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“It is not easy to estimate too highly the series of yearly reports that are coming from Atlanta University relating to the condition of the Negro population of this country.”
The Boston Herald, Feb 24, 1903, Editorial.
Atlanta University always has drawn its students extensively from the cities and large towns, and a great proportion of its graduates are now holding positions at these centers of influence. From these workers information has come to the faculty and trustees of the University from time to time that has led them to believe that there exists a great need for a systematic and thorough investigation of the conditions of living among the Negro population of cities. So, at the annual meeting of the trustees, July 1,1895, President Bumstead brought the subject before the Board, and it was decided to inaugurate such an investigation, and provision was made for holding the first of a series of conferences at the University. The plan at that time was to hold this conference in November, 1895, during the Atlanta Exposition. But upon further consideration, it was deemed wise to change the time to the Commencement in May, 1896.
It was not expected that much in the line of scientific reports based upon accurate data could be presented at this first conference, but it was believed that much information could be gathered from the ordinary experiences and observations of graduates and others, and that the subject could be considered in such a manner as to arouse interest and enthusiasm, and so pave the way for collecting axed digesting extensive and accurate data. Such, it is believed, has been the result of the conference held.
Fortunately for the cause, there was elected as a trustee of the University, in 1895, Mr. George G. Bradford, of Boston, a graduate of Harvard University, who for several years has been making the study of the Negro the occupation of his leisure time. He entered heartily into this plan of investigation, and has taken the lead in it by preparing blanks, opening up correspondence, and in other ways. In his efforts he has had the assistance of Mr. Edward Cummings, Professor of Sociology in Harvard University. It was thought best to begin with the topic of mortality among the Negro population in cities, and so most of the papers and discussions at the conference were upon that subject.
The conference was organized Tuesday evening, May 26, by the election of President Horace Bumstead as chairman, and George A. Towns ('94) and James W. Johnson ('94) as recording secretaries. The addresses, papers and resolutions in this pamphlet furnish a sufficiently detailed account of the proceedings at the two sessions of the conference. Provision for work during the coming year was made by the election of Mr. George G. Bradford of Boston, as corresponding secretary, and an executive committee, consisting of Professor Thomas N. Chase of Atlanta, Butler R. Wilson, Esq., of Boston, Rev. Joseph E. Smith ('76) of Chattanooga, and S. P. Lloyd, M. D., ('89) of Savannah.
This conference has its origin in several striking facts. One of these is the large proportion of the Negro population of the land now found to be living in cities, viz.: one‐sixth, or a million and a quarter out of the whole number of seven and a half millions. Whatever we may think of the wisdom or unwisdom of this drift to the cities, the fact presents a condition that must be met and provided for. For we must remember that the condition and circumstances of Negroes living in cities differ widely from those of the plantation Negroes. They are thrown much more closely together in large masses on narrower areas of land and in more contracted tenements. Negro slums are already beginning to be found. The employments of city Negroes are different from those of the rural brethren, agriculture being replaced by the trades, or the various forms of personal service, and to some extent by mercantile and professional pursuits. Their social life is also different.
Very little attention, too, has yet been given to the specific problems arising out of the changed conditions under which this large proportion of Negro population is now sharing the city life of their white brethren. The Negro has been thought of chiefly as a tiller of the soil, as in fact he is; and much has been done, and very properly, for the improvement of his plantation life. But the problems connected with his life in the cities and larger towns need even more careful study and thorough treatment.
In view of these considerations, it is important to note another fact, and that is that nearly all the graduates of Atlanta University are living and working in the cities and larger towns of the South. This fact is very suggestive, for the problems of Negro city life must be settled largely by Negroes themselves, and the body of our alumni are in some respects specially fitted for this task. Not only are they familiar with the conditions of life in cities, but they have acquired, in their training in this Institution, some degree of accurate observation and careful reflection, some acquaintance with high standards of living, some familiarity with measures of reform and of social and economic improvement that are indispensable for dealing with such matters. Herein is the great opportunity of Atlanta University and of this conference of its alumni for the investigation of city problems which we inaugurate this evening.
Let us not forget that the general subject of this and succeeding conferences‐the study of Negro city life‐and the particular subject of this year‐the mortality of Negroes in cities‐constitute a human problem far more than a Negro problem. We shall use the words "Negro" and "colored," not to emphasize distinctions of race, but as terms of convenience. We are simply to study human life under certain conditions‐conditions which, if repeated with any other race, would have practically the same result. Patient, painstaking and persistent work in gathering reliable statistics and other data will be necessary for our success. Courage and honesty in the search for real facts are called for, and we must be ready to face and deal with even the disagreeable facts and those which upset our previous theories, which our investigations may compel us to recognize as facts.
And let me remind you as I close this brief introduction to the work of our conference, that the richest rewards await the results of our undertaking if we are successful. Dr. Parkhurst has said that it is in the great cities that the life of the nation beats and throbs itself out. What the cities are, that in large degree will the country that surrounds them be. The connection between the two is intimate. So the improvement of Negro life in cities will make itself felt in the improvement of Negro plantation life. And the improvement of Negro life anywhere will be a blessing to the life of the nation as a whole, regardless of race or color.
The rapid growth of our great cities, within recent years, is one of the phases of modern life which brings with it problems whose solution calls for the best efforts of the leading men in the city communities, whether white or black. Special courses for the study of these problems have been established in the Northern colleges, and it is felt that the time has come when Atlanta University must take up the study of those problems of city life which its graduates are called upon to meet and solve. It is none too soon to begin this work, for each year a larger proportion of the colored race are concentrating in the cities.
