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factor is 13.39 as compared with 12.0 for England and Wales. The
principal causes of death were heart disease, which accounted for
30 per cent of the total deaths, cancer 20 per cent and diseases of
the respiratory system 20 per cent. Deaths of persons over the age
of 65 years amounted to 66.3 per cent of the total deaths.
Details of deaths by cause and age are given in Table I of the
Appendix, on pages 50 & 51.
Infant Mortality.
Deaths of infants under one year numbered 41, giving a rate of
22.00 per 1,000 live births compared with 18.66 last year. The rate
for England and Wales is 21.4, the lowest ever recorded.
The tables on page 52 show the deaths from stated causes at
various ages under one year, together with comparative figures over
the last five years.
Perinatal Mortality.
The perinatal mortality rate of infants (viz., stillbirths plus
deaths occurring in the first week of life) was 36.78 as compared with
27.46 last year.
The principal causes of perinatal mortality are as followsi-
(a) Ante-partum death with maceration and ante-partum asphyxia
are both associated with toxaemia of pregnancy, hypertension,
multiple pregnancy and high maternal age.
(b) Intra-partum asphyxia and birth trauma are associated with
long labour, complicated delivery, multiple pregnancy,
prematurity and high maternal age.
(c) Congenital malformations form a heterogenous group including
hydro-cephalus, meningocele, and congenital heart lesions.
(d) Erythroblastosis foetalis and intra-ventricular haemorrhage;
the former is associated with blood group incompatability,
the latter with prematurity.
In (a), (b) and (d), the associated factors are those for which
higher standards of ante-natal care, a better selection of patients at
risk for hospital delivery, and adequate paediatric care (particularly
of the premature infant) will lead to further reduction in mortality.
The policy of encouraging special obstetric list general practitioners,
and the recent abortive attempt to lay down minimum standards of
attendance by general practitioners undertaking obstetric care, under
the aegis of Executive Councils, are measures to ensure such necessary
care.
In (c), congenital malformations, research proceeds. There has
been a dual genetic approach; on the one hand, at the cellular level
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