The Comparative Mortality ot the White and Colored Races in the South. By J. T. Walton, M. D., San Antonio, Texas. Reprint from The Charlotte Medical Journal. Charlotte, N. C. March, 1897. The Comparative Hortality of the White and Colored Races in the South. By J. T. Walton. M. D., San Antonio, Texas. The Negro has several things to show for his quarter century of freedomi as- tonishing progress, encouraging morals and intellectual improvement and an ab- normally large death-rate. In late years, notwithstanding his increasing intelli- gence beneath his own vine and fig tree, he seems to have fallen an easy victim to disease and death. While philanthropists were earnestly looking after him educating him, build- ing churches for him, and otherwise con- tributing to his elevation, it became as a matter of peculiar moment and interest to them to know that, in proportion, he was dying twice as fast as his white brother. Though statistics prior to the emanci- pation are scarce, there is every reason to believe that the colored man's death- rate has largely increased since his libera- tion, for as a slave he seemed hardy enough, his health being guarded by his master for obvious reasons. His physi- cal condition today does not appear very stable or encouraging, for he is showing a striking susceptibility to disease in gen- eral and disorders hitherto uncommon to him, while his powers of resistance in seasons of epidemic seem far from strong. Consumption, in Ante-bellum Jays,'in 2 a colored person was a rarity- the excep- tion and not the rule, some observers going so far as to say they had never seen a case of it. At any rate, physicians who practised in that time are very united in the expression that it was an extremely rare disease among the slave element. It is now, however, a very common affec- tion, occuring more frequently among Negroes than whites. The excess in the proportionate death-rate of the colored people of this country particularly in the South where they form a large element of the population and where comparisons can the more readily be drawn, by reason of their previous condition has received the attention of some very high authority. Prof. Robert Reyburn, M. D., of Washington, D. C., says: "There can be no doubt that the mortality of the Ne- groes now in this country nearly double that of the Caucasian." Dr. G. W. Hub- bard, of Meharry Medical College, an institution for the education of colored physicians, located at Nashville, Tenn., states "when we consider that the death- rate among the colored people of the larger cities of the South is nearly double that of the whites, we can readily under- stand the importance of providing more properly prepared physicians to minister to the physical necessities of their own people, instructing them in regard to the laws of health, and by precept and ex- ample, teaching them to live on a higher and a better plain of life." Dr. Hubbard 3 has given some time to the subject and the above statement must be taken at some account. Dr. Eugene Foster, Presi- dent of the board of health, Augusta, Ga., says "the Negro death-rate in this city is about double that of the whites, and while consumption was formerly rarely met with in the Negro before the war, it is now a common affection among them." These gentlemen are in a position to be authorities upon the subject, and some weight must necessarily be attached to their views. The emancipation was a starting point in the Negro's history in more ways than one. Here began, not only his career as a freedman and the struggle for elevation, but his physical decline. A few years of freedom have very much reversed the order of things as to his physical as well as general state, so, that whether, through ignorance, neglect gradual decrease in vitality, one or severally, it is certain that his death- rate is uniformly double that of the whites and in many cases as much as three or four times as large, while in his mortality from consumption, alone, he is far in excess. Not only is he being born in less num- bers, but he is dying faster. The Ne- groes reputed fecundity seems rather over-estimated, if the reader will pardon the digression. The tenth census shows the following comparative increase for twenty years: Whites 61 per cent.; Colored 48 per cent. The following 4 figures, culled from the latest census re- port, are interesting, if not striking: Comparative rate of increase for a hun- dred years, from 1790 to 1890 are as fol- lows : 1/9° to 1800, whites 35.76, colored 32-33 1800 to 1810, c< 36.12, 37,50 1810 to 1820, (( 34-12, 28.59 1820 to 1830, u 34-03- 31-44 1830 to 1840, << 34-72, 23-40 1840 to 1850, << 37-74, 26.63 1850 to i860, (( 37-69, 22.07 i860 to 1870, << 34-76, 9.86 1870 to 1880, << 29.22, " 34-85 1880 to 1896, . 26.68, I3-5I Average whites, 33.084. colored, 26.018. It will be observed that the general average shows the Negro to be consider- ably in the rear,- with a heavy falling off between '80 and '90. Commenting upon the previous table the census officers says ''in the hundred years the whites in- creased from 80.73 *° 87.80, while the colored element diminished from 19.27 to 11.93. The proportion of colored ele- ments today is two thirds less than it was a hundred years ago." In Missouri in 1850 the Negro element constituted 13.20 of the population; 1890 it had diminished to 5.61. The State of Alabama which has a population of 479,- 441 whites and 468,862 colored, shows the following birth records : 1891, births per thousand, whites 23.65 colored 19.70 5 1892, births per thousand, whites 25.18 colored 23.36 The returns from Florida indicate a similar gain; whites, 11.15, colored 8.36. The City of Baltimore, Md., furnishes the following returns for 1893, births per one thousand, whites 20.60, colored 17.19. Judging from the foregoing, the Negro is by no means increasing as fast as is' generally supposed. If we were to allow even that his rate of increase was equal to or greater than the whites, the product is certainly unstable, as is shown by the heightened death-rate. In 32 southern cities during '92 and '93 the mortality among Negroes exceeded that of the Whites by nearly four per cent. It would be safe to admit that the Negroe's physical state is not any better, but, if anything, worse than prior to his eman- cipation; and the proposition will hold good that while he has made satisfactory advances intellectually, physically he has retrogressed. The writer's observations are the result of an extensive practice in sections thickly populated by colored people. The statistics here given are taken from official sources and seem as far as possible true to the situation. Some early figures from Savannah, Ga., will prove interesting, especially when com- pared with later returns. From 1854 to 1865 the death-rate was much larger among the whites than the blacks, the proportion being as fol- lows .