The New Chivalry—Health, edited by James E. McCulloch, 1915, Southern Sociological Congress, pp. 412–421. PDF
412The campaign for health improvement which is now going on throughout the South is at bottom economic. It is an effort to increase the efficiency of the people by improving their health conditions. This is especially true with reference to the Negro. Along with the movement for health improvement has come a new idea of the value of human life. During the days of slavery each Negro represented to his master so many dollars. Then a high estimate was placed upon the value of a Negro life, for each Negro death represented a financial loss to the master. After the Negroes were emancipated and personal ownership ceased, little value was placed upon the life of an individual Negro; for it was reasoned that if one Negro died another could be had to take his place.
In recent years much effort has been given to conserving the natural resources of the nation—that is, its soil, its forests, its minerals, its waterways, and, most important of all, its people. In this connection comprehensive studies have been made of the financial loss which the nation is sustaining because of the waste of its natural resources. In the 413 estimate of the financial loss to the nation on account of sickness and deaths a money value is placed upon an individual just as it was upon a slave. Attention is called to the fact that when an individual dies the community in which that individual lived sustains a financial loss. The South because of the Negro has the highest death rate of any section of the country and as a result sustains the greatest financial loss from bad health conditions.
There are in the South U50,000 Negroes seriously sick all the time. Let us first of all consider the enormous financial losses which, on account of bad health conditions, the Negroes of the South are directly sustaining. These losses are in doctor’s bills, cost of the care of the sick, funeral expenses, and in the earnings which those who are sick and those who have to take care of them lose. Sickness each year costs the Negroes in the South about $75,000,000. This is an average of more than $8 per individual. Estimates show that here in the South there are probably 450,-000 Negroes who are seriously sick all the time—that is, they are so ill that some one has to take care of them. If this sickness were distributed among the entire black population, it would mean that on an average each Negro inhabitant, man, woman, and child, would be sick eighteen days in a year.
A Negro worker contributes annually $15 to sickness. Of the 450,000 Negroes in the South who are seriously sick all the time, 112,000, or one-fourth, are wage-earners. If the sickness of these 112,000 individuals were distributed among the total Negro workers, it would mean a loss to each of about ten days. The loss in earnings which Negro workers sustain annually on account of sickness amounts to some $45,000,000. When distributed among all Negro workers this loss amounts to about $15 each. In other words, each Negro worker from his earnings contributes annually to sickness about $15.
Prevention of deaths among Negroes would increase the South’s population 100,000 each year. The leading authorities on health are teaching us that a very large percentage of the annual deaths are preventable. Hundreds of thou414sands of people die every year who ought to live. This is especially true of Negroes. It is probable that at least forty-five per cent of the annual deaths among them are preventable—that is, with proper medical attention, proper food, proper sanitary surroundings, and proper observances by the individuals themselves of the rules of health, forty-five out of every one hundred who die could be saved. If this is true, then 100,000 of the 225,000 Negroes who die annually in the South could be kept alive. This would be equal to adding to the population of the South 100,000 individuals each year.
It further appears that on account of the large number of Negroes who are seriously sick all the time and the quarter of a million who die annually, sickness and deaths are costing the Negroes of the South at least $100,000,000 annually, or an average of over $11 for each Negro man, woman, and child. On the other hand, with proper sanitary surroundings, proper attention to the laws of health, $50,-000,000 of this amount could most likely be saved.
The South loses annually because of preventable deaths among Negroes almost $200,000,000. Attention has been called to the great financial losses which, because of diseases and deaths, fall directly upon the Negro. Let us next consider the enormous financial losses which the South as a section suffers from these same causes. Take, for example, the 112,000 Negro workers who are seriously sick all the time. If by sanitary improvements they could be kept well twelve months in the year, there would be 112,000 additional workers who could help till the soil, work the mines, construct railroads, build cities, and do other things for the economic advancement of the South. If these 112.000 Negroes could be added to the working population of any State, the development of the resources of that State would be greatly increased—that is, the working population of Texas would be increased 7 per cent, Alabama 11 per cent, Mississippi 13 per cent, and Louisiana 17 per cent. In addition to the large number of Negro workers who are seriously sick all the time, there are every year 25,000 or 30,000 who die unnecessarily. The annual loss to the South 415 in potential earnings because of preventable deaths among Negroes is almost $200,000,000—that is, if the Negro workers who every year die unnecessarily could be kept alive and at work their earnings for the South during the normal working period of their lives would amount to almost $200,000,000.
