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on p. 27 of this report. In summary it can be said that the Lewisham
Old People's Welfare Association, and other organisations in the borough
for the care of old people, increased their work and their effort, and
in addition machinery was laid down on the administrative side,
particularly as far as LOPWA is concerned, on which a detailed
superstructure for the care of old people can easily be built, provided
money and voluntary effort are available.
Maternity and child welfare
In the introduction of my last report I commented in some detail
on the end of local maternity and child welfare as far as the borough
council was concerned. I drew attention to the spectacular improvements
made in various death rates and sickness rates and said that
although the borough council had ceased its direct responsibility for
maternity and child welfare the influence of the services which they had
themselves set up and administered would probably be felt for some
time. It should therefore be of considerable interest to members of
the council to know of the still further improvements in death rates in
1949. Some of these have been specifically mentioned at the beginning
of this introduction and others will be seen in the section dealing with
vital statistics. I would however particularly draw attention to table 8
on pp. 16 and 17. Last year when I reported a then record low infant
mortality rate of 28 (for 1948) I said from an analysis of the causes of
death that it might be possible to halve that rate, i.e. bring it down to
about 14 per thousand, but that it was doubtful if in the present state
of medical knowledge it could be brought down further. It will now be
seen that the rate has in fact been brought down a considerable way
to the 14 per thousand (19 per thousand is more than half way), but on
analysis of table 5 on p. 14, which shows the causes of the 73 infant
deaths, it would appear that theoretically there could be a further
reduction in the rate. The stillbirth rate last year was 16.2, which represents
a slight increase from the very low figure of 14.8 the previous
year. This indicates a field in which further improvement can be made
in preventing reproductive wastage. The reproductive wastage rate,
which I thought might have 24 as its near-future objective, is in fact 35
(as against 43 last year). The most spectacular decrease in infant deaths
has however been in the age period one month to 12 months.
National statistics indicate that there is a considerable difference
in infant death rates according to social class. The Registrar-General
divides adults into five different social classes which in very general
terms can be described as follows:—
I The professions, service officers and welltodo people concerned
in finance, shipping, etc.
II Intermediate, between class I and the skilled workers.
III The skilled workers
IV Intermediate, between skilled and unskilled workers
V The unskilled workers
(A baby or child of course is put into the class in which its
parent is.)