From this table it appears that the mortality from measles, scarlet-fever, and diarrhœa was greater in Liverpool than in the Strand; but that the other diseases scheduled were more fatal in the Strand than in Liverpool.
We have previously pointed out that the deaths of children from tuberculous and respiratory diseases are greater in London than in any other county, and now we find that the death-rate of children from these two classes of diseases amounted in the 'Strand' to 42,003, far and away the highest figure in the country, Liverpool coming second with 33,218. The death-rate of children from the same causes in Andover was only 9,305, considerably less than a quarter of the Strand death-rate.
Thanks to vaccination and the purity of the water-supply the mortality in the Strand from small-pox and fever is very small, but the mortality of children from the acute air-borne contagia (measles, whooping cough, scarlet-fever, and diphtheria), and still more from the chronic air-borne contagia, is fearful to contemplate.
The big mortality from tuberculous disease forces upon us the reflection that a large number of children who become tuberculous in the 'Strand' do not die within the age limits with which we are concerned, but drop off later in life after years of invalidism and suffering. We have seen that children under five are decimated yearly in the Strand. How many more are crippled for life?
The deaths of children under one year of age per 1,000 births is a safe criterion of the health conditions of a locality. This figure for the ten years 1881-90 was, for the whole of England and Wales, 142. In London, we find that in five districts (Hampstead 117, Lewisham 121, Woolwich 124, Hackney 137, and Wandsworth 141) this mortality was below the average of the whole country, while in the remaining twenty-five districts it was above the average.
In Paddington, Islington, Camberwell, Lambeth, Greenwich, Mile End, Poplar, and Marylebone, it was above 142 and under 150. In St. Pancras, Kensington, St. George's (Hanover Square), St. Giles's, Bethnal Green, and St. Olave's, it was above 150 and under 160; in Chelsea, Fulham, Westminster, Holborn, Shoreditch, and St. Saviour's, it was over 160 and under 170. The City was 171, Whitechapel 173, St. George's-in-the-East 182, Stepney 196, the Strand 226.
To show what this figure of 226—the infant mortality of the Strand—means, I will give the infant mortality of some of the worst towns in Lancashire: in Liverpool 219, Wigan 161, Bolton 163, Salford 183, Manchester 193, Ashton-under-Lyne 173, Oldham 169, Rochdale 145, Burnley 184, Blackburn 178, Preston 203. On the other hand, one may say that the infant mortality of Andover, which has just adopted a great part of the London Building Act, with the approval of the Local Government Board, was (for the ten years 1881-90) 91, or 23 per cent. less than the best of the London districts, and nearly 60 per cent. better than the Strand.
Glancing at the other Hampshire districts, one may note that in the New Forest the infant mortality was as low as 80, and that it was only in Portsea Island (139), Alverstoke (123), and Southampton (135) that even the lowest of the metropolitan figures were approached. It is interesting to note that even the worst districts in Hampshire are below the average of the whole kingdom in the matter of infant mortality.
The Strand
I have previously alluded to the high mortality of the Strand registration district, and my remarks on one occasion were contemptuously dismissed, with the criticism that it was unfair to judge of the state of London by the health of the slums.