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51
section for foetal distress' and 'obstetric shock during labour'. One
maternal death was registered during 1964 giving a rate of 0.26.
The rates returned for England and Wales and Greater
London were 0.25 and 0.38 respectively.
Infantile Mortality
Infant Mortality of any given locality is measured by relating
the number of deaths of children under one year of age recorded
during the year to the number of live births registered for that
particular area during the same period.
Bad housing, overcrowding, poor sanitation, low standards of
education, illegitimacy, all tend to produce higher infant mortality
rates. It follows therefore that the infant mortality rate should
provide a reasonably accurate indication of the social circumstances
of any particular area. However, because approximately
one third of all infants dying in one year will be found to have
been born in the previous year, great care must be exercised when
drawing conclusions from any rise or fall in infant mortality rates,
for such rates are not comparable year by year unless the birth
rates remain more or less constant. Further, it must be borne
in mind that as infant mortality has now reached relatively
small proportions, any slight deviation in the number of deaths
tends to misleading fluctuations in the rate and only a long term
appraisal is likely to reflect the true position.
A recent valuable survey, instituted by the National Baby
Trust Fund, showed that the risk of perinatal deaths in England
and Wales varied geographically from North and West to South
and East, as much as 40 per cent. and confirmed, what is common
knowledge in health departments generally, that poor physique
and standards of health, increasing maternal age, multiparity and
social class, all exert influences on perinatal mortality.
Having elicited the main causes will this data enable
authorities to introduce effective remedies? Not necessarily, for a
number of unexpected complications in the situation have been
revealed. For instance, despite the fact that identical social and
welfare services are available to all social groups (as defined by the
Registrar-General) there is the equivalent of a 30-year gap between
infant mortality rates of unskilled workers and the professional
groups—latest figures show a ratio of 4:1 to the detriment of the
lower group. Again, use made of available welfare and medical
services by Social Group II was twice that of Group V. It is likely
that long term remedies such as 'housing' and 'education' have
greater effects upon infant mortality than is at present visualised.