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quinquennial period, however, the mortality for Shoreditch increased, attaining a
maximum in the five years ending 1899, and has since been decreasing ; on the
other hand, the London infantile mortality decreased until the fourth quinquennial
period and then increased, reaching a maximum during the same period as
Shoreditch and has since decreased. Notwithstanding the rise and fall in the
infantile mortalities, the general death-rates both of Shoreditch and London have
steadily declined throughout. The rise observable in both the general death-rates
during the five years, 1890-91, was without doubt due to influenza outbreaks.
The decline in the general death-rate for Shoreditch—and the same may be said
for London in a lesser degree—has been greater since it synchronised with the
decline in the infantile mortality. Generally, the figures go to show that the rates
for Shoreditch have been subjected to influences common to the whole of the
Metropolis, and they indicate a definite improvement in the public health during
the past forty years especially during the last twenty years. The improvement,
however, is more manifest in the case of the Metropolis, especially when the
infantile mortalities for recent years are compared, that for Shoreditch for a
number of years past ranging at a considerably higher level than that of London.
As helping to throw light upon the reason why such a difference exists
between the infantile mortalities of Shoreditch and the Metropolis, a few words
about the causes of death amongst infants under the age of one year are necessary.
The chief of these causes are: prematurity, debility and wasting, diarrhoea,
enteritis and gastritis, pneumonia, bronchitis, whooping cough, measles, tuberculosis
and suffocation. Briefly, the premature births of infants depend upon
adverse conditions affecting the health of the mothers during pregnancy, such as
insufficient nourishment, excesses of any kind, overwork, injury, certain constitutional
maladies, and other debilitating influences; debility and wasting mainly
result from improper or insufficient feeding or a combination of both, mostly due
to want of knowledge or lack of means on the part of those in charge of the
infants; suffocation in the great majority of instances results from want of forethought
or negligence; the remainder are the results of infections and are
predisposed to by any conditions as regards the infants and their surroundings
which are prejudicial to health, and of these there are none more important than
the want of space which is so frequently met with in the dwellings 'occupied by
the poorer working classes. It is to be pointed out that this does not necessarily
mean overcrowding such as can be legally dealt with by the Sanitary Authority,
but it does imply such close personal contact as to facilitate transference of
infection in the event of the introduction of infection within the dwelling. On
this, the Committee may be reminded, that the standards as to cubic space which
are fixed by the by-laws as to houses occupied by members of more than one
family in force in the Borough are 300 cubic feet for each person where a room is
used for sleeping only, and 400 in cases where the room is used both for living and
sleeping, with half those amounts for children under the ages of ten years. It can
hardly be stated that these amounts are generous even for healthy persons; when