PRELIMINARY REPORT 
ON THE 
DEATH RATE AND CAUSES OF MORTAL- 
ITY OF THE POPULATION OF 
TRINITYXQRPORATION 
TENEMENTS. 
I have the honor submit to you a pre- 
liminary report on the death rate of the Trinity 
tenement population, with special reference to cer- 
tain allegations and charges of the New York Board 
of Health in their report to the Tenement House 
Commission during the month of Decbin her, 1894. 
In this report, as stated in the public press and 
subsequently verified by correspondence with the 
Board of Health, the charge was made and substan- 
tiated by statistics, that the mortality in Trinity 
tenements was in excess of the general mortality of 
the city, and that this excess was largely the result 
of the unsanitary condition of the tenements of the 
corporation of Trinity Church. 
How far the Board of Health was justified in mak- 
ing use of a method of comparison for two death 
rates, based on essentially different populations, 
different not only in quantity but also in quality, 
and how far the Board of Health estimate of Trinity 
Tenement mortality and its true causes was at 
variance with actual facts will be made clear in the 
following pages, which will present in as brief a 
manner as possible the main result of my extended 2 
investigation into the mortality of the tenement 
population of the corporation of Trinity Church. 
To make the result of this investigation as plain as 
possible to those not familiar with statistical methods 
and statistical fallacies, it would require an extended 
discussion of the principles and theories of vital 
statistics. To do this, in a brief report like this one, 
would curtail the more important discussion of the 
subsequent details, and I will therefore confine my- 
self to the statement, that in the pursuit of this in- 
vestigation I have rigidly adhered to the methods 
employed by the highest authorities on the subject 
of vital statistics, from Dr. Farr to Newsholme and 
Dr. Billings. The official reports of the New York 
Board of Health, as well as the report of Dr. Billings 
on the vital statistics of New York and Brooklyn, 
have been made use of in the tables of comparative 
death rates, whicn will form an essential feature of 
this report 
The charge against the sanitary condition of 
Trinity tenements consists in the main of the state- 
ment of the Board of Health, that the death rate of 
16S1 people living in 83 (not 148) tenements, the 
property of the Trinity corporation, located in three 
different wards of the lower part of the city, was 
3.5 per cent, in excess of the general death rate of 
the City of New York for 1893. The actual death 
rate was stated to be 32.48 per 1,000 for Trinity tene- 
ments for the five years'period, 1889-1893, against a 
death rate of 24.01 per 1,000 for the City of New 
York. 
Now we have here in this simple and innocent 
looking statement of the Board of Health the most 
astounding abuse of statistical method ever em- 
ployed by a writer on statistics or the official of a 
Board of Health. I am familiar with the reports of 
nearly every Board of Health in this country and 
of most of the statistical offices in Europe, and can 
assert with all the emphasis it is possible to put in 3 
words, that the method of the New York Board of 
Health to prove the unsanitary condition of Trinity 
tenements is contrary to the theory and practice of 
vital statistics. It is a method that has never before 
been employed by any recognized authority on the 
subject, nor one that will ever be made use of by 
any one who cares for his reputation as a statistician. 
A method, in short, in which two death rates are 
compared for two populations so essentially unlike 
in quantity and quality that the two populations 
compare with each other in such a disproportionate 
way that the fraction denoting the Trinity popula- 
tion can only be expressed by about one-tenth of one 
per cent. No writer on vital statistics, no official of 
a Board of Health has ever attempted to draw far 
reaching conclusions from such visionary premises. 
To make use of the method employed by the Board 
of Health of New York would be to invalidate all 
the results of statistical research; would be a direct 
refutation of the statistical law of large numbers, 
and would reduce the science of vital statistics to 
the basis of childish guesswork. 
