■IB 1366 
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 opy 1 
 
 FACTORS IN AMERICAN 
 MORTALITY 
 
 A STUDY OF DEATH RATES IN THE RACE STOCKS 
 OF NEW YORK STATE, 1910 
 
 Reprinted from the American Economic Review, Vol. VI, No. 3, 
 
 September, 1916, published by the American 
 
 Economic Association, Ithaca, N. Y. 
 
 BY 
 
 LOUIS I. DUBLIN, Ph.D., Statistician 
 
 Metropolitan Life Insurance Company, New York 
 
 1916 
 
- 
 
FACTORS IN AMERICAN MORTALITY 
 
 A STUDY OF DEATH RATES IN THE RACE STOCKS OF NEW 
 YORK STATE, 1910 1 
 
 In an address delivered before this section a year ago, entitled 
 "The Trend of American Vitality," I ventured to point out that 
 the character of our immigration during the last twenty years 
 was a factor in the increasing mortality of the higher age groups. 
 To summarize the argument, it was shown that immigration played 
 a very large part in the growth of population in the states com- 
 posing the registration area ; that the foreign countries from 
 which our immigrants come show uniformly a higher mortality 
 rate than that prevailing in the United States ; and that in the 
 state of New York, in 1910, the mortality of the native born was, 
 as a whole, considerably lower than that of the foreign born. 
 This was found to be true for both sexes, and especially at the 
 adult and higher ages. Brief reference was finally made to the 
 rates from the principal causes of death which apparently ac- 
 counted for these differences. The data then at hand were limited, 
 but were nevertheless sufficient to show that the effect of the 
 mortality of the foreign born on that of the total population 
 was not altogether favorable, and that it was highly desirable 
 to get more evidence on this subject. 
 
 In this paper, I propose to carry the analysis further, and to 
 present the added evidence which has been gathered. I shall 
 submit the mortality figures fo>- the state of New York to an 
 examination to show the facts for each of the important race 
 stocks, and shall attempt to evaluate the various racial elements 
 as factors in the general mortality. Consideration will be given 
 to the important items of sex, age, and causes of death. We 
 shall incidentally obtain a picture of the effect of life in America 
 on the various foreign born peoples. We shall also learn, espe 
 cially from the consideration of the diseases which cause death, 
 where most effort in public health work should in future be directed. 
 
 I present for your consideration a table and two graphs giv- 
 
 1 Read before Section I, Social and Economic Science, American Asso- 
 ciation for the Advancement of Science, December B9, 1915. 
 
ing the mortality rates in the state of New York, for the year 
 1910, of the following three classes of the white population: 
 
 a. The native born of native parentage; 
 
 b. The native born of foreign or mixed parentage; 
 
 c. The foreign born. 
 
 Table 1. — Deaths per 1,000 white population among native born of 
 native parentage, among native born of foreign or mixed parentage, and 
 among foreign born, by sex and by age period: New York state, 1910. 
 
 
 MALES 
 
 FEMALES 
 
 Age period 
 
 Native 
 born of 
 native 
 
 Native 
 
 born of 
 
 foreign 
 
 or mixed 
 
 For- 
 eign 
 born 
 
 Native 
 born of 
 native 
 
 Native 
 
 born of 
 
 foreign 
 
 or mixed 
 
 For- 
 eign 
 born 
 
 
 parentage 
 
 parentage 
 
 
 parentage 
 
 parentage 
 
 
 All ages : 
 
 
 
 
 
 
 
 Crude rate 
 
 15.9 
 
 18.7 
 
 17.2 
 
 13.9 
 
 14.7 
 
 16.3 
 
 Ages 10 and over: 
 
 
 
 
 
 
 
 Crude rate 
 
 13.8 
 
 13.2 
 
 17.5 
 
 12.4 
 
 9.7 
 
 16.6 
 
 Standardized rate 
 
 13.8 
 
 17.2 
 
 17.1 
 
 12.4 
 
 13.9 
 
 16.2 
 
 Under 10 
 
 23.5 
 
 31.0 
 
 8.4 
 
 19.6 
 
 27.0 
 
 8.2 
 
 10-14 
 
 2.5 
 
 2.2 
 
 2.5 
 
 2.6 
 
 2.1 
 
 2.4 
 
 15-19 
 
 3.6 
 
 4.1 
 
 4.4 
 
 3.2 
 
 3.2 
 
 3.2 
 
 20-24 
 
 5.0 
 
 6.8 
 
 5.2 
 
 4.7 
 
 5.2 
 
 4.0 
 
 26-44 
 
 6.9 
 
 14.3 
 
 8.7 
 
 5.7 
 
 9.3 
 
 7.3 
 
 45-64 
 
 18.8 
 
 28.2 
 
 •28.0 
 
 14.3 
 
 20.0 
 
 23.4 
 
 65-84 
 
 77.3 
 
 89.9 
 
 90.4 
 
 68.2 
 
 73.9 
 
 87.7 
 
 85 and over 
 
 268.9 
 
 323.0 
 
 272.7 
 
 242.3 
 
 324.9 
 
 270.5 
 
 A number of observations must be made with reference to 
 Table 1, before a comparison of the figures for the three nativity 
 groups can safely be made. In the group "under age 10" a very 
 low mortality rate appears for the foreign born males and females. 
 The figures are, however, entirely inadequate as measures of the 
 mortality among the foreign born in this age period. The 
 heaviest mortality in the period "under 10" is in the first year 
 of life, at which age there is virtually no foreign born population. 
 In fact, there is only a very small foreign born representation 
 in the entire period under 5. The death rate "under 10" is 
 practically a rate for the period 3-9 for the foreign born. The 
 extremely low figure for the period "under 10" is thus explained, 
 and its incomparability with the other rates is established. The 
 
5 
 
 Graph I 
 
 Mortality in. New York 
 Classified by Nati vitjy <ar\d 
 
 State, 1910, WVite Males, 
 by Ao e Periods 
 
 absence of the foreign born in the earliest ages affects their crude 
 mortality rates for "all ages" very appreciably. At least S, 
 and perhaps 4, deaths per thousand should be added to the figures 
 given, in order to compensate for this lack of infants among 
 immigrants. 
 
