MORTALITY:

By: Joseph Jacobs, Maurice Fishberg

Mortality of Children.

Death-rate. The bulk of the Jews are known to live in the most overcrowded and unsanitary sections of cities in Europe and America, and would, a priori, be expected to show a higher rate of mortality than their non-Jewish neighbors. But, paradoxical as it may at first appear, wherever statistics are available it is conclusively shown that their death-rates are much lower than those of the races and peoples among whom they dwell, notwithstanding the fact that the latter live generally under better sanitary, hygienic, and social conditions. The mortality of infants depends in a great measure on the social and sanitary environment; yet most of the available data indicate a very low infant mortality among Jews as compared with the surrounding non-Jews. J. G. Hoffmann ("Betrachtungen über den Zustand der Juden im Preussischen Staat," in "Sammlung Kleiner Schriften Staatswissenschaftlichen Inhalts," pp. 330 et seq., Berlin, 1843) was the first to point out that such is the case in Prussia. From his figures it is seen that while among Christians nearly one-fifth of all the legitimate children (including still-births) die before they reach their fifth year, the mortality of both legitimate and illegitimate children of Jewish extraction is less than one-sixth of the number of births. It must be remembered that the death-rate of illegitimate children is very high, and that these are included in the statistics of the Jews, but are excluded from those of the Christians. The number of illegitimates among Jews is, however, very small. The same author also points out that 174 out of every 1,000 Christian children in Prussia (1822-40) died before they reached the end of the first year of their existence, while the death-rate among the Jewish infants was only 129 in 1,000. In the same manner it is shown by F. J. Neumann ("Die Sterblichkeit Ehelicher und Unehelicher Kinder, Insbesondere Innerhalb der Jüdischen Bevölkerung in Baden," in "Jahrbücher für Gesetzgebung, Verwaltung, und Volkswirthschaft," 1877, i. 151-164) in Baden that the infant mortality was much lower among the Jews than among the rest of the population, as may be seen from the following table:

Infant Mortality in Baden.

Period of Life.	Protestants.		Catholics.		Jews.
	_______________________		_______________________		_______________________
	1864 to 1870.	1871 to 1873.	1864 to 1870.	1871 to 1873.	1864 to 1870.	1871 to 1873.
First week	2.95	2.80	4.37	4.21	2.43	2.32
Second week	2.25	2.07	2.75	2.62	1.79	1.33
Third week	1.90	2.01	2.68	2.61	1.63	1.29
Fourth week	1.16	1.06	1.40	1.28	0.87	0.81
First month	8.26	7.93	11.21	10.71	6.73	5.73
First half-year	19.54	19.40	22.99	22.79	15.00	13.89
First year	25.69	25.25	28.83	28.46	16.88	17.61

From these figures it is evident that the infant mortality among the Jews was from 8 to 10 per cent lower than among the Christians, and that the chances of surviving the first, the so-called "critical," year were much greater among the Jewish children. The same author elicited also, from the mortality statistics of Baden for 1882, that the death-rate, including still-births, was 22 per cent among the Jews, as against 28 per cent among the Protestants, and 31 per cent among the Catholics.

The following was the infant mortality of Posen in 100 total deaths: During the first year of life: Catholics, 33.14; Protestants, 31.35; Jews, 23.12. During the first ten years of life: Catholics, 56.33; Protestants, 53; Jews, 45.12 ("Sterblichkeitsverhältnisse der Stadt Posen," in "Vierteljahreschrift fürGerichtliche Medicin," 1869, pp. 269-280). In Magdeburg Bergman ("Die Sterblichkeitsverhältnisse der Stadt Magdeburg," 1858, p. 94) records that from 1827 to 1856 the mortality during the first year of life, excluding still-births, was as follows: Among the Jewish boys 14, among the Christian boys 24; among the Jewish girls 13, and among the Christian girls 21.

In Amsterdam the mortality of children under five years of age was 8.85 per cent among the Jews and 11.52 per cent among the Christian population. In Frankfort-on-the-Main, also, the mortality of Jewish children under the age of five was not one-half so high as that of the Christians. Glatter has shown that in Vienna the mortality of infants during the first five months of life was as follows: First month: Jews 8.3, Christians 16.1; second and third months: Jews 15.0, Christians 17.7; fourth and fifth months: Jews 45.6, Christians 52.8.

In Germany and England.