In 1860, only 4.2 per cent of the colored population of the United States were living in the cities. By 1880, the number had increased to 8.4 per cent of the whole colored population, while by1890, it had increased to 12 per cent. This process of concentration in the cities has been relatively much more rapid among the colored people than among the whites, the figures for whites during the same period being 10.9 per cent in 1860, and 15.7 per cent in 1890, or an increase of 4.8 per cent, as against 7.8 per cent for colored. How rapid this increase in the city population really is, may be illustrated by the growth of the colored population in the city of Atlanta, where the increase has been at a rate three times as great as for the country at large. For the decade 1870‐80, the increase was 64 per cent; for 1880‐1890, 72 per cent; while the average increase of colored population for the whole country during the same period was only 20 per cent in each decade.
In taking up the study of city problems, we feel that we cannot do better than begin by an inquiry into the physical and moral condition of the people. It is a line of inquiry which has not been previously pursued on any systematic or extensive scale. Up to the present time, students and investigators of the problems confronting the colored race have confined their attention towards economic or educational questions. Of the physical condition of the Negro under the trying conditions of city life, we have little accurate information. Many of the Southern cities have not had, until within a few years, any city boards of health, and , as a result, there has not hitherto sufficient official data from which any broad generalizations could be drawn, and such data as have been obtainable have not yet been brought together in available form. We have, however, some few data that are sufficient to prove the necessity of the inquiry upon which we have begun.
| Rates per 1,000 | ||
|---|---|---|
| White | Colored | |
| Washington | 19 | 36 |
| Baltimore | 22 | 36 |
| New Orleans | 22 | 37 |
| Louisville | 18 | 32 |
| St. Louis | 17 | 35 |
The excess of colored over white is 90, 63.6, 68, 77 and 106 per cent.
By special report from Washington, these figures would appear to be for that city, 19 whites, 34.7 colored; excess of colored over white, 83 per cent. The death rate among the whites in these five cities ranged from 17 to 22 per thousand, and among the colored from 32 to 37 per thousand, or from 63 per cent to 106 per cent greater among the colored than among the whites. In the city of St. Louis, the death‐rate among the colored was more than twice that among the whites.
| COLORED | ||||||||
|---|---|---|---|---|---|---|---|---|
| Causes | New York | Boston | Baltimore | New Haven | ||||
| No. | Per Ct. | No. | Per Ct. | No. | Per Ct. | No. | Per Ct. | |
| Matters of | ||||||||
| Employment | 19 | 35.18 | 24 | 17.39 | 96 | 29.62 | 9 | 30.00 |
| Sickness | 20 | 37.03 | 63 | 47.65 | 126 | 38.88 | 7 | 23.33 |
| Drink | 4 | 7.40 | 11 | 7.19 | 16 | 4.93 | 3 | 10.00 |
| Shiftlessness and Inefficiency | 3 | 5.55 | 6 | 3.34 | 21 | 6.48 | 1 | 3.33 |
| All Causes | 54 | 2.02 | 138 | 6.65 | 324 | 15.86 | 30 | 6.72 |
In his analysis of causes of destitution among the colored people of Baltimore, we find 38 per cent of all cases of destitution are due to sickness. We have no official figures on this point for Washington or any other Southern city. Bit a similar report for New York shows 37 per cent from sickness, and for Boston 47.6 per cent. These are among cases of destitution of which there is official record. The result might be different, could we obtain the facts for all cases. Among the whites, also, sickness is one of the chief causes of destitution, but the percentage is much smaller, averaging about 20 per cent, while the average among the colored people is 39 per cent, or nearly twice as great. We see, therefore, that one of the first things we must do in improving the condition of the masses of the poorer colored people crowded together in the great cities is to try to lighten the heavy burden of sickness now weighing them down. This will involve an inquiry not only into physical or economic conditions, but into moral conditions as well. We feel, therefore, that in beginning our study of city problems by an inquiry into the causes of the excessive mortality among the colored people, we are striking right at the root of many of the evils that we have been trying to reach.
Important as is the industrial education of a state, it is evident that no rapid economic advance can be made by a race physically or morally weak. It is evident that both physical and moral as well as the economic conditions should be carefully studied, and we shall see later that they should be studied together, as each one acts upon the other. The task, then, which we have undertaken is the inquiry into the exact conditions, physical, moral and economic, affecting life in city communities. Later, when we have gathered sufficient information, we may be able to point out how those conditions may be improved. But at present our chief aim must be to make a thorough and searching investigation.
The method which has been adopted for making this investigation is as follows: In order to gather the necessary data, uniform sets of blanks have been prepared and put in the hands of graduates of this University, and of educated colored men and women located in different cities. These sets consist of three different blanks, known as Nos. 1, 2, and 3. Blanks No. 1 and 2 are to serve the purpose of a permanent record by which to measure the progress of each city community from year to year. As in many cities the official records from which the data for these blanks must be gathered have been in time past very incomplete, we shall be unable to review the past progress of those cities as we should like to, but these records are being made more complete each year, so that in future we shall be able to measure the progress made with some degree of accuracy. Blank No. 3, called the Family Budget blank, provides for a more intimate inquiry into the conditions of life existing in a particular community, and is intended to bring out the causes of results shown in blanks No. 1 and 2. The points of inquiry covered by this blank, No. 3, are:
First‐ General conditions of home life, the size of the homes, their sanitary conditions, and the amount of sickness in the family.
Second‐Economic conditions, occupations of family, the amount of income, etc.
Third‐The expenditure of family for food, rent, intoxicants, etc.,. showing habits of life in the community.
The results of an investigation carried on along the above lines will be brought out in later papers.
