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 1905
[Report of the Medical Officer of Health for London County Council]
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Subject matter such as this may be considered in relation to other hypotheses and I would,
therefore, submit that these increases may be merely apparent or be due to natural causes. Better
certification of deaths, especially of children who survive their birth but a very brief period, would
account for much of the apparent increase of mortality in the beginning of life from premature birth,
&c. Diarrhoeal diseases are largely governed by temperature and in comparing different periods consideration
has to be had for this factor.
In the two periods of Dr. Tatham's tables, 1873-77, and 1898-1902, the mean summer temperature stood in the relation to the mean of antecedent years as follows :—
| Year. | Temperature above or below the mean in deg. F. | Tear. | Temperature above or below the mean in deg. F. |
|---|---|---|---|
| deg. F. | deg. F. | ||
| 1873 | + 0.6 | 1898 | + 3.0 |
| 1874 | + 1.2 | 1899 | + 3.3 |
| 1875 | + M | 1900 | + 2.0 |
| 1876 | + 2.1 | 1901 | + 1.9 |
| 1877 | —1.2 | 1902 | — 0.2 |
Again, in the three periods of Dr. Sykes' table the summer temperatures in relation to the mear were as follows :—
| Year. | Temperature above or below mean, deg. F. | Infantile mortality, Diarrhoeal diseases. | Year. | Temperature above or below mean, deg. F. | Infantile mortality, Diarrhoeal diseases. | Year. | Temperature above or below in mean, deg. F. | Infantile mortality, Diarrhoeal diseases. |
|---|---|---|---|---|---|---|---|---|
| deg. F. | deg. F. | deg. F. | ||||||
| 1888 | — 2.1 | 12 | 1893 | + 2.2 | 20 | 1898 | + 3.0 | 27 |
| 1889 | — 0.8 | 15 | 1894 | — 1.2 | 10 | 1899 | + 3.3 | 26 |
| 1890 | — 0.3 | 15 | 1895 | + 2.7 | 21 | 1900 | + 2.0 | 23 |
| 1891 | — 0.4 | 14 | 1896 | + 0.7 | 20 | 1901 | + 1.9 | 24 |
| 1892 | — 0.5 | 14 | 1897 | + 1.1 | 25 |
' Both in respect of Dr. Tatham's periods and Dr. Sykes' periods, therefore, higher temperatures
prevailed in the summer quarter of the later period.
The following table enables the infant mortality, inclusive of and exclusive of deaths from diarrhoeal diseases, in Dr. Sykes' periods to be compared :—
| Period. | Infant Mortality. | Infant Mortality, less Diarrheal Diseases. | ||||||
|---|---|---|---|---|---|---|---|---|
| Months | Months. | |||||||
| 0-3 | 3-6 | 6-12 | 0-12 | 0-3 | 3-6 | 6-12 | 0-12 | |
| 1888-92 | 69 | 32 | 51 | 152 | 65 | 28 | 45 | 138 |
| 1893-97 | 74 | 34 | 51 | 159 | 69 | 28 | 43 | 140 |
| 1898-1901 | 74 | 35 | 52 | 161 | 68 | 27 | 41 | 136 |
Much of the increase of mortality in the later period is attributable to diarrhoeal diseases,
which are especially subject to climatic conditions, and as already stated, the temperature in the
later period has been favourable to increase of deaths from this cause.
If the period 1888-92 be compared with that of 1898-01, and deaths from premature births be deducted from both, the following figures are obtained for the ages 0-3 months :—
| Period. | Infant mortality. | Less deaths from Premature Birth. | Less deaths from Premature Birth and Diarrhoeal diseases. |
|---|---|---|---|
| 1888-92 | 69 | 53 | 49 |
| 1898-1901 | 74 | 54 | 48 |
The difference, therefore, between these two periods may be explained by (a) an increase in
the number of deaths from diarrhœal diseases, and (b) an increase in the number of deaths from
premature births ; the former is probably due to increased temperature in the summer quarter, the
latter is explicable on the hypothesis of more complete registration, leading to registration in greater
degree of children who survive their birth but for a brief period. Further, reference to diagram IV.
shows the effect which the increasing number of deaths registered as due to premature birth has upon
the maintenance of the rate of infant mortality.