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8 Parish of St. George the Martyr, SouthivarJc.

From the foregoing tables it is clear that the death-rate of St. George's, Southwark,
is abnormally high. One is naturally led to enquire whether a further
analysis of facts and figures will throw any fresh light upon this unenviable state of
affairs.
In looking over the returns of these three sub-districts one is at once struck by
the fact that the general death-rate per 1000 in the Borough Road exceeds that
of the Kent Road by 8-5 per 1000, and that of the London Road by 10 per 1000.
This disproportion may, in my opinion, bo attributed to four causes, (1) Deaths
in public institutions, which are unequally distributed among the various subdistricts
; (2) Density of population, especially in the Borough Road Sub-district;
(3) Poverty, which is conspicuous in each of the sub-districts, but most of all in
the Borough Road; (4) Absence of open air spaces, of which there are none in the
Borough Road.
We will next proceed to discuss these points in detail.
(1) Deaths in public institutions. The deaths which require notice under this
heading are those of parishioners of one sub-district who die in the hospitals of
another sub-district.
In the Evelina Hospital for Children, situate in the Borough Road sub-district,
I find that 3 deaths were those of parishioners from the London road, and 14 from
the Kent Road sub-districts. Correcting for these 17 deaths, the death-rate for
the Borough Road sub-district is reduced from 34-1 to 33.1 per 1,000, a number
which is still excessive. The late Dr. Farr held that " a sustained rate of mortality
above 17 in 1,000 always implies unfavourable sanitary conditions," and, further,
that, " any rate above 30 implies sanitary conditions highly destructive to human
life." In another place, he says that, " When any city experiences a higher rate than
the average, it should become a matter of serious inquiry and concern to its citizens."
Also, " The causes of the differences of the rates of mortality are various, and in
every case demand careful investigation on the spot by the town authorities." And,
" Wherever the mortality exceeds 17 in 1,000 there is much sanitary work to be
done." If we accept these general statements of Dr. Farr, one of the highest
authorities on public health, it is clear that a great deal of sanitary reform is needed
in the Parish of St. George's, Southwark.
(2) Density of population, which is in no small extent accounted for by the
existence of the large institutions already spoken of, and which contain on an average
1,621 inmates. These institutions are scattered in a fairly even manner throughout
the sub-districts. They may be divided into hospitals, asylums, schools, and workhouses—(a)
Hospitals—Two hospitals, the Evelina and the Royal South London
Ophthalmic Hospitals, situated in the Borough Road and London Road sub-districts