In regard to the conferences: It is proposed each year to take up the discussion of certain phases of city life most deserving attention. Just what will be the subjects for these discussions will be determined by the results of investigations already begun, and announcements will be made later. The general plan of conference will not be unlike that of the National Conference of Charities and Corrections, and some of the subjects taken up will be similar to those discussed there, such as home life, child saving, district nursing; scientific study of socia1 problems, such as diversity of employment, co‐operation, loan associations, savings institutions, mutual insurance, etc.. It will probably be found advisable to have at the conference next year section meetings where special topics can be discussed more freely and fully than in the general conference. This is, in general, an outline of the plan upon which the investigation and the conference will be conducted. As the work develops, and we gain more experience, the plan will be modified to meet the needs of the time.
The work of investigation will no doubt prove difficult, and will require not only patient and accurate work, but the willing co‐operation of a large number of individuals. But we believe that there is no body of men and women so well able to do this important work for their communities as the graduates of Atlanta University and similar institutions. They are scattered through all the principal cities of Georgia and the neighboring States; they are all in positions where they have special facilities for the gathering of valuable data, aid their zeal and industry will more than compensate for any lack of scientific statistical training. No one of these graduates can prosecute this work alone. His investigation would necessarily be too limited to produce any accurate results. It is only by compiling and comparing data from many different sources that accuracy can be insured. Co‐operation, therefore, is essential. Though the results accomplished by each individual may seem to him incomplete and insignificant, the combined results of all will prove of the utmost value.
A word of caution: Some of the information brought out by this investigation may prove very unpleasant for us to contemplate. It may seem as if much of our work for the past twenty‐five years had been of no avail. We may be tempted to shut our eyes to the real facts, or to doubt their existence. But if we are to make any progress, we must have the courage to look unpleasant facts in the face. We are not attempting to prove or to disprove any theory, but we are trying to get at the most unfavorable conditions affecting our communities, in order that we may improve those conditions. Accuracy is the first essential in an investigation as important as that upon which we have begun. It is well for us all to keep this in mind, that we may not be tempted by our previous theories or predilections to suppress or distort the information we are called upon to furnish. We need have no fear of the results. The past we cannot mend. It is the future we must look out for, and we need all the knowledge and information we can gather for the solution of the difficult problems before us.
The following is a summary of reports received from the City of Washington. We are indebted to Mr. L. M. Hershaw of the class of '86, for a very complete report for blanks No. 1 and 2, and to the courtesy of Dr. W. Bruce Evans of Howard University, who at very short notice made up for us a small group of family budgets. The results of the investigations made by these two gentlemen, in their own city, may prove helpful to workers in other cities, and may also serve to show how far the blanks serve the purpose for which they were intended. Blanks No. 1 and 2 were to serve as an index to nark the progress of the community. Let us see, therefore, what Mr. Hershaw's reports, in these two blanks, show as to the progress which has been made in Washington during tile last ten or fifteen years:
| White | Colored | |
|---|---|---|
| Average 1878-1882 | 18.61 | 37.12 |
| Average 1888-1892 | 19.19 | 32.08 |
| White | Colored | |
|---|---|---|
| 1880 | 17.6 | 35.5 |
| 1890 | 12.3 | 34.7 |
| 1895 | 15.8 | 28.1 |
The excess of colored over white is 103, 182 and 78 per cent.
Comparing the number of deaths for the series of years is each of the four groups into which the blank is divided, we see a steady decrease in each group without exception, and that in most instances it is a decrease both actually as to number of deaths, and relatively as compared with whites.
The conclusion we should come to is that there has been a general and continued improvement in the condition among the colored people in Washington during the last fifteen years. The only exception to this shown by the blanks is found in blank No. 1, under heading “Illegitimate Colored Births." Comparing the averages for the two five‐year periods given in 1878‐1882 and 1888‐1892, we find the number of illegitimate births per thousand inhabitants to be 5.1 and 5.9, and the percentage of total births to be 18.3 and 25, showing a slight increase for the second period in the actual number of such births per thousand inhabitants, and quite a considerable increase in the proportion of such births to the total number of births (colored), the figures being 113.3 per cent for the first period, and 25 per cent for the second period.
So much, then, for the two blanks as a record of the progress of the community. Let us see how far they give us any indication of the character of the population or of the causes of some of the results to be noticed.
| 1880 | 1890 | |||
|---|---|---|---|---|
| White | Colored | White | Colored | |
| Average death-rate | 18.61 | 37.124 | 19.19 | 32.08 |
| Average birth-rate | 17.16 | 24.47 | 14.89 | 25.02 |
| Excess in death-rate | 1.45 | 12.65 | 4.30 | 7.06 |
But it is to be noticed that so far as these indicate, the colored population is becoming more permanent, while the white population is becoming more transient. It would be interesting if that conclusion could be verified in any way.
| GROUP I | GROUP II | |||||||
|---|---|---|---|---|---|---|---|---|
| White | Colored | Excess of Colored | White | Colored | Excess of Colored | |||
| 1880 | 39.5 | 101.6 | 157 per cent | 1890 | 21.6 | 65.7 | 204 per cent | |
| 1890 | 33.4 | 86.3 | 158 per cent | 1895 | 16.08 | 56.3 | 250 per cent | |
| 1895 | 28.9 | 63.4 | 119 per cent | |||||
| GROUP III | GROUP IV | |||||||
| White | Colored | Excess of Colored | White | Colored | Excess of Colored | |||
| 1890 | 17.4 | 33.6 | 1880 | 117.88 | ||||
| 1895 | 13.35 | 18.2 | 37 per cent | 1890 | 117.00 | 161.5 | ||
| 1895 | 100.6 | 143.6 | 43 per cent | |||||
| 1888-1892 | |||
|---|---|---|---|
| WHITE | COLORED | EXCESS COLORED | |
| Deaths under 5 years | 5.7 | 15.0 | 163.0 per cent |
| Deaths over 5 years | 13.4 | 17.8 | 32.8 per cent |
| Total deaths | 19.1 | 32.8 | |
This shows that the rate of deaths of children under five years of age was 15 per thousand of population among colored, as against 5.7 among the whites, or nearly three times as many for the colored. This difference we may partly attribute to the more permanent character of the Negro population in Washington, and to the fact that there is consequently a larger proportion of children among them than among the whites, but there are other causes, some of which have to do with the social conditions prevailing in that community indicated by the exception to the general progress noted in an early part of this paper, viz: increase in illegitimate births.