 After the first period — that is, beginning with age 10 — the 
 figures for the three classes are for all practical purposes com- 
 parable. The males in the period "10-14" show virtually the 
 same death rate for the three classes, but beginning with "15-19" 
 and continuing to the end of life the rates for the native born 
 of native parentage are the least. In the age periods "20-24" 
 and "25-44," the principal working period of life, the foreign 
 
Graph II 
 
 Rot 
 
 Mortality in New York State, 1910, White Females 
 Classified tw NaVivitvi and tw Aqe Periods 
 
 por -' J J J t»1«pW 
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 If 5.9 '0-1* if.19 To.M IS-Vt )S« «-S4. 5S-41 <S-"H IS 
 
 
 born have a considerably lower mortality than the native born 
 of foreign or mixed parentage, but in the next two age periods — 
 that is, up to the age period "85 and over" — the two sets of 
 figures are practically identical. Very similar conditions obtain 
 for the females. No comparisons can be made in the first age 
 period. The three sets of rates are the same in the age period 
 "15-19." The foreign *born show the least rate in the age period 
 "20-24," but beginning with 25 and continuing throughout the 
 rest of life the native born of native parentage have the most 
 favorable mortality. The foreign born females show the highest 
 mortality in the age period "45 to 84." 
 
 We may then summarize Table 1 as follows: The native born 
 of native parentage, virtually without exception, show the lowest 
 
death rates. This condition is very marked in the adult period 
 of life — at ages 25 to 64. The rates of the native born of 
 foreign or mixed parentage and those of the foreign born — that 
 is, of the children of immigrants and of the immigrants them- 
 selves — do not lend themselves readily to comparison. The 
 rates for the two groups run side by side for some periods 
 and diverge for others, following no obvious law. It is, 
 of course, realized that these two groups of our population 
 are largely incomparable, because of the differences in race 
 composition, especially at the various age periods. Thus the 
 native born of foreign or mixed parentage after middle life 
 represent the children of an older immigration, which occurred 
 prior to 1885, and which was largely Irish and German in com- 
 position. The foreign born after middle life, on the other hand, 
 are more representative of the newer immigration, occurring 
 since 1885, which is largely Jewish, Italian, and Slavic 
 in composition. It is imperative, therefore, that we examine, 
 in so far as data are available, the mortality rates of the race 
 groups that compose the "foreign born." This will throw light 
 not only on the aggregate rates for the "foreign born" — that is, 
 on columns 3 and 6 in the table — but indirectly on the rates of 
 native born of foreign or mixed parentage. 
 
 Fortunately for these purposes I have been able to obtain from 
 the office of the Director of the Census a series of manuscript 
 tables giving the number of persons and number of deaths in the 
 nativity groups composing the foreign born population in the 
 state of New York. It has been possible, as a result, to compute 
 the essential rates for the various age periods and for the two 
 sexes. This will form the principal contribution of this paper. 2 
 
 It is possible to differentiate in the group "foreign born" the 
 following nationalities : Russians, Italians, Germans, Irish, Austro- 
 Hungarians, and English, Scotch, and Welsh. These are arranged 
 in descending order according to their proportionate representa- 
 tion in the population of New York state at the time of the 1910 
 census. It is understood that the several designations are not 
 always exactly synonymous with the race stocks, since a few 
 include a number of different races. This subject will be con- 
 
 3 My sincere thanks are due both to Mr. Sam. L. Rogers, Director of 
 the Census, and to Mr. Richard C. Lappin, Chief Statistician, Division 
 of Vital Statistics, Bureau of the Census, for their courtesy and sub- 
 stantial assistance in providing the sources of my data. 
 
8 
 
 sidered more fully in the treatment of each nationality. To- 
 gether, these six nationalities comprised 2,371,090 persons, or 
 86.9 per cent of all the foreign born, and 26.5 per cent of the 
 total white population of the state of New York in 1910. It is 
 to be regretted that the lack of trustworthy figures makes it 
 impossible to compare each of these foreign nationalities with the 
 native born of the corresponding foreign parentage. Our dis- 
 cussion will, therefore, be limited to a comparison of the death 
 rates by age periods for each of these groups with the native 
 born of native parentage. 
 
 Russians 
 In 1910 there were in New York state 558,952 persons born 
 in Russia. They formed 20.5 per cent of the total foreign born 
 and 6.2 per cent of the total white population. The term 
 "Russian" includes a large proportion of Jews, as well as Poles 8 
 and true Russians. Of all the Russian immigrants into the United 
 States in the period 1899-1910, 43.8 per cent were Jews, and it 
 is highly probable that an even larger proportion of the Russians 
 in New York state in 1910 were of the Jewish race. This is an 
 important point to keep in mind, because the Jews uniformly 
 
 Table 2. — Deaths per 1,000 white population among persona born in 
 Russia, and among native born of native parentage, by sex and by age 
 period; New York state, 1910. 
 
