London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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noted during War service, and most authorities state that War neurosis occurred
almost exclusively in the constitutionally highly strung. It was noted,
especially among the women, that home worries were an important factor,
many of them having to bear heavy domestic responsibilities, often including
the nursing of elderly parents and other sick relatives.
(/) As shown below, the age group at which " breakdowns" took place
was later in the second series :-

Table 55.


This difference is also shewn in the age-distribution of the deaths:-

Table 56.


Deaths from respiratory (tuberculous and non-tuberculous) disease were
both somewhat fewer than in the earlier series. The influence of the 1929
influenza epidemic is to be noted, for in that year there were 3,118 deaths
from the disease among the general population of London.
(g)So far as influenza itself is concerned, there were only three deaths
in the period under review, as compared with twenty-four during 1925-1929.
(h) Accidents were twenty-one as against twenty-two in the former analysis.
Thus, it will be seen that there has not been the rise that would be anticipated
from the general increase in street fatalities.
of service
The annual average number of elementary, excluding special, school teachers
on the staff for the years under review was 5,649 men and 12,038 women, making a
total of 17,687. The average number of elementary, excluding special, school
teachers leaving the service on all grounds annually, was 925. The average number
of those lost by disease, was 139 (56.8 deaths and 82.2 breakdowns), and those
who left on account of other causes, 786, i.e., taking up other appointments, voluntary
retirements at age 60.65, marriage, domestic circumstances, giving up teaching,
going abroad, compulsory retirement, and miscellaneous reasons. It has been
ascertained that in only a very few of these cases has ill-health been even a
contributory factor. Thus it may be said that about 15 per cent, of the annual
wastage is due to death or disease.
It will be seen that the loss to the service through breakdown in the younger
teachers was nil, and only slight (23 cases) in those up to 40 years of age. In this
latter group also, the deaths were few and many of them were due to such causes
as accidents, pneumonia and encephalitis lethargica, from none of which the young
and healthy are immune.
In 1929, it was noted that while women broke down more frequently than men,
the deaths among men were relatively much more numerous. The figures for the
present quinquennium illustrate these facts even more strongly, the yearly average
Males Females
Deaths 1 in 237 1 in 365
Breakdowns 1 in 435 1 in 174
so that a woman is more than twice as likely to be obliged to retire on health grounds
as a man (2.5 :1), but is less likely to die in the service (1 :1.5). In general, the
findings support the suggestion put forward in 1929, that many men have family
obligations and so struggle on when their health would indicate retirement.