232 THE MILK QUESTION 



in the birth rate in eleven European countries has been 

 from an average of 33.7 to 30 per thousand, or about ten per 

 cent of the births. No similar decline has yet appeared in 

 this country, owing to the influx of immigrants into our 

 large cities. The birth rate in the rural regions and among 

 the better classes, however, is showing a decided decline. 

 The effect of immigration is best illustrated by the fact that 

 in New York City in the best residential portion the pre- 

 sent birth rate is four per thousand, while in the tenement 

 district it is forty to forty-five per thousand. 



Infant mortaUty is not expressed as other death rates are 

 expressed; that is, the ratio to the whole population. In- 

 fant mortality is recorded as the number of deaths of child- 

 ren under one year of age to each one thousand births re- 

 corded during the year. It is assumed that the migration 

 of children to and from a district counterbalance each 

 other. For the reason that the registration of births in this 

 country is veiy lax the infant mortality rates are not nearly 

 so accurate as the figures obtained from foreign coimtries. 



The infant mortality is higher in cities than in the coun- 

 try. Extremes are found in mill towns, such as Fall River, 

 which has an infant mortahty of 239.7 to 304.7. This is 

 hardly exceeded by Preston, which for a long time claimed 

 a very black record among the industrial cities. In Charles- 

 ton, South Carolina, the infant mortahty rate is 419.5, 

 and in the District of Columbia, 274.5. In other Southern 

 cities, such as Savannah, Mobile, Key West, Atlanta, 

 Lynchburg, Richmond, etc., the figures are also above 300. 

 These stupendously excessive figures are accounted for in 

 part by the exceedingly high death rate among the negroes, 

 and the incomplete registration of births. The figures from 

 our Southland are balanced by such as Biddeford, Maine, 

 311.6; Fall River, Massachusetts, 304.7, and other mill 

 towns in the North. The best evidence at hand indicates 

 that there has been very Uttle decline in infant mortality. 

 Holt studied the question and found that there has probably 



