Birth Control by Halliday G. Sutherland (guided reading books txt) 📕

water and the means of disposal of refuse. And we have yet to become

acquainted with a poor population spending their scant earnings

entirely, or in a very large proportion, upon the necessities of life;

for such is not the case when half the earnings of a family are thrown

away to provide adulterated alcoholic drinks for one member of it.

Until reforms such as these and others have been carried out, and the

poor are able and willing to conform to known physiological laws, it is

premature to speak of taking measures to lessen the birthrate—a

proposal, be it said, which makes the humiliating confession of man’s

defeat in the battle of life.” [25]

It will be seen that the qualifications practically remove the question from dispute. [26] If the conditions of the poor were thus altered, poverty, as it exists to-day, would of course disappear. As things are, we find that a high death-rate is related to poverty, as is proved, for example, by the death-rate from tuberculosis being four times greater in slums than in the best residential quarters of a city.

The correct answer to the birth controllers is that a high birthrate is not the cause of a high death-rate, because high birthrates, as shown in the previous chapter, are not the cause of poverty, but vice versa. Moreover, all the statistical evidence goes to prove that in this matter we are right and that Malthusians are wrong.

Section 2. HIGH BIRTHRATE NOT THE CAUSE OF HIGH DEATH-RATE: PROVED FROM STATISTICS

In China, where there is said to be a birthrate of over 50 per 1,000, and where over 70 per cent. of infants are helped to die, the high death-rate is due clearly to degraded social customs. In the slums of Great Britain the high death-rate is also due to degraded social conditions. It is not due to the birthrate. Of this the proof is simple, (a) Among the French Canadians, where the average family numbers about nine, this high birthrate is not associated with a high death-rate, but with the increase of a thrifty, hard-working race. In Ontario the birthrate went up from 21.10 in 1910 to 24.7 in 1911, and the death-rate fell from 14 to 12.6. (b) Again, in 1911 the corrected birthrate for Connaught was 45.3 as against a crude rate of 24.7 for England and Wales; and in Connaught, where there is no need for Societies for preventing Parents being Cruel to their Children, the infant mortality rate [27] is very much lower than in England, although the birthrate is much higher and the poverty much greater. In Bradford, a prosperous English town which pays particular attention to its mothers and children, the infant mortality in 1917 was 132 per 1,000 and the birthrate 13.2. In Connaught, where there are no maternity centres or other aids to survival, but on the contrary a great dearth of the means of well-being, the infant mortality was only 50, whilst the birthrate was actually 45! [28] So untrue is it to say that a high death-rate is due to a high birthrate.

Section 3. A LOW BIRTHRATE NO GUARANTEE OF A LOW DEATH-RATE

Again, birth controllers claim that a low birthrate leads to a low infant mortality rate. Now, it is really a very extraordinary thing that, whatever be the statement made by a Malthusian on the subject of birth-control, the very opposite is found to be the truth. During the last quarter of last century a falling birthrate in England was actually accompanied by a rising infant mortality rate! During 1918 in Ireland [29] the crude birthrate was 19.9, with an infant mortality rate of 86, whereas in England and Wales [30] the crude birthrate was 17.7 with an infant mortality rate of 97, and in the northern boroughs the appalling rate of 120. In England and Wales the lowest infant mortality rate was found to be in the southern rural districts, where the rate was 63, but in Connaught the rate was 50.5. This means that in England a low birthrate is associated with a high infant mortality rate, whereas in Ireland a high birthrate is associated with a low infant mortality rate. [31] These cold figures prove that in this matter at least the poorest Irish peasants are richer than the people of England.

Section 4. VITAL STATISTICS OF FRANCE

The Malthusian claim that a low birthrate leads to a low death-rate is also disproved by the vital statistics of France.

“The death-rate of France has not declined at the same rate as the

birthrate has, and, while the incidence of mortality in France was

equal to that of England in the middle of the seventies, the English

mortality is now only five-sevenths of the French. England thus

maintains a fair natural increase, although the birthrate has declined

at an even faster pace than has been the case in France….

“The French death-rate is higher than is the case with most of her

neighbours, and it can quite well be reduced. The reasons for her

fairly high mortality are not to be found in climatic conditions,

racial characteristics, or other unchangeable elements of nature, nor

even in her occupations, since some of the most industrial regions have

a low mortality.” [32]

I have tabulated certain vital statistics of twenty Departments of France.

The following table, covering two periods of five years in twenty Departments, proves that the death-rate was lower in the ten Departments having the highest birthrate in France than in the ten Departments having the lowest birthrate.

TABLE I

THE TEN DEPARTMENTS HAVING THE HIGHEST BIRTHRATE FRANCE

1909-1913 1915-1919

Rates per 1,000 population Still-Rates per 1,000

births population Departments. Living Deaths Natural per 1000 Births deaths

births increase births

Moselle 27.6 16.5 +11.1 - 14.7 15.4 Finist�re 27.2 18.1 +9.1 4.0 15.9 18.2 Pas-de-Calais 26.8 17.4 +9.4 4.2 - - Morbihan 25.7 17.8 +7.9 4.4 15.0 19.0 C�tes-du-Nord 24.5 20.6 +3.9 4.2 14.4 20.0 Bas-Rhin. 24.3 16.2 +8.0 - 13.3 16.1 Meurthe-et- Moselle 23.2 19.2 +4.0 4.3 - - Loz�re 22.6 17.3 +5.2 4.2 12.4 17.5 Haut-Rhin. 22.4 16.0 +6.4 - 10.3 15.4 Vosges 22.0 18.7 +3.3 4.7 - -

