Child Mortality Differences, Personal Health Care Practices, and Medical Technology: The United States: 1900-1930
Citation: Condran, Preston, Samuel H. (1994) Child Mortality Differences, Personal Health Care Practices, and Medical Technology: The United States: 1900-1930.
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Tagged: uw-madison (RSS), wisconsin (RSS), sociology (RSS), demography (RSS), prelim (RSS), qual (RSS), WisconsinDemographyPrelimAugust2009 (RSS)
Child mortality differences by ethnicity were clearly visible in the United States at the turn of the century. In particular, French-Canadians had extraordinarily high mortality and Jews exceptionally low mortality, according to public use samples from the censuses of 1900 and 1910 as well as other ethnographic and historical sources. These differences were not related to the educational levels of mothers, which was a minor factor in mortality at the time and which favored French-Canadians. The mortality differences were almost certainly a reflection of specific child raising practices relating to infant feeding and standards of hygiene. The authors have suggested, consistent with Caldwell's proposals, that these differences were in turn a reflection of a different degree of child-centeredness of French-Canadian and Jewish families. Partly influences by such observations, great emphasis was placed by health authorities on improving maternal practices during the period 1900-1930, and they used a wide variety of means to influence these practices. Cause-of-death data linking the decline in childhood mortality to a list of causes headed by diarrheal diseases lend credence to the notion that private health and child care practices may have been important.
In a number of areas, notably that of infant feeding, which dominated the advice literature particularly a book entitle The Care and Feeding of Children, by Holt, and pamphlets from the Children's Bureau's, the advice given to mothers was largely sound buy current standards. Mothers were being urged to breastfeed; however, there was evidence that breastfeeding was decreasing in the population at that time. For those not breastfeeding, an increase in the emphasis on the importance of sterilizing milk and bottles was an important change in the first decades of the 20th century and might well have had a positive effect ton the life chances of bottle fed babies. In addition, increased emphasis was placed on isolating household members with an infectious disease. Furthermore, the number of individuals receiving these messages was vastly expanded by organized efforts to improve maternal practices and an outpouring of interest in child health on the part of mothers themselves. On the other hand, the authors found little evidence in the advice literature of an increased concern with general hygiene practices, such as handwashing or fly control. Acceptance of germ theories of disease causality certainly focused some attention on these issues, but they never held a prominent position in the child care literature. Finally, use of physicians appears to have expanded little, thereby not having a large effect on mortality decline. Physicians had several new and effective drugs at their disposal and an increased appreciation of hygienic practices themselves, but therapeutics changed very slowly during this period particularly in terms of treating diarrheal diseases. Improved personal health care practices undoubtedly contributed to the decline in infant mortality from 1900 to 1930, but the successes were principally in the domain of prevention rather than treatment.