CHILD MORTALITY IN FAMILIES OF LONG-LIVED STOCK, GENEALOGICAL RECORD OFFICE DATA

Size of No. of families No. of families Total no.

family investigated showing deaths of deaths under 5 years

1 child 6 0 0 2 children 6 0 0 3 " 38 4 5 4 " 40 6 7 5 " 38 4 4 6 " 44 12 13 7 " 34 8 11 8 " 46 13 18 9 " 31 14 20 10 " 27 14 14 11 " 13 6 9 12 " 13 9 16 13 " 1 0 0 14 " 2 0 0 17 " 1 1 2 --- --- --- 340 91 119

The addition of the new families (which were not subjected to any different selection than the first 100) has brought down the child mortality rate. For the first 100, it was found to be 7.5%. If in the above table the number of child deaths, 119, be divided by the total number of children represented, 2,259, the child mortality rate for this population is found to be 5.27%, or 53 per thousand.

The smallness of this figure may be seen by comparison with the statistics of the registration area, U. S. Census of 1880, when the child mortality (0-4 years) was 400 per thousand, as calculated by Alexander Graham Bell. A mortality of 53 for the first four years of life is smaller than any district known in the United States, even to-day, can show for the _first_ year of life _alone_. If any city could bring the deaths of babies during their first twelve months down to 53 per 1,000, it would think it had achieved the impossible; but here is a population in which 53 per 1,000 covers the deaths, not only of the fatal first 12 months, but of the following three years in addition.

Now this population with an unprecedentedly low rate of child mortality is not one which had had the benefit of any Baby Saving Campaign, nor even the knowledge of modern science. Its mothers were mostly poor, many of them ignorant; they lived frequently under conditions of hardship; they were peasants and pioneers. Their babies grew up without doctors, without pasteurized milk, without ice, without many sanitary precautions, usually on rough food. But they had one advantage which no amount of applied science can give after birth--namely, good heredity.

They had inherited exceptionally good const.i.tutions.

It is not by accident that inherited longevity in a family is a.s.sociated with low mortality of its children. The connection between the two facts was first discovered by Mary Beeton and Karl Pearson in their pioneer work on the inheritance of duration of life. They found that high infant mortality was a.s.sociated with early death of parents, while the offspring of long-lived parents showed few deaths in childhood. The correlation of the two facts was quite regular, as will be evident from a glance at the following tables prepared by A. Ploetz:

LENGTH OF LIFE OF MOTHERS AND CHILD-MORTALITY OF THEIR DAUGHTERS.

ENGLISH QUAKER FAMILIES, DATA OF BEETON AND PEARSON, ARRANGED BY PLOETZ

Year of life in which mothers died At all 0-38 39-53 54-68 69-83 84 up ages

No. of daughters 234 304 305 666 247 1846

No. of them who died in first 5 years 122 114 118 131 26 511

Per cent. of daughters who died 52.1 37.5 29.9 19.7 10.5 27.7

LENGTH OF LIFE OF FATHERS AND CHILD-MORTALITY OF THEIR DAUGHTERS

Year of life in which fathers died At 0-38 39-53 54-68 69-83 84 up all ages

No. of daughters 105 284 585 797 236 2009

No. of them who died in first 5 years 51 98 156 177 40 522

Per cent. of daughters who died 48.6 34.5 26.7 22.2 17.0 26.0

To save s.p.a.ce, we do not show the relation between parent and son; it is similar to that of parent and daughter which is shown in the preceding tables. In making comparison with the 340 families from the Genealogical Record Office, above studied, it must be noted that Dr. Ploetz' tables include one year longer in the period of child mortality, being computed for the first five years of life instead of the first four. His percentages would therefore be somewhat lower if computed on the basis used in the American work.

These various data demonstrate the existence of a considerable correlation between short life (_brachybioty_, Karl Pearson calls it) in parent and short life in offspring. Not only is the tendency to live long inherited, but the tendency _not_ to live long is likewise inherited.

But perhaps the reader may think they show nothing of the sort. He may fancy that the early death of a parent left the child without sufficient care, and that neglect, poverty, or some other factor of euthenics brought about the child's death. Perhaps it lacked a mother's loving attention, or perhaps the father's death removed the wage-earner of the family and the child thenceforth lacked the necessities of life.

