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 1929
[Report of the Medical Officer of Health for London County Council]
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borough of Camberwell for the past three years and as comparison of the age-groups
of new cases and of deaths in that area with the corresponding London figures
showed reasonably close agreement it has been assumed that the London agedistribution
of cases is generally similar to that of Camberwell.
The result of comparison of the known cases among mental patients and in the general population thus arrived at is shown in the following table, giving the number of cases which are known among mental patients and the number which would be expected if the incidence among them was the same as that in the general population:—
| Sex. | Phthisis. | Other tuberculosis. | ||
|---|---|---|---|---|
| Actual cases 1925-7. | Expected cases (on London rates). | Actual cases 1925-27. | Expected cases (on London rates). | |
| Males | 290 | 258 | 44 | 27 |
| Females | 429 | 171 | 53 | 31 |
The figures appear to indicate no very marked excess in the percentage of male
mental patients suffering from phthisis, but among female patients the number
tuberculous is shown to be about two-and-a-half times that of the normal population.
Death-rates
There is less difficulty in arriving at similar comparisons of the mortality from
tuberculosis, though the fact has to be borne in mind that more than eight years
have elapsed since the last census of the population of London, a circumstance
affecting the accuracy of the London rates. The figures are as follows:—
Sex.
Phthisis.
Other tuberculosis.
Actual
deaths
1925-27.
Expected deaths
(on London rates).
Actual
deaths
1925-27.
Expected deaths
(on London rates).
Males 108 43 16 2
Females 156 23 19 2
The deaths from pulmonary tuberculosis among male patients are shown to
be about two-and-a-half times as great as the normal, while among female patients
the rate is nearly seven times that of the corresponding London population. The
figures for deaths are consistent with those for cases in the excess shown among
females, but it might have been expected that with so marked an excess of deaths
the excess of cases would have been greater than the figures show.
In considering the mortality from pulmonary tuberculosis among adults in
different populations, it is essential at the same time to take into account the
general death-rate of the population concerned. The question of the relation of
the general death-rate and the phthisis death-rate among adults was discussed in the
Annual Report for 1926 (Vol. III., pp. 20-28), where it was shown that the phthisis
mortality varied very closely with the mortality from all causes whether different
localities or different periods of time or different social groups or different occupational
groups were considered, the conclusion being that phthisis mortality is determined
by much the same causes as govern the general death-rate, nutrition being
the most important factor.
In order, therefore, to interpret the phthisis death-rate of the mental hospitals
populations the death-rate from all causes must be brought into account. The rates
for the same periods as those for which tuberculosis death-rates have been given
are as follows:—
Sex.
i Actual deaths from all
causes 1925-27.
Expected deaths from all
causes (on London rates).
Males 1,830 562
Females 2,139 739