This appendix presents state-level mortality rates calculated from the United States Census mortality data for 1850 to 1900. The appendix includes a discussion of various issues involved in the calculation of the mortality rates for certain diseases, an examination of the accuracy and reliability of the census mortality data, and a listing of the data sources. For specific causes of death for nearly two dozen major infectious diseases, we present cause-specific mortality rates for the entire population for each disease for each census year for each state for which data exist. For all causes of death, we present mortality rates for the entire population as well as mortality rates for (1) four age cohorts—adults (20 years and older), children/adolescents (5 to 19 years), young children (1 to 4 years), and infants (under 1 year), (2) two ethnicity cohorts (whites and blacks), and (3) two nativity cohorts (native born and foreign born) for each census year for each state for which data exist. The mortality rates are reported as rates of death per 10,000 people or per 10,000 of the relevant cohort (adults, children/adolescents, young children, for example). The cause-specific mortality rates for the major infectious diseases are presented in tables C.1 to C.11. The mortality rates for all causes of death for the entire population and for each of the eight cohorts are presented in tables C.12 to C.16.
If no mortality rate is shown for a state for a specific disease, a particular cohort, or the population for a given census year then the census did not report deaths for that state for that category in that year. If a mortality rate of 0.00 is shown for a specific disease or a particular cohort for a particular state, that means the census reported deaths for that category for that state but reported that there were no deaths. The census reported deaths on the basis ethnicity (race) in all census years from 1850 to 1900 except 1860. As a result, no 1860 mortality rates by ethnicity are calculated. The mortality rates reported here for “blacks” for four of the census years (1850, 1870, 1880, and 1900) were calculated from “negro” deaths. For the other census year (1890), the reported “black” mortality rates were calculated from “colored” deaths, which included negroes, Chinese, Japanese, and civilized Indians; the 1890 census did not report separate mortality data for the various ethnic groups. The census reported deaths on the basis of nativity (native born and foreign born) in four census years (1850, 1870, 1890, and 1900). In 1850, the census nativity mortality data were reported for whites and “free colored” but not for slaves. As a result, native-born deaths included both native-born white and native-born “free colored” deaths, and foreign-born deaths included both foreign-born white and foreign-born “free colored” deaths. In 1860 and 1880, no census mortality data were reported on the basis of nativity. In 1870, the census reported nativity mortality data for the entire population (native born and foreign born population), which included whites and “colored.” In the 1890 and 1900 censuses, deaths on the basis of nativity were reported for whites only, identifying deaths as native-born white deaths and foreign-born white deaths.
For 1850, the “malarial fever” mortality rates are calculated from the total deaths reported for bilious, congestive, intermittent, and remittent fevers. For 1860, the “malarial fever” mortality rates are calculated from the total deaths for intermittent and remittent fevers; no other malaria-symptomatic fevers were reported in 1860. For 1870, the “malarial fever” mortality rates are calculated from the total deaths for intermittent, remittent, and typho-malarial fevers; no other malaria-symptomatic fevers were reported in 1870. Beginning with 1880, the census included data on the number of deaths for malarial fever, and bilious, congestive, intermittent, and remittent fevers were identified as malarial fever (United States Bureau of the Census 1886, p. xxxv). Drake ([1850, 1854] 1964, p. 703) also lists bilious, congestive, intermittent, and remittent fevers, among other idiosyncratic names, as malarial fevers.
For 1850 to 1870, the census reported deaths for cholera. For 1850 to 1900, the census also reported deaths for cholera infantum, a common name for cholera symptoms among infants and children, which also was called the “summer complaint” and found primarily in the middle Atlantic and South during the summer months and hot weather. For 1850, 1880, and 1900, the census also reported deaths for cholera morbus, a common name for nonepidemic cholera as well as simple cholera, a disease with cholera symptoms most common in hot climates at the close of summer or early autumn. As a result, the cholera mortality rates are reported in two alternative ways: (1) For all six census years, cholera (all variants) mortality rates are calculated for a particular census from the total deaths from all the types of cholera that were reported in that census. (2) The mortality rates for cholera, cholera infantum, and cholera morbus are reported separately for each census year for which the data were reported.
