42.  Excess of births over pregnancies due to plural births.

43.  See note on page 45.

Table XIV.—Distribution According to Number of Pregnancies and Age Groups of Married Mothers Classified by Nativity.
 
MOTHER’S AGE AND NUMBER OF REPORTABLE PREGNANCIES. ALL MOTHERS. NATIVE MOTHERS. FOREIGN MOTHERS.
Number. Per cent. Number. Per cent. Number. Per cent.
Total pregnancies 1,491 100.0 816 100.0 675 100.0
 1 339 22.7 234 28.7 105 15.6
 2 283 19.0 173 21.2 110 16.3
 3 214 14.4 111 13.6 103 15.3
 4 186 12.5 94 11.5 92 13.6
 5 147 9.8 65 8.0 82 12.1
 6 94 6.3 37 4.5 57 8.4
 7 83 5.6 38 4.7 45 6.7
 8 54 3.6 23 2.8 31 4.6
 9 33 2.2 13 1.6 20 3.0
 10 and over 58 3.9 28 3.4 30 4.4
             
  Under 20 years, total pregnancies 89 100.0 66 100.0 23 100.0
1 74 83.1 55 83.3 19 82.6
2 12 13.5 10 15.2 2 8.7
3 3 3.4 1 1.5 2 8.7
             
  20 to 24 years, total pregnancies 461 100.0 261 100.0 200 100.0
1 178 38.6 114 43.7 64 32.0
2 156 33.8 86 33.0 70 35.0
3 77 16.7 42 16.1 35 17.5
4 39 8.5 14 5.4 25 12.5
5 10 2.2 4 1.5 6 3.0
6 1 .2 1 0.4    
             
  25 to 29 years, total pregnancies 395 100.0 199 100.0 196 100.0
1 57 14.5 45 22.6 12 6.1
2 74 18.7 46 23.1 28 14.3
3 95 24.1 40 20.1 55 28.1
4 75 19.0 40 20.1 35 17.9
5 56 14.2 17 8.5 39 19.9
6 22 5.6 7 3.6 15 7.7
7 14 3.5 4 2.0 10 5.1
8 2 .4     2 1.0
             
  30 to 39 years, total pregnancies 466 100.0 245 100.0 221 100.0
1 30 6.4 20 8.2 10 4.5
2 39 8.4 29 11.8 10 4.5
3 36 7.7 25 10.2 11 5.0
4 63 13.5 33 13.5 30 13.6
5 75 16.1 40 16.3 35 15.8
6 60 12.9 24 9.8 36 16.3
7 56 12.0 28 11.4 28 12.7
8 51 10.9 23 9.4 28 12.7
9 23 4.9 8 3.3 15 6.8
10 and over 33 7.1 15 6.1 18 8.1
             
  40 years and over, total pregnancies 80 100.0 45 100.0 35 100.0
2 2 2.5 2 4.4    
3 3 3.8 3 6.7    
4 9 11.3 7 15.6 2 5.7
5 6 7.5 4 8.9 2 5.7
6 11 13.8 5 11.1 6 17.1
7 13 16.3 6 13.3 7 20.0
8 1 1.3     1 2.9
9 10 12.5 5 11.1 5 14.3
10 and over 25 31.3 13 28.9 12 34.3
Table XV.—Distribution of Married Mothers by Losses Sustained, According to Nativity of Mother and Number of Possible Losses.
 
NUMBER OF BIRTHS OR POSSIBLE LOSSES AND NATIVITY OF MOTHER.   DISTRIBUTION OF MOTHERS ACCORDING TO NUMBER OF LOSSES.
Number of mothers. 1 loss. 2 losses. 3 losses. 4 losses. 5 losses. 6 losses. 8 losses. 10 or more losses.
All mothers 1,491 399 121 60 24 13 8 1 2
 1 birth 335 53              
 2 births 277 67 10            
 3 births 216 73 14 4          
 4 births 187 55 13 8 1        
 5 births 148 48 19 11 1 2      
 6 births 96 44 13 8 2 1 2    
 7 births 82 22 19 10 2   1    
 8 births 54 18 8 10 4 2 2    
 9 births 36 9 10 5 1 1 2    
 10 or more births 60 10 15 4 13 7 1 1 2
                   
