants approached twice the mortality (158.6 per 1,000) of legiti mate infants, while among the white births the mortality of illegiti mate infants was more than three times as great as the mortality (95.9 per 1,000) among legitimate infants. This greater excess in mortabty among the white ibegitimate births accompanied an odd reversal in rates: In the legitimate groups the colored babies had a markedly higher mortabty than the white babies; in the illegiti mate groups the white babies had a shghtly higher mortabty than the colored babies. Among both white and colored infants, although the excess hazard to illegitimate babies can not be measured exactly, the fact of an excess hazard is clearly established.18 i« The unscheduled illegitimate infants include 256 live-bom infants whose condition at the end of the year is not known, 18 live-bom infants who are known to have survived the year, and 109 live-born infants who are known to have died. i i The degree of uncertainty as to the mortality among illegitimate white infants was much greater than that among illegitimate colored infants; in the white group, the condition at one year after birth, whether alive or dead, of 133, or 36 per cent, was unknown; in the colored group the condition of 123, or 21 per cent of the total colored, was unknown. i* See Table 212, Atipendix VII, p. 384. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis IVO IN FAN T MORTALITY, BALTIMORE, MD. T a b l e Y I I .— Infant mortality rates, by legitimacy o f births and color o f mother; live births in 1915. Infant mortality rate. Color of mother. Illegitimate infants. Legitimate infants. Total. T otal...... ....................... ............ ........... . .. White.................................................................................. . Colored............................................................................................... Scheduled. 103.5 294.2 300.7 95.9 158.6 315.5 280.6 319.0 293.4 Age at death and stated cause o f death. A t all ages under 1 year and among the deaths from all stated causes an excess mortality among the illegitimate infants persisted. The excess was greatest, however, in both white and colored groups, in the deaths during the second and third months. This may reflect a genuine peak in the excess hazard or it may reflect a grouping in the later months of infant deaths among the 256 illegitimate infants whose condition at 1 year is not known,19 The one stated cause of death which showed an excess in mortality above the average excess for all causes was syphilis. But, again, this fact should be qualified b y the reminder that less effort might be made in the case of an illegitimate infant than in the case of a legitimate infant to assign a death from syphilis to some other cause.20 Employment o f mother. Employment away from home was far more prevalent among the mothers of children born out of wedlock than in the normal group, even comparing white mothers with white mothers and colored mothers with colored mothers. Apparently, also, these mothers resumed their work after the birth a little sooner than the others. With the limitations already noted as due to the different basis of computation, a rough comparison can be made of the mortality in the two groups among infants of mothers employed away from home during pregnancy; and for both the white and the colored illegitimate infants of working mothers a mortality is found defi nitely higher than that for legitimate infants of working mothers of the same race. Furthermore, it is to be noted that the illegitimate infants of mothers working away during pregnancy had a mortality only slightly higher than that of the other illegitimate infants. In one point, however, the effect of employment away from home seems to appear even in the illegitimate group. Among the illegiti$•It may fairly be assumed that relatively few of tbe infants were removed from Baltimore during the first month, and, further, that such deaths as occurred among the 256 untraced infants occurred chiefly out of the city—therefore, chiefly after the first month of life. 80 See Tables 213,214,215, and 216, Appendix VII, pp. 385 and 386. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 171 ILLEGITIMATE BIKTHS. mate births, as among the legitimate, the percentage of premature births was higher when the mother worked during pregnancy than when she did not. But, also, the percentage of premature births was higher among the mothers of children bom out of wedlock not employed than among the working mothers in the legitimate group. The infant mortality rates among the full-term illegitimate live births were higher, also, than the infant mortality rates among fullterm legitimate live births.21 Poverty. The economic status of the mothers is not clear. Such amounts as are reported for the mothers’ earnings and for the fathers’ con tributions indicate a small income for the mother and suggest that the mortality rates among the illegitimate infants should be compared with the mortality rates among the legitimate infants whose fathers earned nothing or less than $450. This comparison shows that among both white and colored infants, the illegitimate births had higher mortality rates than legitimate births of the same race in families where the father earned nothing at all or less than $450. T able V I I I .—Relative mortality rates, by color, among scheduled illegitimate infants, in comparison with legitimate infants in lowest fathers’ earnings groups. White mothers. Earnings of father and legitimacy of infant. Live births. Legitimate births—Earnings of father: Under $450........................... No earnings....... ...................... Illegitimate births....................... 1,037 138 374 Infant mortality raté. 153.3 210.1 315.5 Colored mothers. Live births. 507 69 581 Infant •mortality rate. 163.7 202.8 280.6 Conditions peculiar to illegitimacy. The irregular relation of the father and mother, the separation of a considerable percentage of the infants from their mothers, and, in particular, the placing of the babies in an institution or boarding home, seem to have been responsible in large measure for the high mortality among illegitimate infants. These factors do not, however, account for it entirely. The very slight difference in mortality between the white and the colored illegitimate infants, has already been noted and in the present discussion they will be considered together. In the scheduled group of illegitimate children as a whole, the infant mortality rate was 300.7 per 1,000 live births. Among the 199 infants whose mothers did not live with the fathers but received something from the fathers for their support, 46 deaths occurred within the year— an infant mortality rate of 231.2 per 1,000. This «1 See Tables 212,218 and 219, Appendix VII, pp. 384 and 387. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 172 IN FAN T MORTALITY, BALTIMORE, MD. rate was definitely lower than the rate (309.9 per 1,000) among thé 242 infants whose mothers did not live with the fathers and received nothing from them, and lower than the rate (347.8 per 1,000) among the 92 infants whose mothers and fathers lived together during the whole or the greater part of the year following the birth. However, 19 deaths occurred among the 39 infants for whom the relation of the mother and father was not reported and a true distribution of these deaths among the other groups might shift the relation of the mortality rates.22 Ch ar t X X n .—Per cent of deaths before end of first year of life among illegitimate infants surviving at 3 months of age, according to separation from mother. Per cent of deaths. All survivors at 3 months of age. Not separated. Separated, The infants separated from their mothers had a mortality from two to three times as high as the infants who stayed with their mothers. Of the survivors at 3 months of age 17 per cent died before the end of the year— 12 per cent in the group who stayed with their mothers, and 32 per cent in the group who were separated from their mothers. Again, of the survivors at 6 months of age, 11 per cent died before the end of the year— 8 per cent in the group who stayed with their mothers « See Table 221, Appendix VU , p. 388. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ILLEGITIMATE BIRTHS. 173 and 24 per cent in the group who were separated from their mothers. A similar difference appears if the colored infants are considered by themselves.23 It may be questioned whether the scheduled group indicates fairly the part played b y the separation of the infant from his mother in the total mortality among all illegitimate infants, since the percentage of infants away from their mothers may have been higher among those who could not be traced than among those for whom it was possible to secure detailed information. But the rates which have been noted show that even in the scheduled group separation of the infant from the mother more than doubled the death rate among survivors of the first three months. At the same time, the death rates were higher even among the infants who stayed with their mothers than among legitimate infants, either white or colored, at the same ages. As to the hazard of institutional life for infants, there were two indications of excessive mortality. In the entire group of 955 illegitimate live births, there were 56 which occurred in an institution, including 2 infants born in jail. Of these 56 infants, 35 are known to have died, while 9 could not be traced and their condition at the end of the year was not known. Assuming that these known deaths are all that occurred, the infant mortality rate was 625 per 1,000 for these 56 infants born in institutions. In the scheduled group of 572 illegitimate live births were 10 live births in institutions. Two of these 10 infants died within two weeks after birth.24 Again, it is possible to compare the percentage of deaths among infants who were at some time during the first year of life in an in stitution or boarding home, and among those who were at no time inmates of an institution or boarding. The actual numbers in the several groups are small and the differences in rates are inconclusive, but they seem to indicate that the hazard to infants in an institution or a boarding home was excessive— in both cases about 3 babies in 8 died. The 30 infants boarding in private homes did not, on the other hand, show a mortality above that for illegitimate infants who were never an inmate of an institution or boarded. In the colored group the mortality among infants boarded in private homes seems to have been even a trifle lower than that in the large group who were never boarded or placed in an institution. But even when all the babies in institutions and boarding homes were eliminated, the other S3 See Table 222, Appendix V II, p. 389. No comparison of mortality among infants under 3 months of age is possible without analysis by the age at which the infant was separated from the mother. The high percentage of total deaths in the age period between 2 weeks and 3 months among infants “ with mother” and the low percentage of total deaths in the age period between. 2 weeks and 3 months among infants “ separated from mother” suggest that the separations occurred mainly in the later months, and after the first month at least. 24 See Table 223, Appendix VII, p. 389. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 174 IN FAN T MORTALITY, BALTIMORE, MD. illegitimate babies still showed a relatively high mortality in com parison with legitimate infants, white or colored.35 Among the infants who were not separated from their mother, the dwelling was shifted in many cases. Of the 528 illegitimate infants who survived at least two weeks, approximately half (262) were removed at least once from one dwelling to another. These removals can not be related, in the tabulation of so small a total group, to other circumstances, but it may be noted that the percentage of subsequent deaths was higher among the babies who were moved about than among the babies who were not subjected to removals.26 Infant feeding. With the prevalence of employment among the mothers of children born out of wedlock and with the considerable minority who did not keep their babies with them, it is not surprising to find a high per centage of the illegitimate infants artificially fed during the early months. In the legitimate group, the number of babies having breast milk and no other food was 88 per cent of all in the first month and 72 per cent of all in the third month. In the illegitimate group, 79 per cent were breast fed in the first month, but only 44 per cent in the third month. By the ninth month, the number breast fed in the illegitimate group had dropped to 12 per cent of all, as against 29 per cent in the legitimate group. These low percentages breast fed were balanced by high percentages artificially fed. Mixed feeding, on the other hand, was rather more prevalent in the illegitimate group than in the other during the early months but less prevalent in the illegitimate group than in the other after the sixth month. The difference in types of feeding reported for the illegitimate group and the legitimate group was especially marked among the white babies, but it was present also among the colored babies. And in the illegitimate group, as to a less degree in the legitimate group, more mixed feeding and less artificial feeding was found among the colored infants than among the white infants. The white illegitimate infants having each specified type of feeding showed higher computed rates per 1,000 infants fed than white legitimate infants having the same type of feeding. The excess in rates persisted even in a comparison of the rates for white illegitimate infants with the rates for white legitimate infants in the lowest earn ings groups. It was most marked among infants artificially fed. The colored illegitimate infants, dn the other hand, showed a clear excess in the computed rate per 1,000 infants fed only in the compari son of breast-fed infants. as See Table 224, Appendix V II, p. 390. 26 See Table 225, Appendix VII, p. 390. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ILLEGITIMATE BIRTHS. 175 Again, comparing tlie computed rates among white and colored ille gitimate infants having each specified type of feeding, it appears that the breast-fed colored illegitimate infants had a mortality twice as high as the breast-fed white illegitimate infants, while the artificially-fed colored illegitimate infants had a mortality slightly lower than the artificially-fed white illegitimate infants. With regard to deaths immediately after birth of infants not fed at all, the most marked excess was among colored illegitimate births.27 The total mortality among illegitimate births, therefore, which was slightly higher in the white group than in the colored group, reflects in the white group an especially high percentage of infants artificially fed, and a marked excess in mortality among these infants, together with a slighter excess in mortality (as compared with white legitimate infants) among infants breast fed or mixed fed and among infants dying immediately after birth without being fed at all. In the colored group, the high mortality among illegitimate infants reflects also a high percentage of infants artificially fed, a high percentage mixed fed during the early months, and a marked excess in mortality among infants breast fed and among infants dying immediately after birth without being fed at all. STILLBIRTHS AND MISCARRIAGES. The stillbirth and miscarriage rates among the illegitimate births were higher than among the legitimate births, even in a comparison of white births with white births and colored births with colored births. Again, eliminating from both groups the mothers who were not gainfully employed away from home during pregnancy or whose employment was not reported, there were found in both the white and the colored groups higher stillbirth rates among the illegitimate births than among the legitimate births. The white illegitimate births (but not the colored illegitimate births) showed also a high miscarriage rate.28 It will be remembered that in the normal group mothers under 20 years of age had a higher stillbirth rate than the older mothers. In the white illegitimate group this difference disappeared, and mothers of all ages had higher stillbirth rates than the mothers in the normal group. In the colored illegitimate group, the stillbirth rate was higher among the mothers 20 years of age and older than among the mothers under 20, and only these older mothers had a stillbirth rate higher than the stillbirth rate among colored mothers in the normal group. 22 See Tables 226 and 227, Appendix V II, p. 391. 28 See Table 212, Appendix VII, p. 384. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 176 IN FA N T MORTALITY, BALTIMORE, MD. T a b l e I X .— Miscarriage and stillbirth rates, by legitimacy, color, and age o f mother; births 1 in 1915. Legitimate. Age and color of mother. White mothers: Under 20 years............................................................ 20 years and over......................................................... Colored mothers: Under 20 years.................................................... . 20 years and over......................................................... Illegitimate. Miscarriages Stillbirths Miscarriages Stillbirths per 100 per 100 per 100 per 100' births. births.1 births. births.1 2.8 3.3 3.4 2.8 4.7 6.3 5.6 5.6 4.0 6.1 11.0 7.7 3.9 6.7 9.5 16.0 1 Includes miscarriages. The high percentage of premature births in the illegitimate group has already been noted. Comparing full-term births with full-term births, however, there was still a higher stillbirth rate in the illegiti mate group than in the legitimate group, except among the 96 fullterm births to mothers of children born out of wedlock not gainfully employed during pregnancy. This rate (2.1 per 100 births) was practically identical with the rate (2 per 100 births) among full-term legitimate births to mothers not gainfully employed away from home during pregnancy.29 » See Table 219, Appendix VII, p. 387. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis GENERAL SUMMARY. The total infant mortality rate in the group of 10,797 live births to married mothers, studied in detail in Baltimore, was 103.5 per 1,000. The deaths from causes peculiar to early infancy were 37.7 per 1,000 live births, the deaths from gastric and intestinal diseases were 29.1 per 1,000 live births, and the deaths from respiratory and other communicable diseases were 26.4 per 1,000 live births. Malforma tions were the stated cause of 39 deaths, or 3.6 per 1,000 live births. External causes, diseases unknown or not specified, and scattering deaths assigned to unusual causes were responsible for a mortality of 6.7 per 1,000 live births. Of the total number of 1,117 deaths, 42.7 per cent occurred within the first month after birth and 27.1 per cent after the sixth month. The mortality in the entire group was approximately the same as the mortality in the cities of the United States birth registration area in 1915 and 1916. An analysis of the conditions under which babies lived and died in Baltimore may fairly be considered an analysis of conditions in a typical American city. Mortality rates markedly above the average for the entire group occurred among the colored families, the foreign-bom Polish families, and the very poor native white families. Low mortality rates— approximating those in New Zealand—were found among the babies of foreign-bom Jewish mothers and in families of the highest earnings groups. Breast-fed babies in every group of the population had lower mor tality than artificially-fed babies in the same group. Computed mortality rates derived from the monthly death rates among babies having the specified types of feeding month by month were 43.3 per 1.000 infants breast fed and 191.4 per 1,000 infants having only artificial food. The earlier the babies were weaned the greater was the excess in mortality among those artificially fed. For example, among infants surviving at the beginning of the third month of fife the percentage of subsequent deaths during the year was 18.7 in the group artificially fed from the first month, 12.4 in the group arti ficially fed from the second month, and 10.6 in the group whose artificial feeding began in the third month. The rates for breast-fed babies and the rates for artificially-fed babies varied greatly with the color and nationality of the mother and the earnings of the father ranging from 91.4 per 1,000 infants breast fed and 387.9 per 1,000 infants artificially fed in the poorest colored families to 13.3 per 1.000 infants breast fed and 27.3 per 1,000 infants artificially fed in the most prosperous families (mainly native white). 101351°—23----- 12 177 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 178 IN FA N T MORTALITY, BALTIMORE, MD. In every group certain measurable conditions accompanied a mor tality above the average for the group: Poverty, employment of mothers away from home during pregnancy or the early months of an infant’s life, housing below standard in point of sanitary equip ment and room congestion, short intervals between births, and the bearing of many children. On the other hand, certain mothers whose infants were exposed to such unfavorable conditions were being reached by the organizations carrying on prenatal and post natal work. New evidence is afforded b y the Baltimore study that poverty is an important factor in infant mortality. Among the 1,544 babies whose fathers earned less than $450 the infant mortality rate was 156.7 per 1,000 live births; among the 431 babies whose fathers earned $1,850 or more the infant mortality rate was 37.1 per 1,000 live births. Eliminating differences in color and nationality and considering only the babies bom to native-white mothers a similar decrease in mortality appears as the fathers’ earnings rise: In the poorest families about 1 baby in 6 died within the year, in the most prosperous families about 1 baby in 26 died within the year. Further, eliminating certain measurable conditions that occur more frequently in very poor homes than elsewhere and considering only Jbabies born to native white mothers who were literate, who were not employed during pregnancy or the year after the birth, who had borne fewer than seven children previous to the birth in 1915, and who reported an inter val of two years or longer since the previous birth if the 1915 baby was not a first-bom child, a marked difference in mortality in the poorest homes and in the most prosperous persists. Even in this favored group the infant mortality rate in the poor homes was more than twice as high as the infant mortality rate in the most prosperous homes. Employment of the mother away from home during pregnancy accompanied, in each color and nativity group, a percentage of premature births above the average for the group and excessive mortality among full-term births from the causes peculiar to early infancy. The mortality from other causes was also higher among the babies whose mothers worked away from home during pregnancy than the mortality that would be expected when allowance is made for the poverty of these families and the large number of colored families and Polish families among them. For the infants whose mothers were employed away during the earliest months after the birth the hazard was markedly increased. Not only did they face the hazard that would naturally occur in a group with so large a percentage of infants weaned during the early months, but also a still greater hazard directly related, apparently, to the fact and cir cumstances of the mothers’ employment away from home. How ever, the actual effect on the total mortality of mothers’ employment https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis GENERAL SUMMARY. 179 away during the first year after a birth was slight, since the number of mothers employed away after the birth was smaller than the number employed away during pregnancy, and employment was usually resumed after the first month or even later in the year, when the period of highest mortality had been already passed. Room congestion and lack of sanitary equipment in the dwelling accompanied death rates among infants surviving the first two weeks higher than the death rates in groups of similar color and nationality and corresponding fathers’ earnings in dwellings of a better type. Of the 5,544 infants in dwellings with less than one person per room, 4.9 per cent died during the year; of the 4,269 infants in dwellings with one person but less than two persons per room, 8.4 per cent died during the year; of the 498 infants in dwellings with two or more persons per room, 11.6 per cent died during the year. . Again, of the 4,486 infants in dwellings with sewer connection, a bath tub, and a toilet for the exclusive use of the family, 4.4 per cent died during the year; but of the 5,850 infants in dwellings lacking one or more of these three items, 8.5 per cent died during the year. In this latter comparison the deaths from gastric and intestinal diseases are noted separately and these show a greater difference than the deaths from other causes. Variations in death rate in relation to housing persist when the greater poverty of the group in the poorer dwellings is considered. The first-born infants had a mortality slightly higher than the mortality of infants second or third in order of birth, but among the later orders of birth the mortality (especially from causes other than the diseases of early infancy) rose steadily. The first-born infants showed a higher percentage of premature births than any others except the infants twelfth or later in order of birth. Having come to birth, whether at full term or prematurely, the first-born babies had a markedly lower mortality than other babies of the correspond ing term, with differences in rates between the first bom and the others far greater than the average difference between first bom and all others when full-term births and premature births are grouped together. The infants of mothers under 20 years of age and of mothers 35 years old or older showed higher mortality rates than other infants. Among the infants of the youngest mothers the high mortality appears in deaths from causes peculiar to early infancy and (when infants were second or third in order of birth) in deaths from other causes. Among the infants of the oldest mothers the high mortality appears mainly in deaths from “ all other causes,” but the first-born infants of the oldest mothers had also an excessive mortality from causes peculiar to early infancy. Variations in mortality according to the infant’s order of birth and the mother’s age were accentuated when the interval since a pre https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 180 IN FA N T MORTALITY, BALTIMORE, MD. ceding birth was short. Throughout, the births following a preced ing birth by an interval of less than two years had a higher mortality than births occurring after a longer interval. The infants bom to the 105 mothers who died within the year after confinement had the highest mortality in the entire group, with a rate of 486.1 per 1,000 live births as compared with the mortality of 100.9 per 1,000 among the infants whose mothers survived. When the mother died from a cause directly related to childbirth or from some other stated cause within two months after her confinement, the infant mortality from all causes rose to 625 per 1,000. The excess mortality was somewhat greater from early infancy than from other causes. A m o n g the negroes all the unfavorable social factors were present. Their poverty was greater than the poverty in any other group in Baltimore (except the small group of Lithuanian families); 44.9 per cent of the mothers were gainfully employed away from home during pregnancy; room congestion was less prevalent than among the foreign-born white families, but the number of dwellings without standard equipment was relatively high; one-fifth of the negro infants were seventh or later in order of birth and 33.5 per cent had followed the preceding birth by an interval of less than two years. But more of the negro mothers than of any others were reached by the prenatal and postnatal work. As the net result of these factors and others not touched upon in such a study as the present one— the negro babies had a high mortality from early infancy (49.8 per 1,000), a high mortality from respiratory and other communicable diseases (65.9 per 1,000), and an average mortality (30.7 per 1,000) from gastric and intestinal diseases. In the Polish group, also, all the unfavorable factors were present. Their room congestion was the greatest in Baltimore; the percentage of mothers gainfully employed away from home during pregnancy was almost as high as the corresponding percentage in the negro families; and the influence of unfavorable factors was not counter balanced by infant-welfare work, since the prenatal and postnatal agencies had reached but few of the Polish mothers. The Polish mortality was especially high from gastric and intestinal diseases (68.8 per 1,000) and above the average from early infancy (43.2 per 1,000). The very poor native white mothers were less generally employed away from home than the Polish or Negro mothers ; their housing was poor in sanitary equipment but they lived in less congested dwellings than the Poles; in interval between births and the bearing of many children conditions were more favorable than among the negroes. Infant-welfare work had reached more of the very poor native white mothers than of the Polish mothers, but fewer in this native white https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis GENERAL SUMMARY. 181 group than in the colored group. In the poorest native white fam ilies the mortality from early infancy was higher than in the Negro or Polish families; and the mortality from gastric and intestinal diseases was markedly above the average though less high than in the Polish group. The foreign-born Jewish families were poorer than the native white families but less poor than the Negroes and the Poles. Practically none of the mothers were employed away from home. Many of them had borne large families but the percentage of mothers pregnant again within 12 months after the birth in 1915 was smaller than in any other color or nationality group. Room congestion was less prevalent than among the Poles but more prevalent than among the native white families. In sanitary equipment, too, the dwellings of the Jewish families were better than the dwellings of the Poles and the Italians. And more of the Jewish mothers than of any others except the Negroes were reached by the prenatal and post natal work. From these and other factors not touched in the present study, the babies in the foreign-born Jewish families had a low mor tality from early infancy (22.9 per 1,000), a low mortality from respiratory and other communicable diseases (15.6 per 1,000), and a markedly low mortality from gastric and intestinal diseases (9.4 per 1,000). In the illegitimate group of 955 live births, 281 infant deaths are known to have occurred, but the condition of 256 infants at 12 months after birth could not be learned. The known infant mor tality rate of 294.2 per 1,000 live births is therefore a minimum statement of the hazard to the illegitimate infants born in Baltimore during 1915. More than two-thirds of the illegitimate births were to colored mothers, and the mortality in the illegitimate colored group was less high than in the illegitimate white group. The excess in mortality among illegitimate infants appears especially in deaths from early infancy, from gastric and intestinal diseases, and from syphilis. For 572 live-born illegitimate infants detailed information was secured which revealed a high percentage of infants artificially fed during the early months. In the colored group the excess mor tality among illegitimate infants seems to be largely accounted for by the prevalence of artificial feeding. But the deaths in the white group were more numerous than the deaths which would have occurred if they had been subject only to the hazard of babies born to married mothers and having the same type of feeding. The chief conditions indicated in such a study as the present one which seemed to increase the hazard to illegitimate infants were the prevalence of care in institutions or boarding homes, the frequent shifts in dwelling place, and the generally low economic level of the mothers https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX I.— BIRTH REGISTRATION IN BALTIMORE. As a preliminary to each of the bureau’s field studies of infant mortality in cities a fairly complete record of births during a given period has been secured. In 1915, when the plans were made for the present study, Maryland had not been admitted to the birth-registra tion area, for which a 90 per cent registration is required by the United States Bureau of the Census. But a steadily increasing annual birth rate (the registered live births rising from 16.9 per 1,000 population in 1908 to 23.3 per 1,000 population in 1915) indicated that registration of births in Baltimore had improved year b y year. During the same period the infant mortality fate had dropped from 241.3 per 1,000 registered live births to 119.8 per 1,000 registered live births, a de crease so marked that, in spite of a reduction in the number of infant deaths, a more nearly complete registration of births is also clearly in dicated. In 1916 Maryland was added to the birth-registration area. The registration law in Maryland in effect at the time of this study was enacted in 1912 and slightly amended in 1914.1 Under this law stillbirths were registered as births and as deaths. “ The record of a birth shall state the date and place of its occurrence, name in full, sex and color, and the number o f the child, whether living or stillborn, whether a twin, triplet, or other plural birth, and the name, color, occupation, birthplace, and residence of parents.” 2 The physician or midwife .was required to register a birth within four days. T able I.—Estimated population, birth rate, and infant mortality rate, shown by registered births and deaths, under 1 year o f age in Baltimore City, 1908-1917-1 Estimated Registered Registered Infant mor population, Birth rate. live births. deaths un tality rate. der 1 year. July 1. Year. 1908 . .......................................... 1909................................................................ 19Ì0................................................................ 1911 ............................................................. 1912................................................................ 1913................................................................ 1914................................................................ 1915................................................................ 1916.. . .................................................... 1917................................................................ 549,499 554,514 559,530 564,545 569,560 574,575 579,590 584,605589,621 594,637 16.7 15.8 17.6 16.4 20.0 21.8 22.0 23.3 25.6 25.1 9,178 8,796 9,858 9,283 11,398 12,542 12,637 13,634 15,085 14,950 2,215 2,227 2,148 1,958 2,026 2,002 1,954 1,633 1.783 1.783 241.3 253.2 217.9 209.8 177.8 159.6 154.6 119.8 118.2 119.3 1 Estimated population computed from figures for censuses of 1900 and 1910. Figures for births and deaths based on annual reports of Baltimore City Department of Public Safety, subdepartment of health, 1908-1917. T a b l e II. — Stillbirths in Baltimore City, 1908-1917.« Year. 1908 1909 1910 1911 1912 Total births, b Still births.» Still births b per 1,000 births. 9,989 9,613 10,680 9,995 12,087 811 817 822 712 689 81.2 85.0 77.0 71.2 56.5 Year. 1913......................... 1914......................... 1915......................... 1916......................... 1917......................... Still Still births b Total births, b births. b per 1,000 births. 13,451 13,663 14,765 16,320 16,217 909 1,026 1,131 1,235 1,267 67.6 75.1 76.6 75.7 78.1 a Derived from annual reports of Baltimore City Department of Public Safety, subdepartment of health, 1908-1917. b Includes all registered dead births, both stillbirths and miscarriages. 11912 C 696; 1914 C 747. The law was further amended in 1916 and 1920 (1916 C 691 and 1920 C 317), but the provisions here referred to were not changed, a 1912 C 696, amending Annotated Code, art. 43, sec. 9. 185 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 186 IN F A N T M O R T A L I T Y , B A L T IM O R E , M D . During 1915 the Baltimore City Department of Public Safety, subdepartment of health, was making a special effort to secure the rigid enforcement of the birth-registration law. Among the devices the health officials were using to trace unregistered births was the checking of infants’ death certificates with the birth records; When it was found that a birth had not been registered, the health warden of the district from which the death was reported called upon the parents of the child and learned who had attended the birth. If the birth had occurred within the city, a complete record was secured from the attendant or, in cases where neither physician nor mid wife had been employed, from the parents of the child. In September, 1915, the Babies Milk Fund Association of Balti more furnished the Children’s Bureau with the names of 813 babies bom in Baltimore City since January 1 of that year, and these names the agents of the bureau checked with the birth records. Most of the mothers in this group were native white, negroes, or foreign-born Jews, and they included 125 negro mothers of illegiti mate babies. All of the births had been attended by physicians. Of the entire number, 724, or 89.1 per cent, had been registered. The Children’s Bureau followed this test by a canvass of certain districts in order to determine whether unregistered births were fairly well distributed throughout the city or confined to particular groups of the population. The districts were selected for the canvass after consultation with various persons in Baltimore and they included eight neighborhoods especially representing native white, Negroes, and six foreign nationalities—Jewish, Polish, Italian, German, Bohe mian, and Lithuanian. Registration was found to be poorest among the Poles and best among the Jews. Of the 555 births found in the canvass, 77 per cent were registered. The low percentage of regis tered births in this group is not accounted for by the large number of cases attended by midwives, for a larger percentage of the mid wives’ cases than of the physicians’ cases had been registered. T a b l e I I I . — R eg istra tion o f birth , by co lo r an d n a tio n a lity o f m oth er; births stu d ied i n special canvass. Births studied in special canrass. Color and nationality of mother. Registered. Total. Number. Per cent.1 Total.............. 655 425 76.7 Native white.......... Foreign-born white: Polish............... Jewish............... Italian............... Lithuanian....... Bohemian......... German............ Other................. Colored.................... Not reported........... . 180 148 82.2 93 59 62 32 19 63.4 84.9 1Not shown where base is less than 50. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 73 42 26 15 12 11 98 5 12 8 8 72 5 73.5 APPENDIX I . 187 T a b l e IV . — Registration o f birth, by attendant at birth; births studied in special canvass. Births stu iied in special canvass. Registered. Attendant at birth. Total. Number. Per cent.1 555 425 76.6 301 224 -11 7 12 237 179 7 2 78.7 79.9 1 Not shown where base is less than 50. The Babies’ Milk Fund Association and other organizations in Baltimore began during 1915 to cooperate with the city health department in securing the registration of unregistered births. In February, 1916, the Children’s Bureau agents interviewed the families of babies born in January, 1915; the following month each ward was visited again for interviews with the families of babies bom in February, 1915, and so on through the year. Whenever the bureau’s agents learned of an unregistered baby who had been bom in 1915, the name and address were reported to the health de partment and the baby was included in the study. How nearly complete was the final record of births during 1915, when the names secured in the course of the field study had been added to the registered births, it is not possible to estimate. It is probable, at least, that the numbers of births of the several color and nationality groups traced in this way tended to diminish the differ ences in the extent to which the known births fell short of the total number in the several groups. Even if the final record remained (as the prehminary canvass indicated the original records to be) between 80 and 90 per cent complete for the foreign-bom Jewish infants and between 60 and 70 per cent complete for the Polish infants, correction of this difference would diminish but would not obliterate the difference in mortality rate apparent in these two groups. In the same way, if it is contended that the poorest babies wereleastlikely to be registered and that part of the apparent excess mortality rate in the poorest families is accounted for by defective registration, it should also be remembered that unregistered births were far more easily traced in the poorest districts than among the well-to-do. It has also been noted that midwives’ cases showed a slightly higher percentage of registered births than physicians’ cases, so the hypothesis that more poor babies than others escaped regis tration may itself be questioned. In general, it m a y b e concluded that in so far as the record of births is incomplete, the infant mortality rates derived in the present study overstate the absolute hazard, but that the relative hazards of the various groups lie in the direction indicated by the figures shown. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX H.- -THE b a b ie s in f a m il ie s w h ic h c o u l d n o t BE STUDIED. • per cent of the legitimate births registered as occurring m Baltimore during the year 1915 are not included in the detailed study. The number excluded (1,871) was made up of three main groups: One thousand four hundred and sixty-six whose families could not be located in Baltimore or were known to have moved away; 381 nonresidents (320 nonresident hospital cases and 61 cases where the family was living in Baltimore but had been absent from the city more than four months during the first year after the baby’s birth); and 24 births whose families were located but about whom information was not available. It was desired to relate the conditmns under which the babies lived and died to the city of Baltimore, and hence infants of nonresident mothers, infants whose families were away from the city for over four months, and infants whose families had moved away were excluded. Moreover, it would have been difficult to secure exact information as to age at leaving; and even if exact information could have been obtained about the ages of infants when they left the city, or returned, the separating of the time spent in the city and the time spent elsewhere and fair computation of the rates among these infants during the months spent m Balti more would have involved minute computations of doubtful value. In this study, as in the earlier studies of the bureau, the nonresidents are therefore omitted from the detailed study. Whether in the families omitted from the detailed study conditions were ^markedly different from those we have been analyzing is a question to which the data afford no satisfactory answer. For the unknown number of babies whose births were never regis tered no information is available. For the other group of 1,871 babies whose births were registered but who could not be included in the detailed study the birth certificates give us certain items. They state the father’s occupation, and the race, nativity, and age of both parents, as given by the physician or midwife who reported the birth. The data about the father s occupation are of uncertain value, but these statements and the statements about the mother’s color and nativity have been tabulated and analyzed. The 320 nonresident hospital cases are not included in this analysis, since they do not represent a part of the Baltimore population. It may be noted i n ' passing that the birth certificates indicate them to be a selected group with a higher percentage of well-to-do native white mothers than the other births registered in Baltimore during the year The following paragraphs, therefore, refer to the 1,551 births to Baltimore mothers who could hot be located or who were known to have moved away or who had been absent from the city more than four months during the year. 189 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 190 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e I . — Color and nativity o f mother, by class o f exclusion; legitimate births1in 191S. Legitimate births.1 Excluded from study. Color and nativity of mother. Included in study. Num ber. All other exclusions. Nonresident hospital cases. Total. Per Per Per Per Num Num cent cent Num cent cent ber. ber. distri distri ber. distri distri bution. bution. bution. bution. Total.......................................... 11,613 100.0 1,871 100.0 320 100.0 1,551 100.0 Native white....................................... Foreign-born white............................. Colored................................................. Not reported. . ..................................... 7,210 2,894 1,509 62.1 24.9 13.0 1,143 378 342 8 61.1 20.2 18.3 0.4 243 27 47 3 75.9 8.4 14.7 0.9 900 351 295 5 58.0 22.6 19.0 0.3 1 Includes miscarriages. More than one in six of the mothers were colored, as against one in eight in the families studied in detail. Eight per cent of the fathers were reported in occupations with median earnings of $1,050 or more, a percentage approximately the same as that in the detailed study. In each race and nativity group the percentage of mothers delivered in a hospital was higher than in the detailed study, and except among the foreign born the percentage attended by a physician not at a hospital was lower than in the detailed study. This suggests a slightly lower economic level in the excluded group. T a b l e II. — Prevalence o f attendance at confinement by physician, by place o f confinement and color o f mother; births 1 to mothers in 1915.2 Per cent of mothers1 attended by a physician. Color and nativity of mother. In hospital. Detailed study. Outside hospital. Excluded legitimate births.8 Detailed study. Excluded legitimate births. Total.................................................... ................... 9.5 20.0 57.9 55.8 Native white...................................................................... Foreign-born white.........................................» ................ Colored.............................................................................. 8.1 10.9 13.5 21.3 13.1 24.1 64.4 40.4 60.4 58.7 45.9 58.6 1 Includes miscarriages. 2 Detailed study figures are based on mothers; excluded legitimate figures are based .on issues. * Except nonresident hospital cases. If the economic status and general character of the white families, native and foreign, and of the colored families were the same in this excluded group as in the included group, one would still expect to find among the excluded families slightly greater losses than in the included group, because of the larger percentage of colored families. What are the facts ? Of the total infant mortality under 1 year in this group there is no direct measure, as deaths doubtless occurred outside the city for which there is no information available. But it may reasonably be https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX II. 191 supposed that few families moved away within two weeks after the baby s birth and that the known death rate among babies under two weeks of age is approximately correct. T a b l e I I I .—Infant mortality and stillbirth rates, by color and nativity o f mothers• excluded legitimate births 1 other than nonresident hospital cases. Excluded legitimate births1 other than nonresident hospital cases. Stillbirths. Color and nativity of mother. Total Miscar Total births.1 riages, births. Num ber. Total....... . 1,551 Native white........... Foreign-born white. Colored............... . Not reported........... 45 900 351 295 5 1 Includes miscarriages. 1,506 70 Known infant deaths. Per 1,000 births.2 Live births. Under 2 weeks Age not and re w e ek s. over. ported. 46.4 1,436 57 73 1 31.0 40.5 98.6 845 332 256 3 28 13 16 33 15 25 1 2 Not shown where base is less than 100. Of the 1,551 births, 1,436 were live births, and among these liveborn babies 57 died m the first two weeks, a death rate of 39.7 per MOO. This rate can be compared with an expected death rate com puted from the rates for each race and nativity in the detailed study. Thus, in the detailed study, the death rate under 2 weeks of age was 35.8 among babies of native white mothers, 33.8 among babies of foreign-born white mothers, and 50.6 among babies of colored mothers. In the excluded group, if these same rates applied one would expect to find 30 deaths among the 845 babies of native white mothers, 11 deaths among the 332 babies of foreign-born white mothers, and 13 deaths among the 256 colored babies, or a total of 54 deaths under 2 weeks of age and a total rate of 37.6 per 1,000. Ac tually, there were 57 deaths and a rate of 39.1 per 1,000, a difference too slight to have significance. On the other hand, the stillbirth rates in the excluded group were * j ^ mo .ers ea°h race and nativity than in the detailed study. Comparing m the same way the expected rate and the actual rate m the two groups, it appears that there were 70 stillbirths instead oi 58 expected, and a rate of 46.5 per 1,000 births instead of 38.1. T a b l e I V .— Excess prevalence o f stillbirths among excluded over rates prevailing among included legitimate births. Excluded legitimate births other than nonresident hospitalcases. Color and nativity of mother. Stillbirths. Total births. Actual. . Total.............. 1,506 70 Expected.1 58 Native white........... Foreign-born white. Colored.................... Not reported........... d eta i^ estudy.nthe baS1S of sWUWrUi rates prevailing in corresponding color and nativity groups in the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 192 IN F A N T MORTALITY, BALTIMORE, MD. Another basis of comparison, less exact but still of interest, is found in the causes of death during the first month. The record of deaths during the third and fourth weeks of age in the excluded group is probably incomplete, but when it shows an excessive death rate from any group of causes, the incompleteness of the record serves as a reminder that this excessive death rate errs, if at all, merely in being an understatement of the facts. In the excluded group, 11 deaths in the first month were assigned to communicable diseases other than the respiratory diseases, with a death rate from such causes alone of 7.7 per 1,000 live births as compared with a rate of 1.2 from similar causes in the detailed study. Syphilis was the given cause of death for 8 of these 11 babies; in the detailed study, dealing with more than seven times as many babies, only 13 deaths during the first month were assigned to communicable diseases and 10 of these to syphilis. The numbers of deaths in both groups are too small to permit any definite conclusions, but they seem to indicate in the excluded group a slightly larger proportion of families in which babies were not protected from disease. T a b l e V . — M ortality during the first month o f life, by cause o f death and inclusion in or exclusion from study; live births in 1915. Deaths during the first month— Among 10,797live-bom infants included in study. Cause of death. Total.* Total. Rate per Num 1,000 ber. live births. Epidemic and other communicable Among the 1,436 live-born infants not included in study.1 2 Under weeks, 2 under weeks 1 of age. month. Num ber. 2 Under weeks, 2 Rate under weeks per 1 1,000 of age. month. live births. 477 44.2 400 77 66 45.9 57 9 17 37 27 357 1.6 3.4 2.5 33.2 8 20 27 323 9 17 2.8 2.8 2.8 27.8 4 2 4 36 2 34 4 4 4 40 13 26 1.2 2.4 9 13 4 13 11 3 7.7 2.1 10 1 1 2 4 i Other than nonresident hospital cases. * Probably incomplete. Note that in study the number of deaths reported at “ 2 weeks, under 1 month” is 19.3 per cent of the number reported “ under 2 weeks!’ ; among excluded infants the corresponding per centage is 15.8 per cent. Mortality during the months later than the first varied with economic status and home surroundings more markedly than the mortality related to prenatal causes and occurring within the first weeks after birth. But of these deaths from postnatal causes the record is too incomplete to warrant the computation of rates. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX m .— INFANT MORTALITY AND STILLBIRTH RATES IN THIS STUDY AND IN BALTIMORE CITY AS A WHOLE. A city’s infant mortality rate is based on the number of live births and the number of deaths under 1 year of age registered during a calendar year. It is stated in terms of the number of deaths per 1,000 live births. In Baltimore, the number of live births registered during 1915 was 13,634 and the number of deaths under 1 year registered during 1915 was l,633.x The infant mortality rates given in the Children’s Bureau field studies of infant mortality are based on the number of deaths under 1 year of age among a group of babies whose births are registered as occurring in a given city during a given period, and whose individual histories have been traced until 12 months after birth or until death. These rates also are stated in terms of the number of deaths per 1,000 live births. The present study is based on births occurring in Baltimore City during 1915. But many of these births during 1915 were not regis tered until 1916, and the births registered in 1915 included births o f an earlier period and several cases of duplicate registration. A few births in Baltimore County had also been entered in the records for Baltimore City. Therefore the total number of live births used by the Children’s Bureau as the starting point for the present s t u d y 13,477 is not the same as the number of live births registered in Baltimore during the year and serving as the basis for the city infant mortality rate. For two divisions within the group detailed schedules were secured! Among 10,797 legitimate babies, 1,117 died under 1 year of age, or 103.5 per 1,000; among 572 illegitimate babies, 172 died, or 300.7 per 1,000. In addition there were 1,725 legitimate babies who could not be traced or for whom detailed information could not be secured or who were omitted from the study as nonresidents. It was learned, however, chiefly from the death records in Baltimore, that 153 of these babies had died; no attempt was made to learn of deaths outside Baltimore. For 383 illegitimate babies detailed schedules could not be taken, but in this group information was secured whenever possible about babies who had left Baltimore; from death records and other sources it was learned that 109 of these babies had died; 18 were known to have survived the first year; and 256 could not be traced. Estimated rates for the excluded legitimate babies and for the ille gitimate babies are discussed on pages 191 and 168, respectively. It should be noted that while no deaths occurring outside Balti more among legitimate infants and only a partial record of deaths occurring outside Baltimore among illegitimate infants are included in the number of known deaths among the total number of live births Department of public safety, annual report, subdepartment of health, to the mayor and city council of Baltimore for the fiscal year ended Dec. 31,1915, pp. 13,16-19. The number of deaths under 1 year of age in during 1915 is given by the U. S. Bureau of the Census as 1,626. (See Mortality Statistics, 1915, 101351°—23------13 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 193 194 IN F A N T MORTALITY, BALTIMORE, MD. on which the present study is based and the rate which might be computed for the entire group is to that extent defective, no cor responding incompleteness due to shifts of residence appears in the deaths included in computing the city rate. For while the city rate excludes all deaths occurring outside the city among babies born in Baltimore, it includes all deaths occurring in Baltimore among babies born elsewhere. It is obvious that with such differences in the selection of live births and of deaths included in the city rate and in the rates computed in the present study, no precise comparison between them is possible. T a b l e I. — Infant mortality rates, by age at death, legitimacy o f birth, and whether or not the birth was scheduled; registered live births in 1915. Known inlant deaths. Legitimacy and group. Regis tered live births in 1915. Total. under Under 2 weeks. 2 weeks, 1 month. 1 month and over. Num ber. Rate. Num ber. Rate. Num ber. Rate. Num ber. Rate. Total............................. U3,477 1,551 115.1 548 40.7 113 8.4 890 66.0 Legitimate: Scheduled........................ 10,797 Not scheduled................. il,725 1,117 153 103.5 88.7 400 70 37.0 40.6 77 12 7.1 7.0 640 71 59.3 41.2 Illegitimate............................ 955 281 294.2 78 81.7 24 25.1 179 187.4 Scheduled........................ Not scheduled................. 572 383 172 109 300.7 284.6 44 34 76.9 88.8 14 10 24.5 26.1 114 65 199.3 169.7 Includes 289 nonresident hospital cases. In comparing the data on stillbirths and miscarriages secured in this report with the data published by the city health department, two differences should be kept in mind. First, there is the differ ence between births registered in 1915 and births occurring in 1915 which has been noted in the preceding discussion of live births and infant mortality rates. Then, there is a difference in the use of the word “ stillbirth.” By the city health department all dead births of whatever term are reported as stillbirths; in the present study births of seven months or more are classified as stillbirths and earlier births are classified as miscarriages. The only stillbirth rates that can be computed from the city health department’s data would not correspond with the stillbirth rate given in the present report, but with a rate secured by combining the still births and miscarriages and dividing the sum by the total births. Such a rate is roughly comparable with a rate based on the city health department’s data, in spite of the difference between births registered in 1915 and registered births occurring in 1915, since the completeness or incompleteness of the data depend in both cases on the ultimate completeness of the registration. Difficulties involved in changes in residence and the tracing of families do not affect the accuracy of the stillbirth rates fos the entire group in the present study. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 105 APPENDIX HI. T able I I .— Stillbirth rates, by registration o f birth and color o f m other; births registered in 1915 and registered births occurring in 1915. S tillbirths a n d m iscarriages. R egistra tion o f b irth a n d color o f m oth er. T o ta l birth s. N u m b e r. R egistered b irth s occu rrin g in 1915............... W h ite ................................................................ C o lo r e d ............................................................. 14,765 12,231 2,534 14,636 12,045 2,555 36 S tillbirths. T o ta l birth s. 1,131 771 360 1,159 755 372 32 P e r 1,000 b irth s.1- 76.6 63.0 142.1 79.2 62.7 145.6 N u m b e r. 14,095 11,647 2,419 29 618 357 236 25 P e r 1,000 b irth s .1 43.8 30.7 97.6 1 N o t sh ow n w here base is less th a n 50. * D ep a rtm en t o f p u b lic sa fety, a n n u al re p o rt, su b de p a rtm e n t o f health, fiscal yea r e n d e d D e c . 31,1915. B altim ore, 1916. f https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX IV.— METHOD BY WHICH MEDIAN EARNINGS AND MEDIAN RENTALS ARE ESTIMATED FROM DATA AVAILABLE IN THE PRESENT STUDY. The exact median of the father’s earnings is the amount earned by the father in the middle of the group or, perhaps more accurately phrased, the median is the earnings at the point in the scale where one-half of the cases fall above and one-half fall below. Similarly, the exact median rental is such an amount that onehalf of the families paid more and one-half paid less. In the tabulations, earnings and rentals are not listed individually, but grouped. The group within which the median falls can be exactly determined; the individual median can be roughly estimated within the group. As typical of the process, which is identical for earnings and rentals, the median earnings of all the fathers studied are com puted below. It will be noted that the numbers refer to births. The presence of plural births (approximately 2 per cent of all) may, however, be disregarded. The slight error involved would not affect the group median, since plural births appear with about the same frequency in all earnings and nationality groups, and would not affect the validity of the comparisons made in the report on the basis of estimated individual medians. B irth s. Total.......................................................... With father’s earnings not reported... Total with known earnings.. . . One-half of total with known earnings Father’s earnings: None.................................................. Under $450....................................... $450 to $549.................................. $550 to $649...................................... . 11,195 226 10,969 5,484.5 222 1, 615 1,523 1,543 4,903 2,490 7,393 $650 to $849...................................... . Comparison of the total earning less than $650 and of the total earning less than $850 with one-half of total with known earnings shows that $650 to $849 is the group in which the median faUs. in other words, the median earnings were between $650 and $850. B irth s. One-half of total with known earnings.............................. ..................................... Total in groups lower than median group.............................................................. 5; 484.5 4t 903 58L5 The point within the median group at which individual median probably falls is : $650 plus I times $200 = $796. Assuming that within the median group the cases are distributed uniformly in respect to earnings, the median point which will divide the cases in the entire series into two equal parts, half above and half below the median, is: times $200 above the sum, $650, which represent the lowest earnings in the median group. $796 as the median earnings. - This gives 197 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX V.— METHOD BY WHICH INFANT MORTALITY RATE IS COMPUTED FOR INFANTS HAYING A SPECIFIED TYPE OF FEEDING; EXPLANATION OF TERMS “ EXPECTED DEATHS” AND “ EXPECTED RATES.” COMPUTED RATE BY TYPE OF FEEDING. Many of the babies who are breast fed throughout the first month are shifted to mixed feeding or to artificial feeding during the second month, and such shifts from one type of feeding to another continue throughout the year. The annual rate is computed (1) from the monthly rate for each month from the first to the ninth, based on all infants receiving a given type of feeding through more than half the month (or until death within the month) and the deaths occurring during the month within this group; and (2) from the survivors of the ninth month, who had had a stated type of feeding during that month, and the deaths occurring after the ninth month within this group. The number of breast-fed babies dwindled from 9,283 during the first month to 2,825 during the ninth month. The number of deaths during the first nine months among babies who at the time of death were receiving breast milk and no other food was 259. These repre sent monthly death rates varying from 15 per 1,000 in the first month to 1.7 per 1,000 in one of the later months. After the ninth month, 23 deaths occurred among the 2,817 survivors of the ninth month who were breast fed during that month. These represent a death rate after the ninth month of 8.2 per 1,000 survivors. B y applying these rates to a hypothetical group of 1,000 babies breast fed throughout the first nine months, the known monthly death rates are translated into terms of infant deaths per 1,000 babies born alive and surviving to be fed. The rate for the first month gives the number of deaths within the first month in the hypothetical t group. Subtracting these deaths from 1,000, gives the number of * survivors at the beginning of the second month, which, in turn, is multiplied by the rate for the second month to give the number of deaths within the second month in the hypothetical group. These, in turn, are subtracted from the survivors at the beginning of the second month. This process is repeated for each month to thé ninth. The survivors of the ninth month in the hypothetical group are then multiplied b y the death rate for survivors of the ninth month who had been breast fed through that month. The sum of the 10 numbers of deaths is the number of deaths which would occur during the first 12 months of life in the hypothetical group of 1,000 breast-fed babies. And, since this number is derived from a group of 1,000, it is identical with the death rate per 1,000 among breast-fed babies. 199 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 200 IN F A N T MORTALITY, BALTIMORE, MD, B R E A S T -F E D IN F A N T S . H y p o t h e t ic a l grou p o f 1,000 infants. A c t u a l group. M on th o f life. I n fa n t su r viv o rs . F irs t........................ ................... .............................. S econ d .......................................... ........................... T h ir d .............. ....................................................... F o u r th .................................................................... F ifth .......................................................................... S ix t h ......................................................................... S even th .................................................................... E ig h th .................................. ............................ N in th .................................................................... T e n th t o tw e lfth ................................................... D e a th s w ith in m on th . M o n th ly d e a th ra te . 139 32 18 15 15.0 3 .9 2 .4 2 .3 3 .4 9,283 8,176 7,400 6,457 5,905 5,352 4,215 3,590 2,825 2,817 20 12 2.2 7 1 .7 8 8 2.2 2.8 8.2 23 In fa n t sur vivors. 1, 000.0 985.0 981.2 978.8 976.5 973.2 971.1 969.4 967.3 964.6 M o n th ly d e a th rate. 15.0 3 .9 2 .4 2 .3 3 .4 2.2 D eaths w ith in m on th . : 15.0 3 .8 2 .4 :; '2 ; 3 3 .3 2.1 1.7 1 .7 2.2 2.8 8.2 2.1 956.7 2 .7 7 .9 43.3 From the sum of the deaths within the month in the hypothetical group is derived the computed annual rate for breast-fed babies o f 43.3 per 1,000 infants fed. In the same way from the computations that follow, are derived the computed annual rate for babies having mixed feeding— 87.4 per 1,000 infants fed— and the computed annual rate for babies having artificial feeding— 191.4 per 1,000 infants fed. M IX E D -F E D IN F A N T S . H y p o th e tic a l grou p o f 1,000 in fa n t s . A c t u a l grou p . M on th o f life . I n fa n t s u rv iv ors. F irs t.......................................................................... S econ d ...................... ............................................... T h ir d ........................................................................ F ou rth ...................................................................... F ifth ........................................................ S ix t h ____: ........................; ...................................... S even th .................................................................... E ig h th ...................................................................... N in t h ........................................................................ T e n th t o t w e lft h ................................................... D eath s w ith in m o n th . 281 608 844 1,303 1,614 1,977 2,845 3,291 3,890 3,878 M o n th ly d e a th ra te . I n fa n t s u rv iv ors. M o n th ly d e a th ra te . 12 42.7 1, 000.0 42.7 4 6.6 8 957.3 951.0 942.0 936.9 931.7 928.0 925.0 921.9 919.0 6.6 9 .5 5 .4 5 .6 4 .0 3 .2 3 .3 3.1 7 .0 7 9 8 9 11 12 27 9 .5 5 .4 5 .6 4 .0 3 .2 3 .3 3.1 7 .0 912.6 A R T IF IC IA L L Y -F E D D eaths w ith in m o n th . 