Following the investigation made by Mr. Hershaw, through official records, we have that made by Dr. W. Bruce Evans, by the family budget method. This latter method is intended to give us an intimate knowledge of the conditions of life among the individual members of the community. Groups of families are selected representing a single neighborhood, trade or class in the community, and accurate information is obtained in regard to the families in each of these groups. By combining, comparing and classifying the information obtained from several groups, we are enabled to come to very accurate conclusions as to the most favorable as well as to the most unfavorable conditions affecting life in that community, and are thus able to determine on the most feasible measures of reform.
Dr. Evans has furnished us the information in regard to one group of twenty‐one families, and although it is impossible for us to make from this one group any generalization in regard to the colored population of the City of Washington, a community of 86,000 persons, the information is very interesting as representing the generally well‐to‐do character of the twenty‐one families represented.
The neighborhood in which they live is reported as being fair or good, and this is confirmed by the following figures deduced from the report, thus:
Thirteen of the twenty‐one families own their own houses. The houses for the most part are supplied with modern conveniences, nineteen having city water, nine sewer connection, etc. The average number of rooms occupied by a family is between five and six, the smallest number being four, while over half have from six to eight.
The average number of people occupying the same sleeping room is two, although in four instances there are four to a room, and in one instance, five.
There are only four cases of sickness reported, while twelve families report no sickness at all.
Only ten families report as to income, but the average for the ten is high, being $664 a year, and in seven families out of the ten the husband entirely supports the family by his sole labor. It is interesting to note the occupations of these seven men. The largest income is earned by a carpenter, who reports his earnings as $780; next comes a barber, earning $720 a year; a teacher, earning $650; a janitor, $560; a laborer, $480; a steward, $390; and a laborer, $250.
This matter of the occupations of city residents is one deserving a special line of inquiry, and it is hoped that some one will undertake to make a report on this subject at the next conference. The data obtained, by a continuation of the family budget investigation, will be found very useful for such a report.
The largest income of one family is that of a family of nine, the father and mother both dead, and the eldest brother and two sisters supporting the family. The brother is an expressman, earning $500 a year; the two sisters are teachers, earning $450 each, making a total of $1400 a year. This family owns its own house, having eight rooms, with city water, sewer connections and other conveniences. Five of the families report savings averaging $123.52 per family.
In concluding this report for the city of Washington, I wish to express regret that the very limited time within which the investigation had to be made should have prevented its being carried through on a more extensive scale, and I wish also to acknowledge once more the valuable assistance rendered by Mr. Hershaw and Dr. Evans.
An attempt was made to fill out blank No. 2 from the records in Atlanta, but the data obtainable were not sufficiently full or accurate for an extended report.
| 1890 | ||
|---|---|---|
| WHITE | COLORED | |
| Population | 37,416 | 28,117 |
| GROUP I. – Consumption and pneumonia, total | 126.0 | 225.0 |
| Rate per 10,000 | 33.7 | 88.0 |
| Excess for colored | 137.0 per cent | |
| GROUP II. – Cholera infantum, convulsions and still-born, total | 123.0 | 230.0 |
| Rate per 10,000 | 32.8 | 81.8 |
| Excess for colored | 149.0 per cent | |
| GROUPI II. – Contagious diseases, total | 90.0 | 78.0 |
| Rate per 10,000 | 24.0 | 27.7 |
| Excess for colored | 15.0 per cent | |
| GROUP III. – Other causes, total | 369.0 | 374.0 |
| Rate per 10,000 | 98.0 | 133.0 |
| Excess for colored | 35.0 | |
| Grand total | 708.0 | 907.0 |
| Rate per 10,000 | 189.0 | 322.0 |
| Excess for colored | 70.0 per cent | |
In looking for causes for excessive death rate among colored people, we see at a glance by this table that the cause is not to be found under heading of Group III, "Contagious diseases," as the excess there is only 15 per cent, as against 70 per cent excess for total death rate. We see that it cannot be found under heading of Group IV, "Other causes," as excess there is only 35 per cent. It must be found, therefore, among the five diseases included under Groups I and II. Looking there we find that 50 per cent of all deaths are due to those five diseases. From consumption and pneumonia there are 225 deaths, or 24.8 per cent of the whole number. From the three children's diseases there were 230 deaths, or 25.4 per cent of the whole number, making for the two groups 50.2 per cent of the whole.
We also see that the excess under Group I was 137 per cent, and under Group II it was 149 per cent. These figures are sufficiently startling, but they are still more so when compared with the figures of 1880. The death rate for consumption and pneumonia that year among the colored people was 60 in 10,000, being 19 per cent of the whole number of deaths, and 91 per cent in excess of the rate among whites. Comparing these figures with those for 1890, we see that the latter year shows a greater actual and relative death rate from those diseases. The conclusion to be drawn from this comparison would be that consumption and pneumonia were on the increase among the colored people for the decade 1880 1890. The causes for that increase are to be sought by such investigations as that planned in blank No. 3, the "Family Budget," which are being made, and will furnish data for the next annual conference.
