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 1898
[Report of the Medical Officer of Health for London County Council]
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shown by the census figures of 1891, it was shown in my annual report for 1894 (page 42) that the
phthisis death-rate in these groups of districts followed the order of overcrowding. The following
table shows the results obtained for each of the years 1894-98 inclusive—
| Proportion of total population living more than two in a room (in tenements of less than five rooms). | Death-rates1 per 1,000 living. | ||||
|---|---|---|---|---|---|
| 1894. | 1895. | 1896. | 1897. | 1898. | |
| Districts with under 10 per cent. | 1.07 | 1.18 | 1.07 | 1.14 | 1.10 |
| „ „ 10 to 15 „ | 1.38 | 1.49 | 1.46 | 1.42 | 1.43 |
| „ „ 15 to 20 „ | 1.57 | 1.64 | 1.61 | 1.63 | 1.61 |
| „ „ 20 to 25 „ | 1.81 | 1.83 | 1.67 | 1.75 | 1.80 |
| „ „ 25 to 30 „ | 2.11 | 2.09 | 2.06 | 2.10 | 2.07 |
| ,, „ 30 to 35 „ | 2.26 | 2.42 | 2.13 | 2.32 | 2.42 |
| „ „ over 35 „ | 2.46 | 2.66 | 2.55 | 2.64 | 2.63 |
There is, therefore, obviously relation between the amount of overcrowding and the phthisis
death-rate. The figures do not, however, suffice to show whether the overcrowding caused phthisis,
or whether the disease by adding to family expenditure or by diminishing the wage earning power
left less money available for rent and thus brought about the overcrowding, or whether again
overcrowding is associated with some other condition or conditions which are favourable to disease.
In all probability all these circumstances have tended to produce the results shown in the table.
Study of the following tables shows that the phthisis mortality at each age increases with
overcrowding. The differences in the death-rates at age 5— in the several groups of districts are
small, but with slight exception the death-rates at the older ages follow the order of overcrowding.
It is interesting to observe that the differences between the death-rates of the several groups
of districts are most marked at the ages at which the mortality from phthisis is greatest.
This will be more clearly seen on reference to diagram XIX., which is based upon the table showing
the comparative death-rates at each age-period for each of the groups of sanitary districts compared
with the least overcrowded group.
| Proportion of total population living more than two in a room. (In tenements of less than five rooms.) | 0- | 5- | 20- | 25- | 35- | 45- | 55 and upwards. |
|---|---|---|---|---|---|---|---|
| Districts with under 10 per cent. | 0.23 | 0.39 | 1.19 | 1.50 | 1.94 | 2.05 | 1.77 |
| „ „ 10 to 15 „ | 0.39 | 0.34 | 1.44 | 2.13 | 3.09 | 2.68 | 1.91 |
| „ „ 15 to 20 „ | 0.62 | 0.37 | 1.05 | 2.01 | 3.41 | 3.43 | 2.36 |
| „ „ 20 to 25 „ | 0.57 | 0.36 | 1.59 | 2.39 | 3.66 | 4.01 | 2.78 |
| „ „ 25 to 30 „ | 0.78 | 0.33 | 1.57 | 2.58 | 4.16 | 4.58 | 3.04 |
| „ „ 30 to 35 ,, | 0.81 | 0.49 | 2.00 | 3.00 | 5.58 | 6.26 | 3.26 |
| „ „ over 35 „ | 0.85 | 0.50 | 1.82 | 3.25 | 6.04 | 6.12 | 4.41 |
| Proportion of total population living more than two in a room. (In tenements of less than five rooms.) | 0- | 5- | 20- | 25- | 35- | 45- | 55 and upwards. |
|---|---|---|---|---|---|---|---|
| Districts with under 10 per cent. | 100 | 100 | 100 | 100 | 100 | 100 | 100 |
| „ „ 10 to 15 „ | 170 | 87 | 121 | 142 | 159 | 131 | 108 |
| „ 15 to 20 „ | 270 | 95 | 88 | 134 | 176 | 167 | 133 |
| „ „ 20 to 25 „ | 248 | 92 | 134 | 159 | 189 | 196 | 157 |
| „ „ 25 to 30 „ | 339 | 85 | 132 | 172 | 214 | 223 | 172 |
| „ „ 30 to 35 „ | 352 | 126 | 168 | 200 | 288 | 305 | 184 |
| „ „ over 35 „ | 370 | 128 | 153 | 217 | 311 | 299 | 249 |
Two questions deserve consideration—(1.) Whether overcrowding is associated in a similar
manner with mortality from other diseases than phthisis; (2.) Whether the increase of mortality
from these diseases in association with overcrowding especially manifests itself at the same ages
as in phthisis.
My annual report for the year 1894, page 43, contains a table which shows that the "all
ages" death-rates from "all causes" and from "all causes other than phthisis" follow overcrowding
precisely in the same way as phthisis. It does not, however, necessarily follow that the
mortality from every disease is increased in similar proportions, or, indeed, increased at all. For
the purpose of comparison with phthisis the diseases tabes mesenterica, tubercular meningitis,
diarrhoea, principal zymotic diseases excluding diarrœa, and cancer have been selected, and