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pneumonia. All except two of these persons were over the age of
55 years. Two deaths—both of males—were allocated to the
asthma group.
The mortality from the respiratory group of diseases since
1876 is given in Table XXXI. From this table it is seen that the
local death rate from these conditions has been steadily falling
during these 60 years. The quinquennial period 1916-1920 was an
exception to this general statement, but the high death rate in
this period was due to the influenza epidemics of 1918 and 1919,
and was reflected in similar high rates elsewhere. This statement
holds even though deaths certified as due to "influenza" are not
included in this group of respiratory diseases. Rates for individual
years are liable to show considerable fluctuation owing to
variations in climatic and other conditions, but it is seen that
generally the downward trend was maintained until a year ago.
The differential rates show that the respiratory mortality
has been consistently higher in males than in females in West
Ham. This feature is also shown very definitely in the differential
rates for the country as a whole. The excess mortality of males
is generally considerable, and is especially marked towards the
later decades of life, when the increased exposure of males to
adverse weather conditions is liable to be followed by a fatal issue.
Comparison of the respiratory death rates of this area with
those for the country as a whole is throughout the period of sixty
odd years unfavourable. This excessive mortality from respiratory
conditions is to be expected in a large industrial area, where the
inhabitants are constantly subjected to the adverse influence of
smoke, fog, and other atmospheric impurities. It can, however,
be easily shown that the excess of the local rates over the national
rates has decreased considerably within recent years, and it is
perhaps justifiable to assert that this decrease is associated with
national and local measures which have been taken in this period
to free the atmosphere of its impurities.
Some support for this theory is obtained from an examination
of the respiratory death rates for the Administrative County
of London. These rates show even better than do the local rates
the progressive downward trend, so that the rate for the last
quinquennial period given was only about a third of the rate for
the period 1876-1880. The interesting point is that, at almost
every quinquennial period, the London rates are approximately
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