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Full resolution (TIFF) - On this page / på denna sida - III. Population and Migration - 7. Population - 5. Controlling the Death Rate
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174 An American Dilemma
reduce the chances of getting adequate medical facilities or the knowledge
necessary for personal health care.
Any intelligent efforts to reduce Negro morbidity and mortality will
result in striking success. This we may deduce from a knowledge of the
vicious circle mechanism and from a knowledge of existing Negro-white
differentials. Perhaps the greatest need of the Negroes, in the way of
reducing sickness and death, is for a dissemination of knowledge on how to
take care of the body in both its normal and Its pathological state. Other
needs are indicated by the diseases for which the Negro rate is strikingly
higher than the white rate (Figure 2).*^ These include pellagra (a result
of dietary deficiency), syphilis (a function of inadequate Information, on
the one hand, and social disorganization, on the other), homicide (partly
a result of cultural isolation of a subordinated people and lack of police
protection in Negro communities),^ pneumonia and influenza (a function
of inadequate care), and tuberculosis (a result, largely, of inadequate sanita-
tion and poor diet).® These diseases not only kill, but also reduce the
efficiency of Negroes to a much greater extent than that of whites. Pellagra,
syphilis, and tuberculosis, at least, can easily be recognized as public prob-
lems—^the eradication of which Is necessary to the health and efficiency of
the entire nation.
The infant mortality rate as registered is 69 per cent higher among
Negroes than among whites (1940) j
the actual difference is probably even
greater.^’^ The discrepancy in maternal mortality rates between the two
races is much higher—official figures indicate that the rate for Negro mothers
is two and one-half times as high as the rate for white mothers (
1940).’^*’’’
Both infant mortality and maternal mortality among the Negroes have been
declining in the last decade. But the fact that they are still much higher
for Negroes indicates that much can yet be done to reduce these types of
death among Negroes.
Ill health reduces the birth rate in ways other than killing off mothers in
their child-bearing period. In the first place, it increases sterility among
men and women. That there is more sterility among Negroes than among
whites is shown by the fact that there are more childless women, both
married and unmarried, among Negroes and that the higher Negro birth
rate is due to a higher average number of children per mother.’*® This
sterility is not innate, as PearP^ has demonstrated, but is caused by general
“We use the data on causes of death to get an index of Negro-white differentials in
disease. Only the causes of death which have a marked differential effect on Negroes and
whites are mentioned here. Practically all causes have some differential effects in favor of
the whites. The only possible exceptions—which seem to affect whites more than Negroes-—
arc scarlet fever, cancer, diabetes, and perhaps a few of the minor rich man’s diseases such
as gout.
See Parts V and IX.
* See Chapter 6, Section a.
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