The health campaigns of Metropolitan Life generally were conducted to reach beyond the policyholder group to the general population. Thus entire communities and areas benefited and the downward trend of mortality in the whole country accelerated. This was a fact to be kept in mind when comparisons were made between improvements in the Metropolitan group and in the general population. In 1911 the death rate from all causes among Metropolitan industrial policyholders, ages 1 to 74, was 13.5 per 1,000.

Thirty years later the rates were less than half this figure. By 1943 there were 6.1 deaths per 1,000. Speaking in terms of longevity, according to the mortality of 1911 the average lifespan of these policyholders was 46.6 years. In 1942 it was close to 64 years, a gain of 17 years. If we look back to the earliest records for the company's industrial types of life insurance—the policyholders covering the period from 1879 to 1890, we find that their average length of life was about 34 years.

Thus the longevity of wage earners and their families has almost doubled in the course of the company's history. These figures, striking enough in themselves, gained particular significance when compared with the corresponding figures for the general population. Broadly comparable data for the two experiences was available only from 1920 onward. In that year the death rate among the industrial policyholders, ages 1 to 74, was 10.4 deaths per 1,000 persons, as against 9.0 in the general population. By 1943, the mortality in each of these groups was about 6 per 1,000.

Thus, the industrial policyholders, starting as they did on a considerably less favorable mortality level, caught up with the general population. This was naturally reflected in the figures on longevity. At the beginning of this period the average length of life was more than four years greater in the general population than among the industrial policyholders. Only two decades later, this advantage over the insured group was virtually wiped out. This remarkable achievement certainly was no accident, and was in part at least the result of the company's welfare program.

In gradually raising the health status of an economically less favored group to the level of the American people as a whole, we have a splendid example of the working of the democratic process. Moreover, over the years methods of underwriting industrial insurance greatly improved, along with life insurance rates and policies available—this too was undoubtedly reflected in the improved mortality. It must be remembered, however, that the industrial policyholders consisted primarily of wage earners and their families. They were not wealthy people.

They could not, when the occasion arose, call in a famous specialist. These wage earners engaged in a variety of occupations, some of which involved exceptional risks to life, and many of which imposed considerable wear and tear on the body. Moreover, these policyholders were not a group selected by a strict medical examination at the time of insurance, though persons obviously ill or seriously impaired were excluded. The great majority of the insured were urban dwellers, and urban mortality commonly ran higher than rural mortality.

Yet by the 1940s this industrial group achieved practically the same mortality experience as prevailed in the general population of one of the healthiest nations in the world. The improvement in mortality was unevenly distributed over the various ages. The greatest advances were made against those diseases which were most amenable to public health control, reflected in people's inability to secure no exam term life insurance policies, and which the Metropolitan particularly attacked.

A spectacular change occurred in infant mortality—this improvement showed up in practically all the major causes of death characteristic of the period of infancy. The most abrupt decline, in the first year of life, occurred in the death rate from diarrhea and enteritis, formerly the outstanding threat to infant life. By 1943, thanks largely to the education of mothers and to the modern methods of preparation, handling, and distribution of foods, especially milk, this death rate was reduced to just about one fifth the figure for 1920.