Part 38

So far as I have been enabled to observe or collect from the extremely imperfect data at present available to the public service, the line of the average ages of the living is comparatively steady; the disturbances by migration and immigration which often compensate each other, for the same place and period, being much the same at different periods, and seldom affect the results materially, whilst the variations in the pressure of the causes of death from year to year, are usually considerable, and warrant the assumption that in general the disturbances occasioning the divergence described, are from the operations of causes of death upon that line. Wherever the pressure of the causes of death has yet been observed to be very great, there the line of mortality, or the average age of death, is below, what may be called, the line of vitality constituted by the average age of the living; and wherever there is on the whole any diminution of those causes of death, as by better ventilation, or by widening streets, opening new thoroughfares, better supplies of water, sewering and cleansing, and improvements in the general habits of the population, there the line of mortality, the infantile mortality especially, diminishes, the average age of each adult class, up to sexagenarians or octogenarians, increases, and the average age of death ascends above the average age of the living. The means of observation are as yet too few to elicit more than indications for the guidance of sustained investigation, to determine whether the divergence of the two lines may be reduced to any rule.

In Liverpool,—where the investigations into the condition of the resident cellar population certainly show an increase of the causes of death,—overcrowding, defective ventilation, bad supplies of water, and increased filth,—the average age of death is, for the whole town, 17 or 18 years only, whilst the average age of the living population, so far as it can be made out from the mode in which the census is prepared, is 24 years. As far as can be ascertained by reference to previous registries of one large parish, where the ages of the dead were formerly entered, the average duration of life in that town has gradually fallen. The average ages of all who were buried in St. Nicholas parish between the years 1784 and 1809 was 25.

In Manchester, the average age of the living is 25 years, but the average age of the dying is only 18. In Leeds, the average age of the living is also 25 years, but the average age of the dying is only 21.

Years. Months.

The average age of all who _live_ in the town parishes of Middlesex, so far as they can be made out from the 26 2 only available materials,—the returns in quinquennial periods,—is only

But the average age of all who _die_, judging from one 27 0 year’s return, appears to be about

If, however, we allow for the understatement of ages, the two lines for the whole metropolis would be nearly coincident. On the experience of Carlisle and Hereford, the average age of death should be twelve years higher.

Arranging the several districts of the metropolis, in the order of the average age of deaths, we find the average age of the living decrease with the average age of the dying; and the proportion of births to the population increase with the decrease of the average age of death. The excess in the proportionate number of births beyond the proportions in such a county as Hereford (1 to 44), where the average age of death is much higher, and proportionate number of deaths to the population, afford important indicia.

──────────────────┬────────┬─────────┬───────┬───────┬───────────────── │Average │ Average │Propor-│Propor-│ Districts in which│ Age of │ Age of │ tions │ tions │ Excess above average Age of │Death in│ all who │ of │ of │ County of Death of the whole│the Dis-│ live in │Births │Deaths │ Hereford in the Population is │ trict, │the Dis- │to the │to the │ Number of: │ of all │ trict. │ Popu- │ Popu- │ │Classes.│ │lation.│lation.│ ──────────────────┼────────┼─────────┼───────┼───────┼─────────┬─────── │ │ │ │ │ Deaths │ │ │ │ │ │ and │Births. │ │ │ │ │Funerals.│ ──────────────────┼────────┼─────────┼───────┼───────┼─────────┼─────── │ Years. │yrs. mon.│ │ │ │ Highest │ │ │ │ │ │ (Comprising 2 │ │ │ │ │ │ Districts.) │ 35│ 27 11│1 to 41│1 to 42│ 966│ 145 Population │ │ │ │ │ │ 120,678. │ │ │ │ │ │ 1. Intermediate (6│ │ │ │ │ │ Districts.) │ 30│ 27 5│1 to 39│1 to 46│ 1,836│ 639 Population │ │ │ │ │ │ 311,022. │ │ │ │ │ │ 2. Intermediate │ │ │ │ │ │ (12 Districts.) │ 27│ 26 11│1 to 33│1 to 40│ 7,457│ 5,718 Population │ │ │ │ │ │ 774,937. │ │ │ │ │ │ Lowest (12 │ │ │ │ │ │ Districts.) │ 23│ 26 5│1 to 30│1 to 41│ 5,705│ 6,822 Population │ │ │ │ │ │ 663,290. │ │ │ │ │ │ ──────────────────┴────────┴─────────┴───────┴───────┴─────────┴───────

It will be observed that in the least healthy districts where the pressure of the causes of mortality is the most extensive, the average age of death falls nearly three years and a half _below_ the average age of the living, whilst in the higher districts the line of mortality rises towards the natural position, or nearly four years above it. But it must still be borne in mind, in the inspection of the returns from the highest district, that the average is made up of districts which are probably retrograding, connected with others which are advancing,—of districts such as are developed by Mr. Worrell, registrar, in his note on one of the returns from St. Pancras, comprising streets, the connected courts and alleys from which are widely as separate and distinct in condition,—and, if I may use such an illustration, as little appropriate for any average that could be represented by numerals—as were the conditions of Lazarus and Dives.