The fallacy involved in the comparison of two 
populations so essentially different in numbers, is 
plain. The law of large numbers eliminates the pos- 
sibility of accidental occurrences and accidental in- 
fluences in the death rate of the population at large, 
which is not the case in the calculation of a death 
rate based on small populations. If, for instance, 
the 326 suicides that occurred in the City of New 
York during 1894 were omitted in the calculation of 
the general death rate, this would only affect the rate 
per 1,000 by 0.17, but if the one suicide that occurred 
in 1894 among the population of Trinity tenements 
were omitted, this would affect the Trinity death rate 
by 0.43 per 1,000. Or in other w« rds, 843 deaths 
could be omitted from the total mortality of the city 
before such an omission or element of error would af- 
fect the general death rate, to the extent as the acci- 4 
dental omission of one death would affect the Trinity 
death rate. Now, in view of the fact that annually 
large numbers of deaths are re-distributed from the 
hospital mortality to the supposed locality or resi- 
dence of the deceased (in the case of Trinity tene- 
ments in one year as many as fourteen deaths were 
thus assigned), it will be plain that the slightest error 
would effect a considerable change in the Trinity 
death rate. In one instance a death was assigned to a 
Trinity tenement though the deceased had not lived 
there for two years past. Such errors cannot pos- 
sibly be avoided, I know; but that is just the very 
reason why death rates should not be calculated on 
small populations, or if done at all, only with ut- 
most care and with due consideration of all the de- 
tails that make up a death rate. 
Dr. Billings has so plainly expressed his opinion 
on this point that I cannot do better than quote his 
own words: " It may be well to caution those not 
familiar with statistical methods and statistical 
fallacies that all death rates or ratios given 
must be considered in connection with the actual 
numbers from which they are derived, because 
in many cases it will be found that extraordinary 
and unusual ratios are due merely to the small- 
ness of the data from which they have been cal- 
culated (Report on Baltimore and Washington, p. 9). 
Newsholme in his work on Vital Statistics advises 
that all districts with a population of less than 3,000 
should be excluded from the general calculation (p. 
136). The same writer in his chapter on statistical 
fallacies refers as follows to the fallacy involved in 
the method employed by the Board of Health. 
" General results from a large aggregation of facts" 
(such as the mean death fate for the City of New 
York, 1890-94) " may be safely applied to a similar 
aggregation of facts" (like the mean death rate for 
the years 1885-90, for instance), but their applica- 
tion to single cases is full of danger." Again, on the 5 
same point, he remarks: " The neglect of the pre- 
caution that the phenomena or event dealt with shall 
be strictly comparable, has given rise to the most 
valid objection which has been urged against the use 
of the numerical method in medicine" (p. 297). 
These fundamental laws of vital statistics are so 
well known to those engaged in the field of statistical 
compilation and research, they have been so fre- 
quently referred to time and again in the reports of 
the Board of Health from 1866 to 1892; that no ex- 
cuse can be offered for their violation in the report 
of the Board of Health to the Tenement House Com- 
mission. 
But not alone was there a violation of the 
fundamental principles of vital statistics, but there 
was an absolute misrepresentation of fact in that 
the death rate for Trinity tenements for 1889-93 
was compared with a death rate for the City of New 
York based on a ficitious population. The death rate 
for the city was based on a population estimated on 
the basis of the police census of 1890 against an ac- 
tually enumerated population of Trinity tenements 
in 1893. Instead of comparing the death 
rate for Trinity tenements for 1889-93, with 
a mean city death rate for 1889-93, calcu- 
lated by a conservative and well-known method 
(Dr. Farr's formulae), on the basis of the 
census of 1890, a fictitious death rate of 24.01 was 
made use of, which has no existence in fact. It is 
always better to understate a death rate than to 
overstate it. There are other elements in the vital 
statistics of a city of far more importance in the 
study of sanitary progress than the death rate. A 
death rate being necessary for a variety of purposes, 
such a death rate should be calculated with the ut- 
most care and precaution, and not be based on a 
population estimated by a method nothing short of 
mere guess work. Such methods cannot be suffi- 
ciently condemned under any conditions, but more 6 
so for a city which claims rank among the foremost 
cities of the world. Dr. Farr's formulae, on the 
principle of the geometrical progression of the 
population is made use of by all the advanced offices 
in Europe and by the Massachusetts State Board of 
Health. It is the only safe method of estimating 
the population for inter-censal years. This method 
.was made use of in the report of Dr. Billings on the 
vital statistics of New York and Brooklyn for 1885- 
90, and the mean death rate for the city for the six 
years, according to this report, was 27.66 per 1,000. 
Calculating the death rate for the city by this 
method, I find a mean death rate of 27.37 for 1889- 
93. This death rate differs but slightly from Dr. 
Billings' official rate for the city for the period of 
1885-90, and may be accepted as a fair indication 
of the health of the city. 
Below I give the rate for each year as well as the 
estimated population, to make this point as plain as 
possible. 
Population. 
Deaths. 