 
 MALES 
 
 FEMALES 
 
 Age period 
 
 Native 
 born of 
 
 native 
 parentage 
 
 Russian 
 born 
 
 Native 
 
 born of 
 
 native 
 
 parentage 
 
 Russian 
 born 
 
 All ages: 
 
 Crude rate 
 Ages 10 and over: 
 
 Crude rate 
 
 Standardized rate 
 
 Under 10 
 
 10-14 
 
 15-19 
 
 20-24 
 
 25-44 
 
 45-64 
 
 65-84 
 85 and over 
 
 15.9 
 
 13.8 
 13.8 
 
 23.5 
 
 2.5 
 
 3.6 
 
 5.0 
 
 6.9 
 
 18.8 
 
 77.3 
 
 268.9 
 
 7.5 
 
 7.7 
 13.1 
 
 4.4 
 1.6 
 
 2.6 
 3.8 
 5.1 
 
 20.1 
 
 78.4 
 
 255.8 
 
 13.9 
 
 12.4 
 12.4 
 
 19.6 
 2.6 
 3.2 
 
 4.7 
 
 5.7 
 
 14.3 
 
 68.2 
 
 242.3 
 
 6.6 
 
 6.8 
 12.S 
 
 3.7 
 
 1.4 
 
 1.8 
 
 2.9 
 
 5.S 
 
 16.0 
 
 69.8 
 
 257.8 
 
 * Figures for Poles given separately in census returns were apportioned 
 between Russians, Austro-Hungarians, and Germans in this order, y 3 , %, and 
 ]/(,, respectively. 
 
9 
 
 show a lower mortality than the races among whom they live. 
 Thus, according to Nowosselsky, the Jews in Russia showed at 
 every age period a death rate half as great as that of the Rus- 
 sians belonging to the Orthodox Church. This is true for both 
 sexes. With the restriction in mind, then, that our figures for 
 Russians are really for a group composed half of Jews, I present 
 Table 2 for 1910 for the state of New York. 
 
 Attention must again be directed to the utter incomparability 
 of the two sets of figures for the age period "under 10." Beginning 
 with "10-14" and continuing through the period "25-44," the 
 rates for the Russian born are uniformly and appreciably lower 
 than those for the native born of native parentage. In the age 
 period "45-64," and in the subsequent period, for males, and in 
 all periods for females, the Russians show a slightly higher mor- 
 tality than the native born of native parentage. For all ages 
 combined, "10 and over," the crude rate for the Russian males 
 is 7.7, as against 13.8 for the native born of native parentage ; 
 for the Russian females the crude rate is 6.8, as against 12.4 
 for those of native parentage. But when standardized for the 
 differences in age distribution, with the distribution of the native 
 born of native parentage as a basis, the rate becomes 13.1 for 
 the Russian males and 12.3 for females. The corresponding 
 figures for the native born of native parentage, 13.8 and 12.4 
 respectively, are the same as the crude rates given above, because 
 these are taken as our standard. When thus standardized the 
 rates for the Russians covering this long period of life are much 
 the same as for the native born of native parentage. The favor- 
 able influence of the Jewish stock is very clearly shown in the low 
 rate of mortality of the Russians in New York state. 
 
 General death rates such as we have quoted are after all but 
 a composite of the rates for the various individual causes of 
 death. Light is, therefore, thrown on the above findings by a 
 more detailed examination of the mortality of persons born in 
 Russia to show the part played by certain of the principal dis- 
 eases and conditions causing death. Unfortunately the rates 
 for specific causes have not yet been computed for the native 
 born of native parentage. As a result, each one of the foreign 
 stocks must be compared with the corresponding figures for the 
 entire group of the native born (Table 3). 
 
 Among Russians in New York state there is a much lower 
 death rate from pulmonary tuberculosis than among the native 
 
IO 
 
 born (Table 4). In the age period "25-44," for example, they 
 show a tuberculosis death rate for males of 117.1 per 100,000, 
 as against 352.0 among natives. In the same age-class females 
 
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12 
 
 show a tuberculosis death rate of 104.7 per 100,000, as against 
 193.3. These differences in the death rates from tuberculosis 
 are alone sufficient to explain the advantageous mortality which 
 we have observed for the Russians. The direct relationship be- 
 tween the low tuberculosis mortality and the large representation 
 of Jews among the Russian born is unmistakable, and this con- 
 clusion accords with the work of a number of other writers. 
 Korosy determined, for the city of Budapest, a tuberculosis mor- 
 tality among Jews of 184 per 100,000, whereas the rate was 
 470 for Catholics and 331 for Calvinists. In both sexes and 
 at all ages up to the end of the age period "25-44!," pneumonia 
 is markedly lower among the Russians in New York state; thus, 
 at ages "25-44" the pneumonia mortality among Russian born 
 males was 51.2, while the corresponding figure for native Ameri- 
 cans was 92.1. This is again in agreement with Korosy, who re- 
 ports the favorable position of the Jews as to pneumonia. Bright's 
 disease, however, is higher among Russians in the later age periods, 
 which are the more significant ones for this disease. The cancer 
 rate is higher among Russian males in the period between 25 
 and 85; at ages "25-44" they have a death rate of 34.3 per 
 100,000 while that for natives from this cause is only 18.6. In 
 the age period "45 to 64," the cancer rate is 277.5 for the 
 Russians against 150.0 for the native born. The death rate of 
 Russian females in the age class "25-44" is 55.3, while that of 
 Americans is only 50.9; thereafter their rates are slightly lower, 
 but the actual number of deaths, particularly those after age 
 65, are scarcely large enough to warrant any general conclusion. 
 The low death rate from violent causes points to the fact that 
 the Russian population does not commonly engage in those occu- 
 pations in which this danger threatens: thus at ages "25-44" 
 there were 65.3 deaths per 100,000 Russian males as opposed to 
 110.0 per 100,000 natives from these causes. 
 
