_INFANT MORTALITY._
The Registrar-General’s Returns--Town _versus_
Country--Selected Districts--Age-periods and Mortality--Causes
of Death--Preston, Leicester, Blackburn--Relation of Married
Women’s Labour to Infant Mortality--Dr. Tatham’s Evidence--Dr.
Farr’s Tables--Recent Statistics--Deterioration of Survivors.
=The Registrar-General’s Returns.=--It is obvious that the influence
of occupation upon the health of married women cannot be adequately
considered without some inquiry as to its effects upon the life and
health of their children. As is the case with so many other vitally
important branches of industrial life, there is but scanty information
of a statistical kind here to guide us, though there is enough
local information, taken in conjunction with the general statistics
which are published from time to time by the Registrar-General, to
establish a close relation between the employment of married women
and a high infantile rate of mortality. In his annual report, the
Registrar-General goes into the subject in some detail. He begins by
pointing out that the year 1891 showed that the proportion of deaths
of infants under one year to a thousand registered births was 149
per thousand, a proportion which was equalled in 1886, and slightly
exceeded in 1890, but was otherwise higher than in any year of the
preceding decennium. He remarks upon the wide differences to be found
between the rates in the various counties, and the persistence of these
differences from year to year; “the general rule being that the rate is
lowest in the purely agricultural, and highest in the mining counties
and those of the textile industries. It is in the towns of these latter
counties that the infantile mortality assumes the highest proportion;
the three towns which are invariably, or almost invariably, the worst
in this respect being Preston, Leicester, and Blackburn.”
This is highly significant, and but for the fact that statistics have
been successful in isolating several towns associated with certain
industries in which married women are very largely employed, it might
have been urged that the high rate of mortality in the towns was simply
due to density of population, lack of fresh air, space, and sunlight.
But the Registrar-General, by the tables which he has compiled in his
last report, enables us to judge as to the effect upon child life,
first, of country air and conditions; secondly, of the average urban
conditions; and thirdly, of urban conditions plus the employment of
women in factory labour. Seeing that Preston, Leicester, and Blackburn
had the highest infantile death-rates of all the towns included in the
weekly returns from 1881 to 1891, he has selected them for what we will
call Group III. Then he has taken five mining or industrial counties,
namely, Staffordshire, Leicestershire, Lancashire, West Riding, and
Durham; and three agricultural counties, namely, Hertfordshire,
Wiltshire, and Dorsetshire. With the help of the death registers of the
various counties and towns for the years 1889, 1890, and 1891, tables
have been prepared showing the causes of death and the exact ages of
infants under a year old who had died, out of one hundred thousand born
in each of the various districts.
---------+------------------------------+----------------------------
| Of 100,000 born, the numbers | Annual Death Rates per 1000
Age. | surviving at each age. | living in each successive
| | interval of age.
---------+---------+----------+---------+---------+---------+--------
| Three | Five | Three | Three | Five | Three
| Rural |Mining and|Selected | Rural |Mining & |Selected
|Counties.| Manuf’g | Towns. |Counties.|Manuf’g | Towns.
| | Counties.| | |Counties.|
---------+---------+--- ------+---------+---------+---------+--------
At Birth | 100,000 | 100,000 | 100,000 | 213 | 331 | 382
3 mths. | 94,820 | 92,051 | 90,874 | 75 | 154 | 240
6 ” | 93,068 | 88,574 | 85,574 | 61 | 128 | 180
12 ” | 90,283 | 83,081 | 78,197 | -- | -- | --
---------+---------+----------+---------+---------+---------+--------
=Age-periods and Mortality.=--The table shews at a glance that there
are more than double as many deaths in the selected towns as in the
rural counties--22,000 as against 10,000, whilst the manufacturing
counties stand at 17,000. It must, however, be observed that this
last group contains the textile districts and various other typically
unhealthy trade areas, so that it is scarcely a fair criterion. An
examination of more detailed statistics which have been reduced to a
tabular shape shew, as the Registrar-General points out, that in the
rural counties and the three selected towns the mortality is at its
maximum in the first week, falls heavily in the second week, remains
at much the same level during the third week, and then shews a fresh
very considerable decline in the fourth. To summarise his conclusions
as to the points of likeness between counties and towns: “Both shew an
excessively high mortality in the earliest days of life, which becomes
less and less as days, weeks, and months pass by, until the seventh
or eighth month has elapsed, when the decline either is arrested or
becomes very much smaller. In both the mortality is so high in the
first three days, or even in the entire first week, that, were it
maintained without diminution, every infant would die without nearly
completing one year of its existence.” But now coming to the points
of difference. We have seen in the first place that the town rate is
more than twice as high as the country. But the town rate is not merely
higher for the whole period, but higher for each fraction of the year.
