APPENDIX I

A brief survey of infant mortality rates for 1916 The following tables have been compiled from data supplied by the Vital Statistics Division. The first is a tabulation of those cities in which the prenatal causes of infant mortality predominated in 1916; the second, those especially affected by gastrointestinal causes, and the third, those having a particularly high rate from respiratory causes. In studying Table I it is interesting to note that the proportion of the foreign-born in the population was (according to the 1910 census) below the average in every city, excepting Jamestown. The foreign element in Jamestown, however, is almost entirely Scandinavian, which may account for the exception.

MORTALITY OF INFANTS UNDER ONE MONTH OF AGE IN N. Y. STATE, 1916 (EXCEPTING N. Y. CITY)

General infant mortality rate under one month. ...
General infant mortality rate under one month for native
and British mothers...
General infant mortality rate under one month for
Russia, Austria and Poland mothers..

The three months showing highest rates

Per cen

48.9

59.

40

Infant mortality under one month: March (51.9) April (50.3) — May (51.8).

The three months showing lowest rates

Infant mortality under one month: July (41.2) —August (41.4) October (42.8).

Infant mortality under one month 1st quarter
Infant mortality under one month 2nd quarter
Infant mortality under one month 3rd quarter
Infant mortality under one month 4th quarter

PER CENT OF TOTAL OF DEATHS BY QUARTERS OF THE YEAR IN

Infant Mortality in New York State in 1916 (Excepting New York City) PER CENT OF DEATHS FROM PRINCIPAL CAUSES

CITIES IN WHICH THE PRINCIPAL CAUSES OF INFANT MORTALITY WERE PREMATURITY, ETC., SHOWING THE NUMBER OF DEATHS PER 1000 BIRTHS IN EXCESS OF THE Average for ALL CITIES (EXCEPTING N. Y. CITY) 1916

Table II

CITIES IN WHICH THERE WAS AN EXCESSIVE DEATH RATE FROM GASTROINTESTINAL DISEASES SHOWING THE NUMBER OF

DEATIIS PER 1000 BIRTHS IN EXCESS OF THE AVERAGE FOR

* There is much reason to believe that the foreign element has greatly increased in Binghamton since 1910. † Does not include nonresident deaths in the infant home.

Table III

CITIES IN WHICH THERE WERE EXCESSIVE DEATH RATES FROM COMMUNICABLE AND RESPIRATORY DISEASES SHOWING THE NUMBER OF DEATHS PER 1000 BIRTHS ABOVE The ▲verage FOR ALL CITIES IN 1916

AVERAGE

At least three conclusions may be drawn from the above tables. First: That the greatest number of deaths among infants born of native mothers were due to prenatal causes, such as premature birth, congenital debility, congenital malformations, accidents at birth, atrophy, etc., while the diseases causing the greatest number of deaths among children of foreign mothers were from gastrointestinal or respiratory causes. Second, that the particular nationalities mostly responsible for the high death rate from gastrointestinal diseases among the foreign-born portion of the population were the Russians, Austrians and Poles. These races were also principally responsible for the exceptionally high death rate from respiratory causes among the foreign element but were exceeded by the Italians with whom it nearly equaled the rate from gastrointestinal causes; and third, that there is need for a careful consideration of the following four factors which are so vitally important in connection with the control of infant mortality: (a) The lack of sufficient and proper education of expectant mothers in matters pertaining to their personal health and hygiene before the coming of the babe; (b) the necessity for a higher standard of midwifery practice; (c) the better care of the nursing mother and the new-born babe; (d) the imperative need of an improved milk supply for the artificially fed infant.