London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1956
[Report of the Medical Officer of Health for London County Council]
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187
The sources and distribution of the various components of atmospheric pollution
have been widely studied, and the subject is well summarised by Meetham (1956).
There are many individual chemical substances present, but to obtain data for comparative
records the analytical examination must normally be limited to tests of
relatively simple type.
Mortality
While the total death rate in London has, since the war, differed little from that
of England and Wales as a whole, and the areal comparability factor has never been
far from unity, there are wide differences in the effects of the constituent causes. In
Table I are set out by sex and age groups standardised mortality ratios* for a number
of different diseases and for all causes. These diseases account for four-fifths of the total
mortality. The figures are taken from the published mortality statistics of the year
1955—a year in which there was no particular epidemic in either London or the country
apart from poliomyelitis which causes relatively few deaths and has no significant
effect on the death rate.
Table 1—
| Age Groups | All causes | Bronchitis | Other respiratory diseases including respiratory tuberculosis | Lung cancer | Other cancer | Cardiovascular diseases |
|---|---|---|---|---|---|---|
| 0-4 | 100 | 250 | 81 | — | (115) | (50) |
| 5-44 | 93 | 104 | 76 | 123 | 108 | 92 |
| 45-64 | 108 | 132 | 110 | 131 | 117 | 94 |
| 65 and over | 102 | 149 | 139 | 155 | 113 | 86 |
| All ages | 103 | 145 | 120 | 143 | 114 | 88 |
| Excess or deficiency of deaths | + 548 | +606 | + 287 | +458 | + 321 | -1,059 |
| 0-4 | 97 | (163) | 78 | — | (109) | (100) |
| 5—44 | 97 | (67) | 82 | (118) | 102 | 93 |
| 45-64 | 96 | 107 | 99 | 186 | 106 | 82 |
| 65 and over | 92 | 127 | 127 | 181 | 102 | 85 |
| All ages | 93 | 124 | 115 | 180 | 104 | 85 |
| Excess or deficiency of deaths | -1,337 | +180 | + 187 | + 150 | + 117 | -1,621 |
Figures in brackets are based on fewer than 20 deaths in either actual or expected mortality and, thereFore, ratios are
unreliable.
The table shows that in London male mortality is higher and female mortality
lower than in England and Wales; the excess male mortality is concentrated mainly
in the middle-aged group, 45-64 years, whilst female mortality is lower at all ages and
especially at 65 years and over. Examination of the disease pattern shows, for males,
an excess of deaths in diseases affecting the respiratory system, an excess which increases
with age. The excess is offset to some extent by fewer deaths from cardio-vascular
* The ratios are calculated by expressing the actual number of deaths in London as a ratio of the corresponding
'expected' number based on the mortality experience of England and Wales and multiplying the result by 100 for ease
in comparison of the figures, e.g., if the actual is the same as the ' expected* then the ratio will be 100, if the actual is
in excess of the ' expected * then the ratio will be over 100 and similarly if mortality is lower than expectation the ratio
will be lower than 100.