Rate per 
1,000, 
1889 .. 
. . .1,481,110 
39,679 
26.79 
1890*. . 
7* 1. or 
.. .1,515,301 
40,103 
26.47 
1891... 
../Z.7.4A- 3. J.'/. .. 
.. .1,550,255 
43,659 
28.17 
1892.. 
...6.7. r 
. . .1,585,925 
44,329 
27.95 
1893... 
. .. 1,622,508 
44,486 
27.42 
1894... 
X.IM:A X.?.. 
.. .1,659,937 
41,175 
24.81 
. Now, if the mean death rate for Trinity tenements, 
stated to be 32.48 per 1,000, had been compared with 
the mean death rate of 27.37 for the period of 
1889-93, there would have been an actual difference 
between the two death rates of only 5.11 per 1,000, 
or 18.6 per cent., being almost one-half of the ex- 
cess shown in the comparisons made by the Board 
of Health. This method would have at least had 
the aspect of fairness, and while by no means rep- 
resentingactualdifferences, the apparent differences 
* Census 1890. 7 
would have been considerably less, as they will 
actually prove to be, in the figures and statements 
which will follow. 
Instead of comparing the death rate for Trinity 
tenements with the death rate for the city in gen- 
eral, the Board of Health should have made nse of 
either of four methods, all of which have been 
made use of by the writer, to trace, if possible, 
whatever reasonable ground there may be in the 
charge of the Board of Health that the tenements 
of Trinity Church are in a highly unsanitary con- 
dition. 
First. The Board of Health could have compared 
the Trinity death rate with the death rate of District 
A, Ward 8, as shown by the Board of Health tene- 
ment census in 1891. This census contains detailed 
death rates for tenements in each ward and the 
different sanitary districts of each ward. By locat- 
ing the Trinity tenements in their respective sanitary 
districts a local death rate could have been cal- 
culated for Trinity tenements, which would have 
been a fair method of comparison. According to 
an actual enumeration of the population of 
Trinity tenements on January 1, 1895. there were 
found to be living some 2,298 people in the 148 
tenements which are the property of Trinity Church. 
Of these 1,10.8 were living in District A of Ward 8. 
The total population of this district in 1890 was 
10,872; hence the Trinity element of the popula- 
tion of this district is about 10 per cent., a propor- 
tion large enough to admit of it being used in a local 
comparison of death rates. In the table below I 
give the details for the Trinity population and the 
tenement population in general for the year 1891, 
the only year for winch a census of this kind has 
been published by the Board of Health (see Annual 
Report, 1891, page 217): 8 
District A, Ward 8th. 
Population, 
Deaths, 
Death 
1891. 
1891. 
Rate. 
All tenements 7,064 
201 
28.45 
Trinity Tenements 1,108 
24 
21.66 
Difference in favor of Trinitv tenements.... 
. .. 6.79 
This table illustrates in a forcible manner a just 
and impartial method that could have been made 
use of by the Board of Health in a comparison of 
the mortality of one selected.class of tenements with 
another in the same locality, inhabited by about the 
same class of population, subject at the same time 
to the same local conditions. This method would 
be preferable to any other, but for the fact that the 
time element is too short, and other methods will be 
made use of to ascertain whether the favorable con- 
ditions shown here for Trinity tenements in 1891 
can be traced for other years. In the table which 
follows I have brought together the death rates for 
a selected class of tenements, mostly in the lower 
part of the city, with the tenements of the Corpora- 
tion of Trinity Church. The table has been com- 
piled from the Real Estate Record and Guide of 
recent date, and is based on official reports of the 
Board of Health: 
Comparative Death Rates of Selected Tenements. 
A. 
Population, 
1893. 
Deaths, 
1889. 1893. 
Death Rate, 
1889. 
1893. 
41 selected tenements 4,079 
154 296 
37.8 
72.6 
83 " Trinity tenements.. 1,681 
47 57 
27.9 
33.9 
Difference in favor of Trinity tenements (per 1,000) ., 
. 9.9 
38.7 
B. 
Population. 
Deaths. 
1889. 1894. 
Death Rate, 
1889. 1894. 
22 selected tenements, 1893.... 1,227 
58 63 
45.8 
49.7 
148 Trinity Tenements, 1895 .. 2,298 
'68 86 
29.6 
37.4 
Difference in favor of Trinity tenements (per 1,000).. 
