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19
Before referring to the causes of the comparatively high deathrate
in Clerkenwell there are two points calling for comment. First
there is no doubt that from the fact that Clerkenwell contains no
public hospitals, asylums or similar institutions there are a large
number of the population who are not enumerated in the district
on account of their absence in various workhouses, hospitals, etc.,
outside the parish. From this it follows that the population of
Clerkenwell is not credited with these numbers, while the deaths
from that class, which this year reached 496, are recorded against
us. The second point is this: though our death-rate is high, a
comparison over a number of years shows it to be a gradually
declining one. The intra-parochial death-rate during the last ten
years averages 15.2. In 1900 it was 13.6 per 1,000. The total
death-rate for Clerkenwell during the last 10 years averages 22*4.
In 1900 it was 21.1.
The cause for our comparatively high death-rate is probably
a composite one, including many external circumstances and
agencies. It is due, that is to say, rather to a set of conditions than
to one condition. Therefore to reduce such a death-rate requires
not one remedy but many. The chief matters requiring constant
supervision are such as affect the number of houses and persons
per acre, the number of persons per house, the structural conditions
appertaining in various parts of the district, the removal of refuse,
the paving of yards, drainage of houses, sanitation of lodging houses
and workshops, and the regular inspection of food including milk
and meat. In addition to these matters of daily routine work there
is infectious disease and its prevention by notification, isolation, and
disinfection. Only by continual supervision can disease be minimized
and death-rates reduced. The situation of the district in the
centre of London and the character of its industrial population are
conditions which undoubtedly affect the public health, and yet
cannot be altered. It is therefore all the more necessary that we
should address ourselves continually to those problems which are
more amenable to treatment.
B2