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Annual Report of the Medical Officer of Health—1895.
35
hawkers, watchmen and messengers, cabmen and omnibusmen, musicians, bargemen
and watermen, carters and carriers, are engaged in outdoor work that is arduous,
prolonged, and often ill-paid and unhealthy. Is it any wonder that men working
under such conditions should turn for solace to alcohol? As a matter of fact nearly
all of them drink to excess. We see, then, that the fifteen highest trade mortalities
fall for the most part upon the town labourers, who are given to drink, and whose
work is of a toilsome and exacting nature. Of course, among them are many persons
of deficient bodily and mental development, who earn their bread in the unskilled
labour market of the cities. In the case of the Cornish miners, countrymen of strong
frames and temperate habits, the high mortality is due to the poisonous dust and the
bad ventilation of the mines.
Turning to the fifteen occupations of lowest mortality, we find that four of them,
namely, fishing, agricultural labour, farming and grazing, and gardening, are carried
on in the open air and away from towns. The rest are partly urban and partly rural
or mixed. Some of them, such as the legal and the clerical professions, appear to
enjoy a specially favourable environment.
On the whole, it may be said that the fifteen callings of lowest mortality are to
a great extent rural, and include many well-to-do persons in town and country, while
those of the highest fifteen are mainly urban, and, with the single exception of the
publicans, belong to the working classes. The majority of those included in the
fifteen lowest mortalities either work in the open air or spend a good deal of time out
of doors, so that it seems clear that the hardship of out-door work cannot in itself be
a chief factor of the high death-rate among town labourers. We must look for some
other explanation of that excessive rate.
That alcohol has a share in the untoward result it is hardly possible to doubt.
Some such relation of cause and effect may be traced in the following table :
Occupation.
Mean Annual Deathrate
per 1,000 living.
Comparative
mortality
figure, 1,000
Age.
25.45
Age.
45.65
Age.
25.65
Barristers and solicitors
7.54
23.13
842
Law clerks
10.77
30.79
1,151
This startling disproportion may be accounted for in great part by the three
following factors:—1. That law clerks lead less regular lives and drink more than
their masters (and worse liquor). 2. That they live in cheaper and less healthv
houses, and work in smaller and less wholesome offices. 3. That they are drawn
from a class, often degenerate town-dwellers, less sound in mind and body than the
middle class which supplies their employers.
Conditions of a similar kind apply more or less to all the fifteen occupations of
highest mortality. So far as the towns are concerned, bad housing is probably to a
great extent due to modern systems of drainage, which are often grossly defective.
In rural districts, where no general house drainage exists, this particular risk will be
avoided. Other defects, such as want of ventilation, dampness, deficient cubic space,
are common both to town and to country.
The factor of faulty drainage applies to workshops as well as to houses. Broadly,
it may be said to cause much bodily weakness, and, like bad ventilation, to predispose
not only to chronic ill health, but also to occasional acute disease. From a physiological
point of view it seems perfectly natural that any one living under bad