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6
regarded, as yet, as more than an upward fluctuation but does appear to mark the
end of the recovery period.
Deaths under one year among illegitimate infants amounted to 39 per 1,000
illegitimate live births, compared with a rate of 30 for legitimate births. The
corresponding rates in 1947 were 47 and 34 respectively. A detailed comparison of
deaths in the legitimate and illegitimate groups is given in Table 6, page 119.
Stillbirths
There were 1,191 stillbirths in 1948, or 1.92 per cent. of all births (legitimate
1.85, illegitimate 2.84). The number of stillbirths and the rate per 1,000 total births
in each year since 1928 is shown in table 5, from which it will be clear that since 1942
there has been a considerable fall in the frequency of stillbirth. Possible reasons
were reviewed in the report for 1946, where it was suggested that an improvement
in the health of the mother as a result both of increased emphasis upon dietary
supplementation, of more effective ante-natal care generally, and more skilled
obstetric service had led to a sharp fall in the stillbirth rate.
Mortality
The total civilian deaths in 1948 amounted to 36,928, or 11.1 per 1,000 of the
civil population. Detailed figures are given in Tables 2, 3 and 4, on pages 115 to 117.
Mortality from infectious disease is discussed below under that heading, and tuberculosis
is dealt with separately. For the latter and other principal causes of death
the trend is indicated by the diagrams on page 9. The discontinuity between 1939
and 1940 is attributable to two causes. In the first place, the Registrar-General
abandoned the rules of selection which had hitherto operated in multiple causes of
death, and, as from 1940, accepted the principal cause of death as shown on the
medical certificate. In addition, the International List of Causes of Death, which
was revised in 1938, was applied in 1940 in accordance with international agreement.
The chief movements resulting from these alterations are estimated to be:—
Approximate change as a percentage
Cause of those formerly assigned to this
cause*
Influenza -11 percent.
Cancer — 3 „
Diabetes — 30 „
Heart disease — 10 „
Other circulatory diseases — 6 „
Bronchitis + 100 „
Pneumonia + 5 „
Other respiratory diseases +50 „
Nephritis + 12 „
Diseases of pregnancy, etc. + 10 „
* Based on the dual classification of deaths for England and Wales, 1939.
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