And as things have been they remain: Enteric disease and differential mortality among ethnic groups in early twentieth century Milwaukee

Objective: This project aims to document enteric disease mortality differentials between German, Irish and Polish communities in Milwaukee, Wisconsin during the early twentieth century. At that time, residential segregation by ethnicity was common as was access to gainful employment. The Polish had the least access to adequately paid jobs and consequently resided in the area of the city adjacent to waterways used for waste disposal. Materials: A total of 14,573 death certificates were examined for the years 1901 through 1905. The certificates include name, places of birth and death, age, sex and cause of death. Methods: Deaths from enteric diseases have been compiled for each ethnic group along with age and sex. Incomplete certificates were excluded from the analysis. Results: A total of 1038 enteric disease deaths were noted. All ethnic groups were affected with the greatest impact in the Polish community. The highest risk was among infants and children in all ethnic groups. Conclusions: Mortality differentials resulted from unequal access to safe water and sewage systems in neighborhoods segregated by ethnicity. Significance: The data demonstrate variation in the timing of the epidemiologic transition among communities separated by only a few kilometers. Limitations: Water- and food borne sources of enteric disease could not be differentiated. Suggestions for further research: The effect of living conditions in these communities can be further studied by analyses of respiratory diseases. This can be expanded by detailed analyses of infant and child mortality.