170 INFANT MORTALITY'S URGENT CALL FOR ACTION 



been considered at length in the report of the special Com- 

 mittee on the Registration of Births, scheduled on the program 

 for presentation at this session, further discussion of that phase 

 of the subject in this paper would be entirely superfluous. Some 

 reference to it, however, by way of acknowledgement of the 

 unfortunate limitations of the best available data, seemed to me 

 necessary before summarizing the statistical tabulations of 

 infant mortality in this country attached to this paper. 



Although no birth returns have been included in the Census 

 Office's annual publications of Mortality Statistics for the last 

 10 years, in all of these reports there has been a classification 

 of deaths by ages in the constantly changing Registration Area, 

 and some idea of the movement of the infant mortality rate 

 in so far as Registration States and cities have been concerned 

 from time to time may be had by a comparison of the annual 

 ratios of deaths under 1 year with the total number of deaths 

 at all ages in each of those years. I had some time since worked 

 out such a comparison for the nine years ending with 1908, and 

 now note in the advance bulletin of Mortality Statistics for 1909 

 just received from the Census Office that Dr. Wilbur therein 

 suggests such a basis of comparison, and furnishes several tab- 

 ulations on those lines which are of real value in any study of the 

 infant mortality of this country. As he puts it (p. 11, Bulletin 

 108): 



"When the proper statement of infant mortality is lacking, 

 recourse may be had to the ratio between the number of deaths 

 of infants under 1 year of age and the population under 1 year, 

 although this ratio is unsatisfactory for many reasons, and the 

 population under 1 year is not available except by estimation for 

 intercensal years. A very crude means of judging of the condi- 

 tion as regards the general extent of infant and child mortality 

 is to compare the total number of deaths of infants under 1 year 

 and of children under 5 years of age with the total number of 

 deaths registered. Other things being equal that is to say, 

 with substantially similar populations with respect to age dis- 

 tribution and in the absence of epidemic diseases prevailing at 

 higher age periods the relative proportions of deaths of infants 

 and children to the total number of deaths should show approxi- 

 mately the prevalence of infantile diseases and the importance 

 of reducing the general mortality by efforts directed toward the 

 prevention of infant mortality." 



This means, in other words, that, in default of national figures 

 for either births or living population under age 1 in the Regis- 

 tration Area, at least one available means of^ attempting to 

 measure the infant mortality for that area is a' comparison of 

 the annual ratios of deaths under age 1 with the total number 



