TABLE NUMBER XXVCauses of Deaths of Children Under 5 Years of Age.Burns1Malnutrition4Syphilis4Tuberculosis Meningitis3Pneumonia51Tuberculosis5Enteritis21Premature9Meningitis2Bronchitis4Influenza2Asphyxia4Hemorrhage1Convulsions6Diphtheria2Rickets1Heart Disease8Mumps1Poliomyelitis1TOTAL130
TABLE NUMBER XXV
Causes of Deaths of Children Under 5 Years of Age.
That the infant mortality rate among colored people is much higher than among the white groups, is generally believed and it is not surprising to find that the mortality among Negro infants in Pittsburgh is much greater than the infant mortality rate for the entire city. Figures for the year 1916-17 were unobtainable. The records of the Department of Health show that during the year 1915 one hundred and four children per thousand born in Pittsburgh, died in their first year.
There were three hundred and fifty-six Negro births in the first seven months of 1917. During the same period eighty-seven Negro children died under one year. Of this number fifty-nine had been born between January and July 1917, which means that one hundred and sixty-six children per thousand die in their first seven months. This clearly indicates that the death rate of Negro infants is far above the death rate of white infants.TableNo.XXValso shows the cause of deaths of children under five years of age who died within the last seven months. At least half of these deaths were due to preventable disorders, as is apparent from the figures in the same table.
TABLE NUMBER XXVI
Colored Bodies Received and Disposed of in Morgue, First Six Months During 1915 as Compared with First Six Months During 1917.
The figures obtained from the Coroner’s Office also indicate an abnormal increase in the number of colored bodies received and disposed of by the County Morgue. There were more than twice as many morgue cases within the first six months of 1917 as during the same period of 1915. That the majority of these bodies were claimed and not disposed of at public expense, is doubtless due to the high wages paid this year. High wages at least provide for burials, which are considered of paramount importance by the Negroes, because of their primitivesuperstition, and abhorrence of having their bodies turned over for the purpose of dissection.
The preceding analysis indicates that the conservation of the health of the Negro in Pittsburgh is a very complex problem, and is inter-related with his social, moral, industrial, housing and racial situation. The Negro is affected by all the elements which render difficult the preservation of health among whites but in a greater degree. Many of the factors which work continuously to undermine his health are to a large extent eliminated among whites; and on the other hand, much of the effective work done by whites to counteract these bad influences is entirely lacking among Negroes.
“The Triad of ‘baby-killers’—poverty, ignorance and neglect”—saysDr.Sobel, of the New York Health Department, “works havoc among Negro children to a greater extent even than among the whites.”
“The well known relationship between family income and infant mortality exists among Negroes as among the whites. The crude death rate is exceedingly high in all Negro districts. There are, however, well-defined differences in their respective rates, resulting, we think, from economic conditions. In the districts where the family income is highest, the death rate is lowest, confirming the opinion that if we can improve the social and economic condition of the Negro, an appreciable reduction in their death rate will have been secured.” (August, 1917 Bulletin of the Department of Health, New York City, pages 87 and 88.)
While we may admit the claim often advanced that even under the same conditions disease and infant mortality among Negroes would ordinarily be higher than that of the whites, because, due to the climatic and environmental maladjustments, his racial power of resistance is not as great as that of the white; the Negro is still confronted with many forces which handicap and work against him, but which are almost non-existent among the whites.
From our discussion of employment, housing and opportunities for advancement in Pittsburgh, the reader will realize the difficulties and hardships which the Negro is compelled to face in this city. Only a very few of the Negro migrants earn more than $3.60 a day for twelve hours work. Half of the families here live in one room dwellings. Practically all of the mothers are doing some work outside the home. The Negroes have as yet no organization for mutual co-operation. They live separate and apart from each other. In many casesfor instance, it was found in our survey, that women living next door to each other for months would hardly know one another, although often they would both come from the same state and even from the same city. The Negroes are more exposed and liable to disease because their social, industrial, educational and moral development is more handicapped than that of the white man. The Negro is apparently as yet not free even in the North; he is still held captive in economic bondage, and is deterred from rising above the lowest servant class. He is, judging from the present situation, limited to common labor at thirty cents an hour during prosperous times.
