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statistics of these houses were obtained for a ten-year period, and by means of
special inquiries in each district material was obtained for the correction of
death rates for the age and sex distribution of the populations. The
inhabitants of the "through" and "back-to-back" houses compared in the
report were of the same class, with similar occupations and wages, though
the rent of the "through" houses, averaging 5s. (id. a week, was naturally
higher than the rent of the "back-to-back " houses, which averaged 4s. 6d. a
week. The corrected average annual death rate from all causes was found to
be greater in the "back-to-back" houses than in the " through " houses to the
extent of 15 per cent. When only those "back-to-back" houses built in
continuous rows were taken for comparison the excess was still greater,
amounting to over 20 per cent. " Back-to-back " houses in blocks of four,
each house having means of side ventilation, showed an average annual death
rate similar to that in " through" houses. The outstanding causes of deaths
which produced the excess of mortality in the " back-to-back " houses were
pneumonia, bronchitis, and other pulmonary diseases (exclusive of phthisis),
and diseases of defective development and malnutrition in young children.
An excess of mortality in "back-to-back" houses from infectious fevers and
from phthisis could also be traced, but these increments were less conspicuous
than in the case of deaths from the causes above mentioned.
The chief sufferers from residence in " back-to-back" houses are infants and
young children and old persons. In part, this probably results from the
greater liability of both young and old to death from pulmonary diseases other
than phthisis. The higher mortality in infants was also in a large degree due
to an excess of deaths certified as due to atrophy, debility, marasmus,
convulsions, and teething. From the first three of these causes the mortality
in the " back-to back" houses stood to that in " through " houses in the
proportion of 169 to 100 ; from the last two the ratio was 164 to 100. These
conditions are associated, on the whole, more closely than any other group of
certified causes of death with the effects of impaired nutrition, imperfect
growth, and abnormal development of the young child, and it is scarcely tobe
doubted that in the earliest period of life the nature of the home, especially,
perhaps, its facilities for obtaining fresh air and sunlight, exert a powerful
influence on their production. The value of these statistical observations is
increased by the fact that the broad conclusions which are indicated by a
studv of the figures in the aggregate are also supported by the figures for the
individual towns in which the investigations were made, in practically all of
which an excess of mortality was found to have occurred in the dwellings
of the "back-to-back " group. The construction of many blocks of flats and
tenements may usefully be considered in the light of this report.
UNDERGROUND ROOMS.
Underground Dwellings.—These are controlled under the Public Health
(London) Act, 1891, Sections 96, 97 and 98.
Underground Sleeping Room*.—These are now controllable under Regulations
to be made by the Council under the Housing and Town Planning Act, 1909,
Section 17 (7).