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where deaths occur among persons removing from London to institutions or nursing
homes outside the County, the deaths are transferred back to London, and the
proportion of persons able to afford such institutional treatment is necessarily
greater among boroughs of the better class, although, as will be seen from the following
table, the administration of the Council's Tuberculosis Scheme has considerably
modified the relation between the better class and poorer boroughs in this respect:—
Increase, per cent., by transfers.
Period
Boroughs largely occupied by Boroughs largely occupied by
well-to-do. poorer class.
1911-13 6.7 1.4
1919-21 5.6 1.5
1923-25 1 4.9 3.0
The second point is that the earning power of workers stricken with phthisis
is at once reduced so that there is a tendency for such persons to drift downwards
in the social scale; and the last stage of self-support is represented, in a number of
cases, by housing accommodation of the poorest type, including common lodginghouses.
No recent records are available in regard to the mortality among the
occupants of common lodging houses, but figures abstracted in 1906-8 show that a
considerable proportion of the deaths in certain boroughs occurred among persons
whose last known address before admission to institutions was a common lodginghouse.
In Holborn such deaths formed 29.0 per cent. of the total; in Westminster,
18.5; and in Stepney 16.9. The percentage of the total deaths in London which
occurred in the common lodging-house population at ages 45-55 was 6.3; ages 55-65,
10.6, and 65-75, 12.2.
The heavy incidence of phthisis upon this class is shown by the following comparison
of the percentage of phthisis deaths to deaths from all causes in the male
common lodging-houses population and in London as a whole for the year 1905:—
Population: 25- 35- 45- 55- 65+
Common lodging-house population 54.3 52.9 48.3 30.8 11.2
London County 39.9 31.0 23.0 11.9 2.7
In the annual report of the County Medical Officer of Health for 1909, page 58,
it is shown that the graduation of phthisis mortality according to "social condition"
in London is similar to the graduation of the London phthisis death-rate in successive
decennia. Similar figures for the age-groups with which we are mostly concerned
here and for more recent years are shown in the following Table, where the phthisis
mortality is also shown as a percentage of the deaths from all causes. It will be seen
from the latter figures that the difference in phthisis incidence in successive decennia
is almost completely correlated to the change in the general death-rate
Phthisis death-rate per 100,000 living. Phthisis, per cent. of all causes.
Age period.
1881-90. 1891-00. 1901-10. 1881-90. 1891-00. 1901-10.
Males—
5-15 27 19 15 6 5 5
15-25 172 146 120 36 35 34
25-45 444 377 291 39 36 36
45-65 516 482 419 17 16 16
Total of Rates 1,159 1,024 845 98 92 91
1901-10=100 137 121 100 109 101 100
Mortality in
successive
decennia.