  Native mothers 816 199 59 19 5 6 1 1  
1 birth 232 29              
2 births 170 36 5            
3 births 111 35 7 1          
4 births 98 33 6 3          
5 births 65 19 10 4          
6 births 38 19 7 1   1      
7 births 37 10 8 3     1    
8 births 21 8 5 3          
9 births 15 4 4 3 1        
10 or more births 29 6 7 1 4 5   1  
                   
  Foreign mothers 675 200 62 41 19 7 7   2
1 birth 103 24              
2 births 107 31 5            
3 births 105 38 7 3          
4 births 89 22 7 5 1        
5 births 83 29 9 7 1 2      
6 births 58 25 6 7 2   2    
7 births 45 12 11 7 2        
8 births 33 10 3 7 4 2 2    
9 births 21 5 6 2   1 2    
10 or more births 31 4 8 3 9 2 1   2
Population, Registered Births, Deaths of Infants under 1 Year of Age, and Infant Mortality Rates for Registration States and Registration Cities having a Population of at Least 50,000 in 1910.
 
AREA.     DEATHS[44] OF INFANTS UNDER 1 YEAR OF AGE.
Population in 1910. Births.[45] Number. Per 1000 births.[46]
REGISTRATION STATES.        
           
Connecticut 1,114,756 27,291 3,476 127
Maine 742,371 15,578 2,108 135
Massachusetts 3,366,416 86,765 11,377 131
Michigan 2,810,173 63,566 7,912 124
New Hampshire 430,572 9,385 1,373 146
Pennsylvania 7,665,111 202,631 28,377 140
Rhode Island 542,610 ([47])6,595 ([47])1,111 ([47])168
Vermont 355,956 7,343 791 168
           
REGISTRATION CITIES OF 50,000 POPULATION OR OVER IN 1910.        
           
Connecticut:        
    Bridgeport 102,054 2,976 367 123
    Hartford 98,915 2,411 286 119
    New Haven 133,605 3,772 406 108
    Waterbury 73,141 2,150 320 149
           
Washington, D. C. 331,069 7,016 1,068 152
Portland, Me. 58,571 1,163 167 144
           
Massachusetts:        
    Boston 670,585 17,760 2,246 126
    Brockton 56,878 1,359 134 99
    Cambridge 104,839 2,462 293 119
    Fall River 119,295 4,591 854 186
    Holyoke 57,730 1,702 362 213
    Lawrence 85,892 3,165 529 167
    Lowell 106,294 2,630 607 231
    Lynn 89,336 2,218 216 97
    New Bedford 96,652 3,873 685 177
    Somerville 77,236 1,728 174 101
    Springfield 88,926 2,438 302 124
    Worcester 145,986 3,918 536 137
           
Michigan:        
    Detroit 465,766 11,960 2,138 179
    Grand Rapids 112,571 2,693 329 122
    Saginaw 50,510 897 130 145
           
Manchester, N. H. 70,063 1,939 375 193
           
New York, N. Y. 4,766,883 129,316 6,159 125
    Bronx Borough 430,980 10,926 11,047 96
    Brooklyn Borough 1,634,351 43,128 5,063 117
    Manhattan Borough 2,331,542 66,112 8,900 135
    Queens Borough 284,041 7,095 865 122
    Richmond Borough 85,969 2,055 284 138
           
Pennsylvania:        
    Allentown 51,913 1,406 202 144
    Altoona 52,127 1,392 166 119
    Erie 66,525 1,713 197 116
    Harrisburg 64,186 1,308 169 129
    Johnstown 55,482 1,628 268 165
    Philadelphia 1,549,008 38,666 5,334 138
    Pittsburgh 533,905 15,059 2,259 150
    Reading 96,071 2,370 336 142
    Scranton 129,867 3,512 520 148
    Wilkes-Barre 67,105 1,840 269 146
           
Rhode Island:        
    Pawtucket 51,622 ([48]) 191 ([48])
    Providence 224,326 ([48]) 827 ([48])

44.  Exclusive of stillbirths.

45.  Provisional figures; exclusive of stillbirths.

46.  Based on provisional figures for births.

47.  The figures for Rhode Island are exclusive of Providence and Pawtucket.

48.  Returns of births not received from State board in time for inclusion.

It will be seen by this table that Johnstown is among the 10 cities of more than 50,000 population which had an infant mortality rate of 1910 in excess of 150 per 1,000 births. These 10 cities and their respective rates are as follows: Lowell, Mass., 231; Holyoke, Mass., 213; Manchester, N. H., 193; Fall River, Mass., 186; Detroit, Mich., 179; New Bedford, Mass., 177; Lawrence, Mass., 167; Johnstown, Pa., 165; Washington, D. C., 152; and Pittsburgh, Pa., 150.