Moreover, the town rates are most in excess of the country ones, not
in the earliest weeks or months of infancy, but in the later months.
“In the first week of life, the town rate exceeds the rural rate by 23
per cent., in the second week by 64 per cent., in the third week by 83
per cent., and in the fourth week by 97 per cent. The same result comes
out when the rates for successive months in the counties and towns are
examined. In the first month the town mortality is 27 per cent. above
the rural rate, in the second month 121 above it, and the excess then
goes on increasing until in the sixth month it amounts to no less than
273 per cent. This is the month in which the difference is greatest,
though it remains throughout the rest of the year at a not very much
lower point.” This progressive increase is a most significant fact,
and it is much to be wished that instead of concluding his examination
at the limit of one year of age, the Registrar had continued it, say
up to five years, so that he might have been able to form some notion
of the further loss of life which falls upon the children in the
districts where their mothers are employed in the mills and factories.
There is not space here to reproduce the two tables in which the
Registrar-General enumerates the causes of death in the rural and town
districts, together with the ages at which death takes place. But
these tables are of such extreme importance that it may be well to
compare some of the more general causes of death.
-------------------------------+----------+---------------
| | Preston,
CAUSES. | Rural | Leicester,
|Districts.|and Blackburn.
-------------------------------+----------+---------------
Premature Birth | 1381 | 2279
Diarrhœal Diseases | 481 | 3961
Convulsions and Diseases of | |
the Nervous System | 1381 | 3776
Diseases of Respiratory Organs | 2105 | 3701
Atrophy | 1738 | 2734
----------------------------------------------------------
The following table shews the period of death in the two districts
respectively:--
----------+----------------+-------------------
| |Preston, Leicester,
Age. |Rural Districts.| and Blackburn.
----------+----------------+-------------------
| Deaths. | Deaths.
1 Month | 3488 | 4947
2 Months | 985 | 2130
3 ” | 707 | 2049
4 ” | 673 | 1967
5 ” | 618 | 1749
6 ” | 461 | 1584
7 ” | 483 | 1475
8 ” | 483 | 1226
9 ” | 454 | 1317
10 ” | 476 | 1220
11 ” | 455 | 1110
12 ” | 434 | 1029
----------+----------------+-------------------
=Relation of Married Women’s labour to Infant Mortality. Dr. Tatham’s
Evidence.=--The most striking difference between the rural districts
and the selected towns is in the case of diarrhœa, which, taken with
enteritis, shews a mortality seven times as great in towns as in the
country. These figures tell their own tale, but it may be well to add
the testimony of Dr. Tatham, for many years the medical officer for
Manchester and Salford, as given before the labour Commission. “In the
year 1881 my attention was first seriously directed to the employment
of young mothers in factories, in the course of my investigations
concerning the causes of our abnormally heavy infant mortality, Salford
being one of the great English towns in which infant mortality was
year after year notoriously excessive. As a result of anxious inquiry,
extending over many years, I was, and still am, convinced that very
much of that excessive mortality was due to infant neglect, consequent
on the withdrawal of maternal care within a few weeks of the birth
of the children. In consequence of this practice the infants were
frequently consigned to the care of some ignorant neighbour, or were
nursed at home by an older child of the family. The children were
artificially and often improperly fed, and a heavy death-roll was the
ultimate result.”
Questioned by the Chairman as to the time, in his opinion, a mother
should remain at home after the birth of the child, Dr. Tatham said, “I
should not be consistent if I said less than six months.”
“That of course in your opinion would have a very important influence
upon the rate of mortality?” “I think it would.”
“And upon the nurture of the children?” “I think so.”
“Is it within your experience that a considerable number of young
married women work in factories?” “A very large number.”
“You speak of the effect upon infant mortality; could you say anything
of the effect upon the mothers themselves?” “I have no doubt that
the health of the mothers will be damaged. It must be so, I am sure;
that part of the subject has not engaged my attention so much as this
terrible question of infant mortality.”