4 2.7 6 .3 9 .0 5.1 5 .2 3 .7 3 ,0 3 .1 2 .9 6 .4 87.4 IN F A N T S . H y p o th e tic a l gro u p o f 1,000 in fa n t s . A ctu a l group. Month o f life . I n fa n t s u rv iv ors. F irs t........................................................................... S econ d ...................................................................... T h ir d ........................................................................ F o u r t h . . . . .............................................................. F ifth ............................................ .............................. S ix t h ....................................... ............................... . S even th .................................................................... E ig h th ...................................................................... N in th ......................................................................... T e n th t o t w e lfth ................................................... 958 1,531 2,006 2,426 2,605 2,725 2,919 3,042 3,153 3,122 D ea th s w ith in m o n th . M o n th ly d e a th rate. I n fa n t s u r v iv ors. M o n th ly d e a th rate. 53 29 37 40 41 56 40 36 31 90 55.3 18.9 18. 4 16.5 15.7 1, 000.0 55.3 18.9 18 4 16.5 15.7 20.6 13.7 11.8 9 .8 28.8 944.7 926. 8 909.7 894.7 880.7 862.6 850.8 840.8 832.6 808.6 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 20.6 13.7 11.8 9 .8 28.8 D eaths w ith in m o n th . 55.3 17.9 17 i is le 14.0 is : l 11.8 10.0 8.2 24.0 191.4 APPENDIX V. 201 In the tables showing computed infant mortality rates b y type of feeding, the numbers of infants having the stated type of feeding during the first month and during the ninth month are shown. In addition, the total number of months of feeding of a specified type from the first to the ninth is given, as a truer indication of the size of the base for the computed rate. “ EXPECTED DEATHS.” In this report the ‘ 1expected deaths” and “ expected rates” are frequently compared with the “ actual deaths” or “ actual rates.” The reason for making such a computation and the method of secur ing the expected deaths are briefly explained in the following paragraphs. Suppose, for example, an analysis is to be made of the relation of mother’s employment during pregnancy to infant mortality. B y classifying live births and deaths according to the employment and nonemployment of the mother during pregnancy, an infant mor tality rate for each group can be obtained. The question imme diately arises, however, whether an undue proportion of the mothers who worked during pregnancy may not be colored or foreign bom , groups in which the infant mortality rates have been found to be nigh. The excessive mortality, therefore, among the babies of mothers who worked may be due merely to the differences in the composition of the groups. Accordingly the next step is to sub divide the group into the native white, foreign-born white, and colored, ana to ascertain in each group the infant mortality rate among babies whose mothers worked during pregnancy and whose mothers did not work. It appears that the rates are still higher for infants of mothers who worked. , The question then arises whether this high mortality may not be due to the general conditions of poverty in homes from which mothers go out to work. Or it may be due to the fact that among the foreign-bom mothers, it was chiefly the Polish mothers who went out to work. The next step in analysis, therefore, is to subdivide these groups still further and to compare in each of the subgroups the mortality among babies whose mothers worked and those whose mothers did not work. The difficulty then arises that the numbers in each of these homogeneous subgroups are so small that great differences in the rates may be due to chance variation. Evidently, some method of summarizing the results of the findings of the different subgroups is necessary, but if the live births and infant deaths in the different groups are merely added up, the result gives the figures from which the analysis originally pro ceeded. It is therefore obvious that the method of summarizing must produce results which are independent of the differences in the distributions of the various factors which complicate the findings in the original group. For this purpose, an expected rate is used for comparison with the actual rate. The method which has been followed in computing an expected rate is, first, to compute the infant mortality rate in each of the sub groups not divided according to the factor upon which information is particularly sought. In the present case infant mortality rates are determined for each color and nationality and earnings group. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 202 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . The second step is to divide the live births in each of the subgroups into two subdivisions— those whose mothers were, and those whose mothers were not, employed during pregnancy. The third step is to multiply the live births in each o f these subdivisions b y the infant mortality rate for the subgroup. The result of this multiplication gives the number of infant deaths in each of the subdivisions of the subgroups if the rate which was true of the subgroups applied to each of the subdivisions. These expected deaths are then added so that one total is secured of all the expected deaths among infants of mothers employed, and another of expected deaths of infants of mothers not employed during pregnancy. These totals of expected deaths are then compared to the totals of actual deaths among infants of mothers employed and not employed during pregnancy.1 If tnere is a tendency for employment of the mother to affect ad versely the mortality oi babies, then in each of the subdivisions of the subgroups the actual number of deaths among infants of mothers employed during pregnancy will tend, other things being equal, to be in excess of the number expected, found by multiplying the live births by the infant mortality rate for the entire subgroup. In each of the subgroups, then, a comparison can be made between the actual number and the expected number of deaths. By adding on the one hand all the expected deaths and on the other all the actual deaths, the validity oi the comparison between the actual and expected deaths is preserved, and the result expresses the comparative mor tality in the two groups after the influence of differences in nation ality and economic condition is eliminated. In summing up the results from all the subgroups the range of variation due merely to chance is greatly lessened, and the conclusion secures the full value of the weight attached to the number of cases in the comparison. Expected rates are found by dividing the number of expected deaths by the total number of live births. These rates may be com pared to the actual rates in the same way that expected deaths are compared to actual deaths. In connection with each table showing expected deaths or expected rates, a statement will be found showing the base upon which these have been computed. 1It is obvious that adding together the actual deaths in each of the subdivisions of each subgroup will give the total deaths among infants of mothers employed and not employed during pregnancy. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX VI.— PREVALENCE OF PRENATAL CARE AND EXTENT TO WHICH THE INFANTS IN THE STUDY WERE REACHED BY INFANT-WELFARE WORK. In its Baltimore study, the Children’s Bureau for the first time in its series of infant mortality inquiries had an opportunity to observe the development of prenatal clinics and infant-welfare work and to ascertain the extent to which these facilities were available to the babies bom during the specified period. The prevalence of prenatal care among the mothers of infants bom in 1915 and the extent to which the infants were reached by the infant-welfare agencies were included in the scope of the inquiry. In Baltimore no public work had yet been undertaken in the field of prenatal care and infant welfare, but three private agencies, the Johns Hopkins Hospital, the Babies’ Milk Fund Association, and the Mothers’ Belief Society, had begun in 1914, 1915, and 1916 to carry on systematic prenatal and infant care. Other hospitals and agencies were making examina tions of women who came to them during pregnancy and were coop erating in various ways with these three agencies. Organizations giving prenatal care. The prenatal care and obsterical service furnished by the Johns Hopkins Hospital included a maternity ward, an out-patient disensary open every day, and a free, outside obstetrical service which, owever, was limited to mothers living not more than a mile from the hospital.1 A clinic nurse visited mothers living within the hospital district, and other mothers were referred for nursing care to the organization next described. The Babies’ Milk Fund Association, organized in 1904 for the dis tribution of pure modified milk, maintained a nursing service which to some extent reached patients of private physicians,2 and supple mented the work of prenatal clinics. The association also maintained an obstetrical clinic in a neighborhood far from any hospital, where foreign-born women predominated.3 A third clinic was carried on by the Mothers’ Relief Society, which held a prenatal clinic once in two weeks at a settlement house, Law rence House.4 The work of the one nurse employed was supple mented through cooperation with the Instructive Visiting Nurse Association. A prospective mother was received b y ‘ the Johns Hopkins Hospital obstetrical clinic only with the understanding that she would return to the clinic at least monthly until confinement5 and E 1A lm o s t all o f th e follow in g w ards w ere in clu d e d in this area: 2 , 3 , 5 , 6, 7 , 8, a n d 10. * A m o n g th e 665 m arried w o m e n a tten d ed d u rin g p re g n a n cy b y th e B ab ies’ M ilk F u n d A ssocia tion ap p roxim ately 63 p er cen t w ere patien ts o f a prenatal clin ic, w h ile a b o u t 11 p er cen t w ere p atients o f a p riva te p h y sicia n o n ly . T w e n ty -fiv e p e r c e n t h a d n o a tten d a n t d u rin g p re g n a n cy e x c e p t th e nurse o f th is asso cia tion . M others receivin g care fro m a nurse o n ly h a v e n o t b e e n in clu d e d i n this report as h a vin g prenatal care. »T h e eastern p a rt o f th e tw e n ty -fo u rth w a rd , i n th e d istrict k n o w n as L o cu s t P o in t . T h e w a rd as a w h o le sh ow ed m ed ia n earnings o f fathers b etw een $650 a n d $850; th e m e d ia n earnings for th e L o cu st P o in t n eig h b orh ood h a d th e y be e n tab u la te d separately w o u ld p r o b a b ly h a v e fallen in t o th e lo w e r earnings grou p . * T h is c lin ic served parts o f w ards 4 ,2 2 ,2 1 ,2 3 ,1 8 ,1 9 . • S ince 1915 th e sta ff has be e n increased, a n d th e pa tie n t is n o w e x p e c te d t o v is it th e c lin ic m o n t h ly u n til th e s even th m o n th , a n d th e n e v e r y t w o weeks u n til con fin em en t. 203 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 204 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . that the baby would be placed under the care of the Babies’ Milk Fund Association until he was at least 1 year of age. The clinic did not usually retain as a patient a woman who could afford a private physician. The Babies’ Milk Fund Association endeavored to devote the major part of its work to women in families with less than a stated income; it preferred not to take as clinic patients women who could and would go to a hospital for confinement or who would employ a private physician. The Mothers’ Relief Society restricted its work to white married mothers who would otherwise have employed a midwife at confinement. It required of the mother full cooperation in the plan of prenatal care, and tried to have mothers brought to the society during the early months of pregnancy. The prenatal service rendered by the Johns Hopkins Hospital included at the first visit a complete physical examination with pelvic measurements, and at this and each later visit a urinalysis. At least one home visit was made by the clinic nurse or one of the nurses on the staff of the Babies’ Milk Fund Association.6 The physician in charge of the Babies’ Milk Fund Association clinic examined the mother thoroughly at her first visit, and she was expected to return to the clinic at least monthly. Urinalysis was made monthly in normal cases. The mother was visited in her home about once in ten days, and if abnormal symptoms were found she was urged to visit the clinic more often. An initial physical examina tion, monthly urinalysis, and weekly visits b y a trained nurse com prised the prenatal supervision carried on in normal cases b y the Mothers’ Relief Society. Prevalence of prenatal care. The three agencies doing systematic prenatal work gave medical prenatal care to 893 married mothers (769 of these received care from the Johns Hopkins Hospital) and 128 unmarried mothers of those who were included in the scheduled groups. In addition, 379 married mothers reported prenatal visits from a nurse of the Babies’ Milk Fund Association or the Mothers’ Relief Society, but no medical prenatal care either from these organizations or from the Johns Hop kins prenatal clinic. Of these 379 mothers, 122 had medical prenatal care from some other clinic and 257 did not have prenatal care from any clinic. Hospital clinics, other than Johns Hopkins gave prenatal care to 546 married mothers (including the 122 who also had visits from nurses of the Babies’ Milk Fund Association or the Mothers’ Relief Society) and to 161 unmarried mothers. Besides the special work organized in the clinics, prenatal advice and care were given by private physicians. A complete statement of the prevalence of prenatal care could be obtained, therefore, only by ascertaining in the case of each mother whether she had received prenatal care during the pregnancy of 1915.7 Standards of prenatal care were drawn up in consultation with medical authorities, and it was agreed that to be classified as having any medical prenatal care a mother must at the very least have consulted a physician once 6 Since 1915, t o th e rou tin e o f each v is it h a v e b e e n a d d e d th e de te rm in atio n o f b lo o d pressure a n d a n a b d o m in a l exa m in a tion . I n ev e r y case a W asserm an n test is tak e n on th e first v is it a n d tre a tm e n t is in stitu ted if a p o s itiv e reaction is secured. . . . . . , , ‘ . 7 The discussion in the following pages is limited to mothers of infants of legitimate birth in the sched uled group. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 205 APPENDIX VI. during her pregnancy or have had a urinalysis.8 Consultations with or advice given by a nurse or midwife were not considered prenatal care. On this basis slightly over half, 52.4 per cent, of the mothers of legitimate infants born in Baltimore in 1915, received some medical prenatal care; nearly half received none. Seven and eight-tenths per cent of the mothers received care from one or more of the three clinics described above, 4.8 per cent from other clinics, and 39.8 per cent from a private physician only. Prenatal care and poverty. Table I shows the prevalence of prenatal care in the different earnings groups. A marked correlation between the prevalence of prenatal care and the earnings of the fathers is evident from the table. Of the mothers in families where the fathers earned less than $850, 56 per cent, as compared with 35 per cent in the families where the fathers earned $850 to $1,849, and with 14 per cent in families where the fathers earned $1,850 or over, received no prenatal care. Of the mothers in families where the fathers earned $2,850 and over, only 10.8 per cent were without some prenatal care. But the greatest lack of care did not occur in the very poorest f a m ilies. In these families clinic care was most prevalent, reaching 34.9 per cent of the mothers in families with no fathers’ earnings and 30.4 per cent of the mothers in families with fathers’ earnings less than $450. In families with a little more money, far fewer mothers went to the clinics, and among several of the groups under $850 the increase in private care as the fathers’ earnings rose was less marked than the decrease in clinic care. Therefore fewer mothers had pre natal care in families where fathers earned more than $450 but less than $650 than in families where the fathers earned nothing or under $450. T able I .— Prevalence o f 'prenatal care among mothers,a by source o f care and by earnings offather. P er cent la v in g prei aatal care. E arnings o f father. P e r cen t h a vin g T o ta l n o pre m o th e rs .« n atal care. T o ta l. F ro m clin ic p h y si cian. 6 F ro m p riv a te p h y s i cia n only. P e r cen t n o t re p o rte d . T o t a l.............................................................. 11,463 47.5 52.4 12.6 39.8 0.1 N o e a r n in g s ......................................................... U n der $850.............................................................. U n d er $450.............................................. .. $450-$549.......................................................... $550-$649.......................................................... $650-$849.......................................................... $850-$l,849............................................................... $850-$1,049.......... ............................................ $1,050-$1,249.................................................... $1,250-$1,449.................................................... $l'450-$1^849.................................................... 232 7,331 41.4 55.6 53.0 58.7 59.8 52.7 34.8 40.5 30.0 32.9 21.3 13.8 18.2 13.9 57.3 44.3 46.9 41.0 40.1 47.3 65.1 59.5 70.0 67.1 78.7 34.9 16.6 30.4 22.4 27.7 16.5 1.3 86.1 81.8 .7 39.7 89.2 58.6 $l,850-$2,249.................................................... $2'250-$2;849.................................................... N o t rep orted .......................................................... 1,668 1,551 1,566 2,546 3,205 1,675 696 444 390 456 143 101 212 239 10.8 86.1 20.8 13.0 7.1 3 .0 4.1 2 .3 2 .5 .3 .2 18.8 a In clu des o n ly m arried m oth ers t o w h o m ch ild ren w ere h o r n i n 1915. b W ith or w ith o u t care fr o m other p h y sicia n , c N o t s h ow n w h en less th a n on e-ten th o f 1 p er cen t. « I n 103 cases th e m oth er re p o rte d ù rin alysis, b u t n o co n su lta tio n w ith a p h y sicia n . https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis .1 .1 20.2 27.1 40.1 62.2 55.4 67.7 64.6 78.5 .3 .1 .1 (*> .1 86.0 81.1 86.1 89.2 39.7 1.7 206 IN F A N T MORTALITY, BALTIMORE, MD. In families where the father’s earnings were below $850, less than ..one-third of the mothers sought private prenatal care and less than one-fifth were reached b y clinics. In families where the father’s earn ings were $850 and below $1,850, less than two-thirds had private prenatal care and less than 1 in 30 was reached by the clinics. In families where the fathers earned $1,850 or over, nearly seven-eighths of the mothers sought private prenatal care. Prenatal care and color and nationality. The different customs of the several race and nationality groups also play their part in causing the variations in prevalence of prenatal care. In general, of course, the more the group clings to the employ ment of midwives at confinement the fewer are the mothers in the group who have medical care during pregnancy. Thus, in Baltimore, at one extreme are the Polish mothers with 86.1 per cent (Table II) reporting no prenatal care (and 77.6 per cent attended b y midwives at confinement), and at the other extreme the colored mothers and the native white mothers with 42.8 per cent and 41.5 per cent, respec tively, reporting no prenatal care (and 25.9 per cent and 27.4 per cent, respectively, employing midwives at confinement). The six national ity groups fall into two divisions: First, the native white mothers, the colored mothers, and the foreign-bom Jewish mothers, of whom many, relatively, had prenatal care; and the Polish, Italian, and “ all other foreign” mothers, of whom relatively few had prenatal care. T a b l e I I .— Prevalence o f prenatal care among mothers,1 by source o f care and by color and nationality o f mother. Per cent having prenatal care Per cent Color and nationality Total having ofmother. mothers.1 noprenatalcare. From clinic physician2. Total. Total. The three clinics. Other clinics. Per cent not reFrom private ported. physician only. Total................ 11,463 47.5 52.4 12.6 7.8 4.8 39.8 0.1 Native white............. Jewish........................ Polish......................... Italian........................ A ll other foreign-bom white...................... Colored....................... 7,117 996 646 435 41.5 46.5 86.1 77.9 58.3 53.4 13.9 22.1 5.6 31.7 8.2 8.5 3.8 22.6 5.7 6.4 1.8 9.1 2.5 2.1 52. 8 21.7 5.7 13.6 .1 .1 780 1,489 63.1 42.8 36.5 57.0 8.8 38.1 6.4 18.9 2.4 19.2 27.7 18.9 .4 .3 1 Includes only married mothers to whom children were bom in 1915. 2 With or without care from other physician. / The native white mothers depended mainly on private physicians, while the foreign-born Jewish mothers and the colored mothers depended mainly on the clinics. In the three other groups where the m ajority of mothers had no prenatal care, about 1 mother in 12 had been reached by the clinics and the percentages having private medical prenatal care ranged from 5.7 per cent of the Polish mothers to 27.7 per cent of the “ other foreign-bom ” mothers. The three clinics doing systematic prenatal work were so located as to be accessible to mothers in the very poor districts in which https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 207 APPENDIX VI. native white families predominated. In the wards within a mile of Johns Hopkins, which treated more prenatal patients than any other clinic, occurred about two-thirds of the births to Jewish, Polish, and Italian mothers. The principal colored neighborhoods were not so accessible to Johns Hopkins and were less accessible to the Babies’ Milk Fund Association clinic. The Mothers’ Relief Society did not accept colored patients. These three clinics together reached 22.6 per cent of the total foreign-bom Jewish mothers and 18.9 per cent of the total colored mothers. The other clinics were accessible to cer tain other very poor districts, including the principal colored neigh borhoods, and reached 9.1 per cent of the foreign-born Jewish mothers and 19.2 per cent of the colored mothers. In the other nationality groups much smaller proportions of the mothers were reached by the clinics. T able I I I .—Prevalence o f prenatal care among mothers,} from specified source, by ward o f residence and median earnings o f father. Per cent having prenatal care. Per cent Ward of residence Total having and median earn mothers.1 no pre ings of father. natal care. From clinic physician.a Total. Total. Total................ Under $650— Ward 2 ......... Ward 3......... Ward 4......... Ward 22....... Ward 5......... Ward 17....... Median earnings: $650-$849— Ward 1......... Ward 24....... Ward 21....... Ward 6......... Ward 23....... Ward 18....... Ward 7 ......... Ward 19....... Ward 10....... Ward 20....... Ward 11....... Ward 13....... Ward 8 ......... Ward 14....... Median earnings: $850 and over— Ward 15....... Ward 12....... Ward 16....... Ward 9......... The three clinics. Other clinics. Per cent not re From ported. private physician only. 11,463 47.5 52.4 12.6 7.8 4.8 39.8 0.1 652 647 240 290 420 287 76.5 63.1 57.1 54.5 50.5 41.1 23.5 36.9 42.9 45.5 49.5 58.5 10.7 26.3 18.8 20.7 37.4 28.6 7.8 19.8 5.4 4.8 30.7 6.3 2.9 6.5 13.3 15.9 6.7 22.3 12.7 10.7 24.2 .24.8 12.1 30.0 .3 825 630 465 623 370 281 694 401 356 643 157 489 634 308 71J) 69.2 54.2 52.8 49.7 49.1 48.4 43.9 43.5 38.6 37.6 33.7 33.0 31.8 29.0 30.6 45.4 47.2 50.3 50.5 51.6 56.1 55.9 61.4 61.8 66.1 66.9 67.5 5.0 6.3 14.4 18.0 10.5 16.7 14.0 11.0 20.8 4.8 9.6 1.8 10.6 15.3 3.4 5.1 8.8 14.6 3.8 6.4 12.8 6.5 15.2 2.5 3.2 .8 8.7 4.2 1.6 1.3 5.6 3.4 6.8 10.3 1.2 4.5 5.6 2.3 6.4 1.0 1.9 11.0 24.0 24.3 31.0 29.2 39.7 33.8 37.6 45.1 35.1 56.6 52.2 64.2 56.3 52.3 645 437 452 517 29.8 28.8 24.1 21.9 69.9 70.9 75.9 77.8 5.3 6.9 7.3 5.4 .8 3.9 1.8 4.6 4.5 3.0 5.5 .8 64.7 64.1 68.6 72.3 1Includes only married mothers to whom children were bom in 1915. a With or without care from other physician. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis .2 .4 .4 .6 .6 .2 .2 .6 .3 .2 .4 208 IN F A N T MORTALITY, BALTIMORE, MD. Prenatal care and wards. Of the five wards (wards 3, 5, 10, 17, and 22) in which 20 per cent or more of the mothers received clinic care, four were among the poorest wards in the city (Table III). Three of these (3, 5, ana 10) were within the Johns Hopkins Hospital district. The other two wards included districts with a large proportion of colored mothers which were conveniently accessible to other hospitals. Other wards showing a large proportion of mothers receiving prenatal care from clinics were ward 4, which was conveniently accessible to two hos pitals; wards 6 and 7, which were within the Johns Hopkins district, and ward 14, which contained a large colored population and was conveniently accessible to other clinics. Wards 3 and 5 had a con siderable Jewish population; it is noteworthy that ward 2, which was in the Johns Hopkins district, had a relatively low proportion of mothers who reported prenatal care, a fact which may be related to its relatively large Pohsh population. Grade of prenatal care. An attempt was made to classify the care received by the mothers roughly into three grades, which were determined upon after consul tations with medical authorities. These grades are designated by the letters A, B, and C—grade C including all cases having the minimum of care already noted which could not qualify as either A or B. To qualify in grade B the care received by the mother must have satisfied all four of the following requirements: (1) Some supervision by a physician. (2) At least one urinalysis. (3) At least an abdommal examination. (4) Pelvic measurements if a primipara. To qualify in grade A, the care must have fulfilled the following additional requirements: Monthly visits to clinic from the fifth to the ninth month or under supervision of private physician from the fifth to the ninth month, and monthly urinalysis during the same period. Several points should be mentioned in connection with the grading of care. In the first place, the requirements even for grade A care are low and may by no means be considered ideal. The fact that so small a proportion of mothers received care of grade A with its low standard is therefore all the more significant. In the second place, though the care given by the three clinics was based upon thenrecords, the classification of care given by the private physicians was based upon the mothers’ statements. The results are, therefore, sub ject to qualification in that the mothers’ memories may have been at. fault or that the mothers may not have understood the object or the scope of the examination made by the physicians. On the other hand, the agents were given careful instructions in regard to the questions to be asked and in every case the answers were so classified as to overstate rather than to understate the extent of care actually received. In the third place, it should be emphasized that the results of this study can not be interpreted as in any way a criticism of the physicians or the clinics, since the small proportion of cases receiving https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX V I. 209 the best grade of care is largely determined by the fact that the mothers did not present themselves for treatment early enough in their pregnancies, or did not continue visits with sufficient regularity. For a better showing the fuller cooperation of the mothers is required, and this can be secured only after the importance of early care is generally recognized and appreciated. ■Tho results of the ^classification by grades of care is shown in Table IV. Of the entire group of mothers of legitimate infants, 5.1 per cent had grade A, 17.1 per cent had grade B, and 25.6 per cent had grade C care. The proportion with grade A care was less than 5 per cent in all earnings groups under $850, and between 5 and 10 per cent m the groups $850 to $1,449, but rose to 39.2 per cent in the group $2,850 and over. T ab le IY —Prevalence o f prenatal care among mothers,l by grade o f care and by earnings offather. Per cent having prenatal care of specified grades. Earnings of father. . Total mothers.1 Total. Total............................... No earnings................................ Under $850.............................. Under $450........................ $450-$549......................... $550-$649........................ $650-$849................................ $850-$l,849.................................... $850-$l,049........................... $1,050-81,249..................... $1,250-$1,449.............................. $1,450-$1,849..................... $1,850 and over................................ $l,850-$2,249............................ $2,250-$2,849....................................... $2,850 and over....................................... Not reported............................................... Grade A. Grade B. Grade C. Grade not reported. 11,463 52.4 5.1 17.1 25.6 4.5 232 7,331 1,668 1,551 1,566 2,546 3,205 1,675 696 444 390 456 143 101 212 239 57.3 44.3 46.9 41.0 40.1 47.3 65.1 59.5 70.0 67.1 78.7 86.1 81.8 86.1 89.2 58.6 1.7 2.2 1.3 1.8 1.6 3.5 8.5 6.6 8.2 9.2 16.4 30.3 21.0 24.8 39.2 4.2 28.9 17.9 25.7 19.5 15.7 13.2 14.0 13.3 14.5 13.5 17.2 17.3 14.0 23.8 16.5 22.6 23.3 21.7 17.7 18.2 20.3 27.2 34.6 33.1 37.6 36.9 33.3 2a 9 36.4 26.7 25.0 23.4 3.4 2.5 2.2 1.5 2.5 3.4 ao 6.6 9.6 7.4 11.8 9.6 10.5 10.9 as a4 1 In clu d es o n ly m arried m oth ers t o w h o m ch ildren w ere b o m i n 1915. Grade B care was most prevalent in the poorest families, with 28.9 per cent of all in the “ No earnings” group and 25.7 per cent of all in the “ Under $450” group.9 Grade C care, on the other hand, was most prevalent in the families between the very poor and the well to do, the percentage having this grade of care ranging from 33.1 to 37.6 per cent of all in the families where the fathers earned $850 but less than $2,250, but falling below 30 per cent in the most prosperous families and below 20 per cent in very poor families. Only in the poorest families (where the fathers earned less than $550) and in the most prosperous families (where the fathers earned at least $2,250) were the mothers who had grade A or grade B care more numerous than the mothers who had grade C care. In the poorest groups care of grades A or B was practically all grade B ; in » T h e h igh percentage o f grade B care a t $2,250 t o $2,849 is based o n a grou p o f 101 m oth ers o f w h o m 76 h a d prenatal care o f a stated grade. T h is v a ria tion fr o m th e general tren d has little signifiran«» ; n „ n sm a ll a grou p . 101351°—23— 14 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 210 IN F A N T MORTALITY, BALTIMORE, MD. the earnings group from $2,250 to $2,849, it was about evenly divided between grades A and B ; and in the group $2,850 and over, it was mainly grade A. , . In quality of care even more than in general prevalence ot care the mothers in families of average means fared less well than the very poor. • . , , . Prenatal care for 48 per cent of tlie mothers who received, care did not begin until after the fifth month, and consequently it could not satisfy the requirements for grade A. More than one-fourth of the mothers who were classified as having prenatal care saw the physi cian only once during pregnancy.10 Only 31.4 per cent had had as many as five consultations. IGA visit merely to engage the services of a physician without medical consultation was not counted as a consultation. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis CONFINEMENT CARE. Hospital facilities. A t the time of this study 13 hospitals received maternity cases11 and 5 maintained outside obstetrical service, with the assistance of students in Baltimore medical schools. Attendant at birth. In all, 67.4 per cent of the mothers were attended at confinement by a physician (Table V). Confinement at home with a private physician attending was the predominating type of confinement care m the city as a whole, with 47.1 per cent of the total births studied. Next in importance numerically were the midwife cases, with 32.3 per cent of the total births. Confinements attended b y the outside obstetrical service of a hospital and confinements occurring in a hospital were about equal in number with 9.9 and 9.5 per cent re spectively of the total births. The 24 births to mothers delivered b y the obstetrician of the Babies7 Milk Fund Association and the 82 births to mothers delivered b y the obstetrician of the Mothers7 Relief Society were together less than one per cent of the total. Twenty-nine births, or 0.2 per cent of the total, took place with neither midwife nor physician in attendance. Confinement care, like prenatal care, shows the greatest lack of medical attendance, according to Table VI, in families between the very poor and those who had more than the average income. The percentage of the mothers who Were attended b y midwives was only 20.7 per cent in the group in which the husband earned nothing and free hospital service reached the largest numbers of cases, but the per centage rose to 44 per cent in the groups in which the fathers earned between $450 and $649. In the families where the fathers earned $650 or more the numbers attended b y midwives decreased, but only in families where the fathers earned at least $1,050 was the percent age of midwife cases smaller than in the poorest group, where the husbands earned nothing. \ T a b l e Y . — Attendant at birth and place o f confinement. Legitimate births in 1915. Attendantat hirth and place of confinement. Number. Total............................................................................... Physician..................................................................................... In hospital........................................................................ Not in hospital................................................................................... Outside obstetrical service...................................... Babies’ Milk Fund Association.................................. Mothers’ Relief Society.................................................. Private..................................................................... Midwife.......... .................................................................... Other and none......................................................................... Per cent distribu tion. 11,613 100.0 7,830 1,105 6,725 1,150 24 82 5,469 3,754 29 67.4 9.5 57.9 9.9 0.2 0.7 47.1 32.3 0.2 11 See Report on the study of agencies in Baltimore, Md., caring for women in confinement, b y Louise Pearce, M. D. Transactions of the third annual meeting of the American Association for Study and Prevention of Infant Mortality, Cleveland, Ohio, 1912, pp. 272-275. 211 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 212 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e V I .— Attendant during confinement period o f mothers, by place o f confinement, and earnings o f father. Per cent attended during confinement period— Earnings of father. B y physician. Total mothers.1 Total. Total. No earnings............ Less than $850........ Less than $450.. $450-1549.......... $550-4649........ $650-4849___... $850-41,849.............. $850-41,049....... $1,05641,249.... $1,25641,449.... $1,45641,849.... 41,850 and over....... $1,8504-2,249.... $2,256-42,849.... $2,850 and over. Not reported.......... By Outside midwife. In of hospital. hospital. 11,463 67.4 9.5 57.9 32.4 232 7,331 1,668 1,551 1,566 2,546 3,205 1,675 696 444 390 456 143 101 78.0 60.6 64.3 56.4: 56.3 63.4 77.8 72.1 81.9 80.9 91.5 93.4 86.7 94.1 97.6 74.9 26.3 7.9 11.8 8.8 7.0 5.4 9.1 6.6 8.5 12.4 17.2 25.9 29.4 25.7 23.6 15.1 51.7 52.7 52.5 47.5 49.2 58.0 68.7 65.6 73.4 68.5 74.4 67.5 57.3 68.3 74.1 59.8 20.7 39.1 34.8 43.5 43.7 36.6 22.0 27.5 18.1 19.1 8.2 6.6 13.3 5.9 2.4 24.7 212 239 - B y other and no attend ant. 0.3 ' 1.3 .2 .8 .1 .1 .2 .4 .3 .4 1 Includes only married mothers to whom children were bom in 1915. Of the mothers who were delivered in hospitals relatively the fewest were among families of average earnings-—that is, between $650 and $849; in this group less than 6 per cent of the mothers went to a hospital. But in the families where the fathers earned nothing and in the families where the fathers earned at least $1,850, approximately 25 per cent of the mothers were delivered in a hospital. Midwife care was not so prevalent among the colored as among the white mothers in Baltimore. No one nationality group of white mothers— not even the native white women— showed quite so high a percentage of attendance by a physician as the colored mothers. O f the foreign-born groups, the Jewish mothers had relatively the largest number attended by a physician and the Polish mothers had relatively the fewest. Except among the native white mothers, with their comparatively large numbers in the upper earnings groups, these differences in the prevalence of medical care at confinement, in the several color and nationality groups, correspond with the differences in the numbers reached by prenatal care from the clinics. A considerable number of mothers had both a midwife and a phy~ sician in attendance. In 208 cases (5.3 per cent of all attended by midwives) a physician was called in during labor and the birth certifi cate was signed by the physician and in 93 cases (2.5 per cent of all delivered b y midwives) a physician was in attendance after the delivery. In addition, 287 mothers not attended by a midwife at confinement employed a midwife as nurse. Of the 29 mothers having neither physician nor midwife in attend ance at confinement, 5 had a physician after the delivery. r* fl https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 213 APPENDIX V I. T a b l e V I I .— Type o f attendant during confinement period, by nationality o f mother. Per cent attended during confinement period— Color and nationality of mother. B y physician. Total mothers.1 Total. Total................................................. 11,463 • 7,117 9Ô6 646 435 780 1,489 67.4 72.4 64.9 21.8 54.7 56.5 73.9 By Outside midwife. In of hospital. hospital. 9.5 57.9 32.4 8.1 23.8 2.9 2.3 6.9 H 5 64.4 41.1 18.9 52.4 50.6 60.4 27.4 35.0 77.6 44.8 42.8" 25.9 B y other and no attend ant. 0.3 .2 •1 .6 •5 .6 .2 i Includes only married mothers to whom children were bom in 1915. Visits by attendant during confinement period. The usual arrangement reported both in cases attended by phy sicians and in those attended by midwives was a daily visit through the fourth day and at least one visit thereafter. Seven-eighths of the physicians’ cases for which the arrangement of visits was reported and practically all the midwife cases fall into this group. The num ber of visits varied with the economic status of the family. When the fathers’ earnings were under $650, less than 10 per cent of the mothers saw the physician 10 times or oftener; when the fathers earned $1,850 or more, 40.3 per cent of the mothers saw the physician 10 times or oftener. Approximately 95 per cent of the mothers who were under the supervision of a physician during pregnancy and 37 per cent of those who had no prenatal care were attended by a physician at con finement. Nursing care. More than one mother in four had no professional nursing care. The greatest lack of such care appeared in the groups where fathers’ earnings were low among mothers who had been attended b y a private physician. The midwife usually gave nursing care to the mother whom she had delivered and such nursing care was the pre dominating type in families where the fathers earned less than $850. Among the families where the fathers earned $850 or more, the practical nurse was in attendance more commonly than the midwife. Only 3.5 per cent of all mothers were cared for by a resident trained nurse, and only in families where the father earned $2,850 or more was this type of care predominant. Care by a visiting nurse was reported by 4.8 per cent of the mothers. Among the foreign-bom Jewish mothers and the colored mothers the proportions cared for by a visiting nurse rose to 12.1 per cent and 11.6 per cent, but in both groups more mothers were nursed by midwives than by visiting nurses. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 214 T able IN F A N T MORTALITY, BALTIMORE, MD. V I I I .— Number o f visits received by mothers from physician follow ing delivery, b y ea rn in g s o f fa th er. Earnings of father. Per cent having Per cent3 having specified number of visits Per no from physician following delivery. cent Total visits not re moth from ported ers.1 physi as to cian fol visits. lowing de 10 and Not re Total. 1 4-9 2-3 livery. over* ported. Total............................. 9,867 36.7 57.0 0.4 2.1 30.4 15.6 as 6.3 No earnings........... . .............. Under $850............................. Under $450...................... $450-$549.......................... $550-$649.......................... $650-$849.......................... $850-$l, 849............................. $850-$l, 049...................... $1,050-$1,249................... $1,250-$l, 449................... $1,450-$l, 849................... $1,850'and over...................... $1,850-82,249................... $2,250-$2,849................... $2,850 and over............... Not reported.......................... 194 6,427 1,457 1,372 1,369 2,229 2,699 1,428 582 372 317 362 116 80 166 185 25.3 43.5 38.8 47.4 49.2 40.6 25.6 31.7 21.5 22.0 9.8 8.0 16.4 70.6 50.9 54.8 47.9 46.4 52.9 66.8 60.5 71.3 70.7 82.6 85.4 73.3 2.1 .5 1.0 .4 .2 .3 .3 .5 3.6 2.6 3.2 3.1 2.3 2.2 1.0 1.0 .9 .8 1.6 .6 .9 30.9 29.9 30.9 28.2 2a 6 31.1 33.2 32.7 39.2 31.5 26.2 la s 17.2 a2 10.7 a9 a2 9.2 14.5 24.5 20.7 24.1 26.9 40.1 40.3 25.8 7.1 10.8 2a 4 6.1 48 7.9 5.7 7.0 11.6 14.8 25.4 26.7 41 5.6 6.4 4.7 44 6.6 7.6 7.8 7.2 -7.3 7.6 6.6 10.3 2.4 31.9 91.6 5a 4 .6 .5 .6 1.6 18.7 29.2 47.0 15.7 247 11.4 6.0 9.7 .2 .3 ao 1Includes only mothers with no complications of confinement. In tabulation the following were in cluded as complications: Instrumental delivery, Caesarean section, convulsions, stillbirth, and miscarriage. * Not shown where base is less than 100. The period of nursing care 12was longest among the mothers having a resident trained nurse, but more than two-thirds of the mothers confined in a hospital and of the mothers employing a practical nurse had nursing care during two weeks or longer. Close to ninetenths of the mothers cared for by a visiting nurse had less than two weeks’ nursing care; 30.6 per cent of them were nursed for less than 7 days. Among the midwife cases, over half had care for less than 10 days; 4.5 per cent were nursed for less than 7 days. The period during which mothers stayed in bed was somewhat longer than the period during which they had professional nursing care. The usual time was from 10 to 13 days. It was shorter than this among the Poles and the Italians of whom 20 and 17 per cent, respectively, were up and about before the fourth day. But only in iamilies where the fathers earned at least $1,450 did hah the mothers with no reported complications of confinement stay in bed for 14 days or longer. Extra household help (usually given by a relative) was continued after the professional nursing had ceased and the mother was up and about. I t lasted in most cases from four to six weeks. Ninety mothers (0.8 per cent of all) had no help and 269 mothers (2.3 per cent of all) had help which lasted less than one week. u If the mother received more than one type of nursing care, the time during which the dominant type of care was received is here considered. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 215 APPENDIX V I. T able I X — Type o f nursing care1received by mothers, by earnings o f father. Earnings of father. Per cent having Total no Total. moth nurs ers.* ing. care.8 Total............... 11,463 No earnings.............. Under $850............... Under $450......... $450-$549............ $550-$649............ $650-$849............ $850-$l,849............... $850-$l,049......... $1,050-$l,249___ $1,250-$l,449___ $1,450-$l, 849___ $1,850 and over........ $1,850-$2,249___ $2,250-$2,849___ $2,850 and over.. Not reported............ 232 7,331 1,668 1,551 1,566 2,546 3,205 1,675 696 444 390 456 143 101 212 239 28.6 34.9 31.8 37.2 30.1 29.9 30.4 23.6 26.0 25.0 19.8 15.1 7.5 8.4 8.9 6.1 31.0 71.4 65.1 68.2 62.8 69.9 70.1 69.6 76.4 74.0 75.0 80.2 84.9 92.5 91.6 91.1 93.9 69.0 Per cent having specified type of nursing care. Trained nurse. Hos pital.4 9.5 26.7 8.0 11.8 9.0 7.0 5.5 9.1 6.7 8.5 12.4 17.2 25.9 29.4 25.7 23.6 15.1 Total. Resi dent. Visit ing.6 8.3 3.5 4.8 2.6 1.0 .4 .7 .4 1.9 5.6 3.6 4.7 7.0 13.8 28.9 14.7 25.7 40.1 5.0 8.2 6.6 10.6 9.0 5.4 3.3 1.2 1.7 1.0 .2 .3 .4 .7 i.0 10.8 7.6 11.0 9.7 5.9 5.2 6.7 5.3 5.7 7.2 14.1 29.4 15.4 26.7 40.1 9.2 4.2 Prac tical nurse. Not re ported. 34.4 18.7 0.5 21.6 41.0 35.9 44.2 45.7 39.4 24.5 30.1 21.1 22.0 9.0 7.2 14.0 6.9 2.8 28.9 4.7 11.3 4.0 .7 11.2 19.0 35.3 31.0 39.4 37.8 43.1 29.2 32.2 31.7 25.9 15.5 1.3 .4 .1 .4 .3 .6 .8 .8 .3 .7 1.5 .9 .7 Mid wife. 1.4 .4 1 In this table nursing care includes only care beginning within first three days after delivery. If two kinds of care were given, the first in order is given preference. a Includes only married mothers to whom children were bom in 19X5. ,. . * Includes 27 mothers who had nursing care only after the third day, and 126 for whom no information in regard to nursing care was secured. ............... .... . . , , .___ . .. f Includes 6 mothers not delivered in hospital, but taken to hospital within three days from delivery. In addition 25 mothers were taken to hospital later in confinement period. . . , 5 In addition, 13 mothers had care from visiting nurse after the third day; 10 of these had no professional nursing within three days, 1 had hospital nursing, 1 midwife, and 1 practical nurse. T able X .— Type o f nursing care1received by mothers, by color and nationality o f mother. Color and national ity of mother. Per cent Total having no moth nurs ers.2 ing. care.8 Per cent having specified type of nursing care. Trained nurse. Total. Hos pital.4 Total. Resi dent. Visit ing.6 Mid wife. Prac tical nurse. Type not re ported. Total............... 11,463 28.6 71.4 9.5 8.3 3.5 4.8 34.4 18.7 0.5 Foreign bom ___ Jewish......... 9,974 7,117 2,857 996 26.7 28.1 23.3 17.9 11 fi 43, 2 28.8 7.6 7.5 7.8 13.3 3.1 6.2 5.6 13.2 3.8 2.6 6.9 12.1 2.9 6.2 4.0 11.6 35.3 29.4 49.8 36.1 82.0 46.0 42.6 28.5 20.9 26.1 7.8 8.4 .3 2.3 16.4 3.6 .6 .7 .3 •4 780 1,489 8.9 8.1 11.0 23.9 2.9 2.3 5.9 13.6 3.8 4.9 .9 1.1 .2 All other___ Colored..................... 73.3 71.9 76.7 82.1 88.4 fifi 8 71.2 59.2 40.8 1.7 1.7 .6 .3 —-------- * 1 In this table nursing care includes only care beginning within first three days after delivery. If two kinds of care were given, the first in order is given preference. 2 Includes only married mothers to whom children were bom in 1915. * Includes 27 mothers who had nursing care only after the third day, and 126 for whom no information in regard to care was secured. . ....... 4 Includes 6 mothers not delivered in hospital, but taken to hospital within three days from delivery. In addition 25 mothers were taken to hospital later in confinement period. , .___ , 5 In addition 13 mothers had care from visiting nurse after the third day; lO of these had no professional nursing within three days, 1 had hospital nursing, 1 had midwife, and 1 practical nurse. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis ‘2 1 6 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . T a b l e X I .—Duration o f nursing care1 received by mothers, by color and nativity o f mother. J Native white mothers. Total mothers.2 Foreign-born white mothers. Colored mothers. Duration of nursing care.1 Per cent Per cent Per cent Number. distri Number. distri Number. distri Number. Per cent distri bution. bution. bution. bution. Total........................ With no nursing care *........... With care.................... Less than 7 days............ 7-9 days............................ 10-13 days......................... 14 days and over.............. Duration not reported__ 11,463 100.0 7,117 100.0 2,857 100.0 1,489 100.0 3,276 8,187 421 2,216 2,618 2,888 44 2a 6 71.4 3.7 19.3 22.8 25.2 .4 2,002 5,115 146 961 1,734 2,244 30 28.1 71.9 2.1 13.5 24.4 31.5 .4 666 2,191 183 942 601 459 6 23.3 76.7 6.4 33.0 21.0 . 16.1 .2 608 881 92 313 283 185 8 40.8 59.2 6.2 21.0 19.0 12.4 .5 r 4 Ï Â dS ? r ^ S S ° M ° “^ SCare0nlrafl“ tt6t“ das,’ “ dl28' » ' ' 1‘»“ “» “ ™ «»>>ta T a b l e X II.- -Number o f days mothers spent in bed or in hospital follow ing delivery by earnings o f father. Total mothers.1 Earnings of father. Per cent with specified number of days in bed or in hospital following delivery. Less than 1 Total___ 2 8,760 No. earnings__ Under $450___ $450~$649......... $650-8849......... $850-$1,049....... $1,050-$1,249... $1,250-$1,449... $1,450 and over Not reported.. 178 1,229 2,432 1,999 1,275 530 327 626 164 0.1 .2 (3) as comph^tions: instrumenta! delive?y, c Ä » Ä t Ä -3 n 4-6 7-9 14 and over. 10-13 3.4 4.6 24.2 45.1 22.7 5.6 6.2 5.3 2.5 1.5 .8 .3 .6 2.4 1.7 6.4 6.5 4.6 2.7 2.6 2.1 1.1 4.3 20.8 30.7 2& 0 25.7 19.1 20.0 16.2 9.3 2a o 41.6 35.1 41.4 49.4 53.8 52.1 55.0 39.0 40.9 30.3 21.4 18.6 17.8 22.8 24.5 26.3 50.0 23.8 s e c t i S Ä v ^ ^ Ä Ä l Ä S ^ ^ ep e r S r “ n0t reP°rted °r Wh° * * * Wlth0ut g e t - u p . T a b l e X I I I .— Number o f days mothers spent in bed or in hospital follow in g delivery, by color and nationality o f mother. Color and nationality of mother. Total mothers.1 Per cent with specified number of days in bed or in hospital following delivery. Less than 1 1-3 4-6 7-9 10-13 14 and over. Total......... 2 8,760 0.1 3.4 4.6 24.2 45.1 22.7 W hite................. Native......... Foreign bom Jewish... Polish. . . Italian... All other. Colored................ 7,621 5,363 2,258 789 521 343 605 1,139 ¿1 3.6 1.2 9.4 .8 19.8 16.6 7.6 1.8 4.9 2.3 11.0 1.9 19.4 26.5 6.8 2.5 22.9 19.9 -30.0 22.3 34.9 30.6 35.5 32.7 46.3 53.7 28.7 44.0 7.5 17.8 33.2 37.2 22.2 22.8 20.8 31.1 17.8 8.5 16.9 25.7 »nÄ S S C https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis (8) •1 .6 Ä S K T p ä S g " ° * “ i>or*ed « * * without getting up. 217 APPENDIX V I. T a b l e X I V .— Household help at confinement and place o f confinement, by color and nativity o f mother. Total mothers.1 Household help at confine ment and place of con finement. Native white mothers. Foreign-bom white mothers. Colored mothers. Percent Per cent Per cent Per cent Number. distri Number. distri Number. distri Number. distri bution. bution. bution. bution. Total............................. 11,463 100.0 7,117 100.0 2,857 100.0 1,489 100.0 At home.................................. Household help................ Adult......................... Child only.................. Laundry only............ No household help 2......... Away from home................... Not reported........................... 10,067 9,855 9,701 105 49 212 1,377 19 87.8 86.0 84.6 .9 .4 1.8 12.0 .2 6,297 6,163 6,084 49 30 134 808 12 88.5 86.6 85.5 .7 .4 1.9 11.4 .2 2,520 2,447 2,384 44 19 73 334 3 88.2 85.6 83.4 /—■L 5 .7 2.6 11.7 .1 1,250 1,245 1,233 12 83.9 83.6 82.8 .8 5 235 4 .3 15.8 .3 1 Includes only married mothers to whom children were bom in 1915. 2 Includes 122 cases where a practical nurse was employed. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis INFANT-WELFARE WORK. Organizations doing infant-welfare work. The principal infant-welfare work carried on in Baltimore in 1915 was done by the Babies’ Milk Fund Association, which conducted 12 (and from November, 1915, 13) infant-welfare centers. The association nurses were paying instructive visits to the mothers whose babies were less than 1. year of age and nursing sick babies under 3 years of age, and modified milk was dispensed in selected cases under the direction of a physician. Infants attended at birth by the obstetrician of the Babies’ Milk Fund Association and all infants attended by the outside obstetrical service of Johns Hopkins Hospital or born in the lying-in wards of Johns Hopkins were referred, n not in need of medical treatment) to the nurses of the Babies’ Milk Fund Association for supervision. Infants bom in other hospitals were less regularly referred to this organization. Many cases were reported to it*by charitable organiza tions. It was the aim of the association to have the nurse visit the mother immediately at the close of the confinement period, in order to give instruction in infant care, and continue her visits at least once a month throughout the first year of the baby’s life. After the baby was about a month old, the mother was expected to take him to the infant-welfare center for supervision by the physician. The mothers whose babies were receiving breast muk and no other food were urged to repeat these visits at least once a month. The mothers of babies artificially fed were encouraged to report at weekly intervals. The nurse’s visits at the home were continued even when the mother failed to take the baby to the infant-welfare center; but it was contrary to the rules of the association for the nurse to direct the feeding of a child who was to be weaned. The centers, again, gave advice about feeding for children who were well or had slight digestive disorders; they did not prescribe treatment for sick children but referred all such cases to the Harriet Lane Hospital or some other clinic for sick children. Nursing care was given, however, to sick children under 3 years of age. The Babies’ Milk Fund Association did not attempt to restrict its infant-welfare work to the very poorest families but as a matter of fact the poorest families predominated among these cases as they did among the prenatal cases. The policy of the Mothers’ Relief Society in relation to infant supervision was changed twice during 1915. During the first months of the year the baby was referred to the Babies’ Muk Fund Associa tion at the end of the confinement period. Later, the policy was followed of having the trained nurse of the Mothers’ Relief Society continue to visit the mother and instruct her in infant hygiene until the baby was 6 months old. In November the society decided to continue this visiting throughout the first year of infancy. The nurse paid a visit to the home at least once a month but the society had no infant-welfare center for supervision of well babies by a physician. Some of the artificially fed babies, however, were taken to the ' 218 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX V I. 219 society s physician, or^ to the Harriet Lane Dispensary or some other dime, for supervision of the feeding.13 Infants reached by infant-welfare work. Only the supervision and advice given by a physician to a mother visiting a,n mfant-welfare center with her baby for consultation, and home visits by a nurse to instruct the mother in the care of her baby are included in the term “ infant-welfare w ork” as used in the present study. Similar advice and supervision are given by private phy sicians or resident nurses in many well-to-doliomes, but no attempt was made to measure the extent of private supervision. Home visits by a nurse for the treatment or care of a baby in sickness or visits by a mother and baby to a hospital or dispensary for this pur pose are also excluded from consideration. Infant-welfare work had been carried on longer than prenatal work and naturally reached more of the families needing care. In all, 2,935 legitimate infants, or 28.2 per cent of those who survived two weeks, had been visited at least once by an infant-welfare nurse or had been taken at least once to an infant-welfare center for consultation. In the poorest families approximately one-half of the babies had such supervision— 48.8 per cent, where the fathers earned nothing, and 51.6 per cent, where the fathers earned less than $450. Com parison o f the several earnings groups shows a steady decrease in the proportion of infants reached by infant-welfare work as the fathers’ earamgs rise, but in each group below $850, from one-fourth to onehalt ot the babies had supervision by infant-welfare agencies. Where the fathers earned at least $1,850, 3.1 per cent of the babies had such supervision. T able X V . Prevalence o f supervision fro m infant-welfare agencies, by earnings offather. Infants who survive d 2 weeks. Earnings of father. Total. Having siipervision from infant-welfare agerLcies. Number. Percent.“ Total........................... No earnings..................... Under $850......... Under $450.............. $450-$549................ $550-$649............ $650-$849........... $850-$l,849............... $850-$l,049.......... $1,050-$1,249............... $1,250-$1,449.............. $1,450-$1,849................. $1,850 and over............... $l,850-$2,249................. $2,250-$2,849...................... Not reported.......................... 2,935 ........................................ 98 ............................................... .......................................... ............................................. OOo ............................................. ............................................. .................................................... ........................................ .......... ............................................ .............................................. .............. 48.8 35.4 13.9 3* 1 92 192 2 i 0.5 32.9 ° Not shown where base is less than 100. . 13 The work of the Harriet Lane Hospital, a children’s hospital connected with Johns Honkintf is not and^abies tlUS dlscussl0ri whlch 1Sconcerned primarily with the preventive and instructive care of mothers https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 220 IN FA N T MORTALITY, BALTIMORE, MD. As in prenatal work, the organizations had been more successful in reaching colored families and foreign-born Jewish families than any others. Nearly two-thirds (60.5 per cent) of the colored babies and nearly one-han (45.1 per cent) of the babies of foreign-bom Jewish mothers had supervision from welfare agencies. The actual number of infants who had such supervision was greatest among the native white families (1,302) but the total number of native white families was large and the percentage having care (20 per cent) was lower in this group than m any other. Even when families with similar earnings are compared, it appears that in each group except that in which fathers’ earnings were from $450 to $549 fewer infants, relatively, of native white mothers than of foreign-born white mothers had supervision from infant-welfare agencies. Among the Poles and Italians the agencies were more successful in reaching families where the mother could speak English than families where the mother could not speak English, but the reverse was true in the foreign-bom Jewish families. Two-thirds of the infants who had supervision at any time within 12 months after birth were still having it at the encf of the year. About 5 per cent died within the year; less than 1 per cent were dis charged to a private physician or transferred from one agency to another without further record of the case; about 6 per cent were dropped by the agency because the mother would not cooperate. But the principal loss of cases occurred in families that moved and were not followed to their new addresses; 18.8 per cent of the infants who had had supervision were not having it at the end of the year because their families had moved. T a b l e X V I .—Prevalence o f supervision from infant-welfare agencies, by color and nationality o f mother. Infants who survived 2 weeks. Color and nationality of mother. Total. Having supervision from infantwelfare agencies. Number. Per cent. 10,397 2,935 28.2 6,498 2,660 937 598 396 729 1,239 1,302 883 423 134 128 198 750 20.0 33.2 45.1 22.4 32.3 27.2 60.5 In every ward, as in the city as a whole, a higher percentage of colored than of white infants had supervision. The need of super vision was of course greatest in the poorest wards, but at the time of this study the work seems to have been more developed or more successful in finding response in certain poor wards than in others. In five of the six wards where the father’s median earnings were lowest the percentage having supervision was well above the average for the city (28.2), when all infants are considered together. But when the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 221 APPENDIX VI. white infants and the colored infants are considered separately two of these wards (second and seventeenth) did not show high percent ages having supervision. In the seventeenth ward, the number having supervision was 40.9 per cent of the total. But of the white infants in this ward only 7.9 per cent had supervision, as compared with the average, 23.9, for white infants, and of the colored infants, who comprised three-fourths of all the infants in the ward, only 53.3 per cent had supervision, as compared with the average, 60.5, for colored infants. In the second ward, where less than 2 per cent of the infants were colored and where very poor white families predomi nated, the percentage having supervision (23.2) was approximately the average for all white families, rich and poor, throughout the city. The white babies in the fifth ward had the highest percentage for white infants; 48.1 per cent of the total had supervision. T able X V I I .—Prevalence o f supervision from infant-welfare agencies, by color o f mother, and ward o f residence. Ward of residence and median earnings of father. Per cent1 of infants who sur vived 2 weeks having super vision from infant-welfare agencies. Total White Colored mothers. mothers. mothers. Median earnings under 1650: Ward 5....................................................................................................... Ward 22...................................................................................................... Ward 3...............................................................................i ....................... Ward 4........................................................................................................ Ward 17............................................................ ......................................... Median earnings #650-$849: Ward 18 ................................................................................................... Ward 21...................................................................................................... Ward 23...................................................................................................... Ward 24.................................................................................. ................... Ward 1............................................- ..................................................- ___ Ward 11...................................................................................................... Ward 8........................................................................................................ Ward 7 ...................... ............................................................................... Ward 19...................................................................................................... Median earnings #850 and over: Ward 12...................................................................................................... Ward 15...................................................................................................... 28.2 23.9 60.5 54.8 47.0 41.2 41.1 40.9 23.2 48.1 39.2 40.6 35.5 7.9 22.3 82.7 73.7 39.1 38.0 36.7 36.1 29.8 27.5 27.5 27.1 25.9 22.7 22.6 22.4 22.4 18.1 31.2 35.5 30.9 36.1 25.8 27.3 12.4 22.0 10.0 22.6 20.7 16.5 18.9 17.0 66.1 21.0 17.2 15.5 13.1 12.8 5.1 11.9 4.6 65.6 60.2 53.3 39.5 42.0 71.6 46.9 1 Not shown where base is less than SO. Of the 2,935 infants reached by infant-welfare work, more than half did not receive supervision regularly, but were taken to* the centers or were visited by the nurses only at irregular intervals. Over one-third, however, had each an average of a visit a month— either a visit from a nurse or a consultation at the center—from the time the supervision was commenced until the end of the year. And 120 babies, or 4.1 per cent of these reached by the infant-welfare work, had each an average of a visit from the nurse and a visit to the center during each month from the time the baby came under the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 222 IN FAN T MORTALITY, BALTIMORE, MD. supervision of the organization until the end of the year. Nine babies each averaged three or four visits a month, including at least one to the center and one home visit of the nurse in each month during the period from the commencement of care until the end of the first year. Of the total number of infants who were reached by infant-welfare work, over half, 55.8 per cent, were never taken to the infant-welfare center; 13.8 per cent were taken once; 14.7 per cent were taken from two to four times; 10.1 per cent were taken from 5 to 10 times; and only '5.3 per cent were taken more than 10 times during the year. The home visits b y the nurses were made more regularly and more frequently than the mothers’ visits with the baby to the center. In only 62 cases did the mother pay one or more visits to the center and have no home visits from the nurse. One-half the babies who were reached by infant-welfare work received supervision before the end of the first month, and more than one-third began receiving it during the second or third months. Over 80 per cent of all these infants who received supervision before the end of the third month were breast fed when it began, approxi mately the same proportion as in the entire group of babies in Balti more. But among the 392 babies whose supervision began at some time between the beginning of the fourth month and the end of the ninth month, artificial feedmg was markedly more prevalent than in the entire group of infants. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX Y II.— TABLES T a b l e 1 —Infant mortality rates in the United States birth-registration area, in certain foreign countries, in Baltimore (selected group) and certain foreign cities, and in cities (population 100,000 or more) in the United States birth-registration area, 1916. Infant mortality rate. Area. United States birth-registration area___ Countries with more favorable rates: Scotland.............................................. England and Wales........................... The Netherlands..................... .......... Switzerland............................. Australia............................................ N orw ay.............................................. New Zealand..................................... 101 97 91 85 W8 70 a64 51 Infant mortality rate. City. Baltimore (selected group).................... Foreign cities with more favorable rates: 103 100 89 86 83 80 73 68 65 59 58 55 W ellington........................................ Auckland............................................ Amsterdam........................................ Zurich............................................ CITIES IN UNITED STATES BIRTH -REGISTRATION A R E A .8 City. Infant mor tality rate. Fall River...................... Lowell............................. New Bedford............... . Scranton......................... Reading.......................... Baltimore....................... W hite....................... Colored..................... Lawrence....................... Pittsburgh...................... W hite...................... Colored.................... Buffalo........................... Detroit............................ 173 146 139 131 125 122 104 219 116 115 113 177 114 112 Infant mor tality rate. City. Providence..................... Bridgeport......... Washington................ W hite................... Colored................. Boston............................ W hite................ Colored..................... Philadelphia............... Colored................. Hartford......................... Infant mor tality rate. City. 110 106 106 83 158 105 104 193 105 102 160 101 68 100 1 Annuaire Statistique de la Suisse. 2 Compiled from Annuaire Statistique de la Norvège, 1919. 