An Early Birth Death Analysis of Rockcastle County Ky
Birth Death Analysis
By Linda Ashley
This is a little Birth Death analysis I made of death certificates in Rockcastle County from 1915. We can compare that to what might be expected today.
Birth Death Analysis in Rockcastle County, KY, 1915
I was interested in learning the causes of death in Rockcastle County, Ky, in 1915. We often hear “Why is there so much cancer today?” and “Why are there so many heart attacks?” Of course, the answer to that is that so many things that people used to die of have been controlled, that there are fewer things left to take us. To confirm that, I have made an analysis of the causes of death exactly one hundred years ago, in 1915.
There are 155 death certificates for Rockcastle County that year. We can assume there are deaths for whom there is no certificate, and so they won’t be included here. One reason is that the requirement that there be a death certificate recorded for each death was only four years old, having gone into effect in 1911. Some people were not aware that they were required, and since there was often no doctor in attendance, the death was never recorded.
This is particularly true for newborns and children. Secondly, even if they were aware, if no doctor was in attendance, often the relatives or neighbors who cared for the individual and buried the body, just didn’t get around to reporting the death to the appropriate office. I have also discovered in previous research that in the case of a homicide, for example, where the person was dead when the sheriff or police arrived, then no doctor was called and no one reported the death to the clerk. I have found such deaths reported in the newspapers, but no corresponding death certificate. I have tallied the deaths by cause of death and by age.
Leading Death Cause, Tuberculosis
The leading cause of death in Rockcastle County, and in Kentucky in general, was tuberculosis. There were twenty-two deaths from TB. There were two children under 5 years old, one between 5 and 12, four between 12 and 21, thirteen between 21 and 50, and one between 50 and 70 and one over 70.
Those of us old enough to remember when TB was prevalent, recall that there were “TB families.” That was, of course, because it was so communicable. Since children often lived in the home where an adult had the disease, they often got it themselves, so seven people under the age of 21 died of TB in 1915.
The largest group, thirteen, died between 21 and 50 years of age. Some of those may have had the disease for some years and finally succumbed to it. Contracting the disease was so easy and it was so deadly, it was less likely for someone to get it past the age 50 and die of it, so only one between 50 and 70 and one over 70 did so.
We can remember the national and state campaigns to eradicate the disease. There were testing days when the health department tested hundreds of people. If one tested positive, then they were sent to TB “sanitariums” or hospitals, such as the one in London, until it was safe for them to rejoin their families. That very quickly ended the “TB families” situation.
Eventually better treatments ended that necessity and closed the hospitals, and essentially ended TB. There have been outbreaks associated with drugs and HIV, but there has not been the threat we all knew before the 1950’s.
The largest number of recorded deaths per age group was for newborns and up to one year of age for a total of 42. The second leading cause of death in the county in the year was stillbirth, which is included in that group of 42. It is not clear how many of those we would call miscarriages now, but probably not many, as most people would not have reported a miscarriage. These are likely children who were full or near term, but who did not survive birth. There were 18 of those reported.
Childbirth was risky business then, and it is remarkable that only 3 mothers (all over the age of 21) are reported to have died of childbirth in 1915. In addition to the 18 children who were called stillborn, another 8 are listed as having died of “premature birth.” Again, some of those could have been miscarriages, or could have been stillborn but obviously too early, but it appears that most were children who actually were born alive but died because of prematurity. So 26 newborns died before or soon after birth.
In addition to the 26 who died near birth, there were a total of 16 other children who died before their 1st birthday. We can hardly imagine that today. Their causes of death were 1 of croup, 6 of digestive/dysentery complaints, 2 of meningitis, 1 of pneumonia or influenza. 1 of suffocation, and 5 for whom the cause of death was undetermined.
For 2 of those, the doctor specifically said the conditions were unhygienic and 2 mentioned malnutrition. Of course, there were no social programs to assist families or check on the children at the time.
Other Leading Causes
Twenty-four children between the ages of 1 and 5 died that year. Of those, 2 are listed as accidents, 1 as appendicitis, 2 of croup, 4 of digestive/dysentery, 1 of diphtheria, 1 of food poisoning, 1 of meningitis, 4 of pneumonia/influenza, 2 were mentioned above with TB, 4 undetermined, and 2 of whooping cough. The immunizations our children receive today would likely have prevented the deaths by diphtheria and whooping cough and perhaps pneumonia/influenza.
The 4 of digestive complaints might have included more cases of food poisoning. After one year, children began eating with the family, but had not built up immunity. “Summer complaint” and “second year sickness” were common, and were usually associated with improperly stored food. Refrigeration, properly canned food, and more choices for children’s foods, along with better hygiene, have all helped cut this number. Again, to have 24 children under 5 die in a small population would be unheard of today.
As we would expect, the largest number of people who died were over 70 years of age. Of those, 2 died of accidents, 3 of apoplexy or stroke, 1 of arteriosclerosis, 2 of cancer, 2 of digestive/dysentery, 4 of heart disease, 1 of infection/gangrene, 1 of old age (unspecified), and 9 of pneumonia/influenza.
I remember my mother saying if an old person would get through March, then they felt safe until the next winter. That was because pneumonia and influenza was the leading killer of the elderly. Those are still dangerous, but antibiotics and other treatments, as well as immunizations, have cut the risk for those diseases.
The 1 who died of gangrene would likely have lived today, but that was before antibiotics. Of the others, cancer, stroke, and heart disease are still leading causes of death.
Of those between 50 and 70 years of age, 1 died of apoplexy/stroke (still a leading cause of death, but less likely in this age range today because of better prevention of high blood pressure and cholesterol),
1 of asthma, 3 of cancer (perhaps a similar percentage of death in the age range today, but more cases from which people do not died because of better treatments and the likelihood that people will have cancer today because they have not previously died of other diseases),
1 of diabetes, 1 heart disease, 3 of pneumonia/influenza, and one of rheumatism. (This could refer to rheumatic fever, rather than arthritis.)
There were only 2 homicides for whom there was a death certificate. However, there were likely more deaths of that cause, but, as explained above, they were not always reported to the clerk.
Besides the one person over 70 who died of infection/gangrene, there was 1 between 12 and 21. Six people, from age 5 to 50, died of typhoid. We rarely hear of typhoid today, thanks to immunizations. In addition, 1 person, age 21 to 50 died of tetanus (lock jaw), 3 children under 12 years of age of whooping cough and 1 under 5 of diphtheria.
Those who refuse to immunize their children don’t know this history. This was actually a light year, as there were sometimes epidemics of typhoid, whooping cough, and diphtheria.
The population of Rockcastle County in 1915 was about 15,000.
Linda Ashley, Author 2018
Birth Death Analysis