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29
"The Medical Officer of Health draws attention to the fact that the infantile
mortality rate during the month of November, 1933, was 44 per 1,000 live births,
and points out that statistics relating to short periods are of little value for comparative
purposes, and only to a limited extent serve as a guide to what the rate
for the complete year might be. Indeed, the rate for 1933, though it may be a
little lower than that for 1932, may quite conceivably be just as high. There are
great difficulties generally in comparing the rates experienced in various boroughs
throughout the metropolis because of the influences exerted on the infantile
mortality rate particularly by local circumstances. In the case of St. Marylebone,
where the number of births is so very steadily falling and is in general so low, a
very slight variation in the number of deaths of infants under one year of age
makes a difference that might almost be described as 'enormous' in the total rate.
One death, for example, actually represents over 1 per 1,000 in the total death
rate. The Borough is unfavourably placed, statistically at any rate, in this way,
but also in other ways, since on account of the presence of large Maternity Hospitals,
nursing homes and homes for unmarried expectant mothers, the number of
deaths amongst illegitimate children—always high—affects the infantile mortality
rate. Moreover, many of the women concerned, although they actually are not
St. Marylebone residents, give an address in St. Marylebone as their home address,
and therefore in the event of the death of the infant this is recorded in the St.
Marylebone statistics. Similarly, if the domicile of the mother is outside the
borders of England and Wales the death is counted as a St. Marylebone death.
Another cause of increase in the Borough infantile mortality rate arises because
of the fact that a considerable portion of the Grand Union Canal passes through
the Borough, and, unfortunately, from time to time unwanted infants are disposed
of by drowning or are abandoned in the neighbourhood of the canal. In 1932 there
were three such deaths which were included as deaths of infants in the Borough,
making an addition of over 3 per 1,000 to the non-preventable infantile mortality
rate. During 1932 a number of deaths were put down as due to gastritis. This is
a condition which is always much more prevalent when the weather in the late
summer and early autumn is particularly warm. The conditions in 1933 were
favourable to the occurrence of gastritis, and it was in spite of the increased efforts
made at the welfare centres and by the health visitors and the Public Health
Department generally to assist the mothers, that a somewhat larger number than
usual of such cases were lost."
The means adopted in the Borough with a view to bringing about a reduction
and generally improving the life and health chances of infants and children are
described in a separate section of the report—Maternity and Child Welfare. This
part being merely statistical, it is not proposed at this point to do more than give
some sort of analysis of the figures relating to deaths amongst infants.
Causes.—A Table (Ministry of Health, Table A.) will be found on page 30,
in which, in addition to the causes of death, are shown the distribution of the
deaths according to age and locality.
So far as age and causation are concerned, conditions vary little year by year.
In 1933, as in other years, the greatest number of deaths occurred in the early
weeks of life. Of the babies, 20 were less than one month old when they died and
28 less than three months. Having regard to the decrease in the death-rate from
87 to 56, these figures are important and may be compared with the corresponding
figures for 1932, 32 and 46 respectively.
The outstanding causes of death and the proportions traceable to them were
those usually noted. Prematurity (numbers 12, 13 and 14 in the table), which, as
usual heads the list, caused 33 in 1932, and 13 in 1933. Diarrhoea and enteritis
(7 and 8) accounted for 32 in 1932 and 14 in 1933. Respiratory diseases took 5
in 1932 and 9 in 1933.
Amongst the other causes of death, mention may be made of whooping cough
and injury at birth which accounted for 4 and 3 respectively. Again this year,
"overlaying" does not appear on the list of death-causes.
Christ Church, which always contributes most largely to the infantile as to
most of the other mortality rates, being the most thickly populated area and that
in which there is most poverty, most overcrowding and most neglect of ordinary
precautions, is again at the head of the list with 20 deaths amongst infants. In
1932 the figure was 36,