, 15.2 
12.3 9 
We have here four comparative death rates, all of 
which are strictly comparable with Trinity tene- 
ment death rates, and ah of which, without excep- 
tion, show in favor of the tenements of Trinity 
Church by differences from 9.9 per 1,000 to 38.7 per 
1,000, or by from 36 to 114 per cent. 
The above rates for selected tenements are by from 
58 to 202 per cent, in excess of the general city death 
rate, and by from 36 to 114 per cent, in excess of the 
Trinity tenement death rate, differences so enor- 
mous that it seems almost incomprehensible that, in 
view of all the recent discussion on the subject, 
nothing should have been said about the death rates 
of these tenements, which have a population of about 
5,300, instead of 83 Trinity tenements, with a popu- 
lation of only 1,681. 
The third method which could have been em- 
ployed, and which is preferable for the main reason 
that a period of six years is taken into account, in- 
stead of single years, as in former tables, would have 
been to compare the mortality in Trinity tenements 
in District A, Ward 8 (in all other districts the 
Trinity element is less than 3 per cent., and there- 
fore not large enough to admit of being compared 
with local death rates) with the death rate of this 
district for the period 1885-90, as stated in the report 
of Dr. Billings on the health of this district. This 
has been done in the following table, which con- 
tains the details of population and mortality for the 
district in general and Trinity tenements in particu- 
lar: 
Mortality of District A, Ward 8. 
Mean 
Population. 
Deaths. 
Death Rate. 
District A, Ward 8, 1890... 
10,872 
1885-90.-2,105 
31.39 tx 
Trinity Tenements, 1895... 
1,108 
1889-94.. 191 
28.72 t 
Difference in favor of Trinity Tenements 
.. . 2.67 10 
In this table two death rates are compared which 
are not exactly for the same periods, but for the 
present purpose it maybe assumed that the mean 
death rate of this district for 1885-90 would not 
differ materially from the mean death rate for 1889- 
94. On account of the want of detailed information 
from this district for the years 1891-4 it is not 
possible to calculate a death rate for 1889-94 in the 
manner as the death rate for 1885-90 was obtained 
by Dr. Billings. According to this table there is 
again a showing in favor of the Tenements of 
Trinity Church, though the difference is less than it 
was for the year 1891. 
The third and less reliable method would have 
been to compare the mortality of the Eighth Ward 
(in which most of the Trinity Tenements are located) 
with the local death rate of the Eighth Ward for 
the five years 1889-93. This would have been a 
justifiable method on the part of the Board of 
Health, since the mortality of the Eighth Ward is 
made up at the office of the Board from week to 
week as the deaths are reported. The method is 
less reliable, however, since there is a want of con- 
fidence on the part of the Board of Health in the 
United States census population of the Eighth Ward 
in 1890 and on the part of the writer in the police 
census of 1890, as well as in the Board of Health esti- 
mate of the population for 1890 and 1892. In the 
Board of Health report for 1890 there are two state- 
ments of the Eighth Ward population. On page 171 
of the report the Police census is quoted, giving a 
population of 41,890. On page 156 of the same report 
the Board of Health estimates the population at 
36,963. The United States census for 1890 gave a 
population of only 31,159. Finally, in the report for 
1892 the population of this ward is estimated (p. 26) at 
44,745. Now, if the estimate of 1890 was correct or 
nearly correct, then there has been an increase in 
the population of this ward during two years of 11 
7,782, or of 3,891 per annum, which if continued for 
a decade, would more than double the population of 
this ward by the end of the present century. In 
view of the fact that the actual deaths have fallen 
off considerably during the last few years, the sani- 
tary improvement of this ward must have been 
extraordinary, so remarkable in fact that estimating 
the population for 1894 on the basis of the New 
York Board of Health estimate for 1892 at 52,527 we 
have a death rate of only 16.51 per 1,000. Or ex- 
pressed in tabular form we have the following 
remarkable result: 
Deaths. 
Rate. 
Population, 1890 
36,903* 
1,287 
34.82 
" 1892 
44,745f 
1,272 
28.42 
" 1894 
52,52'7$ 
867§ 
16.51 
Of course such an enormous increase in the 
population of the Eighth Ward, as well as such an 
exceptionally low death rate, are utterly impossible. 
