It seems probable that the proportion of foreign-born persons is about the same among the insane outside of institutions as among those confined in institutions. In the case of the feeble-minded, upon the other hand, the proportion of persons detained in institutions is so small as to make the representative character of the data secured open to doubt.

The figures obtained from the several sources, though necessarily incomplete, suffice to show that there are in the United States a very considerable number of insane and feeble-minded persons of foreign birth, and that a very considerable proportion of all the insane and feeble-minded confined in the hospitals and institutions of the country are former immigrants.

THE RATIO OF INSANITY AMONG THE NATIVE-BORN AND AMONG THE FOREIGN-BORN.

A further study of the available returns makes possible a comparison in the matter of relative tendencies toward insanity of the native-born with the foreign-born and of the native-born of native father with the native-born of foreign father. Material for such a comparison is supplied by the special report of the Census Bureau. This report will, therefore, be quoted at length."

A per cent distribution by nativity of the white insane of known nativity in hospitals shows very little unless it is compared with a similar distribution of the general white population. A method preferable, however, to such a comparison would have been to show the ratio of insane to general population for each nativity class; but unfortunately general statistics were not collected for 1903, and therefore it is necessary to compare the per cent distribution of the insane enumerated in hospitals on December 31, 1903, and of those admitted during 1904, with a similar distribution of the general population for 1900.

In the following table the proportions of native and foreign born insane in hospitals in continental United States are compared with the proportions of native and foreign born persons in the general population:

TABLE 6.-Proportions of native and foreign born insane in hospitals in continental United States, 1904, and of native and foreign born persons in the general population, 1900.

[Compiled from U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," p. 20.]

a U. S. Census, Special Report, “Insane and feeble-minded in hospitals and institutions, 1904,” pp. 20, 21, and 22.

In discussing this phase of the subject under consideration the census report referred to says:

If the general population of all ages be taken, the bases for the comparison will not be equable, for several reasons. The insane in hospitals are all at least 10 years of age. The immigrants are, for the most part, between 15 and 40 years of age. The number of children under 10 years of age is extremely small among the white immigrants as compared with native whites. Under these conditions a comparison of the proportions of each nativity class in the white insane population of known nativity in hospitals with the corresponding proportions in the general population of all ages would be manifestly unfair, for the inclusion of children under 10 years of age would so increase the proportion of natives in the general population that it would seem as if insanity were more prevalent among the foreign-born as compared with the native whites than is actually the case. Therefore children under 10 years of age are omitted, and the figures given for general population * * refer only to those at least 10 years of age. Even with this modification the figures are on the whole more unfavorable to the foreign-born white than the real facts warrant, as no account could be taken of the large immigration between 1900 and 1903. It is not thought, however, that this omission will seriously affect the conclusions drawn.

*

*

Of the whites at least 10 years of age in the general population of the United States in 1900, 80.5 per cent were native and 19.5 were foreign born; while of the white insane of known nativity enumerated in hospitals on December 31, 1903, 65.7 per cent were native and 34.3 were foreign born. Relatively, therefore, the insane are more numerous among the foreign-born whites than among the native. * * It is not necessary to analyze in the same way the percentages of native and foreign born among the white insane admitted to hospitals during 1904. Although the percentages of native white insane are * a little higher than on December 31, 1903, * * it is evident that the foreign born continue to furnish much more than their proportionate share of insane. It should be remembered, however, that the distinction between native and foreign is rapidly losing significance as a means of gauging the real elements of population from which the insane are recruited most largely. With each year the number of native insane of foreign parentage becomes more and more conspicuous in the total number of insane of native birth.

*

* *

THE NATIVE-BORN OF FOREIGN FATHER COMPARED WITH THE NATIVEBORN OF NATIVE FATHER.

When 34.3 per cent of the white insane of known nativity enumerated in hospitals on December 31, 1903, are foreign born-a proportion much greater than that which the foreign born constituted of the general white population of 1900—it might naturally be expected that a similar condition would be found among the native whites of foreign parentage. Such is not the case, however, * *

*

In the following table the distribution by parentage of the nativeborn white insane in hospitals in continental United States is compared with the distribution by parentage of native-born white persons in the general population:

TABLE 7.-Parentage of native-born white insane in hospitals in continental United States December 31, 1903, and of native-born white persons in the general population, 1900.

[Compiled from U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," p. 22.]

