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9
Nephritis
large proportion of the apparent reduction in the interval was due to the increase in
the civil population upon demobilisation, a purely " statistical " effect.
For nephritis the death-rate in 1951 amounted to 0.12 per 1,000, compared with
0.11 in 1950 and an average of 0.36 over the years 1931-40.
Degenerative
diseases
If, as an indication of mortality from degenerative diseases, heart disease, other
circulatory diseases, cerebral vascular lesions, nephritis and bronchitis are combined,
the following trend becomes apparent:—

The true effects of the war cannot be separated from the statistical influences
described on page 8 (particularly the change in 1940). The rates in recent years
appear to be running higher than pre-war. Degenerative diseases thus continue to
attain greater importance, and are responsible for over half the death-rate.
Cancer
The cancer death-rate for all ages in 1951 was 2.27 per 1,000, slightly higher
than in 1950.
The death-rate from cancer, which is largely a disease of the latter half of life,
can be substantially changed by variations in the age constitution of the population.
Some form of standardisation of the crude rate is therefore essential for true comparative
purposes. Thus in England and Wales the crude cancer mortality rates
between 1938 and 1945 rose 37 per cent. for males and 7 per cent. for females, but
the " standardised " mortality rates (C.M.I.*) were almost stationary, a small rise
for males and a small fall for females.
The difference between the crude and standard rates for London, which lost a
large proportion of the population (more young than old) by evacuation during the
war, would doubtless be larger, but in London age group population estimates were
not available between 1939 and 1946. Age specific rates since 1947 are shown
below:—

Up to 1949, for England and Wales, the comparative mortality index for females
had fallen to 0.937 (1938 = 1.000), while the male index had risen to 1.063.
In London, for both sexes combined, the long-term trend of cancer mortality
can be seen from Table 3 (page 142). The increase there shown between 1891 and
1940 is due partly to the increasing age of the population and partly to improved
diagnosis, but some part is doubtless attributable to increased incidence, particularly
cancer of the lung. The important changes in mortality in London between 1931-33
* Comparative Mortality Index.