The Gamble of Health the Typhoid Fever Commission we have analyzed by wards the death certificates of people dying in Pittsburgh for the past five years. We have grouped these wards into districts, the living conditions of which are more or less of a kind. Let me compare the mortality figures of wards nine and ten and twelve-a group of river wards in the old city, near the mills, peopled for the most part with a wage earning population of small income-compare these wards with ward twenty-two, a new residential district in the East End. What are the chances of life of the men, women, and children living in the one and in the other? The chance of a man's dying of bronchitis in the river wards is two and a half as against one in the East End, it is four of his dying from penumonia as against one in the East End, five of his dying of typhoid as against one in the East End, six of his dying a violent death as against one in the East End. These are rough proportions merely, but they are of terrific significance. Our American boast that everybody has an equal chance falls flat before them. The dice are loaded in Pittsburgh when it comes to a man's health; his health is the workingman's best asset; and the health and vigor of its working population are in the long run the vital and irrecoverable resources of an industrial center. This brings us to a point where we can define more concretely the plain civic responsibility of democracy in an industrial district. That responsibility is to contrive and to operate the social machinery of the community, and to make living conditions in the district, such as will attract and hold a strong and vigorous labor force for the industries on which the prosperity of the district must depend. Here lies the responsibility of the community to the individual manufacturer-and the responsibility of the community to its own future that the efficiency of its workers shall not be mortgaged before they go to work in the morning. This carries a counter responsibility. In the interests of the community as a whole, in the interests of all the industries as against the interests of any single one, the public cannot afford to have such a working force impaired or wasted by unsanitary The Human or health taxing conditions during the working hours. What I mean will perhaps be clearest by illustrating in the case of industrial accidents. Pittsburgh cannot afford to have over 500 workingmen killed every year in the course of employment, or an unknown number of men seriously injured. During the past year, the Pittsburgh Survey has made an intensive inquiry into the facts surrounding the deaths of the entire roster of men killed in industry during twelve months, and of the accident cases treated in the hospitals of the district during three months-not with the idea of raising anew the question of responsibility for particular accidents, but to see if there are any indications as to whether these accidents could be prevented and whether the burden of them falls where in justice it should. The work has been done by a staff of five people, including a lawyer, an engineer and interpreters, and we have had the coöperation of claim agents, superintendents, foremen, trade union officials and others. We found that of the 526 men killed in the year studied in Allegheny county, the accidents fell on Americans as well as foreigners; 224 were native born. The ranks of steel workers and train-men suffer most-the pick of the workmen in the district. There were 195 steel workers killed, 125 railroad men, 71 mine workers, and 135 in other occupations. It was found that it was the young men of the district who went down in the course of industry. Eighty-two were under 20 years of age, 221 between 20 and 30. Over half the men killed were earning less than $15 a week, a fact which raises the question if the law is fair in assuming, as it does in Pennsylvania, that wages cover risk. Fifty-one per cent of the men killed were married with families to support; an additional thirty per cent were single men, partly or wholly supporting a family. It was shown that the greatest losses were not due to the spectacular accidents, but to everyday causes. In the steel industry, for instance, 42 deaths were due to the operation of electric cranes, 31 to the operation of broad and narrow gauge railroads in the mills and yards, and 24 to falls from a height or into pits, vats, etc. Pittsburgh has stamped out smallpox; its physicians are fighting tuberculosis; the municipality is checking typhoid. Cannot engineers, foremen, employers and workmen come together in a campaign to reduce accidents? Considerable has already been done in this direction by progressive employers. The problem is that of bringing up the whole district to progressive standards. On the other hand we have put these industrial accident cases to that same test of human measurement which we found of such significance in gauging the losses due to typhoid fever. This steady march of injury and death means an enormous economic loss. Is the burden of this loss justly distributed? What takes the place of the wages of these bread-winners? What resources of their own have these families to fall back on? What share of the loss is shouldered by the employer? What share falls in the long run upon the community itself, in the care of the sick and dependent? Is the Pennsylvania law fair that exempts the employer from paying anything to the family of a killed alien if that family lives in a foreign country? Are the risks which the law supposes that the workman assumes when he hires out for wages, fair risks under modern conditions of production? Is