London's Pulse: Medical Officer of Health reports 1848-1972

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Islington 1861

[Report of the Medical Officer of Health for Islington, Parish of St Mary]

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know I am sketching an Utopia—an ideal condition of society among the labouring
classes. But this ideal we must place before us, or—nothing. We must aim at
perfection, even though it may be impracticable to reach it. Every illness we prevent,
in any class of society, is, to take the most sordid view, a public economy.
9. The children who died in the Parish under 5 years of age were 1405. Of
these 748 had not reached the termination of the first year of their existence. I do
not know, as I have at present no means of calculating, what proportion these 1405
bear to the number of children within the age of 5 years living in the Parish, but it is
apparent that as there were 35,230 families in the Parish on the 8th of April, one in
every 25 of these lost a child by death during the year. Again, as there were 5355
children* under one year of age, born in the parish and alive at some time during the
year, it may be estimated that about every 7th of'them died before their first year of
life was out. The unregistered births, and the probably small number coming at
that age into the Parish with their parents from elsewhere, might make this proportion
somewhat smaller, but not much. I am not going to enter at length into the causes
of this mortality, as I did so in a former report; I shall merely refer you to the mortality
table for information, simply saying that some of them were purposely killed
directly, others were killed indirectly, while the majority fell victims to maternal
ignorance, to neglect, to improper feeding, and to those numerous unhealthy influences
of habitation, which, with inherited feebleness of constitution, if they do not always
originate disease, unquestionably impress upon it a fatal tendency.
10. It has long been held by Sanitarians that the infant mortality of a district
is about the best index of its unhealthiness or the reverse. Let us see what we can
discover as to the sanitary condition of the several districts into which 1 have divided
our Parish, in respect to this matter. Compared with the population at all ages, there
were in the Parish at large 9.0 in every 1000 carried off while under the age of 5 years.
If you consult the table on the map you will see how differently this mortality was
distributed throughout the several districts. In some it was only 1.8, 2.9, 3.6, 3.7 in
the 1000 who died thus young. In others the number varied from 10 to 18 in the
1000. Doubtless, the same explanation as we offered in respect to adult sickness
and mortality may be put forward, and will have a certain amount of truth on its
side, viz:—that while the adults are in larger proportion in the wealthier districts, so
the infants are in smaller proportion when compared with the poorer; but is it
credible that in the extremes of the two classes there is a difference, such as exist
between 1 and 10, or even 1 and 5 ? Probably before the period of my next Report
I shall have some definite information on this point, one on which it is of the highest
importance I should be informed. In the mean time, I have instituted a limited
inquiry as to the proportion of children under 5 years in several streets occupied by
the labouring classes, and I find them to amount to about 20 per cent of the entire
population of those streets, that is, out of a population of 4759, there were 981 children
under 5 years of age. At the census of 1851, the children under 5 years of age formed
about 12 per cent of the entire population of the Parish. In these same streets 83
children died during the year under 5 years of age, being about 17 per 1000 of the
whole population, and 84 per 1000 of the population under 5 years. In some of the
* The number of children (Islington-torn) living in the parish under one year of age, is obtained by
taking the mean of the births in 1860-61.

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