London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1912

[Report of the Medical Officer of Health for London County Council]

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6
Annual Report of the London County Council, 1912.
The decline
in the birthrate.
The cause of the steady fall in the birth-rate in recent years has been the subject of great
controversy. It must suffice here to say that there is much to be said in favour of the view that the fali
is, in the main, a natural one and represents the adjustment brought about by the ordinary laws which
affect movement and growth of population. The birth-rate in most of the countries of Europe attained
a maximum in the seventies, and it has since declined. There have been conspicuous contrasts, it is
true, presented by the crude birth-rates of one and another European country, and even if these crude
rates be corrected by employment of what has been described as the "correct method of stating
fertility," it is still found that Italy and Austria in a less degree, and France in a more conspicuous
degree, have fallen behind other European countries since 1881. The method of correcting crude rates
just referred to, however, while it takes into account the age of the wife at marriage, does not make
similar allowance for the age of the husband, nor does it have regard to variations affecting the reproductive
capacities of both parents resulting from changes of the population brought about by emigration
or immigration, and possibly in other ways. In the case of France, it is true, there has been but little
migration from or into the country, but there has been noteworthy interchange as between country and
town, and study of the influence of these "migrations interieures" as they are termed by M. Cauderlier
(Les Lois de la Population, p. 188) carries with it conviction as to the large importance, in its effect
upon the birth-rate of such migration. France is, it is affirmed, the country in which this "migration
interieure" is most active. In departments such as Lozere, les Landes, la Haute Saone, l'Ariege, it is,
allowing for the size of the populations concerned, more than double the amount of the emigration from
Germany or England. M. Cauderlier (loc. cit. p. 188) argues that "migration interieure" operates as
follows The birth-rate is higher in the towns because of the excessive proportions of married women
of the reproductive ages (there were 158,000 married women per million inhabitants, from 15 to 50
years of age in the department of the Seine as against 139,000 in France as a whole). Fecundity,
however, is lower in the towns (Seine 116, France 146, Basses Alpes 214, per 1,000 married women).
The excessive proportion of married women in the towns, he says, is due to the fact that immigrants
are in the main single persons eligible for marriage, or people recently married. Thus persons of reproductive
ages are leaving a centre of high for one of low fecundity.
In France, too, other and still more important influences of a very special character have undoubtedly
been at work ; thus, no study of the declining birth-rate in France can be complete, which does not
take account of the Napoleonic wars in the early years of the last century; of the famine, and political
crises ; and in later years, of the effects of the Crimean, Italian and Franco-German wars, of the taxation
imposed to pay off war debt, and finally of financial difficulties and disasters, such as those caused by the
silkworm disease, or the invasion of phylloxera. Another writer upon the French birth-rate, M.
Levasseur, states that, between 1791 and 1813, 41/2 million Frenchmen entered the imperial armies, and
he computes that some 1,800,000 of these yielded up their lives in Napoleon's campaigns. This loss, of
many of the best of its young adult males, may quite possibly have had a very serious effect, lasting for
many years upon the country's birth-rate. Even in the last war (1870-71), it is stated, that 139,000
Frenchmen were killed, and 143,000 wounded. In this country there has been no such disastrous loss
by war or famine, indeed, the Irish famine of 1847, drove many thousands of peasants over here, and
thus actually helped to raise the English birth-rates from the fifties to the seventies. There has, however,
in this country as in France, been large internal migration from the country to the towns ; and
there has of course in England been also much emigration and immigration, sometimes more of one,
sometimes more of the other, but the qualities qua birth-rate of the incoming and outgoing populations
have been by no means identical. The effect, produced by this interchange, upon the phthisis deathrate
has been discussed elsewhere ("Influence of Migration upon the Phthisis death-rate." Proc. Roy.
Soc. Med., Epidemiological Section, 1913), but it may here be noted that the movement in question must
also have had its influence upon the birth-rate. For many years this country was especially favourably
circumstanced, in that it was able to send away in considerable numbers its less desirable sections of
population, and with these may be included from a hygienic standpoint, persons going abroad for the
sake of their health; England is now, however, having its consumptives returned on its hands from
America and the Colonies, and it is losing at the present time, in addition to those who are " unfit," a
considerable number of its more active and enterprising young men and women.
In discussing the phthisis death-rate, in the above-mentioned paper, the migration of young
women from the country into the towns, and into England itself from Scotland and Ireland, was
especially referred to. It was noted, in this connection, that the writers of the Census report, of 1891,
had gone somewhat astray in dealing with this phenomenon, and had been led to deduce, from their
figures, the existence of a widespread tendency of women over 25 to understate, and of girls under 20 to
overstate their ages. In the last Census volume considerable modification of the position previously
taken up is made, and the larger part played by movement of population in the matter is emphasized.
It is moreover, important to bear in mind in this connection, that it is the quality as well as the quantity
of this migration that specially affects the question of birth-rate. M. Cauderlier has a few instructive
sentences on selection (in respect mainly of age) as it affects immigrants into Paris. He says children
and old people are not easy to move. Those who come alone are single men or single women; those
who come two at a time are man and wife, two brothers or two friends; when there are three, one of
them may be a child; and where four come two may be children; but it is rare for a family, in which
there are three or more children, to come to Paris, such a family is already established in the provinces
and remains there.
Special reference may here be made to some charts which M. Cauderlier gives in his book. He
shows (p. 261) curves of mortality for English males at different ages. In 1881, and 1891, the curve given
is the familiar one, which has a maximum at age 0-5, falls to a minimum at 10-15, and then shows a