Wolff reports that among Christians 591 legitimate children out of 1,000 reach the fourteenth year of life, while among the Jews 802 reach this age ("Ueber die Kindersterblichkeit," Erfurt, 1874). Mayer shows that in Fürth during a period of ten years the Jews lost by death 10 in 100 children from one to five years old, while the Christians lost 14 ("Ueber die Lebenserwartung der Israelitischen Bevölkerung Gegenüber der Christlichen," in "Deutsche Zeitschrift für die Statistik," 1863, xxi. 2). In France Neufville found conditions to be the same. During the first five years of life 12.9 in 100 children of Jews die; of 100 children of Christians 24.1 die. In Italy Lombroso shows that in Verona the infant mortality of the Catholics is nearly double that of the Jews. In his work, "London Pauperism," Stallard says that the mortality among Jewish children from one to five years of age is only 10 per cent, while among the Christians it reaches 14 per cent. J. M. Rhodes, at the meeting of the British Medical Association in 1892, presented figures showing that the infant mortality in Manchester, England, reached 198 per 1,000; but in the district of Cheetham, which is largely inhabited by Jews, the death-rate was only 124—less than two-thirds of the average for all the districts of the city. The same has been shown to be true of London by various expert witnesses in their testimony before the Royal Alien Immigration Commission.

A. Ruppin reports that in Prussia in 1882 the proportion per 1,000 children (including still-births) that survived the first year of life was as shown in the following table:

	Boys.	Girls.	Deaths per 1,000 Births, Both Sexes.
Protestants	753	789	229
Catholics	758	796	223
Jews	814	843	171

In Bulgaria and Poland.

In Bulgaria, according to H. Rimalovsky ("Zur Statistik der Bulgarischen Juden," in Nossig, "Jüdische Statistik," pp. 316-321, Berlin, 1903), the mortality of children per 1,000 population was as follows:

Mortality of Children in Bulgaria.

	Ages in Years.
	__________________________________
	Less than 1.	1 to 5.	5 to 10.	10 to 15.
Jews	6.9	12.0	1.4	0.5
Greek Catholics	6.2	12.0	2.2	1.1
Mohammedans	4.6	16.0	17.0	1.2
Armenians	9.0	15.0	1.5	0.7

This shows that during the first year of life the mortality of Jewish infants is higher than that of the non-Jewish children (excepting Armenian); but that in succeeding years the death-rate of the Jews is lower. In Poland also it has been found that during the first year of life the mortality of Jewish infants is higher than among the Catholic population of that country. Thus according to Leo Wengierow ("Die Juden im Königreich Polen," in Nossig, l.c. pp. 293-310) the death-rate per 1,000 births during the first year of life among the Catholics was 140, and among the Jews 143. This appeared rather strange to Wengierow, considering the fact that love for their offspring is very highly developed in Jewish parents as compared with the Catholic population of Poland. He, however, shows that the cause of this high mortality is to be sought in the distribution of deaths according to sex, which shows the following significant results: Against 100 girls of Catholic parentage 107 boys die; against 100 girls of Jewish parentage 132 boys die. More boys are born to Jews than to non-Jews (see Births); and the mortality of males is also larger among Jewish infants. Wengierow attributes this to the lack of antiseptic precautions during the ritual circumcision of Jewish boys. This is a rather far-fetched conclusion, not sustained by statistics of septic infection of boys due to circumcision.

The same conditions have been found to prevail in Galicia. Kitz presents figures showing that during 1882 the death-rates of children under five years of age were as follows: Roman Catholics, 51 per cent; Protestants, 53.6 per cent; and Jews, 56.6 per cent. For Bukowina, Schimmer's statistics are:

Mortality of Children in Bukowina.

Age.	Jews.		Non-Jews.
	______________		______________
	Boys.	Girls.	Boys.	Girls.
One year and under	41.9	35.2	40.6	34.9
First to fifth year	18.2	20.5	14.8	15.8
Fifth to tenth "	3.5	4.2	4.4	4.7

The cause assigned for the great mortality of Jewish children in Galicia and Bukowina is that the proportion of illegitimacy is very large among the Jews in these countries, and the death-rate of Jewish illegitimate children in general is much higher than that of legitimate children. But the apparent frequency of illegitimacy among these Jews is due to the practiseof omitting civil registration of marriages among them in the small towns, as has been pointed out by Kitz and Schimmer (see Births).

In Russia.