The 1850 typhoid mortality rates are calculated from the total deaths reported as caused by “fever, typhoid” in Alabama, Connecticut, and South Carolina and from the total deaths reported (nearly certainly mistakenly) as caused by “fever, typhus” in all other states. For the 1860 to 1900 census, “fever, typhoid” was reported as a cause of death in all states. “Fever, typhus” was reported as a cause of death in all states (except Alabama, Connecticut, and South Carolina in 1850) in 1850, 1870, and 1880. The 1860 census (United States Bureau of the Census 1866, table 12, p. 215) presents a summary table of deaths in the United States for specific causes for 1850 and 1860 and lists “fever, typhoid” but not “fever, typhus.” Moreover, the number of deaths listed for “fever, typhoid” for 1850 correspond to the total number of deaths reported in the 1850 census for “fever, typhus” and “fever, typhoid” combined. The 1870 Census (United States Bureau of the Census 1872, p. xvii) presents a summary table of deaths in the United States for specific causes for 1850 to 1870, indicating there were barely two thousand “typhus” deaths during 1850 to 1870. The summary table also indicates there were nearly 55,000 “typhoid” deaths in 1850 to 1870, which correspond exactly to the total number of deaths reported in 1850 as caused by “fever, typhus” and “fever, typhoid” and reported in 1860 and 1870 as “fever, typhoid.” As a result, we surmise that the deaths reported as “fever, typhus” in 1850 were likely deaths caused by “fever, typhoid.” (The 1860 census, United States Bureau of the Census 1866, p. 239, also indicates that the deaths reported as caused by “typhoid” in 1860 likely included some deaths that were actually reported as caused by “typhus.”) Finally, the pneumonia mortality rates for 1850 are calculated from the total deaths reported for pneumonia and winter fever, a common name at the time for pneumonia. Deaths for winter fever were reported in 1850 only.
Several issues have been raised about the accuracy and reliability of the 1850 to 1900 mortality data reported in the federal censuses (see Condran and Crimmins 1979). (1) There is underenumeration of deaths in the 1850 to 1900 censuses, at least in part because retrospective questions about deaths were asked; respondents are unlikely to accurately recall the past concerning deaths during an entire year preceding the census enumeration (the period of the report). (2) The census mortality data are for one year only and the 1850 to 1900 responses were collected at a time when there was much year to year variation in the leading causes of death, epidemic and infectious diseases. (3) The recollection of age-specific deaths appears to be much worse for infants and the aged, which appear to be especially underenumerated. (4) There are variations in the completeness and quality of the enumeration of deaths and populations across states and over time. While the quality of the mortality censuses appears to have improved over time, scholars consider the 1870 mortality census to be the least complete (especially in the South) and the 1880 mortality census the most complete of the six censuses (Fisher 1899; Condran and Crimmins 1979). (5) By 1900, essentially all of the northeastern portion of the nation had death registration systems, which record more deaths than the retrospective censuses. Massachusetts had a registration system during all of 1850 to 1900 with other eastern states adopting such systems throughout the second half of the nineteenth century; only minor parts of southern and western states had any registrations of deaths by 1900. As a measure of the gap between the census enumeration and deaths recorded in registration systems, we can use an 1880 census comparison between the two different measures of deaths for Massachusetts (exclusive of Boston). In 1880, the census enumeration of deaths for all ages was 79 percent of the Massachusetts registration of deaths; the census enumeration of infant deaths was only 68.5 percent of the Massachusetts registration of infant deaths (United States Bureau of the Census, 1886, table 52, p. 650). (6) Many diseases had not been scientifically identified during the early part of the 1850 to 1900 period, leading to possible misidentification in earlier censuses but more accurate identification in later censuses. And (7) respondents might not have accurately identified any particular disease as a cause of death.
