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 1946
[Report of the Medical Officer of Health for London County Council]
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9
The increase in deaths assigned to congenital malformations is partly attributable
to changes in classification following the adoption of the 5th revision of the International
List of Causes of Death which added about 12 per cent, to the deaths which
would formerly have been assigned to this group. For most diseases there has been
a dramatic reduction in mortality over the last forty years, and, even since 1927, the
improvement is substantial. Since evacuation disturbed the normal biennial
sequence of epidemic outbreaks, the incidence of measles in London up to the end of
1946 has been comparatively light and this partly explains the low mortality, but
there has also been a striking reduction in case mortality in recent years. The equally
pronounced fall in the case-mortality of whooping-cough has also helped to bring
down the infant mortality rate. Diarrhoea and respiratory infections too are now less
frequently contracted, as a result of the efforts of health authorities in improving the
nursing and nutrition of infants. In particular, increasing attention has been paid
to the care of the premature infant, and there are signs that these efforts are having
a salutarv effect on the mortality risk.
Neonatal
mortality
Comparative rates lor London and England and Wales in recent years are:—
| London | England and Walts | |
|---|---|---|
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 manifold difficulties, the mortality in London was gradually brought down to
pre-war level, and it continued to fall.
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 3 and 11 and comparative figures for England and Wales in recent years are shown in table 10, page 24.
| Year | Live births | Deaths | Notifications | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Puerperal sepsis | Other childbirth | Puerperal fever | Puerperal pyrexia | ||||||
| No. | Rate | No. | Rate | ||||||
| 61 | |||||||||
Rates per 1,000 live births.
The maternal mortality rate (1.26) in 1946 was much lower than in 1945 (1.93)
and constitutes a new low record.
The trend of maternal death-rate in the administrative county of London
from 1891 is shown by the figures in table 4. It will be observed from the table that
maternal mortality fell very slowly until the introduction of the sulphonamides, in
the middle thirties, resulted in a substantial decline in the mortality from puerperal
infection. Indeed, but for the war-time increase in abortions with their relatively
higher risk of infection, the sepsis mortality would be an even smaller proportion of
the total than is indicated by the table. In recent years puerperal sepsis has lost