The Glasgow courier., 1916-05-26
POVERTY AND TUBERCULOSIS


POVERTY AND TUBERCULOSIS
These are the essential facts which
force themselves to the attention of
every investigator who faces the
problem of that disease. The tene-
ment house district of Cincinnati
yields a tuberculosis morbidity Just
three times as great as the areas
where better housing prevails. In
1877 families in which tuberculosis ex-
listed the average monthly income for
a family of four was approximately
$57. 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 low sub
sistence level works like black magic
in the spread of tuberculosis. More
over, and this is point over which
the public should ponder, the home
of the average wage Garner was
found to be far less sanitary than the
average factory and workshop. In
regard to all the factors which make
for healthful living, ventilation, suf-
ficient light, proper temperature, and
freedom from overcrowding, 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 a tendency
to decline. She felt no qualms in
making this admission. Rather, she
determined that she would learn why,
with an efficient health department
and favorable climatic influences, she
was suffering from twice the NOR
tality fl ON that disease, as her neigh
Dor Pittsburg. Accordingly the United
States Health Service was requested
to make thorough study of the situ-
alton and submit report. To show
that something more than mere aca-
demic interest obtained, 1892 work
ers in 154 factories of the city volun-
tarily submitted to a physical exam
ination.
The conclusions reached, point dir
ectly 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 hous-
es. Alcoholism was 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 third
of all the cases investigated. Dissi-
patton, overcrowding, bad housing,
and innate lack of personal RESPONSE
bility, were also listed as causes.
An interesting feature of the re-
port, and one which has not previous
ly been dwelt upon in studies of this
character, relates to the effect of i'm
migration and the rate Of growth of
city upon the tuberculosis death
rate. 1t is shown that cities with a
population composed largely of facial
stock having limited resistance to
tuberculosis are subject to high NOR
tality rate from that disease, while
centers having slow rate of popu-
lation increase are likewise subject to
high tuberculosis rate. The evil
dence is submitted in comparative
table covering sixteen American cities
Almost without exception those with
high percentage Of Irish, Scandina-
visan and German stock, and those
in which the negro population is rela'
lively large, have a correspondingly
high mortality, while those where the
] Italian and Jewish element is proper
tionately great have low tubercu
losis death rate. Similarly, sucf
cities as Detroit and Cleveland, will
high rates of population increase
show low tuberculosis mortality
while Cincinnati and Baltimore will
relatively small population increase
have high tuberculosis rate. Doubt
5 less the true explanation of this dis
5 crepancy is that advanced by th'
authors, namely, that where the popu
: lation increase is rapid new building
: are erected to take the place of oil
! insanitary structures and better hous
! ing conditions prevail.