 Italians 
 The Italians are more homogeneous than the Russians, although 
 there is a larger representation of southern Italians and Sicilians 
 among the Italians in New York state than is the case in Italy. 
 According to the 1910 census, the number of persons of Italian 
 birth in New York state was 472,192. This was 17.3 per cent of 
 the foreign born whites and 5.3 per cent of the total white popula- 
 tion in the state. This number is large, in view of the recent date at 
 
!3 
 
 which the Italian immigration began. Thus in the year 1890 the 
 number of foreign born Italians in New York state was only 
 64,141. The tide of Italian immigration in this country rose 
 subsequently to this date. 
 
 The mortality of Italians in their native land is a favorable 
 one. In certain age periods, such as 35 to 64, the rates in 1900 
 and 1901 (the last figures available) were even lower than those 
 for England and Wales ( although, taken as a whole, the mortality 
 of Italians is higher than that of the English). The figures which 
 we have for Italians in their native country justify the conclu- 
 sion that mortality conditions of persons of Italian birth are on 
 the whole better in New York state than in Italy. The following 
 table (Table 5) presents the mortality rates for this nationality, 
 contrasted with those of the native born of native parentage, in 
 New York. 
 
 Apart from the first age period, the figures for which are, as 
 shown above, incomplete, the rates for the Italian males are 
 higher than those for native males through the period "20-24." 
 At the ages "25-44" and "45-64" the two sets of figures are 
 very nearly the same; thereafter — that is, from 65 upward — the 
 Italian majes show a lower mortality, but the number of per- 
 sons at those higher ages is too small to justify drawing any 
 conclusions. 
 
 The Italian females in New York state show, on the whole, a 
 
 Table 5. — Deaths per 1,000 white population among persons born in 
 Italy, and among native born of native parentage, by sex and by age 
 period: New York state, 1910. 
 
 
 MALES 
 
 FEMALES 
 
 
 Native 
 
 
 Native 
 
 
 
 born of 
 
 Italian 
 
 born of 
 
 Italian 
 
 Age period 
 
 native 
 parentage 
 
 born 
 
 native 
 parentage 
 
 born 
 
 AH ages: 
 
 
 
 
 
 Crude rate 
 
 15.9 
 
 9.2 
 
 13.9 
 
 9.7 
 
 Ages 10 and over: 
 
 
 
 
 
 Crude rate 
 
 13.8 
 
 9.0 
 
 12.4 
 
 9.5 
 
 Standardized rate 
 
 13.8 
 
 12.9 
 
 12.4 
 
 13.7 
 
 Under 10 
 
 23.5 
 
 13.1 
 
 19.6 
 
 12.7 
 
 10-14 
 
 2.5 
 
 2.7 
 
 2.6 
 
 3.4 
 
 15-19 
 
 3.6 
 
 5.5 
 
 3.2 
 
 5.7 
 
 20-24 
 
 5.0 
 
 6.2 
 
 4.7 
 
 6.1 
 
 25-44 
 
 6.9 
 
 6.6 
 
 5.7 
 
 7.0 
 
 45-64 
 
 18.8 
 
 19.3 
 
 14.3 
 
 17.9 
 
 65-84 
 
 77.3 
 
 64.6 
 
 68.2 
 
 63.8 
 
 85 and over 
 
 268.9 
 
 120.3 
 
 242.3 
 
 214.S 
 
14 
 
 higher mortality than the males. This is a remarkable condition, 
 in view of the fact that the reverse relation of the sexes usually 
 obtains. The Italian females also show a higher mortality than 
 the native born females of native parentage; this is true in every 
 age period through "45-64." After age 65 the Italian females 
 are somewhat lower than the native females of native parent- 
 age, but here again the number of cases is too small to merit 
 consideration. 
 
 Eliminating the first age period, and considering the rest of 
 life as a whole, the crude rates for Italian males and females 
 are 9.0 and 9.5 respectively. Standardized on the basis of the 
 age distribution of the native born of native parentage, these rates 
 are increased to 12.9 and 13.7. They are to be contrasted with 
 the rates 13.8 and 12.4, respectively, for the native born of 
 native parentage. We may say, then, that the Italians present 
 favorable mortality rates. This is especially true of the males. 
 
 When we consider the causes (Table 6) which go to make up 
 this mortality we find pneumonia, all forms, especially prominent. 
 In practically every age period the pneumonia death rate for 
 Italians is about twice that of native Americans ; sometimes the 
 proportion is even greater. The differences are especially marked 
 among women. Thus at ages "25-44" Italian females have a rate of 
 81.5 per 100,000; the corresponding figure for native Americans 
 is only 54.2. This suggests what has, indeed, been pointed out 
 by Guilfoy, Stella, and other observers — a high prevalence of the 
 acute infections which, especially at the older ages, terminate 
 in the pneumonias and are reported under the last designation. 
 In pulmonary tuberculosis, Italian males are at a decided ad- 
 vantage between ages 20 and 64 — a period which includes the 
 years most significant for this disease. Among the women, on 
 the other hand, conditions are quite different. Almost in every 
 period of life, and particularly at the early ages, they are at 
 a marked disadvantage. At ages "20-24," for example, there is a 
 mortality from pulmonary tuberculosis of 247.7 among Italian 
 women, as opposed to 186.3 among native American women. When 
 we contrast these figures with those of the men, who, at ages 
 "20-24," show a rate of only 140.4 (while that of Americans is 
 216.3), it becomes clear that the unfavorable general mortality 
 of Italian women is due primarily to pulmonary tuberculosis. 
 In respect to organic diseases of the heart, the men show a 
 uniformly low rate. This record is again in marked contrast 
 
i5 
 
 with that of the women, who, upon comparison with native Ameri- 
 cans, are at a considerable disadvantage in every age group 
 except the last. Accidents are strikingly frequent among 
 Italians, in both sexes, and in practically every age group. The 
 
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i6 
 
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 there was a death rate from these causes of 170.6 per 100,000, 
 while the corresponding figure for natives was only 96.9. 
 
