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5
Births
There was an increase in the birth rate for 1960, and it is now above that of England and Wales.
Deaths
There was a slight decrease in the death rate for 1960, and it appears to be becoming stabilised at
about 10 per 1,000, a little below that of England and Wales, which is about 12 per 1,000. The causes of
deaths are shown in Table 1.
Infant mortality
The infant mortality rate fell to a record low figure of 15 per 1,000, which is well below that for
England and Wales (22 per 1,000) (Table 2). There was a slight rise in the stillbirth rate to 20 per 1,000,
which is the same as that for England and Wales.
In 1960, 54 infants died, 38 in the first week of life and another three in the first month.
(a) By wards (Table 3)
For the three years 1958-60, the infant mortality was highest in Carlton (29 per 1,000) more than
three times that of Gladstone (8 per 1,000) and Brent water (9 per 1,000), the best wards. Kensal Rise,
Kilburn, Stonebridge and Roundwood all had high rates of 22 or more per 1,000. The rates in these five
wards have been consistently high, and it is clear that an improvement in the social conditions of these wards
would help to reduce the mortality. It will be interesting to see how far infant mortality will fall in the Carlton
ward as a result of the improvements in housing following the Council's extensive redevelopment scheme.
(b) By social class (Table 4)
The number of deaths by social class gives a further illustration of the effects of environment on
infant mortality; 49 were in the lower social groups, none in social class I, and only 4 in social class II.
(c) Causes of death (Tables 5, 6, 7 and 8).
(i) Prematurity. There were 239 premature births with 14 deaths in the first week of life. Prematurity
was the most important cause of all infant deaths (26% of the total). Generally speaking, there
were more premature births in those wards where overcrowding and bad housing conditions exist.
(ii) Respiratory, diarrhoea and enteritis, and other infections. There were fifteen deaths from these
causes; twelve from respiratory infection, two from gastro-enteritis and one from virus encephalitis.
Thirteen came from the lower social classes and some of them were preventable. One child aged 4 months
had at various times been in the care of five child minders, all with different methods of infant welfare.
Overcrowding is responsible for many infant deaths from respiratory infection.
(iii) Congenital malformations. Most of the deaths from this cause occurred in the neonatal period.
There were 9 deaths, contributing 17% of the total infant deaths. Radioactivity in the form of ingestion of
radioactive dust or exposure to excessive X-rays are thought to contribute to the development of malformations.
Preventive measures are taken to remove another cause of congenital malformation: arrangements
are made to reduce the contact made by expectant mothers in the first three months of pregnancy with cases
of German measles and other virus infections. One mother was in contact with a case of measles in the first
month of pregnancy. She had not had measles before and did not contract the illness. However, the child
died of meningococcal and bilateral talipes equino-varus at three weeks.
(iv) Birth injury. The birth injury rate has remained practically the same, and it is possible some
of the deaths may have been avoided. There is no record of the number of infants who suffered birth
injury and survived.
(v) Other causes. All the deaths classified under other causes occurred in the neonatal period.
Sixty-six per cent. were associated with prematurity (atelectasis and prematurity 4 ; pulmonary syndrome and
prematurity 2; hyaline membrane and prematurity 2). One baby died of blood incompatability : the mother
had no antenatal supervision. Of the other three deaths, two were due to pulmonary syndrome and one to
meconium obstruction.
(d) General.
None of the mothers suffered any severe illness but five had anaemia, one had treatment for venereal
disease, two were exposed to virus infection and two had toxaemia. It is possible that these conditions contributed
to the deaths of the children. Four of the children who died were from twin pregnancies.
(e) Conclusions.
No particular factor emerges as a significant cause of infant deaths in the year, but there is no doubt
that a general improvement in living standards and better maternal care would help to reduce infant mortality
still further, but more research is still required into the causes of congenital malformations and prematurity.
GENERAL PROVISION OF HEALTH SERVICES
Public Health Laboratory Service (Table 9)
Bacteriological specimens (swabs from sore throats, faeces from intestinal infections, cough plates
and post-nasal swabs from whooping cough cases, etc.) are examined by the Public Health Laboratory
Service at the Central Public Health Laboratory, Colindale, and at the branch laboratory in Neasden Hospital.
Specimens delivered by doctors to the Health Department, the Health Clinics (or the branch laboratories
in Neasden Hospital) are collected and taken to the Central Public Health Laboratory. A report by
telephone is given to the doctor next morning followed by a written report.
Samples of milk, ice cream, and water are sent by Public Health Inspectors.