London's Pulse: Medical Officer of Health reports 1848-1972
View report page
Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1954
[Report of the Medical Officer of Health for London County Council]
This page requires JavaScript
showing the mortality from lung cancer during the year 1953 for certain types of area
in England and Wales arranged in order of descending mortality are set out below.
The rates for each male age group decrease with decreasing urbanisation despite the
higher proportion of persons aged 65 and over in the rural areas.
| Areas | Males | Females | Percentage of Popn. 65 and over in Popn. 25 and over | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 25- | 45- | 65- | 75 and over | Total 25 and over | 25- | 45— | 65- | 75 and over | Total 25 and over | |||
| M. | F. | |||||||||||
| All conurbations | 0.12 | 1.71 | 3.69 | 2.45 | 1.15 | 0.03 | 0.20 | 0.44 | 0.57 | 0.18 | 13 | 18 |
| Urban areas 100,000+ | 0.11 | 1.55 | 2.97 | 2.06 | 1.04 | 0.83 | 0.17 | 0.42 | 0.38 | 0.16 | 14 | 19 |
| 50,000-100,000 | 0.10 | 1.35 | 2.79 | 1.53 | 0.92 | 0.03 | 0.15 | 0.25 | 0.32 | 0.12 | 15 | 21 |
| Less than 50,000 | 0.08 | 1.24 | 2.27 | 1.53 | 0.84 | 0.02 | 0.14 | 0.29 | 0.37 | 0.13 | 16 | 20 |
| Rural areas | 0.05 | 1.02 | 1.67 | 1.15 | 0.65 | 0.02 | 0.13 | 0.29 | 0.25 | 0.12 | 17 | 21 |
| E. and W. | 0.10 | 1.43 | 2.78 | 1.81 | 0.96 | 0.03 | 0.17 | 0.36 | 0.42 | 0.15 | 15 | 19 |
It seems evident that, whatever the reasons, urban areas have higher mortality rates
for cancer, and London accordingly has higher rates than England and Wales as a
whole. This pattern also seems to hold good abroad—the United States census of 1951,
for example, disclosed that 53-5 per cent, of lung cancer cases occurred in cities of over
100,000 which accounted for only 29-3 per cent, of the population.
The table set out hereunder shows the average death-rate from lung cancer per 1,000
of the population aged 15 years and over for each of the Metropolitan Boroughs for the
years 1950-54 inclusive, which it will be seen range from 0-79 in Bethnal Green to
0-47 in Kensington with a mean for the County of 0-60. Various environmental and
social factors were examined and the table also shows the degree of overcrowding in the
boroughs as assessed by the percentage of persons living at a density of more than
2 persons per room, and the percentage of social classes IV and V in their populations,
according to the 1951 census; the amount of existing open space according to the London
Development Plan Analysis and the average amount of atmospheric pollution as
measured by the solid deposit and sulphur dioxide concentration recorded by all the
stations within each borough during 1954, according to the Atmospheric Pollution
Bulletin of the Department of Scientific and Industrial Research.
Effects of
certain
environmental
and social
factors
The correlation coefficients of the lung cancer death-rate with the various factors
are + 0.431 for overcrowding; + 0.599 for percentage in social classes IV and V ;
— 0.417 for the amount of open space + 0-085 for atmospheric solid deposit and
+ 0.262 for atmospheric sulphur dioxide concentration. The first three are significant
and the last two are not. The highest correlation is that with the percentage in social
classes IV and V, and it is therefore not surprising to find some degree of correlation
with overcrowding and lack of open space which are frequently associated inversely with
social class. This finding of an association between lung cancer and social class is in
keeping with Logan's (1954) description of the social class gradient in lung cancer. He
noted that the gradient was not found in married women or in men over the age of
65 years.
The correlation between lung cancer and atmospheric pollution was not significant
in this analysis, but this in itself does not preclude an association between them.
145
K1