 Germans 
 
 Foreign born Germans do not now constitute as large a part 
 of the foreign born population of New York state as they did 
 in the decade beginning 1880, when the high water mark of 
 German immigration was reached. The Germans, however, still 
 form one of the most numerous groups of the foreign born in 
 New York state. This is especially true at the higher ages of 
 life. In 1910 they were represented by 436,874 persons, con- 
 stituting 16.0 per cent of the foreign born whites and 4.9 per 
 cent of the total white population. 
 
 The mortality rates of Germans in their native country have 
 been among the more favorable ones in Europe. In the last 
 two decades the rates for the German Empire have shown very 
 satisfactory improvement. It is, therefore, very surprising to 
 find that in New York state the mortality of persons of German 
 birth is fairly high, as is shown in the following table: 
 
 Table 7. — Deaths per 1,000 white population among persons born in 
 Germany, and among native born of native parentage, by sex and by age 
 period: New York state, 1910. 
 
 
 MALES 
 
 FEMALES 
 
 
 Native 
 
 
 Native 
 
 
 
 born of 
 
 German 
 
 born of 
 
 German 
 
 Age period 
 
 native 
 parentage 
 
 born 
 
 native 
 parentage 
 
 born 
 
 AH ages: 
 
 
 
 
 
 Crude rate 
 
 15.9 
 
 27.5 
 
 13.9 
 
 22.6 
 
 Ages 10 and over: 
 
 
 
 
 
 Crude rate 
 
 13.8 
 
 27.7 
 
 12.4 
 
 22.8 
 
 Standardized rate 
 
 13.8 
 
 17.9 
 
 12.4 
 
 14.4 
 
 Under 10 
 
 23.5 
 
 12.7 
 
 19.6 
 
 10.3 
 
 10-14 
 
 2.5 
 
 5.8 
 
 2.6 
 
 1.6 
 
 15-19 
 
 3.6 
 
 3.4 
 
 3.2 
 
 2.7 
 
 20-24 
 
 5.0 
 
 4.5 
 
 4.7 
 
 4.0 
 
 25-44 
 
 6.9 
 
 10.0 
 
 5.7 
 
 6.3 
 
 45-64 
 
 18.8 
 
 27.7 
 
 14.3 
 
 18.4 
 
 65-84 
 
 77.3 
 
 90.4 
 
 68.2 
 
 83.1 
 
 85 and over 
 
 268.9 
 
 263.4 
 
 242.3 
 
 246.4 
 
 We must at the outset remark that the rates for the Germans 
 in the first three age periods, as presented, have no particular 
 merit, because of the small number of persons exposed. After 
 
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i8 
 
 the age period "20-24" the figures are very ample, and may be 
 considered entirely reliable. Beginning, then, with ages "25-4*4," 
 we find that the rate for German males is very much higher than 
 for the native born of native parentage, and this condition con- 
 tinues until the conclusion of the age period "65-84." The last 
 age period, "85 and over," shows a slightly better rate than that 
 for the native born of native parentage. In like manner, the 
 females, beginning with the period "25-44," show higher rates 
 than the native born of native parentage at every age period to 
 the end of life. Considering together ages 10 and over, the 
 crude rate is 27.7 for males and 22.8 for females ; but when 
 standardized as above outlined, the rates for the two sexes are 
 reduced to 17.9 and 14.4, respectively. These are both distinctly 
 higher than the rates for the native born of native parentage, 
 the excess being more marked for males than for females. 
 
 In seeking to determine the causes for this high mortality 
 (Table 8) we find that the pulmonary affections are to a large 
 degree responsible; the degenerative diseases also play an im- 
 portant part. In view of the limitations of the material which 
 have already been pointed out, and in view of the fact that 
 most of the diseases in question have no considerable incidence 
 before the attainment of maturity, we have concerned ourselves 
 for the most part only with ages 25 and over. At almost every 
 age, the pulmonary tuberculosis rates of German males are 
 greatly in excess of those of native Americans ; for example, at 
 ages "45-64" there is mortality of 350.0 per 100,000 among Ger- 
 mans from this cause, while the rate is only 262.1 among natives. 
 The position of the women with regard to pulmonary tuberculosis 
 is favorable throughout practically the whole of life. In virtually 
 every age class pneumonia has a higher death rate among Ger- 
 man males than among the native born ; the same is true for 
 females. Sometimes the differences are very marked, particularly 
 in the case of men; thus at ages "45-64" males of German birth 
 have a pneumonia rate of 269.0 per 100,000, while the corre- 
 sponding rate for native Americans is only 189.6. German males 
 have a higher mortality from heart disease from age 25 upwards ; 
 the same is, in general, true of women, although they have a 
 slight advantage over natives at ages "25-44." In the age period 
 "45-64" German males have a death rate of 328.9 from heart 
 disease, whereas that of the native born is only 316.3; the corre- 
 sponding figures for the female sex are 288.5 for Germans and 
 
