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

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Walthamstow 1904

[Report of the Medical Officer of Health for Walthamstow]

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With a decreasing birth-rate it behoves us to take the greatest care
of those that are born and to ensure that they are viable.
In this connection the survival of the fittest doctrine brings little
comfort, as the bad influences that work in killing the weakest and
poorest leave their mark upon and impair the vitality of the survivors.
To ensure that the strong and healthy will live and that the weakest
may have a chance is the aim of our work.
That there should be no difficulty in reducing our infantile rate to
100 may be easily deduced from existing conditions in portions of the
district. In 1903 the Hoe StreetWard had a rate of 97'3 per 1,000
children born and this year a rate of 109; rates much more favourable
than in any other ward.
Sanitary and seasonal conditions are common to all the wards, and
the only explanation of the low rate of the Hoe Street Ward lies in its
better social condition, the greater care exercised by the well-to-do
towards their offspring, the comparative absence of early marriages
among them, with its consequent ignorance, poverty, and artificial baby
feeding common to all the others.
Mr. Charles Ansell, Actuary of the National Life Assurance Company,
showed in 1874 that, below one year of age, the infant mortality
of the upper and middle classes did not exceed 89 per 1,000 for males
and 70 for females; and the experience of the Prudential Insurance
Company showed that out of half a million of infants under twelve
months insured in the society, the death-rate ranged from 106 to 137
per 1,000 for males and 89 to 114 for females.
These facts warrant us in assuming that anything over a rate of 100
indicates conditions existing productive of lowered vitality and defective
developmental capacity, which are the forerunners of physical degeneration
in the adult.
Apart from sanitary conditions, the greatest improvement may be
looked for in improved methods of education for our girls and their
compulsion to stay at school for a longer time than at present, with a
considerable raising of the age limit before going to work.
That some such protection for the poor in their own interests is
necessary, one has only to notice the poor physique of many of the
factory hands as they come from and go to work. Nothing in the
shape of improvement of the race can be expected from much of this

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