London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1953

[Report of the Medical Officer of Health for London County Council]

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8
Still Births
There were 1,091 still births in 1953 or 21.0 per 1,000 total births—the legitimate and
illegitimate rates being 20.3 and 30.1 respectively. The number of still births and rate per
1,000 total births in each year since 1931 is shown in Table 5 (page 148). It will be seen
that after remaining stable for several years the still birth rate fell sharply in 1943 and
continued to fall until 1948. There has been a rise in 1953, as there has been in neo-natal
deaths (see page 12) but the rate still remains below that of England and Wales.
Mortality
The total deaths in 1953 amounted to 38,636 or 11.6 per 1,000 of the population.
Detailed figures are given in Tables 2, 3 and 4 (pages 145.8). Mortality from infectious
diseases is discussed below under that heading and tuberculosis is dealt with separately
(see page 86). For the latter and other principal causes of death the trend is indicated by
the diagrams on pages 10.11.*
The death-rate from all causes, which, with the increasing age of the population,
had been slowly rising before the war, again rose sharply in 1940. This increase was
partly due to the war-time statistical basis as explained in the footnote below but
the heavy toll of air raids was an important contributory factor. Between 1944 and 1950
there was, however, a decline. The rate of 11.6 in 1953 is somewhat lower than that of
the previous year, and might but for the influenza epidemic in the first quarter of the
year have fallen to the 11.3 per thousand of 1950. It will be noted that for the first time
on record there were no deaths from diphtheria.
Bronchitis
and
heart disease
The death-rate for the bronchitic and heart disease group which was 4.32 in 1953
compared with 4.64 in 1952 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 146).
Cerebral
haemorrhage,
etc.
The death-rate from vascular lesions of the central nervous system in 1953 was
1.20 per 1,000, compared with 1.27 in 1952. The average for 1940-44 which covered the
complete war years was 1.14 as compared with 1.06 for the period 1946-1950. In fact,
except in 1948, the number of cases increased and much of the reduction in the deathrate
was due to the increase in the civil population in the younger age groups following
demobilisation. The rates over the five years ending in 1952 had shown a steady increase
from 1.01 in 1948, 1.07 in 1949, 1.11 in 1950, 1.22 in 1951, 1.27 in 1952—thus the lower
rate of 1.20 of 1953 has arrested the hitherto existing trend.

* The sharp changes that occurred between1939and1940are attributable to two causes. In the first place, the Registrar-General abandoned the rates of selection which had hitherto operated in multiple causes of death, and, as from1940,accepted the principal cause of death as shown on the medical certificate. In addition, the International List of Causes of Death, which was revised in1938,was applied in1940,in accordance with international agreement. The general movements resulting from these alterations are estimated to be :

CauseApproximate change as a percentage of those formerly assigned to this cause †
Influenza— 11 per cent.
Cancer— 3 „ „
Diabetes— 30 ,, ,,
Heart diseases— 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. The 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 found 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 reduce the confusing effect of the large scale reclassification of deaths, heart diseases and bronchitis have been
combined.