Birth and Death Rates

Fertility was high by contemporary standards, but the trend was down, as shown in Table 18.2, continuing the trend that had begun early in the nineteenth century. Live births per 1,000 people fell by almost half over the nineteenth century, from 55 in 1800 (for whites, data for blacks are not available) to 30.1 in 1900. By the turn of the century, Americans were increasingly viewing two children as the “normal” family (David and Sanderson 1987). This trend has continued, and as of the 1990s, the birthrate was less than half that of 1900. Urbanization has been a major source of this decline because the costs of raising an additional child are much higher in the city. Also playing their parts were declining child mortality (which reduced the number of births needed to reach a desired family size), rising female employment (which increased the opportunity

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Source: Chart: "Birthrate and Morality" by Michael R. Haines from THE READER'S COMPANION TO AMERICAN HISTORY, edited by Eric Foner and John A. Garraty. Copyright © 1991 by Houghton Mifflin Harcourt Publishing Company. Used by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

Cost of additional children), and compulsory schooling (which lengthened the time in which children depended economically on their parents).

Even this list of factors, however, may not fully explain the fertility decline. Urbanization was important, but fertility dropped in rural areas as well as urban areas in the nineteenth century. Rising land prices that forced families to accumulate greater financial reserves or do with less land may be the explanation. Fertility was generally lower, moreover, in the United States than in Europe (other than France), a surprising contrast if urbanization and restrictions on child labor were the crucial factors explaining the decline in fertility (Haines 1989, 1990). Meanwhile, death rates—indicated in Table 18.2 by the expectation of life at birth—began a long decline dating from the 1870s.

Surprisingly, specific medical treatments were not a major quantitative factor until well into the twentieth century. Instead, the key factor in the first phase of mortality reduction was improved sanitation, especially better water supplies and sewage disposal (Meeker 1972; Higgs 1979; Haines 1985; and Troesken 2004). America’s biggest cities had been particularly unhealthful; but beginning in the 1890s, they began large-scale projects to provide piped water, filtration and chlorination of water, sewer systems, and public health administration. These improvements brought down the death rates from cholera, typhoid fever, gastrointestinal infections, and other diseases. Death rates fell more for African Americans and recent immigrants than for native born whites. Indeed, in some cases, as Werner Troesken (2004) shows, advocates of improved sanitation appealed to fears of contamination from groups of poor people to win public funding.