Rocco Brindisi, "The Italian and Public Health," Charities v. XII, no. 18 (May, 1904); 483-486.

[Editor’s note: Footnotes have been modified for clarity in presentation.] 

The Italian immigrants, on account of moral and social faults rightly or wrongly attributed to them, have been generally characterized as undesirable; but everybody seems to be willing to recognize that they are gifted with at least two virtues: sobriety and endurance in performing the hardest kind of work. The first quality is an efficient factor of health, the other is a sure sign of psychical and physical vigor.

The major part of our immigration is made up of sturdy mountaineers of the southern Apennines inured to the most laborious agricultural work. The American immigration law, by excluding the weak and the old, has raised the physical standard of the immigrants. So it is that the Italian laborers in this country show a small percentage of disease and a still smaller one of mortality. This, however, is less true in regard to the second generation, whose vitality is impaired, principally by the unsanitary conditions in which they are forced to live.

In 1902, there were in Boston 641 deaths among the Italians. Of the deceased, 175 were born in Italy, and 466 were born in America of Italian parents. The total figures represent 6 per cent of the total number of deaths in the city of Boston and 11.43 per thousand of the population. This rate of mortality is lower than that of any other nationality except the Russians.

The largest percentage of sickness is furnished by the newcomers among the men, and by the women and the children.

The newcomers, especially when, as commonly happens, they land in the early spring, pay their tribute to acclimation by contracting rheumatic and respiratory diseases, such as rheumatism, bronchitis, pneumonia, pleuritis; but fortunately the proportion of deaths is moderate, owing to the strong constitution, the youth and the temperate habits of the patients.

The Italian women here are forced to change entirely their mode of living. From the active rural life in the open air they are plunged at once into a life of relative inactivity and seclusion, and consequently become more or less liable to general impairment of the organic functions. They are frequently affected with dysmenorrhea, dyspepsia, anemia, clorosis and kindred diseases; and their impaired physical condition has an injurious effect on the children, who contribute largely to the mortality.

Besides the maternal influence, improper nursing and insufficiency of fresh air and light are responsible for the great number of ailments and deaths among the Italian children. Rickets and tuberculosis are the most frequent general diseases. Bronchitis, broncho-pneumonia and pneumonia usually affect them in winter and intermediate seasons, while in the hot weather the dreadful host of the so-called summer complaints, from the irritative gastro-enteritis to the deadly cholera infantum, storms and ravages the Italo-American breed.

In substance it can be safely said that the morbidity, like the mortality, is larger among the children of the immigrants than among the immigrants themselves.

The following table shows plainly this disproportion of deaths in Boston during the calendar year 1902, as reported to the local board of health:

A word may be said here of the venereal diseases and alcoholism among the Italians. [end page 483]

It is a general opinion that the genital affections are very frequent among our immigrants, owing to the promiscuous and crowded conditions of their life. I am able to state however, though I cannot prove my statement with statistics, that in the same class of people of other nationalities such diseases are not less frequent.

In one hundred Italian males examined and treated by me for different infirmities, during the month of December last, I find only seventeen cases of venereal diseases. It is to be noticed that I have taken into account only the males, as the most exposed to the contagion, and have purposely chosen the month of December which is the time when our laborers are idle and provided with more or less money earned during the preceding seasons.

As everyone can see, this is not a large proportion by any means, and there is reason to hope that the changed character of our immigration will still reduce the percentage. In 1895, states Dr. Bushee, the excess of males in the Italian population of Boston amounted to 1,592. This inequality of sexes undoubtedly had an important bearing on their mortality; but since then the men have developed the tendency to call their families here and settle with them permanently or for a long period of time, with the consequence of considerable elevation of the moral standard and decrease in the number of loathsome diseases and alcoholists.

Of alcoholism, I need say very little, in asmuch as it is very rare among our people. Of the eighty-eight who died in Boston from alcoholism in the year 1902, none were Italian. During March of this year, 59 Italians were arrested by the police of Division l, which is in the heart of the Italian quarter, and of these only 9 were for drunkenness. It is worthy of note that 5 were arrested on the eighteenth, that is, between St. Patrick's day and St. Joseph's, which shows that they are not habitual drunkards, but go on an occasional spree on holidays. Lieutenant Rosatto, to whom I am indebted for the above information, states that during his long service of seventeen years in that station not one Italian woman was arrested for drunkenness.

The exceptionally numerous saloons in the North End are generally patronized by non-residents coming from other quarters of the city and suburbs. This excessive number of drinking places, besides lowering the moral tone of this section of the city, in which is located the Italian colony, increases the opportunity for residents to indulge in alcoholic beverages. So it happens that some Italians become addicted to beer and hard liquors in preference to the light and rather harmless red wines, to which they were accustomed in the old country.

The problem that confronts the student of the hygienic and sanitary conditions of Italians living in the large cities of the United States is threefold, and involves the consideration of the dwelling-houses, the food and the race traditions. Let us examine briefly these three aspects of the important problem, and see where the faults are and how they can be possibly mended.

The Italian immigrants have tendency to live together in one section of the city, with the result that they transform it into a characteristic community, which is given the name of "Little Italy." The "Little Italy" of Boston is in the historic North End, which, although over a century ago the most aristocratic quarter of the city is now composed of the oldest and most dilapidated buildings, and of the cheapest modern tenement houses, ill ventilated, poorly lighted and scantily provided with modern sanitary improvements.

