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infants which was at the rate of 39 per 1,000. That this improvement in the care
given to the illegitimate child has come to stay is a probability which is borne out
by the fact that the rate was the same in 1948.
I have also thought that a further table giving the summary of infant mortality
in 1948 by age-groupings would be informative, and have therefore included this
additional table. It will be seen that out of 161 infant deaths 34, or 21.12, per cent.,
took place in the first day; 68, or 42.23 per cent., in the first week; 86, or 53.41 per cent.,
in the first month; and 140, or 86.96 per cent., in the first six months. Deaths due
to congenital malformations etc. constitute 34.16 per cent, of all infant deaths, and
to this cause is overwhelmingly due the highest proportion of deaths in the early days
and weeks of life. Prematurity was associated as a principal cause in 14.3 per cent,
of all infant deaths, and again most of these occurred during the first week of life.
The child having survived possible accidents of development and injury at birth, the
greatest single risks in later infancy are due to the respiratory infections, bronchitis
and pneumonia accounting for 23.6 per cent, of infant deaths, mostly in the one to
six months age group. These should be regarded as very largely preventable
deaths to be avoided by better mothercraft, including the proper feeding of the infant;
its reasonable protection from infection by such measures as the provision of a separate
cot; protection from indiscriminate and over-frequent handling by other members of
the family, whether adults or children; and avoidance of unnecessary exposure
to adverse weather particularly during the winter months. It surely cannot bo
helpful for small infants to be taken out in cold and wet weather in the late evening.
As might be expected, respiratory infections and the deaths which may result from
them are seasonal in incidence. Thus, of the 31 deaths due to pneumonia 16 occurred
in the two months January and December, and 23 out of 31 in the four months,
January, February, November and December. 6 out of 7 bronchitis deaths took
place in February and March.
The general reduction in infant mortality also brings to light what is now
becoming one of the major causes of infant deaths, i.e. due to violent causes of one
form or another. 3 deaths were ascribed to overlying, which should be entirely
preventable. Of the 16 deaths due to other violent causes, 11 were connected with
asphyxia due to regurgitated stomach contents. It cannot be doubted that better
mothercraft would also assist in reducing the risks from such causes. Deaths due to
infectious diseases in infancy such as measles, whooping cough, tuberculosis,
meningitis, and even enteritis, now form quite a small proportion of all infant
deaths.
Deaths from Puerperal Causes.—The maternal death rate is again less than one
per 1,000 births, there being only 4 deaths in all.
Other Causes.—In the age group 15.45 by far the greatest single cause of death
is that due to pulmonary tuberculosis. This was the cause of death in 79 out of 210
persons, giving a rate of 37.62 per cent, for this age group. The social significance
of this high proportion is important since in each case there has probably been also
a considerable period of invalidism, perhaps extending over some years at a time
when the patient should be most active and in the prime of life as a breadwinner and
useful member of the community. Consequently, not only is the patient's means
affected but also those of his family. The 79 deaths from pulmonary tuberculosis