Tuberculosis among Negroes costs the South annually enough to establish 3,500 factories in which 700,000 persons could be employed. Of all the diseases with which Negroes are afflicted, tuberculosis is, in many respects, the worst. It is the cause of from 15 to 20 per cent of all their deaths. In other words, one death out of every six among them is from this disease. The burden that results from tuberculosis is one of the heaviest that the Negroes have to bear. The annual deaths among Negroes from tuberculosis amounts to some thirty-five or forty thousand. It is estimated that each death from tuberculosis costs about $4,000. On this basis the deaths among Negroes from tuberculosis cost the South annually over $140,000,000. Consider for a moment the immense amount of capital that is here lost. If this capital could be made available for use, think how many factories it would establish, how many banks it would finance, how many farms in the South it would run. In a word, if just now the South could have available this $140,000,000, it would go a considerable way toward relieving the prevailing financial stringency. According to the census report on manufacturing, the average capital invested in a manufacturing establishment in the South is about $45,000. The average number of employees in a factory is about 225. On this basis, the amount that tuberculosis among Negroes annually costs the South would furnish the capital for 3,500 manufacturing establishments in which over 700,000 persons could be employed.
The financial losses to important cities through waste because of the lack of the conservation of Negro health is greater than all the revenues which the cities raise. Let us next consider the financial losses which through lack of improvement of Negro sanitary conditions the important cities of the South are sustaining. From data given in a 416 recently issued volume of the United States Census Bureau on “Financial Statistics in Cities,” we are able to make comparisons of the revenues which the cities of the South raise with the estimated losses to these cities because of bad health conditions among Negroes. These comparisons indicate that each year the losses to cities of the South because of health conditions among Negroes is almost equal to all revenues which the cities through taxes and all other sources raise.
In two cities the estimated loss from Negro sickness and death is equal to the total city revenues. Birmingham per capita* of her total population raises in revenues $14 and through bad health conditions among her Negro population loses $14 per capita Mobile per capita of her total population raises in revenues $20 and through bad health conditions among her Negro population loses $20 per capita In three cities the estimated losses from Negro sickness and deaths is greater than the revenues which these cities through all sources raise. Montgomery per capita of her total population raises in revenue $18 and through bad health conditions among her Negro population loses $22 per capita Savannah per capita of her total population raises in revenues $21 and through bad health conditions among her Negro population loses $28 per capita Charleston per capita of her total population raises in revenues $15.42 and through bad health conditions among her Negro population loses $27 per capita.
It is of course understood that the loss to cities because of bad health conditions among Negroes is not so much in actual cash as it is in the loss, through waste, of a natural resource that ought to be utilized—that is, within these cities there are thousands of Negroes who are unnecessarily sick and hundreds who unnecessarily die. These Negroes, through education and sanitary improvement, ought to be kept alive and made healthy and efficient to the highest degree, in order that as a natural resource they could be fully utilized.
Combined revenues raised by States, counties, and incorporated places, because of the lack of health conser417ration, do not equal what States lose through Negro sickness and deaths. The Census Bureau a few weeks ago issued a bulletin on “Wealth, Debt, and Taxation.” Among other things, information is given in this bulletin as to the total revenues raised in a State, by the State itself, by the counties, and by incorporated places. A comparison of the losses which, because of the lack of health conservation, the South is sustaining from Negro sickness and deaths, with these combined revenues, indicates that these losses about equal the total revenues raised in the South, by the States, by the counties, and by incorporated places. In eight States the losses sustained on account of Negro sickness and deaths are greater than the total combined revenues which are raised within these States.
In Alabama the combined revenues per capita of the total population were $7.45 and the loss from Negro sickness and deaths $15 per capita In Arkansas the combined revenues were $6.37 per capita and the loss from Negro sickness and deaths $9 per capita. In Georgia the combined revenues were $9.61 per capita and the loss from Negro sickness and deaths $16 per capita. In Louisiana the combined revenues were $13.03 per capita and the loss from Negro sickness and deaths $15 per capita. In Mississippi the combined revenues were $7.79 per capita and the loss from Negro sickness and deaths $20 per capita. In North Carolina the combined revenues were $6.16 per capita and the loss from Negro sickness and deaths $11 per capita. In South Carolina the combined revenues were $5.91 per capitaand the loss from Negro sickness and deaths $19 per capita. In Virginia the combined revenues were $9.74 per capita and the loss from Negro sickness and deaths per capita.
The value of a Negro to-day is five times what it was in the days of slavery. In connection with this discussion of the loss which the South is sustaining because of sickness and deaths among Negroes, it is of interest to note that, on the present basis of estimating the value of a human life, a Negro in the South to-day is worth several times as 418 much as he was worth in the days of slavery. The value of the 4,000,000 slaves which the war between the States freed was about two billion dollars—that is, the average value of a slave was about $500. On the present basis of estimating the value of human life a Negro in the South is valued at about $2,500, and the nine million Negroes in the South have a money value of over twenty-two billion dollars. On this basis, the loss to the South to-day when a Negro dies is about five times as great as it was in the days of slavery. If then the South of ante-bellum days had an interest in conserving the health of the Negroes, to a much greater degree has the South of the present an interest in conserving their health.
