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Vital statistics, England and Wales, 1954
P U B L I C HEALTH,
February,
I955
79
VITAL STATISTICS, ENGLAND A N D WALES, x954 The Reg!strar-General's provisional vital statistics for England and Wales for the fourth quarter of 1954 and for the whole of that year have now been published. * Infant mortality was ahain lower, although there were more stillbirths registered.
N o serious complications have occurred a m o n g the vaccinated. A n e n l a r g e d gland in t h e axilla was f o u n d in 34 cases, w h i c h varied in size f r o m j u s t palpable to the size of a b e a n or hazel nut. I n n o case has there b e e n s o f t e n i n g of the gland or discharge f r o m it. G l a n d u l a r e n l a r g e m e n t m a y develop several m o n t h s after vaccination, and p a r e n t s are asked to r e p o r t t r o u b l e of any sort, b u t only one case has b e e n r e p o r t e d w i t h later e n l a r g e m e n t of an axillary gland to the size o f a hazel nut. M o s t of the cases have b e e n seen f r o m time to time after vaccination at Dawlish Road Clinic or at one of the o t h e r L e y t o n Clinics. In two cases there was a rather deep ulcer w h i c h filled u p and healed. I n the o t h e r cases the reaction was trivial. A M a n t o u x test a year or m o r e after vaccination was d o n e in 69 cases, and in all sensitivity was maintained. W i t h regard to the t e c h n i q u e of vaccination, it is m o s t i m p o r t a n t to inject intradermally a n d n o t subcutaneously. It has b e e n said that this requires special experience, but I think it would be a pity to exaggerate the difficulty. A f t e r all, we school and welfare doctors are doctors, and m u s t have d o n e m a n y m o r e difficult things in our time. M a n y o f us have had m u c h experience in Schick testing, w h i c h a m o u n t s to the same thing. F o r those w h o m a y be less experienced, p e r h a p s one or two hints m a y be useful. I find it easier to do i n t r a d e r m a l injections w i t h the a r m steadied across t h e c o r n e r o f a table. U n l e s s the a r m is steady it is difficult to gauge the resistance o f the skin. T i n y babies are m u c h easier to manage face d o w n across the n u r s e ' s knee on a n u r s i n g chair, usually available in a welfare centre. T h e b a b y should be allowed to settle c o m f o r t a b l y w i t h o u t being held. N u r s e t h e n gently extends t h e arm and steadies the s h o u l d e r (not the head) w~ile the d o c t o r stretches t h e skin b y grasping r o u n d the arm. " I vaccinate babies on the deltoid region, n e v e r on the n a p k i n area, w h i c h I t h i n k is asking for trouble. N o dressing should be applied. T h e r e is a little discharge in m o s t cases after a b o u t a m o n t h . I f it is sufficient to stain t h e clothes a piece of lint can be s a f e t y - p i n n e d to the s h o u l d e r o f the vest so that it hangs loose. O n no account close in the ulcer w i t h plaster. I have h e a r d t h a t P.A.S. is specific for t r o u b l e s o m e ulcers. I u s e d it once or twice on m y two r a t h e r d e e p ulcers, and t h e y certainly s e e m e d to heal quickly. T h e object of this p a p e r is to suggest to o t h e r welfare m e d i c a l officers t h a t this work is suitable for t h e m . T h e opinions expressed are m y o w n and are not necessarily t h o s e of the Essex C o u n t y Council for w h o m I work.
Live Births The total of live births registered in the year was 673,212, wh.tch was 8,752 lower than the total for 1953, but only 74 less than in 1952. The rate per 1,000 population was 15.2, compared with 15.5 in 1953 and 15-3 in 1952. I,ive births registered in the fourth quarter of ]954 numbered 156'892, representing a rate of 14.1 per thousand population, compared with 157,895 (rate 14-2) and 157,759 (rate 14.3) in the same quarter of 1953 and 1952, respectively. Infant Mortality In 1954 there were 17,098 deaths of children under one year of age, representing a rate of 25.5 per thousand related live births, the lowest annual rate ever recorded in this country. This rate compares with 26.8 in 1953, 27.6 in 1952, 29.7 in 1951 and 52.8 in 1938. Infant deaths in the December quarter numbered 4,067, giving a rate of 25.3. This also is a record figure for a fourth quarter, the previous lowest rate for that quarter being 26.2 in 1953. Deaths The deaths registered in the year numbered 501,878~, representing a rate of 11.3 per thousand population, compared with rates of 11.4 in 1953 and 11.3 in 1952. There were 127,417 deaths registered in the December quarter, giving a rate of 11.4 per thousand population. This rate compares with 10.7 and 12.4 in the corresponding quarters of 1953 and 1952. Natural Increase The surplus of registered births over registered deaths was 171,334. Stillbirths There were 16,130 stillbirths registered in the year 1954, representing a rate of 24.0 per thousand total live and stillbirths. This was higher than the rates for 1953 and 1952 of 22.5 and 22.7 respectively. The figure for the December quarter (3,839) represented a rate of 23.8, compared with rates of 23.4 and 23.2 in ]953 and 1925 respectively. * The Registrar-General's Weekly Return No. ~,~ 1955, H.M.S.O., price Is. net or by post from P.O. Box 569, London, S.E.1, price Is. 1-d.