The conservation of health, is as we have seen, no longer the problem of the individual. It is therefore time that we awaken to the realization that sickness and a high mortality rate among Negroes is no longer the problem of the Negro alone. Eventually all of us will have to pay the price for our indifference, both in money and in lives. The taxpayer ultimately pays for hospitals and morgues, as well as for jails and prisons. Our children are not at all immune from the sources of disease which are ravaging the colored children. This problem is our problem; we must face it squarely, and see whether any improvement in this situation is possible.
The significance of such a study and its importance as the basis for a practical program is clearly demonstrated by the remarkable results brought about in New York City through a similar study. After a survey of conditions in the Columbus Hill District, the Negro section of the Borough of Manhattan the startling evidence of conditions prevailing there stimulated the New York Bureau of Child Hygiene to take action. This Bureau has succeeded in reducing the infant mortality rate among colored people from 202 deaths per thousand children born in 1915 to 193.3 in 1916, and to 180 per thousand children born during the first six months of 1917.
Dr.Jacob Sobel, Chief of the Division of Baby Welfare, writes as follows in one of the recent monthly bulletins of the New York Department of Health.[9]
“The stimulus to our program was given by a study of conditions in the Columbus Hill District, and it was here that our efforts were first concentrated. It was our knowledge of the conditions in this district which led to an effort on the part of the Bureau of Child Hygiene to institute a campaign against the excessive death rate among colored infants, by studying primarily the needs of the situation, and by securing the co-operationof all agencies and individuals interested in the welfare of colored people. With this end in view, there was first instituted a preliminary census of the babies residing in the above district, by house to house canvas, and an effort was made to have these babies enrolled at the Baby Health Station within said district. Mothers’ meetings were held at schools, settlement houses, churches, etc., at which the physicians of the Health Department gave short talks to the parents of the neighborhood. The co-operation of prominent colored citizens, ministers, physicians, newspaper men, etc., of the district, was secured. Educational slides, containing pointed references to the high mortality among colored babies, and special reference to the high mortality in particular sections inhabited by colored people, were prepared and displayed on the screens of the various moving picture houses in this and other districts.
“A series of articles on baby care was published in one of the newspapers read largely by the colored race, namely, ‘The Amsterdam News’, under the title of ‘The Baby’, and presented short heart-to-heart talks on baby care. The Department of Health also published a local bulletin for this district, known as ‘The Columbus Hill Chronicle’, in which special attention was directed to conditions among the colored population, with specific recommendations for the improvement of their health and surroundings.
“In view of the large number of working mothers among the colored people, a temporary shelter or day nursery for colored babies was established in this district through the co-operation of the Babies’ Welfare Association, and funds have subsequently been provided, through private means, for the permanent equipment and maintenance, in the heart of this district, of a day nursery for colored children.
“The ‘Little Mothers’ of this district was organized, and in this way a large amount of education was brought into the homes.
“Immediately upon the receipt of notification of births in this and other colored districts, the Bureau of Records notified the Baby Health Station, in order that the home might be visited, and the infant enrolled for care and treatment.
“Special attention was directed to the supervision of colored babies boarded out in the homes, and wherever a colored baby was found, not a relative of the occupant of the premises, information was elicited whether this individual had a permit to board and care for a baby, as required by the provisions of the Sanitary Code.
“Provision was made for the distribution of free milk and free ice, to needy families of the districts, through the organized relief agencies and ice companies.
“Special attention was directed towards securing employment for the fathers, so as to keep the mothers at home as much as possible.
