The tropical regions of the New World in the early modern era offered European migrants great wealth but were also demographically deadly. This paper presents hard data on white mortality in seventeenth- and eighteenth-century Jamaica and shows that white susceptibility to disease, especially yellow fever, led to appalling white mortality. High white mortality, especially in urban areas in the first half of the eighteenth century, meant that Jamaica did not become a settler society full of native-born whites, as occurred in plantation British North America. The failure of white settlement and continuing high mortality accentuated whites' penchant for fast living, for fatalism, and contributed to slave-owners' callous disregard for the welfare of their slaves. White life chances were not helped by inappropriate medical attention. Although Jamaican doctors' explanations of high white mortality were occasionally correct, their adherence to humoral and miasmic theories of medicine led them to promote remedies that were at best ineffectual, at worst detrimental. Contemporaries, however, refused to accept the facts of white demographic decline, in part because to do so would have been to deny the possibility that Jamaica would become Anglicized rather than Africanized.