In Russia the infant mortality of the Jews in the Pale of Settlement is much lower than that of the Christians. According to the figures of the census of 1897 (see "Voskhod," March, 1904, pp. 116-117) the age distribution per 100 total deaths was as follows:

Age.		Christians.	Jews.
Under 1	year	40.91	25.68
1 to 5	year	21.10	22.06
5 to 10	"	4.88	4.81
10 to 15	"	1.92	2.64
15 to 20	"	1.82	3.00
20 to 30	"	3.85	6.01
30 to 40	"	3.63	4.93
40 to 50	"	3.91	4.93
50 to 60	"	4.75	6.78
60 to 70	"	5.94	7.99
70 to 80	"	5.00	7.34
80 to 90	"	2.11	3.84

This table shows that during the first year of life only 25.68 per cent of Jews die, as against 40.91 per cent of Christians. From 1 to 10 years of age the death-rate is about the same for Jews and Christians. After the age of ten the percentage of deaths is perceptibly larger among the Jews.

The low mortality of Jewish infants in the Pale of Settlement is also seen from the following table, which gives the number of deaths during the first year of life per 100 births:

Deaths of Infants in Pale of Settlement.

Months.		Deaths per 100 Births.
		____________________
		Christians.	Jews.
Under 1 month		7.23	2.74
1 to 3	months	5.73	2.28
3 to 6	"	5.60	2.63
6 to 12	"	7.40	5.56
To 1 year		25.96	13.21

All these observations are confirmed by vital statistics of the Jews in the United States. From the reports of the census of 1890 it is seen that the mortality among children of the Russian and Polish Jews in America is lower than that of any other race or nationality, as may be seen from the following table:

Mortality of Children Under Fifteen Years of Age in the United States.

Birthplace of Mother.	Mortality per 1,000.
Bohemia	82.57
Italy	76.41
United States	54.01
Ireland	50.87
England and Wales	50.53
Hungary	47.21
France	47.01
Germany	46.97
Russia and Poland (mostly Jews)	28.67

The fact is well established by other statistical evidence that the districts mostly inhabited by the immigrant Jews in New York, Philadelphia, Boston, Chicago, etc., show the lowest mortality of infants and children, and this in spite of the fact that these districts are the most overcrowded and insanitary in those cities. This low mortality of Jewish children is best illustrated by the life-tables prepared by John S. Billings in his "Report on the Vital Statistics of the Jews in the United States" (Washington, 1890; reprinted in Jew. Encyc. v. 307). From these tables it is found that, according to the birth-rate statistics of males and females among the Jews in Massachusetts, in 100,000 infants 50,684 would be males and 49,316 females. At the end of the fifth year 41,731 male children would be alive, and by the end of about seventy-one years one-half of them would have died. Comparing these with the general population of Massachusetts, where 51,253 children out of every 100,000 are males, only 36,727 would reach the end of their fifth year, and one-half of these would have died at the end of about the forty-seventh year.

The general rate of mortality of the Jews has also been observed in various countries to be lower than that of their Gentile neighbors.

The following are earlier data with regard to the comparative mortality of Jews and others, mainly derived from Legoyt and Lagneau:

Death-Rate per Thousand.

Country.	Epoch.	Jewish.	General.	Reference.
Algeria	1857-72	27.7	39.3	Lagneau, p. 832.
"	1873-76	24.3	29.5	Ib.
Austria	1851-57	21.0	33.5	Schimmer, "Statistik," p. 129.
"	1861-70	21.4	32.5	Ib.
Baden	1857-63	18.0	25.3	"Dict. des Sciences Medicales," s.v.
France	1855-59	17.6	23.9	Legoyt, "Immunités," p. 116.
Prussia	1831-49	22.9	31.0	Hoffmann, l.c.
"	1849-61	23.4	36.6	Legoyt, l.c. p. 109.
Russia	1852-59	28.0	33.8	Ib. p. 97.
"	1867-70	28.5	34.4	Ib. p. 94.
Saxony	1850	24.4	31.0	"Revue Scientifique," 1881, p. 622.
Tuscany	1861	23.4	29.5	Legoyt, l.c. p. 116.

General Death-Rate.

