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

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West Ham 1948

[Report of the Medical Officer of Health for West Ham]

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In 1948 the Infantile deaths dropped to 111: a mortality rate of 30® This new rate
represents a substantial improvement and is welcomed. It must be remembered that we are
dealing here with comparatively small numbers statistically, which means that we must expect
fluctuations, both up and down, from year to year. To give a clear and useful idea of what
has been happening over the past 20 years a diagram has been included opposite this page
showing the infantile deaths and the stillbirths for each year because when these are added
together it gives a better idea of the total wastage of Infant life than either figure alone.
When you look at these figures you will be impressed that while there has been a
general, though uneven, decline in infant deaths for some years the stillbirth rate showed
no tendency to lessen until 1943: since that time the rate has fairly steadily improved.
This improvement may be related to better nutrition resulting from the National Milk and
Vitamins schemes for expectant mothers.
The chief causes of infantile deaths are given in Appendix No. 10 page 46.
but there are some points requiring textual comment. Of these 111 deaths, no fewer than 31
are ascribed to prematurity; but this is not the whole picture, for the death of a premature
baby who dies from some infection may be allocated to that infection rather than to prematurity.
In fact, 49 premature infants died® The question of prematurity is discussed later in this
report.
Deaths due to a group of causes including congenital malformations and birth injury
number 37. The causes of congenital malformations are largely unknown to us and it is not
therefore possible to control their incidence. The number of deaths due to birth injury is
partly a matter of obstetric skill.
The respiratory diseases, pneumonia (l4); bronchitis (5) and influenza (2); whooping
cough (4); tuberculosis (1) and other respiratory diseases (1)5 together accounted for 27
deaths. The infant is particularly vulnerable to such infections. This is a group of diseases
in which overcrowding is likely to be an important factor.
Gastro-enteritis was the cause of death in 11 children under one year of age. This
disease, at one time responsible for an appalling decimation of babies, has greatly declined
in the past 25 years® Its prevention is a matter of hygiene, its solution a matter of education®
MATERNAL MORTALITY® During the year 3 deaths (1 due to puerperal sepsis) occurred as a
result of childbirth. This gives a rate of 0.80 per 1,000 live and still births as against a
rate of 2.l4 for the previous year. The rate for England and Wales as a whole in 1948 was 1.02.
Owing to the comparatively small numbers involved we must expect some up and down
fluctuation from year to year, but the reduction in these very tragic deaths is most welcome®
INFECTIOUS DISEASES.
TUBERCULOSIS. During the year 228 new cases of tuberculosis were notified. This
represents a slight rise over the numbers for the last few years (inset) but it is not possible
to say whether this represents any change in the trend of morbidity. Deaths numbered 106 in
1948, compared with 122 in the previous year. The death rate
per 1,000 of the population for all forms of tuberculosis was
0.6l-(pulmonary 0.55 and other forms 0.06). The rates for
all forms of this disease for England and Wales, and 126
County Borough and Great Towns were respectively 0.51 and 0.59.
The rather higher rate in West Ham may be related to the age
and sex structure of the local population and, as I have said
earlier, this is not known.

Number of Cases of Tuberculosis (Notified)

PulmonaryNon-Pulmonary
194222040
194322738
194419533
194517834
194617823
194716724
194819236
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