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 1945
[Report of the Medical Officer of Health for London County Council]
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8
Neonatal
mortality
frequently contracted, as a result of the efforts of health authorities in improving the
nursing and nutrition of infants. Prematurity is also less fatal though much still
remains to be done.
Deaths in various periods of the first year of life are shown in detail in table 5,
page 16. Deaths under 4 weeks numbered 1,047, or 23.0 per 1,000 live births
compared with a rate of 23.1 in 1944. Comparative rates for London and England
and Wales in recent vears are :—■
London
Enqland and Wales
1931-35 25.1 31.4
1936-40 22.9 29.0
1941 28.4 28.5
1942 24.7 27.0
1943 23.4 25.3
1944 23.1 24.5
1945 230 24.7
The more intense degree of adversity in London during the war is reflected by
the steep rise in the London rate in 1941, and the narrowing of the margin between
London and the country as a whole. In the later years of the war, however, despite
the continuation of difficulties, the mortality in London has been gradually brought
down toward the pre-war level.
Puerperal
fever and
pyrexia;
maternal
mortality
The basic figures in respect of the hazards of childbirth are as given below. Detailed figures for the metropolitan boroughs are shown in tables 1 and 8 and comparative figures for England and Wales in recent years are shown in table 7, page 17.
| Year | Live births | Deaths | Notifications | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Puerperal sepsis | Other childbirth | Puerperal fever | Puerperal pyrexia | ||||||
| No. | Rate | No. | Rate | No. | Rate | No. | Rate | ||
| 1945 | 45,532 | 32 | 0.70 | 56 | 1.23 | 188 | 4.13 | 472 | 10.37 |
| 1944 | 44,554 | 34 | 0.76 | 42 | 0.94 | 172 | 3.86 | 387 | 8.69 |
Rates per 1,000 live births.
The maternal mortality rate (1.93) in 1945 was higher than in 1944 (1.70).
There were more notified cases of puerperal sepsis (including post-abortion sepsis)
but relatively less mortality from puerperal fever. The introduction of sulpha,
drug treatment has led to a striking fall in the fatality from sepsis, as can be seen
from the diagram on the next page which shows the trend of maternal mortality in
London and in England and Wales in recent years.
The sharp rise in London in 1941 was not shared by the country as a whole,
and can be attributed to the effect of the bombardment, which reached its peak
intensity in that year and rendered it difficult to maintain the normal high standard
of hygienic control.
Infectious
diseases
The attack-rates and death-rates of the principal infectious diseases in London
during 1945 and earlier years, and for the constituent metropolitan boroughs in
1945, are shown in tables 1, 2 and 10. A comparison of the death-rates in London
and England and Wales is given in table 9, page 18.
Anthrax
No case of anthrax was notified during the year. London has now been free
from this disease since 1943.
Diphtheria
The attack-rate for diphtheria (0.49 notifications per thousand population)
in 1945 was slightly higher than in 1944 (0.46), but the death-rate, at 0.0092 per
thousand, was lower than in the previous year (0.015). Ten years ago mortality
from this disease was seven times as heavy. Approximately 70 per cent. of London
children have been immunised. While preventive inoculation does not give complete
protection, it does greatly diminish the risk of death. In England and Wales,
" out of every 30 children who died from diphtheria in the years 1942-43, 29 had not
been immunised. In 1944 this death-rate among the unimmunised was about