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ROUTLEDGE LIBRARY EDITIONS: HEALTH, DISEASE & SOCIETY Volume 3 HEALTH AND VITAL STATISTICS HEALTH AND VITAL STATISTICS B. BENJAMIN First published in 1968 by George Allen & Unwin Ltd. This edition first published in 2022 by Routledge 4 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 605 Third Avenue, New York, NY 10158 Routledge is an imprint of the Taylor & Francis Group, an informa business © 1968 George Allen & Unwin Ltd. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN: 978-0-367-52469-2 (Set) ISBN: 978-1-032-25170-7 (Volume 3) (hbk) ISBN: 978-1-032-25176-9 (Volume 3) (pbk) ISBN: 978-1-003-28190-0 (Volume 3) (ebk) DOI: 10.4324/9781003281900 Publisher’s Note The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent. Disclaimer The publisher has made every effort to trace copyright holders and would welcome correspondence from those they have been unable to trace. HEALTH AND VITAL STATISTICS B. BENJAMIN B.SC., PH.D., F.I.A., F.S.S. Director of Research and Intelligence, Greater London Council, Formerly Director of Statistics, Ministry of Health. Ruskin House GEORGE ALLEN & UNWIN LTD MUSEUM STREET LONDON FIRST PUBLISHED IN GREAT BRITAIN IN 1968 This book is copyright under the Berne Convention. Apart from any fair dealing for the purposes of private study, research, criticism or review, as permitted under the Copyright Act 1956, no portion may be reproduced by any process without written permission. Enquiries should be addressed to the publishers © George Allen and Unwin Ltd., 1968 PRINTED IN GREAT BRITAIN in 10/11 point Times Roman Type BY UNWIN BROTHERS LIMITED WOKING AND LONDON PREFACE My earlier textbook, entitled simply Elements of Vital Statistics in deference to the great work by Sir Arthur Newsholme which it attempted to replace, was published in 1959. When it ran out of print it was decided to revise the book radically and to give it a title more consonant with its modern theme and purpose—an account of methods of measurement of health and of health service activity. The best of the earlier volume remains but there has been a pruning of inessential non-statistical text and of certain tabulations which were difficult to update and were only of marginal illustrative value. New material has been introduced to cover recent develop- ments in the various sub-fields of the subject especially in the use of hospital records and in the approach to community health records, and an attempt has been made to recast material from the earlier volume where this seemed necessary to improve lucidity. I have corrected, I hope, all those errors in the first volume which readers were kind and patient enough to point out to me. The same basic approach is retained; of trying to look at the measurement problems that arise in health and welfare services in their day-to-day operation, the sources that may be available to supply the requisite data for their solution and the methods of analysis most appropriate to the particular situation encountered. Little or no mathematical knowledge beyond simple arithmetic is assumed on the part of the reader though on occasion the non- mathematical reader has been deliberately tempted to extend, from other sources, his knowledge of statistical theory. Availability of electronic computers has been assumed in a number of instances, but though a heavy computer user myself I have nevertheless refused to treat computer applications as a subject in itself. I firmly believe that a computer is an invaluable means to an end and not an end in itself. I have tried in this book to concentrate on ends. For most of my professional life I have been concerned with medical and population problems. This book is based on that experience. This means that it is also based on help and guidance over a long period from colleagues too numerous to mention by name. I am deeply grateful to them. CONTENTS PAGE PREFACE 7 1 Introductory 11 2 Population 15 Appendix I Census, 1951—England and Wales 39 Appendix II Local Areas 39 3 Registration of Births, Deaths and Marriages 43 4 Fertility—Measures and Trends 54 5 Mortality—Death Rates and Causes 72 6 Mortality Indices: Life Tables 92 1 Environmental Factors affecting Mortality 116 8 The Measurement of Morbidity 135 9 Statistics of Infectious Diseases 141 10 Tuberculosis 174 11 Maternity and Child Welfare 199 12 Statistics of the Health of the School Children 218 13 Other Public Health Statistics 229 14 Industrial and General Incapacity 238 15 Hospital Statistics 250 16 Cancer Statistics 269 17 Mental Health Statistics 279 18 General Practitioner Statistics 285 19 Field Studies 292 INDEX 303