8 Birth Statistics, 1916, U. S. Bureau of the Census, T a b l e 2.—Legitimacy o f birth, inclusion in and exclusion from , and reason fo r exclu sion from detailed study; total registered births1 in Baltimore in 1915.2 Inclusion or exclusion, reason for exclusion, and legitimacy of birth. Total registered............................. Legitimate........................... Included in detailed analysis......... Excluded from detailed analysis.. Nonresident hospital cases......... Other nonresident cases............. Information not available........... Not located or moved from city................. Illegitimate...................... Legitimacy not reported (foundlings)....... Total births.1 Miscar riages. Still births. Infant deaths. Live births. 14,636 541 618 1,551 13,477 13,484 474 488 1,270 12,522 11,613 1,871 320 61 24 1,466 418 56 11 7 38 398 90 20 5 1 64 1,117 153 22 7 11 113 10,797 1,725 289 49 23 1,364 1,124 28 61 6 108 22 281 955 1Includes miscarriages. 2See Appendix II, p. 189, for discussion of exclusions. 223 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 224 T able 3.— W ard o f residence, by color and n a tion a lity o f m oth er; scheduled legitim ate live births in B altim ore in 1 9 1 5 .1 Live births. Ward of residence. Color and nationality of mother. Total. 10,797 White mothers...................................... 9,492 Jewish........................................ Polish........................................ 2 •3 4 5 6 790 620 627 215 396 596 649 8 9 10 11 598 496 331 145 12 13 14 15 16 If 18 19 20 21 22 23 409 449 289 598 417 252 269 381 606 447 261 351 605 24 609 616 174 317 544 577 576 465 305 74 348 443 130 468 332 68 204 331 591 407 203 319 605 78 6,739 558 259 2,753 228 350 538 49 275 961 7 625 168 279 115 4 133 412 16 8 1 18 318 70 104 59 258 180 366 178 124 432 145 27 527 49 5 428 37 214 91 39 53 322 26 41627 93 37 27 416 52 32 307 25 144 283 503 23 31 102 101 276 43 38 4 75 6 22 20 7 2 2 11 8 1 348 59 11 38 30 17 4 13 447 158 '4 42 5 80 3 5 Irish, English, Scotch, and English-Canadian.................. 786 Lithuanian............................... 2 1 2 132 107 100 98 3 4 1,305 ..... 2 è 8 36 2 1 6 14 21 1 11 11 41 2 1 24 ..... 79 52 1 21 20 6 3 65 3 19 ..... 1 9 15 ..... ‘-" 4 22 72 31 21 6 22 1 ‘ "2* 26 21 12 7l 3 20 3 32 4 7 6 15 . . . . . . . . . . . . . „ ...... "il‘ 2 10 6 65 50 15 2 3 4 7 3 '■■3 ' 3 5 18 1 8 8 5 5 ..... 20 8 61 6 159 184 85 130 24 6 2Ô 2 10 1 14 10 1 8 2 8 "¿è " 6 8 58 40 3 1 4 10 6 1 10 32 — • ' » 1 Allsubsequent tables, unless otherwise specified, are based on the scheduled group of legitimate births occurring in Baltimore during 1915. T able 4 — S a n ita ry con dition o f d w ellin g, by w ard o f residence; in fa n ts born in 1 91 5 who lived at least tw o weeks in dw ellings studied. Infants bom in 1915 who lived at least 2 weeks in dwellings studied. Ward of residence. Sanitary condi tion of dwelling. 2 3 4 5 6 7 Total......... 10,336 754 598 601 207 380 572 621 Water supply: City.............. 10,288 33 Well............. 754 597 1 601 207 380 572 621 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 570 484 317 137 394 434 266 577 405 228 257 361 573 431 250 341 570 476 6 317 ... 137 392 1 426 4 266 569 6 398 3 228 257 360 1 560 11 431 250 341 OO • t'» ■ HO • 1 OO t"»O Total. . 8 IN FAN T MORTALITY, BALTIMORE, MD. Total............................................. 1 101351°— 23- ! 2 9,994 144 187 715 27 12 566 25 7 560 38 3 200 7 374 4 2 569 3 6,111 4,215 10 318 436 128 469 1 99 500 2 92 115 139 241 373 199 497 123 1 7,960 472 582 279 14 592 205 364 517 8 2 16 55 3 2 1 619 2 569 1 2 2 387 3 2 2 408 1 23 2 262 4 1 1 3 1 563 5 8 1 393 466 3 15 314 3 512 56 2 395 89 194 122 1 89 48 337 57 257 177 212 54 495 .82 614 511 317 312 134 313 191 260 6 59 166 5 3 81 243 6 137 1 1 221 4 3 255 349 4 8 550 1 20 2 410 2 336 69 123 105 133 124 246 115 422 151 221 210 79 170 1 143 196 2 451 308 197 220 234 296 178 233 198 261 126 95 1 1 31 37 126 277 253 16 1 143 317 Bath................... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Bath............ 59.1 42.2 21.4 16.5 44.4 36.6 65.2 80.0 89.8 81.6 61.2 65.0 85.5 59.2 79.7 85.8 83.0 53.9 51.8 68.1 73.6 51.3 31.6 41.9 No bath....... 40.8 57.8 78.4 83.2 55.6 63.4 34.8 19.8 9.8 18.4 38.5 35.0 14.5 40.8 20.3 14.2 17.0 46.1 48.2 31.9 26.4 48.7 68.0 57.5.1 Not reported. .2 .4 .2 .6 .3 .3 .4 Sewer connec tio n ................ 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Toilet con nected....... 77.0 62.6 97.3 98.5 99.0 95.8 90.4 98.9 89.6 65.5 98.4 97.8 79.'4 440 97.7 78.2 76.0 86.4 85.6 64.8 51.7 41.3 93.2 58.1 Toilet not 4.2 2.2 20.6 56.0 connected. 22.9 37.0 1.3 1.0 9.6 1.0 10.4 34.3 1.6 2.3 21.8 23.5 13.6 14.4 349 48.3 58.7 6.4 41.9 2.3 No toilet___ .2 .4 .1 .2 .2 .2 Not reported. .4 .2 .3 .3 100.0 46.9 53.1 1 1 1 ii 1 21 242 5 3 310 4 27 555 1 19 3 271 307 1 Per cent distribution.1 100.0 45.2 54.8 APPENDIX VII. ---- TABLES. Spring........ No water___ Location of water: Dwelling___ Hall............. Yard. „ . . . No water___ Not reported Bath: Bath............ No bath____ Not reported. Sewer connec tion: Toilet con nected....... Toilet not connected. No toilet...... Not reported. 1Not shown when less than one-tenth of 1 per cent. 225 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 226 T a b l e 5 —Earnings o f father, by ward o f residence and color o f mother; live births in 1 9 1 5 . Live births in 1915. Earnings of father and color of mother Ward of residence. Total. 1 3 4 5 . 10,797 790 620 627 215 396 . 1,544 1,449 1,489 2,417 1,595 661 419 371 139 95 197 207 214 93 121 146 209 124 30 21 17 5 143 114 136 121 51 12 9 6 3 3 186 135 90 118 33 13 11 6 5 46 32 33 37 27 10 7 6 7 5 12 11 11 22 8 i 2 5 9 105 97 54 56 43 9 3 11 4 9,492 786 609 616 174 317 1,037 1,093 1,337 2,296 1,560 651 414 365 138 94 196 138 173 90 121 146 209 124 30 21 17 5 139 109 134 121 51 12 9 6 3 3 179 133 90 117 33 13 11 6 5 29 23 28 33 25 10 7 6 11 11 21 8 1 2 3 7 75 68 43 51 43 9 3 11 4 1 1 5 3 Colored mothers. 1,305 4 11 11 41 79 Earnings of father: Under $450............ $450-$549................ 507 356 3 4 5 7 2 17 9 30 29 Earnings of father: Under $450___ $450-1549.......... $550-$649.......... $650-$849.......... $850-$l,049........ $1,050-SI,249___ $1,250-11,449___ $1,450-$1,849___ $l,850-$2,249___ $2,250-$2,849___ $2,850 and over. No earnings___ Not reported... White mothers. Earnings of fathers: Under $450......... $450-$549............. $550-$649............. $650-$849............. $850-$1.049.......... $1,050-11,249........ $1,250-$1,449....... $1,450-$1,849....... $l,850-$2,249........ $2,250-$2,849....... $2,850 and over. . No earnings........ Not reported___ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 7 4 12 596 649 598 496 331 145 409 449 289 1 8 4 544 577 576 22 465 31 74 71 348 443 130 16 17 18 19 20 21 22 23 24 417 252 269 381 606 447 261 351 605 49 27 34 70 71 51 35 37 14 6 9 5 9 98 41 23 35 21 7 3 3 1 1 1 7 11 48 41 26 48 37 18 12 14 3 3 33 42 63 184 133 61 33 30 7 4 5 5 6 61 67 80 125 65 18 10 5 70 45 40 50 25 8 4 2 3 50 51 50 93 55 18 12 4 2 6 13 43 55 53 86 51 46 16 8 3 1 3 9 7 1 7 8 3 9 2 4 5 7 56 87 108 192 86 24 21 8 1 1 1 5 15 332 68 204 331 591 407 203 319 605 9 8 28 61 68 49 35 36 14 6 9 2 7 11 2 6 15 16 4 3 2 1 1 1 2 4 21 21 22 43 35 18 12 14 3 3 46 56 73 120 63 18 10 5 46 26 34 45 24 8 4 2 3 33 44 46 92 55 18 12 4 2 2 10 24 30 40 33 47 63 82 183 51 133 45 i 61 16 33 8 30 3 7 1 4 3 5 5 4 6 5 1 7 8 3 6 2 4 3 6 56 87 108 192 86 24 21 8 1 1 1 5 15 85 184 65 50 15 40 58 32 27 19 3 20 | 15 | 9 15 11 24 19 17 7 40 87 19 | 39 1 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . All mothers.. 2 2 $550-8649......... $650-8849......... $850-11,049....... $1,050-11,249... $1,250-81,449... $1,450-81,849... $1,850-82,249... 82,250-82,849... $2,850 and over No earnings... Not reported.. 1 5 4 2 11 5 9 5 10 5 5 6 3 4 4 2 2 5 5 2 2 2 21 19 7 4 2 1 6 i 13 5 9 5 2 2 1 1 2 1 2 1 7 2 1 1 4 1 3 18 12 2 1 1 1 6 9 6 9 3 2 17 20 5 3 1 1 3 2 5 7 4 5 2 6 4 1 7 5 2 6 5 1 4 1 3 2 1 1 4 3 4 1 1 1 Per cent distribution. Earnings of father: $450-8549.......................................... 8550-8649.......................................... 8650-8849.......................................... $850-81,049........................................ $1,050-81,249..................................... $1,250-81,449..................................... $1,450-81,849..................................... $1,850-82,249..................................... $2,250-82,849..................................... $2,850 and over................................ ,No earnings..................................... Not reported................................ 100,0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 14.3 13.4 13.8 22.4 14.8 6.1 3.9 3.4 1.3 .9 1.8 1.9 2.0 11.8 15.3 18.5 26.5 15.7 3.8 2.7 2.2 .6 .9 .6 1.5 23.1 18.4 21.9 19.5 8.2 1.9 1.5 1.0 .5 .5 29.7 21.5 14.4 18.8 5.3 2.1 1.8 1.0 .8 i. 8 1.8 3.5 1.3 21.4 14.9 15.3 17.2 12.6 4.7 3.3 2.8 .5 .9 2.3 4.2 26.5 24.5 13.6 14.1 10.9 2.3 .8 2.8 1.0 .3 .3 2.0 1.0 11.2 12.6 15.3 25.3 16.6 4.9 5.7 2.3 1.0 .7 1.0 1.5 1.8 8.8 11.1 13.9 25.6 19.4 7.6 4.5 2.6 .3 .3 1.1 3.1 1.8 8.2 10.9 13.9 27.9 18.2 8.0 4.7 3.2 .7 .5 1.0 1.7 1.2 6.7 8.3 10.1 21.8 25.2 10.3 4.4 5.8 2.4 .8 1.0 1.0 2.2 14.8 23.4 9.0 5.6 20.1 9.0 11.8 38.9 17.8 11.3 5.4 13.6 14.5 20.0 6.8 7.3 16.3 9.4 6.5 16.3 15.2 14.4 6.9 15.0 13.9 3.4 10.5 14.3 9.7 8.7 8.2 9.1 9.7 13.9 10.4 17.9 23.0 9.0 16.6 25.4 13.5 15.2 16.8 13.9 17.8 22.6 30.4 28.0 18.1 9.0 15.2 17.4 7.3 13.4 17.0 8.3 13.8 13.4 21.9 14.5 3.9 1.4 9.0 8.7 5.5 8.7 12.2 2.8 6.7 12.1 10.1 4.0 3.6 2.8 4.4 3.8 5.2 7.2 8.4 1.2 4.5 4.2 5.4 2.2 3.6 1.4 5.9 6.0 4.5 9.5 8.9 1.2 5.2 2.1 5.0 1.1 .8 1.2 ....... .4 1.1 .3 5.5 3.2 2.2 2.4 4.2 3.4 .7 .4 1.1 .3 .3 .7 4.2 1.6 2.4 4.7 1.4 .2 .8 .8 .4 . . . . . .6 13.1 9.8 6.5 4.5 6.2 2.2 .8 1.6 .9 5.5 1.5 1.2 2.8 2.2 2.4 3.0 2.8 2.7 .3 7.6 2.4 1.3 3.1 2.3 2.2 4.4 4.8 1.8 1.0 1.8 26.8 17.2 15.3 19.2 9.6 3.1 1.5 .8 1.1 1.1 3.4 .8 14.2 14.5 14.2 26.5 15.7 5.1 3.4 1.1 .6 9.3 14.4 17.9 31.7 14.2 4.0 3.5 1.3 .2 .2 .2 1.1 •8 1.4 2. 5 2.0 APPENDIX VII. ---- TABLES. All mothers___ u ..... ................... 227 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 228 T a b l e 6.— Monthly rental, by ward o f residence; infants born in 1915 who lived at least two weeks in rented dwellings studied. Infants who lived at least 2 weeks in dwellings of specified monthly rental. Ward of residence. Total infants. Under $5. $5, under $10. $10, under $15. $15, under $25. $25, under $50. $50 and over. Rental not • reported. Free. Total.......... 7,300 350 4.8 2,579 35.3 2,324 31.8 1,180 16.2 331 4.5 1............................ 2............................ 3 ........................... 4............................ 5 ............................ 6 ............................ 7__ : ..................... 8............................ 9 .. . . . . . . . . . . . . . . . 10.......................... 11.......................... 12................ . 13.......................... 14.......................... 15 ................«___ 16 ......................... 17.......................... 18.......................... 19.......................... 20......................... 21.......................... 22.......................... 23.......................... 24.......................... 429 462 501 181 318 341 296 393 274 256 118 268 329 202 356 247 193 215 274 388 346 215 289 409 69 119 65 1 10 2 5 1 3 1 1 2 11 2 6 1 2 1 3 3 11 5 5 21 16.1 25.8 13.0 .6 3.1 .6 1.7 .3 1.1 ' .4 .8 .7 3.3 1.0 1.7 .4 1.0 .5 1.1 .8 3.2 2.3 1.7 5.1 232 264 302 86 151 127 86 105 51 101 5 39 79 28 42 52 31 66 89 84 145 102 142 170 54.1 57.1 60.3 57.5 47.5 37.2 29.1 26.7 18.6 39.5 4.2 14.6 24.0 13.9 11.8 21.1 16.1 30.7 32.5 21.6 41.9 47.4 49.1 41.6 91 46 92 36 97 135 126 193 119 98 24 91 112 47 91 58 51 75 117 171 144 65 99 146 21.2 10.0 18.4 19.9 30.5 39.6 42.6 49.1 43.4 38.3 20.3 34.0 34.0 23.3 25.6 23.5 26.4 34. 9 42.7 44.1 41.6 30.2 34.3 35.7 20 12 7 21 37 53 51 76 82 36 35 57 67 49 115 92 71 36 42 112 21 24 31 33 4.7 2.6 1.4 11.6 11.6 15. 5 17.2 19.3 29.9 14.1 29.7 21.3 20.4 24.3 32.3 37. 2 36.8 16. 7 15.3 28. 9 6.1 11.2 10.7 8.1 2 1 3 13 1 1 6 3 5 3 23 45 26 45 74 28 18 3 13 9 2 1 1 .5 .2 .6 7.2 .3 .3 2.0 .8 1.8 1.2 19.5 16.8 7.9 22.3 20.8 11 3 ¿3 0.6 95 397 1.7 .4 2.2 4.7 2. 3 .6 .5 .3 • https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 44 1 .3 10 12 10 3 7 8.5 4.5 3.0 1.5 2.0 1 1 .5 1.3 .9 2.7 1.3 1.5 1.2 .8 1.9 2.4 2.0 .3 1.6 1.0 2.8 1.5 1.0 1.4 .5 1.0 1.5 5.4 3.5 2.6 6.0 11.0 5.7 5.9 4.4 2.5 3.6 5.5 16.1 6.3 4.9 11.9 5.6 4.9 9.3 10.7 2.2 1.3 5.2 7.4 2.8 8.1 IN FAN T MORTALITY, BALTIMORE, MD. Number. Per cent. Number. Per cent. Number. Per cent. Number. Percent. Number. Percent. Number. Percent. Number. Percent Number. Per cent APPENDIX VÌI.— PABUES. 229 T a b l e 7. — Tenure o f dw elling, by ward o f residence; infan ts bom in 1915 who lived at least tw o weeks m dwellings studied. Infants who lived at least 2 weeks in dwellings of specified tenure. Ward of residence. Total infants. Dwelling owned. Dwelling rented. Family boarding. Tenure not re Number. Percent. Number. Per cent. Number. Percent. ported. Total. 10,336 2,879 27.9 7,300 70.6 156 1.5 1.......... 2.......... 3 ..... 754 598 601 207 380 572 621 570 484 317 137 394 434 266 577 405 228 257 361 573 431 250 341 578 322 136 97 16 55 225 310 169 192 61 16 114 92 58 214 153 29 37 81 180 83 28 51 160 42.7 22.7 16.1 7.7 14.5 39.3 49.9 29.6 39.7 19.2 11.7 28.9 21.2 21.8 37.1 37.8 12.7 14.4 22.4 31.4 19.3 11.2 15.0 27.7 429 462 501 181 318 341 296 393 274 256 118 268 329 202 356 247 193 215 274 388 346 215 289 409 56.9 77.3 83.4 87.4 83.7 59.6 47.7 68.9 56.6 80.8 86.1 68.0 75.8 75.9 61.7 61.0 84.6 83.7 75.9 67.7 80.3 80.0 84.8 70.8 3 .4 3 10 7 6 15 7 18 .5 4.8 1.8 1.0 2.4 1.2 3.7 3 12 13 6 7 5 6 5 6 5 2 7 1 9 2.2 3.0 3.0 2.3 1.2 1.2 2.6 1.9 1.7 .9 .5 2.8 .3 1.6 4 ...... 5 6 ..... .... 1....... 8....... 9 .... 10 ..... 11.......... 12.......... 13 14 15 16 ..... .... ..... .... 17 .... 18 19 20 .... .... .... 24 .... 21......... 22......... 23 .... T a b l e 8 . — Tenure 1 1 o f dwelling, by color and nationality o f mother; infants bom in 1915 who lived at least two weeks in dwellings studied. Infants who lived at least 2 weeks in dwellings of specified tenure. Dwelling owned. Color and nationality of Total mother. infants. By parents. By others in household. Dwelling rented. Family boarding. Num- Per Num- Per Num- Per Num- Per Num- Per ber. cent. ber. cent. ber. cent. ber. cent. ber. cent. Total....................... 10,336 2,879 Native white.................... Foreign-born white.......... 6,464 1,991 2,649 814 27.9 2,367 ed. 22.9 512 5.0 7,300 70.6 156 1.5 1 30.8 1,541 23.8 30.7 785 29.6 450 29 7.0 4,351 1.1 1,820 67.3 68.7 121 15 1.9 .6 1 6 4 9 .4 1.0 10 2.9 73 5 7o! 9 7* 1 52Ì 9 1 •_8 3.0 1.0 1.1 4 Jewish........................ Polish......................... Italian........................ German...................... Irish, English. Scotch, and English-Canadian1...................... Bohemian.................. Lithuanian.............. All other.................... 931 597 394 308 241 174 97 144 25.9 29.1 24.6 46.8 127 101 96 95 33 74 20 31 26.0 73.3 20.8 32.6 32 71 19 30 25.2 70.3 19.8 31.6 1 3 1 1 Colored............................. 1,223 74 6.1 41 3.4 33 237 25.5 168 28.1 93 23.6 135 43.8 1Includes 93 Irish, 18 English, 8 Scotch, and 8 English-Canadian. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Tenure not 634 423 206 163 92 72T4 27 26.7 72 75.0 63 66.3 2.7 1,129 92.3 2 1.6 4 1 42 11 20 1.6 230 IN FAN T MORTALITY, BALTIMORE, MD. T a b l e 9 . — Tenure o f dwelling, by earnings o f father; infants bom in 1915 who lived at least two weeks in dwellings studied. Infants who lived at least 2 weeks in dwellings of specified tenure. Dwelling owned. . Earnings of father. Total infants. By parents. Total. B y others in household. Dwelling rented. Family boarding. Num Per Num Per Num Per Num Per Num Per ber. cent. ber. cent. ber. cent. ber. cent. ber. cent. Total....................... 10,336 2,879 Under $450........................ $450-8549........................... $550-8849........................... $850-81,249............ ........... $1,250-81,849...................... $1,850 and over................. No earnings...................... Not reported.................... 1,457 1,387 3,749 2,183 751 419 192 198 22.9 512 5.0 7,300 70.6 156 1.5 i 135 9.3 161 11.6 703 18.8 762 34.9 333 44.3 220 52.5 14 7.3 39 19.7 36 41 204 149 42 16 9 15 2.5 3.0 5.4 6.8 5.6 3.8 4.7 7.6 87.2 84.5 74.3 56.8 48.1 43.0 79.7 70.2 16 13 56 33 15 3 16 4 1.1 .9 1.5 1.5 2.0 .7 8.3 2.0 i 27.9 2,367 171 11.7 202 14.6 907 24.2 911 41.7 375 49.9 236 56.3 23 12.0 54 27.3 Ten ure not re port ed. 1,270 1,172 2,786 1,239 361 180 153 139 T a b l e 10. —Dwellings in building; infants bom in 1915 who lived at least two weeks in dwellings studied. Infants who lived at least2 weeksin dwell ings studied. Dwellings in building. Number. Per cent distribu tion. Total........................ 10,336 100.0 1......................................... 2......................................... 3......................................... 6,972 2 ,051 '812 67.5 19.8 7.9 Infants who lived at least 2 weeksin dwell ings studied. Dwellings in building. Number. 4...................... ‘5-9 Per cent distribu tion. 196 1.9 61 26 6 .3 T a b l e 11.— Color, nativity, and mother tongue o f ‘p opulation in Baltimore and in Con tinental United States, 1910} P o p u la tio n . C on tin en tal U n ite d S tates. B a ltim o r e . C olor, n a t iv ity , a n d m o th e r to n gu e . N u m b e r. P e r ce n t d istrib u t io n . P e r ce n t d istrib u tio n . T o t a l .................................................................................................... 558,485 100.0 100.0 N a tiv e w h ite : N a tiv e p a r e n ta g e ........................................................................................... F oreig n or m ix e d p a re n ta g e ....................................................................... 261,474 134,870 46.8 24.1 53.8 20.5 68,898 29,740 11,557 10,476 4,396 3,497 6,306 12.3 5.3 6.6 .8 .6 1.1 .3 .9 4.0 G e r m a n .................................................................................................. . E n glish a n d C eltic.................................................................................. Y id d is h a n d H e b r e w ............................................................................ P o lis h .......................................................................................................... B o h e m ia n a n d M o r a v ia n ..................................................................... Italian....................................................................................... A ll o th e r........... .......................................................................... F o re ig n -b o m w h it e ................................................................................ 2.1 1.9 7.3 .7 .8 77,043 13.8 14.5 4 .5 1.9 2.8 2.0 .6 3.0 3.7 A ll o th e r........................................................................................................... 25 104 1Ö'6Ö3 15,585 11 123 3 ,354 5 043 6*231 1.1 .9 1.5 4.0 O tfier co lo re d .......................................................................................................... 84,749 '349 15.2 .1 10.7 .5 E n glish a n d C e ltic ............................................................................ Y id d is h a n d H e b r e w .................................................................................... B o h e m ia n a n d M o r a v ia n ............................................................................ 1Thirteenth Census of the United States, Vol. I, pp. 125,207,998-1015. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1.1 1.0 .2 APPENDIX VII.— TABLES. 231 T a b l e 12.— Years o f residence o f mother in the United States, by nationality o f mother; births1 in 1915 to foreign-bom white mothers. B ir th s 1 in 1915 t o fo re ig n -b o r n w h it e m o th e rs o f specified n a tio n a lity . Years of residence of mother in the United States. Irish, Eng lish, Scotch, Bohe Lithua All and Eng- mian. nian. other.3 lishCanadian.2 Total. Ger births.1 Jewish. Polish. Italian. man. Total............................. Under 5.................................. 1........................ . ............. 2................................. 3....................................... 4....................................... 2,894 651 132 186 184 149 1,011 188 41 55 55 37 655 160 31 40 45 44 440 157 37 40 41 39 331 48 5 21 12 10 138 15 3 5 2 5 112 5-9.......................................... 10-14....................................... 15-19....................................... 20 and over............................. Not reported.......................... 792 601 303 535 12 294 258 113 155 3 174 114 73 132 2 126 79 45 33 67 59 23 130 4 24 32 25 40 2 105 22 4 8 7 3 - 102 49 10 14 17 8 32 23 10 34 1 51 18 8 6 24 18 6 5 12. 1 3 5 3 Per cent distribution. Total............................ Under 5.................................. 1....................................... 2....................................... 3....................................... 4................................ 100.0 22.5 4.6 6.4 6.4 5.1 100.0 18.6 4.1 5.4 5.4 3.7 100.0 24.4 4.7 6.1 6.9 6.7 100.0 35.7 8.4 9.1 9.3 8.9 100.0 14.5 1.5 6.3 3.6 3.0 100.0 10.9 2.2 3.6 1.4 3.6 100.0 10.7 .9 2.7 4.5 2.7 100.0 21.0 3.8 7.6 6.7 2.9 100.0 48.0 9.8 13.7 16.7 7.8 5-9.......................................... 10-14....................................... 15-19....................................... 20 and ov er............................ Not reported.......................... 27.4 20.8 10.5 18.5 .4 29.1 25.5 11.2 15.3 .3 26.6 17.4 11.1 20.2 .3 28.6 18.0 10.2 7.5 20.2 17.8 6.9 39.3 1.2 17.4 23.2 18.1 29.0 1.4 28.6 20.5 8.9 30.4 .9 48.6 17.1 7.6 5.7 23.5 17.6 5.9 4.9 1Includes miscarriages. 2Includes: 101 Irish, 19 English, 8 Scotch, and 10 English-Canadian. 3 Includes: 24 Russian, 19 Greek, 13 Magyar, 8 Norwegian, 6 Serbian, 5 French, 5 Slovak, 4 Rumanian, 4 Ruthenian, 3 French-Canadian, 3 Dutch, 2 Slavic (n. o. s.), 2 Spanish, 2 Swedish, 1 Arabian, and 1 Danish. T a b l e 13.— A bility to speak English, by literacy and nationality o f mother; births in 1915 to foreign-bom white mothers o f non-English-speaking nationalities. Births in 191, Literacy and nationality of mother. Total. Mothers able to speak English. Mothers not able to speak English. Number. Per cent.1 Number. Per cent.1 Foreign-born white mothers of non-English-speaking nationalities: Literate................................................................... Illiterate.................................................................. Jewish: Literate................................................................... Illiterate......................................................... Polish: Literate................................................................... Illiterate.................................................................. Italian: Literate.................................................................... Illiterate.......................................................... German: Literate.................................................................... Illiterate.................................................................. All other: Literate................................................................... Illiterate................................................................... 1Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1,920 777 1,417 227 73.8 29.2 503 550 26.2 70.8 814 176 697 112 85.6 63.6 117 64 14.4 36.4 354 288 187 47 52.8 16.3 167 241 47.2 83.7 228 196 107 38 46.9 19.4 121 158 53.1 80.6 306 21 272 8 88.9 34 13 11.1 218 96 154 22 70.6 64 74 29.4 IN FA N T MORTALITY, BALTIMORE, MD. 232 T a b l e 14.— A bility to speak English, by years in the United States and nationality o f mother; births in 1915 to foreign-bom white mothers o f non-English-speaking nation alities. Births to foreign-bom white mothers reporting specified number of years in the United States. 5-9. Under 5. Nationality of mother. Unable to speak English. Total. Total foreign-born white mothers of non-Eng lish-speaking nationalties......................... Num ber. Per cent.1 473 104 151 136 23 59 75.4 55.9 95.6 89.5 627 186 158 152 48 83 All other................................ 71.1 10 and over. Unable to speak English. Unable to speak English. Total. 755 288 171 124 67 105 Total. Num ber. 339 48 134 84 13 60 Num ber. Per cent. 1,310 514 312 150 208 126 449 16.7 78.4 . 67.7 19.4 57.1 245 30 123 61 11 20 Per cent. 18.7 5.8 39.4 40.7 5.3 15.9 1 Not shown where base is less than 50. T a b l e 15. — Literacy o f mother, by color and nationality o f mother and earnings o f father; births in 1915. Per cent1 of births to illiterate mothers. Color and nationality. Earnings of father. Foreign-born white. Total. Native white. Total... Under $450... $450-1549____ $550-$649____ $650-$849____ $850 and over. No earnings.. Not reported. 9.7 22.6 16.4 11.7 5.9 2.6 15.3 7.5 1.9 6.1 5,0 2.7 1.6 0.5 1.5 Total. Jewish. Polish. Italian. 27.5 43.1 37.5 29.6 17.8 11.8 50.9 21.6 17.8 26.2 27.5 19.0 11.8 8.8 44.8 54.3 48.9 45.6 31.0 32.2 46.0 62.3 51.6 40.0 30.6 29.5 Ger man. All other. 6.4 22.4 43.7 25.0 26.6 15.6 8.2 M w 6.6 5.3 2.1 Col ored. 12.2 14.2 10.9 14.6 10.4 4.8 9.5 1 Not shown where base is less than 50. T a b l e 16. — A bility o f mother to speak English, by earnings o f father and nationality o f mother; births in 1915 to foreign-born white mothers o f non-English-speaking nationalities. Per cent1 of births to mothers unable to speak English, among foreign-bom white mothers of specified nationality . Earnings of father. Total................................................... TTp^p.r $450 ........................................ .................................... $650-$849....................................................... 1 Not shown where base is less than 50. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis All nonEnglishspeaking nation alities. 39.1 57.6 45.7 43.1 32.5 18.9 48.1 30.0 Jewish. 18.4 33.8 18.3 17.4 16.7 9.1 Polish. 63.5 74.4 65.2 59.2 56.6 52.5 Italian. German. 66.0 77.0 67.7 62.0 54.1 55.7 14.4 26.2 14.7 5.2 All other. 44.6 66.2 33.8 20.0 T a b l e 17. — Occupation group1 o f father, by color and nativity o f mother; births in 1915, Births to mothers of specified color and nativity. Totalbirths. Foreign-bom white. Native white. Colored. Occupation group1 of father. Number. Per cent distribu tion. Number. Per cent distribu tion. Number. Per cent distribu tion. Number. Per cent distribu tion. 11,195 100.0 6,937 100.0 2,837 100.0 1,421 100.0 1,757 3,535 2,591 2,381 706 201 17 7 15.7 31.6 23.1 21.3 6.3 1.8 .2 .1 522 1,888 2,048 1,833 549 85 8 4 7.5 27.2 29.5 28.4 7.9 1.2 .1 .1 499 1,179 470 505 134 44 4 2 17.6 41.6 16.6 17.8 4.7 1.6 .1 .1 736 468 73 43 23 72 5 1 51.8 32.9 5.1 3.0 1.6 5.1 .4 .1 1 For grouping see p. 36. APPENDIX VII.— TABLES, Total................................................................................................................ Group I ...................................................................................................................... Group I I ..................................................................................................................... Group III................................................................................................................... Group I V ................................................................................................................... Group V ..................................................................................................................... No occupation........................................................................................................... Occupation not reported........................................................................................... Own income............................................................................................................... to CO CO https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 234 IN FA N T MORTALITY, BALTIMORE, MO. T a b l e 18.— Infant m ortality and stillbirth rates, by earnings o f father, and color and nationality o f mother; births1 in 1915. Miscarriages. Earnings of father and color Total and nationality of mother. births. Num ber. Per cent.2 Stillbirths. Births. Num ber. Live Infant births. deaths. Per cent.2 Infant mor tality rate.2 All mothers.................. 11,613 418 3.6 11,195 398 3.6 10,797 1,117 103.5 Earnings of father: Under $450...................... $450-$549.......................... $550-$649.......................... $650-8849.......................... $850-81,049....................... $1,050-81,249.................... $1,250-81,449.................... $1,450-81,849.................... $1,850-82,249.................... $2,250-82,849.................... $2)850 and over................ Nò earnings..................... Not reported................... 1,690 1,574 1,590 2,575 1,696 705 449 397 146 103 212 235 241 75 51 47 85 56 27 19 17 3 3 7 13 15 4.4 3.2 3.0 3.3 3.3 3.8 4.2 4.3 2.1 2.9 3.3 5.5 6.2 1,615 1,523 1,543 2,490 1,640 678 430 380 143 100 205 222 226 71 74 54 73 45 17 11 9 4 5 8 15 12 4.4 4.9 3.5 2.9 2.7 2.5 2.6 2.4 2.8 5.0 4.0 6.8 5.3 1,544 1,449 1,489 2,417 1,595 661 419 371 139 95 197 207 214 242 171 162 232 114 44 31 32 5 3 8 43 30 156.7 118.0 108.8 96.0 71.5 66.6 74.0 86.3 36.0 40.6 207.7 140.2 White mothers............ 10,104 330 3.3 9,774 282 2.9 9,492 910 95.9 Earnings of father: Under $450...................... $450-8549.......................... $550-8649.......................... $650-8849.......................... $850-81,049....................... $1,050-81,249.................... $1,250-81,449.................... $1,450-81,849.................... $1,850-82,249.................... $2,250-82,849.................... $2,850 and over............... Nò earnings.................... Not reported.................... 1,087 1,165 1.420 2,440 1,655 695 444 391 145 102 211 156 193 28 38 41 75 53 27 19 17 3 3 7 8 11 2.6 3.3 2.9 3.1 3.2 3.9 4.3 4.3 2.1 2.9 3.3 5.1 5.7 1,059 1,127 1,379 2,365 1,602 668 425 374 142 99 204 148 182 22 34 42 69 42 17 11 9 4 5 8 10 9 2.1 3.0 3.0 2.9 2.6 2.5 2.6 2.4 2.8 159 111 141 218 108 43 28 32 5 3 8 29 25 153.3 101.6 105.5 94.9 69.2 66.1 67.6 87.7 36.2 3.9 6.8 4.9 1,037 1,093 1,337 2,296 1.560 651 414 365 138 94 196 138 173 40.8 210.1 144.5 Native mothers........ 7,210 273 3.8 6,937 198 2.9 6,739 646 95.9 Earnings of father: Under $450...................... $450-8549.......................... $550-8649.......................... $650-8849.......................... $850-81,049....................... $1,050-81,249.................... $1,250-81,449.................... $1,450-81,849.................... $1,850-82,249.................... $2,250-82,849.................... $2,850 and over................ Nò earnings..................... Not reported................... 477 686 971 1,840 1,328 591 340 339 115 89 191 103 140 17 23 35 64 45 25 18 16 3 3 7 8 9 3.6 3.4 3.6 3.5 3.4 4.2 5.3 4.7 2.6 11 19 28 50 32 15 8 8 4 6 7 7 4 2.4 2.9 3.0 2.8 2.5 2.7 2.5 2.5 3.6 3.1 449 644 908 1,726 1,251 551 314 315 108 81 177 88 127 74 83 98 165 86 40 24 29 5 3 6 16 17 164.8 128.9 107.9 95.6 68.7 72.6 76.4 92.1 46.3 3.7 7.8 6.4 460 663 936 1,776 1,283 566 322 323 112 86 184 95 131 133.9 3.8 33.9 Foreign-born mothers 2,894 57 2.0 2,837 84 3.0 2,753 264 95.9 Earnings of father: Under $450...................... $450-8549.......................... $550-8649.......................... $650-8849.......................... $850-81,049....................... $1,050-81,249.................... $1,250-81,449.................... $1,450-81,849.................... $1,850-82,249.................... $2,250-82,849.................... $2,850 and over................ N ò earnings..................... Not reported................... 610 479 449 600 327 104 104 52 30 13 20 53 53 11 15 6 11 8 2 1 1 1.8 3.1 1.3 1.8 2.4 1.9 1.0 599 464 443 589 319 102 103 51 30 13 20 53 51 11 15 14 19 10 2 3 1 1.8 3.2 3.2 3.2 3.1 2.0 2.9 588 449 429 570 309 100 100 50 30 13 19 50 46 85 28 43 53 22 3 4 3 144.6 62.4 100.2 93.0 71.2 30.0 40.0 Italian.................... 440 14 3.2 426 14 3.3 412 36 87.4 Earnings of father: Under $450...................... $450-8549.......................... $550-8649.......................... $650-8849.......................... $850-81,049....................... 124 99 50 89 33 2 6 1.6 122 93 50 85 32 2 3 4 1 1 1.6 20 4 166.7 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 2 4 1 1 3 5 120 90 46 84 31 * Not shown where base is less than 100. 2 13 g 7 235 APPENDIX VII.---- TABUES. T able 18.— Infant m ortality and stillbirth rates, by earnings o f father, and color and nationality o f mother; births 1 in 1915—Continued. Stillbirths. Miscarriages. Earnings of father and color Total and nationality of mother. births.1 Num ber. Earnings of father—Contd. $1 050-41,249............ ....... $L250-$1,449. $1,450-11^849. . $1^850-$2'249.................... $2^250-82^849.................... Jewish.................... Earnings of father: Under $450...................... $450-8549.......................... $550-8649.......................... $650-8849.......................... $850-81,049....................... $1,050-81,249.................... $1^250-81^449.................... $l'450-$li849.................... $l'850-$2'249.................... $2^250-82,849.................... Polish.................... All other................ Earnings of father: Under $450...................... $450-$549.......................... $550-8649.......................... $650-8849.......................... $850-81,049............... ........ $1,050-81,249.................... $1,250-81,449.................... $1,450-81^849................... $l'850-$2'249.................... $2,250-82,849.................... Colored mothers.......... Earnings of father: Under $450...................... $450-8549.......................... $550-8649.......................... $650-8849.......................... $850-81,049....................... $1,050-81,249................... $1^250-81^449. . $1^450-81,849.................... jl'850-$2' 249. $2^250-82^849.................... Num ber. Infant Live Infant mor deaths. tality births. Per rate.2 cent.2 15 8 5 15 8 5 15 8 5 1 1 6 10 1 6 9 2 1 1,011 20 2.0 991 30 198 146 124 190 129 43 59 31 21 7 13 28 22 3 4 3 4 4 2 1.5 2.7 2.4 2.1 3.1 195 142 121 186 125 41 59 31 21 7 13 28 22 5 3 4 5 6 2 655 12 1.8 643 18 2.8 168 145 149 114 45 7 5 1 1 4 4 2 1 2.4 2.8 1.3 8.8 164 141 147 113 45 7 5 1 1 6 3 5 2 1 1 4.3 2.0 4.4 Earnings of father: $450-8549.......................... $550-8649.......................... $650-8849.......................... $850-81,049....................... $1,050-81,249.................... $1,250-81,449.................... $l'450-$lj849.................... $1,850-82,249.................... $2,250-82,849.................. Per cent.2 Births. 10 10 788 120 89 126 207 120 39 32 15 8 5 7 9 11 1,509 603 409 170 135 41 10 5 6 1 1 1 79 48 1 11 1.4 2 1 1 2 3 1.7 .8 1.0 2.5 1 1 88 5.8 47 13 6 10 3 7.8 3.2 3.5 7.4 4 10 9 777 118 88 125 205 117 39 31 14 8 5 7 9 11 1,421 1 4 8 1 1 3.0 961 49 51.0 2.6 2.1 3.3 2.7 4.8 190 139 117 181 119 41 57 31 21 7 12 27 19 11 3 8 13 3 1 1 1 57.9 21.6 68.4 71.8 25.2 625 102 163.2 164 135 144 108 43 6 4 1 1 34 15 22 14 10 207.3 111.1 152.8 129.6 10 9 755 4 2 77 114 85 122 197 116 38 31 13 8 5 7 9 10 1,305 20 6 10 19 9 2 2 2 i i 3 22 2.8 4 3 3 8 1 1 3.4 2.4 3.9 .9 1 1 116 556 3% 164 125 38 10 5 6 1 1 1 74 49 40 12 44 3 4 3 8.2 8.8 10.1 7.3 3.2 507 356 152 121 35 10 5 6 1 1 1 69 41 1 1In clu des m iscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 2N o t sh o w n w h ere hase is less th a n 100. 4 4 1 2 4 1 207 83 60 21 14 6 1 3 14 102.0 175.4 82.0 96.4 77.6 158.6 163.7 168.5 138.2 115.7 T a b l e 19.— Earnings o f father, by occupation; births m 1915. Births in 1915. Earnings o f father. Occupation of father. Total. $450$549 $550$649 $650$849 $850$1,049 L,050- $1,250- $1,4501,249 $1,449 $1,849 All occupations...... ............ ......................................... 11,195 1,615 1,523 1,543 2,490 1,640 687 Manufacturing and mechanical industries........................... 5,040 734 725 810 1,313 748 282 Blacksmiths............................. ..................... Boiler makers................................................. Builders and contractors....................................... Compositors, linotypers, and pressmen......................... Electricians and electrical engineers.............................. Factory operatives.......................................................... Metal........................................ ......................... clothing............................... .....................; ; ; ; ; ; ; ; ; ; W ood manufacturing......................................... ’ ’ ** Food canning............................................................ Other food manufacturing..................................... Textile............................................................... Other.........................t.............. Laborers, helpers, and apprentices (not in manufac turing)........................................................................... Machinists, millwrights and toolmakers.............. Manufacturers, proprietors, officials, etc........................ Shoemakers and cobblers (not in factory)..................... Skilled mechanics, building trades.......... ..................... Tailors.................................................................... Engineers and firemen...................................................[ Others in manufacturing and mechanica 1industries. . ! Trade....................................................... Bankers, brokers, real estate and insurance agents....... Deliverymen....................................... ........................... Laborers................................... ...... ! ! ! ! . ! i !! I ! Retail and wholesale dealers (officials, etc.).................. Salesmen and commercial travelers............................... ' Others in trade............................................. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 380 172 $1,850- $2,250- $2,850and $2,249 $2,849 143 33 100 No earn ings. Not re ported. 205 49 76 40 12 1,957 123 323 196 745 453 117 249 245 275 120 129 125 54 79 21 10 20 62 IN F A N T MORTALITY," BALTIMORE, Under $450 Transportation......................................................................... 1,792 Chauffeurs, teamsters, and expressmen.......................... Conductors, motormen. and trainmen............................. Express, post, telegraph, and telephone employees....... Laborers............................................................................ Proprietors, officials, and managers................................. Others in t r a n s p o r t a t i o n ........................................... 353 402 80 730 28 199 375 319 258 381 230 221 155 137 69 32 32 10 36 16 Clerical occupations................................................................. 25 Domestic and personal service................................................ 215 85 26 Public service.............................. .............................. ............. 319 18 33 APPENDIX V II. ---- TABLES. Barbers................................. ............................................ Janitors and elevator operators........ ........................ Proprietors and managers in hotels, pool rooms, etc___ Saloon keepers and bartenders......................................... Servants.................... ........................................................ Waiters........................................ ...................................... Others in domestic and personal service......................... 128 Firemen and policemen....... . ......................................... Laborers............................................................................ Officials and inspectors..................................................... Others in public service................................................. Professional and semiprofessional pursuits........................... 297 33 28 47 28 Agriculture, animal husbandry, and extraction of minerals. Farmers and farm workers.............................................. Fishermen...................... ............................. ..................... Quarrymen.......................................... .......... ................. Own income..................................... ....................................... No occupation................................................................ ......... Not reported............................................................................ 201 17 10 237 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis to T able 20.— Earnings o f father, by occupation group1 o f father and color and nativity o f m other; births m 1915. 09 00 Births in 1915. Occupation of father. Earnings of father and color and nativity of mother. Total infants. I and II Number. All mothers............ Earnings of father: Under $450................... $450-$549...................... $550-$649...................... $650-$849...................... $850-11,049................... $1,050-$1,249................ $i;250-$l,849................ Not reported............... Native white mothers Earnings of father: Under $450................... $450-$549...................... $550-$649...................... $650-$849...................... $850-$l,049................... $1,050-$1,249................ $1,250-$1,849................. $1,850 and over............ Not reported............... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis n I Per Per cent NumNumcent distriber. distriber. bution. bution. Per Numcent distriber. bution. in and IV Per Numcent distriber. bution. in V IV None. not reported, and own income. ! Per Per Per Per Per NumNumcent Numcent Numcent cent cent distridistridistriber. distriber. ber. distriber. bution. bution.2 bution.2 bution,2 bution.2 11,195 100.0 5,292 100.0 1,757 100.0 3,535 100.0 4,972 100.0 2,591 100.0 2,381 100.0 706 100.0 225 100.0 1,615 1,523 1,543 2,490 1,640 678 810 448 222 226 14.4 13.6 13.8 22.2 14.7 6.1 7.2 4.0 2.0 2.0 1,324 1,138 1,016 1,152 392 107 78 8 25.0 21.5 19.2 21.8 7.4 2.0 1.5 .2 684 459 299 225 44 9 4 38.9 26.1 17.0 12.8 2.5 .5 .2 640 679 717 927 348 . 98 74 8 18.1 19.2 20.3 26.2 9.8 2.8 2.1 .2 273 363 515 1.9 44 1.2 4.9 6.3 6.7 20.5 27.3 11.2 14.2 5.9 .3 2.6 15 19 12 51 93 73 185 237 4 17 2.1 2.7 1.7 7.2 13.2 10.3 26.2 33.6 .6 2.4 .4 33 117 151 159 488 650 266 339 140 8 63 1 1.5 6.0 8.2 13.7 30.8 19.5 9.0 8.0 2.4 .1 2.3 £3 1.3 77 156 212 356 798 505 232 208 63 2 59 3 3 1,155 . 498 547 203 10 122 5.5 7.3 10.4 25.9 23.2 10.0 11.0 4.1 .2 2.5 208 10 92.4 4.4 6,937 100.0 2,410 100.0 522 100.0 1,888 100.0 3,881 100.0 2,048 100.0 1,833 100.0 549 100.0 97 100.0 460 663 936 1,776 1,283 566 645 382 95 131 6.6 9.6 13.5 25.6 18.5 8.2 9.3 5.5 1.4 1.9 314 426 556 707 248 74 50 7 13.0 17.7 23.1 29.3 10.3 3.1 2.1 .3 119 126 129 113 22 3 2 22.8 24.1 24.7 21.6 4.2 .6 .4 195 300 427 594 226 71 48 7 10.3 15.9 22.6 31.5 12.0 3.8 2.5 .4 20 1.1 4 8 9 34 69 56 150 205 4 10 1.5 1.6 6.2 12.6 10.2 27.3 37.3 .7 1.8 1 2 Ì. 5 2.7 5.1 6.1 21.4 29.3 12.3 14.4 6.3 .1 2.2 .7 8 4.4 6.5 12.7 31.3 20.9 10.3 8.8 2.6 («) 2.3 50 94 111 393 537 226 264 116 1.2 3.6 5.8 9.6 26.6 24.9 11.2 11.5 4.4 .5 2,3 91 133 260 641 429 210 181 54 28 141 227 371 1,034 966 436 445 170 2 89 1,286 1 48 1 41 1 89 4 Foreign-bom white mothers............... Earnings of father: Under $450.................. $450-4549.................... . $550-1649.................... . $650-$849.................... . $850-$l,049................ . $1,05041,249................ $1,250-41,849................ $ 1,850 and over.......... . No earnings............... . Not reported............... Colored mothers___ 100.0 1,678 100.0 499 100.0 599 464 443 589 319 2 1.1 483 351 312 342 28.8 20.9 18.6 20.4 7.2 1.7 1.4 207 41.5 24.4 16.6 102 154 63 53 51 16.4 15.6 20.8 11.2 3.6 5.4 2.2 1 .9 1.8 121 29 24 1 122 83 64 14 '4 12.8 2.8 .8 .1 1,179 100.0 975 100.0 470 100.0 505 276 229 229 278 107 25 24 23.4 19.4 19.4 23.6 9.1 105 107 129 234 175 60 98 13.2 24.0 17.9 10.8 11.0 54 61 84 142 67 22 11.5 13.0 17.9 30.2 14.3 4.7 51 46 45 92 108 38 1 2 .1 2.0 A 33 6.2 .9 5 1.0 10 .8 7 27 2.8 6 1.3 ■7 21 100.0 43 421 100.0 1,204 100.0 736 100.0 468 100.0 116 100.0 73 556 396 164 125 38 39.1 27.9 11.5 527 361 148 103 23 4 4 43.8 3h 0 12.3 358 48.6 28.7 36.1 32.1 13.0 8 2 2 27 29 15 18 14 23.3 25.0 12.9 15.5 12 1.9 4 .3 169 150 61 55 15 4 1.7 3.4 3 34 2.8 1 6 J) 5.2 5 10 11 3 74 44 8.8 2.7 .7 .8 .2 5.2 3.1 1 For grouping see p. 36. 8.6 87 48 20 11.8 6.5 1 .1 .3 .3 2.7 11.8 2 2 3.2 .4 .4 14 3.0 2 1Not shown where base is less than 100. 12 .1 134 100.0 50 100.0 24 15 211 100.0 11 100.0 16 11 18 3 3 5 15 9 2 1 6.8 1 8Less than one-tenth o f 1 per cent. 78 100.0 A P P E N D IX V I I .— T A B L E S . Earnings of father: Under $450.................. $4504549...................... $5504649...................... $6504849...................... $85041,049................... $1,05041,249................ $1,25041,849................ $1,850 and over............ No earnings................ Not reported............... ,837 239 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis % 240 IN FAN T MORTALITY, BALTIMORE, MD. * T a b l e 21. — E stim ated m edian earnings o ffa th er, by occupation group o f father and color and n a tivity o f m other; births in 1915. Estimated median earnings of father.3 Color and nativity of mother. Occupation group of father.1 Total. Group TTT Native white. $705 489 610 786 923 1,513 ................................................................. Foreignbom white. $796 560 654 811 942 1,594 Colored. $618 483 585 696 855 1,219 $474 452 489 596 491 850 1 For grouping see p. 36. 2 For method by which median earnings are computed, see Appendix IV , p. 197. 3 Computations exclude cases of no occupation and cases in which earnings were not reported. T a b l e 22. — E arnings o ffath er, by regularity o f his em p lo ym en t, arid by color and nativity o f m other; births in 1 915. Births to mothers of specified color and nativity. Total births. Native white. Earnings of father and regu larity of employment. Foreign-born white. Colored. Per cent Percent Per cent Per cent Number. distri Number. distri Number. distri Number. distri bution. bution. bution. bution. Fathers employed throughEarnings of father: $450-$549........................... $550-$649........................... $650-$849........................... $850-$l,049........................ $1,050-11,249..................... Fathers not employed Earnings of father: $450-$549.................... $550-$649.............. $650-$849........................... $850-$l,049............ $1,050-41,249 Fathers’ employment not Earnings of father: S650-S849 . . . . https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6,524 100.0 4,548 100.0 1,318 100.0 658 100.0 298 654 832 1,619 1,265 1,180 12 110 4.6 10.0 12.8 24.8 19.4 8.5 18.1 .2 1.7 46 278 540 1,187 1,000 461 965 5 66 1.0 6.1 11.9 26.1 22.0 10.1 21.2 .1 1.5 73 143 192 347 239 83 203 6 32 5.5 10.8 14.6 26.3 18.1 6.3 15.4 .5 2.4 179 233 100 85 26 10 12 1 12 27.2 35.4 15.2 12.9 4.0 1.5 1.8 .2 1.8 4,639 100.0 2,365 100.0 1,517 100.0 757 100.0 1,317 869 711 870 375 124 78 210 85 28.4 18.7 15.3 18.8 8.1 2.7 1.7 4.5 1.8 414 385 396 588 283 105 62 90 42 17.5 16.3 16.7 24.9 12.0 4.4 2.6 3.8 1.8 526 321 251 242 80 19 14 47 17 34.7 21.2 16.5 16.0 5.3 1.3 .9 3.1 1.1 377 163 64 40 12 49.8 21.5 8.5 5.3 1.6 2 73 26 .3 9.6 3.4 32 24 2 6 1 31 1 23 2 6 APPENDIX VII.---- TABLES. 241 T a b l e 23.—Duration o f nonemployment, by earnings o f father, and by color and nativ ity o f mother; births in 1915. Births to mothers of specified color and nativity. Total births. Native white. Duration of nonemployment and earnings of father. Num ber. Per cent distri bution. Foreign-bom white. Colored. Num ber. Per cent distri bution. Num ber. Per cent distri bution. Num ber. Per cent distri bution.1 Total............................. 11,195 100.0 6,937 100.0 2,837 100.0 1,421 100.0 Employed entire year___ Nonemployed......................... 6,524 4,639 58.3 41.4 4,548 2,365 65.6 34.1 1,318 1,517 '46.5 53.5 658 757 46.3 53.3 Under 3 months............... 3 months, under 6 .......... 6 months and over.......... Period not reported......... 2,387 831 569 852 21.3 7.4 5.1 7.6 1,403 367 253 342 20.2 5.3 3.6 4.9 655 356 195 311 23.1 12.5 6.9 11.0 329 108 121 199 23.2 7.6 8.5 14.0 Employment not reported. . . 32 .3 24 .3 2 .1 6 .4 Under $450........................... 1,615 100.0 460 100.0 599 100.0 556 100.0 Employed entire year............ Nonemployed........................ U nder "3 months............... 3 months, under 6............ 6 months and over........... Period not reported......... 298 1,317 359 386 285 287 18.5 81.5 22.2 23.9 17.6 17.8 46 414 100 121 125 68 10.0 90.0 21.7 26.3 27.2 14.8 73 526 109 183 116 118 12.2 87.8 18.2 30.6 19.4 19.7 179 377 150 82 44 101 32.2 67.8 27.0 14.7 7.9 18.2 $450-$549.............................. 1,523 100.0 663 100.0 464 100.0 396 100.0 Employed entire year............ Nonemployed....................... U nder 3 months............... 3 months, under 6............ . 6 months and over.......... Period not reported......... 654 869 479 180 39 171 42.9 57.1 31.5 11.8 2.6 11.2 278 385 235 76 16 58 41.9 58.1 35.4 11.5 2.4 8.7 143 321 152 84 21 64 30.8 69.2 32.8 18.1 4.5 13.8 233 163 92 20 2 49 58.8 41.2 23.2 5.1 .5 12.4 100.0 936 100.0 443 100.0 164 100.0 540 396 273 64 9 50 57.7 42.3 29.2 6.8 1.0 5.3 192 251 161 38 3 49 27.5 56.7 36.3 8.6 .7 11.1 100 64 44 5 1 14 61.0 39.0 26.8 3.0 .6 8.5 $550-$649.............................. 1,543 Employed entire year............ N onemployed......................... Under 3 months............... 3 months, under 6............ 6 months and over........... Period not reported_____ 832 711 478 107 13 113 $650-$l,049......................... . 4,130 100.0 3,059 100.0 908 100.0 163 100.0 Employed entire year............ Nonemployed......................... U nder 3 months............... 69.8 30.1 21.9 3.3 .4 4.6 2,187 871 657 91 9 114 1 71.5 28.5 21.5 3.0 .3 3.7 586 322 208 46 7 61 64.5 35.5 22.9 5.1 .8 6.7 111 52 39 68.1 31.9 23.9 Period not reported_____ Employment not reported... 2,884 1,-245 904 137 16 188 1 13 8.0 $1,050 and over.................... 1,936 100.0 1,593 100.0 319 100.0 24 Employed entire year______ 1,734 202 155 13 1 33 89.6 10.4 8.0 .7 .1 1.7 1,426 167 132 10 89.5 10.5 8.3 .6 1.6 89.7 10.3 6.9 .6 .3 2.5 22 2 1 1 25 286 33 22 2 1 8 U nder~3 months............... 3 months, under 6............ 222 226 1Not shown where base is less than 100. 101351°— 23------16 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 53.9 46.1 31.0 6.9.8 7.3 95 131 53 51 74 44 242 INFANT MORTALITY, BALTIMORE, MD. T a b l e 24.— Came o f nonemployment o f father, by color and nativity o f mother; births i n 1915. Births to mothers of specified color and nativity. Total births. Native white. Cause of nonemployment of father. Foreign-bom white. Colored. Percent Percent Percent Percent Number. distri Number. distri Number. distri Number. distri bution. bution. bution. bution. Total............................. 11,195 100.0 6,937 100.0 2,837 100.0 1,421 Employed throughout year.. Nonemployed at some time during year......................... 6,524 58.3 4,548 65.6 1,318 46.5 658 46.3 4,639 41.4 2,365 34.1 1,517 53.5 757 53.3 Work not available......... Illness............................... Other reasons.................. 3,625 721 293 32.4 6.4 2.6 1,802 424 139 26.0 6.1 2.0 1,248 223 46 44.0 7.9 1.6 575 74 108 40.5 5.2 7.6 Employment not reported. . . 32 .3 24 .3 2 .1 6 .4 100.0 T a b l e 25.—Duration o f unemployment o f father, by color and nativity o f mother; births in 1915 in fam ilies with fathers unemployed became work was not available. Births in families with fathers unemployed because work not available. Color and nativity of mother. Total. Native white. Duration of unemployment of father. Per cent dis tribution. Foreign-born white. Per cent dis tribution. Per cent dis tribution. Colored. Per cent dis tribution. In Ex Num In Ex Num In Ex Num In Ex Num clud clud clud ber. clud clud ber. clud clud ber. ing clud ing ing ing ber. ing ing ing ing not not not not not not not not re re re re re re re re port port port port port port port port ed. ed. ed. ed. ed. ed. ed. ed. 3,625 100.0 759 Duration reported............... 2,866 Under 3 months............ 1,983 54.7 3 months, under 6......... 660 18.2 6 months, under 9......... 175 4.8 9 months, under 12....... 34 .9 14 .4 12 months...................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1,802 100.0 20.9 303 79.1 100.0 1,499 69.2 1,135 23.0 276 6.1 68 1.2 14 .5 6 1,248 100.0 575 100.0 16.8 83.2 100.0 274 974 22.0 78.0 100.0 182 31.7 393 68.3 100.0 63.0 15.3 3.8 .8 .3 567 293 90 19 5 45.4 23.5 7.2 1.5 .4 58.2 30.1 9.2 2.0 .5 281 48.9 91 15.8 17 3.0 1 .2 3 .5 71.5 23.2 4.3 .3 .8 75.7 18.4 4.5 .9 .4 APPENDIX VII.---- TABLES. 243 T a b l e 26.—Source o f fam ily income, by earnings o f father; births in 1915. Births in 1915 in families where earnings of father were— Total................ Under $850................. Under $450.......... $450-$549.............. $550-$649.............. $650-$849.............. 11,195 6,175 7,171 3,672 1,615 422 1,523 723 1,543 908 2,490 1,619 222 226 7 3.2 83 36.7 425 3.8 1,105 9.9 284 4.0 820 11.4 77 4.8 442 27.4 55 3.6 176 11.6 3.9 60 91 5.9 92 3.7 111 4.5 763 6.8 381 5.3 82 5.1 77 5.1 78 5.1 144 5.8 542 288 108 58 51 15 8 14 15.2 17.6 15.9 13.5 13.4 10.5 8.0 6.8 103 2.9 58 3.5 22 3.2 15 3.5 5 1.3 3.8 3.4 4.6 2.6 5.8 352 9.8 123 7.5 44 6.5 55 12.8 36 9.5 4.0 2.4 11 11.0 55 26.8 38 69 17.1 30.5 28 12.6 10 4.4 2 2.0 1 .5 136 56 31 11 22 7 4 5 109 49.1 40 17.7 17 14 7.7 6.2 Per cent. Per cent. 22.6 26.2 32.8 30.3 25.1 20.2 Number. Insurance, invest ments, Other tenants income. outside, or rents. Number. Per cent. Meals, gifts. Number. Per cent. Number. Percent. 55.2 2,531 51.2 1,881 26.1 529 47.5 462 58.8 387 65.0 503 $850 and over............ 3,576 2,413 67.5 $850-$l,049........... 1,640 1,098 67.0 $1,050-$1,249........ 678 470 69.3 $1,250-$1,449........ 430 288 67.0 380 $1,450-$1,849........ 263 69.2 $l,850-$2,249........ 143 92 64.3 100 $2,250-$2,849........ 75 75.0 $2,850 and over... 205 127 62.0 No earnings............... Not reported.............. Number. Earnings of mother or Sources children included or both, in family but with earnings1 no other only. sources. Per cent. Total births. Earnings of father. Number. Sole source ofincome. 187 1.7 132 1.8 63 3. 9 29 1 9 19 1.2 21 .8 27 17 3 3 2 .8 1.0 Source not reported. Not sole source of income but supplemented by 9 1 1 .... 3 .7 .5 1 1 .5 2 22 6 9.9 2.7 1 4 1 In family earnings, besides earnings of father, mother, and children, are included income from tenants m home, earnings of foster parents, grandmothers, and aunts, pensions, compensation allowances, and alimony. ’ T a b l e 27.—Source o f fam ily income, by fam ily earnings; births in 1915. Births in 1915 in families where family earnings were— Not sole source of income, but supplemented by— Family earnings.1 Total births. Sole source of income. Num ber- Per cent. Meals or gifts. Insurance, in Source vestments, ten Other income. not re ants outside, ported. or rents. Num ber. Per cent. Num ber. Per cent. 9.9 13.3 33.6 13.6 9.9 5.8 763 362 67 59 81 155 6.8 5.5 5.7 4.5 5.3 6.0 187 100 26 21 19 34 1.7 1.5 2.2 1.6 1.3 1.3 9 2 Num ' Per ber cent. T otal.............. 11,195 Under $850............... 6,585 Under $450......... 1,185 $4o0— $ 5 4 9 ........ 1,309 $550-649.............. 1,518 $650-$849______ 2,573 9,131 5,249 694 1,051 1,268 2,236 81.6 . 1,105 79.7 874 58.6 398 80.3 178 83.5 150 86.9 148 $850 and over______ $850-$l,049......... $1,050-11,249....... $1,250-$1,849....... $1,850 and over.. 4,208 1,776 879 1,034 519 3,601 1,552 770 884 395 85.6 87.4 87.6 85.5 76.1 159 67 37 39 16 3.8 3.8 4.2 3.8 3.1 374 132 54 90 98 8.9 7.4 6.1 8.7 18.9 72 25 18 21 8 1.7 1.4 2.0 2.0 1.5 2 No earnings.............. Not reported............ 40 362 11 270 27.5 74.6 21 51 52.5 14.1 8 19 20.0 5.2 15 4.1 7 U n family earnings, besides earnings of father, mother, and children, are included income from tenants m home, earnings of foster parents, grandmothers, and aunts, pensions, compensation allowances, and alimony. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 244 IN FAN T MORTALITY, BALTIMORE, MD. T a b l e 28.—Earnings o f father as sole source offam ily income, by amount o f his earnings ana color and nativity o f mother; births in 1915. Births in families where earnings of father were sole source of income.1 Native white mothers. Earnings of father. Number. Foreign-bom white mothers. Colored mothers. Per cent Per cent Per cent of total Number. of total Number. of total births.2 births.2 births.2 Total................................................... 4,611 66.5 1,277 45.0 287 20.2 Under $450.................................................... $450-$549....................................................... $550-$649....................................................... $650-$849....................................................... $850-11,049.................................................... $1,050-$1,249.................................................. $i;250-$l'449.................................................. $1,450-$1,849.................. .............................. $l,850-$2,249.................................................. $2j250-$2,849.................................................. 149 411 626 1,281 928 420 235 240 80 65 116 2 58 32.4 62.0 66.9 72.1 72.3 74.2 73.0 74.3 71.4 199 214 229 312 154 46 50 18 12 9 10 5 19 33.2 46.1 51.7 53.0 48.3 45.1 48.5 74 98 53 26 16 4 3 5 13.3 24.7 32.3 20.8 No earnings........................................ ......... Not'reported................................................ 63.0 44.3 i 1 6 1 For total births in each color and nativity' and father’s earnings group, see Table 17, p. 233. 2Not shown where base is less than 100. T a b l e 29.— Fam ily earnings, by earnings o f father; births in 1915. Births in families where father earned specified amount. Total births. $550-$849 $850-$l,249 $1,2501,849 $1,850and over. 2,494 4,091 2,655 1,034 519 40 362 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 22.3 2,345 36.5 625 23.7 90 9.2 26 4.6 3 .4 3.2 49 74.7 19.9 3,455 2.9 452 .8 66 .1 14 1.6 46 85.7 11.2 2,109 1.6 167 .3 22 1.1 20 91.0 7.2 .9 .9 810 100.0 770 95.1 30 3.7 10 1.2 448 100.0 446 99.6 2 .4 No earnings. Per cent dis tribution. Number. Number. Per cent dis tribution. Per cent dis tribution. Number. Per cent dis tribution. Number. Per cent dis tribution. Number. Per cent dis tribution. Number. Total............... 11,195 100.0 3,138 100.0 4,033 100.0 2,318 100.0 Under $550............... $550-$849................... $850-$l,249................ $1,250-SI,849...... : . . . $1,850 and over........ No earnings.............. Not reporfed............ Not reported. Under $550 Family earnings. 222 226 147 2 il 3 i 3 2* 4 40 14 221 APPENDIX VII.— TABLES. 245 T able 30.—Earnings o f mother, by color and nativity; births 1 in 1915 to mothers employed within year after birth o f infant. Births 1 in 1915 to mothers employed within year after birth. White mothers. Colored mothers. Total. Earnings of mother during year after birth of infant. Total. Native. Foreign bom. Num ber. Per cent dis tribu tion. Num ber. Per cent dis tribu tion. Num ber. Per cent dis tribu tion. Num ber. Per cent dis tribu tion. Num ber. Total........... .. 3,354 100.0 2,321 100.0 1,237 100.0 1,084 100.0 1,033 100.0 Under $50............. $50-$149............... $150-$249....... ......... $250-$349.............. $350-$549................. $550 and over........... No earnings.............. Not reported............ 645 1,048 639 258 146 41 4 573 19.2 31.2 19.1 7.7 4.4 439 587 387 18.9 25.3 16.7 9.0 5.5 1.7 231 303 238 153 87 28 3 191 18.7 24.5 19.2 12.4 7.0 2.3 208 281 149 57 41 19.2 26.2 13.7 5.3 3.8 206 461 252 48 18 19.9 44.6 24.4 4.6 1.7 15.7 334 30.8 45 4.4 210 128 39 3 528 1.2 .1 17.1 .1 22.7 .2 11 1.0 2 1 Per cent dis tribu tion. .2 .1 1 Includes miscarriages. T able 31. Monthly rental, by color and nationality o f mother; infants bom in 1915 who lived at least two weeks in rented dwellings studied. Infants who lived at least 2 weeks in dwellings studied. Foreign-born white mothers. A PI O 08 © *3 Monthly rental. O 03 M § -03 AO aA fl Total. 7,300 4,351 1,820 Under $5.............................- 350 123 $5, u n d e rg o ......................... 2,579 1,375 $10, under $15......................2,324 ",553 $15, under $20...................... 905 599 $20, under $25...................... 275 163 $25, under $35...................... 250 158 $35, under $50.................. 81 73 $50 and over........ ................ 44 4Ó Free................. 95 70 397 Not reported..................... 197 203 909 416 89 23 14 6 4 5 151 684 11 314 206 38 13 5 4 296 165 229 7 3 163 92 27 72 63 13 182 66 14 1,129 24 295 355 217 89 78 2 1 2 90 20 Per cent distribution.1 T otal.... Under $ 5 ...... $5, under $10.. $10, under $15. $15, under $20. $20, under $25. $25, under $35. $35, under $50. $50 and over... Free.............. . Not reported.. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 4.8 2.8 11.2 1.6 39.0 4! 4 2.5 35.3 31.6 49.9 45.9 54.1 61.5 35.6 31.8 35.7 22.9 30.1 1.7 22.3 44.2 12.4 13.8 4.9 5.6 .7 4.7 5.5 3.8 3.7 1.3 1.9 1.2 3.4 3.6 .8 .7 .2 .3 .6 1.1 1.7 .3 .6 .6 .9 .2 .1 : ,6 1.3 1.6 .3 .3 .2 .6 5.4 4.5 8,3 13.2, 4.0 6.8 9.2 ...... 1 Not shown where bas eis less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 100.0 2.1 26.1 31.4 19.2 7.9 6.9 .2 1 ft 4.3 246 IN FA N T MORTALITY, BALTIMORE, MD. T a b l e 32.— Monthly rental, by earnings o f father; infants bom in 1915 who lived at least two weeks in rented dwellings studied. Infants bom in 1915 who lived at least 2 weeks in dwellings studied. Earnings of father. 323 196 165 54 41 85 555 324 102 30 19 1 71 487 390 83 16 17 53 587 664 206 42 27 1 13 184 385 206 43 25 1 2 16 52 57 19 21 1 24 46 56 7 46 7 82 4 55 1 43 114 88 30 26 1 1 1 18 Ó 05 Ö5^ 33 ¿SS io <£> 1 27 7 24 37 33 29 17 3 1 6 5 5 13 10 5 2 7 2 7 14 5 1 4 2 16 28 29 15 9 4 5 Not re ported. No earn-1 ings. 916 105 624 300 89 42 39 1 Under $5......... 350 $5, under $10.. 2,579 $10, under $15. 2,324 $15, under $20. 905 $20, under $25. 275 $25, under $35. 250 $35, under $50. 81 $50 and ov e r.. 44 Free................ 95 Not reported.. 397 Under $450. Total__ 7,300 1,270 1,172 1,117 1,669 Total. $2,250$2,849 100.0 $1,850$2,249 Total___ 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 $1,450$1,849 42 6 8 28 35 10 9 8 3 1 9 28 $1,250$1,449 139 12 46 28 11 2 3 3 $1,050$1,249 153 $850$1,049 85 $650$849 $2,850 |and over.] Monthly rental. Per cent distribution.1 Under $5......... 4.8 $5, under $10.. 35.3 $10, under $15. 31. 8 $15, under $20. 12.4 $20, under $25. 3.8 $25, voider $35. 3.4 $35, under $50. 1.1 .6 $50 and o v e r.. Free................ 1.3 Not reported.. 5.4 8.3 49.1 23.6 7.0 3.3 3.1 .1 7.3 47.4 27.6 8.7 2.6 1.6 .1 6.4 43.6 34.9 7.4 1.4 1.5 3.2 35.2 39.8 12.3 2.5 1.6 .1 1.9 3.6 4.8 .6 4.1 .4 4.9 1.4 .3 20.1 13.3 42.0 35.3 22.5 27.2 4.7 9.3 2.7 8.0 .1 .3 .3 .4 .3 6.0 5.6 1.0 8.2 26.5 29.1 9.7 10.7 .5 .5 13.8 7.8 30.1 18.3 7.2 1.3 2.0 2.0 4.2 14.5 22.4 20.0 17.6 10.3 1.8 27.5 3.9 9.1 5.8 20.1 25.2 7.2 6.5 5.8 2.2 .7 6.5 20.1 1 Not shown where base is less than 100. T able 33.— Estimated median rental, by estimated median earnings o f father and by color and nationality o f mother; births in 1915. Annua rental. Color and nationality of mother. Foreign-bom white................................................................................ German...................... ............................................................. Irish, English, Scotch, and English-Canadian....................... Bohemian.................................................................................. Median annual earnings of father.1 Median amount.8 $706 $132 18.6 796 619 141 102 17.7 16.5 664 555 540 619 115 70 101 119 17.3 12.6 18.7 19.2 718 781 703 525 671 130 159 95 95 108 18.1 20.4 13.5 18.1 16.1 474 156 32.9 Per cent of median earnings. i Based on births, except for Irish, English, Scotch, and English-Canadian, Lithuanian, Bohemian, and “ all other” foreign which are based on issues. 8 Based on infants living at least 2 weeks in dwellings studied. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 247 APPENDIX VII.— TABLES. T able 34.—Sanitary arrangements o f dwelling, by color and nationality o f mother and earnings o f father; infants bom in 1915 who lived at least two weeks in dwellings studied. Infants who lived at least 2 weeks in dwellings with specified sanitary arrangements. Color and nationality o'f mother and earnings of father. All arrangements.1 Total infants. None. Other dwellings. Number. Per cent. Number. Per cent. Number. Per cent. All earnings groups: All mothers.......................... 10,336 4,486 43.4 351 3.4 5,499 53.2 Native white................. Foreign-bom white....... 6,464 2,649 3,273 816 50.6 30.8 190 126 2.9 4.8 3,001 1,707 46.4 64.4 Jewish...................... Italian..................... Polish...................... A llother.................. 931 394 597 727 389 80 35 312 41.8 20.3 5.9 42.9 11 9 71 35 1.2 2.3 11.9 4.8 531 305 491 380 57.0 77.4 82.2 52.3 Colored........................... Earnings offather under $650: All mothers.......................... 1,223 397 32.5 35 2.9 791 64.7 4,272 1,081 25.3 234 5.5 2,957 69.2 Native white................. Foreign-bom white....... 1,913 1,409 556 236 29.lt 16.7 111 91 5.8 6.5 1,246 1,082 65.1 76.8 Jewish...................... Polish...................... Italian..................... All other.................. 432 424 243 310 107 20 30 79 24.8 4.7 12.3 25.5 7 52 8 24 1.6 12.3 3.3 7.7 318 352 205 207 73.6 83.0 84.4 66.8 Colored........................... 950 289 30.4 32 3.4 629 66.2 1Dwellings having “ all arrangements” have bath and toilet connected with sewer, and reserved for xclusive use of family. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis T a b l e 35.— Number o f persons in household, by number o f rooms in dwelling, and by color and nativity o f mother; infants born in 1915 who lived at least two weeks m dwellings studied. to oo Infants bom in 1915 who lived at least 2 weeks in dwellings studied. Number of rooms in dwelling. Number of persons1in household and color and nativity of mother. Total. Number of persons in household: 1. . . 2 3. 4 .. . 5 6 7 .. . 8 9 .. 10 11 12 . 13 ... 14 ... 15.. 16 ... 17 ... 18. 19 . 20 10,336 42 731 1,404 1,297 1,130 3,585 11 1,882 1,931 1 720 1,563 1 142 ^866 559 322 186 100 44 29 5 6 1 3 2 i 1 22 4 25 8 i 3 1 2 307 201 104 69 29 10 7 1 568 362 224 126 58 43 22 2 5 246 297 249 184 153 90 51 20 4 2 3 446 619 641 658 471 334 200 107 59 25 10 5 1 8 9 10 884 677 286 163 49 94 142 158 119 111 83 59 32 16 9 7 1 1 1 24 60 82 91 96 88 81 64 32 33 9 5 2 2 6 23 34 44 36 41 36 23 20 11 7 4 2 1 White mothers............................. 9,113 27 674 1,355 1,148 Number of persons in household: 1 2 . 3 4 5 6 7 ......... 8........................................................ 8 1,730 l ' 789 l'539 \ 375 972 700 447 2 17 2 283 181 99 66 27 9 6 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1 145 249 197 195 142 105 53 26 12 1 3 7 5 2 1 1 557 346 214 117 56 42 22 229 267 210 162 135 78 44 1 3 12. 32 17 22 21 14 8 15 5 6 4 1 1 11 12 13 47 34 22 3 2 6 7 4 7 4 3 4 4 1 3 3 5 7 2 6 3 2 .3 4 3 2 4 3 1 1 1 14 16 15 13 5 1 1 2 1 4 1 1 1 1 1 1 1 1 1 1 1 1 1 , 7 1 1 1 1 1 1 1 1 1 1 1 1 1 2 6 1 1 976 3,239 714 506 221 132 39 29 20 13 5 1 134 217 171 174 117 82 47 48 85 123 134 96 78 60 23 56 59 74 72 56 57 6 23 33 35 24 30 27 3 12 31 13 19 19 10 3 2 6 6 3 6 2 1 3 2 4 7 1 1 1 2 1 4 1 1 2 4 3 2 3 2 427 491 586 582 412 284 166 6 1 1 5 1 1 Not re ported. 22 19 18 1 4 1 1 1 1 6 1 1 1 6 1 1 1 1 1 1 IN FAN T MORTALITY, BALTIMORE, MD. All mothers.................................. 2 3 4 6 1 259 147 76 27 17 3 4 1 2 1 1 15 Native mothers...................... Number of persons in household: 19 11 1 2 93 54 23 8 5 41 27 12 4 4 1 1 53 21 23 6 1 2 16 11 8 6 1 9 3 1 4 3 1 272 154 77 24 13 2 1 1 1 4 732 691 692 2,671 206 82 30 12 6 2 179 190 120 84 62 32 16 7 1 1 115 178 121 129 70 46 19 8 3 1 1 15 1 376 501 498 496 331 224 123 59 35 15 5 4 2,649 1 4 3 2 3 1 1 1 1 1 4 — ......................... — 467 95 54 19 1 1 1 1 194 116 37 26 17 13 5 21 6 23 28 34 21 28 23 10 7 7 5 1 2 11 28 11 18 15 9 5 6 3 1 3 3 2 6 6 3 5 2 3 ' 3 2 1 3 2 4 6 1 4 1 2 1 1 2 1 . 