“To supplement the work of baby care, two nurses were assigned by the Department of Health to the Columbus Hill and Upper Harlem Districts, for instruction and supervision of expectant mothers. The Association for Improving the Condition of the Poor also assigned a nurse to the Columbus Hill District for similar instruction, so that a beginning was made to bring the colored expectant mother under the guiding influence of trained nurses.
“The co-operation of the Tenement House Department was affected to the extent that special attention was given to the sanitary condition of the tenements occupied by colored people.
“In a further effort to control the mortality among the colored babies, the policy of the Bureau to assign nurses during the summer months to those districts of the city showing a high infant mortality rate and a high birth rate, was applied with special reference to the colored sections, and a large force was assigned there, each nurse having under her direct charge from 100 to 150 babies during these months, keeping up this complement whenever, through death or removal, the number fell below the required amount.”
It is inevitable with any group, suddenly transferred into a new situation, that striking maladjustments should arise. While single instances of suffering very often are misleading and do not give a just view of the case, numerous and typical incidents which are by no means exceptional or exaggerated may help to visualize the problem.
A Georgia farmer who is making $3.60 a day for twelve hours of work here brought over his wife and eight children, the oldest of whom was thirteen years of age, to a house which he was fortunate to secure on Second Avenue. Only a few weeks after his arrival all of the eight children were taken sick, and two of them, one eleven and the other six years old, died of pneumonia. Because of the contagion of some of his children the man was unable to leave his house for eight weeks. His physician said that the death of the children was due to the over-crowded condition of the house. This man received no charity and the money he had saved up was spent to the last cent on doctor bills.
Mrs. E. H. lives on Crawford Street with her three children the oldest of whom is five years of age. She occupies a small and damp room. Since there is no gas in the house, a red hot stove can always be found burning in the room which is at the same time kitchen, dining room, bedroom and washroom; for Mrs. H’s husband is in jail somewhere in Georgia, and she does washing all day in order to support her children. The water supply of the house is in the street, and the stairway leading to the upper floors is in her room. All of her children were sick; one had pneumonia. She came here a few months ago as everybody else was coming. Relatives and charity are helping to support her.
Mr.F. J. P. was born in Jamaica of well-to-do parents, tobacco planters, and was educated in England as a botanist. He works now as a common laborer in Pittsburgh for he cannot secure work in his own field; he is planning to go back to England.
Mr.J. D. has had his wife here for several months, but still has his only child back in Florida as there is no room for him in his present place.
Messrs.. E. and R. Smith, one living on Penn Avenue, and the other on Ross Street, worked for a steel plant and construction company respectively. E. had an eye accident and was in the hospital for four weeks, while R. had two fingers cut off while at work. The companies paid the hospital bills for both but neither one of them ever heard or knew anything about compensation, and never claimed any.
J. G. hails from West Virginia. He has been in town for two days and has no room as yet. The lodging places he went to asked seventy-five cents a night for a dirty bed. He stayed up both nights, and expects to leave the city as soon as he can.
The Case family have eight children. The oldest is a girl of seventeen years of age who works in a hotel. The mother works every day in the week; she leaves home at seven in the morning and returns at five o’clock in the afternoon. A girl of fifteen takes care of the children in the meantime.
Mr.P. Roberts was a prosperous Negro in Florida. He was an experienced concrete maker, earning according to his statement more than five and six dollars a day at home, and owning property in the South. When the industrial boom began he thought that the wages in his line were much higher here than in his own home town, and that it would pay him to come North. He came to Pittsburgh together with his wife, five children and an old invalid mother who was confined to bed. When firstvisited,Mr.Roberts occupied two small rooms, each having one window, in a rooming house where there were about twenty-five male roomers. This man could get no work here in his own trade, and was trying to save up enough money from his $3.00 to $3.60 a day to go back to Florida. When Roberts was visited again about six weeks after the first visit, his old mother had already passed away, his wife had died of pneumonia, while his oldest girl of sixteen who had been taking care of the four little tots was sick in bed, and the children were playing on the streets. Roberts was still trying to save from his $3.60 a day sufficient money to carry him back to Florida, which he still considers his home, as he owns property there.
