London's Pulse: Medical Officer of Health reports 1848-1972

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Stepney 1915

[Report of the Medical Officer of Health for Stepney]

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connection, it appears that the dcfects in the Register, taken as a whole, are not
on such a scale as to affect seriously the estimates of population based upon it.
By the method described below it was possible to derive from these returns estimates
of the civil population only of each administrative area on August 15th. No
attempt has been made to increase these by allowance for members of the fighting
forces, because apart altogether from the difficulty of ascertaining the average
military population of each district during the year, experience has shown that
under present circumstances only civilian deaths can be tabulated for local areas.
If military deaths were to be included they would have either to be debited to the
area in which they occurred, a course which would render the death-rates of districts
containing large military hospitals meaningless, or to the area of residence. An
attempt made to pursue the latter course has had to be abandoned owing to military
authorities having been unable to furnish to the Registrars the necessary information.
It has been found necessary, therefore, to limit the tabulation of deaths by local
areas to deaths of civilians, and under these circumstances the civilian population
is obviously the proper one to use for the calculation of death-rates.
An additional advantage in the use of National Register populations is that
these consist of habitual residents in each locality and not merely of the persons
who happened to be present therein on a certain date. The deaths tabulated from
the year 1911 onwards are also those of habitual residents only, and therefore the
use hitherto of populations which in certain cases included very large institutional
elements, chiefly composed of non-residents, introduced in these cases serious errors
into the rates calculated from them, as pointed out in the Registrar-General's Annual
Reports. This source of error now, of course, disappears for the time being, and in
such districts an unavoidable break in the continuity of the previously misleading
rates will result. In any case, however, the maintenance of continuity is under
present circumstances obviously impossible, and it is felt that the present estimates
will furnish death-rates calculated to indicate as nearly as may be the health
conditions of the civil population.
The method by which the estimates of civil population have been derived
from the National Register returns may now be described.
The ratio of the total population, less the males aged 15-65 years, to the number
of females aged 15 to 65 years at the date of the census, was calculated for each
administrative area, and this ratio was applied to the number of females on the
National Register; the resulting product plus the number of males aged 15 to 65
years on the National Register, was taken to be the number of the civil population
of the district. A small adjustment was necessary in order to make the sum of the
estimates for the several districts equal to the estimate for the country as a whole
made on the same basis. Further, the population in institutions was not registered,
and this (taken to be the same in the aggregate for England and Wales as at census
date), together with a number of persons of no fixed abode, were distributed evenly
over the whole country. These two adjustments raised the original estimates by
about one per cent.