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13
According to the Registrar-General's summary of the deaths belonging to the borough
there were 1,665, 3 more than calculated locally. Careful search has failed to show that
the local figures are wrong and accordingly they have been used in compiling the various
rates in this report. In any case a difference in total of 3 deaths only varies the death rate
by 0.02 per 1,000 of the population.
The Registrar-General supplies what is known as "a Comparability Factor" (based
on the 1931 Census) for adjusting the local death rate so as to make it really comparable with
the national crude rate or with rates of other districts which have been similarly adjusted.
This factor takes into account variations in population both as regards sex and age-groups
and enables more accurate comparisons to be made than is possible when using crude rates.
The factor for Fulham is 1.01, and the adjusted death rate is, therefore, 11.7.
Certain inferences from the birth rate and death rate tendencies year by year are of
importance and are true locally as well as generally. The birth rate has shown a steady
decline year by year for the last 50 years and has now probably reached its nadir. Thus
the local rate in 1922 was 20.3; in 1925, 16.9; in 1928, 15.4. and in 1931, 15.08.
The death rate of recent years on the other hand, remains reasonably stable and for
the years quoted in the last sentence was 12.1, 10.7, 11.5, and 13.3. The highest incidence
of mortality is in the first quinquennium of life and in old age. It will be obvious, therefore,
that with a diminishing birth rate and a stationary death rate the proportions of the population
in each age-group are changing each year in the direction of a relative preponderance
of the old and a relative diminution of the young. This is well illustrated by the Census
figures for London for the years 1921 and 1931. In these 10 years the number of children
under 5 in the County area decreased by nearly 79,000, and the children between 5 and 10
by 72,000, whilst the number of persons over 10 increased by 64,000. In 1881, 24 per cent.
of the population of London consisted of children under the age of 10 years; in 1921 the
proportion was 17.3 per cent., and in 1931 it had dropped to 14.2 per cent.; from one quarter
to one seventh in 50 years. These figures are the more striking when it is realised that during
this period the infant mortality rate had been more than halved and the death rate of children
under 5, proportionately reduced.
Thus, in due time, should there be no change in the present conditions affecting
health, the death rate will rise because there will be more of the existing population in the
older groups in which death is a natural event. Should present tendencies continue it is
estimated that the population of the country will become stationary by 1940 and subsequently
begin to decline. These facts have obvious and wide implications apart from their bearing
on the vital statistics of the community. Nothing further need be said here beyond recording
the estimate that for the maintenance of the population at its present level, a birth rate of
19—20 per 1,000 is needed.
CERTIFICATION OF CAUSES OF DEATH.
Of the 1,662 deaths belonging to the borough, 1,484 or 89.29 per cent, were certified
by registered medical practitioners; 109 or 6.56 per cent, by coroners after inquests; 67 or
4.03 per cent, by coroners without inquests, while 2 cases or 0.12 per cent, were uncertified.
DEATHS IN PUBLIC INSTITUTIONS.