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London County Council
INTERIM REPORT OF THE
COUNTY MEDICAL OFFICER OF HEALTH
AND SCHOOL MEDICAL OFFICER
FOR THE YEAR 1942
By W. Allen Daley, M.D., F.R.C.P., County Medical Officer of Health and
School Medical Officer.
INTRODUCTION
This interim report sets out in an abbreviated, and mainly statistical, form
the salient features about the health of Londoners during 1942, at the beginning
of which we had already endured 28 months of war. Fortunately the intensive air
bombardment of 1940 and 1941 was not resumed, but there were occasional raids
and the medical and other civil defence services were manned and in a state of
readiness for instant action throughout the year. The drain of man-power and
woman-power into other forms of war work continued, and caused increasing strain
on those remaining to carry out the work of the department.
It is not possible to give the population of London, but the number of children
in the metropolis increased substantially during the year and this was reflected in
increased activity in the school medical and hospital services. As in 1941, the
report gives only the numbers of deaths and of notifications from infectious diseases
and not the rates per 1,000 of the estimated population. Rates based on births
are, however, provided. The deaths relate to those with a domicile in London,
independently of whether the death actually occurred in London or not. Similarly,
the domicile of a mother, and not where the birth occurred, determined whether
the birth of her child was counted as a London birth or not.
The deaths of Londoners numbered 43,537 in 1941, and 36,057 in 1942. Deaths
from violence, including air raids, and from street accidents showed a substantial
reduction. Deaths from influenza were only 198, compared with 397 in 1941, and
from rheumatic fever 29, compared with 40. Infectious diseases showed gratifying
decreases: cerebro-spinal fever 105 to 46, enteric fever 17 to 5, measles 51 to 31,
and diphtheria 82 to 51. There was also a reduction in deaths from pneumonia
from 2,524 to 2,064. The increased numbers of children immunised against
diphtheria have, no doubt, contributed to this decline, but many more will have to
be immunised before we achieve the almost complete disappearance of diphtheria
as a cause of death which has occurred in certain American cities. Scarlet fever
again made only a negligible contribution to the death-rate, 1 death in 1942
and 2 in 1941.
The births numbered 40,654, compared with 33,944 in 1941, the proportion of
male to female births being 1,061 male to 1,000 female, compared with a proportion
of 1,057 male to 1,000 female for the five pre-war years. Illegitimate births, included
in the 40,654, numbered 3,015, a percentage of 7.4 compared with 6.3 in 1938.
The rate of neo-natal mortality declined from 28.4 per 1,000 live births in 1941
to 24.7 in 1942, and the rate of infantile mortality from 57 to 50. The record low rate
47, was attained in 1939. The rate in 1917, the corresponding period of the last
war, was 104.
The rate of maternal mortality was 2.51 in 1942 and 3.05 in 1941, but the rates
of 1940 and 1939, 1.98 and 1.97, respectively, remove any ground for complacency.
No statistics are available relating to the total amount of illness among the
population, not even among those entitled to medical benefit under the National
Health Insurance Act, and our only information on morbidity is the number of cases
600 (M°C. 50301) 1969 (1)