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CITY LIFE AND MALE MORTALITY.
BY J. E. BAKER.
The complexity of modern life appears in concentrated solution in the city. Here we find the demoralizing luxury of the ultra-rich and the awful squalor of the very poor; here, too, the nervous strain and the alluring temptations of the great industrial class, a class far more numerous and far more important than both the extremes of wealth and poverty taken together. Hence Dr. Ogle characterizes the city as "a mighty vampire, continually sucking the strongest blood of the country to keep up an abnormal supply of energy it has to give out in the excitement of a too fast and unwholesome life."
The breaking point in human vitality is death. How people die indicates in a considerable measure how they have lived and how succeeding generations will live. Says Dr. Farr: “There is a relation between death and national primacy ...; there is a relation between the forms of death and moral excellence or infamy." The economic life of the nation depends primarily upon the male sex, and more especially upon it during its years of vigorous maturity. Accordingly, we ought not to be satisfied with the mere knowledge that city death-rates are usually higher than those for the country, but should seek to determine how deadly is city life to men as a class.
The registration area, comprising the states of Rhode Island, Massachusetts, New York, New Jersey, Connecticut, New Hampshire, Michigan, Maine, and Vermont, by the United States census of 1900, had a death-rate in cities of 18.6 and in the rural portion of 15.4 per thousand of population. This higher city death-rate fell more heavily upon men than upon women, for, while the male death-rate in cities was 19.8 per
thousand, the female death-rate was only 17.5 per thousand. In the rural portion of the area, however, the death-rates for the two sexes were fairly equal, the male death-rate being 15.8 and the female 15 per thousand of respective populations. Since the male rate is generally higher than the female rate, it will be convenient to call this difference against the males “excess.” Thus in the registration area the urban excess is higher than the rural excess by 1.5 per thousand of population. Is this typical of the whole United States?
For territory outside of the registration area the census of 1900 did not compute death-rates for the reason that the prevailing lax regulations permit many deaths to go unrecorded. It may be assumed, however, that the deaths of males are recorded with about the same degree of fidelity as the deaths of females: hence deficiencies in the rates which might be computed would be of amount rather than of proportion. From the laws of probability, then, it may be assumed that the omissions in each sex will be approximately equal, and, therefore, the male and female death-rates may be compared with each other, and that comparison carried from state to state.
Outside the registration area no distinction is made in the census between urban and rural populations or urban and rural deaths, but, if city life is particularly deadly to men, then, other conditions being equal, in those states where a large proportion of the population is found in cities, we shall find a high male excess.
The census sets a population of 8,000 as entrance requirement to the rank of city, so the proportion of a state's population found in cities of 8,000 or more is used to determine the rank of that state in urban importance.
So many local influences are at work in every community, subduing or accentuating any general force, that in comparisons between individual states the universal law may be completely hidden. Therefore, it is necessary, after ranking the states according to urban importance, to consider them in groups. Computing the death-rate for each sex in each group (Table I),
Ratio found in Male Female Male to Cities of Death-rate. Death-rate. Female
"Excess." 8,000 or
Rhode Island Massachusetts New York New Jersey Connecticut Illinois Maryland Pennsylvania California Delaware New Hampshire Ohio Colorado Washington Michigan Missouri Wisconsin Montana Minnesota. Utah Indiana. Wyoming Oregon Maine Louisiana Kentucky Iowa. Nebraska Florida Virginia Kansas Tennessee Texas Vermont Georgia. West Virginia South Carolina Alabama Arkansas North Carolina Oklahoma. North Dakota South Dakota Mississippi Nevada Indian Territory New Mexico Idaho Arizona.
81.2 76.0 68.5 61.2 53.2 47.1 46.9 45.5 43.7 41.4 38.6 38.5 38.1 31.9 30.9 30.8 30.7 27.0 26.8 25.2 24.2 24.1 23.9 23.7 22.8 16.4 16.8 15.8 15.0 14.7 14.0 13.4 11.3 11.2 11.0 7.7 7.5 7.3 5.4 5.1 5.0 3.0 2.6 2.6
we find that in the first group of states the male excess is 1.98 per thousand of population; in the second group, 1.49; in the third, .59; in the fourth, .21; and, in the fifth, a minus .02, that is, a female excess. The gradation is marked by its regularity.
But perhaps this smaller male excess in the lower groups is due to the insufficiency of data. For instance, if the normal male death-rate is 16 and the female death-rate is 14, the excess is 2; but, if only half the data are gathered, the rates will be 8 and 7, respectively, and the excess will be only one, giving the gradation just noted. To satisfy this sound objection, use the method of ratios, with the female death-rate as the base, or 1. The ratio between 8 and 7 is the same as between 16 and 14. From this method the ratio in the first group is approximately 1.133; in the second group it is 1.129; in the third group, 1.049; in the fourth, 1.016; and, in the fifth, .998, giving the same gradation as before (See Table I, columns 2 and 3). The fact is established, then, that the male excess increases in size as the cities increase in importance.
The excess in the death-rate among males observable in the cities is not due to a peculiar age composition in the urban population. This is made evident by the census statistics for the registration area. Table II shows, in each of the eight age groups considered, an excess in the death-rate among males in cities as compared with the death-rate among males in the rural districts.
Compiled from United States Census, Vital Statistics, Vol. I, p. lxxx.
To continue the investigation, each state may be studied with four age groups; viz., 0 to 14, 15 to 24, 25 to 54, and 55 upwards, corresponding to the periods of childhood, youth, maturity, decline. By using the same methods of computing rates and the same groups of ten states in each age group, as described in the preceding paragraphs, fairly similar results are obtained. In both the early periods, childhood and youth, the ratio of male to female death-rate shows a sudden drop between the first and second groups of states, while the third, fourth, and fifth groups show a fairly downward tendency in childhood and an indifferent tendency in youth (See Table IIIa). In the period corresponding to decline the movement is so irregular that any interpretation would be too involved and lengthy for present purposes, if at all plausible when done. It does not directly upset the thesis of this study, but it certainly does not support it, except in a far-fetched fashion, when the first two groups are compared with the last three (See Table IIIb).
But the age period 25 to 54, maturity, the age of greatest productivity, of greatest commercial stress, the age of home making and family rearing, the age of greatest vital interest and of greatest industrial importance,—this age, if any, should afford the crucial test as to whether or not the city is a ruthless destroyer of men. With a ratio falling by remarkably regular steps from 1.172 in the first group of states to 1.047 in the second group, then to .914 in the third, and .879 and .815 in the fourth and fifth, respectively, the hustle and dash, the nervous strain, the luxury and allurements of city life, are proved to be positive promoters of male mortality.