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12
General

Infant
mortality
The infant mortality rate in 1949, 27 per 1,000 live births, consitutes a new low
record, and is an improvement on the rate of 31 per 1,000 live births in 1948.
The movements of the death-rates from the principal diseases at ages below one year
since 1911 are shown in Table 7, (p. 123). The diagram on the next page illustrates
the contraction in the fatality of infants since the years 1911-14.
The increase in deaths assigned to congenital malformations and birth injury 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 and partly also to a
tendency for post-mortem examination to be done more frequently resulting in increased
precision in certification. For most diseases there has been a dramatic reduction
in mortality over the last forty years, and, even since 1927, the improvement is
subtantial. The pronounced fall in the case-mortality of whooping-cough and measles
has helped to bring down the infant mortality rate. Diarrhoea and respiratory
infections too are now less frequently contracted, and methods of treatment are
more effective. Increasing attention has been paid to the care of the premature
infant and there are signs that these efforts are having a salutary effect on the
mortality risk.
Neonatal
mortality
Deaths in various periods of the first year of life are shown in detail in Table 6
(p. 123). Deaths under 4 weeks numbered 988 or 17.5 per 1,000 live births, the same
as in 1948. Comparative rates for London and England and Wales in recent years
are:—
London England and Wales
1931-35 25.1 31.4
1936-40 22.9 29.0
1941-45 23.4 25.9
1946 22.2 24.2
1947 18.1 22.7
1948 17.5 19.8
1949 17.5 19.3
There is some irregularity in the decline in both sets of rates and the margin
between them has varied in extent. In London there was a war-time rise arising
from the severe conditions but this setback was soon recovered at the end of the war.
The reduction in infant mortality in the past fifty years as a result both of
rising social standards and the energetic intervention of public health authorities
has mainly been effective against the causes of death (principally infectious) which
do not operate until after the first few weeks of life and deaths within the first four
weeks of life, which arise mainly from prematurity, congenital malformations and
birth injury, have been more resistant to reduction.