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The depletion of sanitary staffs was brought under the notice of the Local Government Board,
and in the closing months of the year difficulties with regard to removal of house refuse in two or
three London boroughs assumed serious proportions, and representation was made to the Board on this
subject also.
The report concludes with statements relating to the Mental Deficiency Act, the Midwives Act,
lying.in homes, and the work carried out in the chemical and analytical branch of the public health
department.
Thanks are especially due to borough medical officers of health for help freely given, and for
enabling the summary in the table on p. 20 to be prepared.
Population.
A.—Vital Statistics.
The population of London County at the census of 3rd April, 1911, was 4,521,685, and it
was estimated by the Registrar.General to have decreased to 4,518,021 by the middle of 1914;
this latter estimate being based in part on the records of births and deaths since the census year, is the
last reliable one made of the London population. In the middle of 1915 the total civil population of the
county was estimated by the Registrar.General at 4,310,030, this figure being deduced from the National
Register of persons aged 15.65, compiled in August, 1915. The Registrar.General estimates the corresponding
population in the middle of 1916, at 4,237,387, based upon the register of 1915, as amended
by records of subsequent movements of the registered population.
There is reason to believe that this estimate is too low. Attention has been directed in previous
reports to the continued outward movement of the London population, and it was shown in the report
for 1913 (p. 3) that this migration mainly affected persons below 15, whose movements would not be
recorded in the National Register. While there is no reason to doubt that this outward movement
continued during 1914, and though to a diminished extent in 1915, it is certain that the gradual cessation
of all building operations since 1914 has practically put an end to all outward movement from London
to the outlying districts. Decreased railway services and increased fares have tended to set up an opposite
movement inwards. From the beginning of 1915 to the end of 1916, the births in London exceeded
the deaths by nearly 67,000, and to this increase must be added thousands of refugees who have found
accommodation within the County; few, if any, of the important London factories or workshops are
idle, and there has been little unemployment except in the first months of the war. Against the factors
tending to maintain or increase the civil population, account must be taken of the decrease due to
enlistment, which, while it undoubtedly in the course of 1916 exceeded the gain as well by inward movement
as from natural increase and immigration, probably did no more than maintain an even balance
up to that time. These observations may throw some light upon the estimates of the Registrar.General.
In the middle of 1914, the estimate was 4,518,021—practically all civilians. In 1915 the civilians
numbered 4,310,030; hence it was calculated that about 200,000 represented not the number of enlistments,
but the balance between, on the one hand, immigration of refugees, plus natural increase, plus
inward movement from the suburbs, if any, and on the other, civilians withdrawn for active service.
From the middle of 1915 to the middle of 1916, the decrease is estimated by the Registrar.General at
about 73,000. Regard being had to the fact that the Derby Scheme came into operation at the end of
1915, and Conscription early in 1916, it will be seen that these estimates allow a considerable augmentation
of the civil population of London during this period, and this augmentation must have been mainly
due to inward movement from the outlying districts—plus natural increase. This inward movement
of population will undoubtedly result in increase of overcrowding in the county, a fact of serious import
to the public health.
The population of the metropolitan boroughs in the middle of 1916, as estimated by the Registrar.
General, is given by him in the 14th weekly return of 1917, and is reproduced in the table appended
to this report (page 19).
Marriages.
The marriages registered in London numbered about 43,800, as compared with 58,354
in 1915 and 43,373 in 1914. The decrease in 1916 is greatest in the latter half of the year, and the
abnormally high number of marriages during the progress of the war probably fairly corresponds with
the movements of enlistment. In the fourth quarter of 1916 the marriages numbered 10,859, as compared
with the corresponding pre.war figure in 1913 of 10,929. In the first quarter of 1917 the marriages
numbered 8,070, as compared with 7,257 in the corresponding quarter of 1914; hence, in this respect,
normal conditions appear to have been re.established. The calculation of a marriage rate for comparison
with pre.war figures is a matter of difficulty owing to the fact that the marriages include men
on active service, while the published estimate of population relates to civilians only. The Registrar.
General calculates a rate of 19 per 1,000 for 1916. In 1915 the rate was probably about 26 per 1,000.
Births.
The births in London County during 1916 numbered 99,336, as against 102,117 in 1915 and
109,952 in 1914. The births in 1916 are not evenly distributed in the four quarters of the year as would
normally be the case, there being, relatively speaking, an excess in the second quarter. In part, this
excess is no doubt due to the increased number of marriages in the summer of 1915.
The estimation of a birth.rate comparable with pre.war conditions is, for the reasons mentioned
above in regard to the marriage rate, a matter of difficulty. The Registrar.General gives a rate of 21.5.
The corresponding rate in 1915 would probably be about 22.5 per 1,000, and these rates may be
generally compared with the 1914 rate of 23.6 and that of 25.0 in the pre.war period 1909.13.
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