Total Averages 24.6 17.7 +6.8 4.2 13.7 17.3

THE TEN DEPARTMENTS HAVING THE LOWEST BIRTHRATE IN FRANCE

C�te-d’Or. 15.4 18.2 -2.8 3.1 9.9 20.5 Allier. 15.1 15.7 -0.6 3.3 8.4 18.8 Gironde 15.1 17.3 -2.2 4.5 10.1 21.2 Haute-Garonne. 15.1 20.4 -5.3 4.0 9.0 22.5 Lot 15.0 21.0 -6.0 4.5 7.5 20.6 Ni�vre 14.9 17.4 -2.5 3.2 8.8 20.0 Tarn-et-Garonne 14.9 20.1 -5.1 4.7 7.9 20.7 Yonne 14.4 19.1 -4.7 3.8 8.9 22.0 Lot-et-Garonne 13.7 19.1 -5.4 4.4 7.4 20.1 Gers 13.2 19.2 -6.0 4.1 6.8 19.8

Total Averages 14.6 18.7 -4.0 3.9 8.4 20.6

Moreover, the figures show that, prior to 1914, the Departments with the lowest birthrate were becoming depopulated. On the other hand, the enormous fall in the birthrate throughout the country from 1915 to 1919 is a memorial, very noble, to the heroism of France in the Great War, and to her 1,175,000 dead. Certain other facts should also be noted. In France the regulations permit that, when a child has died before registration of the birth, this may be recorded as a stillbirth; and for that reason the proportion of stillbirths appears higher than in most other countries.

Malthusian claims are thus refuted by the vital statistics of France; but it should be clearly understood that these figures do not prove that the reverse of the Malthusian theory is true, namely, that a high birthrate is the cause of a low death-rate. There is no true correlation between birthrates and death-rates.

Section 5. COEFFICIENTS OF CORRELATION

As birth controllers rely very much upon statistics, and as figures may very easily mislead the unwary, it is necessary to point out that the Malthusian contention that a high birthrate is the cause of a high death-rate is not only contrary to reason and to facts, but is also contrary to the very figures which they quote. A high birthrate is often associated with a high death-rate, but a general or uniform correspondence between birthrates and death-rates has never been established by modern statistical methods. To these methods brief reference may be made. A coefficient of correlation is a number intended to indicate the degree of similarity between two things, or the extent to which one moves with the other. If this coefficient is unity, or 1, it indicates that the two things are similar in all respects, while if it be zero, or 0, it indicates that there is no resemblance between them. The study of correlation is a first step to the study of causation, because, until we know to what extent two things move together, it is useless to consider whether one causes the movement of the other; but in itself a coefficient of correlation does not necessarily indicate cause or result. Now in this country, between 1838 and 1912 the birthrate and the death-rate show a correlation of .84; but if that period be split into two, the correlation from 1838 to 1876, when the birthrate was fluctuating, is minus .12, and in the period after 1876 the correlation is plus .92. This means that the whole of the positive correlation is due to the falling of the death-rate, and that birthrates and death-rates do not of necessity move together. [33]

After a careful examination of the vital statistics for France, Knud Stouman concludes as follows:

“In France no clear correlation exists between the birthrate and the

death-rate in the various Departments. The coefficient of correlation

between the birthrate and the general death-rate by Departments

(1909-1913) was 0.0692�0.1067, and including Alsace and

Lorraine—0.0212�0.1054, indicating no correlation whatsoever. A

somewhat different and more interesting table is obtained when the

correlation is made with the mortality at each age class:

TABLE II

Under 1 year 0.3647 � 0.0986

1-19 years 0.4884 � 0.0816

20-39 years 0.6228 � 0.0656

40-59 years 0.5028 � 0.0801

60 years and over 0.2577 � 0.1001

“A peculiar configuration is observed in these coefficients in that a

quite pronounced positive correlation exists at the central age

group, but disappears with some regularity towards both extremities

of life. If the mortality has any influence upon the natality this

cannot be in the form of replacement of lost infants and deceased old

people, therefore, as has frequently been suggested. That a high

death-rate at the child-bearing age should be conducive to increased

fertility is absurd, neither does it seem likely that a large number

of children should make the parents more liable to diseases which are

prevalent at this period of life. The reasons must, then, be looked

for in a common factor.

“Now the only disease of importance representing the same age-curve as

do the correlation coefficients is tuberculosis. This disease causes in

France 2 per cent. of the deaths under one year, 24 per cent. of the

deaths from 1 to 19 years of age, not less than 45 per cent. from 20 to

39, 18 per cent. at ages 40 to 59, and less than 2 per cent. at the

ages over 60. Will a high tuberculosis mortality, then, be conducive to

great fertility, or do we have to fear that a decrease of the natality

will be the result of energetic measures against tuberculosis? Hardly.

The death-rate may be reduced, then, without detrimental effects upon

the birthrate.

“What can the factor be which influences both the tuberculosis

incidence and the birthrate? We know that the prevalence of

tuberculosis is conditioned principally by poverty and ignorance of

hygiene. The Parisian statistics, as compiled by Dr. Bertillon and

recently by Professor L. Hersch, show a much higher birthrate in the

poor wards than in the richer districts, and the