The Hawaiian gazette., 1916-05-26

Poverty and Tuberct.losis

lDoVERTY and tuberculosis tuberculosis and
y poverty These arc the essential facts which
orce themselves to the attention Of every nvesti-
gator who faces the problems Of that disease. The
tenement house district of Cincinnati yields a
tuberculosis morbidity just three times as great
as the areas where better housing prevails. In
llo7 families in which tuberculosis existed the aver
age monthly income for a family of four was
approximately $50 After paying the pro-rata
share for food and rent, balance of $5l3 re-
.nained for each individual to meet all other ex-
penses Such low subsistence level works like
black magic in the spread Of tuberculosis.
y The city OF Cincinnati realized that her tuber-
lculosis death rate was fifty per cent above the
average and that it had failed to manifest ten
ldency to decline She felt no qualns in making
this admission Rather she determined that she
would learn why, with an efficient health depart
ment and favorable climatic influences, she was
suffering from twice the mortality from that dis
ease as her neighbor, Pittsburgh Accordingly
the United States Public Health Service was re-
'quested to make thorough study of the situation
and submit a report. To show that something
more than mere academic interest obtained, 49,
1872 workers in 54 factories Of the city voluntarily
Submitted to physical examination. s.sss.s8
The conclusions reached, point directly to the
close connection between poverty and tuberculosis
The great factor underlying the entire problem
was seemingly that of economic conditions. One
sixth of all tuberculosis cases came from cheap
fodging houses. Alcoholism was a prominent
eause and often accelerated the course of the dis
ease, Occupational hazards and bad working con-
|ditions were apparently responsible for about
twenty per cent of the cases, but in the majority
of instances these hazards were not necessarily
inherent in the occupation. Previous tuberculosis
,;.J Of
the cases investigated Dissipation, overcrowd
ing, bad housing, and innate lack of personal re-
sponsbiity were also listed as causes.
An interesting feature of the report, and one
which has not previously been dwell. upon in
studies of this character, relates to the effect of
immigration and the rate of growth OF; the popu-
iation Of city upon the tuberculosis death rate
1t is shown that cities with population COM
posed largely of racial stock having limited re-
siStance to tuberculosis are subject to high
mortality rate from that disease, while centers
having slow rate of population increase like
wise subject to high tuberculosis rate. The evil
dence, is submitted in a comparative table cover
ing sixteen American cities. Almost without ex-
ception those with a high percentage of Irish,
Scandinavian and German stock, and those in
which the negro population is relatively large,
have correspondingly high mortality bile those
where the Italian and jewish elements is proporsi
tonately great have low tuberculosis death rate,
Similarly, such cities as Detroit and. Cleveiaud
with high rates of population increase, show low,
mortality while Cincinnati and Balti-
more with a relatively small population increase
have a high tuberculosis rate. Doubtless the true
explanations of this discrepancy is that advanced
by the authors, namely, that where the population
increase is rapid new buildings are erected to take
the place OF old insanitary structures and better
housing conditions prevail .