19 
 
 247.1 for Americans. With respect to Bright's disease, German 
 males are consistently at a disadvantage throughout all the 
 significant age groups; the same is true of females beginning 
 at age 45. Thus at ages "45-64" the mortality of German males 
 from this cause is 332.4 per 100,000; the corresponding mor- 
 tality for native Americans is 267.2. In the next age class the 
 mortality of Germans is 1306.7, while that of natives is only 
 952.2. Cancer is more frequent at ages "25-84" among German 
 men, and at ages 25-64 among German women. The differences 
 are strikingly large among males ; at ages "45-64," for example, 
 the mortality of German men is 291.3 per 100,000, while that 
 of natives is only 150.0. Suicide is also important; at ages 
 45-64 it accounts for 131.6 deaths per 100,000 German males, 
 but for only 98.0 among natives. A high suicide rate among 
 persons born in Germany has been pointed out by a number of 
 observers. 
 
 Irish 
 
 Irish immigration into the United States attained its highest 
 point as far back as 1851, but it has not ceased to be an im- 
 portant factor in our immigration since that date. In 1910 there 
 were 367,877 persons of Irish birth in the state of New York; 
 they formed 13.5 per cent of the total foreign born and 4.1 
 per cent of the total white population of the state. 
 
 In their own country the mortality rates of the Irish are 
 higher than those of the English, especially for females, but 
 they compare favorably, nevertheless, with those of other races of 
 western Europe. In New York state, however, a surprisingly 
 high mortality for the Irish appears to exist. This is shown in 
 Table 9. 
 
 We may again eliminate from serious consideration all age 
 periods below ages "20-24," because of the absence of Irish immi- 
 grants at the younger ages. Beginning with the period of "20- 
 24," the males show a mortality almost twice that of the native 
 born of native parentage. The rate is nearly three times as 
 great in the next age period, "25-44," and continues to be in 
 considerable excess throughout the rest of life, although the 
 difference is not so marked in the period after 85. Females in 
 the first period, "20-24," show no untoward condition. Begin- 
 ning with "25-44," the rate is more than double that of the native 
 
20 
 
 Table 9. — Deaths per 1,000 white population among persons born in 
 Ireland and among native born of native parentage, by sex and by age 
 period: New York state, 1910. 
 
 
 MALES 
 
 FEMALES 
 
 
 Native 
 
 
 Native 
 
 
 
 born of 
 
 Irish 
 
 born of 
 
 Irish 
 
 Age period 
 
 native 
 parentage 
 
 born 
 
 native 
 parentage 
 
 born 
 
 All ages : 
 
 
 
 
 
 Crude rate 
 
 15.9 
 
 40.2 
 
 13.9 
 
 34.8 
 
 Ages 10 and over: 
 
 
 
 
 
 Crude rate 
 
 13.8 
 
 40.3 
 
 12.4 
 
 34.9 
 
 Standardized rate 
 
 13.8 
 
 25.9 
 
 12.4 
 
 23.5 
 
 Under 10 
 
 23.5 
 
 16.8 
 
 19.6 
 
 10.4 
 
 10-14 
 
 2.5 
 
 
 2.6 
 
 5.1 
 
 15-19 
 
 3.6 
 
 8.1 
 
 3.2 
 
 3.9 
 
 20-24 
 
 5.0 
 
 9.4 
 
 4.7 
 
 4.1 
 
 25-44 
 
 6.9 
 
 18.5 
 
 5.7 
 
 12.0 
 
 45-64 
 
 18.8 
 
 46.3 
 
 14.3 
 
 40.7 
 
 65-84 
 
 77.3 
 
 101.6 
 
 68.2 
 
 107.4 
 
 85 and over 
 
 268.9 
 
 286.1 
 
 242.3 
 
 307.6 
 
 born of native parentage, and this very unfavorable mortality 
 is maintained throughout the remaining age periods of life. Ages 
 10 and over, taken together, present a crude rate of 40.3 for 
 the males and 34.9 for the females. These, when standardized 
 for age periods, are reduced to 25.9 and 23.5 for the respective 
 sexes. The rates are close to twice as high as those of the native 
 born of native parentage. We may infer from the above figures 
 that both male and female Irish born persons living in New 
 York state show mortality rates which are much in excess of the 
 corresponding figures for their own country; indeed, their mor- 
 tality is not far from twice that recorded by the Registrar 
 General of Ireland for similar age periods. 
 
 An examination of the causes for these very unfavorable con- 
 ditions (Table 10) shows, in exaggerated form, a situation not 
 unlike that determined for the German born population of the 
 state. Tuberculosis and pneumonia, as also the degenerative 
 diseases, play a prominent part. With regard to tuberculosis, 
 the Irish born population of both sexes are at almost every age 
 under a disadvantage even greater than that of the Germans. 
 At ages "25-44," for example, there is a mortality from this cause 
 of 662.9 among Irish born males, and of only 352.0 among natives ; 
 in the female sex the corresponding figures are 353.4 and 193.3. 
 In both sexes and at all ages, pneumonia has a higher death rate 
 
21 
 
 among the Irish born. The differences are again very large. At 
 ages "25-44," for example, there is a rate of 211.2 per 100,000 
 among Irish born, but of only 92.1 per 100,000 among native 
 Americans. Irish females in the same age class have a mortality 
 of 110.0, while natives have a rate of only 54.2. Heart disease 
 is strikingly high throughout all the significant age periods in 
 both sexes. Thus at ages "45-64," where the mortality of native 
 females is 247.1 per 100,000, that of the Irish born is more than 
 twice as high — 656.4. In practically every age period, and 
 among both males and females, the same situation obtains with 
 respect to Bright's disease and apoplexy and paralysis. In all 
 ages up to age 84 Irish born males succumb to accidents in large 
 numbers; at ages "25-44," for example, the death rate for this 
 cause among males — 263.7 — was over twice as high as that of 
 native Americans — 103.0. 
 