“We have already learned by this investigation what diseases cause more deaths among our people than among the whites. We have found these to be pneumonia, convulsions, cholera infantum, and consumption. It has also been discovered that there are more still born among our people than among the whites. But there are causes for these things - yes, more causes than the time alloted will allow me to discuss.
"As convulsions and cholera infantum are largely caused by ignorance and poverty, and since these two diseases were discussed at length under those causes, I will pass over them, pausing only long enough to say that it is true that hunger and the want of proper food, as well as the ignorance of how to prepare it, when to eat it and how to eat it, often cause convulsions, cholera infantum and other diseases of the alimentary canal.
"As to still-births: Why should we be surprised at the great number of still births among our women, since they do most of the work that is liable to produce this state of things? They do the cooking, the sweeping, the lifting of heavy pots; they carry the coal, the wood, the water; they carry heavy burdens on their heads; they do heavy washing, make beds, turn heavy mattresses, and climb the stairs several times during the day, while their more favored white sister is seated in her big arm chair, and not allowed to move, even if she wanted to. In these things, my friends, you have the causes of the excess in this trouble.
“The average colored laborer is exceedingly neglectful. He will drive or walk all day in the rain or snow, come home and go to bed with his wet clothes on, with the belief firmly fixed in his mind that unless he lets these clothes dry on him he will contract a cold, and no argument we might use will convince him otherwise. Again, since the colored people here compose the majority of the laboring classes, it stands to reason that they are more exposed than the whites and are therefore more susceptible to those diseases that may be caused by exposure. The colored man sweeps the streets and fills his lungs with the dust and dried bacteria expectorated on the streets a few hours since from the lungs of some consumptive; he drives the garbage carts, he digs the sewers, drives hacks and drays, and in fact does most of the work involving exposure, which naturally makes him more liable to contract such diseases as pleurisy, bronchitis, pneumonia and consumption.
"It has been said by some that the Negro did not die with consumption until he became free, and that this new life brought also a new cause of death to him.
"But this statement in itself is sufficient proof to me that in those dark days of slavery the colored people, as a race, received little or no attention. Any case which calomel, blue-mass or castor oil could not reach, was left to take its own course, with few exceptions. The main cause of their sickness was often neglected, and when death came it was simply a Negro gone that was all. No record was left to show what the cause of death was, and there the matter was dropped. I believe, reasoning from what I see to day relative to the causes that produce consumption, that there were more graves filled with the victims of that disease thirty years before the war closed than there have been for a similar period of time since. The only difference is that now the deaths and their cause are recorded, and we know; then they were not recorded and we did not know.
"Again, experience has taught me that most of the deaths due to consumption among our people were the result of consumption contracted, and riot to congenital consumption, as our enemies invariably put it down.
"The city has neglected and is still neglecting the colored people, and especially that class of them which is dependent upon its charity in times of sickness. It has millions to build prisons with, but not a dollar with which to build charitable institutions. It allows money grabbers to build small huts and crowd into them five times the number of people that should be allowed; it has no law by which the owners of this property can be made to keep it clean. The houses are never painted, the wells are filled with the filth of the neighborhood arid the fences are never white washed, and the city is powerless to interfere. Family after family move into these places, and often only one or two are left to tell the story. My friends, it is one thing to stand here in this clean, well lighted hall and read papers on this subject, but it is altogether different to go down into those dark, poor and humble homes and see death going through destroying the old and the young because of the negligence on the part of those in authority.
"Some of the white physicians neglect the colored people. I wish it to be understood, however, that I mean some, not all, for there are some honorable exceptions to the statement just made. I say they neglect our people, and we cannot blame them. Doctors can no more afford to work for nothing than a teacher or any other person who is working for an honest living. Hence he refuses to go to these people; first, because they are not able to pay, and secondly, because the city has appointed physicians whose duty it is to attend the poor in their various wards. These physicians are paid from $600 to $800 a year to do that work, and then they neglect it, especially such cases as diphtheria.
"While this city has furnished physicians, it has furnished no medicine. It has no free dispensaries, as it should, nor does it pay the physician money enough to furnish medicines applicable in every case, and at the same time care for himself and family. Hence, when he is called to see a patient, it matters not what the disease may be, it is either compound cathartic pills, calomel, Epsom salts, blue mass or castor oil. Any case these remedies don't reach is left to get well if it can or die if it must. I ask, then, in all candor: Is it any wonder that we die so fast when we get such good attention, doctors, such excellent nursing, such fresh medicines applicable in every case of our diseases?
"Here in this city of push, pluck and Christian progress, there is not a decent hospital where colored people can be cared for. At the Grady Hospital, which takes about $20,000 of the city's money annually to run it, is a small wooden annex down by the kitchen, in which may be crowded fifty or sixty beds, and that is all the hospital advantages 40,000 colored citizens have. But, on the other hand, our white friends, with a population of about 70,000, have all the wards and private rooms in the entire brick building at this hospital, together with a very fine hospital here, known as St. Joseph's Infirmary. Hence, my friends, you can see that one of our greatest needs is a first-class up-to-date hospital, where the colored people can not only get proper treatment, but can also have all necessary operations performed. However, this excessive death-rate among us may be best for us. God moves in mysterious ways. He purged us in the burning fires of slavery for more than two hundred and fifty years, preparing us for the great responsibilities of freedom, and now who knows but what He is cleansing us with His fan of death, ridding us of the worthless elements of the race, and thus fitting us for that higher, brighter and nobler citizenship which is yet to come? All we can do is to work, watch, pray and wait.
