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20
The 1931 Report is made by Dr. Powell. Dr. Clarke having
retired in the previous year. The population had increased to
132,965 and Walthamstow was now the largest Municipal Borough (NonCounty)
in England. The birth-rate had dropped to 14.5, while the
death-rate was steady at 10.4 the expectation of life had increased
to about 60 years (Male 58.74, Female 62.88) and the population was
beginning to approximate to a modern distribution, i.e., far fewer
children and relatively more of the middle-aged and elderly. The
Infant Mortality Rate was, however, little improved; from 61.4 in
1921 it had fallen only to 56 per thousand live births though this
was still better than England and Wales (66) or London (65). It is
said that the Infant Mortality Rate is a good index of the quality
of the Health and Welfare services available, and it is gratifying
to note that Walthamstow has been consistently in the lead in
maintaining a low Infant Death Rate.
Notifiable infectious diseases still accounted for much
morbidity, Chicken Pox was made notifiable because of the local
prevalence of Smallpox. Table III shows the incidence of Infectious
Diseases in 1931.

Several more diseases had been added to the list of those
notifiable and there had been little improvement in the case
incidence compared with previous years, but the case mortality ratio,
that is, the number of deaths from diseases divided by the number of
cases occuring, showed a dramatic fall, except for tuberculosis.
Whooping Cough (14 deaths) and Influenza (20 deaths) were not then
notifiable.
Deaths in children under five totalled 155, only 11 per cent of
the total (1,403). Over one third of these were due to congenital
debility and malformation, premature birth, etc., which conditions
nowadays account for the majority of infant deaths. Infantile
Diarrhoea and Enteritis, the great killers of children in the two
earlier decades, accounted for only eight deaths.