4 1 1 i 2 4 3 2 3 2 49 65 58 46 38 39 16 18 3 1 1 1 402 623 457 284 568 145 99 13 2 129 104 75 53 25 8 6 163 140 132 87 44 36 20 50 77 90 78 73 46 28 11 4 1939 50 45 47 36 28 ii 8 51 90 88 86 81 60 43 34 19 8 3 6 ii 14 31 18 17 16 17 9 4 2 5 10 9 14 10 19 14 1 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 3 3 3 1 The number of persons in household does aot inc lude infants born in 1915. 1 407 18 1 1 1 1 42 74 109 103 78 61 44 24 18 8 4 4 27 16 1 5 3 5 1 3 2 4 6 4 1 1 1 1 3 2 1 4 1 1 2 1 1 1 1 1 i 1 1 1 6 1 1 1 1 1 1 -4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 3 1 1 3 Number of persons in household: m 1 1 569 1 1 9 3 3 3 1 1 2 Foreign-bom mothers........... 6 9 3 1 3 1 6,464 1*320 l'072 QR2 065 470 282 164 93 57 18 4 1 1 2 1 1 1 2 250 T able 35.— Number o f \persons in "household, by number o f rooms in dwelling, and by color and nativity o f mother; infants bom in 1915 who lived at least two weeks in dwellings studied—Continued. Infants bom in 1915 who lived at least 2 weeks in dwellings studied. Number of rooms in dwelling. NAmber of persons1in household and m color and nativity of mother. Total. Number of persons in household—Con. 13.. 14.............. 15 .. 20. Number of persons in household: 1.................... .......... .................... 2 . . . ............................................. 3 4. 5 6 ... 7 8 .. 9 .. 10 11 12 13 14 15*.. 16 17 2 3 4 2 1 2 1 6 8 7 1,223 15 3 92 142 181 188 170 166 112 63 39 24 17 12 2 2 1 2 7 2 8 3 1 1 1 2 171 65 31 1 9 19 24 23 33 23 18 5 4 5 3 1 1 4 23 17 24 32 24 11 11 10 3 4 1 9 12 11 9 7 9 3 1 3 1 4 3 2 4 2 6 2 5 1 1 149 154 346 24 20 5 3 2 1 1 11 16 10 9 2 1 17 30 39 22 18 12 7 2 11 32 26 21 25 23 6 7 1 1 19 28 55 76 59 50 34 14 5 2 2 1 1 1 1 1 11 12 13 14 15 16 18 19 22 Not re posted. 1 170 49 2 10 1 1 1 57 1 9 1 1 1The number of persons in household does not include infants bom in 1915. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6 5 1 2 8 5 i 1 1 2 1 1 1 1 1 2 2 1 1 1 1 2 2 3 1 IN FAN T MORTALITY, BALTIMORE, MD. 1 T able 36.—Average number o f persons per room, by size o f household and color and nationality o f mother; infants born in 1915 who lived at least two weeks in dwellings studied.1 Infants who lived at least 2 weeks in dwellings studied. Foreign-bom white mothers. Native white mothers. xoiai. Average number of persons per room and number of persons in household.1 Number of persons per room: Number of persons per room: Number of persons per room: Households of number not reported. Polish. Colored mothers. Italian. Per Per Per Per Per Per Per Per cent Num Num cent cent Num cent Num cent Num cent Num cent Num cent distri distri ber. ber. ber. distri distri distri distri distri ber. ber. ber. distri ber. bution. bution. bution. bution. bution. bution. bution. bution. 10,336 100.0 6,464 100.0 2,649 100.0 931 100.0 597 100.0 395 100.0 726 100.0 1,223 100.0 5,544 4,269 498 25 53.6 41.3 4.8 .2 4,108 2,237 107 12 63.6 34.6 1.7 .2 882 1,418 343 6 33.3 53.5 12.9 .2 342 506 83 36.7 54.4 8.9 68 345 183 1 11.4 57.8 30.7 .2 107 230 55 '3 27.1 58.2 13.9 .8 365 337 22 2 50.3 46.4 3.0 .3 554 614 48 7 45.3 50.2 3.9 .6 5,484 100.0 3,691 100.0 1,375 100.0 506 100.0 314 100.0 175 100.0 380 100.0 418 100.0 72.9 3,999 24.6 1,347 138 . 2.5 3,020 640 31 81.8 17.3 .8 689 596 90 50.1 43.3 6.5 273 218 15 54.0 43.1 3.0 59 189 66 18.8 60.2 21.0 72 97 6 41.1 55.4 3.4 285 92 3 75.0 24.2 .8 290 111 17 69.4 26.6 4.1 4,830 100.0 2,764 100.0 1,268 100.0 425 100.0 282 100.0 217 100.0 344 100.0 798 100.0 1,545 2,922 360 3 32.0 60.5 7.5 .1 1,088 1,597 76 3 39.4 57.8 2.8 .1 193 822 253 15.2 64.8 20.0 69 288 68 16.2 67.8 16.0 9 156 117 3.2 55.3 41.5 35 133 49 16.1 61.3 22.6 80 245 19 23.3 71.2 5.5 264 503 31 33.1 63.0 3.9 22 100.0 9 100.0 6 100.0 1 100.0 3 100.0 2 100.0 7 100.0 . APPENDIX VII.— TABLES. Num ber. Jewish. Total. i The number of persons in household does not include infants bom in 1915. 251 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 252 IN F A N T MORTALITY, BALTIMORE, MD. 37.—Average number o f persons per room, by earnings o f father and color and nativity o f mother; infants born in 1915 who lived at least two weeks in dwellings studied. T able Infants who lived at least 2 weeks in dwellings studied. Average number of persons1 per room and earnings of father. Native white mothers. Total. Foreign-born white mothers. Colored mothers. Nuin- Per cent distribdtion. Num- Per cent distri bution.* Num- Per ceni distri bution.* Num- Percent distri bution.2 All earnings groups___ 10,336 100.0 6,464 100.0 2,649 100.0 1,223 100.0 Persons per room: Less than 1....................... 1 or more.......................... 5,544 4,767 53.6 46.1 4,108 2,344 63.6 36.3 882 1,761 33.3 66.5 554 662 45 3 54.1 1 but less than 2 ........ 2 or more................... 4,269 498 41.3 4.8 2,237 107 34.6 1.7 1,418 343 53.5 12.9 614 48 50 2 ¿9 Not reported.................... 25 .2 12 .2 6 ,2 7 .6 Under $550.................... 2,844 100.0 1,041 100.0 995 100.0 808 100.0 Persons per room: Less than 1....................... 1 or more.......................... 1 but less than 2........ 2 or more.................... 994 1,840 1,555 285 35.0 64.7 54.7 10.0 441 599 551 48 42.4 57.5 52.9 4.6 206 785 581 204 20.7 78.9 58.4 20.5 347 456 423 33 42 9 Not reported.................... 10 .4 1 .1 4 .4 5 .6 $550-1849........................ 3,749 100.0 2,527 100.0 963 100.0 259 100.0 Persons per room: Less than 1....................... 1 or more.......................... 1 but less than 2 ........ 2 or more................... 1,905 1,836 1,682 154 50.8 49.0 44.9 4.1 1,456 1,066 1,025 41 57.6 42.2 40.6 1.6 321 641 535 106 33.3 66.6 55.6 11.0 128 129 122 7 47 1 Not reported................... 8 .2 5 .2 1 .1 2 .8 $850-$l,249..................... 2,183 100.0 1,745 100.0 397 100.0 41 100.0 Persons per room: Less than 1....................... 1 or more.......................... 1 but less than 2 ........ 2 or more.................... 1,509 671 644 27 69.1 30.7 29.5 1.2 1,283 460 452 8 73.5 26.4 25.9 .5 200 196 177 19 50.4 49.4 44.6 4.8 26 15 15 36 6 52’ 4 4.1 4Q 4 2 .7 63 4 Not reported.................... 3 .1 2 .1 1 .3 $1,250 and over............. 1,170 100.0 951 100.0 205 100.0 14 100.0 Persons per room: Less than 1....................... 1 or more.......................... 1 but less than 2 ........ 2 or more................... 958 209 201 8 81.9 17.9 17.2 .7 824 124 119 5 86.6 13.0 12.5 .5 122 83 80 3 59.5 40.5 39.0 1.5 12 2 2 35 7 47 100.0 64 100.0 Not reported.................... 3 .3 3 .3 No earnings................... 192 100.0 81 100.0 Persons per room: Less than 1....................... 1 or more................ ......... 1 but less than 2........ 2 or more................... 67 125 108 17 34.9 65.1 56.2 8.9 31 50 47 3 11 36 27 9 Earnings not reported.. 198 100.0 119 100.0 42 Persons per room: Less than 1....................... 1 or more.......................... 1 but less than 2 ........ 2 or more.................... 111 86 79 7 56.1 43.4 39.9 3.5 73 45 43 2 61.3 37.8 36.1 1.7 22 20 18 2 Not reported.................... 1 .5 1 .8 1 The number of persons in household does not include infants bom in 1915.. 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 14 3 25 34 5 100.0 37 16 18 3 100.0 .— 253 APPENDIX V II.-----TABLES. T able 38.— Total number o f births 1 to mother, by earnings o f father and color and nativity o f mother; single births in 1915. Per cent of births in 1915 to mothers re porting specified number of total births.1 Earnings of father and color and nativity of mother. 1-3 All mothers.............................................................. 4-6 7-9 10 and over. 62.9 23.5 9.5 4.1 Earnings of father: Under $550..:........................................................................... $550-$849................................................................ $850-$l,249.......................................................... $1,250-SI ,849............................................................ $1,850 and over.................................................... No earnings................................................ Not reported..................................; ......................... 54.9 63.5 68.1 68.8 75.3 62.0 65.3 26.5 23.7 21.1 21.8 17.4 25.0 22.5 12.9 9.2 7.3 6.5 5.7 8.8 7.7 5.8 3.7 3.4 2.9 1.6 4.2 4.5 Native white mothers........................................................... 69.4 20.8 7.1 2.7 Earnings of father: Under $550................................................................ $550-$849................................................................ $850-$l,249....................................................................... $1,250-$1,849......... .......................................... $1,850 and over.......................................................... No earnings......................................................... Not reported............................................................................. 63.7 68.3 71.0 72.9 79.9 71.0 69.8 21.9 22.0 19.9 19.6 15.0 18.3 22.5 10.6 7.3 6.4 4.9 3.7 8.6 5.4 3.8 2.5 2.8 2.6 1.3 2.2 2.3 Foreign-born white mothers................................................. 52.3 28.4 13.3 5.9 Earnings of father: Under $550................................................................... $550-$849........................................................................ $850-$l,249..................................................................... $1,250-$1,849............................................................... $1,850 and over.............................................................. No earnings................................................................. Not reported............................................................................. 48.9 54.4 56.0 51.9 45.9 52.9 61.2 30.1 27.3 26.3 30.5 32.8 25.5 22.4 '14.9 12.6 11.3 13.0 18.0 9.8 12.2 6.2 5.7 6.4 4.5 3.3 11.8 4.1 Colored mothers.................................................................... 52.2 27.5 13.0 7.3 Earnings of father: Under $550................................................................................ $550-$849...................................................................... $850 and over..................................................... No earnings.................................................................. Not reported......................... ..........'.................................... 51.4 50.5 64.3 56.9 56.8 27.7 27.0 . 23.2 33.3 22.7 13.3 14.6 8.9 8.3 9.1 7.6 7.8 3.6 1.4 11.4 1Includes miscarriages. T able 39.— Total number o f births 1 to mother, by nationality o f mother; births 1 in 1915 to foreign-born white mothers. Per cent of births1 to brothers reporting specified number of total births.1 Nationality of mother. 1-3 Foreign-born white mothers: Jewish................................................................................ Polish............................................................... Italian..................................................................... All other.................................. .................... 1Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 53.3 45.2 45.9 56.3 4-6 29.1 29.3 34.5 25.1 7 and over. 17.6 25.5 19.5 18.5 254 IN F A N T MORTALITY, BALTIMORE, MD. T able 40.—Keeping o f lodgers, by color and nationality o f mother; infants born in 1915 who lived at least two weeks in dwellings studied. Per cent of infants1 whose mothers kept specified number of lodg ers. Color and nationality of mother. 1 or more. 3 or more. 8.4 0.9 6.5 12.2 .5 1.7 8.7 11.1 18.3 14.2 .8 .5 4.8 2.1 8.8 16.5 7.9 22.9 26.3 .3 1.6 2.1 10.5 10.3 1.3 1Infants who lived at least two weeks in dwellings studied. T able 41.— Mother pregnant within year after birth o f infant, by color and nationality o f mother; live births in 1915. Live births in 1915. Color and nationality of mother. Total. To mot! lers pregnant vrithin the year fa lowing. Number. Per cent. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 10,797 1,563 14.5 6,739 2,753 840 460 12.5 16.7 961 625 412 755 90 144 118 108 9.4 23.0 28.6 14.3 1,305 263 20.2 APPENDIX VII.---- TABLES. 255 T able 42.— Type o f feeding, by month o f life, and by earnings o f father and color and nativity o f mother; infants born in 1915 to native white and colored mothers not employed within year after birth. • Infants whose mothers were not employed and who had specified type of feeding. Month of life of infant, earn Total ings of father, and color and infants. nativity of mother. Breast feeding. Num ber. Per cent. Mixed feeding. Num ber. Artificial feeding. Type of feeding NumPer not re ber. cent. ported. Per cent. NATIVE "WHITE MOTHERS. Earnings of father under $550: Second month................. Third month.................... Sixth month...-............... Ninth month................... Earnings of father, $550 and over: Second month................. Third month............: ___ Sixth month.................... Ninth month.................... 975 923 831 759 770 663 431 218 79.1 71.8 51.9 28.7 56 79 174 309 5.7 8.6 21.0 40.7 4,998 4,846 4,626 4,495 3,868 3,405 2,443 1,393 77.4 70.3 42.8 31.0 224 275 684 1,437 4.5 5.7 14.8 32.0 757 629 394 297 613 478 230 97 81.0 76.0 58.4 32.7 69 136 9.1 11.0 22.3 45.8 302 264 203 165 237 201 118 57 78.5 76.1 58.1 34.5 25 28 47 70 82.8 10.6 23.2 42.4 15.3 19.6 27.2 30.6 149 181 226 232' 18.1 24.0 32.4 37.0 905 1,165 1,498 1,664 COLORED MOTHERS. Earnings of father under $550: Second month.................. Third month.................... Sixth month.................... Ninth month.................... Earnings o f father, $550 and over: Second month. Third month.. Sixth month.. Ninth month.. 9.9 13.0 19.3 21.5 40 35 38 38 13.2 13.3 18.7 23.0 T able 43.— Type o f feeding, by month o f life o f infant, and by literacy and color and nativity o f mother; infants bom in 1915. Month of life of infant, literacy, and color and nativity of mother. Per cent of infants having specified type of feeding. Breast feeding. Mixed feeding. Artificial feeding. 86.7 77.3 70.1 52.1 30.1 2.3 4.8 •6.2 16.0 33.6 11.0 17.9 23.7 31.9 36.3 79.4 75.6 71.1 55.7 33.0 5.6 8.1 9.9 17.4 39.4 15.1 16.3 19.0 27.0 27.5 91.5 85.2 79.0 58.2 27.4 3.0 5.8 9.0 23.8 48.8 5.5 9.0 12.0 18.0 23.8 90.8 83.5 78.4 60.1 30.4 4.2 8.3 11.1 23.3 48.8 5.0 8.3 10.5 16.6 20.8 2.4 9.0 14.2 28.6 48.8 7.1 12.1 15.4 22.9 29.3 6.0 18.9 26.8 43.8 58. 2 6.0 9.8 14.8 21.9 26.1 Native white mothers: Literate— Ninth month....................................................................................... Illiterate— Third month....................................................................................... Sixth month........................................................................................ Foreign-bom white mothers: literate— First month..... ........................................................ .•...................... Second month..................................................................................... Third month. . . : ................................................................................ Sixth month........................................................................................ Illiterate— First month........................................................................................ Third month....................................................................................... Ninth month....................................................................................... Colored mothers: Literate— Ninth month....................................................................................... Illiterate— https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 90.5 78.9 70.4 48.5 21.9 87.9 71.3 58. 5 34.3 15.7 ' 256 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e 44.—Prevalence o f artificial feeding, by month o f life o f infant, and by ability o f mother to speak English arid'nationality o f mother; infants born in 1915 to Jewish, Polish, and Italian mothers. Month o life of infant and nationality of mother. Mothers able to speak English. Mothers not able to speak English. Infant survivors. Infant survivors. Artificially fed. Artificially fed. Total. Total. Number. Per cent. Number. Per cent. Jewish mothers: First month...................................- — Second month................ ...................-. Third month.......................................... Sixth month........................................ . Ninth month......................................... Twelfth month...................................... Polish mothers: First month........................................... Second month........................................ Third month......................................... Sixth month.......................................... Ninth month......................................... Twelfth month............................... — Italian mothers: First month........................................... Second month........................................ Third month.......................................... Sixth month.......................................... Ninth month......................................... Twelfth month...................................... 786 766 764 759 755 748 18 43 56 94 135 193 2.3 5.6 7.3 12.4 17.9 25.8 175 169 168 166 165 165 9 12 14 25 36 47 5.1 /•I 8.3 15.1 21.8 28.5 223 207 205 201 191 186 9 17 22 34 39 48 4.0 8.2 10.7 16.9 20.4 25.8 402 383 382 368 353 343 20 26 38 54 60 75 5.0 6.8 9.9 14.7 17.0 21.9 140 134 134 133 131 130 5 10 11 23 29 41 3.6 7.5 8.2 17.3 22.1 31.5 272 261 259 253 250 247 6 12 17 30 55 73 2.2 4.6 6.6 11.9 22.0 29.6 T a b l e 45.—Prevalence o f artificial feeding, by month o f life o f infant, and by literacy and nationality o f mother; infants bom in 1915 to Jewish, Polish, and Italian mothers. Literate mothers. Illiterate mothers. Infant survivors. Infant survivors. Month of life, o f infant and nationality of . mother. Artificially fed. Artificially fed. Total. Total. Number. Per cent. Number. Percent. Jewish mothers: First month........................................... Second month........................................ Third month.......................................... Sixth month.......................................... Ninth month......................................... Twelfth month...................................... Polish mothers: First month........................................... Second month........................................ Third month.......................................... Ninth month......................................... Twelfth month...................................... Italian mothers: First month........................................... Second month'....................................... Third month.......................................... Sixth month.......................................... Ninth month......................................... Twelfth month...................................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 791 769 768 764 760 754 20 42 56 98 142 201 2.5 5.5 7.3 12.8 18.7 26.7 169 165 163 160 159 158 7 13 14 21 29 39 4.1 7.9 8.6 13.1 18.2 24.7 339 316 314 305 290 284 18 26 38 54 61 76 5.3 8.2 12.1 17.7 21.0 26.8 285 273 272 264 254 245 11 16 22 34 38 47 3.9 5.9 8. i 12.9 15.0 19.2 220 213 211 210 205 204 5 11 13 25 44 57 2.3 5.2 6.2 11.9 21.5 27.9 190 180 180 174 174 171 6 11 15 28 40 57 3.2 6.1 8.3 16.1 23.0 33.3 APPENDIX VII.---- TABLES. 257 T able 46.—Prevalence o f mixed feeding and artificial feeding, by month o f life o f infant, and by place o f employment and color and nationality o f mother; infants born in 1915 to mothers employed within year after birth. Place of employment and color and nationality of mother. Native white mothers: Employed at hom e......... Employed away from Second month. Per cent of infant survivors.1 Mixed fed. Artificially fed. Ninth Second Third Third Sixth Sixth month. month. month. month. month. month. 5.6 5.3 Foreign-born white mothers: 6.3 11.4 Jewish mothers: Employed at home... Employed away from 6.7 13.9 Polish mothers: Employed at hom e.. Employed away from 3.6 7.7 Employed away from 16.9 37.0 26.7 38.2 26.2 48.3 16.0 24.2 9.2 11.8 28.7 58.9 36.2 60.0 4.7 6.0 10.9 12.3 17.3 46.7 31.5 65.0 Ninth month. 31.2 34.6 44.8 45.8 18.8 25.1 28.7 24.2 12.3 20.0 18.5 16.7 20.4 13.8 Italian mothers: Employed at h om e.. Employed away from 8.1 11.1 18.1 40.5 2.7 8.3 16.7 25.5 Employed at hom e.. Employed away from 5.8 9.3 22.0 37.1 19.4 24.0 31.4 37.6 19.6 28.4 54.4 17.5 20.2 28.0 46.8 48.6 53.3 31.5 33.1 39.1 Colored mothers: Employed away from home............................. 1 Each infant is classified according to type of feeding and mother’s employment in each month, except that if a mother worked away from home following aperiodof work at home the latter is disregarded; a mother’ s employment is assumed to continue from the time it commenced until the end of infant’s first year of life. Per cent not shown where base is less than 50. T able 47.— Infant deaths per 1,000 live births} by cause o f death and age; legitimate live births in 1915, Baltimore study, and total registered live births in 1915 in cities o f 10,000 or more population in United States birth-registration .area. Infant mortality rate per 1,000 live births. Gastric and in Respiratory Malformations. diseases. testinal diseases. Regis Regis Balti Balti Regis Balti Regis tration tration tration more more more tration cities.1 study. cities.1 study. cities.1 study. cities.1 103.3 29.1 26.6 19.7 17.8 3.6 6.1 60.4 5.9 6.7 6.3 9.0 3.0 5.4 35.4 .7 1.0 1.9 1.3 2.5 4.1 1.6 .8 1.8 8.0 1.5 .6 9.2 1.4 1.5 1.9 3.0 .3 .4 1.8 3.1 1.6 .2 7.8 3.0 .3 5.1 4.1 18.1 9.3 8.0 .6 .4 7.4 4.5 14.0 5.9 3.9 .1 .2 3.4 10.9 6.5 3.8 3.5 .1 All causes. Age at death. Total............................. Under 3 months..................... Under 2 weeks................. 2 weeks, under 1 m onth.. 1 month, under 2.............. 2 months, under 3............ 3 months, under 6................... 6 months, under 9................... 9 months, under 12................. Balti more study. 103.5 56.0 37.0 7.1 6.0 5.8 19.4 15.1 13.0 Age at death. Total................................................... Under 3 months........................................... Under 2 weeks....................................... 2 weeks, under 1 month........................ 1 month, under 2................................... 2 months, under 3.................................. 3 months, under 6........................................ 6 months, under 9........................................ 9 months, under 12....................................... Infant mortality rate per 1,000 live births. Epidemic and Early infancy. other communicable All other causes. diseases. B alti Balti Regis Balti Regis Regis tration more tration more more tration study. cities.1 study. cities.1 study. cities.1 37.7 35.0 8.5 6.7 6.7 9.3 35.4 32.0 1.9 3.1 2.8 4.9 29.9 25.9 .6 1.2 .8 2.4 3.1 2.7 .4 .6 1.2 .9 1.8 2.1 .6 .9 .5 .9 .6 1.4 .1 .7 .3 .8 1.4 1.0 2.0 1.8 2.0 1.7 1.5 .7 .7 1.9 .8 1.4 2.2 .2 .3 2.0 .6 1.3 i Cities of birth-registration area, 1915. Based on unpublished data furnished by U. S. Census. 101351°— 23------17 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 258 IN F A N T MORTALITY, BALTIMORE, MD. T able 48.—Infant deaths, by cause o f death, with reference to classification numbers in International List o f Causes o f Death; deaths among legitimate liye births in 1915, Bal timore study, and total deaths in United States death-registration area in 1915. ’ Abridged International List N o.1 Detailed International List N o.1 1 Deaths among Infant deaths in infants bom in Baltimore death-registration area in 1915. in 1915. Cause oi death.* cent Num Per Num ber. distri ber. bution. All causes. 102,103 104....... 20 .............. Part o f2 3 ... 22 Part" of 3 3 ... Part of 33.. Part of 33.. Part of 37.. Part of 37.. 5. 6. 7. 9.................... Part of 12___ Part of 12___ Part of 37___ 13 .. 14 .. 15 .. Part of 37___ 35....... ........... 38................... 17................... Part of 37___ 19................... 89.. 91.. 92.. 150. 151[1]................ }l51[2], 152[2], 153 152[1 ]............... G astric a n d in te stin a l diseases * .. Diseases o f th e s to m a c h ......... D iarrhea a n d e n teritis............ R e sp ira to ry d ise a s e s 4..................... A c u te B ro n ch itis ....................... B ro n ch o -p n e u m o n ia ............... P n e u m o n ia ..................... J......... M a lform ation s................................... E a r ly in f a n c y .................................... P rem atu re b ir t h ....................... C on gen ital d e b ilit y .. . . . . ___ In ju rie s a t b ir th ........................ E p id e m ic a n d other co m m u n i ca b le diseases.5 6 M easles......................................... 7 .. Scarlet fe v e r ............................... 8 W h o o p in g c o u g h ...................... 9 ... D ip h th e r ia a n d c r o u p . . . ___ 10 ................................ ' . . . I n flu e n z a ............... . . . ' .............. 14................... D y s e n te r y ..................... ............. 18................... E ry s ip e la s ................................... 24.................. T e ta n u s ........................................ 28,29............. . T u b e rcu lo sis o f th e lu n g s___ 30.................... T u b e rcu lo u s m e n in g itis ........ 31,32,33,34,35. O ther form s o f tu b e rcu lo s is.. 37............... . S y p h ilis .......... ........................... .. 155 to 1 8 6 ..... E x te r n a l ca u s e s ............................... 187,188,189.... Diseases ill-d e fin e d or u n k n o w n .. A l l oth er c a u se s............................... 61. M e n in gitis................................... 71. C on vu lsion s................................ 79. O rganic diseases o f th e h eart. O th e r ............................................ .............. .. Per cent distri bution. 1,117 100.0 148,561 100.0 314 6 308 213 24 149 40 39 407 225 138 44 72 28.1 .5 27.6 19.1 2.1 13.3 3.6 3.5 36.4 20.1 12.4 - 3.9 6.4 34,394 2,193 32,201 23,886 3,401 13,904 6,581 9,327 51,765 29,027 16,824 5,914 12,109 23.2 1.5 21.7 16.1 2.3 9.4 4.4 6.3 34.8 19.5 11.3 4.0 8.2 8 1 18 4 7 1 4 .7 .1 1.6 .4 .6 .1 .4 965 146 3,119 869 982 491 750 .6 .1 2.1 .6 .7 .3 .5 4 10 1 14 10 7 55 10 15 .4 .9 .1 1.3 .9 .6 4.9 .9 1.3 .6 .8 .3 1.4 1.2 2.0 8.4 1.0 1.5 30 2.7 851 1,194 421 2,022 1,727 2,943 12,420 1,444 2,301 son 8,085 5.4 1 The numbers indicate the classification in the abridged and the detailed lists, respectively, of the Manual of the International List of Causes of Death. * in,this list are those used b v tn e U . S. Bureau of the Census (see Mortality Statistics, 1915, p. 442) m classifying the deaths of infants under 1 year. They are those causes of death or groups of causes which are most important at this age. The numbers of the detailed and abridged International Lists will facilitate their identification. In order to make discussion of the figures easier, these causes of death have been grouped in 8 main groups. »The term “ gastric and intestinal diseases/’ as used in the tables and discussion, includes, as above shown, only the diseases of this type which are most important amongjinfants; i. e., diseases of the stomach diarrhea, and enteritis. It does not include all “ diseases of the digestive system” as classified under this heading according to the detailed International List. /T h e term “ respiratory diseases,” as used in the tables and discussion, similarly includes only those of the respiratory diseases which are most important among infants; i. e., acute bronchitis, broncho pneumonia, and pneumonia. It does not include all “ diseases of the respiratory system” as classified under this heading according to the detailed International List. 5 The term “ epidemic and other communicable diseases,” as used in the tables and discussion, includes only those of this group which are most important among infants. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 259 APPENDIX VII.---- TABLES. T a b l e A 9 — In fa n t m orta lity rates, by ca m e o f death, and by color and n a tiv ity o f m oth er; liv e births in 1915. Total deaths. Deaths among infants bom to mothers of specified color and nationality. White. Cause of death. Infant Num- morber. tality rate. All causes........................ 1,117 Gastric and intestinal diseases. Diseases of the stomach. . . Diarrhea and enteritis....... Respiratory diseases................ Acute bronchitis............... Broncho-pneumonia.......... Pneumonia................... Malformations.......................... Early infancy................. ......... Premature birth................ Congenital debility........... Injuries at birth................. Epidemic and other commu nicable diseases..................... Measles............................... Scarlet fever........... .......... Whooping cough............... Diphtheria and croup....... Influenza............................ Dysentery........................ « Erysipelas.......................... Tuberculosis of the lungs.. Tuberculous meningitis Other forms of tuberculosis Syphilis............................ External causes............... Diseases ill-defined or un' known..... ........................... All other causes...................... Meningitis........................ Convulsions................. . Other........................... . https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Total. Native. Foreign bom. Colored mothers. Infant Infant Infant Infant Num- mor- Num- mor- Num- mor- Num- morber. tality ber. tality ber. tality ber. tality rate. rate. rate. rate. 103.5 910 95.9 646 95.9 . 264 95.9 207 158.6 314 6 308 213 24 149 40 39 407 225 138 44 29.1 .6 28.5 19.7 2.2 13.8 3.7 3.6 37.7 20.8 12.8 4.1 274 5 269 149 13 103 33 36 342 183 119 40 28.9 .5 28.3 15.7 1.4 10.9 3.5 3.8 36.0 19.3 12.5 4.2 194 4 190 92 7 65 20 27 257 145 81 31 28.8 .6 28.2 13.7 1.0 9.6 3.0 4.0 38.1 21.5 12.0 4.6 80 1 79 . 57 6 38 13 9 85 38 38 9 29.1 .4 28.7 20.7 2.2 13.8 4.7 3.3 30.9 13.8 13.8 3.3 40 1 39 64 11 46 7 3 65 42 19 4 30.7 .8 29.9 49.0 8.4 35.2 5.4 2.3 49.8 32.2 14.6 3.1 72 8 1 18 4 7 1 4 4 10 1 14 10 6.7 .7 .1 1.7 .4 .6 .1 .4 .4 .9 .1 1.3 .9 50 8 1 11 4 6 1 4 1 10 5.3 .8 .1 1.2 .4 .6 .1 .4 .1 1.1 32 5 1 6 1 5 4.7 .7 .1 .9 .1 .7 18 3 6.5 1.1 22 16.9 5.4 1 .8 .3 .1 1.3 1.8 1.1 .4 .4 .7 7 2 1 9 5 3 1 1 2 1 .4 3 2.3 4 7 .4 .7 2 6 .3 .9 2 1 .7 .4 1 10 3 .8 7.7 2.3 7 55 10 15 30 .6 5.1 .9 1.4 2.8 6 46 9 10 27 .6 4.8 .9 1.1 2.8 3 35 8 7 20 .4 5.2 1.2 1.0 3.0 3 11 1 3 7 1.1 4.0 .4 1.1 2.5 1 9 1 5 3 .8 6.9 .8 3.8 2.3 able 260 T 50.— In fa n t deaths, by ca m e o f death an d m on th o f life ; liv e births in 1915. Deaths among infonts bom in 1915. Occurring i n specified month of life. Cause of death. First. Total. All causes...................... ............................ Gastric and intestinal diseases........................... Diarrhea and enteritis.................................. Broncho-pneumonia..................................... Epidemic and other communicable diseases___ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1.117 314 6 308 213 24 149 40 39 407 225 138 44 • 72 s 1 18 4 7 1 4 4 10 1 14 10 7 55 10 15 30 Under 2 weeks, Second. Third. Fourth. Fifth. under 1 2 weeks. month. Sixth. Sev enth. Eighth. Ninth. Tenth. Elev enth. Twelfth. 477 400 77 65 63 62 71 76 56 56 51 49 42 49 17 1 16 37 6 20 11 27 357 216 97 44 13 8 1 7 20 2 11 7 27 323 197 83 43 9 9 15 29 1 28 17 36 24 20 27 36 12 1 8 3 24 20 2 16 2 1 3 20 17 2 13 2 27 14 1 11 2 1 1 1 5 14 3 1 5 1 4 44 17 2 12 3 2 5 21 1 20 12 2 10 22 15 16 5 7 4 3 19 7 12 27 2 25 21 1 17 3 3 5 44 9 17 4 9 4 32 1 31 19 2 12 5 2 6 1 5 3 1 1 1 7 1 4 4 3 7 1 9 2 4 1 8 1 3 2 2 1 1 3 1 2 2 2 1 3 12 3 1 2 2 1 2 1 3 34 19 14 1 4 2 1 5 4 4 1 1 1 1 1 10 2 3 21 9 12 1 7 1 2 10 1 3 1 1 11 2 1 1 4 2 1 1 6 4 3 8 1 3 1 1 1 1 1 1 13 5 1 7 1 2 4 1 2 1 2 2 1 1 1 3 9 2 1 1 2 1 1 22 11 4 1 1 3 1 4 1 2 INFANT MORTALITY, BALTIMORE, MD, Total. T a b l e 51.— In fa n t deaths, b y age a t death, an d by co lo r an d n a tio n a lity o f m oth er; live births in 1915. Deaths among infants bom to mothers of specified color and nationality. White mothers. ( Total infant deaths. Total. Age at death. Native. Total. Polish. Irish, Eng Per lish, cent Jew Per Ital Ger Scotch, Bohe Lithu All Num distri and ish.1 Num cent ian.1 man.1 ber. bu Eng- mian.1 anian.1 other.1 ber. distri tion. lishbu Canation. dian.1 1,117 100.0 910 100.0 646 100.0 264 100.0 49 102 100.0 36 30 12 42.7 394 43.3 286 44.3 108 40.9 26 35 34.3 17 10 477 12~ 4~ V 5 2~ 83~ 40.1 Under 1 day.............................. \ day, under 2 ........................... I days, under 3 .......................... ? days, under 7 ......................... 1 week, under 2......................... 2 weeks, under 1 month............ 208 40 42 51 59 77 18.6 3.6 3.8 4.6 5.3 6.9 178 36 37 40 43 60 19.6 4.0 4.1 4.4 4.7 6.6 135 24 24 25 33 45 20.9 3.7 3.7 3.9 5.1 7.0 43 12 13 15 10 15 16.3 4.5 4.9 6.7 3.8 5.7 10 4 4 3 3 2 13 4 3 4 3 8 12.7 3.9 2. Ö 3.9 2.9 7.8 5 2 2 5 2 1 7 1 1 2 3 1 2 1 30 14.5 1.9 1 2 16 17 7* 7 1 month, under 2............................. 2 months, under 3 ............................ 3 months, under 6 ............................ 6 months, under 9 ........................... 9 months, under 12.......................... 65 63 209 163 140 5.8 5.6 18.7 14.6 12.5 51 52 159 138 116 5.6 5.7 17.5 15.2 12.7 35 34 113 98 80 5.4 5.3 17.5 15.2 12.4 16 18 46 40 36 6.1 6.8 17.4 15.2 13.6 3 i 7 7 5 3 10 19 17 18 2. 9 9. 8 18.6 16.7 17.6 2 4 6 3 4 2 7 4 4 U 50 25 24 5J$ 24.2 12.1 11.6 Under 1 month.............................. 15 £ 2 3 3 1 10 207 4 100.0 1 i i 1 1 1 1 1 2 2 1 2 3 APPENDIX VII.— TABLES. Per Per Per Per Num cent Num cent Num cent Num cent distri distri distri distri ber. ber. ber. ber. bu bu bu bu tion. tion. tion. tion. Total....................................... Colored mothers. Foreign bom. 1 Per cent distribution not shown where base is less than 50. to o* https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 262 T a b l e 52.— In fa n t deaths, by calendar m on th o f death and cause; live births in 1915. Deaths among infants born in 1915. Occurring in specified calendar month. Cause o’ fdeath. Total. All causes.......................................... Gastric and intestinal diseases.................... Diseases of thestopiach............. ........... Respiratory diseases..................................... Broncho-pneumonia............................... Epidemic and other communicable diseases Measles.................................................... Scarlet fever............................................ Whooping cough.................................... Influenza................................................. Erysipelas............... ..............................Tuberculosis of the lungs...................... Tuberculous meningitis......................... Other forms of tuberculosis................... External causes............................................ Diseases,ill-defined or unknown................. Meningitis............................................... Convulsions............................................ Other....................................................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1,117 314 6 308 213 24 149 40 39 407 225 138 44 72 1 18 4 65 3 3 23 2 14 7 3 18 8 7 3 10 1 1 1 4 Febru ary. 81 7 7 33 4 19 10 3 24 14 10 7 Septem ber. October. Novem ber. Decem ber. 89 75 68 144 140 100 91 76 76 9 11 9 9 32 6 22 4 6 50 27 14 9 10 3 89 2 87 7 30 9 14 78 1 77 46 11 22 10 1 9 14 46 13 18 11 8 11 4 41 25 14 2 6 2 2 40 21 15 4 5 30 20 7 3 2 12 30 14 3 10 1 4 32 17 12 3 10 1 9 11 1 7 3 2 45 25 14 6 3 12 1 11 19 2 12 5 2 32 14 12 6 7 1 11 2 15 32 21 8 6 2 4 1 ............ i ’ 1 i ................ ............... 2 i 1 1 1 1 2 i 1 4 4 10 1 14 10 2 ............... 1 2 i ............. 2 1 2 i 55 10 15 30 6 3 6 2 2 ............ i ' 2 2 4 1 4 August. 112 1 2 < I July. June. May. April. March. 1 1 _ ............ . 3 1 1 1 3 3 1 4 8 3 5 1 2 3 1 4 "l ............. ..............i 3 2 2 2 1 2 1 i 1 6 5 3 3 3 2 3 3 INFANT MORTALITY, BALTIMORE, MD. January. T a b l e 53.— In fa n t m orta lity rates, by calendar m on th o f birth and cause o f death; live births in 1915. Infant deaths from specified causes. Total infant deaths. Month of birth. March............................................................ May................................................................ June............................................................... July................................................................ August........................................................... October.......................................................... December...................................................... Infant Number. mortality rate. Gastric and intes tinal diseases. Respiratory diseases. % ' # Diseases Epidemic ill defined or and other Malfor External communi causes. unknown Infant Infant mations. Infant • and all cable Number. mortality Number. mortality Number. mortality diseases. other rate. rate. causes. rate. Early infancy. 10,797 1,117 103.5 314 29.1 213 19.7 39 407 37.7. 72 885 891 973 793 828 878 999 936 909 904 886 915 82 97 113 103 88 101 97 78 78 94 101 85 92.7 108.9 116.1 129.9 106.3 115.0 97.1 83.3 85.8 104.0 114.0 92.9 33 36 24 38 20 25 21 19 18 30 24 26 37.3 40.4 24.7 47.9 24.2 28.5 21.0 20.3 19.8 33.2 27.1 28.4 14 21 14 16 20 14 31 17 16 18 16 16 15.8 23.6 14.4 20.2 24.2 15.9 31.0 18.2 17.6 19.9 18.1 17.5 2 2 7 3 4 5 4 1 24 26 57 41 36 38 30 27 29 26 44 29 27.1. 29.2 58.6 51.7 43.5 43.3 30.0 28.8 31.9 28.8 49.7 31.7 2 5 5 5 5 13 6 5 8 6 7 5 5 4 2 62 10 X 1 3 1 1 1 3 7 7 5 3 3 4 . 8 6 6 6 7 APPENDIX VII.— TABLES. Total............................................. ...... Live births. 263 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 264 INFANT MORTALITY, BALTIMORE, MD, T able 54.— Infant deaths from gastric and intestinal diseases per 1,000 live births, by age at death; Baltimore City, 1915 and 1916, cities o f birth-registration area, 1915, arid legiti mate group in Baltimore study. Infant deaths from gastric and intes tinal diseases per 1,000 live births. Age at death. Cities of birthregistra group.1 tion area. Baiti- Baltimore City. 1916 1915 29.1 26.7 29.9 32.7 5.9 9.3 7.4 6.5 9.0 8.0 5.9 3.8 7.7 9.2 8.1 4.8 9.9 8.6 8.2 6.0 1 In the Baltimore group the deaths under 1 year of age among infants born in 1915 occurred partly in 1915 and partly in 1916. T able 55.— Infant deaths from diarrhea and enteritis per 1,000 live births, by age at death; England and Wales, 1891 to 1917. Infant deaths from diarrhea and enteritis per 1,000 live births. Period. Age at death. Under 3 3-6 months. months. 1891-1900 ................................................................................................... 1901—1910 ................................................................................................... 1911—1915 ......................................................................................................... 1916 ............................................................................................................ 6.95 5.58 5.56 3.53 3.42 6-12 months. 8.51 6.97 6.35 3.50 3.47 9.71 7.92 7.33 3.55 3.41 (Based on reports of registrar general of births, deaths, and marriages in England and Wales: 1915, cd. 8484; 1916, cd. 8869; 1917, cmd. 40.) T able 56.— Mean temperature and precipitation, by calendar month; Baltimore, 1915 and 1916. Monthly mean temperatine and total precipitation in Baltimore. 1916 1915 Calendar month. Mean Mean Precipi tempera Precipi tation tempera tation ture ture (inches). (inches). (° F.). (° F.). July................................................................................................. 36.0 38.4 39.4 69.2 62.2 70.6 76.9 74.2 71.5 59.6 47.0 35.4 6.81 4.75 1.06 1.37 3.19 6.23 2.22 9.93 2.30 3.86 1.59 3.08 39.5 33.6 37.0 52.6 66.6 69.4 78.0 76.8 67.6 57.6 47.3 36.0 1.51 3.21 3.61 3.68 3.49 5.33 5.04 .83 1.82 1.61 1.97 3.94 Source: U. S. Department of Agriculture, Weather Bureau, monthly issues Climatological Data, Mary land and Delaware Section, 1915 and 1916, and Monthly Meteorological Summary, 1915 and 1916. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis N r T able 57.— Infant deathsfrom epidemic and communicable diseases per 1,000 live births, by age at death and cause o f death; Baltimore City, 1915 and 1916, cities o f birth-registration area, 1915, and legitimate group in Baltimore study. Infant deaths at specified age under 1 year per 1,000 live births. Baltimore City. Cause of death Cities of the birth-registra tion area, 1916. Baltimore stuay. 1916 1915 6.7 1.3 6.4 .7 1.7 .4 2.6 2.9 1.3 1.7 .8 .1 .8 3.7 3.7 .7 .8 .3 1.9 8.6 1.6 6.9 .9 1.9 .6 3.5 4.6 1.5 3.1 .2 1.0 .3 1.6 3.9 .2 3.7 .7 .9 .3 1.9 8.9 4.5 4.4 .6 1.0 .7 2.2 5.9 4.0 1-9 .1 .4 .4 1.0 3.0 .5 2.5 .4 - .5 .3 1.2 9.1 4.0 5.1 .6 2.0 .5 2.1 5.5 3.6 1.9 .1 .9 .1 .8 3.6 .3 3.2 .5 1.1 .3 1.3 APPENDIX VII.— TABLES. Under 1 Under 6 6 months, Under 1 Under 6 6 months, Under 1 Under 6 6 months, Under 1 Under 6 6 months, year. months. under 12. year. months. under 12. months. under 12. year. months. under 12. year. 265 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis T a b l e 58.— Monthly death rates, by type o f feeding, and by color and nationality o f mother; infants born in 1915. Subsequent deaths. Month of life of infant and Infant sur nationality of mother. vivors. In year. Breast fed. In month. Infant sur Per vivors Num Per Num ber. 1,000. ber. 1,000 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis In month. In year. Num Per ber. 1,000 Mixed fed. Infant sur vivors Artificially fed. Subsequent deaths. Infant In month. sur vivors Num Per ber. 1, 000. In month. Num- Per ber. 1, 000. 10,797 10,320 10,255 10,192 10,130 10,059 9,983 9,927 9,871 L, 117 640 575 512 450 379 303 247 191 103.5 62.0 56.1 50.2 44.4 37.7 30.4 24.9 19.3 9,283 8,176 7,400 6,457 5,905 5,352 4,215 3,590 2,825 281 608 844 1.303 1,614 1,977 2,845 3,291 3,890 958 1,531 2,006 2,426 2,605 2,725 2,919 3,042 3.153 240 271 294 293 265 236 191 154 9,492 9,098 9,047 8,995 8,952 8,896 8,836 8,791 8,743 910 516 465 413 370 314 254 209 161 95.9 56.7 51.4 45.9 41.3 35.3 28.7 23.8 18.4 8,137 7,223 6,568 5,761 5,288 4,808 3,827 3,276 2.587 245 484 654 1,036 1.304 1,623 2,378 2,782 3,328 870 1,386 1,820 2,192 2,354 2,460 2,627 2,729 2,825 198 224 248 246 223 6,739 6,453 6,418 6,384 6,351 6,308 6,271 6,237 6,207 646 360 325 291 258 215 178 144 114 95.9 55.8 50.6 45.6 40.6 34.1 28.4 23.1 18.4 5,681 4,985 4,497 3,922 3.588 3,290 2,675 2,324 1,871 156 313 403 646 823 1,012 1,472 1,736 2,092 726 1.153 1,517 1,814 1,938 2,004 2,123 2,176 2,243 95.9 59.0 53 3 46.7 43.1 38.3 29.6 25.5 18.5 2,456 2,238 2,071 1,839 1,700 1,518 1,152 952 716 171 251 390 481 611 906 1,046 1,236 144 233 303 378 416 456 504 553 582 2,753 2,645 2,629 2,611 2,601 2,588 I 2,565 2,554 2,536 Not reported. Subsequent deaths. 121 202 167 134 105 55.3 18.9 18.4 16.5 15.7 20.6 13.7 11.8 46.0 16.6 17.6 14.6 13.6 18.3 13.3 11.4 9.6 Not Subsequent fed deaths. In fantat In month. ■ In once. year. Num Per ber. 1,000. 4 4 1 3 3 2 1 1 1 1 269 4 4 1 3 3 2 1 1 1 1 3 3 172 1 1 62 1 2 2 1 1 1 1 234 1 1 1 76.4 17.2 26.4 13.2 9.6 35.1 15.9 18.1 10.3 1 IN FAN T MORTALITY, BALTIMORE, MD. All mothers: First month................ Second month............. Third month............... Fourth month............. Fifth month................ Sixth month............... Seventh month........... Eighth month............. Ninth month............... White mothers: First month................. Second month............. Third month............... Fourth month............. Fifth month................ Sixth m onth............... Seventh month........... Eighth month............. Ninth month............... Native mothers: First month.......... Second month...... Third month........ Fourth month___ Fifth month......... Sixth month......... Seventh month___ Eighth month....... Ninth month........ . Foreign-born mothers: First month........... Second month........ Third month.......... Fourth month....... Fifth month......... . Sixth month.......... Seventh month Eighth month. Ninth month............. | Subsequent deaths. 961 935 932 931 928 925 924 924 920 51.0 24.6 21.5 20.4 17.2 14.1 13.0 13.0 8.7 625 590 587 577 575 569 558 551 544 163.2 113.6 109.0 93.6 90.4 80.8 62.7 50.8 38.6 412 395 393 389 388 386 383 382 381 87.4 48.1 43.3 33.4 30.9 25.9 18.3 15.7 13.1 755 725 717 714 710 708 700 697 691 1,305 1,222 1,208 1,197 1,178 1,163 1,147 1,136 1,128 25 14 11 10 8 6 6 4 3 7 2 8.0 2.5 1 1 1.6 1.7 1 2 3.4 9.7 4 3 4.3 3.3 878 803 746 638 581 514 366 297 206 35 3 10 2 6 11 7 7 3 56.0 5.1 17.0 3.5 10.4 19.3 12.5 12.7 5.5 559 507 477 430 402 369 276 241 185 64 42 33 21 18 13 7 6 5 13 2 7 1 2 1 1 1 1 23.3 3.9 14.7 2.3 5.0 2.7 3.6 4.1 5.4 17 41.3 2 5.1 4 10.2 1 2.6 2 5.2 3 7.8 1 2.6 1 2.6 1 2.6 372 348 327 302 287 256 201 161 125 19 13 10 7 7 5 3 1 1 5 2 2 13.4 5.7 6.1 2 1 7.0 3.9 102.0 64.8 54.4 50.4 45.1 42.4 31.4 27.3 18.8 30 8 3 4 2 8 3 6 4 39.7 11.0 4.2 5.6 2.8 11.3 4.3 8.6 5.8 647 580 521 469 430 379 309 253 200 42 26 16 14 11 8 7 7 4 7 5 10.8 8.6 1 2.1 2 1 7.9 5.0 158.6 101.5 91.1 82.7 67.9 55.9 42.7 33.5 26.6 83 14 11 19 15 16 11 8 6 63.6 11.5 9.1 15.9 12.7 13.8 9.6 7.0 5.3 1,146 953 832 696 617 544 388 ' 314 238 124 65 49 36 25 18 11 6 5 32 7 4 8 3 3 3 1 1 27.9 7.3 4.8 11.5 4.9 5. 5 7.7 3.2 4.2 1Rate not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 26 27.1 3.2 3 1 1.1 3 3.2 3 3.2 1 1.1 APPENDIX VII.— TABLES. Jewish— First month........ . Second month.... Third month....... Fourth month__ Fifth month....... Sixth month....... Seventh m onth.. Eighth month__ Ninth month...... Polish— First month........ Second m onth... Third month....... • Fourth month. . . Fifth month....... Sixth month....... Seventh month.. Eighth month__ Ninth month...... Italian— First month........ Second month. . . Third month....... Fourth month. . . Fifth month....... Sixth month....... Seventh month.. Eighth month__ Ninth month...... All oth erFirst month........ Second month. . . Third month....... Fourth month. . . Fifth month....... Sixth month....... Seventh month.. Eighth month. . . Ninth month...... Colored mothers: First month..................... Second m onth................ Third month.................... Fourth month................. Fifth month. : ........ ; ___ Sixth month.................... Seventh month................ Eighth month.................. Ninth m onth.................. 268 T a b l e 59.— M onthly death rates, by type offeedin g, and by earnings o f father and color and nativity o f mother; infants born in 1915 .J Month of life of infant, earnings of father, and color and nativ ity of mother. Feeding not ported. Artificially fed. Mixed fed. Breast fed. Total. ALL MOTHERS. Earnings of father: Under $450— First month.......... Second month___ Third month........ Fourth month___ Fifth month......... Sixth month......... Seventh month__ Eighth month___ Ninth month........ Tenth to twelfth month3 $450-1549— First m onth...___ Second month___ Third month........ Fourth month___ Fifth month......... Sixth month......... Seventh month__ Eighth month___ Ninth month........ Tenth to twelfth month3 $550-$649— First month.......... Second month___ Third month........ Fourth month___ Fifth month......... Sixth month......... Seventh month__ Eighth month___ Ninth month........ Tenth to twelfth month3 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1*451 1,434 1,419 1,408 1,390 1,370 1,356 17 15 11 18 20 14 16 1.0 .8 1.3 1.4 1.0 1.2 1*334 32 ¿4 1,382 1,373 1,358 1,340 1,339 1*321 1,312 1,306 1,300 9 15 12 7 18 9 6 6 22 .7 1.1 .9 1.3 .7 .5 .5 1.7 1,452 1,423 29 12 2.0 .8 1,402 1,391 1,382 1,377 11 9 5 14 .8 .6 .4 1.0 7 1*344 17 J> 1.3 1 332 1* 165 1,039 882 793 705 526 428 332 331 31 10 5 2 6 4 1 2.3 .9 .5 .2 .8 .6 .2 i 10 .3 3.0 1,138 1,029 881 803 725 553 460 352 351 4 5 2 2 1 .4 .5 .2 .2 .1 1 1 2 .2 .3 .6 1,294 1,147 18 7 2 4 1 1 2 3 1.4 .6 .2 .4 .1 .1 .3 .6 2 .5 1 047 ‘ *914 849 775 603 523 426 426 1.1 110 170 220 281 305 328 354 372 381 376 11 7 6 8 8 13 10 11 5 15 10.0 4.1 2.7 2.8 2.6 4.0 2.8 3.0 1.3 4.0 2.2 .5 .4 .3 .2 .5 .2 1.1 95 152 207 263 276 285 292 303 323 319 9 4 7 9 4 16 8 2 4 13 2.6 3.4 3.4 1.4 5.6 2.7 .7 1.2 4.1 124 205 272 324 335 353 376 383 386 379 7 4 7 6 6 3 10 9 7 11 5.6 2.0 2.6 1.9 1.8 .8 2.7 2.3 1.8 2.9 50 114 173 254 308 355 488 554 626 626 4 1 4 3 3 4 2.3 .4 1.3 .8 .6 .7 7 38 92 137 214 267 329 476 549 631 630 2 i 3 1 1 1 1 3 1 7 33 71 92 164 207 254 398 457 539 539 3 1 1 2 1 2 .6 1.0 .4 .5 4 .7 Deaths in month. INFANT MORTALITY, BALTIMORE, MD. Deaths in month. Deaths in month. Deaths in month. Infant Infant Infant Infant survivors. survivors. survivors. Number. Percent.2 Number. Percent.2 Number. Percent.3 Number. Percent.2 Deaths in month. survivors. re 2,362 2,311 2,302 2,291 2,277 2,258 2,249 2,243 2,233 2,217 51 9 11 14 19 9 6 10 16 32 2.2 .4 .5 .6 .8 .4 .3 .4 .7 1.4 2,078 1,858 1,684 1,495 1,367 1,240 1,001 852 682 679 37 4 4 3 8 2 1 2 3 7 1.8 .2 .2 .2 .6 2 .1 .2 .4 1.0 60 113 166 251 331 413 604 726 861 857 2,205 2,180 2,170 2,164 2,160 2,153 2,141 2,137 2,132 2,121 25 10 6 4 7 12 4 5 11 23 1.1 .5 .3 .2 .3 .6 .2 2 .5 1.1 1,928 1,711 1,577 1^383 1,266 1,144 932 798 621 619 16 5 .8 .3 1 3 2 2 1 2 .1 .2 .2 .2 .1 .3 53 107 119 203 262 345 496 590 742 738 767 748 745 744 742 740 737 734 733 733 19 3 1 2 2 3 3 1 2.5 .4 .1 .3 .3 .4 .4 .1 10 1.5 1 .2 1 .2 1 .4 6 .8 651 574 519 472 441 408 321 282 223 223 2 .9 424 419 419 418 417 417 417 417 416 415 5 1.2 5 1.3 1 1 .2 .2 377 317 274 232 207 196 1 1 .2 .2 137 109 109 27 39 55 74 85 108 172 192 235 235 12 27 38 59 67 71 91 98 112 112 4 1 .9 1 1 1 .4 ‘ .3 .2 2 4 4 .3 .5 .5 1 1 .8 1 1 1 .4 .3 .2 4 3 .5 ,_4 2 1 1 .6 224 340 452 545 579 605 644 665 690 681 10 4 7 10 10 6 5 6 9 21 4.5 1.2 1.5 1.8 1.7 1.0 .8 .9 1.3 3.1 224 360 472 576 630 662 711 747 767 762 8 5 5 3 3 9 1 4 5 20 3.6 1.4 1.1 .5 .5 1.4 .1 .5 .7 2.6 88 135 171 198 216 224 244 260 275 275 6 3 2.2 1 2 2 2 .5 .9 .9 .8 4 1.5 1 1 .9 .8 1 1 .5 .5 75 107 127 143 150 170 182 195 194 2 2 2 2 2 2 2 2 2 1 1 APPENDIX VII.— TABLES. J650-8849— First month.................... Second month................ Third month.................. Fourth month................ Fifth month................... Sixth month................... Seventh month.............. Eighth month................ Ninth month.................. Tenth to twelfth month8 •850-11,249First month.................... Second month......... ...... Third month.................. Fourth month................ Fifth month....... ........... Sixth month.........1....... Seventh month............. Eighth month................ Ninth month.................. Tenth to twelfth month8 •1,250-81,840First month.................... Second month................ Third month.................. Fourth month................ Fifth month................... Sixth month................... Seventh month.............. Eighth month................ Ninth month.................. Tenth to twelfth month8 •1,850 and over— First month.................... Second month................ Third month.................. Fourth month................ Fifth month................... Sixth month................... Seventh month.............. Eighth month................ Ninth month.................. Tenth to twelfth month8 1 Excludes 35 not fed (died at once). * Not shown where base is less than 100. 8 Figures are infant survivors at beginning of tenth month, who are classified according to type of feeding m the ninth month; and deaths in tenth, eleventh, and twelfth months in each of these groups. The rate shows the deaths in these three months per 1,000 survivors at the beginning of the tenth month. 269 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis T a b l e 5 9 .— M on th ly death rates, by typ e o f feedin g, and by earnings o f fa th er and color and n a tiv ity o f mother; in fa n ts b o m in 1 9 1 5 1— C ontinued. Month of life of infant, earnings of father, and color and nativ ity of mother. Infant survivors. Infant survivors. Infant Number. Percent.2 Number. Per cent.2 all mothers—continued. Earnings of father—Continued No earnings— First month................ Second month.......... Third month............... Fourth month............. Fifth month................ Sixth month............... Seventh month........... Eighth month............. Ninth month............... Tenth to twelfth month8 Not reported— First month............... Second month........... Third month............. Fourth month........... Fifth month.............. Sixth month.............. Seventh month......... Eighth month........... Ninth month............. Tenth to twelfth month8 201 199 198 195 191 184 175 170 169 169 2 1 3 4 7 9 5 1 1.0 .5 1.5 2.1 3.7 4.9 2.9 .6 5 3.0 210 3 4 2 3 2 1.4 1.9 1.0 1.5 1.0 1 4 4 3 .5 2.1 2.1 1.6 26 9 12 10 10 12 14 2.5 .9 1.2 1.0 1.0 1.2 1.4 207 203 201 198 196 196 195 191 187 1 1 1 2 .6 .8 .9 1 1 2 1 1.1 .7 1 .9 1 3 1 1 NATIVE WHITE MOTHERS. Earnings of father: Under $550— . First month............... Second month........... Third month............. Fourth month........... Fifth month___ ____ Sixth m onth............. Seventh month......... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1,058 1,032 1,023 1,011 1,001 991 979 928 814 729 622 557 507 393 18 1 1 1.9 .1 .1 130 169 205 300 1 5 1 1 .8 .6 1 .3 107 160 208 259 275 279 286 Number. Percent.1 Feeding not re ported. Deaths Infant in survivors. month. INFANT MORTALITY, BALTIMORE, MD. Number. Percent.2 Deaths in month. Deaths in month. Deaths in month. Deaths in month. Infant survivors.] Artificially fed. Mixed fed. Breast fed. Total. ^ Fourth month................ Fifth month................... Sixth month.................. Seventh month.............. Eighth month................ Tenth to twelfth month s 965 958 954 7 4 18 .7 .4 1.9 336 264 264 2,568 2,519 2,5C6 2,492 2,476 2,456 2,447 2,435 2,421 2,404 49 13 14 16 20 9 12 14 17 33 1.9 .5 .6 .6 .8 .4 .5 .6 .7 1.4 1,761 1,743 1,735 1,731 1,729 1,722 1,712 1,708 i;704 1,694 18 8 4 2 7 10 4 4 10 18 609 594 591 590 589 589 586 583 582 582 360 355 354 353 353 353 353 352 352 2 .8 2,227 1,971 1,778 1,552 1,422 1,304 1,072 930 768 766 31 6 3 4 6 2 1.4 .3 .2 .3 .4 .2 2 2 6 .2 .3 .8 1.0 .5 .2 .1 .4 .6 .2 .2 .6 1.1 1,524 1,347 1,232 l ’ 078 986 897 ■ 740 6 '6 498 497 10 5 .7 .4 15 3 1 1 2.5 .5 .2 .2 3 3 1 .5 6 1.0 5 1.4 1 1 .3 .3 1 .3 .2 3 2 2 .3 .2 .3 1 .2 514 449 404 365 345 322 259 234 188 188 10 1.9 1 .2 1 .3 1 .4 2 1.1 320 267 232 196 177 171 140 123 101 101 5 1.6 348 400 400 4 1.1 3 .8 60 112 147 253 333 405 592 713 847 844 4 1 .9 41 79 83 144 191 246 356 433 554 550 1 20 24 35 46 50 109 119 151' 151 11 23 30 47 53 54 68 73 83 83 1 .3 1 1 3 5 .2 .1 .4 .6 1 1 1 .5 .4 .3 4 3 .7 .5 2 1 .9 281 294 290 3 4 13 1.1 1.4 4.5 280 436 581 687 •721 747 783 792 806 794 13 6 11 12 13 7 11 11 12 22 4.6 1.4 1.9 1.7 1.8 .9 1.4 1.4 1.5 2.8 196 316 419 508 551 578 615 638 651 646 7 3 4 2 3 7 1 4 5 15 3.6), 1.2 .2 .6 .8 2.3 75 121 152 179 194 202 218 230 243 243 3 3 2.5 .ft l.Q .4, i .6 2 2 1.0 .9 4 1.6 1 1 .9 1 .6 1 1 1 1 1 1 1 1 1 1 1 APPENDIX VII. ---- TABLES. Eighth month................ Ninth month................ . Tenth to twelfth months $550-8849— First month.................... Second month................ Third month.................. Fourth month................ Fifth month................... Sixth month.................. Seventh month.............. Eighth month................ Ninth month.................. Tenth to twelfth month $850-81,249— First month................ Second month........... Third month....... Fourth month......... Fifth m onth.............. Sixth month............ Seventh month.............. Eighth month................ Ninth month............... Tenth to twelfth months $1,250-81,849— First month.................... Second month................ Third month.................. Fourth month................ Fifth month................... Sixth month.................. Seventh month.............. Eighth month................ Ninth month.................. Tenth t o twelfth month 3 $1,850 and over— First month.................... Second month................ 29 93 111 123 128 145 157 168 168 1 Excludes 35 not fed (died at once). * Not shown where base is less than 100. * Figures areinfant survivors at beginning of tenth month, who are classified according to type of feeding in the ninth month; and deaths in tenth, eleventh, and twelfth months in each of these groups. The rate shows the deaths in these three months per 1,000 survivors at the beginning of the tenth month. kq f-i https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Total. Month o f life of infant, earnings of father, and color and nativ ity of mother. Breast fed. Deaths in month. Infant survivors. Infant survivors. Number. Percent.2 Number. Per cent.2 Infant survivors. Deaths Infant in survivors. month. Number. Percent.2 NATIVE WHITE MOTHERS— Con. Earnings of father—Continued No earnings— First month.................... Fourth month................ Sixth month.................. Seventh month.............. Eighth month................. Ninth month.................. Tenth to twelfth month * Not reported— Third month.................. Fourth month................ Fifth month................... Sixth month.................. Seventh month.............. Eighth month................ Tenth to twelfth month3 86 86 85 84 83 78 75 74 74 74 66 57 50 43 41 37 30 28 24 24 1 1 1 5 3 1 2 125 124 123 122 120 119 119 119 116 113 1 1 1 2 1 .8 .8 .8 1.6 .8 3 3 3 569 558 552 545 544 540 531 11 6 7 1 4 9 4 1 6 7 9 9 13 17 19 21 21 1 1 1 2.5 2.6 2.7 102 80 72 66 , 60 52 41 37 28 28 1.9 1.1 1.3 .2 .7 1.7 .8 506 455 416 362 335 294 228 8 5 3 1.6 1.1 .7 2 1 .6 .3 1.0 3 11 15 17 18 24 30 31 36 33 1 19 22 28 §2 33 28 28 27 29 29 i 3 1 20 33 36 38 41 42 48 51 52 52 2 2 1 35 57 69 82 88 102 111 1 i i 1 5 2 1 1 1 2 1 i i i 2 2 FOBEIGN-BORN WHITE MOTHERS. Earnings of father: Under 8450— Seventh month.............. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 27 44 65 99 119 142 190 1.7 1.4 .5 3 1 4 1 6 3 5.9 2.7 i 2 2 2 2 2 2 IN FAN T MORTALITY, BALTIMORE, MD, Number. Percent.2 Deaths in month. Deaths in month. Deaths in month. Infant survivors. Feeding not re ported. Artificially fed. Mixed fed. 272 T able 59.— Monthly death rates, by type offeed ing, and by earnings offather and color and nativity o f mother; infants born in l9 1 5 1— Continued. 101351o—23 527 520 517 7 3 14 1.3 .6 2.7 188 145 144 444 439 436 432 432 432 428 428 426 426 5 3 4 1.1 .7 .9 4 .9 2 .5 5 1.2 419 390 365 317 299 268 204 161 120 120 977 959 954 950 944 937 933 929 921 916 18 5 4 6 7 4 4 8 5 13 1.8 .5 .4 .6 .7 .4 .4 .9 .5 1.4 609 600 599 597 595 595 593 593 592 590 9 1 2 2 1.5 .2 .3 .3 2 .3 47 46 46 46 45 44 40 38 38 38 1 5 .7 3.5 5 2 3 1.2 .5 ;8 2 1.7 903 829 767 697 647 583 437 367 279 278 14 4 3 2 3 1 1.6 .5 .4 .3 .5 .2 3 1 2 .8 .4 .7 4 .7 .5 550 501 466 415 374 331 250 209 155 154 1 ............... 40 31 28 23 20 20 14 9 6 6 1 2 3 1 1 1 4 2 1 .2 1 1 .5 .6 1 ............... 218 253 253 14 26 39 68 84 110 168 199 234 234 29 54 82 118 152 197 321 372 441 440 17 39 56 89 111 145 205 232 274 274 1 .5 2 .8 119 121 119 5 2 7 I .9 1 .5 1 .4 11 23 32 47 49 54 56 68 72 72 .8 .7 .5 .3 .3 .2 .7 45 76 105 135 145 157 175 190 201 198 2 \ 1 3 3 2 3 4 3 8 41 59 76 92 109 118 137 151 162 161 4 1 1 i 2 1 1 1 1 1 1 3 1 6 7 1 10 9 1 9 13 16 19 19 ............... 7 9 11 13 16 15 13 13 13 13 4.2 1.7 5.9 2 1 1 1 1 1 3 i 2 1.0 2.2 2.1 1.3 1.7 . ......... 2.1 1.5 4.0 1 2 1.7 1 3 1.8 APPENDIX VII. ---- TABEES. Eighth month................ Ninth month.................. Tenth to twelfth month 8 *450-8549— First month................... Second month................ Third month.................. Fourth month................ Fifth month................... Sixth month.................. Seventh month.............. Eighth month................ Ninth month.................. Tenth to twelfth month * $550-$849— First month.................... Second........................... Third month.................. Fourth month.............. Fifth month............. Sixth month............... Seventh month.............. Eighth month........ Ninth month........ Tenth to twelfth month * *850 and over— First month................. Second month........... . Third month.................. Fourth month.............. Fifth month................... Sixth month___ Seventh month............. Eighth month................ Ninth month........ Tenth to twelfth month8 No earnings— First month.................... Second month............... Third month.................. Fourth month................ Fifth month................. Sixth month................... Seventh month............ Eighth month................ Ninth month................. Tenth to twelfth month8 1 1 3 1 í 273 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 274 T a b l e 59.— Monthly death rates, by type o f feeding, and by earnings o f father and color and nativity o f mother; infants born in 19151— Concluded. Total. Month of life of infant, earnings of father, and color and nativ ity of mother. Breastfed. Deaths in month. ant vors. Deaths in month. Infant survivors. Number. Percent.2 Number. Percent.2 re Deaths in month. Deaths in month. Infant survivors. Feeding not ported. Artificially fed. Infant survivors. Deaths Infant survivors. month. Number. Per cent.2 FOREIGN-BORN 'WHITE MOTH ERS— continued. Earnings of father—Continued. Not reported— First month.................... Second m onth................ Third month........ ......... Fourth month................ Fifth month.................. Sixth month.................. Seventh month.............. Eighth month................ Ninth m onth................. Tenth to twelfth month8 1 45 43 42 41 41 40 40 39 39 38 2 1 1 489 473 467 464 458 452 444 441 437 435 16 6 3 6 6 8 3 4 2 11 3.3 1.3 .6 1.3 1.3 1.8 .7 .9 .5 2.5 444 374 316 258 227 202 144 115 85 85 12 5 1 2 1 2 347 331 329 325 319 314 16 2 4 6 5 5 4.6 .6 1.2 1.8 1.6 1.6 314 270 242 204 178 159 7 1 2 2 2 1 38 32 29 25 25 22 19 18 11 10 1 1 1 2 2 2 6 6 8 9 9 15 15 1 5 9 10 9 9 10 12 12 13 13 1 1 1 i i i 1 COLORED MOTHERS. Earnings of fathers: Under 8450— First'month.................. , Second m o n t h ............. Third m onth.,............... Fourth month................ Fifth month................... Sixth month_________ _ Seventh m o n th ... . ; __ _ Eighth month................ Ninth month................. Tenth to twelfth month8 $450-8549— First m o n th ,................ Second mouth._____ Third month. . ............... Fourth month_____ Fifth month.............. Sixth m o n th .,................ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 2.7 1.3 .3 .8 .4 1.0 14 48 75 105 122 136 176 191 213 213 2.2 '.4 .8 1.0 1.1 .6 12 30 45 66 81 91 3 1 1 1 1 .8 .7 .6 4 1.9 2 1 1 1 31 51 76 101 109 114 124 135 139 137 4 1 1 4 4 6 2 4 2 4 21 31 42 55 60 64 7 1 1 3 2 4 4.0 3.7 4.4 1.6 3.0 1.4 2.9 1 IN FA N T MORTALITY, BALTIMORE, MD. Number. Percent.2 Mixed fed. 1 1 326 12 1 4.1 .4 1 .5 3 2.6 311 307 305 301 298 297 293 293 292 1 130 147 157 156 309 307 305 302 1 2 2 2 2 1 2 1 1 3 1 1 APPENDIX VII.-----TABLES. Seventh month. . . . . . . . . Eighth month.. . . . . . . . . . Ninth month.................. Tenth to twelfth month * $550 and over— First month.................... Second month.............. Third month.................. Fourth month................ Fifth m onth.. . . . . . . . . . . Sixth month.................. Seventh month.............. Eighth month................. Ninth month................. Tenth to twelfth month8 No earnings— First m onth............. Second m pnth-... . . . , Third month.. . . . . . . . Fourth month........... Fifth month.............. Sixth month.............. Seventh month......... Eighth month........... Ninth month............. Tenth to twelfth month8 Not reported— First month:.;... . . . . . Second month......... . Third month............. Fourth month........... Fifth month......... Sixth, month.............. Seventh month......... Eighth month........... Ninthmonth............. Tenth to twelfth month8 1 1 2 1 2 1 2 2 1 i 1 E x clu d e s 35 n o t fe d (d ie d at o n c e ). * N o t sh ow n w h ere b ase is less t h a n 100: - . . . , _ _ . 8 Figures are in fa n t su rvivors at be gin n in g o f te n th m o n th * w h o are classified acco rdin g t o ty p e o f feed in g in th e n in th m o n th , a n d d eath s in te n th , eleven th , a n d tw e lfth m on th s in each o f these groups. T h e rate sh ow s th e d eath s in these three m o n th s p e r 1,000 su rv iv ors at th e b eg in n in g o f th e t e n th m o n th . 275 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Earnings of father and color and nativity of mother. No earnings.............................................................. Not reported............................................................ Earnings of father: Under $550................................................................ $550-8849............ ...................................................... $850-$l,249................................................................ $1,250 and over......................................................... Not re p o rte d ..................................................... . Earnings of father: Under $550................................................................ $550-$849................................................................... $850 and over............................................................ Not reported............................................................ Earnings of father: Under $550............................................................... $550 and over........................................................... No earnings........................................................ . . . Not reported............................................................ i For first nine months of life only. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis First month. Ninth month. 9,283 2,825 2,611 3,372 1,928 651 377 168 176 684 1,108 621 223 109 37 43 5,681 1,871 928 2,227 1,524 834 66 102 264 768 498 289 24 28 2,456 716 925 903 550 40 38 265 279 155 6 11 1,146 238 758 290 62 36 155 72 7 4 Number. Com Total puted months infant of Ninth First feeding.1 mortali month. ty rate.2 month. 14,422 19,835 11,360 3,891 2,005 798 892 5,150 13,024 8,938 4,807 376 538 5,472 5,509 3,251 191 219 3,800 1,562 231 135 43.3 281 3,890 61.8 46.1 22.5 23.2 13.3 0 0 88 93 53 27 12 1 7 1,257 1,400 742 235 112 74 70 32.7 156 2,092 39.0 39.0 20.2 31.1 (3) 0 21 60 41 31 3 400 847 554 234 21 36 50.2 89 1,236 487 441 274 19 15 63.8 51.1 20.9 (3) (/’ 41 29 17 90.2 36 562 91.4 88.0 (3) (3) 26 7 1 2 370 139 34 19 2 Com Number. Total puted months infant of Ninth First feeding.1 mortali month. ty rate.2 month. 5,655 5,740 2,917 987 575 404 375 1,717 3,462 2,127 1,061 101 185 2,099 1,766 1,168 89 59 1,839 635 214 131 87.4 958 3,153 87.8 108.5 44.6 91.9 205 348 224 88 35 31 27 704 1,076 767 275 195 58 78 85.8 726 2,243 107.0 89.3 48.4 69.7 (3) (3) 107 280 196 104 19 20 294 806 651 411 29 52 61.0 144 582 0 (3) 35.1 101.3 17.9 (3) (3) 46 45 41 7 5 193 201 162 13 13 146.8 88 328 140.4 229.0 (3) (3) 52 29 5 2 217 82 16 13 2 Per 1,000 infants fed. For method of computation, see Appendix V, p. 199. rsLt Com Total puted months infant of feeding.1 mortali ty rate.* 191.4 4,717 7,502 5,149 1,811 1,184 478 524 310.1 185.4 117.3 130.1 27.5 0 0 160.8 2,149 5,833 4,472 2,633 246 361 289.9 178.8 109.6 77.3 (3) (3) 1,196 1,229 945 110 89 274.1 196.9 169.7 0 0 232.1 347.3 1,372 534 122 74 3 Rate not computed. 387.9 252.4 0 0 IN FA N T MORTALITY, BALTIMORE, MD. All mothers........................................................... Earnings of father: Under $550................................................................ $550-1849................................................................... $850-$l,249................................................................ $1,250-SI, 849.......................................... ................. Number. Artificially-fed infants. Mixed-fed infants. Breast-fed infants. 276 T able 60.— Computed infant mortality rates, by type o f feeding, and by earnings o f father and color and nativity o f mother; infants born in 1915. / T a b l e 61 . -Computed infant mortality rates, by type o f feeding, and by nationality o f mother; infants born in 1915 to foreign-born white mothers. Breast-fed infants. Number. Nationality of mother. First month. Ninth month. 2,456 716 Jewish...................................................................... Polish....................................................................... Italian...................................................................... All others................................................................. 