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4
Births
There was an increase in the birth rate for 1963 above that of England and Wales, which was 18-2
per 1,000.
Deaths
There was a slight decrease in the death rate for 1963, and it was a little below that of England and
Wales, which was 12-2 per 1,000. The causes of deaths are shown in Table 1.
Infant mortality
In 1963, 96 children died in the first year of life—57 in the first week and another 8 in the first
month. There was a small increase in the infant mortality rate from 20 to 21, which is the figure for England
and Wales. During 1963 there were 285 births more than in the preceding year and this probably contributed
to the rise in the total number of deaths. The still-birth rate dropped from 21 to 20 but this is still above
the national figure of 17. The slight changes in these rates are unlikely to be significant in view of the comparatively
small population involved (Table 2). The perinatal mortality was 34, the same figure as in the
preceding year.
'a) By wards (Table 3)
Cricklewood has taken the place of Brentwater as the best ward. The rate for Carlton has increased
from 15 to 18 but this is probably not significant in view of the small number involved. Carlton maintains
the overall improvement from the period 1958-1960 when its infant mortality rate was 29. A major factor
in this reduction is probably the extensive redevelopment being carried out by the Council in this area. The
five wards with the highest mortality rates were Kensal Rise (24), Brondesbury Park (23), Harlesden (23),
Willesden Green (22) and Gladstone (22).
(b) By Social Class (Table 4)
Only 3 deaths occurred in social classes I and II, whilst 85 deaths occurred in the lower three classes,
illustrating the effect of environment on infant mortality.
(c) Causes of death (Tables 5, 6, 7 and 8)
Prematurity accounted for one-third of deaths, Eleven of these babies were illegitimate and information
about them was difficult to obtain, but it is likely that six of these mothers did not have adequate
ante-natal care. Thirteen of the deaths occurred in families that lived in a single room. A set of premature
triplets, had they survived, would have had to share a single room with their parents and 3 other children.
Respiratory infections caused the second largest number of deaths. Antibiotics and improved
environmental conditions have halved the rate in the last 20 years but there is still room for improvement.
Five of these deaths, in infants over a month old, occurred in families living in one room.
Congenital deformities caused one-fifth of the deaths. The majority of the abnormalities were cardiac
defects. None of the known causes of congenital deformities was found to be operative in this group, which
indicates a need for more research in this field.
Diarrhoea and enteritis caused only 1 death. The steady improvement in infant care and the availability
of antibiotics have brought this death rate down from 10.0 in the 1936-39 period to the low rate of 0.2
in 1963.
Other infections. In this group the death rate was low, probably due to antibiotics. On occasions,
however, the infection spread in spite of treatment, as in the case of an infant who died in hospital from an
ascending umbilical infection.
Birth injury. In spite of continued improvements in obstetrics the death rate to this cause (1.1) has
not shown much improvement on the 1936-1939 figure of 1.6. One infant died due to an injury at birth
and his body was found abandoned in the Willesden railway sidings. He may have been saved if skilled
obstetric help was available at the time of his birth.
Others. One death at 2 months was due to a malignant tumour (lymphosarcoma) and another at
11 months was due to a subdural haemotoma caused by an accident of unspecified nature.
General. Prematurity is still responsible for the largest number of infant deaths. More research is necessary
regarding its causation but a reduction in the contributing factors of illegitimacy, lack of ante-natal care
and poor environmental conditions, could save infant lives.
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 to the Health Department and the Health Clinics are collected and taken to
the laboratory in Neasden Hospital. A report by telephone is given to the doctor as soon as possible, followed
by a written report.
Samples of milk, ice cream, and water are sent by public health inspectors.