As an asset of the South Negroes are worth one and a half times as much as the assessed value of all taxable property. The value of all the land in the South is about ten billion dollars. The value of all the farm property is about twelve billion dollars. The assessed value of all the taxable property in the South is some fourteen billion dollars. The nine million Negroes in the South are worth twenty-two billion dollars—that is, as an asset of the South they are worth more than all the land or all the farm property. They are worth over one and a half times as much as the total taxable property of the South. Because of their value, it is very important then that the Negroes be made healthy. It is for this reason that white men and black men are working side by side to help improve their health conditions.
By means of health improvement and education the efficiency of the Negro can be doubled. One of the slogans of this century is efficiency. The idea of efficiency has come into the South. It is realized that for the South to take her proper economic place in the nation the efficiency of her population has got to be greatly increased. The best working machine is one in which there is the greatest amount of power generated in proportion to the amount of energy expended. From the standpoint of efficiency the Negro is at present a poor working machine. On account]{.font4} 419 of bad health and a lack of training and efficiency, he is expending about one-half the energy that he is capable of expending, and as a result is doing about one-half the work that he is capable of doing. On the other hand, because of premature deaths, the number of years that he works is about one-half of what they should be. The average life of a Negro is now about thirty-five years. His period of productive work is about fifteen years. If the average length of Negro life was increased to forty-five or fifty years—and this can be done by sanitary improvement—the length of time that the average Negro could work would be increased to from thirty to thirty-five years. It is possible within this century to so improve the health conditions of Negroes that their death rate would be reduced one-half and their average length of life increased one-half.
Increasing the efficiency of the Negro by means of education and better health conditions equals adding five million additional workers to the population of the South. There are in the South five million Negroes who are engaged in gainful occupations—that is, they are helping to develop the resources of the South. Now if by education and health improvement the efficiency of these five million black men and women can be doubled it will be equal to adding five million additional workers to the population of the South; likewise, if the period of productive work of the average Negro can be doubled, it will be equal to adding another five million to the working population of the South.
The death rate among Negroes can be decreased. Recent mortality statistics appear to indicate that the death rate among Negroes is decreasing. Ten years ago the average annual death rate per thousand was about 29. Now it is about 23. As an indication of what can be done in the matter of decreasing the death rate, a recent report states that in Robeson County, North Carolina, the death rate has been reduced from 18 to 12 per thousand. This county is in a malarial district and 55 per cent of the population are Negroes and Indians. The death rate of the Negroes was over 40 per cent higher than that of the whites. The illiter420acy in the county is 40 per cent higher than the average for the whole State. This record in health improvement was accomplished in three years. To the county is means a saving of 100 lives every year, or, in money value, $290,000. The most remarkable thing concerning health improvement in this county is that the death rate from preventable diseases has been reduced 70 per cent.
White people and black people are cooperating to conserve Negro health. One of the most encouraging things in the crusade for Negro health improvement is the hearty manner with which white people and black people are cooperating in this movement for the common welfare. Last year at a conference in New Orleans, called to consider how Negro health conditions might be improved, State and city health officers from all parts of the South in meetings with black men discussed the situation and advised as to the best things that should be done. The very cordial and active assistance given by State and City Boards of Health, by State Departments of Education, by white women’s clubs, and other agencies to the recently held National Negro Health Week is another instance of this cooperation. The highest expression of this cooperation is the large place that is given in this Congress to the consideration of “Health and Race Relations.”
The Negro will do his part in the creating of a greater South. In her crisis the South has found the Negro dependable. Was it at New Orleans in the War of 1812 when, at the call of General Jackson, he fought gallantly for the common defense? Was it in the War between the States, when the white men of the South were away on the battlefields, that he at home cared for their women and children? The South of to-day is facing a great economic crisis. The old system, the old methods in agriculture, and other things have become obsolete; new systems, new methods demanding more skill and intelligence are being instituted. In order to develop these systems to their highest degree every element in her population must be made efficient. The Negro has ever had the interest of the South at heart. In 421 this new crisis that the South is now facing, in the economic transformation that is now taking place, he can be depended upon to do his part. He is earnestly studying his own needs. He sees the great handicap which bad health has placed upon him. With the assistance of the white man he will remove this handicap. He will make himself efficient and do his part in creating out of the new South a greater South.