878 559 372 647 206 185 125 200 1 For first nine months of life only. Com Total puted months infant of feeding.1 mortali ty rate.* 5,029 3,446 2,379 3,588 Number. First month. Ninth month. 50.2 89 1,236 31.4 83.7 43.3 48.6 39 17 18 15 542 259 172 263 2 Per 1,000 infants fed. Artificially-fed infants. Com Total puted months infant of feeding.1 mortali ty rate.2 First month. Ninth month. 61.0 144 582 26.1 105.8 85.4 77.2 27 29 11 77 171 99 84 228 2,377 1,039 697 805 Number. For method of computation, see Appendix V, p. —. Com Total puted months mfant of feeding.1 mortali ty rate.2 232.1 944 658 422 1,317 137.2 385.3 152.9 230.5 APPENDIX VII.— TABLES. Foreign-bom white mothers.......................................... Mixed-fed infants. 277 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 278 T able IN F A N T MORTALITY, BALTIMORE, MD. 62.— M on th ly death ra tes, by ty p e o f fe ed in g , m on th o f life an d cause o f d eath; infants bom in 1915. Deaths in month from specified causes per 1,000 survivors fed in specified way. Month oflife. Breast fed. Total. First........................... Third......................... Fourth....................... Fifth........................... Sixth.......................... Seventh...................... Eighth........................ Ninth......................... Tenth......................... All other causes; Gastric and intestinal diseases. 1.6 1.5 3.1 2.6 2.9 4.4 3.6 2.4 2.0 2.7 1.3 .9 .8 .2 .3 .6 .5 .3 .4 1.0 Mixed fed. 7.1 5.9 3.1 2.5 3.1 1.1 1.2 1.3 .7 Artifi cially fed. 3.1 5.2 10.5 9.1 8.4 13.9 10.6 5.9 4.4 6.6 Total. 42.6 4.8 3.0 3.4 4.1 3.2 2.0 3.2 3.1 2.2 Breast fed. 13.7 3.1 1.6 2.2 3.0 1.7 1.2 1.9 2.5 2.4 Mixed fed. 35.6 6.6 3.6 2.3 3.1 5.1 2.1 2.1 1.8 .9 Artifi cially fed. 52.2 13.7 8.0 7.4 7.3 6.6 3.1 5.9 5.4 3.9 T able 63.— Computed mortality rates fo r first 10 months o f life, by cause o f death o f infant and color o f mother; infants bom in 1915. Computed deaths in first 10 months of life per 1,000 in fants. Cause of death of infant and color of mother. Breast fed. All mothers: White mothers: Colored mothers: Mixed fed: Artifi cially fed. 6.3 32.9 244 59.5 75.1 108.8 5.9 28.4 22.3 51.2 75.5 89.3 8.0 67.1 41.6 99.7 72.7 280.7 T able 64.—Death rates from each month to end o f first year, by month in which artificial feeding began; infants bom in 1915 and artificially fed during some part o f first year o f life. Month in which arti- Fer cent of subsequent deaths among survivors at beginning of specified month' oflife. S econ d. F irs t................................. S econ d ............................ T h i r d .............................. F o u r th ............................ F ifth ................................ S ix t h ............................... S e v e n th .......................... E ig h th ............................ N in th .............................. A fte r n i n t h 2 ................ 20.7 13.3 0 0 0) 0 0 0 0 ■ 2.8 T h ird . F ou rth . 16.4 18.7 12.4 11.2 10.6 9.7 0 0 0 0 0 0 2.4 F ifth . S ix th . . S even th . E igh th . 7.4 5.4 5.6 3 .0 3.3 5 .0 3 .6 6 .4 3 .2 4.2 1.8 1.8 2.1 1.1 13.8 9.9 11.9 8.6 9 .6 6 .9 7 .5 6.0 8.0 8.8 8.0 6.6 5.5 5.1 7.3 3 .9 3 .3 7.3 44 2. 2. 0 0 0 02.0 0 0 0 0 0 0 0 01.7 0 01.5 01.3 N in th . 2.1 2 .4 44 3 '2 1 Since the basis of classification requires that all infants of the several groups shall be alive at the begin ning of the month when first artificially fed, rates for subsequent deaths among survivors at beginning of previous month are not shown. 2Computed from monthly rates for breast-fed infants. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 279 APPENDIX V II.— TABLES. T 65.— Computed (annual) infant mortality rates, by month in which artificial feeding began; infants bom in 1915. able Month of life in which ex clusively artificialfeed ing began. Infants whose artificial feeding began in stated month. Computed (annual) infant mortality rates per 1,000 fed.i 952 622 508 461 217 165 First.................................. S econ d ............................ Third................................. Fourth.............................. Fifth.................................. Sixth.................................. 251.1 170.5 125.5 106.3 79.3 99.6 Infants whose artificial feeding began in stated month. Month of life in which ex clusively artificial feed ing began. 250 163 146 384 157 Eighth......... Twelfth___ Computed (annual) infant mortality rates per 1,000 fedd 73.3 49.8 53.6 48 2 n ]For computation of annual rate it is assumed that during month next preceding the month in which artificial feeding began, the infants were mixed fed and that during earlier months they were breastfed. Computations are based on monthly death rates for breast or mixed fed infants, Table 58, and on the per cent of subsequent deaths among survivors at the begin n ing of the months in which artificial feeding began, Table 64. 2Data not available for estimate. T 6 6 . — Monthly death rates, by month o f life, and by month in which artificial feeding began; infants bom in 1915, and artificially fed. able Monthly death rates per 1,000 infants whose artificial feeding began in specified month. Month oflife. First. Second. Third. Fourth. Fifth. First___ Second.. Third__ Fourth.. F ifth .... S ixth .... Seventh. Eighth.. Ninth__ Tenth. . . Eleventh Twelfth.. T able 55.7 24.5 27.4 30.5 21.8 24.7 24.1 10.4 15.7 18.7 12.2 19.3 11.3 13.0 14.8 13.4 18.6 15.5 22.8 12.6 5.5 12.8 1.9 9.8 9.9 14.1 16.3 4.1 14.6 12.7 8.5 15.1 6.6 15.2 28.6 9.1 9.'2. 4.6 9.3 4.7 2.4 4.6 18.5 9.4 4.8 9.6 9.7 sixth. Seventh. Eighth. Ninth. Tenth. Eleventh. 24,2 6.2 12.5 6.3 6.4 19.2 8.0 4.0 4.0 24.4 4.2 6.1 6.2 6.2 ........ 6.8 13.8 14.6 5.6 5.6 6 7 — Weaning before end o f first year o f life, by color and nationality o f mother; infants bom in 1915 and surviving at one year. Infants born in 1915 and sur viving at 1 year of age. Completely weaned from breast. Color and nationality of mother. Total. Number. Percent.1 German............................................................................................... Bohemian................. ..............T.......................................................... 9,680 • 3,567 36.8 8,582 6,093 2,489 3,193 2,449 744 37.2 40.2 29.9 912 523 376 288 117 97 88 88 240 120 114 114 50 28 40 38 26.3 22.9 30.3 39.6 42.7 1,098 374 34.1 1Not shown where base is less than 100. 2Includes: 85 Irish, 17 English, 8 English-Canadian, and 7 Scotch 2Includes: 19 Russian, 17 Greek, 11 Magyar, 8 Norwegian, 5 Serbian, 5 French, 5 Slovak, 4 Rumanian, 3 Ruthenian, 3 French-Canadian, 2 Dutch, 2 Slavic (n. o. s.), 2 Swedish, 1 Arabian, and 1 Danish. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 280 INFANT MORTALITY, BALTIMORE, MD. T able 68.— Weaning before end o f first year o f life, by earnings offather; infants bom in 1915 and surviving at one year. Infants bom in 1915 and sur viving at 1 year of age. Earnings of father. Completely weaned from breast. Total. Number. Percent.1 Total.................................................................................................. Under $450............................................... $450-8549.................................... $550-8649....................... $6.50-8849........................... $850-81,049............................ $1,050-81,249...................... $1,250-81,449......................................................... $1,450-81,849................... $1,850-82,249.......... $2,250-82,849................. $2,850 and over............................. No earnings........................ Not reported......... ..................... 9,680 3,567 36.8 1,302 1,278 1,327 2,185 1,481 617 388 339 134 92 189 164 184 439 377 429 762 550 291 161 160 72 55 119 62 90 33.7 29.5 32.3 34.9 37.1 47.2 41.5 47.2 53.7 63.0 37.8 48.9 1 Not shown where base is less than 100. T able 69.— In fa n t m orta lity an d stillb irth rates, by color a n d n a tion a lity o f m oth er; births in 1915. m' Stillbirths. Color and nationality of mother. Total. Number. Total................................................... Per 1,000 births. Infant deaths. Live births. Infant Number. mortality rate.1 11,195 398 35.6 10,797 1,117 103.5 9,774 282 28.9 9,492 910 95.9 Native................................................ Foreign born.......................................... 6,937 2,837 198 84 28.5 29.6 6,739 2,753 646 264 95.9 95.9 Jewish............................................. Polish.............................................. Italian............................................. German............................................ Irish, English. Scotch, and English-Canadian2..................... Bohemian....................................... Lithuanian...................................... All other8........................................ 991 643 426 327 30 18 14 9 30.3 28.0 32.9 27.5 961 625 412 318 49 102 36 30 51.0 163.2 87.4 94.3 135 110 104 101 3 3 4 3 22.2 27.3 38.5 29.7 132 107 100 98 15 10 12 10 113.6 93.5 120.0 Colored mothers........................................... 1,421 116 81.6 1,305 207 158.6 White mothers........................................... 1Not shown where base is less than 100. 8Includes 101 Irish, 19 English, 10 English-Canadian, and 8 Scotch. 8 Includes 24 Russian, 19 Greek, 13 Magyar, 8 Norwegian, 6 Serbian, 5 French, 5 Slovak, 4 Rumanian, 4 Ruthenian, 3 French-Canadian, 3 Dutch, 2 Slavic (n. o. s.), 2 Spanish, 2 Swedish, 1 Arabian, and 1 Danish. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 281 APPENDIX "VII.— TABLES, T a b l e 70.— In fa n t m o rta lity an d stillb irth rates, by co lo r an d n a tio n a lity o f m oth er; births, a ll ■pregnancies.1 Births, all pregnancies. Infant deaths. Stillbirths. Color and nationality of mother. Live births. Total. Infant Number. mortality rate. Number. Per cent. Total................................................... 36,047 1,203 3.3 34,844 4,158 119.3 White mothers............................................. 31,312 872 ¿TiT 30,440 3,407 111.9 Foreign bom .......................................... 20,258 11,054 562 310 2.8 2.8 19,696 10,744 2,185 1,222 110.9 113.7 3,656 2,749 1,758 1,355 1,536 95 68 57 42 48 2.6 2.5 3.2 3.1 3.1 3,561 2,681 1,701 1,313 1,488 232 439 189 165 197 65.2 163.7 ill. 1 125.7 132.4 4,735 331 7.0 4,404 751 170.5 i To mothers of scheduled legitimate issues in 1915 who reported no previous illegitimate births. T a b l e 71.— In fa n t m orta lity ra tes,1 by cause o f death, and by co lo r and n a tio n a lity o f m oth er; live births in 1915. Mortality rates among infants bom to mothers of specified color and nation ality. Cause of death. Foreign-bom white. Native white. All causes...................... Gastric and intestinal diseases Respiratory diseases.............. Malformations........................ Early infancy......................... Epidemic and other commu nicable diseases................... External causes...................... Diseases ill-defined or unAll other causes....... ...........- - 95.9 Colored. Total. 95.9 Italian. Jewish. German. Polish. Allother. 87.4 51.0 94.3 163.2 107.6 158.6 22.0 25.2 68.8 32.0 3.2 43.2 38.9 20.6 4.6 27.5 30.7 49.0 2.3 49.8 12.6 1.6 0.4 11.4 16.9 3.1 7.7 2.3 38.8 13.7 4.0 38.1 29.1 20.7 3.3 30.9 9.7 26.7 9.7 34.0 9.4 9.4 1.0 22.9 4.7 1.4 .3 .9 6.5 .4 .7 .4 4.9 6.2 .4 5.2 1.1 4.0 31.4 2.4 2.1 3.1 4.8 9.6 i For figures upon which these rates are based, see Tables 49 and 69, pp. 259 and 280. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis .7 4.6 .8 6.8 282 INFANT MORTALITY, BALTIMORE, MD. T a b l e 72.—-Excess mortality among infants o f Polish mothers over that among infants o f other foreign-horn white mothers when the effect o f greater proportion o f employed among Polish mothers is eliminated; infants o f Polish mothers not employed away from home during infant’s lifetime. Infants of Polish mothers not gainfully employed away from home during specified month o f infant’s life.1 Month of life. Survivors at begin Actual ning of specified deaths. month. Total......... First................... Second................ Third.................. Fourth............... Fifth............ . Sixth................... Seventh.............. Eighth................ Ninth................. Tenth to twelfth. 614 570 561 530 521 505 486 471 449 410 Expected deaths.2 86 53.1 35 3 9 2 5 7 2 6 2 15 23.9 3.4 3.9 2.1 2.6 4.5 1.9 3.3 1.8 5.7 1 The figures include in each month all infants whose mothers were not employed away from home during that month. 2 Expected on the basis of monthly death rates among all infants of foreign-bom white mothers. These expected deaths are slightly greater than would have been expected on the basis of monthly death rates among infants of foreign-bom white mothers not employed away from home. T a b l e 73.—Stillbirth rates, by earnings o f father and color and nativity o f mother; births in 1915. Births to mothers of specified color and nativity. Total. Native white. Earnings of father. Stillbirths. Births, Foreign-bom white. Stillbirths. Stillbirths. Stillbirths. Per Births Per Births, Num Per Births Num 1,000 Num 1,000 Num Per 1,000 1,000 ber. births. ber. births.1 ber. births.1 ber. births.1 Total......... 11,195 398 35.6 6,937 28.5 2,837 29.6 1,615 1,523 1,543 2,490 2,318 44.0 48.6 35.0 29.3 26.7 460 663 936 1,776 1,849 23.9 28.7 29.9 28.2 25.4' 599 464 443 589 421 18.4 32.3 31.6 32.3 28.5 $850-81,049... 1,640 678 $1,050-1,249... 27.4 25.1 1,283 566 24.9 26.5 319 31.3 19.6 $1,250-81,849........ 810 24.7 645 $1,250-81,449.. $1,450-81,849.. 430 380 25.6 23.7 322 323 $1,850 and over... 448 37.! $1,850-82,249.. $2,250-82,849.. $2,850 a n d over........... 143 100 28.0 50.0 205 39.0 No earnings........ Not reported....... 222 67.6 53.1 Under $450.......... $450-8549............. $550-8649............. $650-8849............. $850-81,249........... Colored. 226 17 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 198 16 102 154 26.0 24.9 24.8 103 51 29.1 382 41.9 63 112 86 35.7 38.0 95 131 30.5 20 81.6 556 396 164 125 48 88.1 101.0 73.2 32.0 283 APPENDIX VII.— TABLES. T able 74.— Infant mortality rates, by earnings o f father and color and nativity o f mother; live births in 1915. Live births to mothers of specified color and nativity. Total. Native white. Infant deaths. Earnings of father. Foreign-born white. Infant deaths. Colored. Infant deaths. Infant deaths. Live Live Infant Live Infant Live Infant births. Num Infant mor births. Num mor births. Num mor births. Num mor ber. tality ber. tality ber. tality ber. tality rate.1 rate.1 rate.1 rate.1 Total............. 10,797 1,117 103.5 6,739 646 95.9 2,753 95.9 1,305 207 158.6 1,544 1,449 1,489 2,417 2,256 242 171 162 232 158 156.7 118.0 108.8 96.0 70.0 449 644 908 1,726 1,802 74 83 98 165 126 164.8 128.9 107.9 95.6 69.9 588 449 429 570 409 85~ 28 43 53 25 144.6 62.4 100.2 93.0 61.1 507 356 152 121 45 83 60 21 14 7 163.7 168.5 138.2 115.7 $850-$1,049........ 1,595 $1,050-$1,249.... 661 114 44 71.5 66.6 1,251 551 86 40 68.7 72.6 309 100 22 3 71.2 30.0 35 10 6 1 Under $450............. $450-1549................. $5.50-$649................. $650-$849................. $850-$l,249.............. 264 $1,250-$1,849............ 790 63 79.7 629 53 84.3 150 7 46.7 11 3 $1,250-$1,449___ $1,450-$1,849.... 419 371 31 32 74.0 86.3 314 315 24 29 76.4 92.1 100 50 4 3 40.0 5 6 3 $1,850 and over....... 431 16 37.1 366 14 38.3 62 2 3 $l,850-$2,249.... $2,250-$2,849___ $2,850 and over. 139 95 197 5 3 8 36.0 5 3 6 46.3 40.6 108 81 177 33.9 30 13 19 2 1 1 1 No earnings............ Not reported.......... 207 214 43 30 207.7 140.2 88 127 16 17 133.9 50 46 13 8 69 41 14 5 1 Not shown where base is less than 100. T able 75.— In fa n t m orta lity rates, b y earnings o ffa th er and color and n a tiv ity o f m other; liv e births, a ll pregnancies. Live births, all pregnancies. Color and nativity of mother. Total. Native white. Earnings of father. Infant deaths. Foreign-born white. Infant deaths. Colored. Infant deaths. Infant deaths. Live Live Infant Live Infant Live Infant births. Num Infant births. mor Num mor births. Num mor births. Num mor ber. tality ber. tality ber. tality ber. tality rate. rate. rate.1 rate.1 Total............. 34,844 4,158 119.3 19,696 2,185 110.9 10,744 1,222 113.7 4,404 751 170.5 5,751 4,837 4,975 7,521. 6,874 4,780 2,094 915 634 627 877 648 443 205 159.1 131.1 126.0 116.6 94.3 92.7 97.9 1,512 1,980 2,788 4,963 5,159 3,469 1,690 218 268 355 581 467 300 167 144.2 135.4 127.3 117.1 90.5 86.5 98.8 2,500 1,724 1,655 2,100 1,550 1,180 370 366 183 181 231 160 127 33 143.4 106.1 109.4 110.0 103.2 107.6 89.2 1,739 1,133 532 458 165 131 34 331 183 91 65 21 16 5 190.3 161.5 171.1 141.9 127.3 122.1 $1,250-$l, 849.......... 2,371 $1,250-$l,449... 1,291 $1,450-$1,849... 1,080 200 105 95 84.4 81.3 88.0 1,756 879 877 151 74 77 86.0 84.2 87.8 581 392 189 42 24 18 72.3 61.2 95.2 34 20 14 7 7 $1,850 and over...... 1,134 $1,850-$2,249... 366 $2,250-$2,849... 240 $2,850 and over. 528 61 18 10 33 53.8 49.2 41.7 62.5 892 249 199 444 54 18 10 26 60.5 72.3 50.3 58.6 239 116 40 83 7 29.3 7 3 1 1 1 107 89 156.7 127.5 259 387 47 44 181.5 113.7 215 180 25 27 116.3 150.0 209 131 Under $450.............. $450-$549................. $550-$649................. $650-$849................. $850-$l,249.............. $850-$l,049....... $1,050-$1,249... No earnings............ Not reported.......... 683 698 1N ot shown where base is less then 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 35 18 167.5 137.4 284 T able IN F A N T MORTALITY, BALTIMORE, M TV 76 .— S tillbirth rates, by earnings o f father and color and n a tiv ity o f m other; births, all pregnancies. Births to mothers of specified color and nativity; all pregnancies. Total. Native white. Earnings of father. Stillbirths. Births. Foreign-bom white. Stillbirths. Colored. Stillbirths. Stillbirths. Per Births. Num Per Births. Per Births. Per Num 1,000 Num 1,000 Num 1,000 1,000 ber. births. ber. births. ber. births.1 ber. births.1 36,047 1,203 33.4 20,258 562 27.7 11,054 310 28.0 4,735 331 69.9 6,002 5,050 5,123 7,735 7,078 251 213 148 214 204 41.8 42.2 28.9 27.7 28.8 1,552 2,039 2,858 5,094 5,308 40 59 70 131 149 25.8 28.9 24.5 25.7 28.1 2,561 1,786 1,701 2,160 1,593 61 62 46 60 43 23.8 34.7 27.0 27.8 27.0 1,889 1,225 564 481 177 150 92 32 23 12 79.'4 75.1 56.7 47.8 67.8 $850-11,049........ 4,915 $1,050-$1,249..„ 2,163 135 69 27.5 31.9 3,561 1,747 92 57 25.8 32.6 1,213 380 33 10 27.2 26.3 141 36 10 2 70.9 15 7 67.0 50.7 Under $450.......... $450-1549.............. $550-$649.............. $650-$849.............. $850-$l,249........... $1,250-11,849........ 2,439 68 27.9 1,813 57 31.4 592 11 18.6 34 $1,250-$1,449___ 1,326 $1,450-$1,849___ 1,113 35 33 26.4 29.6 904 909 25 32 27.7 35.2 402 190 10 1 24.9 5.3 20 14 $1,850 and over... 1,172 38 32.4 922 30 32.5 247 8 32.4 3 $l,850-$2,249__ $2,250-$2,849___ $2,850 and over. 375 251 546 9 11 18 24.0 43.8 33.0 257 206 459 8 7 15 31.1 34.0 32.7 117 44 86 1 4 3 8.5 1 1 1 No earnings......... Not reported....... 723 725 40 27 55.3 37.2 274 398 15 11 54.7 27.6 225 189 10 9 44.4 47.6 224 138 1Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 285 APPENDIX V II.---- TABUES. T a b l e 77 .— N eonatal in fa n t m ortality rates, earnings o f fath er, and color and n a tion a lity o f m oth er; live births in 1 9 1 5 . Infant deaths it specified age. Earnings of father and color and nationality of mother. Live births. Under 1 month. Number. 1 month and over. Per 1,000 Per 1,000 live Number. live births.1 births.1 All mothers.......................................................... 10,797 477 44.2 640 59.3 Under $450.............................................................. $450-$549.................................................................. $550-$649.................................................................. $650-1849.................................................................. $850-11,249............................................................. $1,250-$1,849............................................................ $1,850 and over....................................................... No earnings............................................................. Not reported........................................................... 1,544 1,449 1,489 2,417 2,256 790 431 207 214 93 67 66 106 76 42 12 8 7 60.2 46.2 44.3 43.9 33.7 53.2 27.8 38.6 32.7 149 104 96 126 82 21 4 35 23 96.5 71.8 64.5 52.1 36.3 26.6 9.3 169.1 107.5 Native white mothers......................................... 6,739 286 42.4 360 53.4 Under $450.............................................................. $450-$549............................................... ................ $550-$649.................................................................. $650-8849............................................................. $850-$l,249....................................................... $1,250-81,849......................................................... $1,850 and over....................................................... No earnings......................................................... Not reported........................................................... 449 644 908 1,726 1,802 629 366 88 127 29 32 40 75 59 35 11 2 3 64.6 49.7 44.1 43.5 32.7 55.6 30.1 100.2 79.2 63.9 52.1 37.2 28.6 8.2 23.6 45 51 58 90 67 18 3 14 14 Foreign-bom white mothers.............................. 2,753 108 39.2 156 56.7 Under $650.............................................................. Under $450....................................................... $450-8549........................................................ $550-8649........................................................... $650 and over........................................................... $650-8849................................................... $850-81,249....................................................... $1,250 and over................................................. No earnings.............. ....................................... Not reported............................................... ...... Jewish................................................... 1,466 588 449 429 1,191 570 409 212 50 46 961 56 30 10 16 45 24 13 8 4 3 26 38.2 51.0 22.3 37.3 37.8 42.1 31.8 37.7 100 55 18 27 42 29 12 1 9 5 68.2 93.5 40.1 62.9 35.3 50.9 29.3 4.7 27.1 23 23.9 Under $650........................................................... $650 and over............................................ No earnings.............................................. Not reported........................................................... Polish.................................................... 446 469 27 19 625 10 14 1 1 22.4 29.9 12 5 3 3 26.9 10.7 35 56.0 67 107.2 Under $650.............................................................. $650 and over................................................. No earnings.........................................: ............. Not reported.......................................................... Italian................................................... 443 163 10 9 412 22 12 1 49.7 73.6 110.6 79.8 17 41.3 49 13 3 2 19 12 4 46.9 27.8 15 3 1 58.6 20.8 110.2 46.1 Under $650........................................................ $650 and over............................................... No earnings.................................................... Not reported........................................................ All other........................................... Earnings of father: Under $650................................................... $650 and over............................................... No earnings.............................................. Not reported................................................... Colored mothers........................................ 256 144 4 8 755 1 30 39.7 47 62.3 321 415 9 10 1,305 12 15 2 1 83 37.4 36.1 24 21 2 74.8 50.6 63.6 124 95.0 Under $450...................................................... $450-8549............................................................. $550-8649........................................................ $650 and over....................................................... No earnings...................................................... Not reported................................................. . 507 356 152 180 69 41 34 25 10 11 2 i 67.1 70.2 65.8 61.1 49 35 11 13 12 4 96.6 98.3 72.4 72.2 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 286 IN FAN T MORTALITY, BALTIMORE, MD. T able 78.— Infant mortality rates, by cause o f death, earnings o f father, and color and nationality o f mother; live births in 1915. Infant deaths from specified causes. Earnings of father and color and nationality of Live births. mother. Total infant deaths. Gastric and intestinal diseases. Respiratory and other communi cable diseases. Early in fancy. Other causes. Infant Infant Infant Infant Infant Num- mor- Num- mor- Num- mor- Num- mor- Num- morber. tality ber. tality ber. tality ber. tality ber. tality rate.1 rate.1 rate.1 rate.1 rate.1 All mothers............... Earnings of father: Under $450................... $450-$549.................. :. $550-$649...................... $650-1849...................... $850-81,249.................... $1,250-$1,849................. $1,850 and over............ No earnings........... N ot reported. . . . . . . . . . Native white moth ers........................... Earnings of father: Under $450................. $450-$549................. $550-8649.*...............'.. $650-8849....................... $850-81,249.................... $1,250-81,849................. $1,850 andover............ No earnings.................. Not reported......... . Foreign-bom white I mothers............ Earnings of father: Under $650................... Under $450............ $450-8549. . . 4 . . . . . . $550-8649................ $650 and over............... $650-8849................ $850-81,249............. $1,250 and over___ Noearnings........... 4. . . Not reported................ Jewish........... Earnings of father: Unaer$650................. $650 and over......... , . . . No earnings............ Not reported......... . Polish....... .......... Earnings of father: -Under $650.............. . $650 and over.......... . Noeamings.......... ^... Not reported............ Italian................. Earnings of father: Under $650......... ......... $650 and over............... Noeamings...........■:... Not reported................ Allother____. . . . Earnings of father: Under $650................... $650 and over.............. Noeamings ............. .. , 4 . . . Not reported......... . • Colored mothers....... Earnings of father: Under $450........ j ........ $450-8549.................. .1. $550-8649............ . $650 and over............... N oeam ings................. Not reported............... : 10,797 1,117 103.5 314 29.1 285 26.4 156.7 118.0 108.8 96.0 70.0 79.7 37.1 207.7 140.2 73 59 46 55 41 8 2 20 10 47.3 40.7 30.9 22.8 18.2 10.1 4.6 96.6 46.7 74 42 41 63 33 8 2 13 9 47.9 29.0 27.5 26.1 14.6 10.1 4.6 62.8 42.1 646 95.9 194 28.8 124 18.4 74 83 98 165 126 53 14 16 17 164.8 128.9 107.9 95.6 69.9 84.3 38.3 51.2 52.8 37.4 25.5 17.2 12.7 5.5 63.0 17 14 17 38 24 7 1 2 4 37.9 21.7 18.7 22.0 13.3 11.1 2.7 133.9 23 34 34 44 31 8 2 10 8 2,753 264 95,9 80 29.1 1,466 588 449 429 1,191 570 409 212 50 46 961 156 85 28 43 87 53 25 9 13 8 49 108.4 144.6 62.4 100.2 73.0 93.0 61.1 42.5 53 33 12 8 20 10 10 36.2 56.1 26.7 18.6 16.8 17.5 24.4 446 469 27 19 625 22 19 4 4 102 49.3 40.5 443 163 10 9 412 71 25 4 2 36 256 144 4 8 755 27 7 1 1 77 105.5 48.6 4 102.0 24 321 415 9 10 1,305 36 36 4 1 207 112.1 86.7 13 10 1 158.6 507 ¿56 152 180 69 41 83 60 21 24 14 5 163.7 168.5 138.2 133.3 1,544 1,449 1,489 2,417 2,256 790 431 207 214 242 171 162 232 158 63 16 43 30 6,739 449 644 908 1,726 1,802 629 366 88 127 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 51.0 5 2 9 9.4 5 2 2 11.2 4.3 163.2 43 68.8 160.3 153.4 31 8 2 2 •4 87.4 37.7 I ll 10.3 49.2 36.6 42.3 37.6 28.4 45.6 20.9 33.8 37.4 19 17 12 23 20 11 3 3 3 12.3 11.7 8.1 9.5 8.9 13.9 7.0 14.5 14.0 257 38.1 71 10.5 28 28 41 67 51 28 8 3 62.4 43.5 45.2 38.8 28.3 44.5 21.9 13.4 10.9 6.6 9.3 11.1 15.9 8.2 31.5 3 23.6 6 7 6 16 20 10 3 1 2 75 27.2 85 30.9 24 8.7 45 21 7 17 24 18 5 1 4 2 15 30.7 35.7 15.6 39.6 20.2 31.6 12.2 4.7 42 24 4 14 36 19 10 7 3 4 22 28.6 40.8 8.9 32.6 30.2 33.3 24.4 33.0 16 7 5 4 7 6 10.9 11.9 11.1 9.3 5.9 10.5 1 1 4.7 22.9 3 3.1 8 4 1 2 21 17.9 8.5 7 12 1 2 27 15.7 25.6 2 1 4.5 2.1 43.2 11 17.6 45.1 38.6 7 4 15.8 24.5 70.0 ' 13 49.0 7 1 15.6 33.6 407 76 53 63 91 64 36 9 7. 8 29.3 42.9 20 6 1 15.7 9.7 13 31.6 14 34.0 5 12.1 15.6 10 3 39.1 20.8 9 4 35.2 27.8 4 15.6 31.8 26' 34.4 1 22 29.1 5 6.6 40.5 24.1 14 10 2 43.6 24.1 18.7 33.7 3 2 9.3 4.8 40 30.7 86 65.9 17 13 4 1 5 33.5 36.5 26.3 5.6 36 21 7 12 7 3 71.0 59.0 46.1 66.7 6 14 1 1 65 24 21 8 10 1 1 1 49.8 16 12.3 47.3 59.0 52.6 55.6 - 6 5 2 1 1 1 11.8 14.0 13.2 5.6 APPENDIX VII.---- TABLES. 287 T able 79.—Deaths beforefeeding per 1,000 live births, and infant death rates per 1,000fed , by earnings o f father and color and nativity o f mother; live births in 1915. Infants died at once, not fed. Earnings of father and color and nativity of mother. Live births. Number. Infants fed. Subsequ«int deaths. Per 1,000 Number. live 1,000 births.1 Number. Per fed.1 All toothers........................................ 10,797 269 24.9 10,528 848 80.5 Earnings of father: Under $450............................................. $450-1549........................................... $550-$649................................................. $650-$849............................................. $850-$l,249.............................................. $1,250-$1,849................................... $1,850 and over....................................... No earnings........................................... Not reported.......................................... 1,544 1,449 1,489 2,417 2,256 790 431 207 214 49 37 37 55 51 23 7 6 4 31.7 25.5 24.8 22.8 22.6 29.1 16.2 29.0 18.7 1,495 1,412 1,452 2,362 2,205 767 424 201 210 193 134 125 177 107 40 9 37 26 129.1 94.9 86.1 74.9 48.5 52.2 21.2 184.1 123.8 Native white mothers........................ 6,739 172 25.5 6,567 474 72.2 Earnings of father: Under $450............................................. $450-$549.............................. $550-$649............................. $650-$849................................................. $850-$l,249........................... $1,250-$1,849........................................... $1,850 and over....................................... No earnings........................................... Not reported......................................... 449 644 908 1,726 1,802 629 366 88 127 12 23 24 42 41 20 6 2 2 26.7 35.7 26.4 24.3 22.8 31.8 16.4 62 60 74 123 85 33 8 14 15 141.9 96.6 83.7 73.0 48.3 54.2 22.2 15.7 437 621 884 1,684 1,761 609 360 86 125 120.0 Foreign-bom white mothers............. 2,753 62 22.5 2,691 202 75.1 Earnings of father: Under $450............................................. $450-$549................................................ $550-$649................................................ $650-$849................................................. $850-$l,249............................................. $1,250 and over....................................... No earnings............................ .............. Not reported.......................................... 588 449 429 570 409 212 50 46 19 5 11 11 8 4 3 1 32.3 11.1 25.6 19.3 19.6 18.9 569 444 418 559 401 208 47 45 66 23 32 42 17 5 10 7 116.0 51.8 76.6 75.1 42.4 24.0 Colored mothers................................. 1,305 35 26.8 1,270 172 135.4 Earnings of father: Under $450............................................. $450-$549................................................. $550-$649................................................ $650 and over......................................... No earnings........................................... Not reported......................................... 507 356 152 180 69 41 18 9 2 4 1 1 35.5 25.3 13.2 22.2 489 347 150 176 68 40 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 65 51 19 20 13 4; 132.9 147.0 126.7 113.6 288 INFANT MORTALITY, BALTIMORE, MD. T able 80.— Type o f feeding, by month o f life and earnings o f father and color and nativity o f mother; infants bom in 1915. Per cent of survivors.1 Earnings o f father and color and n a tiv ity of mother. All mothers... Earnings of father: Under $450........ $450-8549............ $550-8649............ $650-8849........... $850-^1,049......... $1,050-81,249...... $1,250-81,449___ $1,450-81,849___ $1,850-82,249.... $2,250-82,849.... $2,850 and over. No earnings___ Not reported__ Native white mothers. Earnings of father: Under $850.................. . Under $450............. $450-8549............... . $550-8649............... $650-8849............... $850 and over............... $850-81,049............. $1,050-81,249........... $1,250-81,449.......... $1,450-81,849.......... $1,850 and over___ No earnings................. Not reported............... Foreign-born white mothers.......... ....... Earnings of father: Under $850.................... Under $450............ $450-8549............... . $550-8649............... . $650-8849............... . $850 and over............... $850-81,049............. $1,050-81,249.......... $1,250 and over___ No earnings................. Not reported............... Colored mothers. Earnings of father: Under 8450............. $450-8549............... . $550-8649............... $650 and over........ No earnings.......... Not reported_____ Mixed fed. Breastfed. 1st mo. 3d mo. 6th mo. 9th mo. 1st mo. 3d mo. 6th mo. Artificially fed. 9th mo. 1st mo. 3d mo. 6th mo. 9th mo. 88.2 72.2 53.2 28.6 2.7 8.2 19.7 39.4 9.1 19.6 27.1 32.0 89.3 90.6 89.2 88.0 87.8 86.6 84.1 86.0 90.5 87.1 88.7 84.0 83.8 72.6 50.8 74.9 54.1 74.2 56.1 73.2 54.9 73.9 55.1 69.8 48.6 70.5 56.5 68.7 53.6 67.9 51.9 65.2 41.3 63.7 46.3 56.1 40.2 59.4 43.6 24.8 27.0 31.5 30.5 30.5 25.8 31.6 29.0 31.3 21.7 24.7 21.9 22.5 3.4 12.1 2.7 10.0 2.3 6.5 7.2 2.6 5.9 2.5 2.1 4.6 7.5 3.2 7.2 3.9 1.5 1 8 . 8 1.1 7.6 4.6 10.0 .5 17.2 3.3 14.9 25.6 24.6 18.4 18.3 16.3 15.5 14.9 14.2 15.6 18.5 17.4 28.3 25.6 46.8 48.3 39.9 38.6 35.9 32.3 33.4 30.5 27.6 29.3 25.3 43.8 36.6 7.4 6.7 8.5 9.5 9.7 11.3 12.7 10.1 8.0 11.8 6.7 15.5 12.9 15.4 15.1 19.3 19.6 20.2 25.6 22.0 24.1 23.4 27.2 26.3 26.8 25.7 23.6 21.3 25.5 26.8 28.7 35.9 28.6 32.2 32.6 40.2 36.3 31.5 30.8 28.5 24.7 28.6 30.9 33.6 41.9 34.9 40.5 41.0 48.9 50.0 34.3 40.8 86.6 70.1 52.2 30.1 2.4 6.3 16.0 33.7 11.2 23.6 31.8 36.1 87.1 71.0 87.8 74.0 87.9 69.4 87.7 72.2 86.3 70.3 86.4 69.7 87.0 72.5 85.4 67.6 84.0 70.6 84.8 66.1 88.9 65.4 76.7 58.8 81.6 58.5 52.5 52.5 50.3 53.1 53.1 52.2 54.1 47.6 57.2 52.1 48.4 47.4 44.1 30.5 26.6 28.2 33.9 30.6 29.8 31.1 25.0 34.0 30.6 28.7 32.4 24.1 2.2 2.1 1.9 2.3 2.4 2.6 2.4 2.1 2.9 3.6 3.1 2.4 6.6 8.0 8.7 4.4 6.6 5.5 4.9 4.6 5.4 6.5 8.5 8.2 12.2 17.7 19.3 21.6 17.2 16.1 13.7 14.4 14.1 10.4 11.6 15.3 16.7 20.3 36.9 41.8 41.7 35.1 34.9 29.9 33.6 30.0 27.2 24.7 23.6 28.4 31.1 10.7 10.1 10.1 10.1 11.3 11.0 10.5 12.5 13.1 11.6 8.1 22.1 16.0 22.4 18.1 21.9 23.3 23.1 24.8 22.6 27.8 24.1 27.4 26.2 32.9 29.3 29.8 28.1 28.2 29.7 30.8 34.1 31.5 38.3 32.3 36.3 36.3 35.9 35.6 32.6 31.6 30.1 31.1 34.4 40.3 35.3 45.0 38.8 44.8 47.7 39.2 44.8 91.3 78.9 58.7 28.3 3.3 9.6 23.6 48.8 5.4 11.5 17.6 23.0 91.9 89.1 94.4 93.3 91.8 90.5 90.4 92.9 89.4 85.1 84.4 79.8 75.6 83.7 81.2 79.8 77.9 80.1 80.6 73.5 60.9 70.7 60.0 29.2 54.6 27.9 62.0 28.2 64.9 29.7 60.2 30.7 55.7 26.2 59.2 29.0 54.1 29.9 51.5 20.6 45.5 15.8 55.0 28.2 3.5 4.8 3.2 2.4 3.4 2.8 2.6 2.0 3.4 4.4 9.6 11.8 8.9 8.5 8.6 9.4 8.5 5.1 12.7 15.2 4.9 23.5 26.4 25.5 18.6 22.9 24.4 22.3 22.4 28.4 20.5 20.0 49.7 48.7 54.9 48.7 47.2 46.4 43.1 43.3 52.5 50.0 38.5 4.6 6.2 2.5 4.3 4.8 6.7 7.0 5.1 7.2 14.9 11.1 10.6 12.5 7.3 10.2 11.6 12.7 11.5 14.3 13.7 23.9 24.4 16.4 19.0 12.5 16.6 16.9 19.8 18.5 23.5 20.1 34.1 25.0 21.1 23.3 16.9 21.6 22.0 27.4 27.9 27.0 26.8 34.2 33.3 90.2 68.9 46.8 21.1 2.8 15.7 30.4 49.8 7.0 15.4 22.8 29.1 90.8 90.5 86.7 90.9 91.2 90.0 67.7 73.6 65.7 77.8 49.3 50.0 44.7 50.6 48.5 54.9 27.4 29.7 19.5 23.0 22.6 26.3 12.3 11.1 2.9 3.5 2.0 2.3 1.5 5.0 16.1 13.7 13.6 10.8 29.9 34.2 30.1 29.0 25.0 27.8 48.4 48.6 48.7 51.5 43.6 50.6 59.6 52.8 6.3 6.1 11.3 6.8 7.4 5.0 16.3 12.8 20.7 11.4 20.9 15.8 25.2 20.4 26.5 17.3 24.2 21.6 31.8 25.6 33.8 23.1 28.1 36.1 1 Percentages are based upon total number of survivors at the beginning of the month whose type of feeding was reported. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX VII.— TABUES. 289 T able 81.— Type o f feeding, by month o f life and by nationality; infants bom in 1915 to foreign-bom white mothers. Per cent of survivors.1 Foreign-bom white moth ers: Jewish........................... Polish............................ It a lia n ........................ All other.......... ............ Artificially fed. Mixed fed. Breast fed. Nationality of mother. 1st mo. 3d mo. 6th mo. 9th mo. 1st mo. 3d mo. 6th mo. 9th mo. 1st mo. 3d mo. 6th mo. 93.0 92.4 92.8 87.6 80.1 81.7 83.2 72.7 55.7 65.0 66.3 53.5 22.4 34.1 32.8 28.9 4.1 2.8 4.5 2.0 12.4 8.0 9.7 7.1 31.4 19.5 19.9 18.8 59.0 47.7 45.1 38.1 2.9 4.8 2.7 10.4 7.5 10.3 7.1 20.2 12.9 15.5 13.7 27.7 9th mo. 18.6 18.2 22.0 33.0 1 Percentages are based upon total number of survivors at the beginning of the month whose type of feeding was reported. T able 82.—Relative mortality among infants in fam ilies where the father earned $450 to $549 in comparison with that among infants in fam ilies where the father earned $550 to $849, when effect o f differences in type o f feeding is eliminated; infants bom in 1915 to foreign-bom white mothers. Infants bom in 1915 to foreign-bom white mothers in families whore fathers earned $450 to I549.1 Month of life. Deaths in month. Deaths in month. Deaths in month. Deaths in month. Artificially fed. Mixed fed. Breast fed. Total. Sur Sur Sur Sur viv viv viv viv ors.1 Ac Ex ors. Ac Ex ors. Ac Ex ors. Ac Ex pect pect pect tual. pect tual. ed.* tual. ed.* tual. ed.’ ed.* Fifth Tenth to twelfth *................ 444 439 436 432 432 432 428 428 426 426 23 29.8 5 3 4 8.0 2.2 1.7 2.5 3.0 1.8 1.5 3.2 2.0 3.9 4 2 5 419 390 365 317 299 268 204 161 120 96 12 15.0 5 2 3 6.5 1.9 1.4 .9 1.4 .5 2 1.3 .4 .7 3 14 26 39 68 84 110 168 199 234 249 1.0 1 Í 1 8 6.0 .6 .6 .6 .5 .5 .5 1.7 ii 23 32 47 49 54 56 68 72 81 1 1 3 1 2 8.8 .5 .3 .3 1.0 1.0 .7 1.0 1.4 1.1 1.5 1 Excluding 5 live-bom infants who died at once, never fed. The total live births in foreign-bom white families, father’s earnings group, $450 to $549, was 449; 5infants died at once, never fed; if the rate for deaths of infants not fed (22.0 per 1,000 live births) among infants in foreign-born white families, father’s earnings group $550 to $849, bad applied to the group $450 to $549,9.9 deaths .wouhj have occurred of infants not fed, instead of the 5 that actually occurred. , . * For this comparison the numbers breast fed, mixed fed, and artificially fed during each month of life are multiplied by monthly death rates for breast fed, mixed fed, and artificially fed infants, respectively, for the same month of life in foreign-bom white families where the fathers earned $550 to $849. * Figures for survivors at beginning of tenth, and deaths in tenth, eleventh, and twelfth among them. 101351— 23------ 19 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 290 IN F A N T MORTALITY, BALTIMORE, MD. T able 83.— Infant mortality rates in favored group, by earnings o f father and color and nativity o f mother; live births in 1915. Favored group.1 Earnings of father and color and nativity of mother. A ll others. Infant deaths. Live births. Native white mothers.. Earnings of father: Under $450....................... $450-1549...................... $550-$649...................... . $650-$849......................... $850-$l,249.............. . $1,250-11,849..................... $1,850 and over._____ ____ No earnings.......... ........... Not reported.................... . Foreign-born w h i t e mothers.................... Earnings of father: Under $450......................... $450-$549........................... . $550-$649................... . $650-$849......................... $850-$l,249........................ $1,250 and over................. No earnings................. . Not reported...................... Colored mothers............ Earnings of father: Under $450.. .■.................... $450-$549....... .................... $550-$649............................ $650-$849........................... . $850 and ov er............... . No earnings........................ Not reported..................... Number. Infant mortality rate.2 Infant deaths. Live births. Number. Infant mortality rate.2 4,035 301 74.6 2,704 345 127.6 185 301 492 1,063 1,175 453 281 26 59 21 36 43 77 64 38 13 2 113.5 119.6 87.4 72.4 54.5 83.9 46.3 264 343 416 663 627 176 85 62 68 53 47 55 88 62 15 1 14 10 200.8 137.0 132.2 132. 7 98.9 85.2 832 49 58.9 1,921 215 111.9 112 102 127 214 159 102 4 12 201 11 5 9 16 5 3 98.2 49.0 70.9 74.8 31.4 29.4 89.6 74 23 34 37 20 6 13 8 189 155.5 66.3 112.6 103.9 80.0 54.5 18 476 347 302 356 250 110 46 34 1,104 458 290 118 94 44 65 35 80 53 19 10 9 14 4 7 49 66 34 27 15 4 6 3 7 2 4 1 1 171.2 174.6 182.8 161.0 1 The “ favored group” includes only infants from the second to the sixth in order of birth, bom after an interval of at least 2 years since preceding issue to literate mothers not employed during pregnancy or the year after the birth. N 2 Not shown where base is less than 100. T able 84.—Death rates in favored group per 100 (infants who lived at least two weeks), by average number o f persons per room and earnings o f father; infants bom in 1915 to white mothers, who lived at least two weeks in dwellings studied. Infants (of white mothers) who lived at least 2 weeks in dwellings with specified average number of persons per room. Less than 1. Earnings of father. Favored group.1 1 but less than 2. Others. Favored group.1 2 or more. Others. Deaths. Deaths. Deaths. Deaths. Deaths. Infants. InInInNum Per fants. Num- Per fants. Num- Per fants. NumPer fants. Num- Per ber. Ct.2 ber. ct.2 ber. ct.2 ber. ct.2 ber. Ct.2 Total... 3,247 Under $450... 113 $450-1549........ 193 $550-$849........ 1,146 $850-$l,249___ 1,025 $1,250 a n d over............ 704 No earnings.. 12 Not reported. 54 108 3.3 1,743 114 6.5 1,437 7.1 5.2 4.0 2.6 147 194 631 458 19 12.9 13 6.7 39 6.2 25 5.5 14 2.0 1 2 242 30 41 10 6 2 8 10 46 27 4.1 77 5.4 2,218 175 188 680 272 16 11 36 8 92 15 15 3 3 9.1 5.9 5.3 2.9 207 9.3 450 51 11.3 385 384 880 357 44 32 87 24 11.4 8.3 9.9 6.7 159 93 147 27 19 6 14 3 11.9 107 59 46 1 10 9 .9 8 12 4 7 2 9.5 1 • Favored group ” includes only infants from the second to the sixth in order of birth, bom after aninterval of at least 2 years since preceding issue, to literate mothers not employed during pregnancy or the year after the birth. 2 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 291 APPENDIX VII.— TABLES. T able 85.— Infant mortality rates, by occupation group 1 and earnings o f father and color and nativity o f mother; live births in 1915. Live births in families wherefathers were employed in specified occupations group.2 Groups I and II. Earnings of father and color and nativity of mother. Infant deaths. Live births. Earnings of father: Under $450....................... $450-$549....................... *550-8649......................... . $650-$849.......................... $850-81,249...................... $1,250-$1,8 4 9 ................. 1,850 and o v e r............. No earnings..... ............... Not reported.................... Foreign-bom w h i t e mothers................. Earnings of father: Under $450............. I........ $450-8549.......... ............... $550-8649........................... $650-8849...................... $850-81,249................... . $1,250 and over........... No earnings...................... Not reported.................... Colored mothers. .1....... Earnings of father: Under $450....................... $450-8549............... . $550-8649........................... $650 and over................... No earnings................... Not reported.................... Num ber. Infant mortal ity rate.8 Occupation not reported. Groups III, IV, and V. Infant deaths. Live births. Num ber. Live Infant births. mortal ity rate.8 Infant deaths. 2,344 247 105.4 4,304 380 88.3 8 3 307 416 536 689 313 48 7 54 53 48 63 21 3 175.9 127.4 89.6 91.4 67.1 19 30 50 102 105 50 14 134.8 132.7 134. 4 98.5 70.5 86.1 39.0 1 2 1 28 5 141 226 372 1,036 1,489 581 359 5 95 1,638 164 100.1 1,068 88 476 338 302 335 147 25 69 25 28 26 12 2 145.0 74.0 92.7 77.6 81.6 15 1,100 2 165 150.0 111 110 127 235 262 187 7 29 133 16 3 15 27 13 7 2 5 28 480 324 136 128 76 55 18 14 158.3 169. 8 132.4 109.4 32 2 27 32 16 52 1 5 7 5 3 10 1 2 1 4 2 82.4 4 i 144.1 27.3 118.1 114.9 49.6 37.4 1 1 10 210.5 2 4 i 1 4 1 1 For grouping see p. 36. 2 In families where father had no occupation (including those who lived on own income) 83 births to native-white mothers, with 16 deaths; 43 births to foreign-bom white mothers, with 11 deaths; and 68 births to colored mothers, with 13 deaths, were reported. ' 8 Not shown where base is less than 100. T able 86.—Excess mortality in overcrowded dwellings, with effect o f differences in father's earnings eliminated; infants {born in 1915 to native white mothers) who lived at least two weeks in dwellings with one or more persons per room. Infants (native white mothers) who lived at least 2 weeks in dwellings with 1 or more persons per room. Earnings of father. Expected deaths.1 Infants. Actual deaths. All.......................................................................................... 2,344 208 132.6 Under $450....................................................................................... $450-$549......................................................................................... $550-$649.......................................................................................... $650-$849......................................................................................... $850-$l,249..................................... ‘................................................. $1,250 and over................................................................................ 267 332 432 634 460 124 50 45 41 33 34 51 26 4 9 10 20.0 23.6 29.8 28.5 17.5 3.3 8.1 1.8 Not reported................................................ ................. ................ Per 100 Number. infants.2 7.5 7.1 6.9 4.5 3.8 ,2.7 4.0 1 Expected deaths are calculated by applying to the infants in each earning group the rates for infants (of native white mothers) in the same earnings group who lived in dwellings with less than 1 person per room. 2 Not shown where base is less than 100. Derived from Table 90. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 292 INFANT MORTALITY, BALTIMORE, MD. T a b l e 87.— Excess mortality, by ward o f residence and cause o f death, over mortality expected when differences due to color and nationality are eliminated; live births in 1915. Infant mortality rates from specified causes. Ward of residence. Live births. All causes. Early infancy. Gastric and intestinal diseases. Respiratory and other communi cable diseases. Ex Actual. Ex Actual. Ex Ex Actual. pected.1 pected.1 Actual. pected.1 pected.1 Total............................. 10,797 1.............................................. 2................................ ............ 3 .............................................. 4.............................................. 5 .............................................. 6 .............................................. 7 ........................... ................. 8.............................................. 9 .............................................. 10............................................ 11............................................ 12................... ........................ 13............................................ 14............................................ 15............................................ 16............................................ 17............................................ 18............................................ 19............................................ 20............................................ 21............................................ 22............................................ 23 .......................................... : 24............................................ 790 620 627 215 396 596 649 598 496 331 145 409 449 289 598 417 252 269 381 606 447 261 351 605 103.5 103.5 37.7 37.7 . 29.1 29.1 26.4 26.4 117.7 140.3 106.9 97.7 65.7 85.6 92.4 92.0 78.6 102.7 89.7 92.9 86.9 128.0 80.3 93.5 146.8 107.8 126.0 99.0 136.5 134.1 114.0 99.2 110.0 123.5 88.0 106.5 86.9 91.8 100.9 98.0 100.4 96.1 123.4 104.6 95.1 126.3 107.2 107.7 138.1 108.9 103.7 95.5 102.0 110.0 100.3 100.3 38.0 40.3 36.7 23.3 20.2 33.6 40.1 43.5 24.2 30.2 20.7 36.7 42.3 58.8 30.1 33.6 75.4 55.8 36.7 46.2 47.0 23.0 42.7 29.8 38.7 39.0 31.4 35.8 32.6 35.2 37.3 37.8 36.9 36.3 42.1 39.4 37.4 42.9 39.5 39.8 45.2 38.7 38.3 36.8 38.3 37.9 37.9 36.9 34.2 58.1 35.1 27.9 7.6 23.5 20.0 15.1 30.2 24.2 13.8 14.7 20.0 17.3 18.4 33.6 23.8 14.9 42.0 26.4 58.2 49.8 37.0 33.1 37.0 45.3 23.6 26.5 16.7 24.8 28.7 28.8 29.0 26.3 28.3 28.9 28.1 28.4 28.1 28.5 27.8 27.5 28.6 27.9 28.9 28.0 27.9 31.1 34 2 33.9 25.5 32.6 27.8 18.5 18.5 23.4 16.1 39.3 41.4 26.9 17.8 38.1 25.1 19.2 43.7 33.5 28.9 16.5 20.1 57.5 19.9 23.1 22.9 26.5 23.9 32.6 29.3 23.3 26.0 21.2 22.6 23.9 42.8 25.9 19.4 44.6 29.3 28.5 53.6 31.6 26.2 21.1 244 33.0 24.2 22.8 1 Expected rates are found b y dividing the births in each ward into the deaths calculated by applying the rates for all births in each color and nationality group to the live births of the corresponding groups in the ward. T a b l e 8 8 . —Excess m ortality in overcrowded dwellings, with effect o f differences infather's earnings eliminated; infants ( bom in 1915 to foreign-bom white mothers) who lived at least two weeks in dwellings with less than fine and with two or more persons per room. Infants (of foreign-bom white mothers) who lived at least 2 weeks in dwellings with specified number of persons per room. Less than 1. 2 or more. Earnings of father. Deaths. Deaths. Infants. Actual. Expect ed.1 Infants. Actual. Expect ed.1 40 5.4 10.5 7.6 Total................................................... 882 35 47.3 343 36 25.9 Under $450.................................................... $450-8549....................................................... $550—$649...................................................... $650—$849...................................................... $850-$l,249............ .'...................................... 100 106 107 214 200 122 11 22 15 3 5 4 3 2 2 1 10.1 46 7.‘5 12.4 6.6 1.2 2.3 2.6 131 73 64 42 19 3 9 2 14 3 6 5 3 13.2 3.1 4.5 2.4 .6 5 1.9 .2 Noearnings.................................................. 1 Expected deaths are calculated by applying to the infants in each earnings group the rates for allinfants (of foreign-born white mothers) in the same earnings group wholived at least 2 weeks in dwellings studied. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis A P P E N D I X V I I .-----T A B L E S . 293 T a b l e 89. Excess mortality in overcrowded dwellings, with effect o f differences in national ity eliminated; infants (bom in 1915 to foreign-bom white mothers) who lived at least two weeks in dwellings studied. Infants (of foreign-born white mothers) who lived at least 2 weeks in L ess than 1. Nationality of mother. 1 but less than 2. Deaths. Infants. Deaths. Infants. Infants. Actuàl. Expect Actual. Expect Actual. Expect ed.1 ed.1 ed.1 Infant death rates. T ota l... Jewish............ Polish............ Italian............ Other foreign. 2 or more. Deaths. 882 342 68 107 365 4.0 5.5 35 48.6 9.1 8.5 5.4 25.6 (*) ■B <*) 1,418 506 345 230 337 6.4 ft ft 91 (a) (*) (a) (a) 92.0 13.5 43.3 11.6 23.6 343 83 183 55 22 36 (a) (*) (a) (a) 29.4 2.2 22.9 2.8 1.5 l « Expected deaths” are based on rates for all infants in families of specified nationality. * Not tabu* lated. cent o f infant deaths, by average number o f persons per room, earnings o f fa tter, and color and nativity o f mother; infants bom in 1915 who lived at least two weeks m dwellings studied. Infants who lived at least 2 weeks in dwellings with specified average number of persons per room. Earnings of father and color and na tivity of mother. All mothers.. Earnings of father: Under $450......... $450-$549............ $550-1649.......... $650-$849............ Total.1 Less than 1. 692 6.7 5,544 1,457 1,387 1,428 2 , .321 2,183 $1,250 and over.. 1,170 No earnings___ 192 160 11.0 446 111 8.0 548 105 7.4 609 139 6.0 1,296 91 4.2 1,509 31 2.6 958 34 17.7 67 21 10.6 111 Native white mothers....... 6,464 Earnings of father: Under $450......... 428 S450-S549 395 6.1 4,108 53 12.4 160 53 8.6 281 7.3 437 97 5.9 1,019 75 4.3 1,283 26 2.7 824 14 31 13 10.9 73 SftftO-ftft4Q S85IVS1 9AQ Foreign-born white moth ers............ . Earnings of father: Under $450....... $450-$549.......... 2 or more. Not reported. Deaths. Deaths. Deaths. Deaths. In InInInInfants Num |Per fants Num Pei fants Num Per fants Num Pei fants Deaths. ber. et.2 ber. et.» ber. .et.2 ber. ct.2 10,336 $1,250 and over.. No earnings....... 1 but less than 2. 1,655 1,745 951 81 267 4.8 4,269 359 8.4 498 58 11.6 25 8 824 731 726 9.56 644 201 108 79 91 11.0 64 8.8 61 8.4 76 7.9 34 5.3 4 2.0 17 15.7 12 180 105 87 67 27 8 17 7 22 12.2 7 6.7 7 7 3 6 2 3 3 4 2 187 4.6 2,237 193 8.6 107 15 14.0 239 312 411 614 452 119 47 43 36 15.1 30 9.6 34 8.3 48 7.8 26 5.8 4 3.4 7 __ 8 ..... 28 20 21 20 8 5 3 2 1,418 91 6.4 343 36 10.5 6 4 24 13 18 23 6 131 73 64 42 19 3 9 2 14 10.7 3 6 5 3 .... 4 3 43 38 36 54 53 27 9 7 9.6 6.9 5.9 4.2 3.5 2.8 6.‘ 3 12 7.5 20 7.1 30 6.9 46 4.5 49 3.8 22 2.7 5 3— 2,649 166 6.3 882 35 556 439 56 10.1 19 4.3 29 7.0 32 5.8 13 3.3 2 1.0 10 5 100 106 107 214 200 122 11 22 15 15.0 2.8 5 4.7 1.9 3 1.5 2 1.6 2 __ 1 131 10.7 554 45 8.1 614 75 12.2 48 51 10.8 39 11.6 28 8.9 10 3 186 161 166 25 16 16 8.6 15 9.3 9 5.4 264 159 139 31 11.7 21 13.2 16 11.5 ....( 18 21 12 7 r 5 3 $650-2840 397 $1,250 and over.. 205 No earnings....... 47 Not reported.. : . 42 Colored moth ers............... 1,223 Earnings of father. Under $450......... 473 $450-$549............ 335 $550 and ov er.. . 314 No earnings.. 64 37 wer^M t secured. 6 01 Œ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis S Œ t S 321 «UU 242 293 177 80 27 18 ï 7.5 5.0 7.4 7.8 3.4 3 4 6 9 3 8 2 1 12 5 3 1 3 3 2 2 3 2 2 1 I i i i 1 7.... 7 4 3 .... 1 2 1 2 3 2 1 2 1 5 tW° Weeks' fOT whom fu s in g data 294 T I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . 91 .—Percentage o f infant deaths, by came o f death, sanitary arrangements o f dwelling, earnings o f father, and color and rationality o f mother; infants bom in 1915 who lived at least two weeks in dwellings studied. able Infants who lived at least 2 weeks in dwellings of specified sanitary accommodations. Dwellings lacking 1 or more of 3 specified items. Dwellings with 3 specified items.1 Earnings of father and color and n a t i o n a l i t y of mother. Deaths. Deaths. au Infants. All mothers... Earnings of father: Under 1660........ $550-$849._____ _ $850-$l,249. . . . . . $1,250-41,849----$1,850 and over.. No earnings----Not reported— Native white mothers___ Earnings of father: Under $550....-. $550-$849.......... $850-$l,249....... $1,250-$1,849....... $1,850 and over.. No earnings....... Not reported___ Foreign-bom whitemothers Earnings of father: Under $550........ $550-$849.......... . $850-$l,249....... . $1,250 and over7 No earnings___ Not reported___ Jewish___ Earnings of father: Under $650___ $650 and over__ No earnings Not reported___ Polish... Earnings of father: Under $650---$650 and over__ No earnings....... Not reported__ Italian__ Earnings of father: Under $650....... . $650 and over__ No earnings___ Not reported__ All other.. Earnings of father: Under $650....... $650 and over... No earnings___ Net reported... Colored mother; Earnings of father: Under $550....... $550 and over... No earnings___ Not reported... causes. Gastric and intestinal. Per cent.2 Numher. Per cent.2 495 8.5 230 3.9 216 173 49 12 1 26 18 9.8 7.3 5.7 6.9 107 71 26 2 4.9 3.0 3.0 1.2 21.7 17.3 15 9 12.5 8.7 260 8.1 135 4.2 ' 84 105 39 9 11.0 6.9 6.0 7.4 47 53 19 2 6.2 3.5 2.9 1.6 11 12 20.7 7 7 12.1 1,833 141 7.7 66 3.6 856 677 186 53 35 26 542 65 53 8 1 9 5 17 7.6 7.8 4.3 1.9 38 15 7 4.4 .2.2 3.8 325 190 18 9 562 7 5 2 3 72 2.2 2.6 12.8 42 7.5 51 15 4 2 16 12.6 10.8 30 8 2 2 4 7.4 5.8 3.8 404 139 10 9 314 213 93 4 4 415 12 3 1 5.6 3.2 4 1.9 36 8.7 16 3.9 22 12 2 9.5 6.8 9 6 1 3.9 3.4 94 11.4 29 3.5 67 20 6 1 11.5 11.0 22 3 4 3.8 1.6 Numher. Per cent.2 Numher. Per cent.2 Numher. 4,486 197 4.4 66 1.5 5,850 644 1,389 1,324 578 8.5 5.1 3.2 2.2 1.3 li.i 3.2 17 25 14 6 2.6 1.8 1.1 1.0 72 94 55 71 42 13 5 8 3 4 5.6 2,200 2,360 859 173 34 120 104 3,273 135 4.1 48 1.5 3,191 278 999 1,093 474 7.9 5.6 3.3 2.5 1.5 7 21 11 6 2.5 2.1 1.0 1.3 61 22 56 36 12 % 5 3 1 763 1,528 652 122 26 42 58 816 25 3.1 11 1.3 139 286 211 10 8 5 1 4 3 3 2.9 1.0 1.4 12 16 389 1 7.2 2.8 2.4 0.7 1.5 4 1.0 2 1 1 1.9 0.4 6 107 266 4 1 1 3 1.6 3.7 0.4 1 35 3 1 20 15 2 1 1 80 3 30 47 3 312 13 4.2 6 1.9 79 224 3 10 3.8 4.5 2 4 2.5 1.8 397 37 9.3 7 1.8 227 132 1 17 23 8 4 2 Gastric and intestinal. Infants. 10.1 6.1 6 1 231 177 3 4 826 2.6 0.8 1 581 182 43 20 1 Bath, toilet connected with sewer and reserved for exclusive use of family. *•Not shown where base is less than 50. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 3.1 5.1 4 2 4 2 1 1 0.7 0.6 0.5 1.3 295 APPENDIX VII.---- TABLES. T a b l e 92.— E m ploym ent o f mother at any tim e after marriage, during pregnancy o f 1915, or during lifetim e o f in f ant horn in 1915, by place o f em ploym ent, earnings o f father, and color and n ativity o f m other; mothers (m aternal histories) and births in 1915.1 Earnings of father and color and na tivity of mother. Employed away from home at any time after mar riage. Total. Total. Total. Num Per ber. ct.3 All mothers...... 11,169 2,562 22.9 11,613 1,400 12.1 1,819 $850-$l,049............ $1,050-$1,249......... $1,250 and o v er... No earnings......... Not reported— ±. 777 50.2 1,690 534 36.2 1,574 398 26.0 1,590 404 16.0 2,575 146 8.8 1,696 705 41 5.9 54 4.2 1,307 235 136 62.4 241 72 31.0 494 325 202 169 45 11 16 89 49 29.2 20.6 12.7 5.6 2.7 1.6 1.2 37.9 20.3 Native white mothers......... 7,069 966 13.7 7,210 394 5.5 463 661 949 1,807 1,308 581 1,060 101 139 188 158 171 212 84 29 33 57 34 477 40.6 686 23.9 971 18.0 11.7 1,840 6.4 1,328 591 5.0 3.1 1,074 56.4 103 140 24.5 74 86 74 75 27 7 12 21 18 15.5 12.5 7.6 4.1 2.0 1.2 1.1 20.4 12.9 2,830 748 26.4 2,894 Not reported....... Foreign - born white mothers Earnings of father: Under $450.......... $450-$549......... . $550-$649.............. $650-$849.............. $850-$l,049............ $1,050-$1,249......... $1,250 and ov er... Colored mothers Earnings of father: Under $450........... $450-$549.............. $550-$649.............. $650-$849.............. 049 $1 050-$l,249 594 472 433 590 317 103 217 53 51 1,270 492 343 146 122 4C 9 12 64 42 228 38.4 161 34.1 136 31.4 123 20.8 44 13.9 10 9.7 17 7.8 22 7 848 610 479 449 600 327 101 219 53 53 66.8 1,509 361 73.1 215 62.7 91 62.2 69 56.6 18 2 4 57 31 Away from home. At home. 602 409 17C 135 41 10 14 79 48 15.7 10,797 855 349 20.7 1,544 307 19.5 1,449 262 16.5 1,489 340 13.2 2,417 241 14.2 1,595 79 11.2 661 144 11.0 1,221 42 17.9 207 214 55 22.8 341 179 93 85 20 5 7 84 41 22.1 12.4 6.2 3.5 1.3 .0.7 0.6 40.6 19.2 9.8 6,739 235 3.5 58 12.2 449 79 11.5 644 120 12.4 908 162 8.8 1,726 134 10.1 1,251 45 7.6 551 74 6.9 995 13 12.6 88 25 17.9 127 69 42 25 38 10 1 2 32 16 15.4 6.5 2.8 2.2 .8 .2 .2 12.6 200 7.3 70 43 33 26 8 2 2 12 4 11.9 9.6 7.7 4.6 2.6 2.0 .9 710 At home. Num Per Num Per ber. ct.8 ber. ct.8 Num Per Num Per ber. ct.8 ber. ct.3 1,549 1,476 1,528 2,519 1,665 693 1,289 218 232 Earnings of father: Under $450........... $450-$549.............. $550-1649.............. $650-1849.............. $850-$l,049............ $1,050-$1,249......... $1,250 and ov er... To mothers employed during lifetime of in fant and within 12 months after the birth. To mothers employed during pregnancy. Away from home. Earnings of father: Under $450........... $450-$549.............. $550-$649.............. Live births in 1915. Births in 1915.1 Mothers.2 7.9 1,929 17.9 383 329 254 378 256 88 144 43 54 24.8 22.7 17.1 15.6 16.1 13.3 11.8 20.8 25.2 801 11.9 73 86 123 189 156 53 78 14 29 16.3 13.4 13.5 11.0 12.5 9.6 7.8 22.8 763 27.7 329 11.4 735 25.4 2,753 18.5 14.6 14.7 7.8 2.8 2.9 .9 146 123 98 142 94 31 68 14 19 23.9 25.7 21.8 23.7 28.7 29.8 31.1 677 44.9 374 24.8 1,305 420 32.2 365 28.0 50.9 41.8 36.5 34.8 145 105 44 36 13 3 2 15 11 24. C 25.7 25.9 26.7 507 356 152 121 35 10 14 69 41 202 39.8 94 26.4 35 23.0 21 17.3 2 2 3 40 21 143 113 33 37 14 2 113 70 66 47 9 3 2 13 6 307 169 62 47 9 1 2 55 25 588 449 429 57C 309 10C 212 5C 46 167 130 98 152 86 33 66 14 17 28.4 29.0 22.8 26.6 27.8 33.0 29.7 28.2 31.7 21.7 30.6 15 8 1 Includes miscarriages. . . . . , . . „ « Mothers for whom maternal history was secured. Schedule did not include employment at home prior to pregnancy of 1915. 3 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 296 IN FAN T MORTALITY, BALTIMORE, MD. T a b l e 93.— E m ploym ent o f mother at any tim e after marriage, during pregnancy o f 1915, or during lifetim e o f in fan t horn in 1915, by place o f em ploym ent and n ation a lity; foreign -b om white mothers (m aternal h istones) and births in 1 9 1 5 } Foreign-horn white mothers.2 Nationality of mother. Births in 1915 to foreign-bom white mothers.1 Live births in 1915 to foreignbom white mothers. Employed during life time of infant and within 12 months of birth. Employed Employed during preg away from nancy of 1915. home at any time Total. after mar Total. Total. At home. Away from riage. home. Num Per ber. cent. Num- Per Num- Per her. cent. her. cent. Total.............. 2,830 748 26.4 2,894 Jewish..................... Polish...................... Italian..................... All other.................. 995 634 433 768 6.6 1,011 66.4 655 12.2 440 27.1 788 German............ Irish, English, S c o t c h , and English-Canadian............... Bohemian......... Lithuanian....... Other................ 321 69 21.5 331 136 109 9.6 24.8 65.7 32.0 138 112 105 102 421 53 208 102 100 735 25.4 329 289 28.5 104 15.9 162 36.8 180 22.8 59 29 16.7 24.1 32.4 36.3 1 Includes miscarriages. 2 Mothers for whom maternal history was secured. to pregnancy of 1915 birth. 3 Not available. 2.9 8.9 28.6 10.8 Away from home. Num- Per Num- Per ber. cent. ber. cent. 11.4 2,753 13 1.3 215 32.8 17 3.9 84 10.7 17.8 At home. 27.7 200 961 625 412 755 289 30.1 116 18.6 165 40.0 193 25.6 9 146 7 38 318 (3) (3) (3) 132 107 (3) (3) (3) (3) (3) 100 98 763 (3) (3) <*§ (3) (3) (3) (8) (3) Schedule did not include employment at iinm« prior T a b l e 9 4 E m ploym ent o f mother away fro m home after marriage, by num ber o f b irth s} earnings o f fath er, and color and n ativity o f m other; mothers (m aternal histories). Mothers reporting specified number of births.1 Earnings of father during year after 1915 birth and color and nativity of mother. Native white mothers................ Earnings of father: Under $450..................................... $450-$549......................................... $550-$649......................................... $650-$849......................................... $850-$l,249...................................... $1,250 and over............................... No earnings.................................... Not reported.................................. Foreign-bom white mothers___ Earnings of father: Under $450..................................... $450-$549........................................ $550-$649......................................... $650-$849......................................... $850-$l,249...................................... $1,250 and over............................... No earnings.................................... Not reported.................................. Colored mothers......................... Earnings of father: Under $450..................................... $450-$549......................................... $550-$649......................................... $650 and over.................................. No earnings.................................... Not reported.................................. 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1-3. 4-6. Employed. Employed. 7 and over. Employed. Total. Num- Per Total. Num- Per Total. Num- Per ber. cent.2 ber. cent.2 ber. cent.2 4,884 604 12.4 1,487 215 14.5 698 147 21.1 279 432 626 1,254 1,328 796 74 95 1,468 101 97 102 133 78 25 42 26 356 36.2 22.5 16.3 10.6 5.9 3.1 108 142 226 384 387 190 17 33 811 48 36 39 50 22 5 10 5 219 44.4 25.4 17.3 13.0 5.7 2.6 76 87 97 169 174 74 10 11 551 39 25 30 29 13 3 5 3 Ì7.2 7.5 269 244 216 339 232 109 28 31 679 107 75 56 65 24 9 15 5 403 177 150 127 154 112 67 13 11 334 59 55 46 34 16 4 4 1 238 33.3 36.7 36.2 22.1 14.3 255 187 77 100 34 26 171 101 40 46 28 17 129 91 37 46 21 10 101 60 25 24 20 8 78.3 ‘ 24.3 39.8 30.7 25.9 19.2 10.3 8.3 59.4 67.1 54.0 46.0 27.0 71.3 173 31.4 62 31 34 24 14 4 3 1 41.9 148 78 90 97 76 41 12 9 257 207 80.5 108 65 32 37 9 6 89 54 26 23 9 6 82.4 2 Not shown where base is less than 100. 297 A P P E N D I X V II.-— T A B L E S . T able 95.— Employment o f mother during pregnancy, or within 12 months after the birth, by color o f mother; live births in 1915. Live births in 1915 to— Employment of mother during pregnancy of 1915 or after 1915 birth. White mothers. Colored mothers. Per cent Per cent Number. distribu Number. distribu tion.1 tion.1 Total...................................... Not employed during pregnancy or after birth.......... Employed only after death of infant................. Employed at home on ly2................... Employed away from Home.................... Employment not reported................... 9,492 100.0 1,305 100.0 6,932 61 1,663 835 1 73.0 .6 17.5 8.8 318 12 320 655 24.4 .9 24.5 50.2 1 Not shown when under one-tenth of 1 per cent. * Includes 4 white mothers and 6 colored mothers who worked at home during pregnancy and awav after death of infant, and 1 white mother who may have worked away during life of infant but for whom employment after birth was not reported. T able 96.— Occupation o f mother and employment away frcm home before and after marriage, by color and nationality; mothers {maternal histories). Mothers. Employment of mother away from home, and color and nationality of mother. Employed away from hom e. Total. Total. All mothers............................... Not employed............... Employed.............................. Before marriage only........... After marriage................... Employment not reported.. . White mothers.......... “ Factory. Domestic Other. 11,169 8,791 5,438 1,918 1,435 2,371 8,791 6,229 2,562 7 8,791 6,229 2,562 5,438 4,031 1,407 1,918 954 964 1,435 1,244 191 9,899 7,627 5,342 893 1,392 2,267 7,627 5,913 1,714 5 7,627 5,913 1,714 5,342 4,003 1,339 893 693 200 1,392 1,217 175 7,069 5,520 3,830 503 1,187 1,545 5,520 4,554 966 4 5,520 4,554 966 3,830 3,118 712 503 359 144 1,187 1,077 110 Foreign-born mothers.................... 2,830 2,107 1,512 390 205 N ot employed......................... Employed........................... Before marriage only.............. After marriage.................................. Employment not reported...................... 722 2,107 1,359 748 1 2,107 1,359 748 1,512 885 627 390 334 56 205 140 65 995 704 588 22 94 291 704 638 66 704 638 66 588 552 36 22 18 4 94 68 26 Not employed.............................. Employed.............................. Before marriage only................. After marriage............................ Employment not reported............... Native mothers...................... Not employed................................ Employed................................ Before marriage only................. After marriage............................ Employment not reported.......... Jewish....................... ............. Not employed...................................... Employed..... ...................................... Before marriage only.......................... After marriage.................................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis IN F A N T MORTALITY, BALTIMORE, MD. 298 T able 96.— Occupation o f mother and employment away from home before and after marriage, by color and nationality; mothers {maternal histories)— Continued. Mothers. Employment of mother away from home, and color and nationality of mother. Employed away from home. Total. Factory. Domestic. Total. 