Birth, Poverty and Health

Abstract

AMONG indexes of disease and death none offers a more inviting field for research in the field of vital statistics than the infant mortality-rate. Its distribution among different social classes and different communities has an extremely high dispersion, and the general level within a single composite social group has unique features. While chances of death at other ages declined steadily during the whole of the last three quarters of the nineteenth century, both in Britain and in Western Europe as a whole, the death-rate under one year of age fluctuated about the same figure-150 per thousand for England and Wales-until about 1899. From 1900 there has been a continuous and spectacular change. During the subsequent half-century the number of infant deaths per thousand in our own country has fallen by more than sixty per cent. This being so, it is surprising that contributory social agencies have attracted so little inquiry to date. One reason is a hangover from an ideology widely current in the period when evolutionary concepts furnished a convenient rationale for an economy of unrestricted private competition and colonial misgovernment. What Sir Henry Maine called the “beneficent private war which makes one man strive to climb on the shoulders of another and remain there” was the prevailing creed of the universities when the existence of differential mortality first forced itself on public discussion. Foremost among articles of the creed was the postulate that class mortality and morbidity differences have their origin in differences of genetic constitution.

Birth, Poverty and Health

A Study of Infant Mortality. By Richard M. Titmuss. Pp. 118. (London: Hamish Hamilton, Medical Books, Ltd., 1943.) 7s. 6d. net.