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

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London County Council 1917

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

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by the middle of 1914. From 1915 onwards, estimates of the civil population of London have been
made annually by the Registrar-General from the records of the National Register compiled in August,
1915. In preparing the estimates for 1917 the effect of the revision of the Register early in 1918 has, of
course, not been taken into account, and consequently the estimate of 4,026,901 civilians in 1917 is
probably less accurate than the figures of the two preceding years. The considerable amount of
material collected in connection with food rationing schemes should afford a more accurate basis for
estimating the recent populations, and perhaps at a later date this material may be made available.
The population of the Metropolitan Boroughs in the middle of 1917, as estimated by the RegistrarGeneral,
is given in his 14th weekly return of 1918 and is reproduced in table II. appended to
this report.
Marriages.
The marriages registered in London numbered about 39,400 as compared with 43,855 in 191G»
58,354 in 1915 and 43,373 in 1914. During the first half of the year the marriages recorded are about
equal to the numbers in 1911-14.
The marriage rate for the year 1917 is estimated at 17 per 1,000, the corresponding estimates
for 1916 and 1915 being 19 and 26 respectively. The average for the pre-war period 1911-14
was 18.5.
Births.
The births in London daring 1917 numbered 80,550 as against 99,336 in 1916. The average
anuual number born in the four pre-war years 1911-14 was 110,951. The decline in 1917 upon the
average for 1911-14 was greatest in the socond half of the year, and amounted to over 30 per cent.
The Registrar-General estimates the London birth-rate for 1917 at 17.9, comparing with 21.5
in 1916, and 24 5 in 1911-14.
Deaths (all causes).
The deaths among the civil population of London during 1917 numbered 63,406 as compared
with 62,325 in 1916. The Registrar-General gives the death rate as 15 7 per 1,000 as against 14.7 in
1916.

The distribution of the deaths by ages, in 1917 and the three preceding years, is shown in the following table:—

Year.0-1—2—5-10—15—20—25—35—45—55—65 +All ages.
191411,4773,1892,6541,5119161,1881,36;3,6475,3657,4458,59718,68766,037
191511,4644,0443,4131,7729981,2311,3693,4505,5157,8599,52421,75472,393
19168,8642,6222,2981,4028661,1611,1713,2064,7366,7808,62820,59162,325
19178,4003,1332,8391,4079081,2941,1883,1394,7476,8978,69920,75563,406
Increase(+) decrease(—)1917 over 1916—464+511+ 541+ 5+ 42+133+ 17— 67+ 11+ 117+ 71+ 164+ 1,081

The extremely cold weather experienced in the first, quarter of the year caused a considerable
number of death? among persons over 65 years of age, the total deaths at that age during this quarter
being more than 20 per cent. above the quarterly average for the preceding six years. On the other
hand the favourable weather conditions later in the year resulted in a remarkably low autumnal
mortality at all age.3.
The prevalence of measles is responsible for the greater proportion of the excess inmortality at
ages between one and five years in 1917, as compared with 1916 ; apart from the mortality at this
age, the two years show remarkable similarity.
Infant
mortality.
The reduction in mortality among infants under one year of age apparent in the above table, is
due in a large measure to decrease in the number of births ; but the death-rate did not exceed 104 per
1,000 born. This relatively small death-rate is largely due to the low mortality from infantile diarrhoea
during the summer, when no abnormal heat was experienced. The corresponding mortality rates for
1916 and 1915 were 89 and 112 respectively. In comparing the figures for 1917 with those for the year
1916 (when the infant mortality was the lowest recorded) it is found that the greater part of the excess
in 1917 occurred in the first quarter of the year, (115 as compared with 92 in 1916) when the climatic
conditions were unusually severe.
The mortality from whooping cough was much below the average although in the closing weeks
of the year the prevalence due in 1918 was clearly foreshadowed. The death-rate from this cause in the
first quarter of 1918 exceeded the rate in any year since 1896.
The effect of restriction in the sale of intoxicants in decreasing mortality from overlying was
discussed in last year s report; the decline noted is maintained in 1917 exccpt in the first quarter when
the deaths, which in the corresponding quarter of 1916 were 47, rose to 72. This marked increase in
these fatalities is probably attributable to the abnormally cold weather in this quarter. A similar
increase in overlying mortality occurred during the exceptionally cold winter of 1890-91.
The Medical Research Committee issued in 1917 a report on " The Mortality of Birth, Infancy
and Childhood," which includes an analysis by Dr. W. A. Brend of " The Relative Importance of Prenatal
and Post-natal Conditions as Causes of Infant Mortality." Dr. Brend briefly reviews the causes
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