599 516 54 29 599 178 421 1 599 178 421 516 123 393 54 40 14 29 15 14 433 147 111 4 32 286 147 94 53 147 94 53 111 70 41 4 4 32 20 12 321 270 114 135 21 51 270 201 69 270 201 69 114 69 45 135 114 21 21 18 3 136 122 26 87 9 14 122 109 13 122 109 13 26 21 5 87 80 7 9 8 1 109 101 40 59 2 s 101 74 27 101 74 27 40 17 23 59 55 4 2 2 102 97 84 6 7 5 97 30 67 97 30 67 84 21 63 6 3 3 7 6 1 100 67 33 23 11 33 67 35 32 67 35 32 33 12 21 23 20 3 11 3 8 1,270 1,164 96 1,025 43 104 1,164 316 848 2 1,164 316 848 96 28 68 1,025 261 764 43 27 16 Polish. 634 Not employed.................... Employed........................... Before marriage only.. After marriage............. Employment not reported. M Italian. Not employed.................. Employed......................... Before marriage only. After marriage........... German. Not employed.................. Employed......................... Before marriage only. After marriage........... Irish, English, Scotch, and English-Canadian......................... ...................... Not employed.................. Employed......................... Before marriage only. After marriage.______ Bohemian. Not employed................... Employed......................... Before marriage only. After marriage....... Lithuanian. Not employed.................. Employed......................... Before marriage only. After marriage........... All other. Not employed.................. Employed......................... Before marriage only. After marriage........... Colored mothers. Not employed.................... Employed........................... Before marriage only.. After marriage............. Employment not reported. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Other. T able 97.—Occupation, by time o f employment away from home and color and nationality o f mother; mothers (maternal histories). Mothers1 of specified color and nationality. White. Foreign bom. Occupation,and time of employment of Total mother1 before marriage only and after mothers. marriage. Total. Native. Polish. Italian. Colored. Bohe mian. Lithu anian. Allother. Total.................................................... 11,169 9,899 7,069 2,830 995 634 433 321 136 109 102 100 1,270 N ot employed away from home.................. Employed awayfrom home........................ 2,371 8,791 2,267 7,627 1,545 5,520 722 2,107 291 704 34 599 286 147 51 270 14 122 8 101 5 97 33 67 104 1,164 Factory work............................ Domestic work......................... Other work................................ 5,438 1,918 1,435 5,342 893 1,392 3,830 503 1,187 1,512 390 205 588 22 94 516 54 29 111 4 32 114 135 21 26 87 9 40 59 2 84 6 7 33 23 11 96 1,025 43 Before marriage only............................. Factory work............................ Domestic work......................... Other work................................ 6,229 4,031 954 1,244 2,562 1,407 964 191 5,913 4,003 693 1,217 1,714 1,339 200 175 4,554 3,118 359 1,077 966 712 . 144 110 1,359 885 334 140 748 627 56 65 638 552 18 68 66 36 4 26 178 123 40 15 421 393 14 14 94 70 4 20 53 41 201 69 114 18 69 45 21 3 109 21 80 8 13 5 7 si 74 17 55 2 27 23 4 30 21 3 6 67 63 3 1 35 12 20 3 32 21 3 8 316 28 261 27 848 68 764 16 7 5 4 1 Other work................................ _ - 1 12 APPENDIX VII. ---- TABLES. Jewish. Total. Irish, English, Scotch, German. and EnglishCanadian. 2 i Based on 11,169 mothers for whom maternal history was secured. 299 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 300 T a b l e 98.— Occupation and place o f employment o f mother during pregnancy, by color and nationality; births in 1915.* Births in 19151 to mothers of specified color and nationality. White Occupation and place of employment of mother during pregnancy of 1915 issue. Foreign born. ^ Total. Native. Total. Jewish. Polish. Italian. Irish, English, Scotch, BoheGerman. and mian. EnglishCanadian.? Colored. Lithuanian. All other.* A ll m o th e rs ......................................... 11,613 10,104 7,210 2,894 1,011 655 440 331 138 112 105 102 1,509 N o t e m p lo y e d .............. ................................. E m p lo y e d ........................................................ A t h o m e .................................................... K e e p in g lo d g e r s ............................. 8,391 3,219 1,819 732 174 90 362 347 124 1,400 609 332 133 144 439 232 120 3 7,934 2,168 1,445 686 173 58 74 344 110 723 560 325 106 129 54 23 86 2 6,105 1,104 710 422 37 32 56 107 56 394 272 103 54 115 42 15 65 1 1,829 1,064 735 264 136 26 18 237 54 329 288 222 52 14 12 8 21 1 709 302 289 69 15 13 1 163 28 13 9 335 319 104 46 22 7 1 22 6 215 205 191 8 6 2 1 7 1 261 179 162 61 69 2 243 88 59 28 5 2 7 12 5 29 17 13 1 3 8 3 1 111 27 23 20 75 37 27 6 4 41 64 34 15 17 8 7 2 10 7 6 1 30 29 4 25 54 48 37 19 4 2 1 10 1 11 8 4 3 1 457 1,051 374 46 1 22 288 3 14 677 49 7 27 15 285 2Q9 34 1 Sewmg (for factory).................. Sewing (not for factory)........... Laundering............................... H e lp in g i n h u s b a n d ’ s business. D o in g oth er h o m e w o r k ............. A w a y from h o m e .................................. F a cto ry op e ra tiv e s ....................... C a n n m g, sh u ck in g................ Clothing.............................. O th er fa c t o r y .......................... Charwork, laundress, etc.......... D o m e s tic s e rv a n t.......................... Any other occupation.............. E m p lo y m e n t n o t r ep o rte d ........................ 7 2 1 3 18 12 17 « 11 3 7 1 6 3 4 2 1 1 2 2 2 1 1 3 Per cent distribution.4 All mothers......... Not employed............... Employed...................... At home.................. Keeping lodgers. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 72.3 27.7 15.7 6.3 78.5 21.5 14.3 6.8 84.7 15.3 9.8 5.9 63.2 36.8 25.4 9.1 70.1 29.9 28.5 6.8 51.1 48.7 15.9 7.0 59.3 40.7 36.8 13.9 73.4 26.6 17.8 8.5 80.4 19.6 16.7 14.5 67.0 33.0 24.1 5.4 39.0 61.0 32.4 14.3 52.9 47.1 36.3 18.6 30.3 69.6 24.8 3.0 IN FA N T MORTALITY, Total births.1 Sewing (for factory).................. Sewing (not for factory)........... Laundering............................... Helping in husband’ s business. Doing other home work........... Away from home............................. Factory operatives................... Canning, shucking, e t c .. . . Clothing.............................. Other factory...................... Charwork, laundress, etc.......... Domestic servant...................... Any other occupation............... Employment not reported.................... 3.6 2.2 16.2 1.9 '28*6 27.6 3.8 23.8 1.4 1.0 2.9 APPENDIX Y II. ---- TABLES. 1 Includes miscarriages. s Includes 101 Irish, 19 English, 8 Scotch, and 10 English-Canadian. 2 S w S s £ f t S & a n d l D a S . 13 Magyar* 8 Norwegian’ 6 Serbian,5 French,5 Slovak, 4 Rumanian,4 Ruthenian,3 French-Canadian,3 D utch,2 S la v ic (n .o .s .),2 Spanish, 1Not shown when less than one-tenth of 1 per cent. 301 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 302 IN F A N T MORTALITY, BALTIMORE, MD. T able 99.— Occupation o f mother, by place and time o f employment; live births in 1915 to mothers employed. Live births to mothers employed. Occupation of mother. During 1915 pregnancy. During lifetime of infant. Per cent Per cent Number. distribu- Number. distribution. tion. All mothers employed. At home................................ Keeping lodgers.. . . — ............ Sewing (for factory)................... Sewing (not for factory)............ Laundering..............- j.............. Helping in husband’s business. Doing other home work............ Away from home. Cannery operative......... Other factory operative. Charwork, laundry, etc. Domestic....................... All other......................... Not reported.................. 100.0 2,911 100.0 2,784 1,682 57.8 1,929 69.3 700 161 71 312 328 110 24.0 5.5 2.4 10.7 11.3 3.8 948 143 66 303 345 124 34.1 5.1 2.4 10.9 12.4 4.5 1,229 42.2 855 30.7 315 233 386 191 104 10.8 8.0 13.3 6.5 3.6 220 141 297 121 75 1 7.9 5.1 10.7 4.3 2.7 T a b l e 100 —Employment o f mother during pregnancy o f 1915 and during lifetime o f infant, by color and nationality; births in 1915.1 Per cent of mothers employed Color and nationality of mother. During preg nancy.2 27.7 25.8 21.5 21.5 15.3 36.8 15.4 35.0 29.9 48.7 40.7 33.5 31.0 41.9 41.7 30.6 69.6 1Includes miscarriages. 2 Based on total births in 1915. 8 Based on live births. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis During life of infant.8 60.2 _________ E 303 APPENDIX V II.— TABLES. T a b l e 101.— Employment o f mother during pregnancy o f 1915, by employment after the birth, at home and away from home, by color o f mother; live births in 1915. Live births in 1915 to— Employment of mother. All mothers. Live births. Total............................................ . White mothers. Infant deaths. Live births. Infant deaths. Colored mothers. Live births. Infant deaths. 10,797 1,117 9,492 910 1,305 207 Employed at home during 1915 pregnancy. 1,682 159 1,359 118 323 41 Not employed after birth of infant...... Employed after death of infant: At home................................ Away.......................................... Employed during life of infant: At home.......................................... Away........................................ Employment after birth not reported.. 147 23 130 20 17 3 54 10 54 10 35 4 35 4 19 6 19 6 1,412 70 1,172 17 1 58 1 240 41 12 1 1 Employed away during 1915 pregnancy. . . 1,229 221 659 106 570 115 Not employed after birth of infant....... Employed after death of infant: At home................................ Away...................................... Employed during life of infant: At home........................................ Away............................................. 363 41 274 27 89 14 10 104 10 104 4 51 4 51 6 53 6 53 158 594 10 56 71 259 4 20 87 335 6 36 Not employed during 1915 pregnancy1. . . . 7,886 737 7,474 686 412 51 Not employed after birth of infant...... Employed after death of infant: At home.................... ........ Away............................ Employed during life of infant: At home.......................................... Away................................ Employment after birth not reported. 7,250 640 6,932 603 318 37 22 51 22 51 19 42 19 42 3 9 3 9 359 203 1 7 16 1 321 159 1 6 15 1 38 44 1 1 1 reporrea. 3 live births (2 wbite, 1 colored) and 1 death (white); employment during 1915 pregnancy not https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 304 IN FAN T MORTALITY, BALTIMORE, MD. T a b l e 102.— Infant mortality rates, by mother's employment away from home during pregnancy or within year after bvrth, earnings o f father, and color and nativity o f mother; live births in 1915. Live births in 1915 to mothers— Employed away from home during pregnancy or within year after birth.1 Earnings of father and color and nativity of mother. Not employed away from home during pregnancy or within year after birth. Infant deaths. Infant deaths. Live births. Infant Number. mortality rate.2 Live births. Infant Number. mortality rate.2 1,553 302 194.5 9,244 815 88.2 181 69 10 5 24 13 203.1 169.1 $1,250 a n d o v e r ........ .................... N o e a r n in g s ................................. N o t re p o r te d .................................. 891 408 61 18 112 63 2,102 3,498 2,195 1,203 95 151 232 325 148 74 19 17 110.4 92.9 67.4 61.5 N a tiv e w h ite m o th e r s ........ 501 99 197.6 6,238 547 87.7 E arnings o f fa th er: U n d e r $550................................ . $550-$849................................ .. $850-$l,249.................... $1,250 a n d o v e r .............................. N o earnings.................................... N o t re p o r te d ...... ................... 216 167 36 12 41 29 42 30 5 4 11 7 194.4 179.6 877 2,467 1,766 983 47 98 115 233 121 63 5 10 131.1 94.4 68.5 64.1 A ll m o th e r s ................................ E arnings o f fa th er: U n d e r $550.......................... ....... $550-1849.......................................... $850-$l,249................................... 214.3 112.6 F oreig n -b orn w h ite m others. 381 70 183.7 2,372 194 81.8 E arnings o f fa th er: U n d e r $550.......... ........................... $550-$849.......................................... $850 a n d o v e r ................................. N o ea rn in gs.................................... N o t re p o r te d .................................. 213 128 18 16 6 43 19 2 3 3 201.9 14& 4 824 871 603 34 40 70 77 32 10 5 85.0 88.4 53.1 C olored m o th e r s ....... ............... 671 133 198.2 634 74 116.7 E arn in gs o f fa th er: U n d e r $550...................................... $550 a n d o v e r ................................. N o earn in gs.................................... N o t r e p o rte d .................................. 462 126 55 28 96 24 10 3 207.8 190.5 401 206 14 13 47 21 4 2 117.2 101.- 9 1 Includes 2 mothers whose employment was not reported. 2 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 305 APPENDIX VII.---- TABLES. T a b l e 103 .—Infant mortality rates (by cause o f death) and stillbirth rates, by employment o f mother during pregnancy and color and nativity o f mother; births in 1915. Stillbirths. Infant deaths. Early All other Total. Employment during pregnancy Total infancy. causes. liv e of 1915, and color and nativity births. Per of mother. Num 1,000 ber. Infanl Infant Infant births.1 Num mor Num mor Num mor ber. tality ber. tality ber. tality rate.1 rate.1 rate.1 All mothers..... .............. . 11,195 398 35.6 10,797 1,117 103.5 407 37.7 710 65.8 Not employed................................. 8,123 Employed at home......................... 1,752 Employed away from home.......... 1,317 Employment not reported............. 3 240 70 88 29.5 40.0 66.8 7,883 1,682 1,229 3 736 159 221 1 93.4 94.5 179.8 293 44 70 37.2 26.2 57.0 443 115 151 56.2 68.4 122 9 Native white mothers.......... 6,937 198 28.5 6,739 646 95.9 257 38.1 389 57.7 Not employed................................. 5,896 Employed at home......................... 674 Employed away from home.......... 366 Employment not reported............. 1 162 18 18 27.5 26.7 49.2 5,734 656 348 1 541 56 49 94.3 85.4 140.8 223 18 16 38.9 27.4 46.0 318 38 33 55.5 57.9 94.8 1 . Foreign-born white mothers. 2,837 84 29.6 2,753 264 95.9 85 30.9 179 65.0 Not employed................................. 1,791 Employed at home......................... 723 Employed away from home.......... 322 Employment not reported............. 1 53 20 11 29.6 27.7 34.2 1,738 703 311 1 144 62 57 1 82.9 88.2 183.3 50 15 20 28.8 21.3 64.3 94 47 37 1 54.1 66,9 119.0 Colored mothers.................... 1,421 116 81.6 1,305 207 158.6 65 49.8 142 108.8 25 32 59 57.3 90.1 93.8 411 323 570 1 51 41 115 124.1 126.9 201.8 20 11 34 48.7 34.1 59.6 31 30 81 75.4 92.9 142t1 Not employed..................... ........... Employed at home......................... Employed away from home.......... Employment not reported............. 436 355 629 1 1 Not shown where base is less than 100. 101351°— 23------20 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 306 IN FA N T MORTALITY, BALTIMORE, MD. T a b l e 104.— Excess infant mortality (by cause o f death) and stillbirth rates among infants o f mothers employed during pregnancy, over those expected when effect o f differences color and nationality and earnings o f father is eliminated; births in 1915. Deaths from all causes. Stillbirths. Employment of mother during pregnancy. Live >irths. births. Early infancy. in All other causes. Infant [nfant Infant Num mor Num mor Num mor ber. tality ber. tality ber. tality rate.1 rate.1 rate.1 Per Num 1.0001 ber. births. AT.T, MOTHERS. Not employed: Employed at home: Employed away from home: 8,123 240 256 29.5 31.5 7,883 736 759 93.4 96.3 293 290 37.2 36.8 443 469 56.2 59.5 1,752 70 70 40.0 40.0 1,682 159 176 94.5 104.6 44 62 26.2 36.9 115 114 68.4 69.0 1,317 88 72 66.8 54.7 1,229 221 170 179.8 138.3 70 54 57.0 43.9 151 116 122.9 94.4 3 3 1 1 NATIVE WHITE MOTHERS. Not employed: Employed at home: Employed away from home: 5,896 162 168 27.5 28.5 5,734 541 538 94.3 93.8 123 217 38.9 37.8 318 321 55.5 56.0 674 18 19 26.7 28.2 656 56 65 85.4 99.1 18 25 27.4 38.1 38 40 57.9 61.0 366 18 11 49.2 30.1 348 49 42 140.8 120.7 16 15 46.0 43.1 33 27 94.8 77.6 1,791 53 53 29.6 29.6 1,738 144 158 82.9 90.9 50 52 28.8 29.9 94 106 54.1 61.0 723 20 22 27.7 30.4 703 62 62 88.2 88.2 15 21 21.3 29.9 47 41 66.9 58.3 322 11 9 34.2 28.0 311 57 44 1 183.3 141.5 20 12 64.3 38.6 37 32 119.0 102.9 436 25 35 57.3 80.3 411 51 63 124.1 153.3 20 21 48.7 51.1 31 42 75.4 102.2 355 32 29 90.1 81.7 323 41 49 126.9 151.7 11 16 34.1 49.5 30 33 92.9 102.2 629 59 52 93.8 82.7 570 115 84 201.8 147.4 34 27 59.6 49.4 81 57 142.1 100.0 1 1 FOREIGN-BORN WHITE MOTHERS. Not employed: Employed at home: Employed away from home: 1 1 1 COLORED MOTHERS. Not employed: Employed at home: Employed away from home: Expected2. . . ....... ................. 1 1 1 1 Not shown where base is less than 100. ................... . . . . l . a Expected stillbirths and deaths are calculated by applying to the births (or live births) in each nationality, earnings and employment of mother group, the average rates prevailing in the same nation ality and earnings group; among the foreign-bom white mothers average rates prevailing in each na tionality group are used. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 307 APPENDIX VII.-----TABLES. T able 105.—Prevalence o f premature births, by employment during pregnancy and color and nativity o f mother; live births in 1915. « Live births. Employment during pregnancy of 1915, and color and nativity of mother. Premature births. Total. All mothers...... ................... Not employed................................ . Employed at home........................ Employed away from home......... . Employment not reported............ Native whife mothers......... Full term. Number. Per cent.1 Term not reported. 10,797 10,196 591 5.5 10 7,883 1,682 1,229 3 7,430 1,615 1,149 2 450 65 76 5.7 3.9 6.2 3 2 4 1 6,739 6,322 415 6.2 2 Not employed................................ Employed at home........................ Employed away from home......... . Employment not reported............ 5,734 656 348 1 5,377 619 325 1 356 36 23 6.2 5.5 6.6 1 1 Foreign-bom white mothers 2,753 2,654 97 3.5 2 Not employed................................ Employed at home........................ Employed away from home......... Employment not reported............ 1,738 703 311 1 1,669 687 297 1 67 16 14 3.9 2.3 4.5 2 Colored mothers................... 1,305 1,220 79 6.1 6 Not employed................................ Employed at home........................ Employed away from home......... Employment not imported............ 411 323 570 1 384 309 527 27 13 39 6.6 4.0 6.8 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1 4 1 308 IN F A N T MORTALITY, BALTIMORE, MD. T able 106.—Infant mortality rates, by cause o f death and by employment o f mother during pregnancy and color and nativity; full-term live births in 1915. Infant mortality rates.1 0 FullEmployment during pregnancy of 1915, and color and nativity term live of mother. births. Employment not reported............................................................. All causes. Early All other infancy. causes. 10,196 77.7 14.7 63.0 7,430 1,615 i' Ì49 2 67.2 76.2 147.1 13.9 9.3 27.9 53.3 66.9 119.2 6,322 68.3 13.4 54.9 5,377 619 ■325 1 67.0 63.0 101.5 13.9 6.5 • 18.5 53.1 56.5 83.0 2,654 78.7 15.8 62.9 1,669 687 297 1 63.5 78.6 161.6 13.2 11.6 40.4 50,3 67.0 121.2 1,220 123.8 18.9 104.9 384 309 527 85.9 97.1 167.0 15.6 9.7 26.6 70.3 87.4 140.4 1 Not shown where base is less than 100. T able 107.—-Interval between cessation o f work and confinement, by occupation and color o f mother; births in 1915 1 to mothers em ployed during pregnancy. Per cent3 of births1 to mothers reporting specified interval between cessation of work aim. confine ment. Occupation and place of employment during pregnancy of 1915 and color of mother. Total births.1 None. weeks, 2 months Interval Under 2 2under 2 and over. not re weeks. months. ported. All mothers employed during pregnancy............................................... 3,219 45.1 7; 2 10.7 35.6 1.3 Employed at home...................................... 1,819 67.1 6.3 8.6 16.7 1.3 Keeping lodgers.................................... Sewing 7for factory).............................. 86.1 32.8 2.0 8.6 3.3 16.7 7.1 40.8 1.5 1.1 Laundering............................................ Husband’ s business.............................. Other home work.................................. 732 174 80 362 347 124 48.3 70.3 69.4 10.2 9.2 8.1 15.2 8.1 10.5 25.1 11.8 8.1 1.1 .6 4.0 Employed away from home........................ 1,400 16.6 8.5 13.4 60.1 1.4 Factory operatives................................ Canning, shucking, etc................... 7.1 9.0 3.8 5.6 31.0 13.4 18.3 8.5 10.8 10.5 1.4 10.5 5.6 6.7 12.3 17.8 6.0 5.6 14.6 15.5 10.8 70.6 61.7 79.7 82.6 42.6 65.1 61.7 1.5 .6 Other factory.................................. Charwork, laundress, etc...................... Domestic servant.................................. Any other occupation........................... 609 332 133 144 439 232 120 4.9 1.4 .4 2.5 White mothers................................... 2,168 50.3 6.6 9.6 32.0 1.4 Employed at home...................................... Employed away from home........................ 1,445 723 70.7 9.7 5.5 8.9 7.8 13.3 14.7 66.5 1.3 1.7 Colored mothers.......................... .... 1,051 34.4 8.5 12.8 43.1 1.1 Employed at home...................................... Employed away from home........................ 374 677 53.5 23.9 9.1 8.1 11.5 13.6 24.6 53.3 1.3 1.0 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 3Not shown where base'is less than 100. 309 APPENDIX V II.-----TABLES. T able 108.— Infant deaths under 1 month per 1,00o live births and stillbirth rates, by interval between cessation o f work and confinement, color o f mother, and place o f employ ment; births in 1915 to mothers employed during pregnancy. Births in 1915 to mothers employed during pregnancy. Stillbirths. Interval between cessation of work and confinement, color of mother, and place of em ployment. Total births. Infant deaths. 1,000 Number. Per births.1 Number. Mothers employed at home: White.................................. Under 1 month of age.' Total. Per 1,000 Per 1,000 live Number. live births.1 births.1 1,397 38 27.2 118 86.8 36 26.5 Interval— None or under 2 weeks__ 2 weeks and over.............. Not reported..................... 1,067 312 18 23 14 1 21.6 44.9 83 32 3 79.5 107.4 24 11 1 23.0 36.9 Colored.................................... 355 32 90.1 41 126.9 14 43.3 Interval— None or under 2 weeks__ 2 weeks and over.............. Not reported..................... 218 132 5 20 10 2 91.7 75.8 23 16 2 116.2 131.1 9 4 1 45.5 32.8 Mothers employed away from home: W h ite..................................... 688 29 42.2 106 160.8 50 75.9 Interval— None or under 2 weeks... 2 weeks and over.............. Not reported..................... 116 560 12 7 21 1 60.3 37.5 16 89 1 146.8 165.1 9 41 82.6 76.1 Colored..................................... 629 59 93.8 115 201.8 45 78.9 Interval— None or under 2 weeks__ 2 weeks and over.............. Not reported..................... 186 436 7 18 40 1 96.8 91.7 48 65 2 285.7 164.1 19 26 113.1 65.7 iN ot shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis IN FA N T MORTALITY, BALTIMORE, MD. 310 T able 109.—Age o f infant when mother began work, by place o f mother's employment and color and nationality o f mother; infants bom in 1915 to mothers employed during in f ant's first year o f life, and subsequent infant deaths. Infants of mothers of specified color and nationality who were employed during infant’s life. In fants. Mothers employed after birth of infant........... Ago of infant: Employed at home....... Age o t infant: Employed away from home......................... Age of infant: Not reported.................. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Native. Total. White. Subse Deaths quent before In deaths end of fants. in month year. of life. Subse Deaths quent before In deaths end of fants. month in year. of life. Age of infant, and place of employment of mother. Subse Deaths quent before deaths end of in month year. of life. 2,784 161 15 1,999 104 14 1,036 52 5 755 537 293 269 168 117 152 100 115 102 107 58 13 58 37 21 11 9 11 3 4 1 4 2 2 3 3 686 351 171 153 109 67 98 71 79 71 84 46 13 46 17 12 3 7 9 2 2 1 3 2 2 3 2 282 192 98 82 73 36 54 43 50 40 44 35 7 23 10 8 1 1 1,929 87 8 1,564 68 8 801 34 2 005 405 194 140 97 60 86 56 49 56 54 25 12 45 18 12 2 i 4 2 3 2 41 12 9 2 3 2 1 1 1 268 165 80 57 46 26 34 27 22 25 30 14 7 ,21 6 5 3 1 652 305 141 100 72 38 62 42 31 42 46 21 12 855 74 7 435 36 235 18 60 132 99 129 69 57 66 44 66 46 53 33 1 13 19 9 9 8 7 3 3 1 1 1 14 27 18 25 27 10 20 16 28 15 14 21 2 4 3 i 3 1 1 1 1 1 1 3 1 1 34 46 30 53 37 29 36 . 29 48 29 38 25 1 1 3 1 1 1 3 1 1 5 5 3 3 7 6 2 2 1 1 1 6 1 3 1 1 4 2 1 2 1 1 1 2 i i 4 1 1 2 1 3 1 1 1 311 APPENDIX V II.---- TABLES. T able 109.— Age o f infant when mother began work, by place o f mother's employment and color and nationality o f mother; infants born in 1915 to mothers employed during infant's first year o f life, and subsequent infant deaths— Continued. Infants of mothers of specified color and nationality who were employed during infant’s life. Foreign born. Age of infant, and place of employment of mother. In fants. Mothers employed after Age of infant: Employed at home....... Age of infant: Employed away from Age of infant: Not reported.................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Total. Italian. Jewish. Subse Deaths quent before In deaths end of fants. in month year. of life. Subse Deaths quent before In deaths end of fants. in month year. of life. Subse Deaths quent before deaths end of in month year. of life. 963 52 9 172 8 1 298 4 2 404 159 73 71 36 31 44 28 29 31 40 11 6 23 7 4 3 3 7 1 2 2 1 3 3 1 1 1 1 1 1 152 68 23 14 11 3 6 6 3 6 5 1 2 1 1 1 1 2 77 35 16 16 8 3 8 1 1 2 4 763 34 6 165 8 1 289 4 2 384 140 61 43 26 12 28 15 9 17 16 7 5 20 6 4 2 2 1 75 34 15 15 8 3 7 1 1 2 3 3 1 150 67 22 13 10 3 6 6 2 4 5 1 2 1 1 1 1 200 18 20 19 12 28 10 19 16 13 20 14 24 4 1 2 1 1 2 1 1 1 1 3 3 1_ 3 3 5 1 2 1 1 1 7 9 2 1 1 1 2 1 1 1 1 1 1 1 3 1 1 2 f IN F A N T MORTALITY, BALTIMORE, MD. 312 T a b l e 109.— A ge o f infant when mother began work, by place o f mother's employment and color and nationality o f mother; infants born in 1915 to mothers employed during infant's first year o f life, and subsequent infant deaths— Concluded. Infants of mothers of specified color and nationality who were employed during infant’s life. Foreign born. Colored. Age of infant, and place of employment of mother. Polish. All other. Subse .Deaths Subse before quent end quent Infants. deaths of Infants. deaths in year. month in year. of life. Mothers e m p l o y e d after birth of infant.. Age of infant: 1 month........................... 5 months......................... 8 months......................... 10 months........................ Employed at home....... Age of infant: 9 months..... ................... Employed away from home.......................... Age of infant: 8 months......................... 11 months........................ Not reported................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 262 25 66 20 15 26 11 16 20 12 18 19 29 8 2 6 2 1 3 3 5 1 4 1 1 231 15 2 785 57 109 36 19 15 6 9 10 9 7 4 2 2 3 12 1 1 1 1 1 69 186 122 116 57 50 54 29 36 31 23 12 12 20 9 8 2 2 1 2_ 193 13 1 365 19 104 28 16 10 5 4 8 5 4 3 1 2 3 11 1 1 1 43 100 53 40 25 22 24 14 18 14 g 4 4 6 3 2 1 1 420 38 26 86 69 76 32 28 30 15 18 17 15 8 8 14 6 6 1 1 1 1 1 1 2 1 1 116 9 2 55 11 8 5 3 2 7 3 2 8 7 4 1 4 1 1 1 1 1 1 146 16 2 38 2 11 9 7 21 8 14 13 9 16 11 22 4 1 2 1 1 1 5 g 3 5 1 5 2 4 3 1 1 1 3 3 4 1 1 1 1 Deaths Subse Deaths before before end of Infants. quent end of deaths month month in year. oflife. oflife. i 1 i 1 j' 1 1 1 APPENDIX VII.-----TABLES. 313 T a b l e 110.— Excess -mortality among infants o f mothers employed during infant's life time, by time o f resumption o f work, place o f employment, and color and nationality o f mother, over mortality expected when eff ect o f differences in color and nationality o f mother is eliminated; infants bom in 1915 to mothers employed during infant's lifetim e. Infants of mothers employed at home. Age of infant when mother began work, and color and nationality of mother. Deaths. Deaths. Total. Actual. Total. 1,929 Under 3 months__ 2 months, under 6.. 6 months and over. Age not reported... 1,294 297 326 12 Native white mothers. Under 3 months__ 3 months, under 6.. 6 months and over. Age not reported... Foreign-bom white mothers. Infants of mothers employed away from home. 801 87 34 513 129 152 7 763 Under 3 months__ 3 months, under 6.. 6 months and over. Age not reported... 585 81 92 5 Colored. 365 Under 3 months__ 3 months, under 6.. 6 months and over. 196 87 82 34 19 Ex pected.1 Total. Actual. Ex pected.1 92.4 855 72.7 13.6 6.1 291 255 308 1 35.0 235 6.7 27.7 5.0 2.3 59 62 114 2.2 2.9 1.6 74 46.5 23.4 16.2 6.9 31.1 200 11.0 26.5 2.9 1.7 51 57 91 1 4.3 4.1 2.6 5.3 420 18.5 5.7 181 136 103 2.1 38 28.8 16.9 9.2 2.7 . f E^P®cted deaths are calculated by applying to the infants of employed mothers in each color and na- S r<?uP ?he avera|[e rates of subsequent deaths in the same color and nationality group. The numrato°nf went i? worh duringthe ^ t month of the infant’s life is m ultipliedbythe e of sribsequeiit deaths among all survivors of the first month; the number of infants whose mothers want to workduring the second month is multiplied by the average of the rates of subsequent deaths among survivors at thebegmnmgand survivors at the end of the second month; and s i m il a r l y for each later month8 ^ ht w S , r w en together. to fonn the groups shown in the table. In calculating ex p ^ t^ d ea th s m the foreign-born white group, calculations were made separately for the Jewish, Polish, Italian and all other groups and the results added to form the total in the foreign-bom white group. ’ a https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis IN F A N T MORTALITY, BALTIMORE, MD. 314 T able 111.— Excess mortality among infants o f mothers employed during infant's life time, by place o f employment, over mortality expected when effect o f differences m in fants' ages and in fathers' earnings is eliminated; infants bom in 1915 to native white and to colored mothers. Infants whose mothers’ employment be gan in some previous month.1 Earnings of father, and color, nativity, and place of employ Surviving at begin ning of2— ment of mother. Second month. Mothers employed at home.................................................. Earnings of father: $55ft-$849 Earnings of father: XJriqp.r $5.50 ....................................................... - .................................................... Mothers employed away from home................................... Earnings of father: XTniW $5.^0 ..................................................... Earnings of father: * Twelfth month. Infant deaths.3 Actual. Expected. 296 257 1,033 710 47 31 55.1 31.5 50 111 71 25 39 141 300 196 73 323 10 7 12 2 16 10.0 14.1 6.1 1.3 23.6 32 7 30 13 238 85 480 157 15 1 40 9 18.4 5.2 28.1 6.2 7 5 1 8 1 4.6 1.6 17 95 51 9 2 323 31 21.9 15 2 267 56 26 5 18.8 3.1 1 From this comparison are omitted (1) infants of foreign-born white mothers; (2) infants of native white and of colored mothers in families where the fathers earned nothing or amounts not reported; (3) the litetime and deaths of infants lived in the months in which the mothers went to work—that is, if the mothers went to work in the tenth month, thelifetime and deaths in that month, and (4) lifetime and deaths of infantsin eases where the age ofthe infant at the time the mother went to work was not reported, a The numbers for months between the second and the twelfth are omitted. a The actual deaths are the sum ofthe deaths occurring month b y month among the “ infant survivors at the beginning of each month. The expected deaths are the sum of the deaths among these infant sur vivors expected on the basis of monthly death rates among all infants of native white and of colored mothers respectively in the specified fathers’ earnings group. T able 112 .— Nationality o f mother, by place o f her employment and age o f infant when mother began work; infants bom in 1915 to mothers employed during in fan ts lifetim e. ________ ________________ ___________________ Infants of specified age when mothers began work. Color and nationality of mother and place of em ployment. Under 3 months. 3 months and over. Not Per cent reported. Per cent Number. distribu- Number. distribution. tion. Mothers employed at home............. 1,294 100.0 623 100.0 12 Native white............................................... Jewish.......................................................... Polish.......... .............................................. Italian.......................................................... All other foreign-bom white...................... Colored......................................................... 513 239 74 124 148 196 39.6 18.5 5.7 9.6 11.4 15.1 281 50 41 40 42 169 45.1 8.0 6.6 6.4 6.7 27.1 7 Mothers employed away from home. 291 100.0 563 100.0 1 Native white............................................... Polish.......................................................... All other foreign-bom white...................... Colored......................................................... 59 27 24 181 20.3 9.3 8.2 62.2 176 118 30 239 31.3 21.0 5.3 42.5 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1 1 3 1 APPENDIX V II.— TABLES. 315 T able 113.—Earnings o f father, by mother's place o f employment, color and nativity; and age o f infant when mother began work; infants o f mothers employed during infant's lifetime. Infants of specified age when mothers began work— At home. Earnings of father and color and nativity of mother. Under 3 months. Away from home. 3 months and over. Under 3 months. 3 months and over. Age Age not not Per Per Per Per re re cent cent cent Num cent Num dis Num Num ported ported. dis dis ber. dis ber. tribu ber. tribu ber tribu tribu tion. tion. tion. tion. All mothers. 1,294 100.0 623 100.0 Earnings of father: Under $450___ $450-$549...... $550-$649......... $650 and over.. No earnings... Not reported.. 228 216 175 612 26 37 17.6 16.7 13.5 47.3 2.0 2.9 155 111 78 247 17 15 24.9 17.8 12.5 39.6 2.7 2.4 Native white. 513 100.0 281 100.0 Earnings of father: Under $450....... $450-$549.......... $550-$649.......... $650 and over... No earnings___ Not reported... 39 54 84 314 7 15 7.6 10.5 16.4 61.2 1.4 2.9 34 31 39 158 7 173 12 12 291 100.0 563 100.0 119 54 23 29 50 16 40.9 18.6 7.9 10.0 17.2 5.5 222 125 69 88 34 25 39.4 22.2 12.3 15.6 6.0 4.4 7 59 100.0 176 100.0 12.1 ....... 11.0 1 13.9 .......... 56.2 4 2.5 2 4.3 .......... 16 10 5 12 14 53 32 2 27.1 16.9 8.5 20.3 23.7 3.4 30.1 18.2 11.4 22.2 10.2 8.0 51 100.0 100.0 43.1 19.6 3.9 21.6 9.8 2.0 32.4 22.3 20.3 18.2 4.8 2.0 20 39 18 14 Foreign-born white. 585 100.0 Earnings of father: Under $450................. $450-$549.................... $550-$649.................... $650 and over............. No earnings............... Not reported.............. 123 95 72 269 10 16 21.0 16.2 12.3 46.0 1.7 2.7 Colored......... 196 100.0 169 100.0 181 100.0 239 100.0 66 33.7 34.2 9.7 14.8 4.6 3.1 77 46 14 24 6 45.6 27.2 8.3 14.2 3.6 1.2 81 34 16 6 31 13 418 18.8 8.8 3.3 17.1 7.2 121 60 19 22 9 8 50.6 25.1 7.9 9.2 3.8 3.3 Earnings of father: Under $450....... $450-$549.......... $550-$649.......... $650 and over... No earnings__ Not reported... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 67 19 29 9 6 100.0 5 25.4 19.7 14.5 37.6 1 1 3 .6 2 1 316 IN FA N T MORTALITY, BALTIMORE, MD. T able 114.— Interval between cessation o f work and confinement, by interval between confinement and resumption o f work; infants o f mothers employed away both during pregnancy and within year after the birth. Infants of mothers employed away duringpregnaney and resuming such work within specified time after birth. Under 3 months. Interval between cessation of work and confinement. Number. 3 months and over. Per cent Per cent distrib Number. distrib ution. ution. 236 100.0 358 100.0 80 23 43 88 2 33.9 9.7 18.2 37.3 .8 40 24 49 241 4 11.2 6.7 13.7 67.3 1.1 T able 115.— Excess mortality among infants o f mothers employed away from home during infant’s lifetime, by mother’s employment during pregnancy and age o f infant when mother resumed work, over mortality expected when effect o f differences in mother’s color and nationality, and father’s earnings is eliminated; infants o f mothers employed away from home during infant’ s lifetime. Infants of mothers employed away during lifetime of infant. Mother employed away during pregnancy. Mother not employed away during pregnancy . Age of infant when mother resumed work. Deaths. Deaths. Infants. * Actual. Ex pected A Infants. Actual. Ex pected.1 AH....................................................... 594 56 35.0 260 18 10.7 Under 3 months........................................... 3 months, under 6 ........................................ 6 months and over....................................... 236 183 175 33 17 6 19.9 11.3 3.8 54 72 *134 8 7 3 4.2 4.1 2.4 1 See note 1, Table 110, p. 313. * Includes 1 infant of a mother whose employment was not reported. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX VII.-----TABLES. T 317 116.— Infant survivors and infant deaths, by type o f feeding, month o f life, place o f mother's em ploym ent, and color and nationality o f mother; infants o f mothers employed during infant's lifetime. able Infants of mothers employed during infant’s lifetime. Month of life of infant, and place of employment, color, and nationality oi mother. Total. Artificially fed. Not re ported. Mixed fed. Breast fed. Infant Deaths Infant Deaths Infant Deaths Infant Deaths Infant sur sur in sur sur sur in in in vivors. month. vivors. month. vivors. month. vivors. month. vivors. All mothers employed during infant’s life: Third month................... Fourth month................. Fifth month.................... Sixth m onth................... Seventh month............... Eighth month................. Ninth month................... Tenth month................... Employed at home during infant’s life: Fifth month.............. Seventh month........ Eighth month.......... Ninth month............ Tenth month............ Employed away from home during infant’s life: Eleventh month....... White mothers employed during infant’s life: Fifth month.................... Sixth month................... Seventh month............... Eighth month................. Ninth month................... Twelfth month............... Employed at home dining infant’s life— Fifth month.............. Sixth month............. Eighth month........... Ninth month............ Eleventh month....... Twelfth month......... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 763 1,282 1,565 1,821 1,973 2,063 2,199 2,283 2,385 2,471 2,566 5 7 13 13 24 16 15 13 15 11 14 597 860 903 933 915 717 642 500 385 294 242 2 1 1 2 4 2 1 1 2 693 1,091 l)280 1,411 1,503 l) 551 1,633 1,677 1,718 1,766 1,811 4 3 9 5 12 4 12 8 7 9 6 566 791 813 823 797 624 552 430 330 241 196 2 I 1 1 2 1 1 1 2 60 191 285 410 470 512 566 606 667 705 755 1 4 4 8 12 12 3 5 8 2 8 31 69 90 110 118 93 90 70 55 53 46 684 1,028 i'l9 2 1,338 1,438 1,488 1,577 1,638 1,707 1)770 1)844 4 5 7 8 14 9 9 10 7 9 8 557 746 745 758 732 584 531 420 331 258 212 2 i 650 948 1,084 1,178 1,246 1,276 l)336 1,370 1,394 1,429 1,468 4 3 6 4 8 2 8 7 6 7 5 533 701 694 693 665 527 474 376 294 218 177 2 i 3 1 1 2 1 2 i 2 2 1 1 2 2 i i i i i 2 1 2 2 3 3 4 2 5 3 2 4 101 245 364 459 525 594 662 723 804 863 919 3 4 10 8 17 10 12 7 10 9 7 43 110 192 266 344 520 624 751 847 942 997 1 1 1 1 3 1 1 1 84 190 274 321 361 406 456 495 540 582 618 2 2 8 3 9 2 10 4 4 8 4 12 67 105 162 188 231 270 308 348 371 408 2 2 2 2 3 1 2 2 1 3 17 55 90 138 164 188 206 228 264 281 301 1 2 2 5 8 8 2 3 6 1 3 85 185 269 333 381 419 464 505 562 503 651 2 3 7 5 10 6 7 5 5 8 5 1 1 1 1 1 1 1 1 78 165 234 276 309 340 378 409 444 480 511 2 2 6 2 6 1 7 3 4 7 4 1 1 1 1 1 1 1 1 55 177 297 428 532 751 894 1,059 1,195 1,313 1,405 42 97 177 246 324 484 581 712 813 908 981 39 82 155 208 271 408 483 584 655 730 780 1 2 2 1 1 4 1 1 Ì 1 3 __ tn i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 IN FAN T MORTALITY, BALTIMORE, MD. 318 T a b l e 116.— Infant survivors and infant deaths, by type o f feeding, month o f life, place o f mother's employment, and color and nationality o f mother; infants o f mothers employed during infant's lifetime— Continued. Infants of mothers employed during infant’s lifetime. Month oi life of infant, and place of employment, color, and nationality of mother. Total. Breast fed. Artificially fed. Not re ported. Mixed fed. Infant Deaths Infant Deaths Infant Deaths Infant Deaths Infant sur sur sur sur in in in in sur vivors. month. vivors. month. vivors. month. vivors. month. vivors. White mothers employed during infant’s life—Con. Employed away from home during infant’s life 1 Native mothers employed during infant’s life— Third month................... Fifth month.................... Ninth month.............. Eleventh m onth... Twelfth month... Employed at home dur ing infant’ s life— Fifth month. L.. Ninth month. . Employed away from home during infant’ s life— Foreign-bom mothers em ployed during infant’s life— Seventh month............... Eighth month................. Twelfth month............... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 34 80 108 160 192 212 241 268 313 341 376 2 1 4 6 7 1 3 1 2 3 24 45 51 65 67 57 57 44 37 40 35 282 471 565 641 707 736 787 826 871 907 947 2 3 6 6 6 3 3 5 4 4 5 220 325 336 346 342 285 262 217 172 131 105 268 430 507 559 602 625 658 682 701 722 749 2 2 5 3 3 1 3 3 4 3 3 210 303 311 318 312 260 235 194 157 113 89 14 41 58 82 105 111 129 144 170 185 198 402 557 627 697 731 752 790 812 836 863 897 1 2 10 22 25 28 30 25 27 23 15 18 16 2 2 1 2 8 6 6 5 3 5 3 337 421 409 412 390 299 269 203 159 127 107 1 1 3 3 2 2 1 1 1 1 1 1 1 2 1 1 1 1 2 1 1 1 1 1 1 1 1 i 3 15 22 38 53 76 98 128 158 178 201 16 30 61 90 130 197 246 307 366 424 465 15 23 52 74 102 161 202 252 292 341 378 1 7 9 16 28 36 44 55 74 83 87 26 67 116 156 194 287 335 405 447 484 516 1 1 1 1 1 1 1 1 1 1 3 1 1 1 2 1 1 1 1 1 2 1 1 1 7 20 35 57 72 79 86 96 118 123 140 2 1 1 1 46 116 168 205 235 254 279 302 333 352 377 1 2 6 4 ' 5 2 3 2 2 3 3 43 104 144 167 188 204 221 236 252 268 282 1 2 5 1 3 3 12 24 38 47 50 58 66 81 84 95 39 69 101 128 146 165 185 203 229 251 274 1 1 3 4 5 3 1 2 3 3 1 3 2 2 1 1 1 1 1 5 4 4 3 3 5 2 i i i i i i i i APPENDIX VII.---- TABLES. 319 T a b l e 116.— Infant survivors and infant deaths, by type o f feeding, month o f life, place o f mother’s employment, and color and nationality o f mother; infants o f mothers employed during infant’s lifetime—Continued. Infants of mothers employed during infant’s lifetime. Month of life of infant, and place of employment, color, and nationality of mother. Total. Breast fed. Artificially fed. Not re ported. Mixed fed. Infant Deaths Infant Deaths Infant Deaths Infant Deaths Infant sur in sur in sur in sur in sur vivors. month. vivors. month. vivors. month. vivors. month. vivors. Foreign-bom .mothers employed during infant’s life—Continued. Employed at home during infant’s life— Second month.......... Third month............ Fourth month______ Fifth month.............. Sixth month............. Seventh month........ Eighth month.......... Ninth month............ Tenth month........... Eleventh month....... Twelfth month......... Employed away from home during infant’ s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month........... Tenth month............ Eleventh month....... Twelfth month........ Jewish mothers employed during infant’s life-^ Second month................. Third month................... Fourth month................. Fifth month................... Sixth month.................... Seventh month............... Eighth month................. Ninth month................... Tenth month................... Eleventh month............. Twelfth month............... Employed at home during infant’ s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... Employed away from home' during infant’ s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 382 518 577 619 644 678 688 693 707 719 20 39 50 78 87 101 112 124 143 156 178 152 219 241 255 266 269 275 281 283 288 293 150 216 237 250 260 263 269 275 276 279 284 2 3 4 5 6 6 6 6 7 9 9 2 1 1 1 5 1 5 4 2 4 2 1 1 3 5 1 1 1 1 1 1 1 1 1 323 398 383 375 353 267 239 182 137 105 88 14 23 26 37 37 32 30 21 22 22 19 1 1 1 1 1 1 1 24 59 103 134 169 247 281 332 363 389 402 2 8 13 22 25 40 54 73 84 95 114 134 175 155 147 135 92 80 54 40 29 20 10 30 59 75 95 135 145 167 175 180 187 133 173 153 145 133 90 78 54 40 29 20 10 30 59 74 94 134 144 165 172 175 182 1 2 2 2 2 2 2 1 1 1 1 2 3 5 5 1 1 1 1 1 1 1 1 35 61 90 109 121 136 157 173 192 212 229 4 $ 11 19 25 29 28 30 37 39 45 g 14 26 32 35 41 49 59 67 78 86 7 13 24 30 32 38 46 55 63 74 82 1 1 2 2 3 3 3 4 4 4 4 1 1 1 3 1 4 2 2 4 i i 1 2 3 1 1 1 1 ......... i "■■■* 1 i 320 IN FA N T MORTALITY, BALTIMORE, MD. T a b l e 116.— Infant survivors and infant deaths, by type o f feeding, month o f life, place o f mother's employment, and color and nationality o f mother; infants o f mothers employed during infant's lifetime— Continued. Infants of mothers employed during infant’s lifetime. Month of life of infant, and place of employment, color, and nationality of mother. Total. Breast fed. Artificially fed. Not re ported. Mixed fed. Infant Deaths Infant Deaths Infant Deaths Infant Deaths Infant sur in sur sur in in sur in sur vivors. month. vivors. month. vivors. month. vivors. month. vivors. Polish mothers employed during infant’ s life— Second month................. Third month................... Fourth month................. Fifth month.................... Sixth month.................... Seventh month............... Eighth month................. Ninth month................... Tenth month................... Eleventh month............. Twelfth month............... Employed at home dur ing infant’ s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month....... . Tenth month............ Eleventh month....... Twelfth month......... Employed away from home during infant’ s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month.. . . . . Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... Italian mothers employed during infant’s life— Second month................ Third month................... Fourth month................. Fifth month..................... Sixth month.................... Seventh month............... Eighth month................. Ninth m onth.................. Tenth month............ . Eleventh month.............. Twelfth month................ Employed at home dur ing infant’ s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis • 66 85 99 125 135 146 161 170 186 204 229 55 65 73 78 81 82 89 90 91 98 103 11 20 26 47 54 64 72 80 95 106 126 76 111 126 141 149 151 159 159 159 161 163 74 108 122 136 144 146 153 153 153 155 156 1 1 4 5 3 2 3 2 1 2 1 2 1 1 1 3 5 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 2 54 63 68 77 78 63 66 50 43 41 36 47 52 54 54 52 40 42 33 25 22 20 7 11 14 23 26 23 24 17 18 19 16 68 90 92 97 96 76 64 54 45 35 31 66 87 90 95 94 75 62 52 43 34 30 1 1 1 1 1 1 1 1 1 1 i 1 3 10 18 27 31 55 69 94 110 126 150 1 1 1 1 9 12 13 21 26 28 26 26 33 37 43 2 5 10 12 14 27 32 42 49 57 61 6 8 9 12 15 15 15 15 17 19 22 1 5 8 15 17 28 37 52 61 69 89 3 4 4 9 11 13 • 11 11 16 18 21 1 1 1 1 6 12 16 25 29 47 58 66 72 83 84 2 9 18 19 24 28 37 39 42 43 48 6 12 14 22 26 43 54 62 68 78 80 2 9 18 19 24 28 37 39 42 43 46 1 3 3 1 1 3 i i i 2 1 2 3 1 i 1 1 i 1 2 1 i i 2 321 APPENDIX V II.---- TABLES. T able 116.—Infant survivors and infant deaths, by type o f feeding, month o f life, place o f mother’ s employment, and color and nationality o f mother; infants o f mothers employed during infant’ s lifetim e— Continued. Infants of mothers employed during infant’s lifetime. Month of life of infant, and place of employment, color, and nationality of mother. Total. Breast fed. Artificially fed. Not re ported. Mixed fed. Infant Deaths Infant Deaths Infant Deaths Infant Deaths Infant sur in sur sur in in sur in sur vivors. month. vivors. month. vivors. month. vivors. month. vivors. Italian mothers employed during infant’s life—Con. Employed away from home' during infant’s life— Second month........... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... All other foreign-bom white mothers employed during infant’s life— Second month................. Third month................... Fourth month................. Fifth month.................... Sixth month.................... Seventh month............... Eighth month................. Ninth m onth.................. Tenth month................... Eleventh month............. Twelfth month................ Employed at home during infant’ s life— Second month........... Third month............ Fourth month........... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month.. . . . Twelfth month......... Employed away from home during infant’s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... Colored mothers employed during infant’s life—^ Second month................. Third month................... Fourth month................. Fifth month.................... Sixth month.................... Seventh month............... Eighth month................. Ninth month................... 101351°— 23----- 21 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 2 3 4 5 5 5 6 6 6 6 7 108 142 161 176 181 186 195 202 208 210 212 103 129 145 155 159 160 167 170 173 175 176 2 3 2 2 2 1 2 2 2 1 1 2 1 3 1 2 1 2 1 2 1 3 1 2 1 1 1 5 13 16 21 22 26 28 32 35 35 36 69 254 373 483 535 575 622 645 81 93 94 91 81 68 59 45 31 22 20 1 77 86 86 81 74 62 57 43 29 20 18 1 40 114 158 175 183 133 111 80 2 7 15 23 29 39 50 63 78 90 95 95 20 34 44 56 61 68 73 79 87 93 97 6 12 20 26 35 43 51 63 74 79 79 1 1 1 2 13 80 120 182 208 267 313 347 20 31 39 48 50 55 59 • 64 70 76 79 1 1 3 3 3 4 7 12 15 16 16 16 4 7 8 10 7 6 2 2 2 2 2 1 2 6 5 10 7 6 3 2 3 3 4 4 4 4 5 4 ' 1 2 1 i 3 1 1 1 i 2 1 2 1 2 i 1 1 2 i 2 i 1 i 3 5 8 11 13 14 15 17 17 18 16 60 95 126 144 175 198 218 i 1 3 3 7 4 5 2 322 IN F A N T M O R T A L I T Y , B A L T IM O R E , M D . T a b l e 116.— Infant survivors and infant deaths, by type o f feeding, month o f life, place o f mother’s employment, and color and nationality o f mother; infants o f mothers employed during mother’s, lifetim e— Concluded. Infants of mothers employed during infant’s lifetime. Month of life of infant, and place of employment, color, and nationality of mother. Total. Breast fed. Not re Artificially fed. ported. Mixed fed. Infant Deaths Infant Deaths Infant Deaths Infant Deaths Infant sur in sur in sur in • sur in sur vivors. month. vivors. month. vivors. month. vivors. month. vivors. Colored mothers employed during infant’ s life?—1 Con. Tenth month................... Eleventh month............. Twelfth month............... Employed at home during infant’s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... Employed away from home during infant’s life— Second month.......... Third month............ Fourth month.......... Fifth month.............. Sixth month............. Seventh month......... Eighth month.......... Ninth month............ Tenth month............ Eleventh month....... Twelfth month......... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 678 701 722 8 2 6 54 36 30 43 143 196 233 257 275 297 307 324 337 343 3 1 4 2 4 1 33 90 119 130 132 97 78 54 36 23 19 26 111 177 250 278 300 325 338 354 364 379 1 2 1 1 2 3 4 6 5 2 2 7 5 7 24 «9 45 51 36 33 26 18 13 11 1 1 1 1 1 1 382 405 424 4 28 37 58 73 112 141 167 192 212 217 9 52 83 124 135 155 172 180 190 193 207 3 1 3 242 260 268 1 1 6 25 40 45 52 66 78 86 96 102 107 1 1 1 1 2 1 1 2 i 2 2 10 35 55 81 92 109 120 132 146 158 161 5 1 2 2 1 3 1 3 1 i 1 1 1 2 4 3 2 1 5 2 323 A P P E N D I X V I I .-----T A B L E S . T able 117.— Excess mortality among infants o f mothers employed during infant's life time, by place o f employment, over mortality expected when effect o f differences in type o f feeding, in color and nationality and {in native white fam ilies) m earnings o f father are eliminated; infants o f mothers employed during infant's lifetime. Deaths among infa nts whose mothers were employed.1 Type of feeding and color and nationality ofmother. A t home. Actual deaths. Total...................................................................................... Native white......................................................................... Foreign-born white............................................................... Colored................................................................................... Away from home. Expected Actual deaths.2 deaths. Expected deaths.2 83 96.8 68 53.8 14 10 59 20.5 16.7 59.6 6 20 42 44 13 2 Sfi.2 32 34.9 15 8.3 5 3 24 5.2 5.0 24.7 2 4 9 1.4 6.5 32 35.2 16 10.9 7 2 23 9.4 5.1 20.7 1 4 ii 1.4 2.7 6.8 19 26.7 37 34.6 2 5 12 5.9 6.6 14.2 3 12 22 2.6 9.1 22.9 d 1 Deaths among infants of native white mothers in families where the fathers earned nothing or the amounts were not reported are omitted from the actual and expected deaths; likewise deaths in two very small groups. 11 infants whose mothers worked away from home, in fathers’ earnings groups 1850 and over, and 27 infants with mixed feeding whose mothers worked at home, in fathers’ earnings groups $1,250 and over. 2 The expected deaths are calculated by applying to the months of lifetime lived by infants fed in each specified way at eaeh age whose mothers were employed at home or away from home in each color and nativity group-^-for the native white group in eaeh earnings group, and for the foreign-bom white in each major nationality group—the rates which prevailed among all infants in the corresponding age, type of feeding, color, and nativity, earnings, and nationality group. These deaths were then added to form the groups shown in the table. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 324 IN F A N T M O R T A L I T Y , B A L T IM O R E , M D . T a b l e 118—Infant mortality rates, by time o f mother's employment away from home, color and nativity o f mother, and earnings o f father; live births, all pregnancies. Live births, all pregnancies. Mother never employed Mother employed away Mother employed away before marriage only. after marriage. away.1 Earnings of father during year after 1915, birth and color and nativity of mother. Live births. Num ber. Infant deaths. Infant deaths. Infant deaths. Live Infant births. mor tality rate.* Num ber. Live Infant births. mor tality rate.* Num ber. Infant mor tality rate.* All mothers.................. 8,181 812 99.3 17,491 1,825 104.3 9,172 1,521 165.8 Earnings of father: Under $550...................... $550-1849.......................... $850-$l,849....................... $1,850 and over................ No earnings..................... Not reported................... 2,053 2,535 2,631 589 153 220 240 271 223 28 19 31 116.9 106.9 84.8 47.5 124.2 140.9 3,616 7,106 5,871 498 133 267 438 785 534 31 13 24 121.1 110.5 90.9 62.2 97.7 89.9 4,919 2,855 743 47 397 211 871 448 91 2 75 34 177.1 156.9 122.5 Native white mothers.. 4,603 452 98.2 12,143 1,271 140.7 2,950 462 156.6 Earnings of father: Under $550...................... $550-$849.......................... $850-$l,849.................. $1,850 and over.............. . No earnings................... . Not reported................... 596 1,363 1,979 482 60 123 74 158 170 27 7 16 124.2 115.9 85.9 56.0 229 596 395 26 10 15 131.3 114.2 87.0 65.5 82.4 1,152 1,171 '398 13 134 82 183 182 53 1 30 13 158.9 155.4 133.2 130.0 1,744 5,217 4,538 397 65 182 3,291 323 98.2 4,423 435 98.3 3,030 464 153.1 1,316 1,078 615 148 106 45 112.5 98.3 73.2 9.3 1,293 1,645 1,256 102.9 95.4 103.5 1,615 1,032 260 34 66 23 268 149 27 1 11 8 165.9 144.4 103.8 61 70 133 157 130 5 2 8 Foreign-bom w h i t e mothers................... Earnings of father: Under $550..................... $550-$849........................ $850-$l,849...................... $1,850 and over.............. No earnings................... Not reported.................. Colored mothers......... Earnings of father: Under $550..................... $550-$849........................ $850-$l,849...................... $1,850 and over.............. No earnings................... Not reported.................. 12 223.9 287 37 128.9 925 119 128.6 3,192 595 186.4 141 94 37 18 7 8 127.7 579 244 77 3 7 15 76 32 9 131.3 131.1 2,152 652 85 420 117 11 195.2 179.4 197 106 34 13 172.6 122.6 ft 10 4 1Includes 12 for whom employment was not reported. * Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 188.9 161.1 1 1 325 A P P E N D IX V I I .— T A B L E S . T able 119.— Stillbirth rates, by time o f mother's employment away from home, color and nativity o f mother, and earnings o f father; births, all pregnancies. Births, all pregnancies. Mother never em ployed away.1 Earnings of father during year after 1915 birth and color and nativity of mother. Mother employed away before mar riage only. Stillbirths. Stillbirths. Births. Mother away riage employed after mar- Stillbirths. Per Births. Num Per Births. Num Per Num 1,000 1,000 1,000 ber. births.8 ber. births.8 ber. births.8 8,443 262 31.0 17,978 487 27.1 9,626 454 47.2 Earnings of father: Under $450...................... ....... $450-$549.................................. . $550-1649.................................. . $650-$849.................................. . $850-$l,849................................. $1,850 and over......................... No earnings.............................! Not reported............................. 1,187 940 952 1,644 2,716 613 163 228 33 41 29 32 85 24 10 8 27.8 43.6 30.5 19.5 31.3 39.2 61.3 35.1 1,651 2,085 2,614 4,681 6,024 511 135 277 58 62 65 124 153 13 2 10 35.1 29.7 24.9 26.5 25.4 25.4 14.8 36.1 3,164 2,025 1,557 1,410 777 48 425 220 160 110 54 58 34 1 28 9 50.6 54.3 34.7 41.1 43.8 All mothers.......................... 65.9 40.9 Native white mothers......... . 4,750 147 30.9 12,453 310 24.9 3,055 105 34.4 Earnings of father: Under $450.............................. . $450-$549........... ........................ $550-$649.................................. . $650-$849.................................. . $850-$l,849................................ $1,850 and over........................ No earnings............................. ' Not reported........................... 242 374 508 879 2,052 502 66 127 7 13 10 14 73 20 6 4 28.9 34.8 19.7 15.9 35.6 39.8 14 28 38 95 117 10 2 6 21.9 24.4 21.4 26.6 25.1 24.6 28.4 34.7 38.5 34.2 38.6 7 1 49.6 31.9 670 519 571 644 414 13 141 83 19 18 22 22 16 31.5 640 1,146 1,779 3,571 4,655 407 67 188 Foreign-born white mothers 3,378 87 25.8 4,542 119 26.2 3,134 104 33.2 Earnings of father: Under $450............................... $450-$549.................................. $550-$649.................................. . $650-$849.................................. $850-$l,849................................ $1,850 and over........................ No earnings........... ................. Not reported............................ 858 491 421 690 624 111 92 91 13 20 16 17 9 4 4 4 15.2 40.7 38.0 24.6 14.4 36.0 686 642 696 993 1,289 101 61 74 17 18 18 26 33 3 24.8 28.0 25.9 26.2 25.6 29.7 1,017 653 584 477 272 35 72 24 31 24 12 17 12 1 6 1 30.5 36.8 20.5 35.6 44.1 Colored mothers................... 315 28 88.9 983 58 59.0 3,437 245 71.3 Earnings of father: Under $450............................... $450-$549.................................. $550-$649.................................. $650 and over........................... No earnings............................. Not reported........................... 87 75 23 115 5 10 13 8 3 4 34.8 325 297 139 200 7 15 27 16 9 6 83.1 53.9 64.7 30.0 1,477 853 402 380 212 113 110 68 20 25 15 7 74.5 79.7 49.8 65.8 70.8 61.9 1 Includes 12 for whom employment was not reported. * Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 4 326 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . T a b l e 120.— Infant mortality rates, by number o f births 1 to mother, her employment away from home, ana color and nativity; live births, all pregnancies. Live births, all pregnancies, to mothers having specified number of births. Employment away from home, and color and na tivity of mother. Num ber. Infant deaths. Infant deaths. Tnfant deaths. Live births. 7 and over. 4-6. 1-3. Infant Live mor tality births. rate.2 Num ber. Live Infant Infant births. Num mor mor ber. tality tality rate.2 rate.2 All mothers.................. 11,590 1,106 95.4 11,464 1,239 108.1 11,790 1,813 153.8 2,259 167 73.9 2,865 247 86.2 3,045 396 130.0 Employed after marriage— Employment not reported... 7,135 2,190 0 599 338 2 84.0 154.3 5,704 2,889 6 590 402 103.4 139.1 4,652 4,093 636 781 136.7 190.8 Native whitemothers.. 7,888 721 91.4 6,395 689 107.7 5,413 775 143.2 1,652 113 68.4 1,582 154 97.3 1,360 185 136.0 5,278 955 3 457 151 86.6 158.1 3,909 898 6 405 130 103.6 144.8 2,956 1,097 409 181 138.4 165.0 2,624 237 90.3 3,677 356 96.8 4,443 629 141.6 1,209 88 72.8 1,582 191 120.7 94.9 128.6 1,441 1,420 187 251 129.8 176.8 139.4 1,934 409 211.5 103 20 194.2 255 1,576 40 349 156.9 221.4 Employed“ before marriage Employed" before marriage Employed after marriage— Employment not reported... Foreign-born white 499 Employed" before marriage Employed after marriage— Employment not reported... Employed* before marriage Employed after marriage___ 86.2 1,517 607 1 109 84 1 71.9 138.4 1,465 1,003 139 129 1,078 148 137.3 1,392 194 108 11 101.9 74 5 97.1 164.0 330 988 46 143 340 628 2 1Includes miscarriages. 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 43 33 103 1 139.4 144.7 S2Î APPENDIX V II.— TABLES. T able 121.— Infant mortality rates (by cause o f death) and stillbirth rates, by employment o f mother away from home, during pregnancy and after birth, and by color and nativity o f mother; births in 1915. Infont deaths. Stillbirths. Employment away from home, and color and nativity of mother. Live Total births. Num Per births. 1,000 ber. births.1 All mothers......................................... 11,195 Not employed................................................ Employed before birth in 1915: Before marriage only........................... After marriage and prior to but not during pregnancy of 1915.................... Dining pregnancy of 1915....................... Employed only after birth in 1915............... Employment not reported........................... 2,356 Early infancy. All other causes. Infant Infont Num mortal- Num mortal ber. • ity ber. ity rate.1 rate.1 35.6 10,797 407 37.7 710 72 30.6 2,284 73 32.0 123 53.9 6,347 193 30.4 6,154 220 35.7 346 56.2 1,144 1,317 24 7 43 88 2 37.6 66.8 1,101 1,229 22 7 43 70 39.1 57.0 84 151 5 1 76.3 122.9 Native white mothers............ ............ 6,937 198 28.5 6,739 257 38.1 389 57.7 Not employed................................................ Employed before birth in 1915: Before marriage only.............................. After marriage and prior to but not during pregnancy of 1915.................... During pregnancy of 1915....................... Employed only after birth in 1915............... Employment not reported........................... 1,512 43 28.4 1,469 48 32.7 72 49.0 4,585 127 27.7 .4,458 168 37.7 250 56.1 463 366 7 4 10 18 21.6 49.2 453 348 7 4 25 16 55.2 46.0 31 33 3 68.4 94.8 Foreign-bom white mothers............... 2,837 84 29.6 2,753 85 30.9 179 65.0 Not employed................................................ Employed before birth in 1915: Before marriage only.............................. After marriage and prior to but not during pregnancy of 1915.................... During pregnancy of 1915....................... Employed only after birth in 1915............... Employment not reported...................... 735 18 24.5 717 19 26.5 45 62.8 1,386 43 31.0 1,343 36 26.8 67 49.8 387 322 6 1 10 11 2 25.8 34.2 377 311 4 1 10 20 26.5 64.3 28 37 1 1 74.3 119.0 Colored mothers.................................. 1,421 116 81.6 1,305 65 49.8 142 108.8 Not employed................................................ Employed before birth in 1915: Before marriage only.............................. After marriage and prior to but not during pregnancy of 1915.................... During pregnancy of 1915....................... Employed only after birth in 1915............... Employment not reported...................... ... 109 11 100.9 98 6 376 23 61.2 353 16 45.3 29 82.2 294 629 11 2 23 59 78.2 93.8 271 570 11 2 8 34 29.5 59.6 25 81 1 92.3 142.1 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 398 . 1 1 65.8 6 j| 328 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . T a b l e 122.—Excess mortality among infants o f mothers employed away from home, by time o f mother's employment, over mortality expected when effect o f differences in number o f births 1 to mother, color and nativity o f mother, and earnings o f father are eliminated; live births, all pregnancies. Live births, all pregnancies. Employment of mother away from home before and after marriage. Not employed after marriage....................................... Never employed...................................................... Employed before marriage only............................ Employed after marriage......................... ................... Actual deaths. Live births.2 Expected deaths.* Infant Infant Number. mortality Number. mortality rate. rate. 33,463 3,962 118.4 3,960.9 118.4 24,892 7,801 17,091 8,564 7 .2,550 762 1,788 1,412 102.4 97.7 104.6 164.9 2,740. 7 869.5 1.871.2 1.220.2 110.1 111.5 109.5 142.5 1Includes miscarriages. 2 The 1,381 live births and 196 actual deaths in families where fathers earned nothing or the amounts were not reported are omitted from the computation. s Expected deaths are calculated by applying to the live births in each mother’s employment, color and nativity, number of issues, and father’s earnings group the rates prevailing among all infants (irrespective of mother’s employment) in the same color and nativity, number of issues, and father’s earnings group. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis A P P E N D I X V I I .— T A B L E S . 32Ô T able 123.—Employment o f mother away from home, by age o f mother when she began work, and color and nativity; births ( all pregnancies) to mothers employed away from home at some time prior to birth in 1915. Births, all pregnancies, to mothers who began work away from home at speci fied age. Total births. Employment away from home and color and nativity of mother. Under 14. 14-15. Per cent Per cent Per cent Number. distribu Number. distribu Number. distribu tion. tion. tion. All mothers........................................ 27,604 100.0 9,319 100.0 8,002 100.0 Employment away from home: Before marriage only............................. After marriage....................................... 17,978 9,626 65.1 34.9 5,518 3,801 59.2 40.8 5,618 2,384 70.2 29.8 Native white mothers........................ 15,508 56.2 5,160 55.4 4,949 61.8 Employment away from home: Before marriage only............................. After marriage....................................... 12,453 3,055 45.1 11.1 3,805 1,355 40.8 14.5 4,112 837 51.4 10.5 Foreign-born white mothers............. 7,676 27.8 2,270 24.4 1,985 248 Employment away from home: Before marriage only............................. After marriage....................................... 4,542 3,134 16.5 11.4 1:397 873 15.0 9.4 1,268 717 15.8 9.0 Colored mothers................................. 4,420 16.0 1,889 20.3 1,068 13.3 Employment away from home: Before marriage only............................. After marriage....................................... 983 3,437 3.6 12.5 316 1,573 3.4 16.9 238 830 3.0 10.4 Births, all pregnancies, to mothers who began work away from home at specified age_ Employment away from home and color and nativity of mother. 20-24. 16-19. Num ber. 25 and over. Per cent Num distri ber. bution. Per cent distri bution. Num ber. Not re Per cent ported. distri bution. All mothers.................................. 7,788 100.0 1,543 100.0 729 100.0 223 Employment away from home: Before marriage only...................... After marriage................................. 