The calculation is only made for the purpose of 
illustrating the method employed by the Board of 
Health in the estimate of the population of the 
Eighth Ward, a ward which, like other sections of 
the lower part of the city, has shown httle or no in- 
crease in tenement building operations during recent 
years. If we, however, estimate the Eighth Ward 
popu ation on the basis of a mean of the four differ- 
ent estimates, we have a population of 38,704, which, 
however, in the writer's opinion, still considerably 
overstates the reasonably possible condition. The 
application of this estimate of the Eighth Ward 
population, with comparative death rates for Trinity 
Tenements, is made in the following table: 
*Board of Health report, 1890. 
[Board of Health report, 1892. 
on increase 1890 to 1892, 7,782. 
§ Reported mortality compiled from weekly statements. 12 
8th Ward. 1889-1893 
Mean 
Av. 
Death 
Deaths. Mortality. 
Rate. 
Estimated mean population.. . 
. .38,704 
6,033 v'' 1,209 P- 
31.25 
Trinity Tenement population. 
. . 1,522 
X 229 . 46 , 
30.22 
Difference in favor of Trinity Tenements 
1.03 
Although the death rate for the Eighth Ward is 
based on the most favorable estimate of the popula- 
tion, the death rate again shows in favor of the 
Trinity Tenements. If I had based the Eighth 
Ward death rate on the United States Census or on 
the Board of Health estimate for 1890, the difference 
in favor of Trinity Tenements would have been 
much greater. Thus on the strength of four in- 
dependent methods of investigation, the same con- 
clusion is arrived at, that the mortality in Trinity 
Tenements is not only not in excess of the local 
death rate, but, to the contrary, from 1.03 per 1,000 
to 38.7 per 1,000 below the death rate of selected 
tenements of the same ward or the same sanitary 
district. If we summarize the four methods of 
calculation, we have the following result, in which, 
for the sake of argument, the total Trinity death 
rate as well as the mean city death rate are in- 
cluded : 
Summary of Comparative Death Rates. 
Trinity Tenement Difference 
Death Rates. (per 1,000). 
Tenement census, 1891 28.45 
v 21.66 v in favor T. T. 
6.79i 
Selected tenements, 89-93. .72.60 
vZ 33.90 v 
38.70 «■ 
" " , 89-92..49.70 
Y 37.40 * 
12.80 t 
U. S. census report, 85-90. .31.39 
v 28.72 V 
2.67 ► 
8th Ward estimated pop... .31.19 
30.22 v- 
1.03 v 
General city death rate, 
89-93 27.37 
32.48;ngainstT. T. 
5.11 . 
This table forcibly illustrates the great injustice 
done the Corporation of Trinity Church through a 13 
charge of great gravity based on absolutely nothing 
but the merest guesswork. It is plainly shown in 
the above table that only by such methods as have 
been employed by the Board of Health in compar- 
ing the Trinity death rate with the assumed city 
death rate for 1893 could the excess of 35 per cent, 
be made plausible. But it is hardly necessary to 
enter into any argument of this kind to prove ab- 
solutely the false and unjustifiable charge of the 
Board of Health. The fact can be demonstrated, 
on the strength of official records, that the charges 
of an excessive death rate, the due consequence of 
unsanitary condition, are absolutely without the 
shadow of a foundation; that in fact the condition 
of Trinity Tenements in this respect is superior to 
that of the Eighth Ward in particular and the city 
in general. This is made possible through a thorough 
analysis of the causes of the Trinity Tenement 
mortality for the six years 1889 to 1894. 
Sanitary science does not concern itself so much 
with death rates as with the actual causes of 
mortality. Certain diseases, commonly called filth 
diseases, are recognized as preventable, and the chief 
duty of a Board of Health - in fact, the very reason 
for the existence of a Board of Health-has been and 
is, to check the spread of such diseases, and finally, 
as has been done in the case of smallpox, and is 
now being done in the case of diphtheria, to reduce 
the mortality from such diseases to a minimum, if 
not to entirely exterminate them. 
The five principal filth diseases are smallpox, 
scarlet fever, diphtheria, measles and typhoid fever. 
These diseases are recognized as preventable, and 
sanitary science claims as its highest reward the 
diminution of the death rate due to these causes. 
