Willcox: Fewer Births and Deaths 
difference is not commonly realized. In 
New York State boy babies under 1 year 
of age suffer from a death rate sixty-five 
times that of boys of 10 to 14. The 
death rate of nonagenarians rises to 
159 times that of the youth. 
It would be a natural expectation of 
one who is told that the death rate is 
rapidly falling that the gains had been 
distributed somewhat evenly up and 
down the scale of years. But this antic- 
ipation is not borne out by the facts. 
Even in a hurried survey like this two 
points, the possible increase of infant 
mortality and the possible increase of 
mortality among the aged, call for 
mention. 
DEATH AMONG INFANTS 
High medical authority in England 
alleged nearly ten years ago that 
infant mortality is stationary or in- 
creasing and this conclusion won some 
acceptance in the United States. For- 
tunately the figures proved to be 
susceptible of another explanation. But 
into that question there is now no need 
to go, since even in England and on the 
face of the figures infant mortality has 
decreased since 1900. Indeed among 
the nineteen countries of Europe for 
which statistics are at hand there is not 
one in which infant mortality has shown 
no decrease since the beginning of the 
twentieth century. In the United 
States the registration of births is still 
very defective and there are no large 
population groups for which we know 
the true infant mortality, that is, the 
number of children dying in the first 
year of life to each thousand living 
births. Our best substitute for this 
figure is the ratio between the deaths 
under 1 year of age and the living 
children under 1. In the registration 
States of 1900, comprising 26.3% of the 
country’s population, this ratio fell 
from 162.4 in 1900 to 141.7 in 1910, 
indicating that infant mortality fell 
about one eighth in the decade. 
When we turn to the other end of 
life, the indications of our American 
figures are less gratifying. In the 
registration States of 1900 the death 
12% 
rate decreased between 1900 and 1910 
for every age period below 55 and 
increased at nearly every age period 
above 55. On this point our experience 
is apparently at variance with that of 
Europe. The latter indicates that be- 
fore 1900 the fall in the death rate 
extended to all ages below 55 and was 
especially great at ages between 5 and 
35, but that for ages above 55 it was 
slight or absent. The English life 
tables recently published and speaking 
for a more recent period show that at 
every age above 5 years the mortality 
in 1901-10 was less than that in 1891— 
1900 and that the mortality in 1910-12 
was less than that in 1901-10.4 
DEATH AMONG THE AGED 
The apparent increase of mortality 
at high ages in our registration States, 
in opposition to the general trend in 
other countries, invites and should 
obtain more careful and thorough analy- 
sis than it has thus far received or than 
I have been able to give it for this paper. 
Although it appears in both sexes, it 
does not show itself among women until 
the age of 60 is reached, while among 
men over 45 the death rate in 1910 
exceeded that in 1900. It appears also 
among the three classes of native white, 
foreign born white and colored, earliest 
among the colored with whom the 
increase appears in each sex at every 
age above 30, latest among the foreign 
born whites with whom the increase does 
not appear in either sex until the age of 
60 and then for females appears only 
for the ten year age period 60-69. It 
appears in a prevailingly agricultural 
State like Vermont at an earlier age 
and more definitely than it does in a 
prevailingly industrial State like Massa- 
chusetts or Rhode Island. In a recent 
reference to this change, based mainly 
upon the figures for Massachusetts and 
New Jersey between 1880 and 1910, 
three possible causes were mentioned, 
‘the amalgamation of the various races 
that constitute our population,” “lack 
of adaptation to our rapidly developing 
civilization”? and ‘‘some unknown bio- 
logic influence,” and a preference for the 
3 March, Statistique intern. du Mouvement de la Population, Vol. I, p. 450. 
4Reg Gen., Supplement to 75th Ann. Rep., Pt. I, Life Tables, p. 20. 