5,810 1,978 74.6 25.4 848 695 55.0 45.0 66 663 9.1 90.9 118 105 N ative white mothers................. 4,367 56.1 715 46.3 227 31.1 90 Employment away from home: Before marriage only...................... After marriage................................. 3,889 478 49.9 6.1 561 154 36.4 10.0 33 194 4.5 26.6 53 37 2,244- 28.8 672 43.6 440 60.4 65 Employment away from home: Before marriage only...................... After marriage................................. 1,549 695 19.9 8.9 255 417 16.5 27.0 33 407 4.5 55.8 40 25 Colored mothers........................... 1,177 15.1 156 10.1 62 8.5 68 372 805 4.8 10.3 32 124 2.1 8.0 62 8.5 25 43 Foreign-bom white mothers....... Employment away from home: After marriage.— ^........................ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 330 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . T a b l e 124.—Employment o f mother during pregnancy o f 1915, by place o f employment, age when she began work away from home, and color and nativity; births in 1915 to mothers employed away from home at some time prior to the birth. Births in 1915 to mothers who began work away from home at specified age. Total births. Place of employment during pregnancy of 1915, and color and nativity of mother. 14-15. Under 14. Per cent, Number. distribu Per cent Per cent tion. Number. distribu Number. distribu tion. tion. All mothers........................... 8,809 100.0 2,530 100.0 2,635 100.0 Not employed................................. Employed at home......................... Employed away from home.......... Employment not reported............. 6,192 1,299 1,317 1 70.3 14.7 15.0 1,595 436 499 63.0 17.2 19.7 1,919 359 357 72.8 13.6 13.5 Native white mothers.......... 5,415 100.0 1,501 100.0 1,752 100.0 Not employed................................. Employed at home......................... Employed away from home.......... Employment not reported............. 4,542 506 366 1 83.9 9.3 6.8 1,170 174 157 77.9 11.6 10.5 1,481 156 115 84.5 8.9 6.6 Foreign-born white mothers. 2,095 100.0 540 100.0 527 100.0 Not employed................................. Employed at home......................... Employed away from home.......... 1,304 469 322 62.2 22.4 15.4 335 123 82 62.0 22.8 15.2 354 . 115 58 67.2 21.8 11.0 1,299 100.0 489 100.0 356 100.0 346 324 629 26.6 24.9 48.4 90 139 260 18.4 28.4 53.2 84 88 184 23.6 24.7 51.7 Colored mothers................. Not employed................................. Employed at home......................... Employed away from home.......... Births in 1915 to mothers who began work away from home at specified age. Place of employment during preg nancy of 1915, and color and nativity of mother. Number. 25 and over. 20-24. 16-19. Not rePer cent Per cent ported. Per cent distri- Number. distri- Number. distributton. button.1 button.1 All mothers.......................... 2,886 100.0 559 100.0 144 100.0 55 Not employed............................... Employed at home....................... Employed away from home......... Employment not reported............ 2,177 386 323 75.4 13.4 11.2 396 86 77 70.8 15.4 13.8 72 •20 52 50.0 13.9 36.1 33 12 9 1 100.0 1,777 100.0 301 100.0 60 Not employed................................ . Employed at home........................ Employed away from home......... Employment not reported............ 1,573 138 66 88.5 7.8 3.7 259 27 15 86.0 9.0 5.0 40 8 12 Native white mothers......... Foreign-bom white mothers 730 100.0 206 100.0 78 Not employed................................ Employed at home........................ Employed away from home......... 461 168 101 63.2 23.0 13.8 114 48 44 55.3 *23.3 21.4 31 11 36 Colored mothers... .............. 379 100.0 52 100.0 6 Not employed................................ Employed at home........................ Employed away from home......... 143 80 156 37.7 21.1 41.2 23 lì 18 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis . 1 1 4 Ö4 * 100.0 19 3 1 1 14 9 4 1 100.0 17 5 5 7 A P P E N D IX V I I .-----TABL.ES. 331 T a b l e 125.— Excess m ortality and stillbirth rates among infants o f mothers employed away from home, by age o f mother when she began work, over average rates after effect o f differences o f color and nativity is eliminated; births, all pregnancies. Births, all pregnancies. Stillbirth rates per 1,000 births. Age at which mother began work away from home. Infant mor t a 1i t y per 1,000 live births. Total. Under 14........................................................................ 14-15............................................................................... 16-19.......................................... .................................... 20-24............................................................................... 25 and over..................................................................... 9,319 8,002 7,788 1,543 729 Actual. Ex pected.1 Actual. E x pected.1 36.1 34.5 30.3 29.8 41.2 35.8 32.9 33.8 32.0 31.8 139.6 122.6 106.9 127.6 161.7 127.7 123.7 125.0 123.2 123.3 1 To find expected rates, the births in each group of births to mothers employed, classified by color and nativity and by mother’ s age at beginning work, are multiplied by the rates prevailing among all infants in each color and nativity group; the sum of the deaths (or stillbirths) in each age of mother group is then divided by the births in that group. T a b le 126.—Excess mortality (by cause o f death) and stillbirth rates among infants o f mothers employed away from home, by age o f mother when she began work, over average rates after effect o f differences o f color and nativity is eliminated; births in 1915. Births in 1915. Stillbirth rates per 1,000 births. Age at which mother began work away from home. Total. Early infancy. Actual. Under 14..................................... 14-15............................................ 16-19............................. .............. 20-24............................................ 25 and over.................................. 2,530 2,635 2,886 559 144 Infant mortality per 1,000 live births. 40.7 41.4 31.5 19.7 34.7 E x pected.1 39.1 36.1 36.0 34.3 27.1 All other causes. Actual. Ex pected.1 Actual. E x pected.1 38.3 38.0 41.1 31.0 57.6 39.8 39.4 39.0 38.0 33.1 75.8 72.8 54.7 74.8 64.7 70.6 67.5 67.8 66.8 60.4 1 To find expected rates, the births in each group of births to mothers employed, classified b y color and nativity and b y mother’ s age at beginning work, are multiplied by the rates prevailing among allinfants in each color and nativity group; the sum of the deaths (or stillbirths) in each age of mother group is then divided by the births in that group. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 332 I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . T able 127.—Infant mortality rates, by literacy o f mother, earnings o f father, and color and nationality o f mother; live births in 1915. Literate mothers. Earnings of father and color and nation ality of mother. All mothers........................................ Earnings of father: Under $450.......... .................................. $450-8549................................................. 8550-8649................................................ 8650-8849................................................ 8850-81.249............................................ 81,250-81,849........................................... 81,850 and over........................... . No earnings..-........................................ Not reported.......................................... Native white mothers........................ Earnings of father: Under $450............................................. 8450-8549.................................. 8550-8649................................................. 8650-8849................................ 8850-81,249............................................. $1,250 and over...................................... No earnings.......................................... Not reported.......................................... Foreign-bom white mothers............. Earnings of father: Under $650............................................. Under $450............................................. $450-8549................................................. 8550-8649................................................. $650 and over......................................... 8650-8849................................................. $850 and over......................................... No earnings........................................... Not reported.......................................... Jewish.......................................... Earnings of father: Under 8650............................................. $650 and over......................................... Not reported.......................................... Polish........................................... Earnings of father: Under 8650............................................. 8650 and over......................................... Not reported.......................................... Italian......................................... Earnings of father: Under $650............................................. 8650 and over......................................... No earnings........................................... Not reported.......................................... All other....................................... Earnings of father: 8650 and over......................................... Colored mothers................................. Earnings of father: Under $550............................................. Not reported.......................................... 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Illiterate mothers. Infant deaths. liv e births. Infant Number. mortality rate.1 Infant deaths. Live births. Infant. Number. mortality rate.1 9,746 979 100.5 1,041 136 130.6 1,193 1,206 1,314 2,273 2,186 773 428 177 196 6,610 192 145 140 220 152 61 16 30 23 622 160.9 120.2 106.6 96.8 69.5 78.9 37.4 169.5 117.3 94.1 349 241 174 144 69 17 3 30 14 127 50 26 22 12 6 2 143.3 107.9 126.4 83.3 421 611 883 1,699 1,790 993 88 125 1,987 68 75 93 163 125 66 16 16 174 161.5 122.7 105.3 95.9 69.8 66.5 27 33 25 27 11 2 6 8 5 2 1 1 128.0 87.6 2 761 1 89 912 333 278 301 1,014 466 548 26 35 791 94 48 18 28 73 45 28 3 4 37 103.1 144.1 64.7 93.0 72.0 96.6 51.1 551 254 170 127 177 104 73 24 9 169 62 37 10 15 14 8 6 10 3 12 112.5 145.7 58.8 118.1 79.1 76.9 337 421 17 16 339 18 15 1 3 59 53.4 35.6 108 48 10 3 285 4 4 3 1 42 37.0 219 111 3 6 220 37 21 1 168.9 189.2 72.7 34 4 3 1 20 151.8 16 224 52 7 2 190 114 100 2 4 637 12 3 1 105.3 30.0 15 4 106.4 62 97.3 141 44 2 3 117 78 33 5 1 153 9 2 4 23 150.3 106 38 6 3 15 4 3 1 141.5 46.8 174.0 242 382 4 9 1,149 27 34 111.6 89.0 1 183 159.3 756 294 63 36 128 41 11 3 169.3 139.5 13 5 24 1 15 189.0 117.0 71.0 147.4 105.3 128.2 333 APPENDIX VII.-----TABLES. T a b le 128.—Relative mortality among infants o f illiterate mothers when effect o f differ ences in mother’s color and nationality and fath er’s earnings is elim inated; births in 1915 to illiterate mothers. Deaths among infants of illiterate mothers. Color and nationality of mother. Actual.1 Expected.2 Total......................................... 118 119.9 Native white mothers...................... 23 8 38 19 11 19 14.9 7.2 44.4 18.0 12.9 22.5 Jewish mothers.................................. Polish mothers................................... Italian mothers.................................. All other foreign-horn white mothers Colored mothers................................. were “ none” or “ not reported” are omitted in this computation. 2 Expected deaths in each nationality group are the sum of the deaths found by multiplying the births (for illiterate mothers) classified by father’s earnings by the rates prevailing among all infants m the corre sponding nationality and earnings groups. T able 129.— Infant mortality rates, by mother’s ability to speak English, earnings o f father, and nationality o f mother; live births in 1915 to foreign-born white mothers o f non-English-speaking nationalities. Live births to foreign-bom white mothers of non-Englishspeaking nationalities. Earnings of father and nationality of mother. Mother able to speak English. Infant deaths. Live births. Foreign-bQm white mothers of nonEnglish-speakmg nationalities...... Earnings of father: Under $650............................................ Under $450...................................... $450-8549....... ................................. $550-8649........................................ $650 and over........................j ......... $650-8849.......................................... $850 and over.................................. No earnings........................................... Not reported.......................................... Jewish.......................................... Earnings of father: Under $650............................................. $650 and over......................................... No earnings........................................... Not reported.......................................... Polish........................................... Earnings of father: Under $650............................................. $650 and over......................................... No earnings........................................... * Not reported.......................................... Italian.......................................... Earnings of father: Under $650............................................. $650 and over......................................... No earnings........................................... Not reported.................................. All other....................................... Earnings of father: Under $650............................................. $650 and over........................................ No earnings........................................... Not reported.......................................... 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Mother not able to speak English. Infant Number. mortality rate.1 Infant deaths. Live births. Infant Number. mortality rate.1 1,594 125 78.4 1,027 124 120.7 711 244 235 232 825 363 462 27 31 786 60 30 12 18 57 33 24 3 5 39 84.4 123.0 51.1 77.6 69.1 90.9 51.9 712 334 199 179 279 171 108 22 14 175 91 53 15 23 21 13 8 10 2 10 127.8 158.7 75.4 128.5 75.3 76.0 74.1 336 14 19 17 223 18 16 1 4 39 53.6 38.6 110 55 8 2 402 4 3 3 36.4 63 156.7 144 72 3 4 140 23 15 48 10 4 i 25 160.5 78.6 299 91 7 5 272 72 66 7 4 20 3 108.7 2 170 14 82.4 184 78 4 6 132 63 100 2 5 1 11 4 9 1 49.6 174.9 159.7 90.0 91 37 3 1 57.1 91.9 1 18 11 5 2 136.4 334 IN F A N T M O R T A L I T Y , B A L T IM O R E , M D . T able 130.—Relative mortality among infants o f mothers not able to speak English, as compared with mortality expected on the basis o f average rates, when effect o f differences in mother’s color and nationality and father’s earnings is eliminated; live births in 1915 to foreign-born white mothers unable to speak English. Deaths am ong infants of foreign -bom white mothers unable to speak En glish.1 Nationality of mother. Expected.2 Actual.2 112 113.4 7 58 23 24 8.3 62.8 23.9 18.4 1 Actual and expected deaths in fam ilies where the father’s earnings were “ none” or “ not reported” are u iiJU /te u . . 1 The expected deaths in each nationality group are the sum of the deaths found by multiplying the births (to mothers unable to speak English) classified by father’s earnings by the mortality rates for all infants in the corresponding nationality and earnings group. T able 131.—Prevalence o f infant-welfare work, by ability o f mother to speak English and nationality; infants born to Jewish, Polish, and Italian mothers and surviving two weeks. Infants surviving 2 weeks and having specified postnatal care (institutional). Ability to speak English and nationality of mother. Total infants surviv ing two weeks. Care graded as bet ter than poor. No care. Number. Per cent. Number. Per cent. Jewish: Able to speak English............................................ Not able to speak English..................................... Italian: Able to speak English............................................ Not able to speak English..................................... Polish: Able to speak English............ ............................... Not able to speak English..................................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 768 169 177 53 23.0 31.4 439 75 57.2 44.4 134 262 30 24 22.4 9.2 84 184 62.7 70.2 210 388 14 20 6.7 5.2 156 308 74.3 79.4 335 A P P E N D IX V I I .— T A B L E S . T able 132.—Infant mortality and stillbirth rates, by order o f birth; births in 1915, and births, all pregnancies. Births in 1915. Infant deaths. Stillbirths. Order of birth.1 Births. Infant deaths. Stillbirths. Live Live Births. births. Infant Per births. Num Infant Num 1,000 mor Num Per Num mor 1,000 ber. births. ber. tality ber. births. ber. tality rate. rate. Total............. 11,195 First.......... «........... Second.................... Third...................... Fourth.................... Fifth and sixth...... Seventh to ninth... Tenth and later___ Births, all pregnancies. 2,999 2,471 1,525 1,164 1,503 1,058 475 398 35.6 10,797 1,117 103.5 36,047 1,203 33.4 34,844 4,158 119.3 131 62 44 37 54 42 28 43.7 25.1 28.9 31. 8 35.9 39.7 58.9 94.8 92.6 91.8 106. 5 108.4 127.0 179.0 39.7 10,327 1,196 25.7 7,500 770 28.2 5,130 572 29.1 3,701 470 33.3 4,528 591 37.8 2,775 395 56.6 164 883 115.8 102.7 111.5 127.0 130.5 142.3 185.7 2,868 , 272 2,409 223 1,481 136 1,127 120 1,449 157 1,016 129 447 80 10,754 7,698 5,279 3,812 4,684 2,884 936 427 198 149 111 156 109 53 1 “ Order of birth” means order of issue for births in 1915 and order of pregnancy for births, all pregnancies • T able 133.—Infant mortality and stillbirth'rates, by order o f birth and color o f mother; single births in 1915, and single births, all pregnancies, to mothers who reported no plural births. Single births in 1915. Births. All mothers___ 10,915 Order of birth: First....................... Second and third... Fourth to sixth___ Seventh to ninth... Tenth and later___ Infant deaths. Stillbirths. Order of birth1 and color of mother. Births, all pregnancies to mothers who reported no plural births. Infant deaths. Stillbirths. Live Live In Births. In births. Per births. fant fant Num 1,000 Num mor Num Per Num mor 1,000 ber. births. ber. tality ber. ber. tality births. rate. rate. 378 34.6 10,537 1,023 2,956 3,910 2,570 1,032 447 126 103 84 42 23 42.6 26.3 32.7 40.7 51.5 2,830 3,807 2,486 990 424 259 91.1 10,330 334 87.7 12,246 241 96.9 7,740 120 121.2 2,531 69 162.7 765 97.1 33,612 1,089 32.4 32,523 3,671 112.9 398 322 234 92 43 38.5 9,932 1,114 26.3 11,924 1,208 30.2 7,506 900 36.3 2,439 323 56.2 722 126 112.2 101.3 119.9 132.4 174.5 White mothers. 9,529 269 28.2 9,260 834 90.1 29,205 783 26.8 28,422 3,000 105.6 Order of birth: First........................ 2,699 Second and third... 3,443 Fourth to sixth___ 2,189 Seventh to ninth... 852 Tenth and later___ 346 98 75 56 27 13 36.3 21.8 25.6 31.7 37.6 2,601 3,368 2,133 825 333 223 85.7 9,184 268 79.6 10,730 193 90.5 6,631 96 116.4 2,079 54 162.2 581 304 220 169 62 28 33.1 8,880 20.5 10,510 25.5 6,462 29.8 2,017 48.2 553 966 984 714 244 92 108.8 93.6 110.5 121.0 166.4 Colored mothers 1,386 109 78.6 1,277 189 148.0 4,407 306 69.4 4,101 671 163.6 28 28 28 15 10 108.9 60.0 73.5 83.3 99.0 229 439 353 165 91 1,146 1,516 1,109 452 184 94 102 65 30 15 82.0 67.3 58.6 66.4 81.5 1,052 1,414 1,044 422 169 148 224 186 79 34 140.7 158.4 178.2 187.2 201.2 Order of birth: First....................... Second and third... Fourth to sixth___ Seventh to ninth... Tenth and later___ 257 467 381 180 101 36 66 48 24 15 157.2 150.3 136.0 145.5 164.8 1 “ Order of birth” means order of issue for births in 1915 and order of pregnancy for births all Dree- LrtftlAS. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis J 9 tr © I N F A N T M O R T A L I T Y , B A L T IM O R E , M D . 336 T ab le 134.—Stillbirth rates, by number o f births 1 to mothers, order o f pregnancy, and color o f mother; single births, all pregnancies, to mothers who reported no plural births. - Single births, all pregnancies, to mothers who reported no plural births and who reported specified number of total births.i Total. 4-6. 1-3. Order of pregnancy and color of mother.5 Births. Stillbirths. Stillbirths. Stillbirths. Births. Per Birth?. Num 1,000 ber. births. Per 1,000 births. Num ber. Per 1,000 births. All mothers.................. 33,612 Order of pregnancy: 10,330 7,312 4,934 7,740 St?vell 111 to ninth............ T hui,h and later............... 1,089 32.4 11,855 408 34.4 11,226 320 28.5 398 186 136 234 92 43 38.5 25.4 27.6 30.2 26.3 56.2 6,691 3,750 1,414 271 98 39 40.5 26.1 27.6 2,385 2,342 2,316 4,183 88 53 57 122 36.9 22.6 24.6 29.2 29,205 783 26.8 10,689 311 29.1 9,802 228 23.3 33.1 20.2 21.0 25.5 29. 3 48.2 6,060 3,372 1,257 209 71 31 34.5 21.1 24.7 2,083 2,046 2,021 3,652 67 34 38 89 32.2 16.6 18.8 24.4 White mothers............ Order of pregnancy: Third............................... 9,184 438 4,292 6 621 Seventh to ninth. ........... Tenth and later ............... 304 130 90 169 62 28 Num ber. > Single births, all pregnancies, to mothers who reported no plural births and who reported specified number of total births.i 10 and over. 7-9. Order of pregnancy and color of mother.5 Stillbirths. Stillbirths. Births. All mothers— Order of pregnancy: First.................... Second................. Third................... Fourth to sixth.. Seventh to ninth. Tenth and later.. White mothers. First.................... Second................. Third.................. Fourth to sixth.. Seventh to ninth. Tenth and later.. Births. 1,000 Number. Per births. 1,000 Number. Per births. 6,882 206 29.9 3,649 155 42.5 915 891 888 2,597 1,591 27 23 26 82 48 29.5 25.8 29.3 31.6 30.2 339 329 316 960 940 765 12 12 14 30 44 43 35.4 36.5 44.3 31.3 46.8 56.2 5,900 781 763 766 2,236 1,354 151 21 18 14 63 35 25.6 26.9 23.6 18.3 28.2 25.8 2,814 260 257 248 743 725 581 93 7 7 7 . 17 27 28 33.0 26.9 27.2 28.2 22.9 37.2 48.2 . i Includes miscarriages. . . . . , . . , . .. __ . 5 The figures and rates for infants of colored mothers are not given separately, since the groups are too small to yield satisfactory comparison. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 337 APPENDIX VII.-----TABLES. T 185.— In fa n t m o rta lity rates, by n um ber o f births 1 to m other, order o f preyn an cu b irth * 1™ °* m oth er; M ngle liv e births, a ll p regn a n cies, to m others w ho rep orted n o p lu ra l able Live births, all pregnancies, to mothers who reported no plural births and who reported specified number of total births.1 Total. Infant deaths. 1-3 Order of pregnancy and color of mother.» Live births. All mothers............. 4-6 Infant deaths. Num ber. Infant mor Live tality births. rate. Num ber. Infant deaths. Live Infant births. mor tality rate. Num ber. Infant mor tality rate. 32,523 3,671 112.9 11,447 1,059 92.5 10,906 1,135 104.1 Order of pregnancy: First....................... Second..................... Third................... Fourth to sixth............... Seventh to ninth......... Tenth and later............. 9,932 7,126 4,798 7,506 2,439 722 1,114 696 512 900 323 126 97.7 106.7 119.9 132.4 174 5 112.2 6,420 3,652 1,375 637 304 118 99.2 83.2 85.8 2,297 2,289 2,259 4,061 283 219 421 123.2 92.6 96.9 103.7 White mothers............ 28,422 3,000 105.6 10,378 914 88.1 9,574 957 100.0 Order of pregnancy: First........................ Second..................... Third..................... Fourth to sixth............... Seventh to ninth. . . ___ 8,880 6,308 4,202 6,462 2,017 966 571 413 714 244 92 108.8 90.5 98.3 110.5 5,851 3,301 1,226 565 255 94 96.6 77.2 76.7 2,012 2,016 246 176 184 351 122.0 212 1,983 3,563 121.0 87.5 92.8 98.5 166.4 Live births, all pregnancies, to mothers who reported no Eirths i r^ s an<^ w h o reported specified number of total 7-9 10 and over. Order of pregnancy and color of mother.* Infant deaths. Live births. All mothers...................... Order of pregnancy: First................................... Second.............................. Third.................................. Fourth to sixth................ Seventh to ninth............ Tenth and later................ White mothers............... Order of pregnancy: First............................. Second................................ Third.............................. Fourth to sixth......... ........ Seventh to ninth............... Tenth and later.............. _____________________ __________________ 1 1 Includes miscarriages Infant Number. mortality rate. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Infant Number. mortality rate. 6,676 890 133.3 3,494 587 168.0 888 868 862 2,515 1,543 *133 123 126 319 189 149.8 141.7 146.2 126.8 122.5 327 317 302 930 896 722 61 57 49 160 134 126 186.5 179.8 162.2 172.0 149.6 174.5 5,749 715 124.4 2,721 414 152.1 760 745 752 2,173 1,319 110 144.7 132.9 131.6 116.4 116.8 253 250 241 726 698 553 45 41 36 177.9 164.0 149.4 151.5 128.9 166.4 99 99 253 154 s r ^ t o S d la t o d^ ^ fS ^ S 5 . ° 0l0red mothers are not ^ 101351°—23-----22 Infant deaths. Live births. 110 90 92 seParate1^- stace the gr0^ps are too IN F A N T MORTALITY, BALTIMORE, MD. 338 T a b l e 136.— Excess m ortality am ong infants o f mothers reporting large num bers o f births 1 over m ortality expected at average rqtes when effect o f differences in color and n ativity and fath er’ s earnings is elim inated; live births, all pregnancies. Live births, all pregnancies. Expected deaths.3 Actual deaths.8 Number of births1 to mother. Total. Number. Total.................................................... .......... 1 fnS 4 to fi 7 to 9 ....................................................... ........................................................... ........................................ .......................... Infant Infant mortal Number. mortal ity irate. ity rate. 33,463 3,962 118.4 3,962.1 118.4 11,138 10,996 7,112 4,217 1,038 1,182 990 752 93.2 107.5 139.2 178.3 1,263.5 1,300.4 866.4 531.8 113.4 118.3 121.8 126.1 1 Includes miscarriages. . , . , , .. ,, •__„ „„ aBirths and actual and expected deaths m families where the earnings of the father were none or “ not reported” are omitted from this comparison. . _ s The expected deaths in each number of issues to mother group are the sum of the deaths found Dy multiplying the live births (to mothers with specified number of issues), classified by color and nativity of mother and b y earnings of father, by the average rates of mortality prevailing among all infants m the corresponding color and nativity and earnings groups. T a b l e 137.— In fa n t m ortality rates, by order o f birth and earnings o f fath er; single live births in 1915 and all live births, all pregnancies. Live births in families where fathers earned specified amount during year after birth in 1915. Order of birth.1 Live births. $850 and over. $550-8849, Under $550. Infant deaths. Infant deaths. Infant deaths. Live Infant births. Num mortal ber. ity rate. Live Infant births. Num mortal ber. ity rate. Infant Num mortal ber. ity rate. Single births in 1915. Total............................ 2,914 First....................................... Second.................................... Third...................................... F o u r th ........... ..................... Fifth and sixth............... ...... Seventh to ninth................... Tenth and later..................... 632 578 382 328 451 377 166 130.4 3,814 356 93.3 3,393 216 63.7 128.2 81 119.4 69 109.9 42 131.1 43 56 • 124.2 164.5 62 162.7 27 1,079 849 502 394 504 347 139 92 77 45 36 44 34 28 85.3 90.7 89.6 91.4 87.3 98.0 201.4 1,003 847 495 340 372 234 68 67.8 55.5 60.6 58.8 59.1 81.2 98.0 380 102 47 30 20 22 19 10 Births, all pregnancies. Total............................. 10,588 1,549 146.3 12,496 1,504 120.4 10,379 909 87.6 2,741 2,132 1,563 1,215 1,562 1,049 326 382 284 205 187 226 195 70 139.4 133.2 131.2 153.9 144.7 185.9 214.7 3,795 2,707 1,828 1,310 1,597 960 299 460 294 207 163 214 115 51 121.2 3,385 2,366 1,538 1,029 1,175 665 295 154 133 99 87.1 65.1 86.5 ' 96.2 103.8 106.8 158.4 F i r s t ................................... Second..................... - — - ••Third..................................... Fourth.................................... Fifth and sixth...................... Seventh to ninth.................... Tenth and later..................... 108.6 113.2 124.4 134.0 119.8 170.6 221 122 71 35 f “ Order of birth” means order of issue births in 1915 and order of pregnancy for births, all pregnancies. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 339 APPENDIX V II.— TABLES. T a b l e 138. In fan t m ortality rates, by order o f birth,1 earnings o f fath er, and color and n ativity o f m other; single live births in 1915. Single live births of specified order of birth .1 First to third. Earnings of father and color and nativity of mother. Fourth to sixth. Infant deaths. Live births. Num ber. Seventh and later. Infant deaths. Infant Live mor births. tality rate.2 Num ber. Infant deaths. Infant Live mor births. tality rate.2 Num ber. Infant mor tality rate.2 Native white mothers.. 4,567 372 81.5 1,364 128 93.8 641 85 132.6 Earnings of father: Under $550....................... $550-$849. . . . . . . . . . . . . . $850~$lj249.. . . . . . . . ____ $1,250 and over................ No earnings................... Not reported................... 667 1,765 1,247 735 65 84 145 72 49 125.9 82.2 57.7 66.7 235 557 354 175 15 28 31 55 23 131.9 98.7 65.0 153 249 160 25 36 19 163.4 144.6 118.8 12 68.6 88 11 •11 Foreign - born white mothers..................... 1,402 119 84.9 769 65 84.5 517 65 125.7 Earnings of father: Under $550...................... $550~$ $ 4 9 ... ......... $850 and over.......... No earnings................... Not reported............... 491 529 328 26 28 42 50 17 7 3 85.5 94.5 51.8 306 270 171 20 33 107.8 74.1 40.9 214 178 108 U 34 19 158.9 106.7 Colored mothers.......... 668 102 152.7 353 48 136.0 256 39 152.3 Earnings of father: Under $550..................... $550 and over................... No earnings..................... Not reported................... ----------- --- «_____ __________ 434 171 40 23 26 7 3 66 152.1 152.0 238 83 35 5 176 65 7 30 170.5 1 Includes miscarriages. T able 11 11 22 10 5 g 9 2 7 4 1 147.1 6 2 6 1 8 2 Not shown where base is less than 100. 139.— In fa n t m ortality rates, by order o f birth,1 earnings o f father {detailed grou ps); single live births in 1915 to n ative white m others. Single live births of specified order of birth .1 First to sixth. Earnings of father. Seventh and later. Infant deaths. Live births. Infant Number. mortality rate.2 Infant deaths. Live births. Infant Number. mortality rate.2 Total__ 5,931 500 84.3 641 85 Under $450.... $450-$549......... $550-1649......... $650-$849......... $850-$l,249___ $1,250-$1,849__ $1,850 and over No earnings__ Not reported.. 364 538 792 1,530 1,601 569 341 80 116 54 61 72 128 95 47 14 16 13 148.4 113.4 90.9 83.7 59.3 82.6 41.1 73 80 94 155 160 44 18 13 112 .1 9 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 8 * Not shown where base is less than 100. 132.6 12 13 23 19 3 2 148.4 118.8 IN F A N T MORTALITY, BALTIMORE, MD. 340 T a b l e 140. — Prem ature birth, by order o f birth; 1 live births in 1915. Live births in 1915. Live births in 1915. Premature. Order of birth.1 Premature. Order of birth.1 Total. Total. Number. Percent .2 Number. Per cent.2 m 797 2,868 2 409 l ’ 481 1 127 Fifth....................... i '818 591 230 128 69 41 5.5 Sixth....................... 8.0 Eighth.................... Ninth...................... Tenth...................... 5.3 4.7 3.6 2.7 22 631 440 337 239 172 90 185 Twelfth and later.. 28 16 15 13 4.4 3.6 4.5 5.4 4.7 4 17 9.2 8 2 Not shown where base is less than 100. Includes miscarriages. T a b l e 141.— Prem ature birth, by interval since preceding b irth ;1 live births in 1915, second and later in order o f birth.1 Live birl hs in 1915, second and late in order of birth.1 Interval since preceding birth.1 Premature. Total. Number. Per cent.2 7,929 361 4.6 2,072 2,950 1,364 1,496 47 132 105 50 69 5 6.4 3.6 3.7 4.6 2 Not shown where base is less than 50. i Includes miscarriages. T a b l e 142. — In fa n t m ortality (specified causes) and stillb irth rates, by order o f b irth ;1 single births in 1915. Single births in 1915. Infant deaths. Stillbirths. • Order of birth. Early infancy. Allother causes. Total. Live births. Total. Per Num 1,000 ber. births. Num ber. Infant mor tality rate. Num ber. Infant mor tality rate. Num ber. Infant mor tality rate. Total.............. 10,915 378 34.6 10,537 1,023 97.1 357 33.9 666 63.2 126 60 43 34 50 42 23 42.6 24.7 29.1 30.1 34.7 40.7 51.5 2,830 2,372 1,435 1,095 1,391 990 424 259 208 126 104 137 91.5 87.7 87.8 95.0 98.5 104 85 52 25 37 32 36.7 35.8 36.2 155 123 74 79 Seventh to ninth___ Tenth and later....... 2,956 2,432 1,478 1,129 L441 1,032 447 54.8 51. 9 51. 6 72.1 71.9 88.9 i Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 120 69 121.2 162.7 22 22.8 26.6 32.3 51.9 100 88 47 110.8 APPENDIX VII.---- TABLES. 341 T a b l e 143— In fa n t m o rta lity rates, by age, co lo r, and n a tiv ity o f m oth er; liv e births in 1915 and liv e births, a ll pregn a n cies. Live births to mothers of specified color and nativity. Total. Native white. Infant deaths. Age of mother. Live births. Foreign-bom white. Infant deaths. Colored. Infant deaths. Infant deaths. Live Live Live Infant births. Infant births. Infant births. Infant Num mor Num mor Num mor Num mor ber. tality ber. tality ber. tality ber. tality rate.i rate.i rate.i rate.i Births in 1915. Total............. 10,797 1,117 Under 20................. 20-24................. 25-29................. 30-34.................... 35 and over.......... 35-39................. 40 and over...... Not reported.......... 947 3,283 2,987 1,958 1,618 1,206 412 4 103.5 6,739 126.7 336 102.3 270 90.4 187 95.5 203 125.5 153 126.9 50 121.4 666 120 646 2,195 1,890 1,132 856 630 226 1 95.9 2,753 77 115.6 208 94.8 154 81.5 104 91.9 103 120.3 77 122.2 26 115.1 111 264 662 795 608 576 432 144 1 95.9 1,305 207 158.6 17 153.2 50 75.5 73 91.8 51 83.9 72 125.0 55 127.3 17 118.1 170 426 302 218 186 144 42 3 26 78 43 32 28 152.9 183.1 142.4 146.8 150.5 145.8 1 21 7 Births, all pregnancies. Total............. 34,844 4,158 Under 20................. 20-24................... 25-29.................... 30-34........................ 35 and over........... 35-39................. 40 and over....... Not reported.......... 119.3 19,696 2,185 4,105 608 148.1 2,507 12,583 1,492 118.6 7,370 9,851 1,061 107.7 5,513 5,441 614 112.8 2,817 2,807 358 127.5 1,472 2,281 289 126.7 1,189 526 69 131.2 283 57 25 17 110.9 10,744 1,222 343 136.8 812 110.2 550 99.8 284 100.8 185 125.7 152 127.8 33 116.6 11 780 3,652 3,281 1,989 1,018 833 185 24 125 406 334 219 126 103 23 12 113.7 4,404 751 170.5 160.3 818 1,561 1,057 635 317 259 58 16 140 274 177 171.1 175.5 167.5 174.8 148.3 131.3 111.2 101.8 110 .1 123.8 123.6 124.3 1 11 47 34 13 2 1 Not shown where base is less than 100. T a b l e 144.— S tillbirth rates, by age, color, and n ativity o f m other; births in 1915. Births to mothers of specified color and nativity. Total. Native white. Age of mother. Stillbirths. Births. Num ber. Total___ 11,195 Under 20.......... 20-24................. 25-29................. 30-34................. 35 and over___ 35-39.......... 40 and over. Not reported...! 995 3,382 3,087 2,029 1,698 1,259 439 4 Per Foreign-bom white. Stillbirths. Births. 1,000 births.1 Colored. Stillbirths. Stillbirths. Births. Births. Num Per Num Per Num Per 1,000 1,000 ber. 1,000 ber. ber. births.1 births.1 births.1 398 35.6 6,937 198 28.5 2,837 84 29.6 1,421 116 81.6 48 99 48.2 29.3 32.4 35.0 47.1 42.1 61.5 688 22 32.0 24.9 26.8 25.8 42.5 45.5 34.2 116 676 820 622 602 447 155 5 14 25 14 26 15 43.1 20.7 30.5 22.5 43.2 33.6 71.0 191 455 325 245 21 109.9 63.7 70.8 100 71 80 53 27 2,251 1,942 1,162 894 660 234 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 56 52 30 38 30 8 1 11 202 152 50 3 29 23 27 16 8 8 110.2 79.2 52.6 342 T IN F A N T MORTALITY, BALTIMORE, MD. able 145.— S tillbirth rates, by age o f mother and earnings o f fa th er; sin gle births in 1915 . and all births, all pregnancies. Births in families where fathers earned specified amount during year after birth in 1915. Age of mother. Stillbirths. Stillbirths. Stillbirths. Births. $850 and over. $550-8849 Under $550. Per Births. N u m -. 1,000 ber. births.1 Num ber. Per Births. 1,000 births.1 Per Num 1,000 ber. births.1 Single births in 1915. Total............................ 3,054 140 45.8 3,936 122 31.0 3,487 379 923 737 494 517 24 35 35 28 18 63.3 37.9 47.5 56.7 34.8 394 1,302 1,056 653 531 10 20-24...................................... 25-29....................................... 30-34....................................... 33 33 25.4 25.3 31.3 32.2 47.1 1,10 1 4 21 25 172 949 94 27.0 10 58.1 19.0 22.7 25.5 42.2 18 25 19 744 521 22 Births, all pregnancies. 20-24....................................... 25-29....................................... 30-34...................................... 11,052 464 42.0 12,858 362 28.2 10,689 310 29.0 1,628 3,948 2,858 88 54.1 40.8 37.4 38.4 39.6 1,609 4,833 3,552 1,854 997 13 45 117 92 63 41 4 28.0 24.2 25.9 34.0 41.1 859 3,680 3,360 1,881 891 18 30 97 96 52 31 4 34.9 26.4 28.6 27.6 34.8 1,668 908 42 1 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 161 107 64 36 8 343 APPENDIX V II.— TABLES. T a b l e 146.— In fan t m ortality rales, by age o f m other and earnings o f fa th er; sin gle live births in 1915 and a ll liv e births, dll 'pregnancies. Live births in families where fathers earned specified amount during year after birth in 1915. Under $550. Age of mother. $550-1849. Infant deaths. Live births. Num ber. $850 and over. Infant deaths. Live Infant births. mor tality rate.1 Num ber. Infant deaths. Live Infant births. mor tality rate.1 Num ber. Infant mor tality rate.1 Single births in 1915. Total............................. 2,914 380 130.4 3,814 356 93.3 3,393 216 63.7 Under 20................................ 20-24....................................... 25-29....................................... 30-34....................................... 35 and over............................. Not reported.......................... 355 888 702 466 499 4 52 115 82 56 74 1 146.5 129.5 116.8 120.2 148.3 384 1,269 1,023 632 506 43 103 90 56 64 112.0 81.2 88.0 88.6 126.5 162 931 1,076 725 499 10 68 56 47 35 61.7 73.0 52.0 64.8 70.1 All births, all pregnancies. Total............................. 10,588 Under 20................................ 20-24....................................... 25-29....................................... 30-34....................................... 35 and over............................ Not reported.......................... 1,549 146.3 12,496 1,504 120.4 10,379 909 87.6 261 552 371 223 132 10 169. 5 145.8 134.9 139.0 151.4 i,564 4,716 3,460 1,791 956 9 239 537 392 214 116 6 152.8 113.9 113.3 119.5 121.3 829 3,583 3,264 1,829 860 4 80 335 249 149 87 9 96.5 93.5 76.3 81.5 101.2 1,540 3,787 2J51 1,604 872 34 'Not shown where base is less than 100. T a b l e 147.— In fan t m ortality rates fro m specified causes, by age o f m other; sin gle live births in 1915. Single live births in 1915. Infant deaths. Age of mother. Early infancy. Total. Total. All other causes. Infant mortality Infant rate.1 Number. Infant mortality Number. mortality rate.1 rate.1 Total.................................. 10,537 1,023 97.1 357 33.9 666 63.2 Under 20....... ............................. 20-24............................................ 25-29............................................ 30-34............................................ 35 and over.................................. 35-39........................... ......... 40 and over........................... Not reported............................... 940 3,224 2,910 1,896 1,563 1,164 399 4 114 309 242 169 188 141 47 1 121.3 95.8 83.2 89.1 120.3 121.1 117.8 45 101 94 54 , 62 48 14 1 47.9 31.3 32.3 28.5 39.7 41.2 35.1 69 208 148 115 126 93 33 73.4 64.5 50.9 60.7 80.6 79.9 82.7 i Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 344 T IN F A N T MORTALITY, BALTIMORE, MD. able 148.—Premature births, by age, color, and nativity o f mother; live births in 1915. Live births to mothers of specified color and nativity. Age of mother. Total live births. Total..... ...................... Under 20................................ 20-24....................................... 25-29....................................... 30-34....................................... 35 and over............................. 35-39................................. 40 and over...................... Premature live births. Num ber. Per cent.1 415 6.2 6,739 59 147 103 61 45 36 9 666 2,195 1,890 1,132 856 630 226 Colored. Foreign-born white. Native white. 8.9 6.7 5.4 5.4 5.3 5.7 4.0 Total live births. Premature live births. Total live births. Premature live births. Num ber. Per cent.1 Num ber. Per cent.1 2,753 97 3.5 1,305 79 6.1 111 662 795 608 576 432 144 1 8 21 31 16 21 15 6 7.2 3.2 3.9 2.6 3.6 3.5 4.2 170 426 302 218 186 144 42 3 14 29 15 10 10 6 4 1 8.2 6.8 5.0 4.6 5.4 4.2 . 1 Not shown where base is less than 100. T able 149.—Stillbirth rales, by order o f birth and age o f mother; births in 1915, and births, all pregnancies. Births of specified order of birth.1 Second and third. First. Age of mother. Seventh and later. Stillbirths. Stillbirths. Stillbirths. Stillbirths. Births. Fourth to sixth. Births. Births. Per Births. Num Per Per Per Num 1,000 Num 1,000 Num 1,000 1,000 ber. births.* ber. ber. births.8 ber. births.8 births.8 Births in 1915. Total.......... 2,999 131 43.7 3,996 106 26.5 2,667 91 34.1 1,533 70 45.7 741 1,449 561 187 61 54 7 35 53 26 16 1 1 47.2 36.6 46.3 85.6 246 1,588 1,409 546 207 176 31 12 35 33 14 12 11 1 48.8 22.0 23.4 25.6 58.0 62.5 8 337 966 853 500 408 92 3 1 11 34 23 22 18 4 32.6 35.2 27.0 44.0 44.1 8 151 443 930 621 309 1 7 18 45 23 22 46.4 40.6 48.8 37.0 71.2 Under 20.......... 20-24................. 25-29................. 30-34................. 35 and over....... 35-39........... 40 and over. Births, all pregnancies. Total.......... 10,754 Under 20.......... 3,181 20-24................. 5,371 25-29................. 1,681 414 30-34................. 99 35 and over....... 89 35-39.......... 10 40 and over. 8 Not reported... 427 39.7 12,977 347 26.7 8,496 267 31.4 3,820 162 42.4 117 197 73 33 5 4 1 2 1,054 6,197 4,153 1,228 316 277 39 29 51 154 90 29 15 13 2 8 48.4 24.9 21.7 23.6 47.5 46.9 41 1,367 3,755 2,490 817 709 108 26 3 40 120 74 27 22 5 3 29.3 32.0 29.7 33.0 31.0 46.3 41 571 1,502 1,696 1,293 403 10 2 26 57 74 48 26 3 45.5 37.9 43.6 37.1 64.5 36.8 36.7 43.4 79.7 i “ Order of birth” means order of issue for births in 1915, and order of pregnancy for births, all pregancies. aNot shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis If. T able 150.— Infant mortality rates, by order o f birth and age o f mother; live births in 1915, and live births, all pregnancies. Births of specified order of birth.1 Second and third. First. Age of mother. Infant deaths. Infant deaths. Live births. Num ber. Fourth to sixth. Num ber. Infant deaths. Infant deaths. Live Infant births. mor tality rate.2 Num ber. Tenth and later. Live Infant births. mor tality rate.2 Num ber. Infant deaths. Live Infant births. mor tality rate.2 Num ber. Infant mor tality rate.2 Births in 1915. Total................................................................... 2,868 272 Under 20....................................................................... 20-24............................................................................. 25-29.............................................................................. 30-34............................................................................. 35 and over................................................................... 35-39....................................................................... 40 and over............................................................ Not reported................................................................ 706 1,396 535 171 60 53 79 125 44 14 10 8 2 T 94.8 3,890 111.9 89.5 82.2 81.9 234 1,553 1,376 532 195 165 30 359 92.3 2,576 277 107.5 1,016 129 127.0 447 80 179.0 38 160 95 45 21 18 3 162.4 103.0 69.0 84.6 107.7 109.1 7 326 932 830 478 390 88 3 3 47 102 76 48 41 7 1 144.2 109.4 91.6 100.4 105.1 8 139 350 518 396 122 1 4 29 36 60 45 15 208.6 102.9 115.8 113.6 123.0 5 75 367 202 165 16 64 41 23 174.4 203.0 139.4 Births, all pregnancies. Total......................... ......................................... 10,237 Under 20.................. ................................................... 20-24............................................................................. 25-29............................................................................. 30-34............................................................................. 35 and over................................................................... 35-39...................................................................... 40 and over............... ............................................ Not reported..................... ...... ....... ............................ 3,064 5,174 1,608 381 94 85 9 6 1,196 115.8 12,630 1,342 106.3 8,229 1,061 128.9 2,775 395 142.3 883 164 185.7 414 568 153 39 19 16 3 3 135.1 109.8 95.1 102.4 1,003 6,043 4,063 1,199 301 264 37 21 181 686 337 102 32 29 3 4 180.5 113.5 82.9 85.1 106.3 109.8 38 1,327 3,635 2,416 790 687 103 23 13 225 465 262 84 73 11 12 169.6 127.9 108.4 106.3 106.3 106.8 37 514 1,207 1,010 848 162 7 11 101 154 123 106 17 6 196.5 127.6 121.8 125.0 104.9 2 31 238 612 397 215 2 5 57 100 65 35 239.5 163.4 163.7 162.8 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 345 1 “ Order of birth” means order of issue for births in 1915 and order of pregnancy for births, all pregnancies. * Not shown where base is Jess than lfiQ. APPENDIX VII.— TABLES. Live Infant births. mor tality rate.2 Seventh to ninth. 346 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e 151.— Infant mortality rates, by order o f birth and aye and color o f mother; single live births in 1915, and all live births, all pregnancies. Live births of specified order of birth.1 Second and third. First. Age and color of mother. Infant deaths. Infant deaths. Infant deaths. Live births. Fourth and sixth. Seventh and later. Infant deaths. , Live Live Live Infant Infant births. Infant births. Infant births. Num mor Num mor Num mor Num mor ber. ber. ber. tality tality tality ber. tality rate.2 rate.2 rate.2 rate.2 Single births in 1915. White mothers. 2,601 223 85.7 3,368 268 79.6 2,133 193 90.5 1,158 150 129.5 604 20-24........................ 1,282 25-29........................ 504 30-34....................... 153 58 35-39................. 51 7 65 96 39 14 9 7 2 107.6 74.9 77. 4 91.5 166 1,303 L251 475 173 147 26 24 114 76 36 18 15 3 144.6 87.5 60.8 75.8 104.0 102.0 3 220 766 729 414 330 84 1 1 26 68 59 38 32 6 1 118.2 88.8 80.9 91.8 97.0 3 93 325 737 496 241 2 18 32 98 68 30 98.5 133.0 137.1 124.5 157.2 439 66 150.3 353 48 136.0 256 39 152.3 66 226 87 38 22 18 4 12 35 12 4 3 3 3 94 139 77 38 34 4 2 1 13 18 12 4 3 1 129.5 3 49 84 119 86 33 1 1 9 12 17 12 5 Colored mothers 229 36 20-24........................ 25-29....................... 30-34........................ 98 93 21 15 2 2 11 22 2 35-39................. 1 1 / 154.9 142.9 Births, all pregnancies. 98.6 7,080 841 118.8 3,004 433 144.1 2,523 4,755 1,516 340 87 78 9 4 336 5ÒÌ 143 35 17 14 3 3 133.2 105.4 94.3 102.9 745 5,245 3,766 1,090 270 239 31 15 127 170.5 557 106.2 293 77.8 88 80.7 29 107.4 26 108.8 3 4 19 1,000 3,130 2,187 729 631 98 15 5 152 379 219 76 68 8 10 152.0 121.1 100.1 104.3 107.8 22 382 1,189 1,404 1,074 330 7 8 69 161 189 147 42 6 180.6 135.4 134.6 136.9 127.3 Colored mothers 1,102 161 146.1 1,499 244 162.8 1,149 220 191.5 654 126 192.7 541 419 92 41 7 7 78 67 10 4 2 2 144.2 160.0 258 798 297 109 31 25 6 6 54 129 44 14 3 3 209.3 161.7 148.1 128.4 19 327 505 229 61 56 5 8 8 73 86 43 8 5 3 2 223.2 170.3 187.8 17 163 256 218 171 47 5 37 50 34 24 10 227.0 195.3 156.0 140.4 White mothers. 9,225 1,035 20-24........................ 25-29........................ 30-34........................ 35-39................. 20-24........................ 25-29........................ 30-34........................ 35-39 .. 2 112.2 11,131 1,098 l“ Order of birth’ ’ means order of issue for births in 1915 and order of pregnancy for births, all pregnancies. * Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX V II.— TABLES. 347 T able 152.— In fa n t m orta lity rates, by order o f birth , age o f m oth er, and ea rn in g s o f fa th e r ; liv e birth s, a ll ‘p reg n a n cies. Live births, all pregnancies, of specified order of pregnancy.1 First. Age of mother and earnings offather during year after birth in 1915. Second and third. Infant deaths. Live births. Fourth to sixth. Seventh and later. Infant deaths. Infant deaths. Infant deaths. Live Live Live Infant births. Infant births. Infant births. Infant Num mor Num mor Num mor Num mor ber. tality ber. tality ber. tality ber. tality rate.* rate.* rate.* rate.* Under $850... 6,536 842 128.8 8,230 990 120.3 5,684 790 139.0 2,634 431 163.6 Age of mother: Under 20.......... 2,280 20-24................. 3,239 796 25-29................. 30-34................. 168 48 Not reported... 5 332 389 88 18 13 2 145.6 120.1 110.6 107.1 793 4,216 2,427 647 132 15 156 500 245 72 15 2 196.7 118.6 100.9 111.3 113.6 31 1,013 2,572 1,554 497 17 12 188 342 185 56 7 185.6 133.0 119.0 112.7 35 416 1,026 1,151 ' 6 12 88 162 164 5 211.5 157.9 142.5 $850 and over. 3,385 295 87.1 3,904 287 73.5 2,204 221 100.3 886 106 119.6 Age of mother: Under 20.......... 657 20-24................. 1,738 25-29................. 749 30-34................. 197 43 Not reported... 1 62 155 55 17 5 1 94.4 89.2 73.2 86.3 166 1,573 1,492 511 156 6 17 149 78 27 14 2 102.4 94.7 52.3 52.8 89.7 6 268 907 755 262 6 1 30 99 62 24 5 111.9 109.2 82.1 91.6 4 116 366 399 i 1 17 43 44 1 146.6 117.5 110.3 1 For total rates, all orders of pregnancy combined, see Table 150, page 345. * Not shown where base is less than 100. T able 153.— In fant mortality rates from specified causes, by age o f mother and order o f birth;1 single live births in 1915. Infant mortality rates*from specified causes among births of specified order of birth.1 Age of mother. All births. First. Second and third. Fourth to sixth. Seventh to ninth. Tenth and later. Early AU Early AU Early AU Early All Early AU Early AU in other in in other in other in other other in other fancy. causes. fancy. causes. fancy. causes. fancy. causes fancy. causes. fancy. causes. Total...... 33.9 63.2 36.7 54.8 36.0 51.7 Under 20.......... 20-24................. 25-29................. 30-34.......... : . . . 35 and over...... 35-39.......... 40 and over 47.9 31.1 32.2 28.5 39.4 41.2 34.2 73.4 64.0 50.7 60.7 80.1 79.9 80.7 45.6 28.4 38.1 47.6 83.3 94.3 62.7 57.5 40.0 35.7 83.3 56.6 56.0 32.7 32.9 37.0 56.4 60.6 99.1 64.7 32.9 40.9 51.3 48.5 1Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 24.9 72.0 32.3 88.9 51.9 110.8 35.0 23.2 17.4 32 5 32.9 34.1 89.2 71.8 70.7 58.4 63.2 45.5 65.7 26.3 25.8 28.4 17.2 131.4 70.2 87.3 79.9 112.1 59.7 51.1 51.5 50.6 104.5 113.6 144.3 75.9 * Not shown where base is less than 100. 348 IN FAN T MORTALITY, BALTIMORE, MD. T a b l e 154.— Stillbirth and infant mortality rates, by interval since preceding birth,1 earnings o f father, and color and nativity o f mother; births in 1915, second and later in order o f birth.1 Births in 1915 (second and later in order of birth)1after speci fied interval since preceding birth.1 Under 2 years. Earnings of father and color and nativity of mother. Stillbirths. Births. 1,000 Number. Per birtns.2 Infant deaths. Live births. Infant Number. mortality rate.* All mothers........................................ 2,149 77 35.8 2,072 304 146.7 Earnings of father: Under $550............................................. $550-1849................................................ $850-$l,249............................................. $1,250 and over...................................... No earnings........................................... Not reported.................................. 714 783 391 176 41 44 37 25 6 2 6 1 51.8 31.9 15.3 11.4 677 758 385 174 35 43 128 101 63 14 10 g 189.1 133.2 111.7 80.5 Native white mothers........................ 1,195 21 17.6 1,174 162 138.0 Earnings of father: Under $550................................... $550-$849................................................ $850-11,249............................................. $1,250 and over.............................. Nò earnings...................................... Not reported.......................................... 216 507 293 139 16 24 2 12 3 2 2 9.3 23.7 10.2 14.4 214 495 290 137 14 24 44 69 33 9 4 3 205.6 139.4 113.8 65.7 Foreign-bom white mothers............. 554 16 28.9 538 74 137.5 Earnings of father: Under $550............................................. $550-$849................................................ $850 and over.................................... No earnings.................................... Not reported.......................................... 212 204 118 9 11 5 7 3 1 23.6 34.3 25.4 207 197 115 149.8 121.8 95.7 ii 31 24 11 3 5 Colored mothers............................... . 400 40 100.0 360 68 188.9 Earnings of father: Under $550............................................. $550 and over......................................... No earnings.......................................... Not reported.......................................... 286 89 16 9 30 6 3 1 104.9 256 83 13 8 53 12 3 207.0 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis & 2 Not shown where base is less than 100. APPENDIX VII.---- TABLES. 349 154.— Stillbirth and infant m ortality rates, by interval since preceding birth,1 earnings o f father, and color and nativity o f mother; births in 1915, second and later in order o f birth1— Continued. T able Births in 1915 (second and later in order of birth)1after specified interval since preceding birth1—Continued. Not reported. 2 years and over. Earnings of father and color and nativity of mother. Infantdeaths. Stillbirths. Births. Live Per births. Num Num 1,000 ber. ber. births.3 Still Live Tnfant Infant Births. births. births. deaths. mor tality rate.3 All mothers...................... 5,999 189 31.5 5,810 536 92.3 48 1 47 5 Earnings of father: Under $550........................... 1,717 $550-1849.............. 2,111 $850-$l,249........... 1,236 '699 117 119 57 68 31 22 5 6 33.2 32. 2 25.1 31.5 42.7 50.4 1,660 2,043 l' 205 677 112 113 197 195 69 38 23 14 118.7 95.4 57.3 56.1 205.4 123.9 16 13 14 3 1 1 1 15 13 14 3 1 1 4 1 Native white mothers___ 3,508 99 28.2 3,409 302 88.6 23 23 1 562 1,348 947 546 41 64 10 45 21 19 2 2 17.8 33.4 22.2 34.8 552 1,303 '926 527 39 62 74 125 54 33 7 9 134.1 95.9 58.3 62.6 2 7 12 1 1 2 7 12 1 1 1,740 46 26.4 1,694 134 79.1 17 17 2 664 605 407 35 29 13 18 10 1 4 19.6 29.8 24.6 651 587 397 34 25 58 50 16 8 2 89.1 85.2 40.3 8 5 4 8 5 4 2 751 44 58.6 707 100 141.4 8 1 7 2 491 193 41 26 34 g 2 69.2 41.5 457 185 39 26 65 24 8 3 142.2 129.7 6 1 1 5 1 2 Earnings of father: $550-$849. $850-$l,249......... Foreign - bom w h i t e mothers......................... Earnings of father: $550-$849. .. Colored mothers............... Earnings of father: Under $550........................... 1Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1 3 Not shown where base is less than 100. 1 1 350 IN FA N T MORTALITY, BALTIMORE, MD. T a b l e 155.— Infant mortality and stillbirth rates, by interval since preceding birth 1 and period o f gestation; births in 1915. Stillbirths. Interval since preceding birth1 and period of gestation. Live births. Births. Number. Per cent. Infant deaths. Infant mortality rate. 103.5 Total..................... 11,195 398 3.6 10,797 1,117 No previous birth.......... Interval: • 1 year........................ 2 years...................... 3 years...................... 4 years and over___ Not reported............ 2,999 131 4.4 2,868 272 94.8 2,149 3,045 1,398 1,556 48 77 95 34 60 1 3.6 3.1 2.4 3.9 2.1 2,072 2,950 1,364 1,496 47 304 291 118 127 5 146.7 98.6 86.5 84.9 106.4 Full-term births... 10,430 234 2.2 10,196 792 77.7 No previous birth.......... Interval: 1 y ear.................. 2yeais...................... 3 years...................... 4 years and over___ Not reported............ 2,726 90 3.3 2,636 173 65.6 1,979 2,891 1,332 1,459 43 41 49 20 33 1 2.1 1.7 1.5 2.3 2.3 1,938 2,842 1,312 1,426 42 219 219 88 91 2 113.0 77.1 67.1 63.8 47.6 Premature births.. No previous birth.......... Interval: 1 year........................ 2 years.................... . 3 years...................... 4 years and over....... Not reported............ ' 755 164 21.7 591 322 544.8 271 41 15.1 230 98 426.1 158 151 64 96 5 36 46 14 27 21.4 30.5 21.9 28.7 132 105 50 69 5 85 70 30 36 3 643.9 666.7 600.0 521.7 600.0 Term not reported. 10 10 3 300.0 No previous birth.......... Interval: 1 y e a r ................... 2 years...................... 3 years...................... 4 years and over....... Not reported............ 2 2 1 500.0 2 3 2 1 2 3 2 1 2 666.7 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 351 APPENDIX V II.— TABLES. T a b l e 156.— Interval since preceding birth 1 by earnings o f father and color and nativity o f mother; live births in 1915, second and later in order o f birth.1 Live births in 1915 second and later in order of birth.1 Earnings of father and color and nativity of mother Total. Interval under 2 years since pre ceding birth.1 Number. Per cent.2 All mothers................................................................. Native white mothers......................................................... Earnings of father: Under $550.............................................. .............................. $550-8849................................................................ $850-$l,249................................................................... $1,250 and over....................................................... Nò earnings.................................................................. Not reported........................................................ Foreign-bom white mothers........................... ......................... . Earnings of father: Under $550.............................................................. $550-$849............................................................................ $850-$l,249.................................................................. $1,250 and over.............................................................. Nò earnings............................................................. Not reported......................................................................... Colored mothers................................................................... Earnings of father: Under $550.................................................................. $550 and over................................................................. .. No earnings............................................................................... Not reported.......................................................................... 1 Includes miscarriages. 2 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 7,929 2,072 26^1 4,606 1,174 25.5 768 1,805 1,228 665 54 86 214 495 290 137 14 24 27.9 27.4 23.6 20.6 2,249 538 23.9 866 789 337 179 42 36 207 197 81 34 8 11 23.9 -25.0 24.0 19.0 1,074 360 33.5 718 269 52 35 256 83 13 8 35.7 30.9 352 T IN F A N T MORTALITY, BALTIMORE, MD. able 157.— Number o f mother’s 'pregnancies, by duration o f mother’s married life and earnings o f fattier; live births, all pregnancies. Live births,1 all pregnancies, to mothers reporting specified number of pregnancies. Duration of mother’s married life and earnings of father during year after 1915 birth. 2 and 3 4-6 7-9 10 and over. 1,521 Earnings of father under $550.................................... 2,142 3,508 2,731 Years married: Under 6 years................................................................ 6-10 years...................................................................... 11-15 years....... . ........................................................... 16 and over....................... ............................................ 1,535 504 74 29 277 1,801 1,036 394 7 290 1,080 1,354 248 1,273 Earnings of father $550-$849..................................... 3,209 4,228 2,525 1,429 Years married: Under 6 years............................................................... 6-10 years.................................................................... . 11-15 years........................... ........................................ 16 and over.................................................................... 2,251 808 135 15 273 2,247 1,376 332 215 1,172 1,138 143 1,286 Earnings of father $850-$l,249.................................. 2,050 2,174 1,271 720 Years married: Under 6 years.......... J................................................... 6-10 years......................... T .................... .................... 11-15 years............................................... . ................... 16 and over.................................................................... 1,265 621 138 26 107 1,085 774 208 100 673 498 61 659 Earnings of father $1,250 and over........................... 1,154 1,111 563 310 Years married: Under 6 years............................................................... 6-10 years...................................................................... 11-15 years.................................................................... 16 and over.................................................................... 588 466 74 26 31 577 369 134 50 201 312 5 20 285 l Omitting those for which earnings of father during year after 1915 birth were “ none” or “ not reported. " https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis A P P E N D IX V I I .-----T A B L E S . T a b l e 158. 353 Infant mortality rates, by number o f mother’s pregnancies, duration o f manned life and earnings o f father; live births, all pregnancies. Live births, all pregnancies, to mothers reporting specified duration of married life. Under 6 years. Number of mother’s pregnancies, and earnings of fathe during yea- after 1915 birth. 6-10 years. Infant deaths. Live births 11-15 years. Infant deaths. 16 years and over Infant deaths. Infant deaths. Live Live Live Infan ; births Infan births Infant births Infant Num mor Num mor Num mor Num mor ber. tality ber. tality ber. tality ber. tality rate.1 rate.1 rate.1 rate.1 Earnings of father under «550............ 2,450 Number of mother’s pregnancies: 1-3.................... 2,166 4-6.................... 277 7-9.................... 7 10 and over...... 1 346 141.2 2,602 330 126.8 2,441 407 | 166.7 3,050 457 149.8 1 286 58 2 132.0 209.4 511 1,801 290 36 70.5 224 124.4 70 241.4 77 1,036 1,080 248 14 120 115.8 192 177.8 81 326.6 29 394 1,354 1,273 40 164 249 101.5 121.1 195.6 399 110.9 3,283 398 121.2 2,831 354 125.0 2,771 350 126.3 349 50 105.0 183.2 821 2,247 215 73 278 47 88.9 123.7 218.6 140 1,376 1,172 143 13 133 173 35 92.9 96.7 147.6 244.8 15 332 1,138 1,286 1 30 125 194 90.4 109.8 150.9 2,959 236 79.8 2,951 228 77.3 2; 312 204 88.2 2,150 241 112.1 Number of mother’s pregnancies: 1-3.................... 2,821 4-6.................... 138 7-9.................... 10 and over___ 222 14 78.7 101.4 1,134 1,662 150 5 59 136 33 52.0 81.8 220.0 214 1,143 874 81 14 79 100 11 65.4 69.1 114.4 54 342 810 944 5 22 79 135 64.3 97.5 143.0 167 30 179.6 160 26 162.5 170 19 111.8 185 32 173.0 159 8 30 188.7 42 108 10 5 21 194.4 5 102 63 97 13 175 29 E arnings of father, «550«849............ 3,597 Number of mother’s pregnancies: 1-3.................... 3,324 4-6.................... 273 7-9.................... 10 and over...... Earnings o f father, «850 or over. Earnings of father,none. Number of mother’s pregnancies: 1-3.................... 4-6.................... 7-9.................... 10 and over...... Earnings of father, not reported__ Numberof mother’s pregnancies: 1-3.................... 4-6.................... 7-9.................... 10 and over___ 1. 1 222 31 139.6 120 7 198 24 27 4 136.4 35 85 3 4 1 1 Not shown where base is less than 100. 101351°— 23------23 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 58.3 107.8 162 17 12 116 34 1 104.9 103.4 87 10 ' 165.7 354 IN FAN T MORTALITY, BALTIMORE, MD. T able 159.—Infant mortality rates, by interval between birth in 1915 and preceding birth;1 live births in 1915, second and later in order o f birth,1 and live births preceding single births in 1915. Live births preceding single births in 1915.2 Live births in 1915. Infant deaths. Infant'deaths. Interval between 1915 birth and preceding birth. Total. Num ber. Infant mor tality rate.8 Total. Num ber. Infant mor tality rate.8 7,062 753 106.6 7,929 845 106.6 1,661 2,716 1,257 1,417 11 336 241 72 97 7 202.3 88.7 57.3 68.5 . 2,072 2,950 1,364 1,496 47 304 291 118 127 5 146.7 98.6 86.5 84.9 1Includes miscarriages. s These figures are approximate only, since if preceding birth resulted in plural live births only the one which lived the longer was included. 8 Not shown where base is less than 100. T able 160.—Stillbirth rates, by interval between birth in 1915 and preceding birth; births in 1915, second and later in order o f birth, and births preceding single births in 1915.1 Births 1 preceding single births in 1915.2 B irths1in 1915. Stillbirths and miscarriages. Interval between 1915 births and preceding birth.1 Total. Num ber. Per 1,000 issues.8 Stillbirths and miscarriages. Total. Num ber. Per 1,000 issues.8 Total................................................... 7,959 897 112.7 8,539 610 71.4 1 year............................................................ 2 years.......................................................... 3 years.......................................................... 4 years and over........................................... 2,101 2,953 1,348 1,509 48 440 237 91 92 37 209.4 80.3 67.5 61.0 2,268 3,152 1,443 1,624 52 196 202 79 128 5 86.4 64.1 54.7 78.8 1Includes miscarriages. * These figures are approximate only, since if preceding issue resulted in plural issues, only the one result ing in a live birth or, if none resulted in a live birth, that one having the longer period of gestation was included. 8 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX V II.---- TABLES. 355 T a b l e 161.— Mother reported pregnant within first year after birth, by age o f infant when the pregnancy began, by color and nationality o f m other; live births in 1915 to mothers reported pregnant within year after the birth in 1915 and infant deaths subsequent to commencement o f pregnancy. Total. First. Second. Third. Fourth. 7 6 16 10 64 29 127 54 1,300 327 4 3 13 9 51 21 106 44 Native.................... Foreign................... 6,739 2,753 646 5,899 264 2,293 426 157 840 460 220 107 1 3 1 2 10 3 6 38 3 13 14 7 74 32 30 14 Jewish............ Polish............... Italian.............. Allother.......... 961 625 412 755 49 102 36 77 871 481 294 647 33 51 19 54 90 144 118 108 16 51 17 23 . 1 1 3 2 3 2 4 1 1 11 9 2 2 6 2 3 Colored.......................... 1,305 1,207 1,042 128 263 79 3 3 3 1 13 8 21 10 Infant deaths. 406 583 Live births. 1,563 8,192 Infant deaths. 711 910 ILive births. 9,234 9,492 Total.................... 10,797 Infant deaths. Live births. 1,117 White............................ Live births. Infant deaths. Color and nationality of mother. Mother reported pregnant in speci fied month in first year after birth of infant. Mother reported pregnant in 1 year. Live I births. Infant deaths. Live I births. Infant deaths. Live | births. Infant deaths. Mother not reported pregnant within 1 year. Mother reported pregnant in specified month in first year after birth of infent. Fifth. Sixth. Sev enth. Eighth. Ninth. Tenth. Month Elev enth. Twelfth. not re ported. I Live 1births. I Infant 1deaths. 1 Live 1births. 1Infant 1deaths. I Live 1 births. [ Infant deaths. Live births. Infant 1 deaths. | Live births. Infant deaths. Live births. Infant deaths. Live births. Infant deaths. Live 1 births. Infant deaths. Live I births. Infant deaths. Color and nationality of mother. Total..................... 205 63 186 44 221 Wlhite.............................. 174 49 144 33 182 Native...................... 116 Foreign.................... 58 30 19 92 52 Jewish............... Polish................ Italian............... All other............ 10 19 11 18 1 11 1 6 9 12 17 14 3 7 4 2 11 25 14 10 Colored............ .............. 31 14 42 11 39 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 59 174 34 161 52 140 27 136 17 122 38 16 60 14 24 136 28 112 24 76 13 78 18 17 121 25 I kT 22 67 11 66 14 12 79 5 42 19 53 6 43 10 42 1 24 9 5 1 1 1 2 4 83 57 17 10 87 49 2 9 2 1 15 21 11 10 3 6 1 6 16 12 15 3 1 1 10 13 13 6 2 3 1 13 10 11 9 7 34 7 25 7 15 3 16 17 43 5 24 1 1 3 3 6 8 7 1 5 4 7 8 2 9 2 12 IN F A N T MORTALITY, BALTIMORE, MD. 356 T 162.— Infant deaths, by age at death, relation o f infant death to mother’s pregnancy after the birth, and color and nativity o f mother; live births in 1915 to mothers pregnant within year after birth. able Deaths among infants whose mothers became pregnant within year after birth. Age at death of infant and color and nativity of mother. All mothers....................................................................... . 3 months) under 4........................................................................... 4 months, under 5........................................................................... 7 months) under 8........................................................................... Native white mothers.......................................................... 3 months) under 4..........................................-x............................... 7 months) under 8........................................................................... Foreign-bom white mothers................................................ Died in a Month of Died in a Died in succeed preg previous the same nancy not ing month. month. month. reported-1 74 5 3 3 4 3 2 2 5 1 1 2 1 4 10 7 7 9 11 12 11 1 1 1 15 41 4 2 2 1 2 1 2 3 1 1 1 2 5 4 4 6 6 6 7 2 75 9 22 1 47 7 8 1 3 6 1 1 1 1 1 2 65 3 38 5 3 8 4 3 1 1 2 1 300 27 178 19 24 23 19 16 7 5 6 2 1 2 1 160 93 7 13 14 12 7 5 3 4 1 1 1 2 1 1 2 1 1 1 1 3 1 2 2 4 6 2 1 11 1 1 1 1 2 2 1 1 1 2 ! __ i Of the 18 infant deaths for which the month in which the mother became pregnant wasmot reported, II which occurred in the first month and 2 in thesecond have been classified in this table as “ died in a previous month.” https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX VII.-----TABLES. 357 T a b l e 163.— M onthly death rates, by month o f life and by pregnancy o f mother during infant's first year o f life; live births in 1915. Infants born in 1915.1 Mother pregnant during infant’s lifetime. Total. Month of life. Surviving Deaths in month. Surviving Deaths in month. at begin at begin ning of ning of month. Number. Per 1,000. month.2 Number.8 Per 1,000. First.............................................................. Third............................................................ Fourth.............................. ............................ Fifth............................................................. Sixth............................................................. Seventh......................................................... Eighth........................................................... Ninth............................................................ Tenth............................................................ Eleventh....................................................... Twelfth......................................................... 10,528 10,320 10,255 10,192 10,130 10,059 9,983 9,927 9,871 9,820 9,771 9,726 208 65 63 62 71 76 56 56 51 49 45 46 19.8 6.3 6.1 6.1 7.0 7.6 5.6 5.6 5.2 5.0 4.6 4.7 12 51 139 298 445 608 746 879 980 1,057 1,108 3 1 4 10 7 6 9 11 12 11 58.8 7.2 13.4 22.5 11.5 8.0 10.2 11.2 11.4 9.9 1 Excludes 269 infants who died immediately after birth, not fed. a Includes infants surviving at the beginning of each month, whose mothers had previously become pregnant. 8Includes only deaths among infants shown in preceding column. T a b l e 164.— Computed infant mortality rates, by mother's pregnancy during infant's lifetim e; infants born in 1915. Computed mortality rate per 1,000 infants fed. Period. Mothers preg nant during All mothers. infant’ s life time. Second to twelfth month..................................................................................... 60.4 154.5 T a b l e 165.— Prevalence o f interval under two years between births, by order o f birth; single live births in 1915, second, and later in order o f birth,1 and all live births, all pregnancies.2 Single live births in 1915. Order of birth. Total. All live births, all pregnancies.1 Interval under 2 Number years since pre of preg ceding birth.1 nancies. Total. Number. Per cent. Second......................................... Third........................................... Fourth........................................ Fifth............................................ Sixth........................................... Seventh.........; ............................ Eighth......................................... Ninth.......................................... Tenth to fourteenth................... Fifteenth or later........................ 2,372 1,435 1,095 795 596 426 329 235 393 31 703 381 242 174 137 114 81 64 113 17 29.6 26.6 22.1 21.9 23.0 26.8 24.6 27.2 28.8 54.8 1Includes miscarriages. * Omits live births to mothers reporting but a single pregnancy. * Or more. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Average interval under 2 years be tween pregnancies. Number. Percent. 2 3 4 5 6 7 8 9 10-14 8 15 4,658 4,237 4,218 3,832 3,453 2,899 2,383 2,052 3,861 303 3,378 2,680 1,908 1,670 1,601 1,425 899 947 2,440 303 72.5 63.3 45.2 43.6 46.4 49.2 37.7 46.2 63.2 100.0 358 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e 166.— Interval between births,1 by age o f m other; single live births in 1915, second and later in order o f birth.1 Single live births (second and later in order of birthJ) to mothers of specified ages. Total. Interval since pre ceding birth.1 Live births. Total................ 1 year......................... 2 years........................ 3 years....................... Not reported.............. Under 20. Per cent distri bution. 7,707 2,026 2,867 1,316 1,451 47 Percent distri bution. Live births. 100.0 26.3 37.2 17.1 18.8 .6 20-24. Live births. 100.0 59.7 35.3 5.0 238 142 84 12 1,849703 778 249 114 5 25-29. Per cent distri bution. 100.0 38.0 42.1 13.5 6.2 .3 Percent distri bution. Live births. 2,385 592 941 410 432 10 100.0 24.8 39.5 17.2 18.1 .4 Single live births (second and later in order of birthsi) to mothers of specified ages. 30-34. Interval since preceding birth.1 Live births. 1,728 356 578 341 438 15 Total................................. 1 year.......................................... 3 years......................................... Not reported............................... 1 35-39. Percent distri bution. Live births. 100.0 20.6 33.4 19.7 25.3 .9 40 and over. Percent distri bution. 1, 111 187 378 222 313 11 100.0 16.8 34.0 20.0 28.2 1.0 Live births. 392 45 108 81 154 4 Not Per cent reported, live distri births. bution. 100.0 11.5 27.6 20.7 39.2 1.0 4 1 1 2 Includes miscarriages. T a b l e 167.— Infant m ortality rates from specified causes and stillbirth rales, by order o f birth 1 and interval since preceding birth;1 single births in 1915, second ana later in order o f birth.1 Single births in 1915 second and later in order of birth.1 Stillbirths. Interval since preceding birth and order of birth.1 Infant deaths. Total Live births. Num Per births. Total. 1,000 ber. births.8 Early All other infancy. causes. Infant mor Infant Infant tality Num mor Num mor rate.* ber. tality ber. tality rate.* rate.* 7,959 252 31.7 7,707 764 99.1 253 32.8 511 Second and third births___ 3,910 103 26.3 3,807 334 87.7 137 36.0 197 51.7 1 year............................ 2 years........................... 3 years........................... 4 years and over............ 1,118 1,410 572 802 8 34 29 13 27 30.4 20.5 22.7 33.7 1,084 1,381 559 775 8 129 106 40 59 119.0 76.8 71.6 76.1 49 41 17 30 45.2 29.7 30.4 38.7 80 65 23 29 73.8 47.1 41.1 37.4 Fourth to sbjth births........ 2,570 84 32.7 2,486 241 96.9 62 24.9 179 72.0 1 year............................ 2 years........................... 3 years........................... 4 years and over........... 578 972 513 489 18 25 30 9 20 43.3 30.9 17.5 40.9 553 942 504 469 18 82 85 35 36 3 148.3 90.2 69.4 76.8 18 19 9 13 3 32.5 20.2 17.9 27.7 64 66 26 23 115.7 70.1 51.6 49.0 Seventh and later births__ 1,479 65 43.9 1,414 189 133.7 54 38.2 135 95.5 405 571 263 218 22 16 27 10 11 1 39.5 47.3 38.0 50.5 389 544 253 207 21 68 62 35 22 2 174.8 114.0 138.3 106.3 14 22 10 8 36.0 40.4 39.5 38.6 54 40 25 14 2 138.8 73.5 98.8 67.7 Total.......................... 1 year............................. 2 years........................... 3 years........................... 4 years and over........... Interval not reported... 1Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis * Not shown where base is less than 100. 66.3 APPENDIX VII.---- TABLES, 359 T a b l e 168.— Infant m ortality rates from specified causes and stillbirth rates, by age o f mother and interval since preceding birth;1 single births in 1915, second and later in order o f birth.1 Single births in 1915 second and later in order of birth.1 Stillbirths. Age of mother and interval since preceding birth.1 Total births. Infant deaths. Total. Early infancy. All other causes. Per Num 1,000 liv e ber. births.® births. Infant Infant Infant Num mor Num mor Num mor ber. tality ber. tality ber. tality rate.® rate.® rate.® Interval 1 vear............ 2,101 75 35.7 2,026 279 137.7 81 40.0 198 97.7 Under 20............................... 20-24................................. 25-29.............................. 30-34...................................... 35 and over........................... 35-39................................ 40 and over..................... Not reported......................... 152 721 612 369 246 199 47 1 10 18 20 13 14 12 2 65.8 25.0 32.7 35.2 56.9 60.3 142 703 592 356 232 187 45 1 24 87 81 45 42 37 5 169.0 123.8 136.8 126.4 181.0 197.9 10 27 26 8 10 9 1 70.4 38.4 43.9 22.5 43.1 48.1 14 60 55 37 32 28 4 98.6 85.3 92.9 103.9 137.9 149.7 Interval 2 years.......... 2,953 . 86 29.1 2,867 253 88.3 82 28.6 171 59.6 Under 20............................... 20-24............ .............. .......... 25-29...................................... 30-34...................................... 35 and over........................... 35-39................................ 40 and over................. 86 794 967 602 504 390 114 2 16 26 24 18 12 6 20.2 26.9 39.9 35.7 30.8 52.6 84 778 941 578 486 378 108 11 72 66 42 62 44 18 92.5 71.2 72.7 127.6 116.4 166.7 3 23 22 17 17 14 3 29.6 23.4 29.4 35.0 37.0 27.8 8 49 44 25 45 30 15 63*0 46.8 43.3 92.6 79.4 138.9 32 23.7 1,316 110 83.6 36 27.4 74 56.2 19.7 23.8 11.6 41.1 34.8 12 249 410 341 303 222 81 1 3 22 25 26 34 23 11 52.2 39.0 55.7 75.9 72.1 Interval 3 years.......... 1,348 Under 20............................... 20-24............... ..................... 25-29...................................... 30-34...................................... 35 and over........................... 35-39................................ 40 and over..................... Not reported......................... 12 254 420 345 316 230 86 1 5 10 4 13 8 5 Interval 4 years and over.......................... 1,509 58 38.4 1,451 20-24...................................... 25-29...................................... 30-34...................................... 35 and over........................... 35-39................................ 40 and over..................... 118 447 451 493 330 163 4 15 13 26 17 9 33.9 33.6 28.8 52.7 51.5 55.2 114 432 438 467 313 154 Interval not reported.. 48 1 47 5 3 20-24...................................... 25-29....................................... 30-34....................................... 35 and over........................... 35-39................................ 40 and over..................... Not reported....... , ................ 5 10 16 15 11 4 2 5 10 15 15 11 4 2 1 1 2 1 1 1 1 1 1Includes miscarriages. * Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1 88.4 61.0 76.2 112.2 103.6 9 9 7 11 7 4 36.1 22.0 20.5 36.3 31.5 3 13 16 19 23 16 7 117 80.6 51 35.1 66 45.5 9 29 40 39 28 11 78.9 67.1 91.3 83.5 89.5 71.4 2 17 13 19 13 6 17.5 39.4 29.7 38.5 41.5 39.0 7 12 27 20 15 5 61.4 27.8 61.6 42.8 47.9 32.5 2 1 1 1 â6Ô IN F A N T MORTALITY, BALTIMORE, MB. T a b l e 169.— Infant m ortality ratesfrom specified causes, by age o f mother, order o f birth f and interval since precedinq birth ;1 sinqle live births in 1915, second and later in order o f birth.1 Single births (second and later in order of birth1) following preceding birth1 specified interval. láve births. Early infancy. Early infancy. All other causes. Live births. In In fant Num fant Num mor mor ber tality ber. tality rate.3 rate.4 S e c o n d and third births1 1,084 49 73.8 2,715 32.4 87.6 83.0 58.2 95 972 1,042 429 177 28.8 29.8 37.3 56.5 32.5 64 115.7 1,915 45.2 137 554 292 83 18 Fourth to sixth births1......... 553 Under 2 0 ....___ 20-24................... 25-29................... 30-34................... 35 and over....... . Age not reported. 5 144 225 137 41 1 27.8 35.6 14.6 S e v e n t h to ninth births1 259 42.5 20-24................... 25-29................... 30-34................... 35 and over......... Age not reported. 5 71 106 77 Tenth and later births1....... . 130 25-29...-............. 30-34................... 35 and over......... 4 30 96 18 80 117 54.5 25.9 39.6 50.8 115 60.1 120.0 131.4 35.7 19.3 16.6 26.8 89.3 56.4 59.0 56.1 131.3 719 29.2 72.3 (*) 18.9 (s) 84.9 1 66 232 420 30.2 23.8 60.3 71.4 23.1 20 153.8 285 90.3 19 66.7 27 94.7 1 35 249 Live births. 43.1 1 168 674 661 410 1 1 Includes miscarriages. 3 Not shown where base is less than 100. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis All other causes. In In fant Num fant Num mor mor ber. tality ber. tality rate.3 rate.3 73.0 39.7 44.5 Under 20............ 20-24.................. 25-29................... 30-34................... 35 and over......... Infant deaths. Infant deaths. Infant deaths. Age of mother and order of birth.1 Interval not reported. 2 years and over. 1 year. 64.3 by 104.4 18 Early All in other fancy. causes. APPENDIX V II.---- TABLES. 361 T a b l e 170.— Prevalence o f plural births,1 by color and nativity o f mother; births 1 in 1915 and births,1 all pregnancies. Births in 1915.1 Color and nativity of mother. Births all pregnancies.1 Plural. Plural. Total. Total. Number. Per cent. Number. Per cent. Total................... ............................... 11,613 296 2.5 38,630 830 2.1 Native white................................................ Foreign-bom white..................................... Colored......................................................... 7,210 2,894 1,509 183 74 39 2.5 2.6 2.6 21,752 11,632 5,246 465 250 115 2.1 2.1 2.2 1 Includes miscarriages. T a b l e 171.— Infant m ortality, stillbirth, and miscarriage rates, by color and nativity o f mother; single and plural births 1 in 1915. Births in 1915.1 Color and nativity of mother. Miscarriages per 100 births.1 Stillbirths per 100 births. Single. Single. Plural. Plural. Infant mortality rate (per 1,000 live births). Single. Plural. Total................................................... 3.6 5.4 3.5 7.1 97.1 361.5 W hite........................................................... Native................................................... Foreign bom .......................................... Colored......................................................... 3.2 3.8 1.9 5.7 4.7 4.9 4.1 10.3 2.8 2.8 2.8 7.9 5.3 4.0 8.5 20.0 90.1 89.0 92.6 148.0 327.6 365.3 230.8 642.9 1Includes miscarriages. T a b l e 172.— Infant m ortality, stillbirth, and miscarriage rates, by color and nativity o f mother; single and plural births,1 all pregnancies. •Births, all pregnancies.1 Color and nativity of mother. Miscarriages per 100 births. Stillbirths per 100 births. Single. Plural. Single. Plural. Infant mortality rate (per 1,000 live births). Single. Plural. Total................................................... 6.6 10.6 3.3 7.3 113.5 407.0 White.................................I........................ Native.................................................... Foreign bom .......................................... Colored......................................................... 6.1 6.8 4.9 9.7 10.3 11.0 9.2 12.2 2.7 2 7 2.7 6.9 6.4 5.8 7.5 12.9 106.5 105.3 108.6 162.4 383.3 389.7 371.4 568.2 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 362 IN F A N T MORTALITY, BALTIMORE, MR. T a b l e 173.— In fan t m ortality, stillbirth, and miscarriage rates, by character o f plural birth;1 plural births1 in 1915 and all pregnancies. Plural births.1 Stillbirths. Miscarriages. Infant deaths. Character of plural births.1 Total births.1 Num ber. Plural births in 1915........ *Plural births, all preg- Births. Per cent.2 Num ber. Live births. Per cent.2 Num ber. Infant mor tality rate.2 296 16 5.4 280 20 7.1 260 94 361.5 281 15 315 1 5.3 266 14 18 2 6.8 248 12 86 8 346.8 830 88 10.6 742 54 7.3 688 280 407.0 806 24 83 5 10.3 723 19 52 2 7.2 671 17 270 10 402.4 1Includes miscarriages. 2 Not shown where base is less than 100. 3 One twin (miscarriage) was born in 1914 prior to schedule year. T a b l e 174.— Prevalence o f plural births, by age o f mother; births in 1915 and births, all pregnancies. Births, all pregnancies. Births in 1915. Plural Age of mother. Plural. Total. Total. Number. Per cent. Number. Per cent. 20-24.............................................................. 25-29.............................................................. 30-34.............................................................. 35-39.............................................................. 11,195 280 2.5 36,047 742 2.1 995 3,382 3,087 2,029 1,259 439 4 11 64 80 62 45 18 1.1 1.9 2.6 3.1 3.6 4.1 4,276 12,976 10,160 5,634 2,368 '560 73. 41 193 228 158 98 24 1.0 1.5 2.2 2.8 4.1 4.3 T a b l e 175.— Prevalence o f plural births, by order o f birth ; births in 1915 and births, all pregnancies. Births, all pregnancies. Births in 1915. Order of birth.1 Plural Plural. Total. Total. Number. Per cent. Number. Per cent. First.............................................................. Second and third......................................... Fourth to sixth............................................ Seventh and later........................................ 2,999 3,996 2,667 1,533 43 86 97 54 1.4 2.2 3.6 3.5 10,754 12,977 8,496 3,820 140 211 263 128 1.3 1.6 3.1 3.4 i “ Order of birth” means order oi issue for births in 1915 and order of pregnancy births, all pregnancies. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 863 APPENDIX V II.— TABLES. T a b l e 176.— Prevalence o f plural births, by age o f mother and order o f birth;1 births in 1915. Births of specified order of birth.1 Second and third. Fourth to sixth. Seventh to ninth. Tenth and later. First. Age of mother. Plural births. Total births Num- -Per ber. ct.2 Plural births. Plural births. Total births Num- Per ber. ct.2 Total births Num- Per ber. ct.2 Total......... 2,999 43 1.4 3,996 86 2.2 2,667 97 741 1,449 '56Ì 187 54 7 7 23 10 3 246 .9 1.6 1,588 1.8 l'409 1.6 546 176 31 2 27 38 19 .8 1.7 2.7 3.5 2 12 3.6 30 3.1 24 2.8 29 7.1 20-24............ 25-29............ 30-34............ 35-39............ Not reported 8 337 966 853 408 92 3 Plural births. Total births 3.6 1,058 8 144 363 412 130 1 Plural births. Num- Per ber. ct.2 Total births Num- Per ber. ct.2 26 2.5 475 28 5.9 2 2 8 8 6 (!) 1.4 2.2 1.9 4.6 7 80 209 179 8 8 12 10.0 3.8 6.7 1 Includes miscarriages. * Not shown where base is less than 60. T a b l e 177.— Prevalence o f plural births, by occurrence o f previous plural births; all pregnancies. Pregnancies. Resulting in plural birth.1 Occurrence of previous plural birth. Total. Number. Per cent. Total................................................................................................................. 38,211 734 411 27 1.1 3.7 1 Includes miscarriages. T a b l e 178.— Prevalence o f prematurity, by single and plural births; births in 1915. Premature births. Single and plural births. All births: Single......................................................................................................... Plural......................................................................................................... Live births: Single........................................................................................................ Plural......................................................................................................... https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Total births. Number. Per cent. 10,915 280 690 65 6.3 23.2 10,537 260 534 57 5.1 21.9 364 IN FA N T MORTALITY, BALTIMORE, MD. T able 179.— In fa n t m orta lity rates, by sin g le and 'plural births and p rem a tu rity; births in 1 9 1 5 . Infant mortality rate. Single and plural live births. Full term. Premature. Single............................................................................................................................ Plural........................................................................................................................... 528.1 1701.8 73.9 266.0 1 Based on 57 live births. T a b l e 180.— T yp e o ffee d in g , by m onth o f l i f e ; in fa n ts b o m o f p lu ra l births in 1 9 1 5 . Infant survivors having specified type of feeding. Total twins and triplets. Month of life. Breast feeding. Mixed feeding. Artificial feeding. Number. Per cent. Number. Per cent. Number. Per cent. First............................................ Second......................................... Third........................................... Fourth........................................ Fifth............................................ Sixth........................................... Seventh....................................... Eighth........................................ Ninth.......................................... Tenth............ ............................. 1237 218 211 203 194 189 187 184 172 168 133 102 66 48 43 38 36 27 23 17 56.1 46.8 31.3 23.6 22.2 20.1 19.3 14.7 13.4 10.1 29 38 48 52 50 48 41 46 44 46 12.2 17.4 22.7 25.6 25.8 25.4 21.9 25.0 25.6 27.4 31.6 35.8 46.0 50.7 52.1 54.5 58.8 60.3 61.0 62.5 75 78 97 103 101 103 110 111 105 105 1 Excludes 23 infants who died immediately after birth, not fed. T able 181.— In fa n t m ortality and stillb irth rates, b y p eriod o f gesta tion ; b irth s 1 in 1 9 1 5 . Miscarriages and stillbirths. Period of gestation. Total births.1 Infant deaths. Live Total. 1 3 Under month, months Infant 1 under 3 and Num mortal month. months over. ber. ity rate. Per Num cent of ber. issues.2 Total............................. 11,613 816 7.0 10,797 1,117 103.5 477 128 512 10,430 1,173 234 582 2.2 49.6 10,196 591 792 322 77.7 544.8 207 268 108 19 477 35 507 664 2 418 164 82.4 24.7 89 500 2 86 234 2 468.0 85 181 2 i.9 1 34 10 3 2 1 10 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 2 Not shown where base is less than 100. 365 APPENDIX VII.---- TABLES. T a b l e 182.— In fa n t m ortality rates, b y p eriod o f gesta tion and color and n a tiv ity o f m other; live births m 191 5 . Full-term live births. Premature live births. Infant deaths. Infant deaths. Color and nativity of mother. Total. Num ber. Infant mor tality rate.1 Total. Num ber. Infant mor tality rate.1 Total................................................... 10,196 792 77.7 591 322 544.8 Native white................................................ Foreign-born white...................................... Colored......................................................... 6,322 2,654 1,220 432 209 151 68.3 78.7 123.8 415 97 79 213 55 54 513.3 1 Not shown where base is less than 100. T a b l e 183 .— In fa n t m ortality and stillbirth rates, by sex o f in fa n t and color and n a tiv ity o f m oth er; births 1 in 1 9 1 5 . Miscarriages. Sex of infant and color and nativity of mother. Total births.1 Stillbirths. Live Infant Births. Per Per births. deaths. Num 1,000 Num 1,000 ber. births.2 ber. births.2 Infant mor tality rate. All mothers................. 11,613 418 36.0 11,196 398 35.6 10,797 1,117 103.5 Male.................. .................... Female................................... Not reported.......................... 5,922 5,559 132 199 88 131 33.6 15.8 992.4 5,723 5,471 1 215 182 1 37.6 33.3 5,508 5,289 634 483 115.1 91.3 White mothers............ 10,104 330 32.7 9,774 282 28.9 9,492 910 95.9 Male....................................... Female................................... Not reported.......................... 5,177 4,802 125 144 62 124 27.8 12.9 992.0 5,033 4,740 1 155 126 1 30.8 26.6 4,878 4,614 526 384 107.8 83.2 Native................... 7,210 273 37.9 6,937 198 28.5 6,739 646 95.9 Male....................................... Female................................... Not reported.......................... 3,695 3,408 107 116 51 106 31.4 15.0 990.7 3,579 3,357 1 110 87 1 30.7 25.9 3,469 3,270 377 269 108.7 82.3 Foreign bom ......... 2,894 57 19.7 2,837 84 29.6 2,753 264 95.9 Male....................................... Female................................... Not reported.......................... 1,482 1,394 18 28 11 18 18.9 7.9 1,454 1,383 45 39 30.9 28.2 1,409 1,344 149 115 105.7 85.6 Colored mothers.......... 1,509 88 58.3 1,431 116 81.6 1,305 207 15a 6 Male........................................ Female................................... Not reported.......................... 745 757 7 55 26 7 73.8 34.3 690 731 60 56 87.0 76.6 630 675 108 99 171.4 146.7 1Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis * Not shown where base is less than 100. 366 IN FAN T MORTALITY, BALTIMORE, MD. T a b l e 184.— M a scu lin ity , by color and n a tio n a lity o f m oth er; births 1 in 1 91 5 . Color and nationality of mother. Irish, English, Scotch, and English- Colored............................................................... Total births.1 Live births. Sex Mascu not re Male. Female. linity.8 ported. Mascu Male. Female. linity.8 5,922 5/559 1,065.3 132 5,508 5,289 1,041.4 5,177 4,802 1,078.1 125 4,878 4,614 1,057.2 3,695 1,482 3,408 1,084.2 1,394 1,063.1 107 18 3,469 1,409 3,270 1,344 1,060.9 1,048.4 507 337 236 173 497 1,020.1 312 1080.1 200 1180.0 158 1094.9 -7 6 4 481 322 « 221 167 480 303 191 151 1,002.1 1062.7 1157.1 1106.0 1 66 51 53 48 66 56 47 50 7 630 675 69 54 55 51 69 58 49 51 745 757 984.1 Stillbirths. Color and nationality of mother. Male. Irish, English, Scotch, and English- Fe male. 933.3 Miscarriages. Sex Mascu not re linity.8 ported. Male. Fe male. Sex not re ported. 215 182 1,181.3* 1 199 88 131 155 126 1,230.2 1 144 62 124 1 116 28 51 11 106 18 7 6 4 110 45 87 39 17 12 6 4 13 6 8 5 9 3 9 2 4 3 1 2 1 1 2 2 2 2 2 1 2 2 1 60 56 55 1 1 26 7 1Includes miscarriages. * Number of male births per 1,000 female births among those for whom sex is reported; not shown where baseisless than 100. 8Includes 101 Irish, 19 English, 8 Scotch, and 10 English-Canadian. 4 Includes 24 Russian, 19 Greek, 13 Magyar, 8 Norwegian, 6 Serbian, 5 French, 5 Slovak, 4 Rumanian 4 Ruthenian, 3 French-Canadian, 3 Dutch, 2 Slavic (n. o. s.), 2 Spanish, 2 Swedish, 1 Danish, and 1 Arabian. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 367 APPENDIX VII.---- TABLES. T a b l e 185.—Miscarriages, stillbirths, and infant deaths, by interval between confine ment and death o f mother and by period o f gestation; births 1 in 1915 to mothers who died within year follow ing confinement. Births1 in 1915 to mothers who died within year following con finement. Interval between confinement and death of mother and period of ges tation. Infant deaths. Total Miscar Still Live births.1 riages. Births. births. births. All mothers who died year after confinement............................ Period: Mothers who died in month following confinement................... Period: Mothers who died in year but after first month following confinement............................ Period: 7 months and over................. Total. Gastric and in Early testi nal dis- infan cyeases. 106 13 93 21 72 35 7 18 69 37 16 21 69 24 3 21 14 7 55 17 3 14 19 16 3 13 7 13 13 3 15 3 12 47 8 39 17 22 15 2 10 24 23 9 14 24 15 1 14 13 4 4 11 11 1 10 5 10 1 9 2 8 8 59 5 54 4 50 20 5 8 45 14 7 7 45 9 2 7 1 3 44 6 2 4 14 6 2 4 5 5 5 3 5 2 3 7 V 3 10 1 9 1Includes miscarriages. T a b l e 186.—Death o f mother, by period elapsing after confinement and cause o f mother's death; births 1 in 1915 to mothers who died within year follow ing confinement. Births1to mothers who died within year following con finement. Cause of mother’s death. W ithin 3 months. Total. 3 months or after. 1,000 Number. Per 1,000 Number. Per 1,000 Number. Per births.1 births.1 births.1 All causes........................................... 106 9.1 62 5.3 44 3.8 Connected with childbirth.......................... All other causes........................................... 50 56 4.3 4.8 44 18 3.8 1.5 6 38 .5 3.3 1Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 368 IN F A N T MORTALITY, BALTIMORE, MD. T able 187 —Stillbirths, miscarriages, and infant deaths, by color and nationality o f mother; births1 in 1915 and births 1 all pregnancies. Color and nationality of mother. Total..........................- ....................... B irths1in 1915. Births 1all pregnancies. Still Infant births Births.1 and mis deaths. carriages. Still Infant births Births.1 and mis deaths. carriages. 11,613 7,210 1,011 655 440 788 1,509 816 1,117 38,630 3,786 4,158 471 50 30 28 33 204 646 49 102 36 77 207 21,752 3,870 2,858 1,883 3,021 5,246 2,056 309 177 182 220 842 2,185 232 439 189 362 751 1Includes miscarriages. T able 188.—Stillbirth and miscarriage rates, by color and nationality o f mother; births 1 in 1915 arid births,1 all pregnancies. ✓ Miscarriage rates (per 100). Color and nationality of mother. Total........................... - ........................................................ Stillbirth rates (per 100). Births,1 Births1 all preg in 1915. nancies. Births1 in 1915. Births,1 all preg nancies. 3.6 6.7 3.6 3.3 3.8 2.0 1.8 3.2 1.4 5.8 6.9 5.5 3.8 6.6 4.3 9.7 2.9 3.0 2.8 3.3 2.9 8.2 2.8 2.6 2.5 3.2 3.1 7.0 1Includes miscarriages. T able 189.— Miscarriage rates, by earnings o f father and color and nativity o f mother; births 1 in 1915 and births,1 all pregnancies. Miscarriage rates (per 100 births1). Earnings of father during year after 1915 birth. Births1 in 1915. Total Under $450.............. $450-1549................. $550-$649................. $650-849................... $850-$1,049.............. $1,050-$1,249.......... $1,250 and over....... $1,250-$1,449.... $1,450-$1,849.... $l,850-$2,249__ $2,250-$2,849— $2,850 and over. No earnings............ Not reported.......... 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Foreign-born white mothers. Native white mothers. Births,1 Births1 all preg in 1915. nancies. Births,1 all preg nancies. Colored mothers. Births,1 Births1 all preg in 1915. nancies. 3.8 6.9 2.0 5.0 5.8 9.7 3.6 3.4 3.6 3.5 3.4 4.2 4.4 5.3 4.7 2.6 3.4 3.7 7.8 6.4 7.3 1.8 6.2 3.1 6.1 1.3 7.0 1.8 6.7 2.4 6. 8 1.9 7.9 0.9 8.5 1*0 7.7 .......... . 5.2 ............... 5.4 5.5 5.3 4.1 5.1 3.6 4.9 5.4 3.6 5.7 7.8 3.2 3.5 7.4 ............... ............... ............... ............... ............... ............... 10.6 10.2 7.4 10.8 8.4 6.4 .............. . 9.5 ............. 7.7 ................ 5.9 ............... 3.4 6.0 » Not shown where base is less than 100. 6.7 8.0 APPENDIX VII.---- TABLES. T able 369 190 .— Stillbirth and miscarriagerates, by employment o f mother away from home ana color and nativity; births 1 all pregnancies. Stillbirths and miscarriage rates. Employment of mother away from home. Native white mothers. Foreignborn Colored white mothers. mothers. Miscarriagerates per 100 births.* Total................................. Never employed away............... Employed before marriage only Employed after marriage___ 6.9 5.0 9.7 6.9 6.1 9.6 5.4 4.9 4.7 13.1 6.7 10.3 Stillbirth rates (per 100 births). Total.................................. Never employed away............... Employed before marriage only. Employed after marriage........... 2.8 2.8 7.0 3.1 2.5 3.4 2.6 2.6 3.3 8.9 5.9 7.1 1 Includes miscarriages. T able 191. Legitimacy o f birth1 and scheduling o f illegitimate births,1 by color o f mother' total registered births1 in 1915. Registered births * in 1915. White mothers. Legitimacy of birth * and scheduling of illegimate births. Still births and mis carri ages. Live Infant births. deaths. Color of mothers not reported. Colored mothers. Still births and mis carri ages. Live Infant births. deaths. Still births and Live Infant mis births. deaths. carri ages. Total registered............ 755 11,290 1,136 372 2,183 414 32 4 1 Legitimate............................. Illegitimate............................ Scheduled....................... Not scheduled................. Legitimacy not reported....... 709 46 29 17 10,916 374 163 >211 1,018 118 52 66 249 123 78 45 1,602 581 409 >172 251 163 120 43 4 4 1 1 Includes miscarriages. * Includes 133 white live births and 123 colored live births whose condition at 1 year of age was unknown. 101351°—23----- 24 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 370 IN F A N T MORTALITY, BALTIMORE, MD. T able 192.— Employment o f mother during pregnancy, by color o f mother; scheduled legitimate and illegitimate births1 and total illegitimate births1 in 1915. Illegitimate births.1 Legitimate births1 (scheduled). Employment of mother during pregnancy, and color. Scheduled. Total.3 Per cent Per cent Per cent Number. distribu Number. distribu Number. distribu tion. tion. tion. 679 100.0 10.9 5.1 63.7 . 20.4 ÏÏ9" 43 499 18 ÜS 420 100.0 192 100.0 78.5 14.3 7.2 52 14 223 131 12.4 3.3 53.1 31.2 49 6 126 11 25.5 3.1 65.6 5.7 1,509 100.0 704 100.0 487 100.0 457 374 677 1 30.3 24.8 44.9 .1 70 43 493 98 9.9 6.1 70.0 13.9 70 37 373 7 14.4 7.6 76.6 1.4 1,124 11,613 100.0 8,391 1,819 1,400 3 72.3 15.7 12.1 122~ 57 716 229 10,104 100.0 7,934 1,445 723 2 * in clu d e s im scam u-gro. 100.0 _ • _. , 6.3 73.5 2.7 , ,, 2 Information about the mothers of the 445 issues for which no schedules were secured is based on the birth certificates. T able 193.— Occupation o f mother during pregnancy, by color o f mother; illegitimate births1 in 1915. Illegitimate births1in 1915. White mothers. Total. Colored mothers. Occupation of mother during pregnancy. Per cent Per cent Per cent Number. distribu Number. dsitribu- Number. distribu tion. tion. tion. 1,124 331 142 52 41 49 94 66 57 21 13 11 10 6 4 3 3 12 122 17 105 229 100.0 420 100.0 704 100.0 29.4 12.6 4.6 3.6 4.4 8.4 5.9 5.1 1.9 1.2 1.0 .9 .5 .4 .3 .3 1.1 10.9 1.5 9.3 20.4 66 102 39 30 33 8 7 1 5 13 10 1 6 4 3 3 8 52 5 47 131 15.7 24.3 9.3 7.1 7.9 1.9 1.7 .2 1.2 3.1 2.4 .2 1.4 1.0 .7 .7 1.9 12.4 1.2 11.2 31.2 265 40 13 11 16 86 59 56 16 37.6 5.7 1.8 1.6 2.3 12.2 8.4 8.0 2.3 1 9 .1 1.3 4 70 12 58 98 .6 9.9 1.7 8.2 13.9 1 Includes miscarriages. . . . . , , ... . ... a Includes 1 each of the following: Chorus girl, companion, haar-dresser, demonstrator, peddler, florist s helper, proprietor of grocery store, farm worker, maid in hospital, maid in department store, lady s maid, ana prostitute. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis -ajrx-.Ci.lNIMA VJL1.---- TABL.ES. TiBLE **» & Illegitimate blrtte. t . ;year Employed. Occupation of mother during pregnancy. Total All occupations. Domestic......................... Factory o p e r a t i v e ! I I I ’ Textile and clothing.II Cannery and food. . . . . Other factory and fac tory n. s.......... Laundress.................... ] ] ]' Charwoman........... ..I ..I I ! Waitress, cook, or kitchen girl................................. . A ll other........................... Not em ployed..... IIIIIII] Schoolgirl..............II" Other.......................HI Not reported...............IIH] e ^ o t a a duriog Em ploy Not Wait ment em Fac not ployed. Total. Domes tory Laun Char ress, cook, All re tic. oper dress. woman. or others. port ative. kitchen ed. girl. 679 127 522 168 109 90 68 45 42 19Q 115 44 38 30 16 19 5 6 167 96 39 32 128 5 1 3 9 81 36 25 10 3 1 1 7 4 7 2 7 2 6 1 1 33 8 5 3 25 83 53 i 7 20 2 1 G2 1 2 8 42 3 1 1 1 2 12 70 10 60 40 34 47 3 44 2 4 4 12 1 1 2 10 1 9 1 3 1 3 29 3 5 1 56 42 51 119 14 105 18 13 1 12 12 1 2 25 4 5 3 2 1 16 1Includes miscarriages. T able im .-O c c u p a tio n d u rin g p reg m n ey b , a ye o f m oth er: «leg itim a te b irth s' in 1915• Illegitimate births i in 1915. Occupation of mother during pregnancy. Age of mother. Total. Under 16. All occupations. Domestic....................................... Factory operative___ ..;I!IIM IH ! Textile and clothing............... Cannery and food..... , . ......... Other factory and factory n . s.. Laundress........................................ Waitress, cook, or kitchen girl ..II! Charwoman.................................... Nursemaid.......................... III!!'* " Stenographer or clerk... 11111111 ’ " Seamstress................................. II] Chambermaid............. 1.111111111"' Saleswoman........................*...111. Nurse............................... * 1 1 .1 '” ] School-teacher.............. IIIIIIIIIIII Telephone operator.........III III" All other8.......................... I I I '. ’ I " Not employed................... I I I I I I !" Schoolgirl............. ......... Other........................L ...I I I I !" Not reported....................IIIIIIIII" 16-20 20 and over. Not reported. 1,124 55 454 610 5 331 142 52 41 49 94 66 57 21 13 11 10 6 13 1 1 152 65 24 17 24 23 22 13 13 4 4 5 165 76 27 24 25 69 43 42 6 9 7 3 6 1 2 1 2 2 2 ........... ........... ....__ r 2 3 3 12 122 .......... 22 17 6 105 16 229 10 4 65 9 56 82 1 ................ 3 .......... ... 7 1 35 2 33 134 3 1 Includes miscarriages. maid, and prostitute. S ^ https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis f a m w S & r S ^ hair-dresser demonstrator, peddler, flor ' arm worker’ ™ d 111 hospital, maid in department store, ladyi 372 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e 196.— A ge o f mother, hy color; illegitimate births 1 in 1915. Illegitimate births1in 1915. White mothers. Total. Colored mothers. Age of mother. Percent Per cent Percent Number. distribu Number. distribu Number. distribu tion. tion. tion. Total................................................... 1,124 100.0 420 100.0 704 100.0 16-17 ................................................ 18-19 ............................................. 20-24 .................................................... 25-29 ....................................................... 30-34 ....................................................... 35-39 .................................................... 509 55 180 274 373 114 62 45 16 5 45.3 4.9 16.0 24.4 33.2 10.1 5.5 4.0 1.4 .4 149 10 44 95 185 48 17 13 6 2 35.5 2.4 10.5 22.6 44.0 11.4 4.0 3.1 1.4 .5 360 45 136 179 188 66 45 32 10 3 51.1 6,4 19.3 25.4 26.7 9.4 6.4 4.5 1.4 •4 1Includes miscarriages. . 2 Sixteen years is the age of consent in Maryland. T a b l e 197.— Marital condition at confinement and one year later, by color o f mother; scheduled illegitimate births 1 in 1915. Scheduled illegitimate births1in 1915. Marital condition of mother at 1 year after confinement. Total. Married. Marital condition at confinement and color of mother. Un Per cent changed. disNum ber. tribution. To father of child. Not re ported to whom married. To an other. Mother died. Not re ported. Num Per Num Per Num Per Num Per Num Per Num Per ber. ct.2 ber. ct.2 ber. ct.2 ber. ct.2 ber. ct.2 ber. ct.* White mothers___ 192 100.0 142 74.0 19 9.9 12 6.3 Single........................... Widowed, divorced, or separated.................. 149 77.6 117 78.5 16 10.7 9 6.0 Colored mothers... 487 100.0 406 83.4 37 7.6 16 3.3 Single........................... Widowed, divorced, or 426 87.5 351 82.4 37 8.7 16 3.8 i 20 5 29 15.1 7 3.6 7 3.6 52 10.7 5 1.0 .8 4 50 5 0.5 1 1.6 15 7.8 .7 6 4.0 2 1 1 1 1 3 1 .2 7 11 2.3 16 3.3 10 2.3 12 2.8 1 4 1 TnpindAs miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 3 3 1 * Not shown where base is less than 100. A P P E N D IX v ii .— t a b l e s 373 . T a b l e 198.— Order o f birth,1 by color o f mother; total and scheduled illegitimate births 1 in 1915. Ulegitimate births1 in 1915. Scheduled. Total. Order of birth1 and color of mother. Number. 1Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Per cent Per cent distri N um ber. distri bution. bution. 420 100.0 192 100.0 345 42 13 10 9 1 82.1 10.0 3.1 2.4 2.1 .2 140 26 11 7 8 72.9 13.5 5.7 3.6 4.2 704 100.0 487 100.0 407 139 50 61 43 4 57.8 19.7 7.1 8.7 6.1 .6 268 95 41 45 38 55.0 19.5 8.4 9.2 7.8 374 HtfTAJSTT MORTALITY, BALTIMORE, MD. T a b l e 199.— Order o f birth,1 by color o f mother and legitimacy;^ scheduled illegitimates births1in 1915, and previous births 1to mothers o f scheduled illegitimate births1 in 1915. Previous births1 to mothers of scheduled illegitimate births1 in 1915. Order cf birth1 and color of mother. All mothers........................................ Fifth............................................................. Fifth ......................................................... 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Scheduled illegiti mate births in 1915. Total. All All previous previous Dirths1 births1 illegiti legiti mate. mate. 679 792 399 ' 131 408 121 52 17 20 15 14 11 9 5 2 1 2 1 1 121 104 51 80 75 84 77 72 45 20 11 24 13 15 106 82 30 36 45 54 14 11 12 12 16 15 12 28 16 9 192 142 33 33 140 26 11 3 3 1 2 2 1 1 1 1 26 22 9 12 5 12 14 8 9 12 13 16 14 3 9 4 6 8 487 650 366 98 268 95 41 14 17 14 12 9 8 4 2 1 1 1 95 82 42 68 70 72 63 64 36 20 11 12 15 90 68 27 36 45 54 14 2 8 6 8 15 6 28 16 9 9 11 12 Previous births1 Legiti macy divided not as to legiti reported. macy. 189 8 6 24 15 18 28 40 18 20 12 6 11 12 4 2 3 4 7 16 9 13 15 51 25 2 1 2 4 5 6 14 8 12 9 73 138 9 13 48 3 6 6 20 10 12 14 32 18 20 3 4 7 16 15 375 APPENDIX V I I — TABLES. T a b l e 200.— Legitim acy o f previous births,1 by order o f birth;1 scheduled illegitim ate births 1 in 1915. Scheduled illegitimate issues in 1915. Order of birth.1 Legitimacy of previous birthsA Second and later. Total. First. Total. All mothers...................... 679 All previous births »illegitimate. All previous births1legitimate.. Legitimacy not reported............ 189 37 32 13 White mothers................. 192 All previous births1illegitimate. All previous births1legitimate.. 24 16 Legitimacy not reported............ 4 Colored mothers............... 487 All previous births1illegitimate. All previous births1legitimate.. 165 21 24 9 Legitimacy not reported............ 408 140 268 Seventh and later. Fourth to sixth. Third. 271 121 52 52 46 189 37 32 13 106 11 4 41 6 4 1 28 11 11 2 14 9 17 6 52 26 11 7 8 16 9 7 2 1 1 1 4 2 24 16 8 4 s Second. . i 1 5 2 219 95 41 45 38 165 21 24 9 90 2 34 4 3 27 7 9 2 14 18 12 4 3 1Includes miscarriages. T a b l e 201.— Occupation o f father, by color o f mother; illegitimate births 1 in 1915. Illegitimate births1in 1915. Illegitimate births1in 1915. Occupation of father. Occupation of father. White Colored Total. mothers. mothers. All occupations. . 1,124 2 420 2 704 Professional pursuits *.. Laborers........................ Teamsters, chauffeurs, 308 31 277 Railway emp ->yees----Proprietors and dealers. no 63 58 36 34 30 26 26 22 34 27 20 22 88 29 31 36 30 30 6 4 25 15 10 26 20 6 Factory operatives....... Servants..................... Skilled mechanics, Others in mechanical industries................... 4 Janitors and elevator Public employees6....... Other occupations8— No occupation.............. Students................. Others.......... ......... Father dead........... White Colored Total. mothers. mothers. 20 19 19 12 11 13 3 18 9 10 9 29 21 6 3 12 232 7 14 7 1 2 4 149 7 16 1 3 6 10 2 15 14 5 1 8 83 1Includes miscarriages. »Includes 2 issues with colored fathers; 1 occupation not reported; ldead. »Includes 2 issues with white fathers—1 teamster, etc., and-1 clerk—and 15 issues with fathers’ color and occupation not reported. * Includes 4 physicians, 4 musicians, 3 school-teachers, 2 photographers, 2 jockeys, 1 lawyer, 1 dentist, 1 artist, 1 draftsman, and 1 editor. 6Includes2 soldiers, 1 policeman, 1 postman, 1 detective, 1 officerin a reformatory, and 3 whose occupa tions are not specified. , , ,___, . . * Includes 7 tailors, 7 fishermen or oystermen, 6 hospital orderhes, 5 saloon keepers or bartenders, 2 tele phone operators, 1 butcher, and 1 baker. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 376 IN FAN T MORTALITY, BALTIMORE, MD. T able 202.—Age o f mother, by age o f father and color o f mother; illegitimate births 1 in 1915. Illegitimate births1in 1915. Age of father. Age of mother. Under 20. Total. Total. 16 17 18 19 50 Not re 20-24 25-29 30-34 35-39 40-44 45-49 and ported. over. All mothers....... 1,124 110 3 17 43 47 408 195 83 76 29 20 Under 20................... 12........................... 13 ...................... 14 ...................... 15 ...................... 16 ............... 17 ...................... 18 ...................... 19........................... 20-24......................... 25-29......................... 30-34......................... 35-39......................... 40 and over.............. Not reported............ 509 2 4 12 37 66 114 144 130 373 114 62 45 16 101 3 16 40 42 243 2 67 9 9 5 4 3 14 25 54 78 72 139 18 1 2 4 10 23 27 72 35 11 8' 2 1 3 4 38 20 11 4 1 1 1 4 3 22 16 16 12 1 2 3 3 4 9 7 1 1 1 1 2 2 5 5 2 2 2 1 3 4 7 4 2 3 4 13 23 29 22 7 9 1 2 1 1 3 3 6 2 1 2 4 15 9 7 3 3 2 4 5 14 13 4 5 1 1 1 5 White mothers.. 420 19 1 3 4 11 133 84 29 18 149 16 1 2 3 10 63 27 2 2 3 7 15 29 46 49 185 48 17 13 6 2 2 1 1 1 1 2 4 3 1 3 6 13 20 21 63 6 Colored mothers. 704 91 2 14 39 36 Under 20................... 12........................... 13 ............ .......... 14 ...................... 15 ...................... 16 ...................... 17 ...................... 18 ...................... 19......................... , 20-24......................... 25-29......................... 30-34......................... 35-39......................... 40 and over............... Not reported............ 360 2 4 9 30 51 85 98 81 188 66 45 32 10 3 85 2 14 37 32 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 1 1 1 1 1 1 2 3 3 5 2 2 4 14 9 6 2 2 2 4 4 12 9 1 4 1 1 3 8 15 34 13 5 4 1 1 2 12 9 2 3 1 7 4 4 1 275 111 54 58 22 16 185 2 40 7 7 5 4 3 11 19 41 58 51 76 12 1 2 3 7 15 12 38 22 6 4 1 2 2 2 1 1 2 1 2 1 1 10 1 1 2 3 15 12 12 11 1 124 2 3 1 2 7 7 1 1 1 1 5 4 2 1 3 6 10 10 9 63 12 4 4 1 1 67 27 1 1 2 4 26 11 9 1 1 3 7 13 18 11 13 86 17 9 5 4 4 39 1 3 2 13 21 26 17 3 6 191 66 1 1 Under 20................... 12........................... 13 ...................... 14 ...................... 15 ...................... 16 ...................... 17 ...................... 18 ...................... 19........................... 20-24......................... 25-29......................... 30-34........................ 35-39......................... 40 and over............... Not reported............ 2 3 5 4 3 12 2 2 1 3 2 1 2 4 7 8 1 4 23 5 5 1 3 3 APPENDIX VII.---- TABLES. 377 T a b l e 203.—Place o f confinement, by legitimacy o f birth;1 total and scheduled births1 in 1915. Births1in 1915. Place of confinement and legitimacy of birth.1 Total. Number. Illegitimate *........................................ Hospital...................................... Institution.............................. Private house........................... Legitimate................................ Hospital............................... Other................................. Scheduled. Per cent Per cent distri Number. distri bution. bution. 1,124 100.0 679 100.0 517 56 551 46.0 5.0 49.0 245 10 424 36.1 1.5 62.4 13,484 100.0 11,613 100.0 1,735 11,749 12.9 87.1 1,105 10,508 9.5 90.5 1Includes miscarriages. *Includes 420 white and 704 colored issues; hospital, 218 white and 299 colored; institution, 54 white and 2 colored; private house, 148 white and 403 colored. The “ private houses” include boarding and lodging houses one house of prostitution, several homes of midwives, and the waitresses' home connected with a hospital. Matermty homes in Baltimore send all confinement cases to hospitals. T a b l e 204.—Attendant at birth, by color o f mother; scheduled legitimate and illegitimate births1 in 1915. Legitimate births.1 Illegitimate births.1 Attendant at birth and color of mother. Number. Per cent Per cent distri Number. distri bution. bution. A ll mothers....... 11,463 100.0 679 100.0 Physician.................... In hospital............ Outside hospital.. Midwife....................... Other or none.............. 7,721 1,088 6,633 3,713 29 67.4 9.5 57.9 32.4 .3 571 245 326 100 8 84.1 36.1 48.0 14.7 1.2 White mothers.. 9,974 100.0 192 100.0 Physician.................... In hospital............ Outside hospital... Midwife....................... Other or none.............. 6,620 887 5,733 3,328 26 66.4 8.9 57.5 33.4 .3 151 76 75 39 2 78.6 39.6 39.1 20.3 1.0 Colored mothers. 1,489 100.0 487 100.0 Physician.................... In hospital............ Outside hospital... Midwife.......... : ........... Other or none.............. 1,101 201 900 385 3 73.9 13.5 60.4 25.9 .2 420 169 251 61 6 86.2 34.7 51.5 12.5 1.2 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 378 IN FAN T MORTALITY, BALTIMORE, MD. T able 205.—Prenatal care, by color o f mother; mothers o f scheduled legitimate and illegitimate births1 in 1915. B irths1in 1915 to mothers having speci fied prenatal care. Total mothers. Legitimacy of birth1and color of mother. Care of grades A and B. No care. Number. Per cent. Number. Percent. All mothers: Legitimate.............. Illegitimate............. White mothers: Legitimate........... .. Illegitimate.............. Colored mothers: i Legitimate.............. Illegitimate............. 11,463 670 5,443 263 47.5 39.3 2,551 199 22.3 29.7 9,974 191 4,806 93 48.2 48.7 2,095 37 21.0 19.4 1,489 479 637 170 42.8 35.5 456 162 30.6 33.8 i Includes miscarriages. T a b l e 206.— Mother’s mode o f living during whole or greater part o f year after confinem ent, by color o f mother; scheduled illegitimate births 1 in 1915. Scheduled illegitimate births1in 1915. , Mother’s mode of living during whole or greater part.of year after confinement. Total......................................... - ........ With husband or otfier man (not father of philH) ............................................... i includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis White mothers. Total. Still births, miscar Per cent Infants Per cent riages, surviving Number. distri and Number. distri bution. infant 2 weeks.2 bution. deaths under 2 weeks.2 679 100.0 151 528 192 100.0 275 68 111 45 66 83 21 19 40.5 10.0 16.3 6.6 9.7 12.2 3.1 2.8 57 9 30 15 3 2 218 59 81 (3) (3) 68 18 17 79 12 25 17 8 23 6 19 41.1 6.3 13.0 8.9 4« 2 12.0 3.1 9.9 16 14 72 2.4 2.1 10.6 8 6 21 8 8 51 ¿,5. 3 20 2.6 1.6 10.4 (3) (3) v * For per cent distribution, see text table, p . 161. 8 Not tabulated. APPENDIX VII.— TABLES. 379 T a b l e 206.— Mother's mode o f living during whole or greater part o f year after confinement, hy color o f mother; scheduled illegitim ate births1 in 1915— Continued. Scheduled illegitimate births1in 1915. White mothers. Mother’s mode of living during whole or greater part of year after confinement. Still Still births, births, miscar miscar riages, Infants Per cent riages, Infants and surviving Number. distri and surviving infant 2 weeks.2 bution. infant 2 weeks.2 deaths deaths under under 2 weeks.2 2 weeks.2 Total................................................. Parental home............................................. With other relatives or friends................... With father of child................................... Married. ; ............................................ Unmarried............................................. Own establishment or boarding................. At service...................................................... In institution or hospital............................. With husband or other man (not father of child)......................................................... Died.............................................................. Not reported................................................. 1 Includes miscarriages. Colored mothers. (3) (3) 39 153 487 100.0 112 375 17 2 6 62 10 19 196 56 86 28 58 60 15 40.2 11.5 17.7 5.7 11.9 12.3 3.1 40 7 24 156 11 11 52 2.3 2.3 10.7 (3) (3) 4 2 19 6 17 3 2 3 2 1 17 2 For per cent distribution, see Text Table III, p. 162. 62 (3) (3) (3) (3) 11 49 5 4 18 6 7 34 * Not tabulated. T a b l e 207.—Earnings o f father or contributions to the support o f mother or child during yearfollow ing birth o f infant, and mode o f living, by color o f mother; scheduled illegiti mate births 1 in 1915. Scheduled illegitimate births1in 1915. Earnings of father or contributions to the support of mother or child during year following birth of infant, and mode of living. Total. White mothers. Colored mothers. Per cent Per cent Per cent Number. distribu Number. distribu Number. distribu tion. tion. tion. Total................................................... 679 100.0 192 100.0 487 100.0 Did not live with mother2....................... 526 77.5 144 75.0 382 78.4 Contributed: Nothing.................................................. Under $5................................................. $5-824................................................. $25-849.................................................... $50-899................................................. $100 and over......................................... Amount not reported........................... 305 18 23 19 49 58 54 44.9 2.7 3.4 2.8 7.2 8.5 8.0 94 1 2 7 19 13 8 49.0 .5 1.0 3.6 9.9 6.8 4.2 211 17 21 12 30 45 46 43.3 3.5 4.3 2.5 6.2 Q. 2 9.4 Lived with mother2................................. 111 16.3 25 13.0 86 17.7 Earned: Under $450............................................ $450-8649........................................ $650-8849................................................. $850-81,249........................................... $1,250 and over..................................... Amount not reported...................... Mode of living not reported..................... 51 35 8 6 1 10 42 7.5 5.2 1.2 .9 .1 1.5 6.2 4 8 4 5 1 3 23 2.1 4.2 2.1 2.6 .5 1.6 12.0 47 27 4 i 9.7 5.5 J* 7 19 1.4 3.9 i Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis During entire or greater part of year. 380 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e 208.— Contribution o f father to the support o f mother or child during yearfollow ing birth o f infant y by mode o f living y and by color o f mother7.scheduled illegitimate births in 1915. Scheduled illegitimate births1in 1915. Contribution of father to the support of mother or child during year following birth of infant, mode ofliving, and color of mother. Live births. Total. Stillbirths and miscarriages. Per cent Per cent Per cent Number. distribu Number. distribu Number. distribu tion. s tion. tion. All mothers........................................ 679 100.0 572 100.0 107 100.0 Father’s mode ofliving:' Did not live with m oth ercontributed nothing...................... Contributed..................................... Lived with mother3.............................. N ot reported...................... ................. - 305 221 111 42 44.9 32.5 16.3 6.2 242 199 92 39 42.3 34.8 16.1 6.8 63 22 19 3 58.9 20.6 17.8 2.8 White mothers................................... 192 100.0 163 100.0 29 100.0 94 50 25 23 49.0 26.0 13.0 12.0 72 48 22 21 44.2 29.4 13.5 12.9 22 2 3 2 487 100.0 409 100.0 78 100.0 211 171 86 19 43.3 35.1 17.7 3.9 170 151 70 18 41.6 36.9 17.1 4.4 41 20 16 1 52.6 25.0 20.5 1.3 Father’s mode ofliving: Did not live with mother— Colored mothers............................ Father’s mode ofliving: Did not live with mother— Contributed nothing...................... Contributed..................................... Lived with mother3.............................. Not reported.......................................... Includes miscarriages. * Not shown where base is less than 50. * During entire or greater part of year. i https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX V II.---- TABLES. 381 T a b l e 209.— M ortality among mothers during year after confinement, by cause o f death and color; mothers o f scheduled legitimate and illegitimate births 1in 1915. Mothers who died in year following confinement. Causes due to pregnancy and confinement. Color of mother and legitimacy of birth.1 Total. Puerperal septicemia. Total. Per 1,000 live births. Num ber. Per 1,000 confine ments. Num ber. Per 1,000 live births. Per 1,000 confine ments. Mothers of legitimate births1.......... >105 50 4.6 4.4 18 1.7 1.6 W hite.......................................... Colored........................................ 90 15 45 5 4.7 3.8 4.5 3.4 13 5 1.4 3.8 1.3 3.4 14 6 10.5 9.0 2 3.5 3.0 3 11 1 5 6.1 12.2 5.2 10.4 1 1 6.1 2.4 5.2 2.1 Mothers of illegitimate births White.......................................... Colored........................................ Mothers who died in year following confinement. Causes due to pregnancy and confinement. Color of mother and legitimacy of birth.1 Puerperal albumi nuria and convul sions. Num ber. Other causes due to confinement. All other causes. Per Per Per Per Per Per 1,000 1,000 Num 1,000 1,000 Num 1,000 1,000 live confine ber. live confine ber. live confine births. ments. births. ments. births. ments. Mothers of legitimate births1......... 14 1.3 1.2 18 1.7 1.6 55 5.1 4.8 W hite........................................ Colored...................................... 14 1.5 1.4 18 1.9 1.8 45 10 4.7 7.7 4.5 6.7 Mothers of illegitimate births1....... 1 1.7 1.5 3 5.2 4.5 8 14.0 11.9 6.3 2 6 12.3 14.7 10.5 12.5 W h ite ...................................... Colored....................................... 1 2.4 2.1 3 7.3 1Includes miscarriages. * The number of mothers was 1 less than the number of issues, since 1 birth resulted in plural issues. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 382 IN F A N T MORTALITY, BALTIMORE, MD. . T a b l e 210.— Earnings o f mother, by period worked during year after confinement and type o f remuneration; scheduled illegitim ate births 1 in 1915. Illegitimate births1 to working mothers receiving specified type of remuneration. Cash plus meals. Cash alone. Earnings of mother and period worked during year after confinement. Per cent Per cent Number. distri Number. distri bution.1 bution.3 $50-$149 $15ft-$249 £250-4349 102 100.0 183 100.0 3 27 39 22 11 2.9 26.5 38,2 21.6 10.8 4 77 86 15 1 2.2 42.1 47.0 8.2 0.5 48 100.0 47 100.0 Room and board only.1 Not reported. 2 10 2 10 $£0-4149 $1504249 $2/50-4349 3 2 40 5 2 29 11 6 3 59 100.0 43 33 24 2 55.9 40.7 3.4 23 20 3 2 1 100.0 2 2 1 2 2 17 1 17 1 Includes miscarriages. 3 Rate not shown where base is less than 50. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 383 APPENDIX V II.---- TABLES. T a b l e 211.— Mother's and infant's mode o f living during year after birth, by color o f mother; scheduled illegitimate infants born in 1915 and surviving at least two weeks. Illegitimate infants bom during 1915 and surviving at least 2 weeks. Living during greater part of first year of life. Away from mother. Mother’s mode ofliving during entire finement, and color. Total. Boarding. With With With In in moth moth stitu With er. Total. er’s foster tion In oth rela par or hos board In pri ers. vate tives. ents. pital. ing home. home. All mothers................................. 528 429 99 Parental home.................................... With other relatives or friends............ With father of child............................. With husband or man other than father................................................. At service............................................. In institution or hospital................ Own establishment or boarded........... Died...................................................... Not reported......................................... 218 59 81 201 48 79 17 11 2 8 18 17 68 8 51 8 6 16 62 4 5 12 1 6 4 46 White mothers........................... 153 120 Parental home...................................... With other relatives or friends............ With father of child............................. With husband or man other than father................................................ At service............................................. In institution or hospital..................... Own establishment or boarded........... Died...................................................... Not reported......................................... 62 10 19 13 10 17 39 18 4 5 7 7 1 1 3 5 3 1 i 3 i i 5 i i 3 ii 16 ii 33 6 16 8 3 52 9 19 10 1 3 1 5 2 2 6 17 19 1 17 2 3 16 17 1 1 3 1 2 16 Golored mothers......................... 375 309 66 Parental home...................................... With other relatives or friends............ With father of child............................. With husband or man other than father................................................. At service.............................................. In institution or hospital..................... Own establishment ôr boarded............ D ied ..................................................... Not reported......................................... 156 49 62 149 39 60 7 10 2 3 1 6 12 6 3 9 3 49 7 34 45 3 4 4 4 30 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 3 3 1 13 i i 10 3 4 1 31 15 5 7 1 1 1 4 1 1 1 2 i 1 2 1 3 3 2 2 2 4 1 13 10 2 legitimate and illegitim ate births 1 and total illegitim ate births1 in 1915. Total births.1 Condition at 1 year. Births. Number. Percent. Number. Percent. Total. Known. A ll mothers: Illegitimate births1— Employed away from home during pregnancy— Illegitimate births1— White mothers: Illegitimate births1— Employed away from home during pregnancy— Illegitimate births1— Colored mothers: Illegitimate births1— Employed away from home during pregnancy— Illegitimate births 1 Includes miscarriages. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 11,613 418 3.6 11,195 398 3.6 10,797 10,797 1,124 679 61 46 5.4 6.8 1,063 633 108 61 10.2 9.6 955 572 699 572 1,400 83 5.9 1,317 88 6.7 1,229 1,229 77 52 11.5 11.3 594 410 458 410 9 492 9,492 716 499 45 37 6.3 7.4 671 462 10,104 330 3.3 9,774 420 192 24 16 5.7 8.3 396 176 22 13 5.6 7.4 374 163 241 163 723 35 4.8 688 29 4.2 659 659 6.8 8.9 191 102 126 102 8.2 1,305 1,305 223 126 18 14 8.1 11.1 205 112 14 10 1,509 88 5.8 1,421 116 704 487 37 30 5.3 6.2 667 457 677 48 7.1 629 466 350 493 373 27 23 5.5 6.2 458 409 12.9 10.5 581 409 59 9.4 570 570 63 42 13.5 12.0 403 308 332 308 86 48 Infant deaths. Un known. 256 136 133 65 123 71 Based on live Based births^ on t o t a l. live “ condi tion births. known.” 1,117 103.5 103.5 281 172 402.0 300.7 294.2 300.7 221 179.8 179.8 170 129 371.2 314.6 286.2 314.6 910 95.9 95.9 489.6 319.0 315.5 319.0 118 52 106 160.8 160.8 55 36 436.5 352.9 288.0 352.9 207 158.6 158.6 163 120 355.9 293.4 280.6 293.4 115 201.8 201.8 115 93 346.4 301.9 285.4 301.9 IN F A N T MORTALITY, BALTIMORE, MD. Legitimacy of birth,1 employment away from home during pregnancy, and color of mother. Infant mortality rate. Live births. Stillbirths. Miscarriages. 384 T a b l e 212.— Infant mortality and stillbirth rates, by employment o f mother away from home during pregnancy, and color o f mother; scheduled APPENDIX VII.-----TABUES. 385 T a b l e 213.—A ge at death, by color o f mother; deaths among illegitim ate live births in 1915. Deaths of illegitimate infonts. Deaths of illegitimate in fonts. Age at death. Age at death. All White Colored mothers. mothers. mothers. Total.................. 281 118 163 Under 1 month........... Under 1 day......... 1 day, under 2...... 2 days, under 3__ 3 days, under 7___ 1 week, under 2 ... 102 34 14 5 10 15 33 10 4 1 2 7 69 24 10 4 8 8 All White Colored mothers. mothers. mothers. Under 1 month—Con. 2 weeks, under 1 9 25 13 23 14 10 24 43 29 48 33 26 2 months, under 3....... 3 months, under 6....... 6 months, under 9....... 9 months, under 12___ 15 16 25 19 16 T a b l e 214.—Deaths per 1,000 live births, by age at death and color o f mother; total • illegitimate and scheduled legitimate live births in 1915. Deaths per 1,000 live births. All mothers. Age at death, Legiti mate. Illegiti mate.1 White mothers. Legiti mate. Illegiti mate.1 Colored mothers. Legiti mate. Illegiti mate.1 Total................................. ..................... 103.5 294.2 95.9 315.5 158.6 280.5 Under 1 month............................................. Under 2 weeks....................................... 2 weeks, under 1 month........................ 1 month, under 2.......................................... 2 months, under 3........................................ 3 months, under 6........................................ 6 months, under 9................. ....................... 9 months, under 12....................................... 44.2 37.1 7.1 6.0 5.8 19.4 15.1 13.0 106.8 81.7 25.1 45.0 30.4 50.3 34.6 27.2 41.5 35.2 6.3 5.4 5.5 16.8 14.5 12.2 88.2 64.1 24.1 66.8 34.8 61.5 37.4 26.7 63.6 50.6 13.0 10.7 8.4 38.3 19.2 18.4 118.8 92.9 25.8 31.0 27.5 43.0 32.7 27.5 1 Based on total illegitimate live births (374 white, 581 colored) and probably an understatement of the true rate, smce condition at 1 year was not known for 133 white and 123 colored illegitimate infants. T a b l e 215.— Cause o f death, by co lor o f mother; deaths among illegitimate live birth in 1915. Deaths of illegitimate infants. Cause of death. AU White Colored mothers. mothers. mothers. All causes.......................................................... Gastric and intestinal diseases................................ Malformations.................................................. . Early infancy........................................................ Premature birth................................... Congenital debility................................... Injuries at birth.................................. Respiratory and other communicable dieases........................ Respiratory................................................ Syphilis............................................................ Other communicable........................... All other causes1................................................. 1 Includes 5 deaths, “ cause ill-defined or unknown.’ ! 101351°—23----- 25 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 281 67 10 104 37 39 62 3 34 79 26 52 17 10 21 53 386 IN F A N T MORTALITY, BALTIMORE, MD. T a b l e 216.— Infant mortality rates, by cause o f death and color o f mother; total illegitimate and scheduled, legitimate live births in 1915. Infant mortality rates. Cause of death. Legiti mate. Colored mothers. White mothers. AU mothers. Illegiti mate.1 Legiti mate. IUegitimate.1 Legiti mate. Illegiti mate.1 All causes............................................ 103.5 294.2 95.9 315.5 158.6 280.5 Early infancy............................................... 29.1 3.6 37.7 70.2 10.5 108.9 28.9 3.8 36.0 98.9 2.7 133.7 30.7 2.3 49.8 51.6 15.5 92.9 20.8 12.8 4.1 40.8 64.9 3.1 19.3 12.5 4.2 37.4 90.9 5.3 32.2 14.6 3.1 43.0 48.2 • 1.7 26.4 82.7 21.0 69.6 65.9 91.2 49.0 7.7 9.2 60.2 20.7 10.3 10.0 29.3 Respiratory and other communicable dis eases........................................................... T 19.7 1.3 5.4 54.5 17.8 10.5 15.7 .4 4.9 45.5 13.4 10.7 6.6 22.0 6.1 10.7 i Based on total illegitimate live births (374 white, 581 colored) and probably an understatement of the ue rate, since condition at 1 year was not known for 133 white and 123 colored infants. T a b l e 217.— Cause o f death, by age at death; infant deaths among illegitim ate live births in 1915. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APPENDIX V II.---- TABUES. 387 T a b l e 218. -A ge o f infant when : imther began work, by color o f mother; scheduled legitimate and illegitimate infants bom in 1915. Legitimate infants. Total mothers employed. Age of infant when mother began work, and color of mother. Number. All mothers employed. Under 1 month___ 1 month, under 2... 2 months, under 3.. 3 months, under 6.. 6 months and over. Not reported.......... White mothers employed. Under 1 month___ 1 month, under 2... 2 months, under 3.. 3 months, under 6.. 6 months and over. Not reported.......... Colored mothers employed. Under 1 month___ 1 month, under 2... 2 months, under 3.. 3 months, under 6. 6 months and over. Not reported.......... Mothers employed away from home. Illegitimate infants of mothers employed. Per cent Per cent distri- Number. distri- Number. button. button. button. 2,784 100.0 855 100.0 371 100.0 755 537 293 552 634 13 27.1 19.3 10.5 19.8 22.8 .5 60 132 99 255 308 1 7.0 15.4 11.6 29.8 36.0 .1 41