Condran and Crimmins (1979, p. 16) indicate that there is general agreement that overall mortality declined in the 1850 to 1900 period, as indicated in the census data. Yet they note that some suggest the decline began pre-1850 while others suggest that it began circa 1880. They recognize that the census mortality data show that overall infant deaths increased from 1850 to 1890 but suggest that the increase may not be real; it is likely due to the improving nature and greater completeness of the censuses later in the period. Condran and Crimmins (1979, p. 16) also recognize, though, that infant deaths likely did increase in some areas (urban areas, for example). They further note that infant deaths reported in the 1850 to 1890 censuses are not strictly comparable to those reported in 1900 because the 1900 census did not include stillborn deaths in infant deaths as was the case in the 1850 to 1890 censuses.
Despite underreporting of deaths, especially for infants and the aged, the fact that diagnosis of diseases at the time was problematic, and other issues with the census mortality reports, what we are interested in is examining differences in death rates among various cohorts and across states (disease ecologies) for different diseases; we are not interested in the absolute level of mortality per se. We will have problems if there were systematic differences in the classification of diseases and the reporting of deaths across states in each census. We are not certain if there were such systematic differences, and even more troublesome, we do not believe the data would allow us to identify all such differences if they did exist. Is there evidence that different states reported, say malaria, or any specific infectious disease, differently or reported deaths differently in a given census? We are not sure if there is such evidence. Some scholars maintain that the relative level of mortality across states is reasonably accurate even if the absolute levels are not (Yasuba 1962); others, however, suggest there was large variation in the quality of the reports and completeness of enumeration from state to state (Condran and Crimmins 1979, pp. 10, 14).
While the absolute values of some of the death data reported in the 1850 to 1900 censuses are underenumerated, viewed cautiously, we believe the mortality estimates in this appendix can shed light on how widespread certain infectious diseases were and their trends in the second half of the nineteenth century. In particular, the mortality rates do well at indicating the relative prevalence of various groups of infectious diseases (warm-weather fevers, upper respiratory diseases, gastrointestinal tract diseases, and intestinal parasites/worms) in the second half of the nineteenth century across various regions of the United States (Northeast, East North Central, and the South), and among most age cohorts and ethnicities (race or ancestral heritages). Moreover, the US Census mortality data are the only data available on a (approximately) uniform basis for the 1850 to 1900 period for causes of deaths for specific diseases for all states.
The mortality and population data necessary to calculate the mortality rates are contained in United States Bureau of the Census (1854, 1855, 1864, 1866, 1872a, b, 1882, 1885, 1886, 1894, 1895, 1896, 1897, 1902a, b, c) and Historical Census Browser (University of Virginia Library). For 1850, the mortality data are from United States Bureau of the Census (1855, pt. 1, table 6; pt. 2, app., pp. 50–301). The 1850 population data are from United States Bureau of the Census (1854) and Historical Census Browser (University of Virginia Library). For 1860, the mortality data are from United States Bureau of the Census (1866, tables 1, 3, 4). The 1860 population data are from United States Bureau of the Census (1864, Recapitulation, pp. 592–97) and Historical Census Browser (University of Virginia Library). For 1870, the mortality data are from United States Bureau of the Census (1872b, tables 2, 5, 7, 9). The 1870 population data are from United States Bureau of the Census (1872a, table 1). For 1880, the mortality data are from United States Bureau of the Census (1885, app., tables 1, 2, 4; 1886, tables 13, 18, 57). The 1880 population data are from United States Bureau of the Census (1882, table 1). For 1890, the mortality data are from United States Bureau of the Census (1894, tables 1, 2, 5, 7; 1896, table 1). The 1890 population data are from United States Bureau of the Census (1895, table 9; 1897, table 2). For 1900, the mortality data are from United States Bureau of the Census (1902b, table 19; 1902c, tables 4, 8). The 1900 population data are from United States Bureau of the Census (1902a, table 2).