Even the lowest proportion of deaths to the population presented in the district returns, that of Hackney, where it is only 1 to 56. appears to be a proportion in excess by nearly one-eighth, _i. e._ the deaths from epidemics, as well as the excess of more than one-third in the deaths of children under 10 years of age. The return, from the healthiest district in the returns, of the average age of deaths gives an average of 7 years’ loss of life for the whole population; whilst for the _adults_ of the middle classes it gives 10 years, and for the _adults_ of the working classes 7 years’ premature loss of life. Even in the county of Hereford where there is a proportion of deaths of 1 to 64 of the population, and the standard of the Carlisle table of insurance where an average age of 39 years of death is attained, it will be observed that even this average includes a large proportion (542), or nearly 1-third in the number of deaths under 10 years of age, and 123 or 1–14th deaths from epidemics, besides others involving deaths from preventible causes. Only 329, or 1 in 5 of the deaths in this very healthy county, were deaths registered as from old age. By the removal of this excess of deaths, the excess of births which replace them would even in these districts be of course still further diminished.

It may be conjectured that if there were the means of distinguishing accurately the various classes of the living amongst whom these deaths fall, the irregularity of the proportionate number of deaths which probably arise amongst the labouring classes would be accounted for. The present returns of the number of births do not distinguish the classes amongst whom the births occur. Taking the districts in the order of the average age in which deaths occur to the labouring classes, and comparing the proportions of the deaths and funerals with the proportions which occur in Hereford, the excess of deaths and funerals was in 1839 as follows:—

┌──────────────────────────────┬───────────┬──────────────────────────┐ │ │Average Age│Excess in Number of Deaths│ │Districts in which average Age│of Death of│ of Artisans, &c., in the │ │of Death of Artisans, &c., is │ Artisans, │District above the Deaths │ │ │&c. in the │of Agricultural Labourers │ │ │Districts. │ in Herefordshire. │ ├──────────────────────────────┼───────────┼──────────────────────────┤ │1. Highest number of the class│ 38│ 483│ │ (comprising 2 Districts.) │ │ │ │2. Intermediate (1) number of │ 27│ 548│ │ the class (5 Districts.) │ │ │ │3. Intermediate (2) number of │ 23│ 1,773│ │ the class (10 Districts.) │ │ │ │4. Lowest number of the class │ 20│ 4,121│ │ (15 Districts.) │ │ │ └──────────────────────────────┴───────────┴──────────────────────────┘

The totals of the subjoined district returns for the metropolis are as follows:—

┌──────────────┬──────────────────────────┬────────┬────────┬─────────┐ │ │ │ Number │Average │ Average │ │ │ │ of │ age at │ age at │ │ │ Number of deaths of each │ deaths │death of│death of │ │ │ class. │ from │all who │the whole│ │ │ │Epidemic│ die │ class, │ │ │ │disease.│ above │including│ │ │ │ │ 21. │children.│ ├──────────────┼────────┬────────┬────────┼────────┼────────┼─────────┤ │ │ │Children│ │ │ │ │ │ │Adults. │under 10│ Total. │ │ │ │ │ │ │ years. │ │ │ │ │ ├──────────────┼────────┼────────┼────────┼────────┼────────┼─────────┤ │Gentlemen │ 1724│ 529│ 2253│ 210│ 60│ 44│ │Tradesmen │ 3970│ 3703│ 7682│ 1428│ 51│ 25│ │Labourers │ 12045│ 13885│ 25930│ 5469│ 49│ 22│ │Paupers │ 3062│ 593│ 3655│ 557│ 60│ 49│ │Undescribed │ 2996│ 2761│ 5757│ 1051│ 56│ 28│ ├──────────────┼────────┼────────┼────────┼────────┼────────┼─────────┤ │ Totals │ 23806│ 21471│ 45277│ 8715│ 53│ 27│ └──────────────┴────────┴────────┴────────┴────────┴────────┴─────────┘

The following totals of the mortuary registration of the several registrars’ districts in Hereford for the same year are given for comparison:—