It may also be interesting to add the one question which was asked
by the representative of the manufacturing interest, Mr. Tunstill, a
cotton spinner--“Have you considered the financial question that is
involved in this recommendation of yours?” And the answer, “I have
purposely avoided that; I leave that to those much better able to judge
of it than I am.”
=Dr. Farr’s Tables.=--It is most unfortunate that there should be such
a lack of medical and statistical evidence as to the effect of factory
labour upon the health of mothers. For this, I suppose, we shall have
to wait for the gradual development of the human element in statistical
science, though local medical evidence can be produced to shew the
mischief that is constantly caused to the mother’s health. This
question of infant mortality is at any rate beyond the region of the
speculative, and all schools of thought, however divided they may be
by the great controversy between freedom and the regulation of women’s
labour, must be agreed that it would be nothing short of a national
disgrace to allow matters to drift on year after year as they have
been doing for many years past. It is now twenty years since Dr. Farr,
the great health statistician, shewed the waste of life that was going
on in the textile centres. He took the towns of Oldham, Nottingham,
Manchester, Salford, Leeds, Norwich, Portsmouth, and London, found
the number of women of twenty years and upwards who were engaged in
the textile manufactures and household duties in each, and then worked
out the particulars of infant mortality from 1873 to 1875. The result,
which is to be found in a table in his work on _Vital Statistics_, is
extremely striking. Thus, in Oldham, where 11,178 women were set down
as engaged in textile manufacture, out of a total of 32,343 women of
twenty years of age and upwards, the infant death rate per thousand
births stood at 180; in Nottingham, where upwards of half the women
were similarly employed, at 200; in Manchester and Salford, where a
quarter of the women were engaged in textile manufacture, at 188; in
Portsmouth, where there is no textile work, 146; and in London, where
there is also none, 159.
=Recent Statistics.=--But in 1891 the infantile death rate in the
worst textile towns exceeded any of the figures produced by Dr. Farr.
Thus in Preston the mortality was 220. There is a slight improvement,
but only slight, in the other towns investigated by Dr. Farr. Thus
in Oldham the rate is 171 instead of 180, in Manchester 178 instead
of 188. None of the figures that have been published, however, give
anything like an adequate account of the real state of affairs. What we
want is a statement confined to the children of those employed in any
given industry where married women’s labour is prevalent. To take an
entire town like Manchester or Salford is only to approximate to the
facts. In both these towns there are healthy suburbs and large numbers
of well-to-do people whose children are taken away every year to the
seaside, and there are many industries which are healthy, and where no
women’s labour is employed. But anyone who cares to take the trouble
to examine the Registrar’s report, and to work out the death rates of
the poorer quarters of Manchester and Salford, Bradford, Burnley, and
Blackburn, or to take the Potteries and make similar calculations for
Hanley, Burslem, and Stoke will be appalled by the contrast between the
figures of those places and the rural death rate. He will find that,
instead of being twice as high, the rate of infant mortality is even
four or five times as high as in the country districts. Such figures
as we have however, are sufficient, as I have said, to shew the close
connection between the employment of mothers in mills and the death of
children.
=Deterioration of Survivors.=--As to the deterioration of the survivors
there can be no question. The evidence of Dr. Tarrop, quoted before,
and of other certifying surgeons is conclusive on this point. That
school of thought which frames its industrial policy on the theory of
the survival of the fittest, can scarcely point to any very triumphant
results in the districts which we have been considering. They may
assert, and will no doubt continue to assert, that the wholesale
sweeping-off of damaged lives in the early months is a great boon
to the race, and that the survivors, having stood the ordeal, are
presumably more or less seasoned for the discharge of their functions.
It must be pointed out, however, that the tests applied are one and
all unnatural ones, and that if the laws of nature are to be consulted
we shall be right in assuming that the children who have died are
those who were best fitted to live. For what are we to think of the
standard of living which subjects all new-comers to their capacity
of assimilating adulterated and unhealthy food, dispensing with
maternal care, breathing air which is foul, and existing without
sunshine? Yet this is the kind of test which the pseudo-scientists of
the day are so proud of applying, and the result is a weedy, sickly,
unnatural generation, brought up without regard to any one of the
most fundamental laws of nature. It would be every bit as reasonable
to evolve a system of botany which rejected, as extinct or dying,
families of plants, which could not be cultivated in a dark chamber or
in a refrigerator, as to create conditions of industrial life without
reference to the laws of nature or the teachings of health, and then to
argue that the fitness of the race depends upon compliance with them.