Unsanitary conditions of dwellings, filthy habits 
of the occupants and filthy occupations of the popu- 
lation are to-day recognized as being the chief causes 
in the propagation, if not in the production, of the 14 
above named filth diseases. It is, therefore, but 
fair, that any charge as to the unsanitary condition 
of Trinity Tenements should be investigated along 
the line followed in all other investigations of this 
sort, namely, that the charge should be sustained by 
such facts as would prove that in Trinity Tenements 
the mortality due to such causes was in excess of the 
local mortality from the same causes. 
It is principally for this purpose that the mortal- 
ity is compiled, according to cause, for each house, 
street and ward, to enable the student of vital statis- 
tics and sanitary science to trace directly the local 
cause of an excessive death rate. In the tenement 
census of 1891 the Board of Health followed Dr. 
Billings in the method used for the census report for 
1885-90, and for each sanitary district, tenement 
death rates are given which are a fair index of the 
prevaling causes of the mortality. This having been 
a satisfactory method for the Board of Health cen- 
sus of 1891, why was not the method employed to 
sustain the charges against the tenements of the 
Corporation of Trinity Church? Solely and only, be- 
cause it was not possible to prove the asserted excess 
of the mortality in Trinity Tenements. Solely and 
only, becahse the very facts in this case condemn the 
statement that the mortality of Trinity Tenements 
is the result of unsanitary, conditions in which these 
tenements are claimed to have been kept for a num- 
ber of years past. This assertion of mine is easily 
proved, and I below give a statement of the actual 
mortality according to cause for the six years 1889- 
94. It should be understood that these causes have 
been obtained by actual transcript of all death cer- 
tificates at the Health Office having reference to the 
deaths in the Trinity Tenements during the past six 
years. This table is the most interesting, the most 
complete, and, therefore, the one most deserving of 
careful consideration: 15 
Causes of Mortality in Trinity Tenements. 
1889-1894. 
Smallpox.... 1 
Measles 8 
Scarlet fever 6 
Diphtheria....... 9 
Whooping cough 5 
Typhoid fever 2 
Cerebro-spinal fever 3 
Diarrhoeal diseases 34 
Syphilis L 
Septic diseases 8 
Influenza 8 
Total zymotic 85 
Parasitic diseases 3 
Dietetic diseases . 1 
Consumption.... 72 
Other constitutional 19 
Premature birth 1 
Old age 7 
Total nervous system 53 
Total circulatory system 31 
Total respiratory system... 96 
Total digestive system 27 
Total urinary system 25 
Total diseases of parturition 3 
Total integumentary system 1 
Suicide 5 
Accident 15 
Debility and marasmus 15 
Aggregate total459 
This table may be condensed in the manner that 
the actual mortality is expressed in the ratio per 
100,000 of population and at the same time be com- 16 
pared with similar death rates for the Eighth Ward 
and the city at large: 
Measles 
1889-1894. 
1885-1890. 
City of 
New York. 
45.67 tz 
Trinity 
Tenements. 
58.02 
W ard 
Eight. 
48.64 1 
Scarlet fever 
43.51 
53.25 
52.19 tz 
Diphtheria and croup 
87.03 y 
192.52 Z 
181.63 ? 
Typhoid fever 
14.51 . 
22.53 v/ 
24.27 
Diarrhoeal diseases 
. . 246.59 
307.22 Y 
316.85 
Consumption 
. . 516.19 „ 
499.74 
391.75 
Pneumonia 
.. 420.65 
319.51 v/ 
287.89 i 
Diseases of nervous system.. 
.. 384.39 
310.29 i 
241.96 y, 
Diseases of urinary system... 
.. 181.31 t 
208.91 . 
173.72 jz 
We have here the most complete refutation of the 
charge that the mortality in Trinity Tenements was 
caused by unsanitary conditions. We have here 
the most convincing proof that whether the death 
rate be high or low the asserted unsanitary condi- 
tion of the habitations cannot be proven on the 
strength of the Board of Health death rate. To the 
contrary, the above rates prove that those very dis- 
eases, to which is attributed the high rate of city 
mortality in general, are less prevalent in Trinity 
Tenements than in the Eighth Ward or the city at 
large. More convincing proof could not be asked 
for; but there are still further convincing facts to 
sustain the assertion, that the death rate of Trinity 
Tenements is not excessive and not enhanced by 
unsanitary conditions. 