┌──────────────┬──────────────────────────┬────────┬────────┬─────────┐ │ │ │ Number │Average │ Average │ │ │ │ of │ age at │ age at │ │ │ Number of deaths of each │ deaths │death of│death of │ │ │ class. │ from │all who │the whole│ │ │ │Epidemic│ die │ class, │ │ │ │disease.│ above │including│ │ │ │ │ 21. │children.│ ├──────────────┼────────┬────────┬────────┼────────┼────────┼─────────┤ │ │ │Children│ │ │ │ │ │ │Adults. │under 10│ Total. │ │ │ │ │ │ │ years. │ │ │ │ │ ├──────────────┼────────┼────────┼────────┼────────┼────────┼─────────┤ │Gentlemen │ 49│ 19│ 68│ 2│ 65│ 45│ │Farmers, &c. │ 205│ 45│ 250│ 14│ 60│ 47│ │Labourers │ 833│ 324│ 1157│ 87│ 58│ 39│ │Paupers │ 26│ 11│ 37│ 1│ 71│ 51│ │Undescribed │ 124│ 143│ 267│ 19│ 68│ 30│ ├──────────────┼────────┼────────┼────────┼────────┼────────┼─────────┤ │ Totals │ 1237│ 512│ 1779│ 123│ 60│ 39│ └──────────────┴────────┴────────┴────────┴────────┴────────┴─────────┘

The total number of births registered in the several districts in the metropolis, where it is yet far from complete, in the year 1839, was 51,232, or 1 to 37 of the population. The total number of births registered in Hereford during the same year was 2579, or 1 to 44.

The positions advanced in the Sanitary Report of the greater proportion of births in the districts where the deaths are the most frequent, is confirmed in respect to the metropolis by a more recent return with which I have been obligingly favoured by the Registrar-General, in which he shows,—

┌──────────────────────────────┬─────────────────────────┬────────────┐ │ │ │ Ratio of │ │ │ Proportion per cent. │ deaths to │ │ │ │ births. │ ├──────────────────────────────┼────────────┬────────────┼────────────┤ │ │ Deaths. │ Births. │ │ ├──────────────────────────────┼────────────┼────────────┼────────────┤ │“Unhealthiest sub-districts │ 3·14│ 3·66│ 1 to 1·17│ │Less unhealthy sub-districts │ 2·68│ 3·18│ 1 to 1·19│ │Average sub-districts │ 2·43│ 3·35│ 1 to 1·38│ │Healthier sub-districts │ 2·17│ 2·64│ 1 to 1·22│ │Healthiest sub-districts” │ 1·87│ 2·47│ 1 to 1·32│ ├──────────────────────────────┴────────────┴────────────┴────────────┤ │“The mortality is 68 per cent. higher in the unhealthy than in the │ │healthy sub-districts: the proportion of births is 48 per cent. │ │greater in the unhealthy than in the healthy sub-districts.” │ └─────────────────────────────────────────────────────────────────────┘

If the deaths in the metropolis during 1839 had been in the same proportion to the population as they were in Hereford, there would have been 8866 funerals less during that year.

If the proportion of births in the metropolis during that year had been the same as in Hereford, there would have been 16,053 births the less.

Or to vary the illustration:—

If the deaths in Hereford had been in the same proportion as the deaths in the metropolis, the community in that county would during that year have had 977 funerals the more.

If the births in Hereford had been in the same proportion as in the metropolis, there would during that year have been 540 births the more.

If the deaths in the whole of England and Wales had been in the proportions attained in some districts, and attainable in all, namely, 1 in 50, there would during the year have been 31,866 funerals less, and more than ten times that amount of cases of sickness the less.

If the proportions of births in the whole kingdom had been the same as those occurring in average healthy districts—such as that of the town district of Hackney, for example, of 1 to 42—there would have been 139,958 births the less to make up for the excess of deaths.

* * * * *

The importance of the subject will justify the reference to other examples.

The commissioners for taking the census of Ireland have bestowed considerable labour to effect various improvements, with a view to determine more accurately the actual condition and progress of the population. They have attempted, amongst other improvements, to ascertain not merely the total number of houses, but the number of each description of houses in each district. From the want of any system of mortuary or birth registration in Ireland their attempts to ascertain correctly the proportions of deaths and births to the population appear to have been to some degree frustrated; and the return of the average age of death must be received as an approximation, giving higher than the real chances of life in that country. From the mode which the commissioners adopted of collecting the ages of the living, by taking the actual age of each individual with precautions, it appears probable that their returns on this head are more trustworthy than those obtained in England.

The proportions of births to the population obtained by the Census Commissioners in Ireland are, I conceive, below the real amount; the proportions of deaths are confessedly so. The proportions of deaths and several other results may however serve for comparison between one province and another and between one county and another. I have taken the following results from several of their tables, or have had them calculated from their data. I submit them as indications of the momentous public truths that still lie open for investigation, of which truths the most important are the extent of the operation of the causes of mortality, which can only be correctly ascertained on the spot by inquiries for a mortuary registration, by responsible officers of superior qualifications and intelligence as officers of health. The fractional numbers are omitted in the returns from the provinces.