“Again, the educated and the more highly favored of our people often neglect their own race. They neglect the poor, they will not support race enterprises, they fail to support their own business and professional men, and yet they want to pose as big men and leaders of their people. But, as I see it, that is not carrying out the idea of a truly educated person. Education does not mean that we must stop work, but it rather means that we must go to work with greater energy to help elevate our people along all lines, and thereby make them better citizens and better Christians. Neither does to graduate and get a diploma mean to separate us from our people, but it rather means to bind us closer to our race, our country and our God. It matters not whether we be preachers, teachers, lawyers, doctors, or whether we are engaged in business, we should remember that God has made us the pillar of cloud by day and the pillar of fire by night to lead our people, which we cannot do unless we keep near to them. I speak of these things because they have much to do with the health of the people. If we patronize race enterprises, if we patronize our preachers, teachers, lawyers, dentists, and business men, it will increase our wealth, with which we can help the poor of our race; it will open other avenues of labor for our people, we will be able to build health resorts and hospitals for them, and do many other things beneficial to their health that we are not able to do now because we fail to support each other.
"Taking all things into consideration, I don't think the death‐rate of the colored race is so far in excess of the whites. Is it any wonder that we die faster than our white brother when he gets the first and best attention, while we are neglected on all side? They have the best wards and treatment at the hospital, while we must take it second‐hand or not at all; they have all the homes for the poor and friendless, we have none; they have a home for fallen women, we have none; they have the public libraries whey they can get and read books on hygiene and other subjects pertaining to health, we have no such privileges; they have the gymnasiums where they can go and develop themselves physically, we have not; they have all the parks where they and their children can go in the hot summer days and breathe the pure, cool air, but for fear we might catch a breath of that air and live, they put up large signs, which read thus "For white people only;" they live in the best homes, while we live in humble ones; they live in the cleanest and healthiest parts of the city, while we live in the sickliest and filthiest parts of the city; the streets on which they live are cleaned once and twice a day, the streets on which we live are not cleaned once a month, and some not at all; besides they have plenty of money with which they can get any physician they wish, any medicine they need, and travel for their health when necessary; all of these blessings we are deprived of. Now, my friends, in the face of all these disadvantages do you not think we are doing well to stay here as long as we do?"
"As each city has its Negro settlements, and as the great rank and file of the race belong to the grade or class called the poorest and most ignorant, of this kind are the largest settlements. These people have small wages, many with nothing to do a great part of the year, and the majority have no steady employment. For food, rent, fuel and clothing they are dependent upon the odd jobs that pay not more than fifty cents per day for two or three days in a week. To eke out a living on such an income requires, they know, the strictest economy, but how to economize they know not, yet thinking they know, in their way they set about it. The first step is to cut down the expense of living by taking no more house room than barely enough in which to turn around. A small family, parents and two or three children, take one room. The landlord will not agree to have this cleaned before they move in, although it has not been cleaned or repaired in a score of years, and during that time as many different families, with each a different disease, have lived in it. The tenant can't afford to have it cleaned, so he contents himself by sweeping the floor before his household goods are brought in. The truth is, he does not see the importance of having the house thoroughly cleaned before occupying it, and if the rent is cheap he does not parley, but pays the installment and takes possession.
"In this room, 15x15, sometimes smaller space, are placed a bedstead, a three-quarters bed, sometimes two (but in these days of cheap furniture and installment sales, a folding lounge very often takes the place of the second bedstead), one or two tables, a trunk, bureau, not less than four chairs, tubs, boards, etc., for laundrying, cooking utensils, and a lot of odds and ends. These, with the family, give breathing space scarcely sufficient for one, yet by some means it is hoped to get enough for the whole family.
"It may be that the work of the mother of the family requires that she be away from home all day. Leaving at six a.m., without giving any care to the house or children, she returns at eight o'clock at night. The children are asleep, in the street, or at some neighbor's, where they have been all day. The tired mother, after a few words, goes to bed. She awakes next day only to carry out the same program. Perhaps there are no children; then the uncleaned house is securely fastened. Perhaps once in several months, time is spared for house cleaning, or it may be put off till moving day.
"A family in which the father has steady employment at fifty or seventy five cents per day, and the mother' and girls are doing the washing of one or two families, numbering six or seven persons each, bed and table linen included, for 75 cents to $1.25 per week, furnishing the soap, starch and fuel for the same, rents a house of two or three rooms. Yet the above wages will give but scanty living for parents, five or six children and grandmother. Rent, fuel, food, clothing, books for the children if they are in school, the minister's salary, and the assessment for the new church building, and during the summer an excursion all of these must be paid for out of the wages of the family. Inferior material for clothing, if stores that deal in second hand apparel are not patronized, most inferior food, the most dilapidated houses, must be used.
“Another class, there is, some of whom from choice are idle, others, from inability to obtain work, have no visible means of support. These manage, by living in groups something after the Italian manner, to exist. Four to six occupy one room, in which there is little or no furniture. One or two meals a week, with a little food here and there, serve to sustain life and nourish disease, moral and physical. There is another class more noble than those mentioned. It is composed of persons anxious to own a home, and although they receive but scanty wages, they are not easily discouraged and go to work determined to own some land. Of course, they must buy the cheapest land and on the easiest terms the low places surrounded by ponds outside the city limits, in the city beyond the extension of the sewers and other sanitary arrangements, places where you can see the miasma rise and touch it, as it were, with your hands. The houses put up are but apologies for houses. The people of these localities spend a good portion of the fall fighting chills and fever, till alas! poor, earnest, honest, simple folk, when they think their systems are enured to exposure and malaria, disease has laid fast hold upon them.