But before I consider the additional evidence in 
support of the last' table I will say a few words in 
regard to the death rate from consumption and 
pneumonia. These are, on the whole, slightly in 
excess of those given for the city at large or the 
Eighth Ward; but this excess is due to the fact 
that the average age of those living in Trinity 
Tenements is higher than of the Eighth Ward 
or city population in general. That is, the 
population of young people under 21 is less in 17 
Trinity Tenements than in the population in gen- 
eral. This is proved by the following table, which 
shows the percentage of decedents for each group of 
ages for the city at large (1889-1892) and for the 
tenement population of the Corporation of Trinity 
Church. 
Percentage of deaths at certain age groups to 
total mortality: 
1 
Under 5 Years. 
5 to 25. 
Over 25 Years. 
Trinity Tenements, 1889-1894. 
• 33.1% • 
7.8% * 
59.1% . ' 
City of New York, 1889-1892. 
• 42.0% v 
10.5% t 
47.5% (X 
This table is compiled according to a method fre- 
quently employed by the New York Board of Health 
and is of some value, though not absolutely reliable. 
The figures, however, are in part supported by the 
following table, which gives the mortality of chil- 
dren under 5 years per 1,000 Jiving at the same 
period of age, and which proves that the child mor- 
tality is less in the Trinity Tenements than in the 
Eighth Ward or the city in general: 
1889-1891 
Trinity 
Tenements. 
101.01 
1885-1890. 
Ward Eight, 
District A. 
City of 
New York. 
1892-1894 
. . .. 87.80 4/ 
1889-1894 
.. .. 99.70 {/ 
118.03 ./ 
109,48. 
These two tables prove that the mortality under 
25 years is relatively lower in Trinity Tenements 
than in the city at large, and that the child mortal- 
ity is considerably less in the Trinity Tenements 
than in either District A of Ward Eight or for the 
entire city. In view of the well-known fact 
that the mortality from consumption is greatest 
during the ages, period 15 to 45, the excess in 
the mortality from this disease is explained on this 
ground. For the City of New York, according 
to Dr. Billings, the death rate from consumption for 
persons 15 to 45 years of age was 471.81 per 100,000 18 
of population (Census report, p. 34). If a rate were 
obtainable for the Eighth Ward, it would, without 
question, show a still higher rate and therefore but 
a slight difference fiom the rate for Trinity Tene- 
ments if both rates were based on population of the 
same average age. On the strength of these state- 
ments, the assertion is therefore warranted that the 
mortality in Trinity Tenements is first, not in ex- 
cess of the local death rate; second, only about 18 
per cent, instead of 35 per cent, in excess of the 
city death rate, and finally that those causes of mor- 
tality which are justly attributed to filthy and un- 
sanitary conditions are less prevalent in Trinity 
Tenements than in the city at large or the Eighth 
Ward in particular. 
It now only remains for me to call your attention 
to a few more facts which are deserving of notice, in 
that they will add additional support to the asser- 
tions thus far made. 
During the six years, 1889-94, there occurred 
344 deaths from smallpox in the city, but only one 
death from this cause occurred in a Trinity tene- 
ment during the same period. During the year 1892 
the disease was epidemic in the Eighth Ward, 20 
deaths occurring in this ward alone, but only one 
death occurred in Trinity tenements. During the 
six years, 1889-94, there occurred 2,239 deaths from 
typhoid fever, but only two deaths from this cause 
occurred in Trinity tenements; 3,708 deaths from 
measles, but only 8 in Trinity tenements; 4,939 
deaths from scarlet fever; but only 6 in Trinity tene- 
ments, and 10,086 deaths from diphtheria, but only 9 
in Trinity tenements. During the two years, 
1891-92, 2,797 deaths were due to diphtheria in this 
city, but not one death from this cause occurred in 
a Trinity tenement. 
Now if these tenements were in such a filthy and 
unsanitary condition, how was it possible that in 
view of the great prevalence of all classes of filth 19 
diseases in the city, and the Eighth Ward in particu- 
lar, but very few deaths were due to those causes in 
the tenements of the Corporation of Trinity 
Church? 
But furthermore, if we consider the mortality of 
1894, we find still more convincing evidence of the 
unfairness and injustice of the charges against the 
sanitary condition of Trinity tenements. During 
the past year there were 156 deaths from smallpox 
in the city; but not one death from this cause in a 
Trinity tenement. There were 541 deaths from 
scarlet fever, but not one death from this cause in a 
Trinity tenement; 325 deaths from typhoid fever, 
but none in a Trinity Corporation tenement; 215 
from cerebro spinal meningitis, and not a single 
death from this cause in a Trinity tenement; and yet 
in the face of ah these facts, perfectly familiar to 
the Board of Health, from whose official records 
these data have been compiled, the charge is made 
and attempted to be sustained by statistics that an 
excessive mortality in Trinity tenements was trace- 
able to the- highly unsanitary condition in which 
it was asserted these houses were being kept. 