Dr. Ploetz has pointed out[192] that this objection is not valid, because the influence of the parent's death is seen to hold good even to the point where the child was too old to require any a.s.sistance. If the facts applied only to cases of early death, the supposed objection might be weighty, but the correlation exists from one end of the age-scale to the other. It is not credible that a child is going to be deprived of any necessary maternal care when its mother dies at the age of 69; the child herself was probably married long before the death of the mother.

Nor is it credible that the death of the father takes bread from the child's mouth, leaving it to starve to death in the absence of a pension for widowed mothers, if the father died at 83, when the "child" herself was getting to be an old woman. The early death of a parent may occasionally bring about the child's death for a reason wholly unconnected with heredity, but the facts just pointed out show that such cases are exceptional. The steady a.s.sociation of the child death-rate and parent death-rate _at all ages_ demonstrates that heredity is a common cause.

But the reader may suspect another fallacy. The cause of this a.s.sociation is really environmental, he may think, and the same poverty or squalor which causes the child to die early may cause the parent to die early. They may both be of healthy, long-lived stock, but forced to live in a pestiferous slum which cuts both of them off prematurely and thereby creates a spurious correlation in the statistics.

We can dispose of this objection most effectively by bringing in new evidence. It will probably be admitted that in the royal families of Europe, the environment is as good as knowledge and wealth can make it.

No child dies for lack of plenty of food and the best medical care, even if his father or mother died young. And the members of this caste are not exposed to any such unsanitary conditions, or such economic pressure as could possibly cause both parent and child to die prematurely. If the a.s.sociation between longevity of parent and child mortality holds for the royal families of Europe and their princely relatives, it can hardly be regarded as anything but the effect of heredity,--of the inheritance of a certain type of const.i.tution.

Dr. Ploetz studied the deaths of 3,210 children in European royalty, from this viewpoint. The following table shows the relation between father and child:

LENGTH OF LIFE OF FATHERS AND CHILD-MORTALITY OF THEIR CHILDREN IN ROYAL AND PRINCELY FAMILIES, PLOETZ' DATA

At Year of life in which fathers died Years all ages 16-25 26-35 36-45 46-55 56-65 66-75 76-85 86 up

No. of children. 23 90 367 545 725 983 444 33 3210

No. who died in first 5 years 12 29 115 171 200 254 105 1 887

Per cent. who died 52.2 32.2 31.3 31.4 27.6 25.8 23.6 3.0 27.6

Allowing for the smallness of some of the groups, it is evident that the amount of correlation is about the same here as among the English Quakers of the Beeton-Pearson investigation, whose mortality was shown in the two preceding tables. In the healthiest group from the royal families--the cases in which the father lived to old age--the amount of child mortality is about the same as that of the Hyde family in America, which Alexander Graham Bell has studied--namely, somewhere around 250 per 1,000. One may infer that the royal families are rather below par in soundness of const.i.tution.[193]

All these studies agree perfectly in showing that the amount of child mortality is determined primarily by the physical const.i.tution of the parents, as measured by their longevity. In the light of these facts, the nature of the extraordinarily low child mortality shown in the 340 families from the Genealogical Record Office, with which we began the study of this point, can hardly be misunderstood. These families have the best inherited const.i.tution possible and the other studies cited would make us certain of finding a low child mortality among them, even if we had not directly investigated the facts.

If the interpretation which we have given is correct, the conclusion is inevitable that child mortality is primarily a problem of eugenics, and that all other factors are secondary. There is found to be no warrant for the statement so often repeated in one form or another, that "the fundamental cause of the excessive rate of infant mortality in industrial communities is poverty, inadequate incomes, and low standards of living."[194] Royalty and its princely relatives are not characterized by a low standard of living, and yet the child mortality among them is very high--somewhere around 400 per 1,000, in cases where a parent died young. If poverty is responsible in the one case, it must be in the other--which is absurd. Or else the logical absurdity is involved of inventing one cause to explain an effect to-day and a wholly different cause to explain the same effect to-morrow. This is unjustifiable in any case, and it is particularly so when the single cause that explains both cases is so evident. If weak heredity causes high mortality in the royal families, why, similarly, can not weak heredity cause high infant mortality in the industrial communities? We believe it does account for much of it, and that the inadequate income and low standard of living are largely the consequences of inferior heredity, mental as well as physical. The parents in the Genealogical Record Office files had, many of them, inadequate incomes and low standards of living under frontier conditions, but their children grew up while those of the royal families were dying in spite of every attention that wealth could command and science could furnish.