The vital statistics of Prussia, which are fairly complete and satisfactory, show the lower death-rate among Jews in a very striking manner. In that country, according to figures in Mullhall's "Dictionary of Statistics," the annual death-rate has been found to be per 1,000 population as follows:

Years.	Christians.		Jews.
	_______________		______________
	Males.	Females.	Males.	Females.
1822-40	28.7	27.0	22.1	19.1
1841-66	30.2	28.2	19.8	17.9

and from Arthur Ruppin's recent compilation the mortality has been found to be as follows:

Years.	Among Jews.	Among Christians.
1878-82	17.53	25.23
1888-92	15.71	23.26
1893-97	14.73	21.84

From these figures it is clear that while the general mortality rates increased during the period 1822-66, that of the Jews decreased; the decrease continuing to such an extent that in 1897 the rate was only 14.73 per 1,000 population. Among the Christian population a decrease manifested itself between 1878 and 1897, but it was not so large as that among the Jews. The mortality of 14.73 per 1,000 of the Jews in Prussia is considered by Ruppin "so low that it has not been reached in any country in the world, and is the ideal of hygienic and sanitary achievement to which all may strive." It is remarkable that this low mortality mostly occurs among children under fifteen years of age, the number of deaths among whom is much smaller with the Jews than with the Christians. The mortality of persons over fifteen years of age is only a little less among the Jews than among the Christians; and during the five years 1893 to 1897 it was even 0.4 per 1,000 larger, as may be seen from the following table:

Years.	Among Jews.		Among Christians.
	______________________________		______________________________
	Under 15 Years.	15 Years and Over.	Under 15 Years.	15 Years and Over.
1878-82	7.40	10.13	13.41	11.82
1888-92	5.06	10.65	12.17	11.09
1893-97	3.96	10.77	11.47	10.37

Hungary also possesses good records of vital statistics, and there it is found that the mortality of the Jews is much below that of their non-Jewish neighbors. Lombroso's figures show that the rate of mortality of Christians under fifty years of age in that country is 14 in 1,000, while that of the Jews is only 10. Körösi shows the same for Budapest for all deaths. For 1885 to 1893 his figures are:

Roman Catholics	722	deaths	per	10,000.
Lutherans	788	"	"	"
Calvinists	550	"	"	"
Other Protestants	625	"	"	"
Jews	376	"	"	"

From 1886 to 1890 the mortality per 1,000 of the population in Budapest was, according to Körösi, as follows:

Age.		Catholics.	Lutherans.	Calvinists.	Jews.
Under 5 years		160	145	135	76
5 to 10	years	17	15	16	9
10 to 30	"	11	10	10	6
30 to 50	"	21	22	18	11

In Austrian Galicia the available data tend to confirm the low general mortality of the Jews, notwithstanding the poor economic and social conditions under which they find themselves and in spite of the high infant mortality. V. Kitz ("Die Bewegung der Bevölkerung in Galizien i. J. 1882 mit Rücksicht auf Konfessionen," in "Statistische Monatsschrift," 1883, p. 550) shows the mortality per 1,000 population to be as follows: Roman Catholics, 33.2; Greek Catholics, 42.0; Protestants, 29.1; Jews, 29.4.

In Algiers Legoyt ("De la Vitalité de la Race Juive," in "Jour. de la Société Statistique de Paris," 1865, vi.) records that there occurred one death among 22.5 Europeans, and only one death among 35.8 Jews. According to Boudin ("Géographie Médicale," ii. 216) the mortality in Algiers in 1844 and 1845 per 1,000 population was 57.7 among the Europeans and only 33.9 among the Jews.

In Bulgaria.

In Bulgaria, where the general mortality during the period 1893-99 was 26 per 1,000 population, the number of deaths according to religious belief was as follows: Jews, 22; Greek Catholics, 24; Mohammedans, 27; Armenians, 44. In general the mortality among the Jews was 22 and among others 28 per 1,000 population. A point worthy of notice in connection with the mortality in Bulgaria is that the Armenians, who, like the Jews, live mostly in cities, show the highest mortality rate, while the Jews, in spite of being townfolk, show the lowest (H. Rimalovsky, "Die Jüdische Bevölkerung in Bulgarien," in Nossig, "Jüdische Statistik," p. 316).

The mortality of the Jews in Warsaw, Poland, is also less than that of the Christian population, notwithstanding the fact that the infant mortality is very great among the Jews. According to Wengierow. (l.c.), it appears that in 1889 in 1,000 population the mortality was: 28.1 Christians and only 17.9 Jews. The same is the case with the Jewish population of Russia. According to the census of 1897, the mortality in the Pale of Settlement was 26.3 per 1,000 among the Christians, while among the Jews it was only 16.3 ("Voskhod," March, 1904, p. 127).

In the United States.