The native whites of foreign parentage also appear to advantage when contrasted with the native whites of native parentage. The native whites of foreign parentage constituted 27.7 per cent of the total native white in the general population of 1900, while those of foreign parentage, including mixed parentage, formed 27.3 per cent of the total native white insane of known parentage enumerated in hospitals on December 31, 1903. The native whites of native parentage, on the other hand, constituted 72.3 per cent of the white population and 72.7 per cent of the white insane. *** Although the figures * *** indicate that the native whites of foreign parentage contribute a relatively smaller number of insane in hospitals than the native whites of native parentage, this fact has little bearing upon the comparative liability to insanity of the two classes. The truth is that the native whites of foreign parentage are still too youthful to furnish a number of insane proportionate to their representation in the population, as may be seen by comparing the percentages of the native whites of native parentage with those of native whites of foreign parentage in the age periods in which insanity is most likely to occur.

The census report presents and discusses the figures for the age groups between 25 and 44 years, the period in which insanity is most likely to occur, as follows:

TABLE 8.-Parentage of native-born white insane in hospitals in continental United States, December 31, 1903, and of native-born white persons in the general population, 1900, by specified age groups.

[From U. S. Census, Special Report, "Insane and feeble-minded in hospitals and institutions, 1904," p. 22.]

Upon reference to the foregoing table it is seen that in the age groups from 25 to 44 years those of foreign parentage constituted a larger percentage of the native white insane of known parentage enumerated in hospitals on December 31, 1903, than of the general native white population of 1900. It also shows that as the age periods advance the proportion of the native white general population with native parents increases, while that with foreign parents declines. It might be permissible, therefore, to infer that if the age distribution of the native whites of foreign parentage, instead of showing a comparatively greater concentration in the earlier age groups, were similar to that of the native whites of native parentage, the relative number of insane contributed by the two classes would at least be equal.

Immigration on a large scale is of too recent origin to make it possible to demonstrate with any degree of exactness how far insanity occurs with greater or with less frequency among the native whites of native parentage than among the native whites of foreign parentage. Whether the percentages of insane shown for the last-mentioned group are not on the whole rather in advance of their numerical strength in the country must also remain an open question for the present.

The data relating to the proportion of aliens among the feebleminded, as compared with the proportion of aliens in the total population, are discussed in the census report as follows: "

a U. S. Census, Special Report, Insane and feeble-minded in hospitals and institutions, 1904," p. 210.

Among the white feeble-minded of known nativity the number of native feebleminded was 14,456, or 93.4 per cent, and of foreign born, 1,038, or 6.6 per cent. The largest percentage of foreign born among the white feeble-minded, 17.3, is found in Ohio, which is followed by Minnesota with 12.6 per cent, and New York with 12.1. In other States having exceptionally large foreign populations the percentages of foreign born among the white feeble-minded in institutions are in all cases under 10. It is probable, therefore, that in most instances the number of foreign-born white feebleminded in the population of a State bears little relation to the number that happens to be committed to institutions.

THE ALIEN INSANE, CLASSIFED BY NATIONALITY OR RACE.

In the report of the Commissioner-General of Immigration for 1908, previously referred to, insane "aliens" are classified according to the race or people to which they belonged, but no such classification is afforded for the 25,128 foreign-born persons who had become naturalized. Consequently the relation of each race or people to the total number of foreign-born insane can not be shown by the data from this source. However, the following table showing the racial distribution of the "alien" insane is of interest:

TABLE 9.-Aliens detained in institutions for the insane in the United States, 1908. [Compiled from Annual Report of the United States Commissioner-General of Immigration, 1908.]

It appears from the foregoing table that among the 25,606 "aliens" in institutions for the insane for whom information was secured, the Irish, numbering 6,167, or 24.1 per cent of the total, and the Germans, numbering 5,795, or 22.6 per cent of the total, have the largest representation. The Scandinavians, with 10.2 per cent of all the insane "aliens," rank third, and the English, with 8 per cent, fourth. Of the remaining races, the Poles, South Italians, and French have the largest number of insane aliens. It will be noted that in the case of many of the races or peoples the number of insane aliens. reported falls short of 100.

Original data secured by the Immigration Commission for the system of New York City hospitals known as "Bellevue and Allied Hospitals," show the general nativity and race of persons admitted to treatment." These data, so far as they relate to the insane, are presented in the following table:

TABLE 10.-Persons received at Bellevue and Allied Hospitals, New York City, for treatment for insanity, August 1, 1908, to February 28, 1909.

From this table it appears that of the 1,485 persons for whom complete data are reported, 941, or 63.4 per cent, were foreign-born, 306, or 20.6 per cent, native-born of foreign father, 193, or 13 per cent, native-born whites of native father, and 31, or 2.1 per cent, native-born negroes of native father. Among the foreign-born of the races for which information is given the Irish, Hebrews, and Germans

a See Immigrants in Charity Hospitals, pp. 253 to 290 of this volume.