"Another class, who have learned something of cleanliness and hygiene, are forced by their poverty, for the sake of cheap rents, to live in most sickly and unclean neighborhoods, with but scanty food and no money or medicines or nourishment when they are sick, which is quite often.
“There is yet another class who, by their perseverance, intelligence and economy, have made for themselves better houses, comfortable homes in healthy localities; these see hearts ache with alarm at the devastation that is being made, but how to stop it is to them the unsolved problem of their race.
"College settlements they cannot have, for the mighty lever of modern civilization, money, is wanting to them. The planting of factories, shops, etc., to furnish employment is for the same cause, at this time, to them an impossibility.
"That the moving spirit of these meetings may be a Moses come to lead out of the wilderness is greatly to be hoped. That from these meetings may be evolved plans that will bring some relief, is the prayer and aim of all concerned."
"The child, once launched into what is for most of us a life of struggle and work, is at the point where we may discuss his career. What are we to do with him? How guide him and fit him for the battle of life, that he may make the most of himself, and contribute his mite towards the improvement of the world and the evolution of the race?
"The first point upon which I would insist is that his entry into the world shall be accomplished with all the care possible, exerted by a careful, conscientious and thoroughly trained doctor. It is a most unfortunate and common practice among the poor and ignorant to employ midwives to attend their women in labor; they seem not to realize the great danger to themselves and their children, of having for attendance at such a time women wholly ignorant of human anatomy and physiology, totally untrained in habits of care and cleanliness, utterly unfit for the work they presume to do. I cannot too strongly insist upon the great danger arising from this practice of employing midwives, and would urge upon each and every one of you, whose work leads you in any way among the poor and ignorant, to warn them against this practice, and urge them to seek proper medical aid and assistance. By so doing you will do much towards decreasing the mortality among the new born and insuring a letter state of health and vigor among the mothers.
“Improvement in this direction is the more easily accomplished on account of the numerous hospitals and dispensaries now found in all cities. It is safe to say that, as a general thing, the best physicians of the city will be found on the staffs of these hospitals; medical aid and advice are invariably free; with one or more of then is generally connected an obstetrical department, and by merely applying at these institutions, a woman can be attended, either at the hospital or at her home, during labor and convalescence, by a physician properly prepared, by a long course of study, to do thoroughly scientific obstetrical work.
"I would then suggest to you that in all cases possible you urge these people to seek such institutions, and thus free themselves from the great dangers inevitably arising from attendance by a midwife. It seems to me a practicable way of saving life among the new born and preserving health and strength among mothers.
"The high rate of mortality among infants is a subject well worthy the consideration of all thoughtful men and women, and naturally leads one to enquire as to causes and possible remedies. Prominent among the causes of this high rate must be mentioned bad heredity and injudicious and harmful management of these little ones by their parents. As a result of these two causes, many children are ill prepared to meet and battle with the acute diseases almost inevitably before them; they are more apt to contract disease than a healthier child; they are more apt to die from it, when once contracted, as their resisting power is weakened by their heredity and their management since birth.
"Now what is the remedy? What can we do to counteract hereditary weakness? How manage our children so as to give them the best health and greatest resisting power possible? While the most successful solution of these problems necessitates the assistance of a trained physician, yet much aid can be furnished by the parents, and indeed without their constant and hearty co-operation, little can be done by their medical adviser. The general directions as to details must be given by the doctor; the patient, daily, hourly, minutely execution of these details must devolve upon the parents. What, then, are the practical steps to be taken? you will ask. First, as to the question of heredity. Humanity is not perfect; we all of us, even though we do not admit it, are conscious of certain defects in our own characters physical, mental or moral. The tendency towards these defects we transmit to our own children, and though by care and wise management the growth of these defects may be held in check, or they may not even be apparent, or may exist only as a blemish, yet let us not blind ourselves to the fact that the seed is there, and that without keen watchfulness on our part it may grow and develop into the glaring defect we seek to avoid. Tell your physician of the weakness there may be in yourself, of the hereditary taint which may exist, actively or passively, that you may have his help in the training of your child, his assistance in fighting the weak points, and developing the strong traits which fortunately also exist, hereditary and self developed.
"For example, to particularize, take the well known disease of consumption. You yourself may be free from it, your parents or some members of your family may have been or may now be afflicted with it. Tell your doctor of this fact, show him your infant or child, that he may examine him thoroughly, that in the future, in illness or in health, he may be constantly on the lookout for signs which may escape your notice, not through carelessness on your part, but merely because it is not the business of your life to be looking for these signs. Consumption is not, of course, the only disease or defect which may exist in us; there may be a weak heart, a weak stomach, weak bowels, weak kidneys, weak brain, weak nerves. By frankly facing such facts, and by care and watchfulness such as I have mentioned, we may do much either to strengthen the weak point, or often to crush out the bad seed altogether.
“Nor do I hesitate to speak thus to you who must be considered the vanguard of humanity, when you may think that this paper has to do with mortality among the infants of our less fortunate brethren.
“There is so much in these thoughts that you and I, each and every one of us, can take home to himself and herself; we are all human, and though in the course of ages, by the process of evolution, we have arrived at the top of the animal scale, we are not yet perfect, and must transmit to our descendants our vices as well as our virtues. And I would suggest that you urge upon those needing your help, as I have sought to urge upon you, the importance of early and constant attention to the points mentioned above. Do not be discouraged by thinking that these poor helpless infants cannot have the medical aid and advice which I suggest. They can. It is in the cities that the most of this work can be done. As I leave already said, it is in the cities that such advice and aid can be had at the hospitals and dispensaries. So, if the necessity arise, if their children be not thriving, urge them to seek these institutions where, I am sure, much good will be done them.
