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6
The second cause affecting the statistics was the outbreak of war. A young and
healthy section of the population was, from September, 1939, excluded from the
mortality statistics, which henceforth related only to civilians. This selective factor
was bound to inflate the death-rates, since the population in respect of which they
were calculated was now on the average older and less healthy.
To mark the discontinuity in the diagram, the curves have been broken at 1939.
In so far as the slopes of the curves before and after 1940 are more important than
absolute figures, it is possible to take the two parts of the diagram together and to
observe continuity in trend. To reduce the confusing effect of the large-scale reclassification
of deaths, heart disease and bronchitis have been combined.
The death-rate from all causes, which, with the increasing age of the population,
had been slowly rising before the war rose sharply in 1940. This rise was
partly a feature of the war-time statistical basis as explained above, but the heavy
toll of air-raids (2.59 per 1,000 in 1940) was an important contributory factor. Even
in 1945 the fatality from V-bombs was 0.34 per 1,000, but for which the general
death-rate would have fallen to 13-8 per 1,000.
Tuberculosis
Another cause of the rise in the death-rate, notably in 1941, was the increase in
deaths from tuberculosis. This rise was only temporary and measured the effect of
war conditions in hastening the death of those with advanced tuberculosis (a).
When this source of increased mortality had been exhausted, the tuberculosis deathrate
returned toward a normal level. A similar trend was observed in certain other
European towns (b), Paris, Bucharest, Brussels, and in Belfast. In Paris (c), where
the pre-war tuberculosis death-rate was twice as high as in London, the peak rise
above 1938 (37 per cent.) was proportionately less than in London (72 per cent.).
Paris suffered more privation from rationing, but endured less bombardment with its
attendant shelter life, evacuation, loss of sleep, etc. In Prague, Budapest, Vienna
and Amsterdam (b) tuberculosis mortality continued to rise throughout the war
years. Information regarding Warsaw is incomplete, but in 1944 the death-rate for
tuberculosis was over three times the pre-war value (d).
Bronchitis
and heart
disease
The death-rate for the bronchitis and heart disease group has followed a similar
trend to that of the rate for " all causes " of which it forms a large part. Figures for
the component diseases are shown in table 2 (page 13). Mortality from heart
disease and bronchitis, after reaching a higher level in the early years of the war,
subsided, and for the last four years has remained relatively stable.
Pneumonia
and other
respiratory
diseases
Mortality from pneumonia rose sharply in 1940 and remained higher than
formerly until 1943, when it began to fall, reaching in 1945 a level lower than the
average of the immediate pre-war years. The rate for " other respiratory diseases "
was distorted in 1940 by the statistical revision but has since declined fairly
steadily.
Diabetes
Diabetes mortality has fallen steadily throughout the war. Food ratiomng has
presumably been a contributory factor.
Cancer
Despite the ageing of the population, the cancer death-rate has remained comparatively
stable in the last few years.
Road
accidents
Deaths from road accidents are analysed by age in table 4, page 15. The re-issue
of a basic petrol ration during 1945 and the corresponding increase in motor traffic is
reflected in a rise in fatal road accidents, the increase being more noticeable among the
very young and the very old.
Infant
mortality
The infant mortality rate in 1945, 44 per 1,000 live births, constitutes a new low
record, an improvement on the previous record of 47 per 1,000 live births in 1939.
The movements of the death-rates from the principal diseases at ages below one year
(a) Stocks, P. (1942) British Medical Journal 2.750.
(b) Tuberculosis Reference Year Book (New York).
(c) Maclouf, A., and Moine, M. Revue de Pathologie comparee et d'Hygtene generale, 1946.
(d) U.N.R.R.A. Bulletin, IV, 7-