Filth may not be the cause of disease, but it certainly 
has been proven to be a condition of disease, and if 
the statements in regard to the sanitaiy condition 
of Trinity tenements were true, the mortality returns 
would present an entirely different character. As a 
natural consequence we should find an excessive 
prevalence of just such diseases as have fitly been 
called filth diseases but which have been proved on 
the authority of the Board of Health records not 
have been excessively prevalent in Trinity tene- 
ments during the 5 years, 1889-94. We have re- 
cently been informed that the present death rate of 
New York City was the lowest on record for 75 
years, but nothing has been said about the fact that 
there was an increase in the mortality from small- 
pox, diphtheria and measles and but a very slight de- 20 
crease in the mortality from scarlet and typhoid 
fevers and diarrhoeal diseases. The decrease in the 
mortality was among those causes over which the 
Board of Health has little if any control, and there- 
fore the falling off in the actual mortality iQ less the 
work of the Board of Health than the result of other 
natural causes and possibly to an actual decrease of 
the population during 1894. 
One word in conclusion in regard to the state- 
ment that some of the Trinity Tenements are " Hot 
beds of disease." This statement was made at 
the time with special reference to consump- 
tion. I have carefully tabulated the mortality 
from this cause for each tenement for the 
six years, and find only three instances in which 
three deaths from consumption occurred during the 
six years under observation in any one house. It is 
far too early at the present stage of our knowledge 
of the cause of consumption to advance any claim or 
propose any theory on such insufficient evidence. 
Consumption among the poor is increased chiefly 
through the combined influence of hereditary pre- 
disposition, environment, occupation and indiffer- 
ence to personal hygiene. If the suggestions of the 
Board of Health for the prevention of this fearful 
malady were respected and obeyed there is no doubt 
but that the mortality could be greatly diminished. 
But how can the poor avoid " sleeping in the same 
room occupied by one who has consumption" if 
that one room is the only one they can afford to 
rent, or how can the poor consult the family phy- 
sician regarding the social relation of persons suffer- 
ing from suspected consumption* when they are 
unable to even consult the "physician " behind the 
counter of a drug store? Well has the Board of 
Health said " that the means for the prevention of 
consumption lie largely within the power of the 
affected individual." Why, then, at the same time, 
* Circular on Consumption-N. Y. Board of Health. 21 
place all the blame for the prevalence of this, as well 
as all the other preventable diseases, on the wrong 
shoulders? But, as I have said before, there is no 
evidence whatever of any excessive prevalence of 
this disease in a single one of the tenements of 
the corporation of Trinity Church. 
I have far exceeded my original purpose to make 
this report a very brief one, yet I have only been 
able to present some of the most important phases 
of the problem under discussion. In a final report 
which is to follow, details will be presented and 
supplementary data will be included which it has 
not been possible to introduce here. Enough has 
been said, however, to dispose at once and forever 
of the charges made against the sanitary con- 
dition of Trinity Corporation tenements and I sin- 
cerely trust that those most interested in the truth 
in regard to these charges will find in these state- 
ments, all of which are based on actual facts de- 
rived from official sources, sufficient proof to refute 
charges which were, as has been shown in these 
statements, based on nothing but statistical guess 
work. I will conclude my report with a recent 
utterance of the editor of the (London) Lancet, in 
which a somewhat similar attempt at false statis- 
tical method was condemed with the following 
timely remark: "We have so strong a conviction of 
the powerful influence that our national system of 
mortality statistics has exercised on tne progress 
of public health in England, that we think it to 
be of the first importance that public faith in 
these statistics should not be weakened by am- 
biguous term, by false method and by unsound 
deduction." 
Very respectfully yours, 
Frederick L. Hoffman. 
Actuarial Department, Prudential Ins. Co., 
Newark, N. J., February 8, 1895. 
14034K] Presented to the 
Statistical Division, Surgeon-General's 
Library, United States Army 
Washington, D. C. 
BY 
The Prudential Insurance Co. of America 
Newark, New Jersey