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7
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. The rate for 1948, at 11.1,
represents a substantial improvement on the pre-war mortality.
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 disease. Recent
experience in both mortality and morbidity is more fully discussed in a later paragraph.
Tuberculosis
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 3 (page 116). Mortality from heart
disease and bronchitis, after reaching a higher level in the early years of the war,
subsequently declined. The 1947 figure is an upward fluctuation in this general trend
and reflects the severe winter. The 1948 figure is very much lower and marks a
return to the trend which was being followed immediately prior to 1947. After
allowing for the changes in classification outlined above, it can be said that the 1948
death-rate from heart disease is 10 per cent. below the level of 1936-40, and the
1948 death-rate for bronchitis is about one-half of the rate experienced in the period
1936-40. These two reductions are the chief elements in the fall in the general
death-rate.
Bronchitis
and heart
disease
Mortality from pneumonia rose sharply in 1940 and remained higher than
formerly until 1943, when it began to fall, reaching in 1945 and maintaining in 1946
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 thereafter
declined fairly steadily. In 1947, however, there was an increase in respiratory
mortality, associated with the severe weather conditions of February and March.
In contrast, 1948 was a year of very light mortality for respiratory disease. The
death-rate for pneumonia fell to 0.54 per 1,000, well below the previous low record
of 0.67 of 1935.
Pneumonia
and other
respiratory
diseases
Diabetes mortality has been falling steadily since 1939, partly as a result of
more effective treatment and partly as a result of the dietary stringency of the was
and post-war years. In 1948 the number of deaths at ages under 55 was 27—a record
low figure which compares with an average of 31 in 1945-7.
Diabetes
The cancer death-rate for all ages for 1948, was 2.11 per 1,000, a little higher
than in 1947, and this is the second successive year in which a slight rise has been
recorded.
Cancer is a disease of advanced age and mortality is sensitive to changes in the
average age of the population which has not only been rising naturally consequent
upon the falling birth-rate during the pre-war years (see Table 3), but, so far as
mortality statistics are concerned, has also been artificially increased by the removal
of young persons from the civilian population, to which such statistics relate, by
evacuation and mobilisation movements of the war years. Any analysis of cancer
mortality should therefore either have specific reference to advanced age groups or
to rates which have been "standardised" for age, i.e., rates which are still averages
over the whole population but averages in which the representation follows not the
actual pattern, disturbed as it is by temporary factors, but a standard pattern which
is kept invariant over the period under consideration. The importance of this
adjustment can be seen from the following figures for England and Wales, for which
estimates of the population in age groups are available. The difference between the
two sets of figures here measures only the effect of mobilisation since, for the country
as a whole, the evacuation movements would cancel out.
Canoer