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sickness occurs they become totally inadequate. Fortunately there are hospitals
and other institutions for the reception of the sick and these to a considerable
extent save the situation.
Generally it may be stated that the influences at work affecting the infantile
mortality are many, and they are in the main dependent upon circumstances
intimately associated not only with the sanitary environment, but also with the
social condition and the habits of the people.
As having a very important bearing upon, and in fact being a most potent
influence in the production of the excessive infantile mortality in Shoreditch
comparing it with that of London, it is to be mentioned that Shoreditch has a far
larger proportion of the poorest sections of the community amongst its population
than London as a whole, which is distinctly greater than it was forty years ago,
and there is no reason for believing that this proportion is decreasing, rather the
contrary appears to be the case. Moreover, there are in the Borough, as compared
with London generally nearly three times as many persons dwelling on each acre.
With the exceptions of Bethnal Green and Southwark, which have approximately
the same density per acre as Shoreditch, the Borough is the most densily
populated district in London. Although during the past thirty years in Shoreditch
the density of the population per acre has markedly decreased, there being
now over 15,000 fewer persons and 3,621 fewer inhabited houses, none the less there
ha3 been a gradual increase in the number of persons in the inhabited houses.
According to the figures of the last census this would appear to be at least 15 per
cent. greater than in 1881. It may also be noted that the birth-rate for the
Borough, although it shows a considerable decline, still remains much above the
average for London. This fact may be taken as indicating that in the densely
populated area of Shoreditch there is a larger number of infants to be cared for
proportionately than is the case with London generally, and without doubt there
are less means to do it with.
Poverty and its hardships, especially those associated with the congestion of
a population on an area, promote the existence of conditions prejudicial to the
health of the people generally, and under such conditions infants are as a rule
proportionately affected. In these respects Shoreditch is unquestionably heavily
handicapped as compared with London as a whole. Whilst what has been stated
affords an explanation of the marked difference between the infantile mortalities
of Shoreditch and London, it may also be taken as pointing to the necessity of
greater activity in Shoreditch and an amount of work above the average for the
Metropolis being required for the Borough if its infantile mortality is to be
reduced to something approaching that for London. Such a reduction is within
the bounds of possibility provided the necessary efforts are made. With reference
to this it will be noticed, on turning to the table of mortality rates, that the
infantile mortality markedly decreased between 1899 and 1909, the decrease, in
fact, for Shoreditch amounting to 22 per cent., for London to 27 per cent., and the
averages for the three years 1910-12 show further decreases. Now, during these
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