* 6 1854 deaths per thousand whites 97.9. colored 34-3- 1865 deaths per thousand whites 84.8. colored 68.9. The gradual increase of the rate among the blacks is obvious. In 1870 the tables showed deaths per l,ooo whites 30.1, colored 43.5. In the sixteen years inter- vening till 1886, this gain continues, as may be seen from the following remark- able figures: 1886 deaths per 1,000 whites 17.1, colored 49.8. From 1886 to 1893 the average annual death rate was whites 18.57; colored 43 37. The mortality from consumption in this city is also large, reliable figures of which, however, I have not at hand. Mortuary tables of Charleston, S. C., give, in 1877, the proportion of deaths for the whites one in 44, colored one in 25. In 1886 whites I in 48; colored I in 20. I have no late returns from that city beyond the comparative mortality from consumption being in '92, eight per cent., for the whites and 13 per cent., for the colored, as related to the total mortality. The average annual death-rate for the State of North Carolina computed from the monthly report of twenty-five towns was, in 1893, whites 12.50, colored 19.80. There were 103 deaths from consump- tion among the whites and 102 among the colored during this year. The State of Alabama which has a larger negro population gives the follow- ing returns: 1891, deaths per thousand, 7 whites 7.98, colored 8.799. In 1891 deaths from consumption, whites 318, colored 543. I892, deaths per thousand, whites 8.65, colored 11.60; 1892, deaths from consumption, whites 318, colored 500. From 1880 to 1894, thirteen years, the average annual death rate in the city of Augusta, Ga., was whites 16.47, colored 32.04. The deaths from consumption, were 1892, whites 21, colored 45. 1893, whites 24, colored 54. The following returns from Macon, Ga., show deaths for past ten years: whites 1605, colored 2971; difference 1366. From Brunswick, Ga., I have been able to secure only the report of mortality from consumption: 1890, whites 7, colored 5. 1891, " 4, 16. 1892, " 6. 24. Average, " 5.66, " i5- The city of New Orleans, La., which has a very high death rate, shows the following comparative mortality: Deaths per thousand, 1892, whites 25.72 colored 39.59 Deaths per thousand, 1893, whites 24.40 colored 38.19 From consumption, 1892, whites 458 colored 447 From consumption, 1893, whites 447 colored 393 In Tennessee, February, 1893, six cities reported an average annual death- rate per 1,000 was, whites 10.80, colored 8 24.75 > July, IS94, the death rates for five cities was, whites 10.15, colored 19.36. The mortality from consumption is also arge in this State. The average death-rate for 17 years in the District of Columbia was, whites 18.57, colored 33.72. The proportion in Virginia was about 2 to 3, both as regards to the total mor- tality and that from consumption. Baltimore, Md., showed an annual death-rate of 19.19 from the whites, and 30.76 for the colored population. The same city shows that out of the total mor- tality nine per cent, of the whites die from consumption, while fifteen per cent, of the colored die from the same cause. The annual rate per thousand in the State of Florida, in 1892, was, whites 8.04, colored 8.59. The seeming paucity here of the rates is due to influx of white in- valids into this State, and also the imper- fection in the returns for the blacks, many deaths going unreported. Atlanta, Ga., in 1892, gives a propor- tion of deaths from consumption as related to total mortality, whites 9 per cent., colored 18 per cent. The uniform excess in the colored mortality is apparant. To those who have accustomed them- selves to regard the negro as something less than a physical giant, this will, no doubt, prove surprising information. His rate of increase is not prodigious as has been supposed, and there seems but little ground for-the apprehension that the 9 country will eventually be dominated by a "seething, surging mass of black hu- manity." Indeed, it is a question whether at this rate there will be ultimately any of the race left. The prediction that it would eventually become absorbed in the other race may have more truth in it than most of us want to imagine, for it is fast losing its individuality-is a multi-colored in- stead of a black race. The simon pure African negro is fast becoming a creature of the past in this country, and the rapid- ity with which he is becoming blended with the other race, taking on its mental as well as physical characteristics, sug- gests that he must inevitably lose himself. The consideration of the causes of this disproportionate mortality is no less in- teresting than the condition itself. To one acquainted with the situation of the race in large parts, it is difficult to account for the state of affairs. The question seems pertinent as to whether the trans- portation of the race from a native climate, a natural habitant, to a country differing in climatic conditions did not materially unfit it for residence, at least survivial here. Miscegenation, no doubt, has worked its evils in the premises, the gradual ad- mixture of Caucasian blood, resulting in anything but robust physique. The ma- jority of negroes who die of consumption are of the lighter element; and a large per cent, of them will be found on careful examination with a latent tendency to rhe disease. Of the two elements, black and colored, the later is the most unstable. Ignorance and poverty are potent causa- tive factors ; with the former we might expect a disregard for even the most trivial laws of health, seeing how careless even educated humanity is on this point. Poverty means deprivation and crowding with all its concomitant evils. In the days of slavery, while a stranger to lux- ury, the negro was, nevertheless, reason- ably comfortable. His log cabin with its ample ventilla- tion was far preferable to the dwellings which he now occupies, in many cases ; he was fairly well fed, kept better hours, had good medical care and was kept aloof from many excesses to which he now abandons himself without stint. His life is now one of continuous irregularity, and the struggle for maintenance is telling upon him. However, avoiding details, the writer would offer the following as a good summary of causes bearing on the conditions named : First, the heretofore almost general ignorance of the negro, including his want of education, special and general. Second, lack of proper food and cloth- ing. Third, illy ventillated dwelling places and meeting places. Fourth, want of medical care. Fifth, unhealthy habits and surround- ings. 10