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4
Births
There was an increase in the birth rate for 1964 above that of England and Wales, which was 18 4
per 1,000.
Deaths
There was a slight decrease in the death rate for 1964, and it was a little below that of England and
Wales, which was 11.3 per 1,000. The causes of deaths are shown in Table 1.
Infant mortality
In 1964, 103 children died in the first year of life—60 in the first week and another 11 in the first
month. There was a slight increase in the infant mortality rate from 21 to 22 which was a little above the figure
for England and Wales (20). The still-birth rate dropped from 20 to 18, but this was still above the national
figure of 16. The perinatal mortality rate dropped from 34 to 31 (Table 2).
(a) By wards and social class (Tables 3 and 4)
The worst wards were St. Raphael's and Carlton which had rates twice as high as the whole Borough
but too much significance should not be placed on these figures in view of the small number involved. However,
it is clear that an improvement in social conditions in some wards would certainly reduce the mortality.
The number of deaths by social class illustrates in the same way the influence of environment onmortality.
There were only nine deaths recorded in classes I and II.
(b) Causes of death (Tables 5, 6, 7 and 8)
Prematurity is again the most important single factor in infant mortality; 37 premature babies died
(36 per cent of total infant deaths). Twelve of the babies were illegitimate and information about some of
them was difficult to obtain. As far as could be ascertained, eight of the mothers did not have adequate antenatal
care.
Respiratory Infections caused the second largest number of deaths (23). Antibiotics and improved
environmental conditions have halved the rate in the last 20 years, but there is still room for improvement.
Congenital malformations caused 15 per cent of the deaths. In those cases investigated, the pregnancies
were normal, with no history of virus infection or pelvic radiation.
Diarrhoea and enteritis caused three deaths. The steady improvement in infant care and the availability
of antibiotics have brought this death rate down from 10 in the period 1936-1939 to the low rate of
0 6 this year.
Other infections caused only one death. A child of one week died of meningitis with pneumonia as
a secondary cause.
Birth injury. In spite of continued improvements in obstetrics, the death rate due to this cause (2.4)
has remained almost unchanged for many years. In the periods 1940/45, 1946/50 and 1956/60, it was 2.1,
2.7 and 11 respectively.
Other causes. Three deaths in this group could have been avoided. A girl of six months died of
carbon monoxide poisoning and inhalation of fire fumes, when an oil stove overturned; a boy of seven weeks
died of asphyxia due to carbon monoxide inhaled when gas escaped from a defective gas pipe; and a boy of
five months died of asphyxia due to inhalation of vomit. One baby died of blood incompatability, despite
good ante-natal supervision; one died of acute myeloid leukemia; and another died of sickle cell anaemia. An
illegitimate child of 10 months was suffocated by a towel and then placed in a polythene bag. The mother
was convicted of infanticide.
(c) Conclusions
More research is necessary into the causes of prematurity and congential malformations, 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.
The percentage of ice cream samples graded 2, 3 or 4 was almost the same as last year. There were
no unsatisfactory samples of water or milk.
Uncleanliness and scabies (Table 10)
Since September, 1952, treatment for scabies, lice and nits has been carried out by arrangement with
the Middlesex County Council at the Stonebridge Health Clinic.
As compared with 1963, there has been a considerable decrease in the number of children, particularly
school children, treated for lice and nits. There has been a very slight increase in the number of
children over five treated for scabies, but the numbers treated are still small and there is no evidence of a
significant increase in the prevalence of this condition among the population.