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105
It is well known that the conditions prevailing in most urban
communities are unfavourable to infant life. There are sufficient
grounds for believing that the urban infant is almost as
healthy at birth as is the rural. Indeed, during the first month
of life, when more than one-third of the total infant mortality
occurs, the urban excess over the rural is only about 8 per cent. ;
during the first three months the urban excess is 11.6 per cent.;
in the next three months it is 43 per cent. ; while in the second
half of the first year it is 67 per cent. higher in the urban than
in the rural districts. Generally, as Dr. Newsholme has pointed
out, the towns having respectively high or low rate of infant
mortality have similarly a high or low mortality in the next
4 years of life, and those with excessive infant and child mortality
continue to experience excessive mortality, though in less degree,
at the higher ages.
A steady improvement in this rate from 1901 onwards is
one of the most striking features of recent statistical history.
Some conception of the life-saving thus secured may be gathered
from the following illustration. In the seven years 1906-12 the
deaths of 736,682 infants occurred in England and Wales,
equivalent to an average rate of 115 per 1,000 births. Had the
infant death-rate been 144 per 1,000, as it had been in the seven
years 1899-1905, there would have perished 922,454 infants in
the years 1906-12. Thus the improved conditions imply a saving
of 185,772 lives during these seven years.
Infant mortality increases as the social position of the community
declines; but that the excessive death-rates associated
with urban poverty are not necessarily due to poverty is proved
by the fact that the rate amongst the infants of agricultural
labourers is quite low. We are thus driven to the conclusion that
artificial feeding, connoting unsatisfactory arrangements for the
protection of food from contamination and the consumption of
faultily prepared as well as contaminated food, is mainly
responsible for the high urban infant mortality among the poorer
class.