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Annual Report of the Medical Officer of Health,—1893. 11
The highest were:—
Bolton 24.1 per 1,000
Manchester 24.1 „
Preston 26.4 „
Liverpool 27.3 „
The death rate of Edinburgh was 19.8, that of Glasgow 23.4, and that of Dublin
270.
The lowest rates in foreign and colonial cities were:—
Sydney 157per 1000.
Brisbane 16.3 ,,
Christiania 17.5 „
San Francisco 17.9 „
Amsterdam 18.6 ,,
Cincinatti 187 „
While the highest were:—
Breslau 29.1 ,,
Madras 30.9 „
Alexandria 36.3 ,,
Moscow 35.9 „
St. Petersburgh 39.6 „
Zymotic or Preventable Death Rate.
It may be noted that the term "zymotic" applies to the following seven diseases :
—Small-pox, measles, scarlet fever, diphtheria, whooping cough, "fever" (i.e.,
typhus, simple continued, and typhoid), and diarrhoea.
I have called the above zymotic diseases "preventable," because I regard all
communicable disease, broadly speaking, as coming under that heading. Diarrhoea
is a symptom rather than a disease, and, although not usually communicated from
one person to another, it may be regarded as the almost invariable result of bad
environment. At the same time, it must be clearly understood that a vast amount
of preventable disease, such as that due to alcoholism, is not zymotic in the ordinary
sense of the term—that is to say, disease communicable from the sick to the
healthy.
The corrected death-rate in St. George, Southwark, from the seven principal
zymotic diseases was 4-0 per 1,000 in 1893, as against 3'0 per 1,000 in the whole of
London for the same period, and 3-18 in the 33 great towns of England and Wales.
As in the calculation of the general death-rate, so with the zymotic death-rate,
the deaths of non-parishioners occurring within the district have been excluded,
whilst on the other hand the deaths of parishioners in public institutions outside the
parish have been included. Unless a proper distribution of these deaths be made,
especially of those from zymotic diseases, no really trustworthy data can be secured
upon which to calculate the rates of mortality.
Among the,41 Metropolitan Sanitary Districts the zymotic death-rates ranged
from 1-3 per 1,000 in Hampstead, and in the City of London; 1*5 in St. Martin-inthe-Fields;
16 in St. George, Hanover Square; 17 in Lewisham ; and 18 in St.
James, Westminster, to 4-0 in St. George, Southwark; 41 in Bethnal Green; 4 6 in
Shoreditch; 4-7 in Limehouse; 4 9 in Clerkenwell and in St. George-in-the-East;
and 5 6 in St. Luke. From these figures, therefore, it is evident that St. George's,
Southwark, has an excessive death-rate from zymotic diseases.