60 INFANT MORTALITY 



tions to prevent infant mortality. It revealed also the fact that 

 very little accurate information exists and, where it does exist, it 

 is not in such form as to permit intelligent comparison. 



The statistical reports of boards of health and state boards 

 of charity afford no usable material. The State Board of Charity 

 of Massachusetts is considered one of the most reliable sources 

 of information in the United States. That Board has been accus- 

 tomed for many years to publish an annual "Summary of Infants 

 Under Two Years of Age. Report to the State Board of Charity 

 under the law which provides for the protection of infants and 

 the licensing and regulating boarding houses for them." This 

 summary enumerates a list of institutions, showing the number 

 of infants, male and female, and the number who died in licensed 

 homes and in unlicensed homes, and the aggregate number of 

 deaths. On a casual examination one would suppose that this 

 summary covered all of the infants cared for by the institutions 

 named ; but on inquiry it was learned that the summary covers 

 only children who die in family homes, and does not include 

 children who die in institutions named. The statistics, therefore, 

 are valueless as far as the general question of infant mortality 

 in institutions is concerned. 



The New York State Board of Charities publishes statements 

 from year to year with reference to the care of children in all 

 the private institutions of the State, including mortality statis- 

 tics. An examination of these statistics shows that for a series 

 of years the statistics relative to certain institutions for infants 

 showed for each institution the number of "persons died/' After 

 a series of years, this heading was changed from "persons" to 

 "boys and girls." Subsequently it was changed to "under 2 

 years." 



The discovery of this variety of headings led to an examina- 

 tion, which revealed that under "persons received" and "persons 

 died" was included not only infants, but also their mothers. It 

 was discovered also that when children under 2 years were in- 

 cluded a much more favorable mortality rate was produced than 

 if children under 1 year only were included. 



The institutional statistics of infant mortality were found to 

 be misleading in many cases, because of the practice of basing 

 the death rate on the entire number of children cared for during 

 the year. Take, for example, an institution which had 50 infants 

 on hand at the beginning of the year, received 100 infants, 

 making a total of 150, and had 50 deaths. That would give an 

 apparent death rate of 33-1-3 per cent. ; but if the whole number 

 of children received for a series of years was taken, and it was 

 ascertained just how many of these children had died, the mor- 

 tality rate would be found to be nearer 50 per cent. 



