London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Heston and Isleworth 1948
[Report of the Medical Officer of Health for Heston and Isleworth]
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The overall death rate is so low that despite tlie increasing proportion of deaths at age 65 years
and over, the number of old persons in the population is steadily increasing. Age has its own special
difficulties and the growing problem of the aged is a challenge to our health and social welfare services.
The chief causes of death during the year were heart disease (110), cancer (84), Bronchitis and pneumonia
(57), and cerebral haemorrhage (46) in males, and heart disease (123), cancer (82), cerebral haemorrhage.
etc., (73), and bronchitis and pneumonia (33) in females.
The burden of producing and supporting the young and of maintaining the aged falls almost wholly on the population aged 15-54 years. From Table IV the percentage of the total deaths from various causes occurring at ages 15-54 and 55 and over years have been extracted, and are shown below:—
| Cause of death | Percentage of total deaths from cause occurring at age | |
|---|---|---|
| 15-54 | 55 and over | |
| Tuberculosis | 70.0 | 29.7 |
| Cancer | 23.1 | 76.9 |
| Cerebral haemorrhage, etc. | 6.6 | 93.4 |
| Heart and circulatory diseases | 10.8 | 88.4 |
| Bronchitis and pneumonia | 6.5 | 86.0 |
| Road traffic and other accidents | 37.0 | 52.6 |
It wall be seen that of the major causes of death tuberculosis, followed by road traffic and other
accidents represent the greatest menace to the producing and reproducing section of the population. Both
causes are preventable and a reduction in such deaths and incapacity would make a considerable contribution
to our national wellbeing and towards the maintenance of our expanding social services.
In the following tables the change in the local infant mortality rate over 5 year periods from 1898 is shown:—
| No. of live births | No. of deaths under 1 year | Infant Mortality Rate | |
|---|---|---|---|
| 1898-1902 | 4,369 | 698 | 160 |
| 1903-1907 | 5,264 | 665 | 126 |
| 1908-1912 | 5,383 | 590 | 110 |
| 1913-1917 | 4,661 | 461 | 99 |
| 1918-1922 | 4,326 | 327 | 76 |
| 1923-1927 | 4,333 | 271 | 63 |
| 1928-1932 | 6,055 | 318 | 53 |
| 1933-1937 | 7,121 | 313 | 44 |
| 1938-1942 | 6,912 | 393 | 57 |
| 1943-1947 | 8,210 | 345 | 42 |
| 1948 | 1,545 | 46 | 30 |
It will be seen that apart from a break in 1938-42 the fall in the infant mortality rate has been
steady and continuous. The rate of fall is slowing down as preventable deaths are beiner eliminated.
The chief causes of infant deaths are (a) prematurity and congenital defects and (b) infections. The following table shows the trend of the infant mortality rate for these two conditions:—
| Rate per 1,000 live births. | ||||||
|---|---|---|---|---|---|---|
| 1911-15 | 1940-44 | 1945 | 1946 | 1947 | 1948 | |
| Cause of death. | ||||||
| Prematurity, congenital defects, etc. Gastro-enteritis pneumonia and other | 30.4 | 22.7 | 23.6 | 17.1 | 18.9 | 19.3 |
| infections | 62.6 | 22.8 | 12.1 | 4.4 | 15.2 | 6.4 |
Some signs of a downward trend in deaths from prematurity and congenital defects are appearing.
The reduction in infant deaths from infection is striking but the considerable fluctuation from year to year
stresses the need for continuous effort to remove overcrowding, ignorance and poverty which contribute
so greatly to the occurrence, spread and neglect of infections.
Maternal Mortality.—The number of deaths due to causes associated with pregnancy and childbirth
was one. This gives a maternal mortality rate per 1,000 total (live and still) births of 0.6 as compared
with 1.0 for England and Wales. Maternal deaths are usually divided into those due to septic infection
and those due to diseases and other conditions associated with pregnancy and labour, and the
local trend of deaths from these two causes is shown below:—
Maternal deaths per 1,000 total (live and still) births.
| Sepsis | Other causes | Total | |
|---|---|---|---|
| 1930-34 | 2.6 | 1.7 | 4.4 |
| 1935-39 | 1.0 | 2.1 | 3.1 |
| 194044 | 0.7 | 1.2 | 1.9 |
| 1945 | 0.6 | 1.3 | 2.0 |
| 1946 | 0.5 | 1.6 | 2.2 |
| 1947 | — | 0.5 | 0.5 |
| 1948 | — | 0.6 | 0.6 |