London's Pulse: Medical Officer of Health reports 1848-1972

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Camberwell 1856

[Report of the Medical Officer of Health for Camberwell, St. Giles]

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11
1632 inhabitants, Camberwell 17,742, Peckham 19,445, and St.
George's, which has an area considerably smaller than either
of the others, 15,849. The population, therefore, of the several
districts displays great differences in point of number, and
naturally the number of deaths in each district exhibits a like
disproportion. Thus, in Dulwich, 17 persons died, in Camberwell
434, in Peckham, 416, and in St. George's 316—that is,
without allowing for increase of population, there died in
Dulwich 10-4 in a 1000, in Camberwell 24-5 in a 1000, in
Peckham 21-4 in a 1000, and in St. George's 19-9 in a 1000.
The difference here indicated is something remarkable; in one
locality 10 persons died in a 1000, in the other localities from 19
to 24 persons died in a 1000. Can this be true ? Is it certain
that no deception exists ? Let us examine into the matter
rigorously.
I need scarcely remind you that the smaller the numbers we
have to deal with, the more liable we are to be misled by fallacies.
Thus, in calculating the mortality of the whole of
London, though fever may be concentrated in the Fever Hospital,
and consumption in the Hospital at Brompton, the places
in which the deaths occur are still in London, and therefore
the general mortality is in no wise affected by the localization
of the diseases. In calculating the mortality of districts however,
the formation of foci of disease in the way indicated,
must frequently prove productive of serious error, inasmuch as
it causes certain localities in which hospitals and infirmaries are
situated to appear disproportionately unhealthy, and those
localities in which these institutions do not exist to seemingly
enjoy a comparative immunity from disease. And in estimating
the death rate of a still smaller portion, as that of a sub-district,
the liability to error becomes yet more increased by the fact
that the poor, the aged, and the insane of several districts are
frequently accumulated into one. Thus the sub-district of
Camberwell contains the Workhouse, in which 73 deaths occurred,
and two Lunatic Asylums from which 87 deaths were
returned ; so that there is collected in that sub-district, a population
amounting to about 1200 persons, who are for the most
part diseased or aged, and in whom therefore an excessive mortality
takes place, which swells most unfairly the mortuary
tables of that locality. In order then to arrive as nearly as
possible at the truth with regard to the actual and relative