London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1894
[Report of the Medical Officer of Health for London County Council]
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The differences observed in these rates are, therefore, solely due to differences in the age and
sex distribution of the population, since the rates of mortality operating on the groups of population
at various ages have been assumed to be constant.
It will thus be seen that from 1841 to a point between 1861 and 1881 the age and sex distribution
of the population had been so changing as to act prejudicially upon the death rates, while from
this point to the year 1891 a reversal of this process has taken place, the changing age and sex distribution
of the population tending gradually to diminish the death rates.
If the age and sex distribution of the population shown by the censuses of 1891,1881, 1871, &c.,
be regarded as constant for the periods 1886-94. 1876-85, 1866-75, &c., respectively, it will be seen
that the constitution of the population as regards age and sex in the period 1886-94 was more
favourable to the death-rate than the constitution of the population of any of the other periods under
consideration, except that of 1836-45.
Assuming that the age and sex distribution of the population for each period under consideration had been identical with that of the period 1886-94, the approximate effect on the death rates may be shown as follows—
| Period. | Mean death rate. | Excess per cent. over mean death rate of 1886-94. | Amount of this excess due to difference of age and sex distribution (compared with 1886-94). |
|---|---|---|---|
| 1846-55 | 25.10 | 24.6 | 0.4 |
| 1856-65 | 23.56 | 17.0 | 2.0 |
| 1866-75 | 23.62 | 17.3 | 2.5 |
| 1876-85 | 21.58 | 7.1 | 1.8 |
| 1886-94 | 20.14 | — | — |
It will thus be seen that the excess of the mean death rates in the periods previous to 1886-94
shown in the table is only in trifling degree due to differences of age and sex distribution.
The following table has been prepared for the purpose of comparing the death rate of the registration County of London with that of other English towns having populations of more than 200,000 persons at the census of 1891. It will be seen that three of these towns in the ten years 1884-93, and five of these towns in 1894, had a lower death rate than that of London.
All Causes.
| Population estimated to the middle of 1894. | Death rate per 1,000 living. | Population estimated to the middle of 1894. | Death rate per 1,000 living. | ||||
|---|---|---|---|---|---|---|---|
| 1884-93. | 1894. | 1884-93. | 1894. | ||||
| London | 4,349.166 | 20.4 | 17.8* | West Ham | 238,184 | 19.3 | 16.2 |
| Manchester | 520,211 | 26.2 | 20.4 | Bristol | 226,578 | 19.5 | 17.3 |
| Liverpool | 507,230 | 26.0 | 23.8 | Bradford | 223,985 | 20.5 | 17.0 |
| Birmingham | 492,301 | 21.0 | 18.6 | Nottingham | 223,584 | 20.4 | 17.2 |
| Leeds | 388,761 | 21.8 | 17.9 | Hull | 212,679 | 20.2 | 17.4 |
| Sheffield | 338,316 | 22.1 | 17.8 | Salford | 205,828 | 24.9 | 21.0 |
Again the death rate of London in the ten years 1884-93 and the year 1894 was lower than the corresponding death rate for each of the undermentioned foreign cities—
All Causes.
| Death rate per 1,000 living. | Death rate per 1,000 living. | ||||
|---|---|---|---|---|---|
| 1884-93. | 1894. | 1884-93. | 1894. | ||
| London | 20.4 | 17.8* | St. Petersburg | 29.8 | 31.4 |
| Paris | 23.3 | 20.3 | Berlin | 22.3 | 18.2 |
| Brussels | 21.5 | 18.1 | Vienna | 25.1 | 22.8 |
| Amsterdam | 22.4 | 18.3 | Rome | 24.7 | 19.4 |
| Copenhagen | 21.8 | 18.7 | New York | 25.5 | 21.1 |
| Stockholm | 21.2 | 18.3 | |||
In 1885 the Registrar-General began to distribute the deaths from all causes and from certain
zymotic diseases, occurring in institutions, to the sanitary districts to which thev belong and death rates
corrected in this sense can therefore be obtained for each of the years 1885-94. For the purpose of a
more precise statement, it is necessary to have regard to the age and sex distribution of the several
populations, and to correct each crude death rate by the proper factor; the following table is thus
obtained—
*Including deaths of Londoners in the Metropolitan Workhouses, Hospitals, and Lunatic Asylums, situated outside Registration
London, but excluding deaths of persons not belonging to London occurring in the Highgate Smallpox Hospital, in the London Fever
Hospital, in the Middlesex County Lunatic Asylum at Wandsworth, and in the Metropolitan Asylums Board Hospitals within
registration London.