 The above figures for both the German and the Irish strains 
 in New York state help to explain some of the surprising condi- 
 tions which we found in our discussion of the general death 
 rates in Table 1. Thus, it will be remembered that, at ages "25- 
 44," the native born males of foreign or mixed parentage — 
 that is, first generation Americans — showed a death rate of 
 14.3 per thousand, while the mortality of the native born males 
 of native parentage was only 6.9, and that of the foreign born 
 males was only 8.7. The German and Irish are the predominating 
 races included in the native born of foreign or mixed parentage 
 in this age period, and it is doubtless their influence that accounts 
 for this high mortality. The foreign born of the same age period, 
 on the other hand, now largely composed of Russian Jews 
 and Italians, present, as we have seen, much more favorable 
 conditions. 
 
 Austro -Hungarians 
 
 Austro-Hungarian immigration into New York state is com- 
 paratively recent, having become appreciable only since 1890. 
 Recently, the number of those coming from this country has in- 
 creased by leaps and bounds, and in the last few years they 
 have represented one of the most numerous components of our 
 immigration. In 1910 there were 341,846 Austro-Hungarians, 
 who constituted 12.5 per cent of the foreign born whites and 
 3.8 per cent of the total white population. 
 
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23 
 
 As was observed for the Russians, this nationality is likewise 
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 In Austria-Hungary the mortality rates are relatively high 
 at all age periods, the figures being somewhere between those of 
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 Table 11. — Deaths per 1,000 white population among persons bom in 
 Austria-Hungary and among native born of native parentage, by sex 
 and by age period: 'New York state, 1910. 
 
 
 MALES 
 
 FEMALES 
 
 Age period 
 
 Native 
 
 born of 
 
 native 
 
 parentage 
 
 Austro- 
 Hungarian 
 born 
 
 Native 
 
 born of 
 
 native 
 
 parentage 
 
 Austro- 
 Hungarian 
 born 
 
 AH ages: 
 
 Crude rate 
 Ages 10 and over: 
 
 Crude rate 
 
 Standardized rate 
 
 Under 10 
 10-14 
 15-19 
 20-24 
 25-44 
 45-64 
 65-84 
 85 and over 
 
 15.9 
 
 13.8 
 13.8 
 
 23.5 
 
 2.5 
 
 3.6 
 
 5.0 
 
 6.9 
 
 18.8 
 
 77.3 
 
 268.9 
 
 9.3 
 
 9.4 
 14.3 
 
 7.4 
 
 2.8 
 
 4.1 
 
 4.3 
 
 6.7 
 
 21.0 
 
 77.5 
 
 301.6 
 
 13.9 
 
 12.4 
 12.4 
 
 19.6 
 2.6 
 3.2 
 
 4.7 
 
 5.7 
 
 14.3 
 
 68.2 
 
 242.3 
 
 7.4 
 
 7.3 
 12.4 
 
 8.2 
 
 1.6 
 
 2.0 
 
 3.5 
 
 5.8 
 
 18.2 
 
 63.9 
 
 213.5 
 
 The first two age periods, "under 10" and "10-14," must be 
 disregarded because of the paucity of data. Beginning with the 
 period "15-19," and continuing throughout the rest of life, the 
 rates for the Austrian males fluctuate slightly above and below 
 the rates for the native males of native parentage. The Austrian 
 females in the two periods "15-19" and "20-24" show more favor- 
 able rates than the natives of native parentage. In the next 
 age period, "25-44," the two sets of figures are virtually identical. 
 
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 In the period "45-64" the Austrian females show higher rates, 
 while at ages "65-84" the relationship is reversed. The figures 
 for the last age period may be disregarded because of insufficient 
 numbers. 
 
 On examining the causes of death of this nationality (Table 12), 
 we find a surprisingly large number of deaths from violence 
 (excluding suicide). This may be attributed to the unskilled and 
 perilous occupations in which immigrants from Austria-Hungary 
 engage to a very large degree. The disadvantage of these people, 
 as opposed to native Americans, is apparent in almost every age 
 class and in both sexes ; it is particularly striking and consistent 
 among males. Thus at ages "20-24" the mortality from these 
 causes was 139.7 among Austro-Hungarians and only 96.9 among 
 natives. The deaths from these causes formed 32.2 per cent of 
 all deaths of Austro-Hungarian males at ages "20-24" and only 
 16.8 per cent of the total deaths among the native born in New 
 York state. In the later years the rates for cancer and Bright's 
 disease are also higher in both sexes. For example, among males 
 aged "45-64" there was a cancer mortality of 259.8 per 100,000 
 among Austro-Hungarians, in contrast with only 150.0 among 
 native Americans. 
 
 English, Scotch, and Welsh 
 
 Immigration from England, Scotland, and Wales into the state 
 of New York has been of secondary importance in comparison 
 with the great wave of immigration from eastern and southern 
 Europe. In 1910 there were only 193,359 of these stocks in New 
 York state, constituting 7.1 per cent of the foreign born and 
 2.2 per cent of the total white population of the state. So 
 light has been the immigration from these countries in recent 
 years that the total number under age 25 is too small to give 
 reliable death rates. 
 
 The mortality rates of England, Scotland, and Wales are among 
 the most favorable in Europe. Moreover, the fullness of the 
 official returns from these countries makes comparisons readily 
 possible with the corresponding figures found in New York state, 
 which are presented herewith (Table 13). 
 