"Much that has been said in the discussion of heredity of course applies in speaking of the management and training of infants, but a few more points seem to be of importance. When shall we begin the active training of infants? To this question I would answer most emphatically, at the moment of birth. This, perchance, will cause you to smile: What, discipline a baby just born! How? The whole question is summed up in a nutshell, regularity of habit. Come with me on my daily rounds, and see how quickly and easily that small bundle of humanity becomes the tyrant of the household; many of you perchance realize this in your own families. It is all the more lamentable, because it can be prevented. Fortunately, the moral and physical are so intimately blended in the young human animal that the training of one unconsciously involves the training of the other. The new born babe does nothing but eat, sleep and cry; at least manage it that he shall eat with regularity, at stated times, as you do yourselves, but of course oftener, and his other occupations will regulate themselves; he will sleep properly and regularly, and if healthy will cry but little. Fixed, regular habits of thought and action in our own lives are of an importance too well known to need more than a passing mention. They are of equal importance in infancy and childhood, but unfortunately this fact is rarely appreciated, and we cannot begin too early to start the young life in habits of regularity, which once applied in the first weeks, in the only way possible, i.e., in the matter of food and sleep, will gradually extend themselves in other directions with the growth and development of the child, and will do much to strengthen and bring out a well‐rounded and well‐disciplined character."
"Any one who will give the least observation to this matter will see that the cities are the hot beds of crime, misery and death among the colored people. Here the people are huddled together, often with two or three families in one room. Without employment for more than half the time, they are consequently insufficiently fed and poorly clothed. When sick they are unable either to employ a physician or to buy medicine. At least twenty-five per cent of them die without medical aid. In the city of Savannah, during the year 1894, 251 colored persons died without medical attention: This is 33 1/3 per cent of the total number of deaths among these people for that year. About 60 per cent of this number of deaths were children under the age of ten. Twenty four thousand of the 52,000 population of Savannah are Negroes. Hence it will be seen that whatever affects these people, affects at least nearly half the population of our chief seaport. What is true of Savannah, I judge to be approximately true of all the cities of Georgia and of most of the cities of the South."
Resolved, That the papers presented by the graduates of Atlanta University and others show an alarming increase in the death-rate of the Negro population of cities and large towns, from such diseases as consumption and pneumonia, due in a great degree to ignorance, poverty, negligence and intemperance.
Resolved, That the investigations thus far made show the necessity for continuing the search for exact data on a larger scale, with a view to ascertaining more definitely the causes and seeking out and applying remedies for existing conditions.
Resolved, That the corresponding secretary and executive committee of this conference be and are hereby instructed to continue the investigations on these and other lines pertaining to the welfare of the Negro population in cities, and invite the hearty co-operation of all the graduates of the Atlanta University, and of other interested in the investigation and solution of city problems.
This text is an abridged second edition of the first in a series of conferences held by Atlanta University to conduct a sociological study of the conditions of African-Americans in the United States. The original conference was held in 1896, and this text was published in 1903. The proceedings from the Atlanta Conferences became the basis for the historic Atlanta University Studies.
The Atlanta Conferences were originally intended to focus on the problems of African-Americans in cities. When, W.E.B. DuBois was hired by Atlanta University President Horace Bumstead as a professor of sociology and head of the conferences in 1897, DuBois expanded the scope of the project. He envisioned the Atlanta Conferences as a ten-year cycle study, each year gathering sociological data and findings on a different facet of the social condition of African-Americans. DuBois acknowledged that the Atlanta University Studies were not perfect. However, the importance of the studies was made of more than just the information. As DuBois wrote in his autobiography:
It must be remembered that the significance of these studies lay not so much in what they were actually able to accomplish, as in the fact that at the time of their publication Atlanta University was the only institution in the world carrying on a systematic study of the Negro and his development, and putting the result in a form available for the scholars of the world.2
As a note on this edition: this abridgement does not contain the following sections from the full first conference proceedings: Intemperance as a Cause of Mortality, Ignorance as a Cause of Mortality, General Conditions of Mortality, and Remarks from Bishop L.H. Hosley. The following sections in this text are extracts: Causes of Excessive Mortality: Neglect, Causes of Excessive Mortality: Poverty, Infant Mortality, The Cities: (Letter from President R.R. Wright). Additionally, this edition originally had, on its cover, extracts from: Letter from Prof. Edward Cummings and Letter from George W. Cable. However, The History of Medicine Division, National Library of Medicine copy of this text is rebound, and does not include these extracts.
Author: Conference for the Study of the Negro Problems (1st : 1896 : Atlanta University)
Editor: Chase, Thomas N.
Title: Mortality among Negroes in cities: proceedings of the Conference for Investigations of City Problems held at Atlanta University, May 26-27, 1896.
Edition: Second edition, abridged.
Publicaton information: Atlanta, Ga.: Atlanta University Press, 1903.
Collation: 24 p. : tables ; 23 cm.
Series: Atlanta University Publications, no. 1.
Notes: First published in 1896 in 51 p.
Also available in microfilm ([Bethesda, Md.]: National Library of Medicine, 1993).
Call number: W3 C33 1896
Credit: Electronic text for Medicine in the Americas edited by Amanda Reyes, February, 2004.
William Edgar Burghardt Du Bois, "The American Negro at Paris," The American Monthly Review of Reviews, Vol. XXII, November 1900, No. 5, p. 577.
Du Bois, William Edward Burghardt, 1868-1963, Chapter 13: Atlanta University in The Autobiography of W.E.B. DuBois: A Soliloquy On Viewing My Life From the Last Decade of It's First Century. New York, NY: International Publishers, 1968, pp. 448.
