View report page

23
The general trend of morbidity and mortality since 1921 is indicated by Table
10 (page 143), and is also illustrated by diagram below. The consistent decline in deaths
and notifications during the inter-war years was substantial. New cases of pulmonary
disease were reported at the rate of 2.1 per 1,000 living in 1920 and at only 1.3 per
1,000 in 1938, a fall of about 40 per cent, in just less than twenty years. In 1938 the
death-rate from pulmonary disease was 0.64 per 1,000, i.e., about 40 per cent, lower
than the 1920 rate of 1.04 ; a saving of some 1,600 deaths annually at the 1938
population level. In the early years of the war the upsetting of the balance between
input and output of energy, the general deterioration in living conditions, the strain
placed upon the population by bombardment and the increased opportunities for
the spread of infection, associated with the discharge of tuberculous patients from
hospitals to make room for air-raid casualties, all combined to reverse the trend of
both morbidity and mortality and, by 1941, the ground gained in the inter-war years
had been lost. Mortality rates rose to a peak of 1.02 per 1,000 for pulmonary disease
and 0.14 per 1,000 for non-pulmonary disease in 1941, but, in so far as this rise was
mainly due to the impact of the hard conditions of war upon existing advanced
cases, it was short-lived and the mortality quickly began to decline again as the war
progressed. By 1946 the mortality rates had fallen below the pre-war levels and they
may now be regarded as having fallen below even the level to which they might have
been expected to decline on the basis of pre-war trends.