Infant mortality in Scotland / the report of a sub-committee of the Scientific Advisory Committee.

  • Great Britain. Department of Health for Scotland. Scientific Advisory Committee on Medical Administration and Investigation.
Date:
1943
Catalogue details

Licence: Public Domain Mark

Credit: Infant mortality in Scotland / the report of a sub-committee of the Scientific Advisory Committee. Source: Wellcome Collection.

    16/88 (page 14)
    The mortality over parts of the Highlands and Islands is low and bears com- parison with the S.E. of England. Urban and Rural Areas : When urban and rural areas in the two countries are compared (Table 7), the same difference in favour of England and Wales is Table 7.—Infant Mortality Rates (I.M.R.), Neonatal Mortality Rates (N.M.R.) and Mortality between 1 and 12 Months (1-12) in Rural and Urban Areas of Great Britain, 1984-88 I.M.R. | N.M.R. | 1-12 I.M.R. | N.M.R. | 1-12 Scotland England & Wales Large Burghs. 86 38 48 Gtr. London . 54 24 30 Small Burghs . 65 Other County Landward 36 29 Boroughs . 65 33 32 Areas : 65 Other Urban Districts... : 54 31 23 Rural Districts 50 30 20. 1 In England, Rural Districts. found in both types of area. Both in Scotland and in England and Wales, the infant mortality is lower in rural areas than in urban areas. The excess mortality in urban areas in general suggests that certain town influences adversely affect infant mortality, but recent experience in the U.S.A. shows that such influences can be overcome. From 1915 to 1928 urban mortality was higher than rural, but since then the reverse has been the case. In the U.S.A., births and deaths are not allocated to the place of residence of the mother as in Great Britain, but to the place of occurrence of the birth or death. A special investigation in 1939 (Sommers, 1942) of infant mortality in the white population by place of residence showed that the mortality in cities (over 10,000) had been reduced to 41, and was below that in rural areas, 46; but that mortality in small towns (2,500-10,000) was still 50 and above both the city and rural death rates. “ Towns provided the least favourable oppor- tunity for infant survival, having apparently sacrificed the healthful environ- ment of the rural area without having attained the superior facilities of the city.” The experience of Holland, where the infant mortality rate (1930-32) in towns with a population over 100,000 was 37, and in rural areas 54, has been similar (Titmuss, 1943). The general surplus of adverse conditions in Scotland, affecting both rural and urban areas, places the special hospital and medical services at a disadvantage and prevents their full influence from being manifested. Cities of Great Britain: The four Scottish cities are compared with cities or aggregates of cities of comparable size in England and Wales in Table 8 (p. 15). From this it will be seen that the infant mortality rate in Glasgow in 1934-38 was 99, the highest of any city or large burgh in Great Britain. Its rate is 27 per cent. higher than that of Liverpool and 57 per cent. higher than that of Birming- ham, cities of comparable size. It is 60 per cent. higher than that of the county of London and 83 per cent. higher than that of Greater London. The cities of Aberdeen and Dundee show rates of 76 and 77; Coventry, Southampton, Bolton and Swansea are all 20 to 25 per cent. lower; only Sunderland is as high. Edinburgh is the only Scottish city which compares at all favourably with cities of similar size in England and Wales, but, even so, Bristol and Sheffield, with rates of 46 and 54, are lower. Similarly the neonatal rates of the four Scottish cities, particularly Glasgow, are among the highest in the list. Yet from the preceding discussion of urban and rural rates in U.S.A. and Holland, it is evident that the conditions of life in large cities need not be associated with a high infant mortality rate.