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 1934
[Report of the Medical Officer of Health for London County Council]
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15
There is, it will be observed, a marked decrease upon the initial percentage in
the case of tuberculosis and bronchitis, and a noteworthy increase in the percentage
of pneumonia deaths.
With regard to premature births and congenital defects, the borderline of distinction
is not sufficiently definite for any reliable deduction to be made from the
relative changes in the percentage of deaths from these causes ; and possibly, in
the case of pneumonia, the increase may partly or wholly represent an increased
preference for pneumonia over bronchitis on the certificate of the final cause of death.
The remarkable decrease in infant mortality during the past twenty years is
common, in much the same degree, to areas of differing social condition or environment
in London. For the purpose of illustrating the variation of the rates according to
the class of locality, tables were given in the annual reports of the medical officer for
the years 1908 to 1910, which showed the mortality rates for certain groups of metropolitan
boroughs. The test of social condition or environment used in the reports
referred to was the percentage of persons living more than two per room, and on
this basis the metropolitan boroughs were classed into five groups. Group I represented
the boroughs with best environment or social condition and comprised those
with less than 7.5 per cent, of the population living more than two per room, while
at the other extreme group V contained all boroughs in which the proportion so living
was 27.5 per cent, or more.
Similar tables have been prepared for the period 1930-1932 for purposes of comparison.
There have, of course, been changes in the status of some of the boroughs in
the intervening twenty years, but it will be seen that notwithstanding these changes
the graduation of the rates for the five groups in the period 1930-1932 is very similar
to that for the years 1908-1910, and it is, therefore, reasonable to assume that the
mode of grouping adopted affords a satisfactory basis of comparison.
| Group. | Deaths per 1,000 births. | ||||||
|---|---|---|---|---|---|---|---|
| During first week. | During first month. | During first year. | |||||
| 1908-10. | 1930-32. | 1908-10. | 1930-32. | 1908-10. | 1930-32. | Decrease per cent. | |
| I | 20 | 19 | 32 | 27 | 83 | 55 | 34 |
| II | 22 | 18 | 36 | 22 | 106 | 59 | 44 |
| III | 21 | 18 | 36 | 25 | 108 | 68 | 37 |
| IV | 23 | 17 | 37 | 25 | 112 | 70 | 38 |
| V | 22 | 17 | 36 | 24 | 127 | 72 | 43 |
| Total | 22 | 18 | 35 | 25 | 108 | 64 | 41 |
In the last column of the table the percentage decrease of the infant mortalityrates
in each group for the first year of life is given, and, allowing for the fact that
considerable changes in density of population have occurred in some of the boroughs,
these percentage figures may be taken to indicate a practically constant rate of decline
among the different classes of population concerned.
The first point of particular interest in the figures is the fact that at the earliest
period of life the mortality-rates are apparently not affected by the differing environmental
conditions, and show less improvement relatively in the course of the
twenty years, there being only a decrease of 18 per cent, in the mortality during the
period. There is some slight indication in the figures for 1930-1932 that the infants
born to mothers in the more densely populated or poorer boroughs have a better
survival rate in the first week of life than those born in the better class areas. The
second point is the remarkable fact that the infant mortality in the first year of life
at the present time in the poorest group, comprising Bethnal Green, Finsbury,