If the infant mortality problem is to be solved on the basis of knowledge and reason, it must be recognized that sanitation and hygiene can not take the place of eugenics any more than eugenics can dispense with sanitation and hygiene. It must be recognized that the death-rate in childhood is largely selective, and that the most effective way to cut it down is to endow the children with better const.i.tutions. This can not be done solely by any euthenic campaign; it can not be done by swatting the fly, abolishing the midwife, sterilizing the milk, nor by any of the other panaceas sometimes proposed.

But, it may be objected, this discussion ignores the actual facts.

Statistics show that infant mortality campaigns _have_ consistently produced reductions in the death-rate. The figures for New York, which could be matched in dozens of other cities, show that the number of deaths per 1,000 births, in the first year of life, has steadily declined since a determined campaign to "Save the Babies" was started:

1902 181 1903 152 1904 162 1905 159 1906 153 1907 144 1908 128 1909 129 1910 125 1911 112 1912 105 1913 102 1914 95

To one who can not see beyond the immediate consequences of an action, such figures as the above indeed give quite a different idea of the effects of an infant mortality campaign, than that which we have just tried to create. And it is a great misfortune that euthenics so often fails to look beyond the immediate effect, fails to see what may happen next year, or 10 years from now, or in the next generation.

We admit that it is possible to keep a lot of children alive who would otherwise have died in the first few months of life. It is being done, as the New York figures, and pages of others that could be cited, prove.

The ultimate result is twofold:

1. Some of those who are doomed by heredity to a selective death, but are kept alive through the first year, die in the second or third or fourth year. They must die sooner or later; they have not inherited sufficient resistance to survive more than a limited time. If they are by a great effort carried through the first year, it is only to die in the next. This is a statement which we have nowhere observed in the propaganda of the infant mortality movement; and it is perhaps a disconcerting one. It can only be proved by refined statistical methods, but several independent determinations by the English biometricians leave no doubt as to the fact. This work of Karl Pearson, E. C. Snow, and Ethel M. Elderton, was cited in our chapter on natural selection; the reader will recall how they showed that nature is weeding out the weaklings, and in proportion to the stringency with which she weeds them out at the start, there are fewer weaklings left to die in succeeding years.

To put the facts in the form of a truism, part of the children born in any district in a given year are doomed by heredity to an early death; and if they die in one year they will not be alive to die in the succeeding year, and vice versa. Of course there are in addition infant deaths which are not selective and which if prevented would leave the infant with as good a chance as any to live.

In the light of these researches, we are forced to conclude that baby-saving campaigns accomplish less than is thought; that the supposed gain is to some extent temporary and illusory.

2. There is still another consequence. If the gain is by great exertions made more than temporary; if the baby who would otherwise have died in the first months is brought to adult life and reproduction, it means in many cases the dissemination of another strain of weak heredity, which natural selection would have cut off ruthlessly in the interests of race betterment. In so far, then, as the infant mortality movement is not futile it is, from a strict biological viewpoint, often detrimental to the future of the race.

Do we then discourage all attempts to save the babies? Do we leave them all to natural selection? Do we adopt the "better dead" gospel?

Unqualifiedly, no! The sacrifice of the finer human feelings, which would accompany any such course, would be a greater loss to the race than is the eugenic loss from the perpetuation of weak strains of heredity. The abolition of altruistic and humanitarian sentiment for the purpose of race betterment would ultimately defeat its own end by making race betterment impossible.

But race betterment will also be impossible unless a clear distinction is made between measures that really mean race betterment of a fundamental and permanent nature, and measures which do not.

We have chosen the Infant Mortality Movement for a.n.a.lysis in this chapter because it is an excellent example of the kind of social betterment which is taken for granted, by most of its proponents, to be a fundamental piece of race betterment; but which, as a fact, often means race impairment. No matter how abundant and urgent are the reasons for continuing to reduce infant mortality wherever possible, it is dangerous to close the eyes to the fact that the gain from it is of a kind that must be paid for in other ways; that to carry on the movement without adding eugenics to it will be a short-sighted policy, which increases the present happiness of the world at the cost of diminishing the happiness of posterity through the perpetuation of inferior strains.

While some euthenic measures are eugenically evils, even if necessary ones, it must not be inferred that all euthenic measures are dysgenic.