View report page

The peaks in the year 1918 were due to the pandemics of influenza which raged at
the close of the first world war and which affected young people to a greater extent
than the aged ; the peaks in 1929 were for a similar reason though in this epidemic the
age distribution was different—the old being affected more than the young. The peaks
in 1922 in the rates for boys and girls aged 1-4 were due to the prevalence of epidemics
of measles and whooping cough.
The total death rates for the various age/sex groups, whilst informative, do not
give the whole picture. Accordingly, in the diagrams shown on pages 160 to 163 an
indication is given of changes in the causes of death over the half-century by showing,
for each sex and each age group separately, the major causes of death for the years
1901,1926 and 1951 : 1901 and 1951 have been chosen as years at each end of the period
with most reliable population figures (census years) and the year 1926 as midway
between these two.
Because of the wide variation in death rates, both between age groups and between
years, and the desire to give the maximum pictorial effect to changes in the causes of
death, scales of death rates have been chosen which best accommodate the particulars
displayed : for this reason neither the horizontal nor the vertical scales are the same for
each age group and in addition they may vary from year to year within an age group.
Hence, except as an indication of the order of ranking of a specific disease they require
careful study and reference to the scale employed.
Finally, no allowance has been made for the sharp change in the classification of
deaths which took place in 1940 when the Registrar-General abandoned the rules of
selection which had hitherto operated in multiple causes of death.* In the earlier years
deaths from certain infective and respiratory diseases were of such proportions as to
merit individual mention with the residual deaths from these major groups described
as 'other infective' or 'other respiratory', whereas in some instances in 1951 deaths
from these causes are so few as no longer to justify their separate mention and they
are accordingly included in ' all infective 'or' all respiratory '.
Looking at the diagrams for each of the age groups in turn the most striking change
is in infant mortality (0-1 year): some terms used for causes of death in 1901 are no
longer current medical terminology in death certification, e.g. ' feeding difficulties and
teething ' rickets'. In 1901 the most frequent cause of death in infancy was gastritis,
enteritis and diarrhoea which by 1926 had fallen to second place and by 1951 to last
but one of the specified causes. Prematurity, which in 1901 held second place rates
highest in 1926 and in 1951; this is the cause of death in infancy which, despite its
reduction from 1907 per 100,000 infant deaths in 1901 to 1,411 in 1926 and to 472 in
1951 still offers the greatest resistance to further reduction of the infant mortality rate,
see page 16. The lesser causes in 1901 of congenital malformations (see also footnote
below*), post-natal asphyxia and birth injury have become more important by 1951
because of the very great reduction in deaths from the infective and respiratory causes.
In young children (1-4 years) the specific infective causes of death—diphtheria,
measles and scarlet fever—seen at the turn of the century have largely disappeared as
causes of mortality. Violence (accidental death) despite its decline from 99 deaths per
100,000 population in 1901 to 38 in 1926 and 20 in 1951 now ranks as second in importance
instead of more than half-wav down the list in earlier vears.

† Based on the dual classification of deaths for England and Wales. 1939.
154