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London County Council.
Report of the Public Healtli Committee submitting the report of
the Medical Officer of Health of the County of London for
the year 1902.
The passing of the Public Health (London) Act, 1891, placed the London County Council in
direct relation with sanitary administration in the county of London. This Act came into operation on
1st January, 1892, and for that and each succeeding year the medical officer has prepared and presented
to the Council a report on the health of Loudon. These reports show the results of the tabulation and
study of the vital and other statistics of the county contained in the Registrar-General's returns, and
in the weekly returns of infectious diseases supplied by the Metropolitan Asylums Board, or obtained
from other sources, as well as information collated from the annual reports of the medical officers
of health of London sanitary districts. The date at which the annual report of the county medical
officer can be issued each year is therefore necessarily dependent upon the dates at which the reports
of the local medical officers are received, and it has not in practice been found possible to issue the
report of the county medical officer much before the end of the year succeeding that to which it relates.
In submitting the medical officer's report for 1902, we observe that the London death rate from
all causes per 1,000 living was only 17*2, the lowest ever recorded except that for 1901, which
was 17.1.
The health of London, judged by its general death rate, has steadily improved within registration
times, and the last ten or iifteen years compare favourably in this respect with any similar series of
years preceding them. In 1889 the death rate was lower than any recorded before that year; during the
four succeeding vears there was a set-back, acc «unted for largely, no doubt, by the prevalence of
influenza; in 1894 a minimum death rate of 17.4 was registered, and this record has now been
twice broken, viz., in the years 1901 and 1902.
We are glad to observe that the rate of infant mortality in London was particularly low in
the year under consideration, and for the period of 1892-1901 was lower in London than in any
of the othei principal English towns except Bristol.
The number of marriages in London in 1902 was 40.817, piving an annual rate of persons married
of 17.8 per 1,000 living, a slight increase on the rate (17.6) for 1901. The birth rate is still steadily
declining, the rate for 1902 being 28.5 per 1,000 living, the lowest recorded in London since the
institution of civil registration.
In July, 1902, we presented to the Couucil an extended life table based upon the mortality
in the decennium 1891-1900 and showing for the London population the expectation of life at each year of
age. The report now presented contains life tables based on figures relating to two metropolitan boroughs,
one rich and the other poor. The difference in the expectation of life in these boroughs (Hampstead
and Southwark) is, as might be anticipated, marked. The figures can be compared with the
corresponding figures, obtained by Dr. Farr 60 years ago, in respect of two districts similarly contrasted
by him, viz., St. George, Hanover-square, and Whitechapel, aud it is of special interest
to note that the expectation of life at the younger ages in the poor district of to day approaches that
in the rich district of 60 years ago.
During 1902 no fewer than 1,814 deaths occurred in London from smallpox, the death rate
being higher than had been the case since 1885. Several cases were notified at intervals in various
parts of London in the first six months of 1901, but the first considerable extension of the disease
took place in St. Pancras in August, 1901, and cases subsequently occurred in all the metropolitan
boroughs. As it became apparent that difficulty was being experienced in the diagnosis of cases owing
to the fact that a generation had grown up in comparative ignorance of smallpox, and that many cases
of this malady were being mistaken for cases of chicken-pox, the Council decided on our recommendation
to make chicken-pox a notifiable disease. We also obtained authority from the Council to employ
experts whose services were made available for the diagnosis of doubtful cases of smallpox, and
arrangements were made for daily reports as to cases to bo sent in, manifolded, and distributed to
medical officers of health throughout London. Information as to the occupations of persons attacked
by the disease is given in a report by Dr. Hamer, presented to us by the medical officer.
(Appendix II.)
Under our instructions special efforts were made to minimise the spread of the disease in
common lodging-houses. Houses in infected localities were kept under close observatian by the
Council's officers, visits in the early morning being found particularly useful. It became necessary to
incur expenditure in connection with the provision of food and lodging in some instances in which
there was special reason for concluding that lodgers were sickening with the disease, and were hence
likely, if lost sight of, to spread it. The close supervision of the movements of some 5,000 "contacts"
was accomplished, and the expenditure incurred upon food and lodging amounted to only about £35.