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It will be noted that while the London rates for ages under 10 years are generally
in excess of those for England and Wales, this excess has gradually declined, and
in the past twenty years there is little difference between the two sets of figures.
From the third table, showing the London rates, England and Wales being taken
as 100, it will be seen that the excess in the London mortality is generally greater
at age 0-5 and 5-10, but that at age 10-15 the London rate is generally below the figure
for England and Wales. It might perhaps be urged that the more adverse environment
of the London children in the earlier decennia, when England and Wales was less
urbanised, resulted in the elimination of weaklings, so that the surviving population,
on attaining the age of 10 years, was healthier than the generally more favourably
circumstanced population of England and Wales as a whole. This is consistent
with Dr. E. C. Snow's conclusion that "natural selection, in the form of a selected
death rate, is strongly operative in man in the early years of life." (The Intensity
of Natural Selection in Man. Drapers' Company Research Memorial, 1911.)
The age of lowest mortality falls within the age group 10-15 years. Figures
relating to the three years 1920-1922 show a minimum rate at 13 years of age, the
death-rate at that age being less than one-sixth of that for all ages.
The principal causes of death at school age are the common infectious diseases
(especially diphtheria), tuberculosis, diseases of the heart and respiratory diseases.