London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1897
[Report of the Medical Officer of Health for London County Council]
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5
The question is whether it is the sole explanation of the relatively increased incidence upon
ages 3—, 4—, 5—, and the only way in which this can be tested is by adding scarlet fever
deaths to diphtheria deaths, and considering the changes in the age incidence of the two diseases
combined. The disadvantage attending the adoption of this course is, however, to obscure and
minimise any changes in the age incidence of diphtheria, for it cannot be urged that the whole
of the scarlet fever mortality of earlier times would now be attributed to diphtheria. Notwithstanding
this obscuration, the percentage decrease at the ages 3—, 4— and 5— has been, with trifling
exception, less than the decrease at the other age periods in each of the periods 1871-80, 1881-90 and
1891-6 compared with 1861-70 in England and Wales, and especially in London. This will be seen
by reference to the following tables (IV. and V. (C).)—
TABLE IV. England and Wales. (A) Scarlet fever, diphtheria and croup—Death rates per 1,000,000 living.
| Period. | All ages. | 0— | 2— | 3— | 4— | 5— | 10— | 15— | 20 and upwards. | |
|---|---|---|---|---|---|---|---|---|---|---|
| 1861-70 | 1,402 | 3,735 | 8,379 | 8,642 | 8,106 | 6,457 | 2,823 | 650 | 213 | 68 |
| 1871-80 | 1,005 | 2,403 | 5,884 | 6.251 | 5,966 | 4,817 | 2.016 | 422 | 137 | 47 |
| 1881-90 | 640 | 1,488 | 3,783 | 3,930 | 3,934 | 3.340 | 1,402 | 262 | 77 | 30 |
| 1891-6 | 509 | 1,235 | 3,058 | 3.114 | 3.290 | 2,845 | 1,123 | 217 | 76 | 30 |
(B) Death rate per 1,000,000 living, death rate at " all ages " being taken as 100.
| 1861-70 | 100 | 266 | 598 | 617 | 578 | 460 | 201 | 46 | 15 | 5 |
| 1871-80 | 100 | 239 | 585 | 622 | 594 | 479 | 201 | 42 | 14 | 5 |
| 1881-90 | 100 | 233 | 591 | 614 | 615 | 522 | 219 | 41 | 12 | 5 |
| 1891 -6 | 100 | 243 | 601 | 612 | 646 | 559 | 221 | 42 | 15 | 6 |
(C) Increase or decrease per cent, of death rates at each age-period in 1871-80, 1881-90, and 1891-6, compared with the death rates at each age-period in 1861-70.
| 1871-80 | —28.3 | —35.7 | —29.8 | —27.7 | —26.4 | —25.4 | —28.6 | —35.1 | —35.7 | —30.9 |
| 1881-90 | —54.4 | —60.2 | —54.9 | —54.5 | —51.5 | —48.3 | —50.3 | —59.7 | —63.8 | —55.9 |
| 1891-6 | —63.7 | —66.9 | —63.5 | —64.0 | —59.4 | —55.9 | —60.2 | —66.6 | —64.3 | —55.9 |
TABLE V. London. (A) Scarlet fever, diphtheria and croup—Death rates per 1,000,000 living.
| Period. | All ages. | 0— | 1— | 2_ | 3— | 4— | 5— | 10— | 15— | 20 and upwards. |
|---|---|---|---|---|---|---|---|---|---|---|
| 1861-70 | 1,565 | 4,417 | 10,355 | 11,218 | 9,732 | 7,609 | 3,141 | 607 | 212 | 82 |
| 1871-80 | 900 | 2,238 | 5,642 | 6,138 | 5,789 | 4,788 | 1,878 | 313 | 105 | 47 |
| 1881-90 | 747 | 1,827 | 5,045 | 5,252 | 5,168 | 4,278 | 1,529 | 235 | 82 | 36 |
| 1891-6 | 814 | 2,001 | 5,674 | 5,637 | 5,700 | 4,888 | 1,783 | 290 | 89 | 36 |
(B) Death rate per 1,000,000 living, death rate at " all ages " being taken as 100.
| 1861-70 | 100 | 282 | 661 | 717 | 622 | 486 | 201 | 39 | 14 | 5 |
| 1871-80 | 100 | 249 | 627 | 682 | 643 | 532 | 209 | 35 | 12 | 5 |
| 1881-90 | 100 | 245 | 675 | 703 | 692 | 573 | 205 | 31 | 11 | 5 |
| 1891-6 | 100 | 247 | 700 | 695 | 703 | 603 | 220 | 36 | 11 | 4 |
(C) Increase or decrease per cent, of death rates at each age-period in 1871-80, 1881-90, and 1891-8, compared with the death rates at each age-period in 1861-70.
| 1871-80 | —42.5 | —49.3 | —45.5 | —45.3 | —40.5 | —37.1 | —40.2 | —48.4 | —50.5 | —42.7 |
| 1881-90 | —52.3 | —58.6 | —51.3 | —53.2 | —46.9 | —43.8 | —51.3 | —61.3 | —61.3 | - 56.1 |
| 1891-6 | —48.0 | —54.7 | —45.2 | —49.8 | —41.4 | —35.8 | —43.2 | —52.2 | —58.0 | —56.1 |