it in the long run, to the interest of the employer to leave to the haphazard, embittered gamble of damage suits, this question of meeting in a fair way the human loss, which with even the best processes and the greatest care, is involved in the production of utilities. I am not in a position here to put forward the economic facts brought out by our inquiries; but I can say that on every hand, among employers and claim agents and workmen, there is profound dissatisfaction and an increasing open-mindedness toward some such sane and equitable system of workingmen's compensation as those in operation in Germany and in England. But this question of industrial accidents is only part of another and larger question of the relation of industry to health. The Industry and workers of Pittsburgh are dealing not with simple ploughs and washtubs and anvils, but with intricate machines; in great work rooms where hundreds work side by side; dealing with poisons, with voltage, with heat, with a hundred new and but half mastered agents of production. Are the conditions under which some of this work is carried on directly inimical to health? Could they be bettered without serious loss to the trades and with great gain to the workers? Let me illustrate from the women-employing trades. The Supreme Court of the United States has recently upheld the Oregon statute prohibiting the night labor of women in certain industries on the ground that such work is a danger to health. From mid-August to the first of December, in the stogy trade of Pittsburgh, women work from two to three evenings a week; laundries customarily work Friday nights until ten, eleven and twelve o'clock in order to return goods to customers Saturday, and overtime in all departments before every holiday. We have cases of ironers working until 1:30 and 3 a.m. The Christmas trade involves night work in the paper box factories for three months; and in the confectionery trades from October 15 to December 15; and the women are known to work 75 to 80 hours a week, which is in excess of the Pennsylvania legal limit. Again, take the matter of insanitary work rooms. In the rapid development of the factory trades in America, we have only begun to devise our plants with reference to the health of the worker as well as with reference to output. In only two of the 28 commercial laundries in Pittsburgh, is the wash room on the upper floor. In 26, rising steam and excessive heat not only cause discomfort in the other departments, but tend to induce diseases of the respiratory organs. Tobacco dried in racks in many of the stogy sweatshops, makes the air heavy with nicotine, fills the room with fine dust and increases the danger, always present in tobacco trades, from tuberculosis. In foundries and machine shops, the custom of placing annealing ovens in the rooms where the cores are made, causes excessive heat in the work room and fills the air with black dust. We have the statements of old employees that not more than 25 girls of the 300 in the coil winding room in one of the Pittsburgh electrical industries have been in the plant as long as three or four years. The speeding up tends to make the girls nervous, weak and easily overcome by illness. Apart from the dangers of accident, of speeding and injurious processes, the health of a working force bears a direct relation to the length of the working day. The tendency with respect Democracy and Free Time to both hours and Sunday work in the steel industry in Pittsburgh has been, for fifteen years, towards an increase, and there is no indication that the end has yet been reached. There is not the opportunity here to analyze the time schedule of the varied departments of the steel industry, but in a majority of them the day of 24 hours is split between two shifts of workers; and the men work not six days, but seven a week. And a very considerable share of them, once a fortnight in changing shifts, work a long turn of 24 hours. Employers may differ as to whether they can get the most work and the most effective work out of a man if he works 12 hours a day, or 10, or 8. But I hold that the community has something at stake here. How much citizenship does Pittsburgh get out of a man who works 12 hours a day seven days a week? How much of a father can a man be who may never see his babies except when they are asleep; or who never gets a chance to go off into the country for a rollick with his boys? The community has a claim on the vigor and intelligence of its people, on their activity in civic affairs, which I believe it is letting go by default. It is getting only the tired-out leavings of some of its best men. My argument, then, is that if the civic responsibilities of democracy in an industrial district are to be met, the community should do what a first-rate industrial concern would do, figure out the ground it can cover effectively and gear its social machinery so to cover it. By social machinery I mean hospitals, schools, courts and departments, the structure of the city and all that wide range of activities that have a direct bearing on the living conditions of a people. Second, hold these agencies as closely accountable as are enterprises in the business world; and bring them to the ultimate touchstone of their effect on the welfare of the average citizen. Unless a wage earning population is so insured against disease, its vigor and effectiveness so conserved, the community is not meeting its responsibilities toward the industries which must depend upon these workers for output and profit. In turn, the public should see to it that the industries do not cripple nor exploit the working force which |