View report page

17
underlines the fact that the social class advantage which has always
been possessed by the baby in classes I and II, as compared with
classes IV and V, still persists in spite of the levelling out of the social
classes and in the medical services available for them.
For the 9 towns (excluding Plymouth and Portsmouth) giving
pulmonary tuberculosis notifications, the rate was 135 per 100,000
population (Lewisham 117) and the deaths from respiratory tuberculosis
gave a rate of 26 (Lewisham 16). Deaths from heart disease were
346 per 100,000 population, deaths from pneumonia 48, and from
bronchitis 70 per 100,000 (Lewisham 380, 55 and 90 respectively).
The pulmonary tuberculosis notifications show that only 7 percent
were in classes I and II, 70 percent in class III and 23 percent in
classes IV and V. On the other hand deaths from heart and circulatory
diseases show that 17 percent were in classes I and II, 57 percent in
class III and 26 percent in classes IV and V. Deaths from pneumonia
and bronchitis occupied a rather intermediate position in the social
classification. In pneumonia, 14 percent were in classes I and II and
30 percent in classes IV and V, whilst in bronchitis 11 percent were in
classes I and II and 30 percent in classes IV and V, leaving 56 percent
in the case of pneumonia and 59 percent in the case of bronchitis in
class III.
Reverting to the child welfare statistics, the social class divisions are
more apparent. The notified premature birth rate for the towns was
71-9 per thousand births, the rate of social class I being 45-9, II 48-2,
III 68*4, IV 84-6 and V 82-1. The registered stillbirth rate for the
towns was 18-4 and here the social class I rate was 16-4 with classes
II to V 17-8, 19-5, 24-0 and 24-9 respectively. The infant death
rate for the towns was 28 • 3 per thousand livebirths, and here again there
was a fairly wide divergence between the social classes, class I being
17-6, II 21 -4, III 26-8, IV 33-3 and V 37-1. These variations, though
considerable, are rather less than in the previous year.
Comparison with other areas
A mere drop in the number of deaths from a certain cause may be
satisfactory ; a drop in the rate, i.e. the number of deaths per thousand
ol the population, is more satisfactory, especially when considered
over a period of time during which the population may have changed
considerably. Even here there may be invalidating factors, such as the
age distribution of the population. Furthermore, a drop in numbers
or rates, although apparently satisfactory, may, in comparison with
larger areas, be seen to be not so good, perhaps because the rates for
those larger areas have dropped even more. In other words although
Lewisham, for example, may have improved, other areas may have
improved more, or more rapidly. The diagrams herewith illustrate
certain Lewisham statistics in relation to:—
(1) the whole administrative County of London, and
(2) the whole of England and Wales.