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that was bettered only In 1954 when it was 18 Dividing the infantile mortality
rate between legitimate and illegitimate children we find that the rate for
legitimate children was 24 and for illegitimate children it was 12, This is the
first time we have been able to record so surprising a difference Going back
to 1939 there have been only two occasions when the infantile mortality rate of
illegitimate was lower than that of legitimate children namely in 1941 when the
figures were 52 and 44 and in 1949 when the figures were 31 and 30, It is not
so long ago since the mortality of illegitimate children was twice that of
legitimate children In 1956 we find it was half, This reflects a better understanding
of the problems of the unmarried mother, a better appreciation on her
part of her responsibility to her child and indeed a tribute to the doctors and
the voluntary agencies in the borough who advise and help her.
Of the 53 children who died before they attained the age of one year, death
occurred in the first day of life in 18 cases 14 between 1 and 7 days, and
6 between the first and fourth weeks It will be seen therefore that the bulk of
infantile mortality today is neonatal mortality: occurring during the first four
weeks of life. To lower the rate we must look to better understanding of antenatal
care and obstetrics Three mothers died of puerperal causes, giving a
maternal mortality rate of 1.25 per thousand live and still births
Tuberculosis
Reference to the graph on page 25 will show a steady diminution in the
number of cases of tuberculosis notified each year This graph, however, does
not tell the whole story for in fact many of the cases notified were in their
early stages and were discovered only as a result of a routine X-ray examination.
The bulk of them would therefore have been curable in view of the modern improvements
in the treatment of this once much more fatal disease 191 cases were notified
during the year. Of these 11 were over 65 and only 14 were individuals under the
age of 20 years, the bulk being in the age period 25 to 35 years This group
accounted for 66 notifications. Of the 191 primary notifications 58 were in
persons over 45 years of age It will be seen therefore that tuberculosis is
no longer a disease of young people, and the large proportion of notifications
is of individuals about or over middle age. In some cases the condition is
already well established and chronic when notified and it is sometimes very
difficult to render such patients free from infection. It is possible that the
major source of infective tuberculosis in the country today is from this older
age group of chronic infectious cases.
I have no record of the past history of each individual case notified but
have reason to think that an undue proportion of the new notifications is in
people who have come to England from abroad.
28 individuals died of tuberculosis during 1956 Of these five were over
75 years of age and four between 65 and 74 There were no deaths in persons
under 24 and only two in the age group 25 to 34. This is due to the effects of
better treatment. The 28 deaths from tuberculosis represents the smallest number
recorded in the borough from this disease and compares with 312 in 1920, when
admittedly the resident population at 228,980 was 95 880 more than in 1956,
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