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 1937
[Report of the Medical Officer of Health for London County Council]
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The movement of the death.rates from the principal diseases at ages below one year since 1910 are shown in the following table:– Table 5
| Cause of death | 1911 to 1914 | 1915 to 1918 | 1919 to 1922 | 1923 to 19.26 | 1927 to 1930 | 1931 to 1934 | 1933 | 1934 | 1935 | 1936 | 1937 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Measles | 3.40 | 3.84 | 1.64 | 2.02 | 2.07 | 1.44 | 0.28 | 2.60 | 0.07 | 2.35 | 0.05 |
| Whooping.cough | 3.63 | 4.45 | 2.50 | 2.60 | 3.14 | 2.27 | 2.45 | 1.88 | 1.77 | 2.51 | 2.73 |
| Influenza | 0.27 | 1.10 | 0.81 | 0.38 | 0.48 | 0.40 | 0.46 | 0.30 | 0.18 | 0.27 | 0.40 |
| Tuberculosis | 3.40 | 3.20 | 1.52 | 1.26 | 0.89 | 0.77 | 0.83 | 0.60 | 0.56 | 0.71 | 0.44 |
| Bronchitis | 6.41 | 6.72 | 4.42 | 2.91 | 2.30 | 2.16 | 1.50 | 2.48 | 1.90 | 2.26 | 1 .95 |
| Pneumonia | 12.28 | 14.96 | 12.60 | 11.51 | 12.10 | 11.45 | 8.27 | 13.40 | 9.79 | 11.42 | 10.83 |
| Diarrhœa | 24.28 | 16.10 | 12.16 | 9.36 | 8.87 | 10.86 | 10.70 | 12.01 | 10.61 | 13.79 | 11 .62 |
| Premature birth | 1816 | 17.42 | 17.00 | 14.74 | 1417 | 14.91 | 15.23 | 14.65 | 14.11 | 13.13 | 13.60 |
| Congenital defects | 14.69 | 14.66 | 11.26 | 8.39 | 7.38 | 7.22 | 6.84 | 7.81 | 6.88 | 6.97 | 6.14 |
| Other causes | 21.48 | 20.55 | 15.09 | 11.83 | 12.60 | 13.52 | 13.44 | 11.27 | 12.01 | 12.47 | 12.40 |
The death.rates from various causes shown above are stated in the following table as a proportion of the deaths from all causes in each of six successive four. yearly periods and the three.year period 1935.1937:– Table 6
| Cause of death. | 1911 to 1914 | 1915 to 1918 | 1919 to 1922 | 1923 to 1926 | 1927 to 1930 | 1931 to 1934 | 1935 to 1037 |
|---|---|---|---|---|---|---|---|
| Measles | 3.1 | 3.7 | 2.1 | 3.1 | 3.2 | 2.2 | 1.3 |
| Whooping.cough | 3.4 | 4.3 | 3.2 | 4.0 | 4.9 | 3.5 | 3.8 |
| Influenza | 0.3 | 1.1 | 1.0 | 0.6 | 0.8 | 0.6 | 0.4 |
| Tuberculosis | 3.1 | 3.1 | 1.9 | 1.9 | 1.4 | 1.2 | 0.9 |
| Bronchitis | 6.0 | 6.5 | 5.6 | 4.5 | 3.6 | 3.3 | 3.3 |
| Pneumonia | 11.3 | 14.5 | 15.9 | 17.7 | 18.9 | 17.6 | 17.3 |
| Diarrhœa | 22.5 | 15.6 | 15.4 | 14.4 | 13.9 | 16.7 | 19.7 |
| Premature birth | 16.8 | 16.9 | 21.5 | 22.7 | 22.1 | 23.0 | 22.3 |
| Congenital defects | 13.6 | 14.3 | 14.3 | 12.9 | 11.5 | 11.1 | 10.9 |
| Other causes | 19.9 | 20.0 | 19.1 | 18.2 | 19.7 | 20.8 | 20.1 |
| All causes | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 |
The infant mortality.rate has remained remarkably uniform since 1922. In the
period 1911.1922, the average annual rate was 97 per 1,000 births, but for 1923.1934
it has varied little from an average of 65, representing a decrease of nearly one.third.
No doubt the rate for 1911.1922 would have been lower but for the adverse conditions
of war time; but the conditions, whatever they were, which brought about the
marked decline down to 1922 appear thereafter to have reached the limit of their
good effect.
When the changes in the proportion of deaths from various causes are considered,
the percentages do not show any marked variation except in the case of tuberculosis.
Thus the measles and whooping.cough deaths in the period 1911.1922 formed
6.6 per cent, of the total and 7.0 per cent, in 1923.34; respiratory diseases 19.9
and 21.9 per cent.; diarrhoea and enteritis 17.8 and 15.0 per cent.; premature
birth and congenital defects together 32.5 and 34.4 per cent.; all other causes
23.2 and 21.7 per cent. Broadly, one may say that each of the diseases comprised
under these headings has reacted equally to the conditions prevailing in the two
periods.
With regard to tuberculosis, the decrease in proportion from 2.7 to 1.5 seems to
indicate some specific factor acting in addition to that which has caused the general
improvement observed; in regard to this undoubtedly the notification of tuberculosis
(since 1912), and the subsequent extension of the work of the tuberculosis dispensaries,
must be considered; but the increasing accuracy of death certification is an unknown,
and undoubtedly important, factor.