In the following table the numbers and rates of live births, stillbirths, deaths and deaths of children under one year of age registered in the December Quarter and in the whole year 1954 are compared with the corresponding figures for 1953, 1952, 1951 and ]938 : - ENGLAND AND WALES
Live births
Stillbirths
Death (including non-civilians)
Deaths of infants under one year
Number
Per 1,000 total population
Number
Per 1,O00 total live and stillbirths
Number
Per 1,000 total population
Number
Per 1,OOO related live births
Fourth quarter o f : - 1954 1953 1952 1951 1938
156,892 157,895 157,759 153,995 143,756
14-1 14.2 14.3 13.9 13.8
3,839 3,777 3,755 3,812 5,833
23'8 23"4 23'2 24-2 39"0
127,417 118,992 136,554 121,894 119,366
ll'4 10.7 12-4 ll.0 11-5
4,067 4,305 4,731 4,583 7,504
25'3 26"2 29-0 28"5 49-4
Year : - 1954 1953 1952 1951 1938
673,212 681,964 673,286 679,689 621,204
15-2 15"5 15-3 15"5 ]5'1
16,130 15,683 15,647 16,019 24,729
24.0 22.5 22.7 23"0 38.3
501,878 503,529 497,484 549,380 478,996
11.3 11.4 11.3 12.5 ll-6
17,098 18,324 18,555 20,224 32,724
25.5 26"8 27"6 29"7 52-8
February,
I955
79
VITAL STATISTICS, ENGLAND A N D WALES, x954 The Reg!strar-General's provisional vital statistics for England and Wales for the fourth quarter of 1954 and for the whole of that year have now been published. * Infant mortality was ahain lower, although there were more stillbirths registered.
N o serious complications have occurred a m o n g the vaccinated. A n e n l a r g e d gland in t h e axilla was f o u n d in 34 cases, w h i c h varied in size f r o m j u s t palpable to the size of a b e a n or hazel nut. I n n o case has there b e e n s o f t e n i n g of the gland or discharge f r o m it. G l a n d u l a r e n l a r g e m e n t m a y develop several m o n t h s after vaccination, and p a r e n t s are asked to r e p o r t t r o u b l e of any sort, b u t only one case has b e e n r e p o r t e d w i t h later e n l a r g e m e n t of an axillary gland to the size o f a hazel nut. M o s t of the cases have b e e n seen f r o m time to time after vaccination at Dawlish Road Clinic or at one of the o t h e r L e y t o n Clinics. In two cases there was a rather deep ulcer w h i c h filled u p and healed. I n the o t h e r cases the reaction was trivial. A M a n t o u x test a year or m o r e after vaccination was d o n e in 69 cases, and in all sensitivity was maintained. W i t h regard to the t e c h n i q u e of vaccination, it is m o s t i m p o r t a n t to inject intradermally a n d n o t subcutaneously. It has b e e n said that this requires special experience, but I think it would be a pity to exaggerate the difficulty. A f t e r all, we school and welfare doctors are doctors, and m u s t have d o n e m a n y m o r e difficult things in our time. M a n y o f us have had m u c h experience in Schick testing, w h i c h a m o u n t s to the same thing. F o r those w h o m a y be less experienced, p e r h a p s one or two hints m a y be useful. I find it easier to do i n t r a d e r m a l injections w i t h the a r m steadied across t h e c o r n e r o f a table. U n l e s s the a r m is steady it is difficult to gauge the resistance o f the skin. T i n y babies are m u c h easier to manage face d o w n across the n u r s e ' s knee on a n u r s i n g chair, usually available in a welfare centre. T h e b a b y should be allowed to settle c o m f o r t a b l y w i t h o u t being held. N u r s e t h e n gently extends t h e arm and steadies the s h o u l d e r (not the head) w~ile the d o c t o r stretches t h e skin b y grasping r o u n d the arm. " I vaccinate babies on the deltoid region, n e v e r on the n a p k i n area, w h i c h I t h i n k is asking for trouble. N o dressing should be applied. T h e r e is a little discharge in m o s t cases after a b o u t a m o n t h . I f it is sufficient to stain t h e clothes a piece of lint can be s a f e t y - p i n n e d to the s h o u l d e r o f the vest so that it hangs loose. O n no account close in the ulcer w i t h plaster. I have h e a r d t h a t P.A.S. is specific for t r o u b l e s o m e ulcers. I u s e d it once or twice on m y two r a t h e r d e e p ulcers, and t h e y certainly s e e m e d to heal quickly. T h e object of this p a p e r is to suggest to o t h e r welfare m e d i c a l officers t h a t this work is suitable for t h e m . T h e opinions expressed are m y o w n and are not necessarily t h o s e of the Essex C o u n t y Council for w h o m I work.