 For reasons indicated above we shall not consider the death 
 rates in the first four age periods in this table. In the age 
 period "25-44" there is a considerably higher mortality for the 
 British males than for the native born of native parentage. This 
 
26 
 
 Table 13. — Deaths per 1,000 white population among persons born in 
 England, Scotland, and Wales, and among native born of native parentage, 
 by sex and by age period: New York state, 1910. 
 
 
 MALES 
 
 FEMALES 
 
 
 Native 
 
 English 
 
 Native 
 
 English 
 
 
 born of 
 
 and 
 
 born of 
 
 and 
 
 Age period 
 
 native 
 
 Scotch 
 
 native 
 
 Scotch 
 
 
 parentage 
 
 born 
 
 parentage 
 
 born 
 
 All ages: 
 
 
 
 
 
 Crude rate 
 
 15.9 
 
 21.8 
 
 13.9 
 
 20.6 
 
 Ages 10 and over: 
 
 
 
 
 
 Crude rate 
 
 13.8 
 
 22.6 
 
 12.4 
 
 20.8 
 
 Standardized rate 
 
 13.8 
 
 16.6 
 
 12.4 
 
 15.8 
 
 Under 10 
 
 23.5 
 
 7.0 
 
 19.6 
 
 6.0 
 
 10-14 
 
 2.5 
 
 3.7 
 
 2.6 
 
 3.3 
 
 15-19 
 
 3.6 
 
 5.8 
 
 3.2 
 
 5.8 
 
 20-24 
 
 5.0 
 
 4.3 
 
 4.7 
 
 3.8 
 
 25-44 
 
 6.9 
 
 8.7 
 
 5.7 
 
 7.6 
 
 45-64 
 
 18.8 
 
 24.6 
 
 14.3 
 
 21.0 
 
 65-84 
 
 77.3 
 
 86.6 
 
 68.2 
 
 79.9 
 
 85 and over 
 
 268.9 
 
 261.9 
 
 242.3 
 
 279.6 
 
 condition continues throughout the period "45-64." In the last 
 period the rates are very much the same. In the age period 
 "25-44" the British females likewise show a higher mortality than 
 do the native born of native parentage, and this condition con- 
 tinues throughout the rest of life. Considering all ages, 10 and 
 over, the crude rate for males is 22.6 and for females 20.8. 
 Standardized rates are respectively 15.6 and 15.8, which are 
 considerably higher than the corresponding figures 13.8 and 12.4 
 for the native born of native parentage. It is difficult to under- 
 stand why the mortality of the British in New York state should 
 be so much higher than that found in their own country. 
 
 No group of causes (Table 14) stands out with such promi- 
 nence as to enable us to draw any general conclusions, and, 
 indeed, the basic figures before age 25 and after age 64 would 
 scarcely be large enough to justify them. It may be interesting, 
 however, to note that pneumonia is higher among British males 
 at ages "25-84" and among females at all ages beginning with 
 age 25, than among natives. At ages "45-64," for example, there 
 is a mortality, from this cause, of 252.7 per 100,000 among 
 males born in England, Scotland, and Wales, but of only 189.6 
 among native Americans ; the corresponding figures for females 
 are 199.7 and 130.3, respectively. Cancer is higher among 
 British males in all age groups beginning with age 45, and 
 among British females at ages "25-84." Thus there is a rate 
 at ages "45-64" of 239.7 per 100,000 among males of this stock, 
 
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 in contrast to 150.0 among native males; the mortality of British 
 females from this cause is 360.9, while that of natives is 287.4. 
 Heart disease is higher among males at ages "25-44" and "65-84," 
 and among females at all ages beginning with age 45. Bright's 
 disease is likewise higher among females at ages "45-84." 
 
 Summary 
 The lowest mortality rate in the population of New York 
 state is found among the native born of native parentage. This is 
 true for both sexes and for virtually every age period, but is 
 marked at the adult ages. The foreign born and their native born 
 offspring agree much more closely with each other than they do 
 with the native born of native parentage. There are marked 
 variations, to be sure, in the several age periods and in the 
 two sexes, but the first generation Americans and the foreign 
 stock from which they have arisen show unmistakably their close 
 connection. The death rates of the component races among the 
 foreign born present very marked variations. Remarkably low 
 rates are found among the Russians, and this is largely accounted 
 for by the presence of a large proportion of Jews among them. 
 The Italians follow very closely with exceptionally low rates 
 of mortality, although Italian females at certain age periods 
 show rather unfavorable conditions, especially from the respiratory 
 diseases. The remaining races may be arranged roughly in the 
 following increasing order of mortality: Austro-Hungarians, 
 British, Germans, and Irish. Of these four nationalities, the 
 first appears to be the only one whose mortality in New York 
 state is more favorable than that prevailing in the native country. 
 The very high rate of mortality among the Germans and es- 
 pecially among the Irish is one of the surprising facts of this 
 study. Apparently it is the very high incidence of pulmonary 
 tuberculosis that is largely responsible for this condition, although 
 the degenerative diseases also present rates much in excess of those 
 for the native born of native parentage or for the same nationalities 
 abroad. These facts are clearly indicative of unfavorable conditions 
 of life and work among the peoples in question, and point definitely 
 to the need of special public health work by the state and various 
 city departments of health for these groups of the population. 
 A large number of unnecessary deaths would readily be prevented 
 by a concerted effort carried over a period of years. 
 
 Louis I. Dublin. 
 Metropolitan Life Insurance Company. 
 
LIBRARY OF CONGRESS 
 
 01 3 737 827 9 #