"In some of the principal streets of the North End," writes Dr. Bushee, "as well as in the smaller tenements of the back alleys, Italians live in more crowded manner than any other people in the city. In 1891, when the tenement-house census of Boston was taken, two precincts of the North End occupied almost exclusively by Italians contained 259 families, or more than one-fourth of the total population, who were living on an average of two persons to a room: and 154 of the fami- [end page 484] lies were occupying single rooms. The average number of persons to a room for the two precincts was 1.41. Since that time, the board of health has ordered vacated some of the less sanitary of these houses, and has improved the condition of others; in 1895, however, the average density of the population for the whole ward and probably also for the precincts was found to have increased somewhat, and in 1899 individual cases of crowding were discovered, which were worse than those reported in 1891. A partial census of another part of the North End, taken in 1898, shows comparatively little change in the average density of the population. In 1891 the average number of persons to a room was found to be 1.37 and in 1898, 1.39."

This gives an idea of how the Italians crowd together in the houses of the North end, but it is due them to say that the conditions described are now somewhat improved, as stated in the latest publication of the South End House, Americans in Process: "Many of the Italians are beginning to seek something better. They are now, in considerable numbers, moving into the more desirable tenements to the west of Hanover street; and some families, especially of the second generation, are taking a more significant step in detaching themselves from the colony and settling amid pleasanter surroundings.

I know many Italian families in Winthrop, South Boston and Dorchester, living in their own houses, clean and comfortable. This is the most convincing proof that the much-slandered Italians, as well as any other people, are capable of bettering themselves.

Dr. S. H. Durgin, the chairman of the Boston Board of Health, writes me: "In a general way I would say that, while the Italians are prone to overcrowding, they are in other respects found to be in a fair sanitary condition, and decidedly improving from year to year in our city." The progressive improvement of the sanitary conditions of the North End is largely due to vigilance of the Board of Health which, especially in the last decade, has caused the demolition and partial reconstruction of many bad tenement houses. Undoubtedly, the total destruction of

all and every building would be the most efficacious means of inducing the inhabitants to scatter themselves in the rest of the city and suburbs; but such radical treatment being impossible, for obvious reasons, it is to be expected that the work will be gradually performed by the combined efforts of the health authorities and the more progressive Italians. There is already a North End Improvement Association, which is looking toward the betterment of the sanitary conditions of this quarter, and perhaps the appointment of Italian health inspectors, chosen among competent and honest young men, would contribute to the final success.

Many an American, taking as standard of dietetics his own mode of living, assumes that the Italians feed themselves poorly, because they do not eat a sufficient quantity of meat. This is a mistake. The Italians in Boston--and I think the same may be said of all the large cities of the United States--eat much more meat than they used to consume in the old country, and still suffer immensely more from stomach troubles here than they did in Italy. There is no physiological law which determines how much meat a man must eat, in order that his organism may be kept in good running order. A difference exists between individuals, and a still wider one between peoples and races on account of differences in climates, habits and constitutions. People of the same nationality may differ in their dietetics according to the different latitudes. The northern Italians, for instance, eat more meat and less vegetables than the southerners. Many times I have cured dyspepsia, constipation, or more serious digestive ailments, by simply reducing the quantity of meat and increasing the proportion of vegetables in the menu.

The fact that it is the Italians who have introduced in the American kitchens the dandelions, the celeries, the fennels and many other greens, and that they have increased the use of fruits in this country, shows their natural taste--which is a natural need--for these edibles, a greater abundance of which would be a real blessing to all. "The Italians have, in fact," to quote again from Americans in Process, "created a wholesome appetite for fruit among the mass of the people... [end page 485] Even the newest immigrant, with his push-cart, his wares attractive, and unwittingly acts as the dietetic missionary of the back streets throughout the city."

It is true that there are Italians who, rather from a mistaken spirit of economy than from lack of means, feed themselves poorly; but their number is very small. The old shame of rummaging the garbage barrels in search of decayed food is gradually disappearing, owing to the general sentiment of reprobation among the Italians, which I am confident will in the near future sweep away definitely this degrading habit.

I have already said that the Italians here learn to drink beer and hard liquors, which were utterly unknown to them in Italy. Fortunately, the abuse of these intoxicants is limited, and the number of drunkards among our immigrants is daily decreasing, owing to the moral effect of family life. Another important cause of temperance is, in my opinion, the light red wine which the Italians manufacture for their own use.

The Italians, like all the peoples with ancient habits and traditions, cling to many prejudices and superstitions, which often hamper those who work with them. Among these prejudices, I will quote the horror they generally have for hospitals. Many of them still hold the opinion that hospitals are strictly devoted to the treatment of destitute patients left to the mercy of heartless physicians. In the majority of cases, to advise an Italian patient to enter a hospital arouses the hostility of the patient and his family.

Superstition, aided by ignorance, frequently makes them cheerfully submit to the extortions of the many professional swindlers and dupers. Charms, amulets ex-votos, oftentimes defeat hygiene and baffle the efforts of the health authorities and the physician. It is to be noticed, however, that no prejudices are to be found among the educated Italians. The Italian mind, when unbiased and untrammeled by ignorance and superstition, is wide open to truth. And it is, in my opinion, education alone, that most powerful factor in the progress of humanity, which will accomplish the work of regeneration among the Italian immigrants. It is education, through the public institutions and the missionary work of the physicians, that will bring the principles of hygiene and their practical benefits into the Italian homes, while waiting for the more substantial fruits of the schools.

There is not the slightest doubt in my mind that the rising generation of our Italians will be, in regard to sanitary conditions, on the same level with the American people. [end page 486]