London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1923
[Report of the Medical Officer of Health for London County Council]
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compared with the census population in the same period. The difference between
the two columns is largely dependent upon the growth of population by immigration.
With regard to the figures represented by the last column (relating to the years
1920.22), it should be noted that 1920 was a year in which the number of births was
greatly in excess following upon the return to civil life of those on war service ; on
the basis of the average for the two years 1921 and 1922, the excess of the actual
population would be considerably less, and is indicated in the diagram by an arrowhead
shown in the column for the period 1920.22.
In Section 5, the relationship between the sexes in the life.table population is compared
with that given by the census for successive periods. The excess of females
in the actual population is greater throughout, and this is due to the attraction to
London of young women, principally for domestic service. It is noteworthy that
in the life.table population the excess of females was greatest in the sixties,
thereafter there has been a continuous decline not impossibly connected with the
increased employment of women in business. The large excess of females in the
census population in 1921 is, of course, the result of the war.
In Section 6 of the diagram, the death.rate and birth.rate calculated on the
enumerated population are contrasted with the life.table figures; the life.tables
give the true death.rate of the population, that based on the census population
and registered deaths being distorted by changes in the birth.rate, in the course of
time, and by the effects of migration. The average death.rate for London in 1920.22
was, on the basis of estimated population and deaths recorded, 12.9 per thousand.
If this were the true death.rate Londoners would have an expectation of life equal
to 1000/12.9 or 78 years. Actually the expectation, as appears from the life.table for
1920.22 was about 56 years.
Smallpox. The year 1923 marks another successful period in dealing with the prevention
of smallpox in London, only 11 cases with one death having occurred during the year.
There is probably no branch of public health administration which has achieved better results in the prevention of disease during the past 20 years than that which deals with the control of smallpox in London, as the following table which compares the recent figures with those of earlier years will demonstrate :—
| Quinquennia. | Deaths from smallpox. | Admissions to M.A.B. hospitals (first hospital opened 1.12.70). | Uases of smallpox (i) in London and (ii) in England and Wales. | ||
|---|---|---|---|---|---|
| England and Wales. | London. | ||||
| London. | England and Wales. | ||||
| 1871.75 | 47,320 | 9,914 | 16,455 | — | — |
| 1876.80 | 9,226 | 5,625 | 16,818 | — | — |
| 1881.85 | 10,443 | 5,486 | 23,457 | — | — |
| 1886.90 | 1,846 | 42 | 244 | — | — |
| 1881.95 | 2,980 | 367 | 4,822 | — | — |
| 1896.1900 | 1,078 | 33 | 349 | — | — |
| 1901.05 | 4,263 | 1,591 | 10,516 | — | — |
| 1906.10 | 83 | 2 | 50 | — | — |
| 1911.15 | 59 | 13 | 88 | 86 | 691 |
| 1916.20 | 77 | 10 | 121 | 80 | 782 |
| 1921 | 5 | 0 | 2 | 2 | 336 |
| 1922 | 27 | 20 | 72 | 65* | 973 |
| 1923 | 7 | 1 | 13 | 11 | 2,493 |
| 1st quarter of 1924 | ? | 0 | 0 | 0 | 1,003 |
•The majority of these occurred in an institution and were infected before the true character of the disease
had been revealed.
This table shows that, in spite of the fact that smallpox has been steadily gaining
ground since 1920 in the rest of the country, London has enjoyed comparative
freedom from its ravages, and when the fact of London's special vulnerability is taken
into account, the results shown are the more remarkable. The success must be attributed
to the close co.operation on the part of the Ministry of Health, the Council,