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

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Whitechapel 1878

[Report of the Medical Officer of Health for Whitechapel]

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11
In Commercial Street, Leman Street, Great Alie Street, Mansell
Street, and in other parts of the District, a considerable number of the
old-fashioned gullies, which were large receptacles for offensive matter, have
been broken up, and new and improved gullies formed and properly
trapped."
It appears that the sum expended on sewers from 1856 to 1878 was—
For construction £9672 1 0
Repairs and alterations 6159 12 2
Cleansing 10312 7 2
Total £27,144 0 4
Benefits resulting from Sanitary Improvements.
It may fairly be asked what the ratepayers have gained by the carrying
out of the extensive sanitary improvements in this District, a portion only
of which I have here recorded. In the first place it will be perceived on
looking over the table published on page 12 of my report for the Quarter
ended on Saturday, the 31st March, 1877, that the rate of mortality in
this District has considerably decreased. Thus in 1838, which was a very
unhealthy year owing to a severe epidemic of fever, the rate of mortality
was 44.2 per 1000 ; in the following year it was 35.2 per 1000; while in
1876 it was 23.9 per 1000. In 1877 it rose to 25.2, and in 1878 it was
25.6 per 1000; or 1 in 39 of all living. It has, however, been alleged that
the rate of mortality in the whole of London has not been lessened since
1840, when the Registrar-General's returns show that the death rate in
that year was 24.0 per 1000, and in 1878 it was 23.5 per 1000—a difference
of only 0.5 per 1000. There is no denying the facts tabulated
year by year by the Registrar-General; but, if the returns are carefully
analyzed, it will be found that in those districts where the population was
spread over a large area, the rate of mortality was comparatively
low; whilst in the more densely populated districts it was proportionately
high. Where, owing to the increase of population in the whole of
London the formerly sparse districts became more densely populated, the
rate of mortality from that cause increased; while in those districts in which
there was very little space for new dwelling houses to be erected the death,
rate decreased, owing to the improved sanitary works which have been
carried out in them; for, other things being equal, density of population
tends to increase the rate of sickness and mortality. This seems to be, as
is shown by the Registrar-General, a universal law; and hence it is found
that villages as they become populous or grow into towns, assimilate to the
latter in the frequency of diseases and a higher death rate.