It should be borne in mind that the absolute infant mortality rate of 134, computed for the group of babies included in this investigation, that is, for those born in Johnstown in 1911, can not be compared with any of the approximate rates in the foregoing table, since the basis of computation is entirely different. But the method used in this report seemed to be the only practicable one for our purpose, namely, to measure the infant mortality rate in different districts of the city where the babies are subjected to varying conditions.

Conditions similar to those existing in Johnstown were found in Chicago by Dr. Alice Hamilton, Bacteriologist in the Memorial Institute for Infectious Diseases, Hull House. The results of a study made of 1,600 families in the neighborhood was published in 1910. The investigation was undertaken to find out the truth or falsity of a general feeling among the district nurses that a high birth rate was accompanied by a high death rate. It was found that a high birth rate was not so much accompanied as outrun by a high death rate. The number of children live-born was compared with the number of children who reached the age of three, so it is a study of child mortality, rather than of infant mortality. The child mortality rate rises and falls very much as does the infant mortality rate in Johnstown. A table calculated from the data of all the families shows an ascending mortality rate:

No. in Family Child Mortality Rate
4 children and less 118
6 children and more 267
7 children and more 280
8 children and more 291
9 children and more 303

Expressed in words this table says that child mortality increases as the number of children per family increases, until we have a death rate in families of eight and more, which is two and a half times as great as that in families of four children and under.

FOURTH ANNUAL REPORT OF THE CHIEF, CHILDREN’S BUREAU, U. S. DEPARTMENT OF LABOR, Washington,
October 7, 1916

INFANT MORTALITY—MANCHESTER

The findings of the bureau’s earlier study in Johnstown, Pa., are confirmed in many respects by the findings in Manchester—the coincidence of a high infant mortality rate with low earnings, poor housing, mother’s work, and large families.

The mortality rate among the 1,564 live-born babies studied in Manchester was 165 per 1,000 births, which is considerably higher than the estimated rate for the whole country.

Manchester is primarily a textile town, and the textile mills employed 36.3 per cent. of all the fathers of babies born in Manchester during the 12 months covered by the study. Of the fathers, 13.7 per cent. were earning less than $450 per year; 48.5 per cent. less than $650; 22.9 per cent. $850 or more; 6.4 per cent. $1,250 or more.

Of the babies with fathers earning less than $450, about 1 in 4 died before it was 12 months old. The great majority of the babies had fathers in the wage group from $450 to $849, and of these about 1 in 6 died. Of the babies whose fathers earned $850 but less than $1,050, 1 in 8 failed to survive. Where the fathers earned $1,050 or more, 1 baby in 16 died in the first year.

Where families lived two or more persons per room, the infant death rate was twice as high as where they lived less than one person per room. The babies living in houses occupied by a single family died at the rate of 86.1 per 1,000, but those in tenements occupied by more than six families died at the rate of 236.6 per 1,000.

When the mother was a wage earner the baby’s chances of living were less than when she was not. Babies of mothers who had worked at some time during the year before the baby’s birth died at the rate of 199.2 per 1,000, while babies of nonworking mothers died at the rate of 133.9. Babies of mothers employed away from home some time during the year after childbirth while the baby was still alive and under four months old had a rate of 277.3, while babies of mothers not employed during that time had a rate of 122.

Babies of foreign-born mothers did not fare so well as babies of native mothers. The differences of rates, however, are only partly accounted for by their lower earnings. The largest foreign element in Manchester is Canadian French, and among them the infant mortality rate, 224 per 1,000 live births, is greater than that among any other group of the population, although their earnings are in general higher than those of other foreigners.

Sheer size of family appears to be one factor in this high Canadian-French rate, one-third of their babies being sixth or later in order of birth, while over one-sixth of these mothers had had from 9 to 18 children. These Canadian-French babies in families of 6 or more children died at the rate of 246.2 per 1,000 and the rate rises to 277.2 per 1,000 when only babies ninth or later in order of birth are considered.