Child Mortality & Divine Grace

Last weekend on a Christmas candle light tour I visited the historic Carlyle House in Old Town Alexandria, Virginia, a grand colonial mansion built in the 1750s by a Scottish merchant who was one of Alexandria’s founding fathers. A friend to George Washington, he was one of the wealthiest, perhaps the richest man in town. He certainly had the grandest house. But his vast wealth was no protection from tragedy.

Carlyle outlived 9 of his 11 children. One of the two remaining children, the last surviving son, died one year after his father, at age 15 fighting in the American Revolution. Only one of the eleven lived into full adulthood. Today society would rightly be suspicious of any parent losing so many children. Surely there was foul play! But over two centuries ago, losing nine or ten children was certainly very grievous but not very unusual. Wealth offered no protection from disease and death, and child mortality among slaves and the very poor was likely not much different than for the very privileged. Doctors were almost useless against most serious illness. Germ theory was more than a century from meaningful discovery.

Martha Washington, who would have visited Carlyle House many times, outlived all four of her children, plus her first husband, who died when she was 26. Two of her children died as toddlers. One died as an epileptic teenager with her step father George Washington desperately praying over her. The fourth died of illness in his mid twenties. George and Martha adopted two of four surviving grandchildren.

A century later, child mortality was little improved. Mary Lincoln outlived three of her four children. She was driven to near madness as First Lady by the death of her second little son, possibly sickened by dirty Potomac water piped to the White House, and who was ailing during her first big social extravaganza in the newly redecorated White House, an evening that otherwise would have been her greatest triumph. Her husband later reputedly threatened her, in reaction to her hysterics, with a mental hospital. As grieving president he more quietly frequented his second son’s grave, perhaps even opening the crypt to view the corpse. Lincoln may have got religion in his deep grief. His favorite poem, often recited, was about death. Nearly everybody lived with routine death, including by small children.

Through the 19th century nearly every family lost a child, often many more. Looking at my own family history, several of my great grandparents lost young siblings in the late 19th century. But none of my grandparents did in the early 20th century, as medical knowledge had increased. My grandmother said her earliest political memory was of the death of President Coolidge’s teenage son, who died in the White House from a blister gained while playing tennis, which the best doctors could not remedy. Penicillin was a decade away. Coolidge would say all the glory of the presidency departed with his son’s death.

In the second half of the 20th century child death became a tragic oddity in America and the Western world thanks to medical science, advances in hygiene and improving diets. When a child now dies from disease or accident, it is a great horror, one that mercifully only a small percentage of today’s parents in America experience. But only a few generations ago it was commonplace for nearly all families. How many reflect with appreciation on this incredible reduction in child death? Mostly we just assume the present time is normal. But for thousands of years and hundreds of millions of people everywhere in all cultures the reality was that the death of young children was routine.

Wonderfully, the plunging child mortality rates that occurred in the West early in the last century have since become global. As this article by Max Roser details, today mortality for young children in rich countries, which now includes many formerly Third World countries, is less than one percent. In the 18th and 19th century young child mortality in the West could be 30-50%. Over the last half century globally, it fell from almost one of every five children under five to fewer than one of 20. The numbers continue to dramatically improve almost everywhere. In 40 years child mortality improved ten fold in China and Brazil. In the poorest countries it’s fallen over 50 years from one in 4 young children to one in ten.

In 1800, the year after Washington died, global young child mortality was over 40%. Today it’s about 4%. The blessings of medical knowledge and increased wealth allowing for better hygiene and safety have been universalized.

The inconsolable grief and suffering that nearly every family suffered only a few generations ago is incalculable. Many tens of millions of parents losing young children must have suffered from chronic depression, anxiety, and near insanity, without access to antidepressants or mental health therapy, often resorting instead to alcoholism, opiates, withdrawal from active life, or resentments and rages against surviving children and spouses. (Carlyle wrote his brother in Scotland how their children’s deaths had depressed and worsened the health of his wife, who would herself die in childbirth.) Those times must have been grim, with even the most advantaged people living in the actuarial equivalent of today’s war ravaged Aleppo, Syria, but probably even worse. And that grimness was the reality for everybody until the last century or so.

Often someone will complain cluelessly that our present times are the worst. But in fact, even in today’s troubled world, we are living in the best times, the most privileged and blessed times. How many are aware and grateful? That millions and millions of young children who once routinely died now unexceptionally survive and thrive around the world should be cause for endless thanks, right? Two hundred years from now nobody will visit an historic house from the early 21st century and hear how the owners unexceptionally lost 10 of 11 children before full adulthood. Thank God.