From various statistics of the Jews in the United States of America the same phenomena are to be observed. In spite of the fact that the immigrant Jews live there in the congested tenement districts of cities, their rate of mortality is much below that of the other races and peoples in the same locality. From Billings' statistics of 60,330 Jews living in the United States on Dec. 31, 1889, it has been elicited that the average annual mortality was only 7.11 per 1,000 population, which is "little more than half the annual death-rate among other persons of the same social class and condition of living in this country" ("Vital Statistics of the Jews in the United States," p. 10). In the "Report of Vital Statistics of New York City for 1890" it is shown that during the six years ending May 31, 1890, the mortality was as follows:

Birthplace of Mother.	Mortality per 1,000 Population.
Bohemia	43.57
Italy	35.29
Ireland	32.51
United States	32.43
England and Wales	27.67
Germany	24.27
France	23.28
Hungary	22.43
Russia and Poland (mostly Jews)	14.85

The Russian and Polish Jews are thus shown to have the lowest mortality. Moreover, their low death-rate, as the census report points out, does not fully appear in these figures, because a considerablenumber of those whose mothers were born in Hungary and Germany are Jews with a low death-rate, and if it were possible to eliminate them, the death-rates of the Germans and Hungarians would stand at much higher figures. Then, again, among those registered as Russians and Poles were a certain number of Christians. If these could be separated into a special group, the mortality of the Jews would be shown to be much lower. To verify these figures Fishberg has analyzed the mortality figures for the Seventh, Tenth, Eleventh, and Thirteenth wards of New York city, which are inhabited by over 80 per cent of Jews. He found that during 1899 the death-rate per 1,000 population was as follows: in the Seventh Ward, 18.16; in the Tenth, 14.23; in the Eleventh, 16.78; and in the Thirteenth, 14.52. The Seventh Ward, which has a very large population of non-Jews (probably 40 per cent), shows the highest mortality; and the Tenth, which has the smallest proportion of non-Jews, only 14.23. This is confirmed by vital statistics in Chicago, which "has a large population of Jews, among whom the death-rate is low. A curious illustration of this is found in a comparison of the vital statistics of two of the river wards. In the old Seventh Ward the death-rate is only 11.99 per 1,000, while in the neighboring ward it is 45.9 per cent higher. The sanitary conditions of both wards are as bad as possible; but in the ward with a low death-rate the Jews live" (Robert Hunter, "Tenement Conditions in Chicago," 1891, p. 158). Similar statistics are available for Boston and other cities in the United States.

Causes of Low Mortality.

The causes of the low mortality of the Jews are various. In some countries it is to be seen that it mainly depends on the low mortality of children under ten years of age. In such cases it may be attributed to the great care taken by Jewish mothers in rearing their offspring; to the fact that Jewesses in eastern Europe only rarely work in factories or even at home (excepting at household duties), and so have more time to devote to their children; and also to the fact that Jewesses, excepting in cases of illness, almost invariably nurse their children at the breast. But that the cause of the low general mortality of the Jews can not invariably be attributed to the low mortality during infancy and childhood may be seen from the statistics for Poland, Galicia, Bukowina, and Prussia, where the mortality among Jewish children is equal or even larger than that among the Christians in these countries, and yet the general average mortality at all ages is much lower with the Jews than with non-Jews. It must be mentioned that illegitimate children of Jewish extraction have a much higher mortality than non-Jewish children of this class, which goes to show that the low mortality in other cases is wholly due to the greater care taken by Jewish mothers in rearing their children.

In eastern Europe the Jews do not engage in dangerous trades, such as mining, etc.; thus a large number are not exposed to death. A larger proportion of Jews are merchants, small traders, etc., and these are known to be a long-lived class. A careful scrutiny of the diseases to which the Jews are more or less liable (see Morbidity) shows that the Jews are less liable to succumb to some of the most frequent diseases which contribute largely to swell the rate of mortality among others, such as consumption, pneumonia, etc. All these can be referred to social causes, among which the rarity of alcoholism and syphilis is of most importance. The complete rest enjoyed by the Orthodox Jew on the Sabbath may also be a notable factor in warding off disease and death in the case of many.

That the low mortality of the Jews is to be ascribed mainly to social causes is confirmed by the fact that the death-rates of the Jews are smallest in countries where they live isolated from their non-Jewish neighbors, pursuing their mode of life according to their traditions and belief. On the other hand, wherever the Jews commingle and assimilate with their Gentile neighbors, adopting their mode of life, their death-rate increases. This is best shown in the vital statistics of American Jews, the death-rate of the native-born being 9.16 per cent as against only 7.61 in the foreign-born. This may be ascribed to the fact that alcoholism, syphilis, etc., are more frequent among the former, that they also engage more often in dangerous trades, and that their wives more frequently work in factories, etc., after marriage.

J. M. Fi.