174 INFANT MORTALITY'S URGENT CALL FOR ACTION 



before the five new States were added to the Registration list, 

 the ratio of deaths under 1 to total deaths in 1909 was lower 

 than that of 1900 by 1.6, and of course its complement, the 

 ratio of deaths over age 1 to total deaths, necessarily increased 

 to that extent. In short, this method of approximately measur- 

 ing infant mortality by no means conflicts in its general showings 

 with the indications of a decrease of infant mortality in the 

 Registration Area of the United States which the decrease in the 

 actual number of infant deaths so long as the area remained 

 unchanged would seem conclusively to suggest. 



Much more convincing evidence of the hoped-for decrease 

 in the actual waste of infant life in this country is afforded by 

 the ten-year study of the registered living births, deaths under 

 age 1, and deaths at all ages, and their respective ratios, in cer- 

 tain States having well established registration systems, which 

 I present in Table III attached to this paper (and also in Charts 

 III and IV). Through the co-operation of the registration 

 officials of Massachusetts, Connecticut and New York, I have 

 been enabled to obtain the figures for 1909 in advance of the 

 publication of their several reports, and in the case of Massa- 

 chusetts and Connecticut have thus been able to tabulate com- 

 parisons for the last 10 years; in the case of New York State, 

 the comparison was restricted to six years, as the New York 

 State Department of Health did not separately classify deaths 

 under 1 year prior to 190 i. 



The general significance of this table may be summarized in the 

 statement that in both Connecticut and Massachusetts the num- 

 ber of deaths under 1 year was smaller in 1909 than in 1900, 

 despite the decided increase in population and living births in 

 each case, and the ratio of infant deaths to living births of 

 course shows a marked decrease. In Connecticut there has been 

 an apparent decrease of no less than 40 infant deaths per 1,000 

 living births in the last 10 years, and in Massachusetts there 

 has been an apparent decrease of 29.5 in the same period. In 

 the last six years the nominal ratio of infant deaths to living 

 births, in New York State has decreased 21.4, and in the face 

 of the continuous increase in the population of the Empire State 

 the number of infant deaths recorded for the entire State has 

 increased only about 1,100 in 1909 as compared with 1904. 

 Lest these large apparent declines in the infant death rates of 

 these three representative States may be taken more literally 

 than the facts warrant, I must again at this point call attention 

 to the unquestioned increase of late years in the percentage of 

 registered births, thanks to the vigorous efforts of the Division 

 of Vital Statistics of the Bureau of the Census, and various 

 other helpful agencies, and again remind you that the actual 



