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London County Council.
Report of the Public Health Committee, submitting the report of
the Medical Officer of Health of the County of London for
the year 1907.
In submitting the report of the Medical Officer of Health of the County of London, we are
able for the third year in succession to state that the death-rate recorded has not exceeded that of any
previous year. In 1905 the death-rate was 15.1, lower than ever before ; in 1906 it was again 15.1;
and in 1907 it fell to 14.6. If comparison be made between the years 1905, 1906 and 1907 and
the decennial period 1891-1900, it will be found that there was a gain to the community of 19,000,
19,000 and 22,000 lives, respectively, in the three recent years, representing a gain in " life capital "
for the three-year period of upwards of 2,000,000 years of life. It should be noted, moreover, that
the birth-rate for 1907 (25.6) is the lowest on record in London since the institution of civil
registration.
The report contains tables giving some interesting contrasts between two selected districts—
Hampstead and Shoreditch—differing widely in their social circumstances. In the former district
the proportion per cent, of domestic servants to families is 16 times as high as in the latter, while, on
the other hand, in Shoreditch the percentage of the population living under conditions of " overcrowding
" is nearly 30 per cent., as compared with only 6.4 percent, in Hampstead. The difference
in the character of the populations in the two districts finds its natural reflection in the mortality
statistics, and it transpires that in Shoreditch the general death-rate is practically twice as high, the
phthisis death-rate nearly three times as high, and the infantile mortality nearly twice as high, as it
is in Hampstead. On turning to the " expectation of life," this is at birth nearly 16 years less in
Shoreditch than in Hampstead, both among males and females; and at each age the figures for the
two districts stand in marked contrast. The population of Shoreditch is, as the Medical Officer
says, but a sample of a much larger population in London and elsewhere whose mortality is increased
by causes which must be regarded as largely preventable.
Epidemic diseases.—The death-rate from the principal epidemic diseases in 1907 is very low
only 1.42. No death occurred from smallpox, and the deaths from measles, influenza, diphtheria
enteric fever, diarrhoea and phthisis were below the average, but those from scarlet fever and
whooping cough were above the average.
The report makes reference to the causes which have contributed to the decline of the phthisis
death-rate, and an instructive comparison is instituted between England and Ireland is respect to the
behaviour of " phthisis " and of " all causes less phthisis " in the two countries. While in England
there is marked improvement under both these heads, Ireland has maintained not only its high deathrate
from phthisis but also from " all causes less phthisis." There appears much reason for
thinking that the improvement in the social circumstances of the English population has been the
material cause of an increased resistance to disease generally, and this has been specially manifested
in the decline of the phthisis death-rate.
The reported prevalence of cerebro-spinal fever in Glasgow and Belfast, in 1906, caused us to
have enquiry made which resulted in our asking the Council on 26th February, 1907, to make an
Order requiring cases of the disease to be notified for a period of six months, and we subsequently
extended this for a further period of eighteen months. During the year 1907, 25 deaths were
attributed in London to this disease, a number in excess of the average number recorded in the last
few years. Probably this increase was an indirect effect of requiring cases of cerebro-spinal
meningitis to be notified. In Glasgow, with one-sixth of the population of London, 847 deaths
were attributed to this cause during 1907. Dr. Wanklyn has studied the cases notified in London,
and the results of his observations are given in Appendix I.
By-laws regulating offensive businesses.—During the year the Council made new by-laws
regulating offensive businesses. The principle of the use of the " closed chamber " is extended by
these by-laws to all offensive processes, and improvement in the method of ventilation of these
chambers is required.
18560 A 2