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Though it is true that in recent years cool summers have favoured a low mortality, there can be
no doubt that the unprecedented fall in the number of deaths among infants has been very largely
due to the excellent work of the lady health visitors. In the Metropolis whilst the general death- .
rate has fallen steadily since 1870, the mortality amongst the infantile population, in spite of notable
sanitary reforms, remained stationary until the year 1900. From this year onwards as the table
shows the infant death-rate has continued to fall and some part of the decline, which was already
well marked in the years 1901-05 must be attributed to indirect rather than direct administrative
measures when we consider that prior to the year 1905 only one lady inspector in the whole of
London was engaged in advising mothers of the poorer classes in the management of their babies.

The death-rate in North Kensington is 55 per cent, greater than, or more than half as high
again as the rate in South Kensington. Golborne and Norland are the poorest districts and have
the highest mortality. In the districts adjoining Golborne and Norland wards an excessive number
of deaths masks the low mortality which prevails in the more favoured portions of the wards of
St. Charles and Pembridge. Had the death-rate of South Kensington prevailed throughout the
Borough the deaths in North Kensington would have numbered 397 instead of 305. The difference
of 108 deaths represents the preventible waste of life which will without any doubt be prevented
within the next 20 years.
Causes of High Infantile Mortality.—The principal causes of high infantile mortality are
to be sought in the conditions which accompany poverty. Lack of food both for mother and child,
improper food, crowding of persons in rooms, want of air, uncleanly homes, neglect deliberate or
inevitable and ignorance are perhaps the conditions which chiefly affect the health of infants in the
homes of the poor. To pay rent for the minimum of cubic space allowed by the law, to live on
insufficient food and to supplement the weekly income by sending their wives out to work are the
means by which numbers of casual labourers keep themselves and their families from the workhouse.
If the mother is obliged to go out to work, the neglect I have described as inevitable must
follow. There are then certain injurious influences, the direct outcome of poverty, which the
Council's visitors can do but little to alleviate. On the other hand, in giving advice as to feeding,
cleanliness and the necessity of fresh air, especially to the teachable mothers of first babies, an
immense amount of good can be and is effected by the Health Visitors.