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.

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    Rowland Wilson, Department of Labour and National Service, Australia, and Dr. H. Watt, Director-General of Health, New Zealand, for specially prepared accounts of conditions in Australia and New Zealand which, we regret, were received when this report was already in the press and too late for inclusion. We also wish to express our appreciation of the work of the Secretary, Mr. J. B. Swan, whose efficient help has contributed greatly to the success of the work of the Committee, and our thanks to other officials of the Department of Health for Scotland for their assistance. SUMMARY OF EVIDENCE ff pases evidence presented applies almost entirely, except for Part II, Still- births, to conditions up to 1939. Part I.—The Mortality of Live-Born Infants Scotland has the highest infant mortality rate of seventeen countries, including the Dominions, the United States of America and all the countries of Western Europe, except Spain and Portugal. | The problem of this high mortality has been analysed in two parts: deaths under one month of age (neonatal mortality) and deaths between one month and twelve months. To bear comparison with New Zealand or Holland, Scotland would have to reduce neonatal mortality by 30 per cent., and mortality between one and twelve months by 75 per cent. It is therefore obvious that success is more likely to follow quickly on efforts to improve the latter than the former. The saving of lives by these reductions would be 3,640 annually. Comparison of the death rates in different areas shows that there is, in Scotland, a general heaping up of adverse conditions contributing to high infant mortality, affecting both rural and urban areas, greatest in the West Central (urban) and North East (rural )areas. Study of the causes of death shows that prematurity and deaths ascribed to “ congenital debility ’’ are mainly responsible for the excess mortality in the first month. The causes are therefore mainly operative before birth, but some reduction could be effected by improving nurseries and nursery staffing in maternity hospitals so that premature and sick babies can be isolated, and neonatal infection brought under stricter control. The excess between one and twelve months is due chiefly to infectious diseases. To understand this finding, it is necessary to appreciate the nature of the adverse environmental conditions contributing to the high incidence of, and mortality from, infections. These are in the main poverty, faulty feeding and poor housing. In Scotland, as compared with England and Wales, the percentage of unemployment is higher, the proportion of people living in poverty twice as high and the per- centage of overcrowding six times as great. In addition, especially in the in- dustrial belt, severe winter conditions influence child life adversely and tend to increase the severity of the commoner infectious diseases of children. The birth rate among the Scottish poor is at a high level such as is desired for the whole population. Families are therefore larger. This in itself increases poverty since wages are not adjusted to the size of the family. But the ex- perience of New Zealand and Holland shows that a high birth rate need not be accompanied by a high infant death rate. Part I1.—Stillbirths The excess of stillbirths in Scotland is as great as the excess of neonatal deaths,