These amazing instances of individual maladjustments are bound to arise in any group which goes through such a sudden and abnormal transformation. But they are even more frequent in the race which is still primitive and child-like in many ways, with no one to direct, guide and protect them.
But the significance and danger of these wrongs are even of greater importance for the community as a whole, than for the few individuals affected. The fact cannot be over-emphasized that the community ultimately pays the price for its stupidity. Indifference to this problem at present when it still can be coped with and adjusted will result in an uncontrollable situation later. We have seen above some of the costly results of our housing and wage conditions. We have also learned in this war that we can no longer afford to breed and foment discontent and antagonism among our own people. We must not only see that the strangers among us are adjusted, but that they also do not become a menace to the well-being of the community.
It is not sufficient that we bring these people here, give them a “bunk-house” or a basement to sleep in, and a job in our mills for twelve hours a day. Once these people are in our midst they become a part of ourselves, and if we desire them to work in harmony with our own interests and not become anti-social malcontents we must go further than that. We must see that they become part and parcel of our community, that they are educated and made familiar with the problems that we are facing locally. The man who is here for several days and stays up all night because he can find no place to sleep cannot be expected to remain for long a social being. Pittsburgh’s progress will be greatly handicapped if a certain element of our community has to take advantage of the saloonand vice resorts for relaxation. Neither can we afford to let a considerable part of our voting population remain, because of lack of intelligence, the prey and spoil of politicians who may jeopardize the whole life of the city for their own selfish interest. We cannot permit sickness and high mortality rates among the dark-skinned people. One of our big steel mills had to have its whole office and plant forces vaccinated, and was even in danger of being quarantined, when a number of Negroes working in the plant scattered all over the city after a case of smallpox was discovered in the rooming house where these men stopped. The Department of Health had a big task hunting these men, and the danger to which the whole city population was exposed was obvious. No more can we afford to let the Negroes become the victims of all sorts of anti-social elements and feel complacent after we send them for a period of time to the jail or workhouse. They are a heavy burden upon the taxpayer while they are in these Institutions and often become even a greater menace when they are released. Our utmost attention is therefore essential to meet the maladjustments before they have become acute; and we do not base this claim upon sentimental grounds but upon the benefits of economic and social far-sightedness.
Many Negroes in the North seem to understand the situation, and are striving to do their best to help adjust conditions. Some of the Negro churches in this city for instance tried to ameliorate the housing conditions by converting their churches into lodging places for the newcomers until rooms could be found for them. Besides the Provident Rescue Mission on Fullerton Street, which accommodated thirty to forty men at a time during the entire winter, at least one other church converted the entire building into quarters for migrant families. The latter church accommodated a number of families until the committee in charge could secure homes for the newcomers. But the responsibility of the white people is just as great, and it is indeed in very opportune time that a prophetic warning is sounded by a colored writer in a Cleveland paper as follows:
“Let them alone—permit them to grope blindly through the mazes of startling new environments, and in a few years a social problem will be created that will require a half century and millions of dollars to solve.”
“Let them alone now, permit and enforce them to live in unsanitary districts and homes, relieved of Christian and moral influence, and what is perhaps a 20,000 responsibility today, will become a 50,000 heavy, crime-breeding burden tomorrow.”
“Let them alone today, permit them to become the flotsam and jetsam of neglect, or pernicious discrimination—such as they were in the South—and tomorrow, having inhaled a bit of Northern freedom, they may become a dark, sinister shadow falling athwart the white man’s door.”
“Let them alone today, permit them to be retired to over-crowded shacks and shanties where sanitation is an unuttered word, and tomorrow, contagions, arising from these congested, unsanitary shanties and shacks, will fly, like the black bat of night, over our fair city, and in its wake will stalk the gaunt form of Death, claiming thousands of our best white and Colored citizens as a debt paid for inaction.”
[9]August, 1917 Bulletin of the Department of Health, New York City.