Live Births The total of live births registered in the year was 673,212, wh.tch was 8,752 lower than the total for 1953, but only 74 less than in 1952. The rate per 1,000 population was 15.2, compared with 15.5 in 1953 and 15-3 in 1952. I,ive births registered in the fourth quarter of ]954 numbered 156'892, representing a rate of 14.1 per thousand population, compared with 157,895 (rate 14-2) and 157,759 (rate 14.3) in the same quarter of 1953 and 1952, respectively. Infant Mortality In 1954 there were 17,098 deaths of children under one year of age, representing a rate of 25.5 per thousand related live births, the lowest annual rate ever recorded in this country. This rate compares with 26.8 in 1953, 27.6 in 1952, 29.7 in 1951 and 52.8 in 1938. Infant deaths in the December quarter numbered 4,067, giving a rate of 25.3. This also is a record figure for a fourth quarter, the previous lowest rate for that quarter being 26.2 in 1953. Deaths The deaths registered in the year numbered 501,878~, representing a rate of 11.3 per thousand population, compared with rates of 11.4 in 1953 and 11.3 in 1952. There were 127,417 deaths registered in the December quarter, giving a rate of 11.4 per thousand population. This rate compares with 10.7 and 12.4 in the corresponding quarters of 1953 and 1952. Natural Increase The surplus of registered births over registered deaths was 171,334. Stillbirths There were 16,130 stillbirths registered in the year 1954, representing a rate of 24.0 per thousand total live and stillbirths. This was higher than the rates for 1953 and 1952 of 22.5 and 22.7 respectively. The figure for the December quarter (3,839) represented a rate of 23.8, compared with rates of 23.4 and 23.2 in ]953 and 1925 respectively. * The Registrar-General's Weekly Return No. ~,~ 1955, H.M.S.O., price Is. net or by post from P.O. Box 569, London, S.E.1, price Is. 1-d.
In the following table the numbers and rates of live births, stillbirths, deaths and deaths of children under one year of age registered in the December Quarter and in the whole year 1954 are compared with the corresponding figures for 1953, 1952, 1951 and ]938 : - ENGLAND AND WALES
Live births
Stillbirths
Death (including non-civilians)
Deaths of infants under one year
Number
Per 1,000 total population
Number
Per 1,O00 total live and stillbirths
Number
Per 1,000 total population
Number
Per 1,OOO related live births
Fourth quarter o f : - 1954 1953 1952 1951 1938
156,892 157,895 157,759 153,995 143,756
14-1 14.2 14.3 13.9 13.8
3,839 3,777 3,755 3,812 5,833
23'8 23"4 23'2 24-2 39"0
127,417 118,992 136,554 121,894 119,366
ll'4 10.7 12-4 ll.0 11-5
4,067 4,305 4,731 4,583 7,504
25'3 26"2 29-0 28"5 49-4
Year : - 1954 1953 1952 1951 1938
673,212 681,964 673,286 679,689 621,204
15-2 15"5 15-3 15"5 ]5'1
16,130 15,683 15,647 16,019 24,729
24.0 22.5 22.7 23"0 38.3
501,878 503,529 497,484 549,380 478,996
11.3 11.4 11.3 12.5 ll-6
17,098 18,324 18,555 20,224 32,724
25.5 26"8 27"6 29"7 52-8