The Topeka state journal., 1916-08-10
THE TUBERCULOSIS PROBLEM


THE TUBERCULOSIS PROBLEM.
Poverty and Observation-Disclosures
losis and poverty!
These are the essential facts which
force themselves to the attention of
every investigator who faces the prob
lem of that disease. according to
bulletin on this subject which was is
sued recently by the United States
public health service.
The tenement house district of Gin
cinnati, for instance. yields G tubercu-
losis morbidity just three times as
great as the areas where better
housing prevails. In 1877 families in
which tuberculosis existed the average
monthly income for family of four
was approximately s57. After paying
the pro rata share for food and rent,
a balance of $5.13 remained for each
Individual to meet all other expenses.
Such a low subsistence level works
like black magic in the spread of tu-
berculosis. Moreover, and this is
point over which the public should
ponder, the home of the average wage
tary than the average factory and
workshop. In regard to all the factors
which make for healthful living, ven
tilation, sufficient light, proper tenn
perature, and freedom frcm over
crcwding, the score was in favor of
the factory in nearly every instance.
The city of Cincinnati realized that
her tuberculosis death rate was so
per cent above the average and that
it had failed to manifest tendency to
decline. She felt no qualms in max
ing this admission. Rather, she de-
termined that she would learn why,
with an efficient health department
and favorable climatic influences, she
was suffering from twice the mortality
from that disease as her neighbor,
Pittsburg. Accordingly the United
States public health service was re-
quested to make a thorough study of
the situation and submit a report.
TO show that something more than
mere academic interest obtained, 49,
9S2 workers in 154 factories of the
city voluntarily submitted to a ply
sical examination.
The conclusions reached point di-
rectly to the close connection between
poverty and tuberculosis. The great
factor underlying the entire problem
was seemingly that of economic con-
ditions. One-sixth of all tuberculosis
cases came from cheap lodging houses.
Alcoholism was a prominent cause,
and often accelerated the course of
the disease. Occupational hazards
and bad working conditions were ap-
parently responsible for about 20 per
cent of the cases, but in the majority
of instances these hazards were not
necessarily inherent in the occupa-
ton. Previous tuberculosis in the
family occurred In practically a third
of all the cases investigated. Dissipa-
ton, overcrowding, bad housing and
innate lack of personal responsibility
were also listed as causes.
An interesting feature of the report,
and one which has not previously been
dwelt upon in studies of this charac-
ter, relates to the effect of immigra-
ton and the rate of growth of the
population of city upon the tubcrcu-
losis death date. 1t is shown that
cities with a population composed
largely of racial stock having a limited
resistance to tuberculosis are subject
to high mortality rate from that dis
ease, while centers having a slow rate
of population increase are likewise
subject to a high tuberculosis rate.
The evidence is submitted in a COM
parative table covering sixteen Ameri-
| can cities. Almost without exception
those with a high percentage OF Irish.
Scandinavian and German stock, and
those in which the negro population is
| relatively large, have a corresponding
ly high mortality, while these where
the Italian and Jewish element is pro
portionately great have a low tuber-
culosis death rate. Similarly. such
cities as Detroit and Cleveland, with
high rates of population increase
show a low tuberculosis mortality
while Cincinnati and Baltimore, With
relatively small population increase
have high tuberculosis rate. Doubt
less the true explanation of this dis
crepancy is that advanced by the au-
thors, namely, that where the popu-
lation increase is rapid new buildings
insanitary structures and better hous-
ing conditions prevail.
U. S. COMPETITION NOT FEARED
The exceptionally favorable position
in which the manufacturers and ex,
porters of the United States find