TABLE 1—

The Irish Transition in the United States: Summary of US Census-Related Data on Socioeconomic Circumstances and Cardiovascular Disease, 1850–1980

Census Data Year	Observations and Analysis of the Health of Ethnic Irish Groups in the US and Comparisons With Other Immigrant and Nonimmigrant Groups
1850	Irish born constituted 4.81% of the total population in the US but made up 6.23% of deaths from circulatory disease, 7.12% of deaths from respiratory disease, and 6.33% of deaths from tuberculosis. All-cause death rates were 16.41 per 1000 deaths, comparable with the US average (16.16 per 1000 deaths).
1870	Crude death rates from circulatory disease for Irish-born Americans were 85.9 per 100 000 deaths, comparable with rates among Americans born in England and Wales (90.1 per 100 000) but higher than for all foreign-born immigrants to the US (55.7 per 100 000) and for US-born White Americans (41.4 per 100 000).
1880	Health status of Americans of Irish and German extraction is contrasted. Deaths from heart disease and dropsy stood at 62.3 per 1000 deaths among Americans of Irish-born parentage, 60.9 per 1000 deaths among Americans of German-born parentage, 64.5 per 1000 deaths among Black Americans, and 56.1 per 1000 deaths among White Americans generally. Tenement conditions were implicated in high death rates of poor White Americans. Rates of tuberculosis infection were excessive among immigrants to the US of Irish-born parentage.
1890	Heart disease and dropsy death rates were higher overall among foreign-born Americans than among US-born Americans. Irish rates of heart disease and dropsy are the highest of any immigrant group in the United States—Americans with mothers born in Ireland at 15–45 years of age: 96.86 per 100 000 (compared to 66.32 per 100 000 for native-born White Americans); at 45–65 years: 401.94 per 100 000 (compared to 305.68 per 100 000 for native-born White Americans); and at 65 years and older: 1 199.33 per 100 000 (compared to 1129.01 per 100 000 for native-born White Americans).
1900	Irish-born immigrants represented 2.12% of the US population, but Americans of Irish-born parentage number 4 981 047, or 6.53% of the total population. However, this Irish group (both Irish-born and of Irish-born parentage) contributes 10.54% of total deaths from circulatory disease in the US.
1910	Death rates from organic heart disease were 5.63 per 1000 among Americans born in Ireland compared to 0.82 per 1000 of Americans born in Italy. Death rates for other circulatory disease were 1.90 per 1000 for Americans born in Ireland and 0.23 per 1000 in Americans born in Italy. Americans of Irish origin accounted for 10.11% of organic heart disease cases and 11.24% of circulatory disease cases in the US, though immigrants born in Ireland made up only 1.47% of the total US population. Dublin and Baker32 reviewed in more detail the available data for Pennsylvania and New York, confirming excessive mortality for those of foreign and mixed (one parent not from US) parentage and those who were foreign born—this excessive mortality was especially true for the Irish of all categories, being about double the rate for second-generation Americans. Heart disease for males born in the US aged 45–64 years was 232.5 per 100 000 in Pennsylvania and 316.3 per 100 000 in New York, compared to 529.3 per 100 000 for Irish-born males in Pennsylvania and 580.2 per 100 000 in New York. Rates of heart disease were also much higher among similar groups of Irish women when compared with overall rates for women in Pennsylvania and New York.
1920	Age-adjusted death rates from cerebral hemorrhage per 100 000 population were reported according mother’s country of birth—New York City: 99.9 Ireland vs 81.9 US, Pennsylvania: 95.7 Ireland vs 86.1 US, New York State: 85.6 Ireland vs 67.2 US, and Chicago: 82.4 Ireland vs 60.4 US. Americans with mothers born in Ireland had higher rates of cerebral hemorrhage than any other group, including Americans with US-born mothers. The highest rate of heart disease was in New York (389.3 per 100 000) for those with mothers born in Ireland and the lowest, in Pennsylvania, for those with mothers born in Italy. In a detailed monograph, Carpenter33 reported the health status of immigrants and their children, including socioeconomic circumstances; he singled out the Irish for special mention as being at particularly excessive risk of poor health.
1930	The total foreign-born population from Ireland was 1 037 234 in the US. National mortality data were not published, but a Boston-based census tract–level study found that the highest rates of infant mortality were in Charlestown and South Boston (neighborhoods in Boston, Mass),33,34 though the Irish were integrated across the city. A strong inverse relationship was also found between 1930s socioeconomic indicators and present-day health status. The correlation between infant mortality rates during the 1930s and the coronary heart disease rate in the 2001 Health of Boston report35 was 0.564 (P < .05), with the highest rates being in Charlestown and South Boston.
1950	Two area-based studies showed excess mortality among those of Irish extraction in the US. Trulson et al.36 showed that first-generation Irish have higher death rates than US- born Bostonians with US-born parents and Stamler et al.37 showed considerably excessive risk at 45–64 years for the Irish in America compared with other immigrant groups, US-born Americans, and the Irish in Ireland.
1980	Rosenwaike and Hempstead,38 analyzing data through the 1980 US census, concluded that the SMR (Standardized Mortality Ratio) for heart disease is 0.95 for those male immigrants to the US born in Ireland compared with US-born males, but with a ratio of 1.16 to the rate for Italian American males and that an excess of cerebrovascular disease existed, with SMR 1.13 in men and 1.56 in women compared with the US-born population.

Note. We refer to several classifications of circulatory diseases (“circulatory disease,” “cerebrovascular disease,” etc.) as they were used in the different historical reports. The terminology regarding race/ethnicity also varies from census to census—respondents may be categorized according to (a) whether they were native born vs foreign born, (b) whether they were of native-born vs foreign-born parentage, or (c) their country of origin. All data were taken from US Census Bureau reports21–30 unless otherwise cited.