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Research Article

Why Londoners have low death rates from ischaemic heart disease and stroke.

BMJ 1992; 305 doi: (Published 19 December 1992) Cite this as: BMJ 1992;305:1551
  1. D. J. Barker,
  2. C. Osmond,
  3. B. Pannett
  1. MRC Environmental Epidemiology Unit, Southampton General Hospital, University of Southampton.


    OBJECTIVE--To explain the low death rates from cardiovascular disease in London. SETTING--London and the other counties of England and Wales. SUBJECTS--Women living in London during 1901-10 and people in London dying during 1968-78. RESULTS--At the beginning of the twentieth century young women aged 15-34 in London had remarkably low death rates, largely because of low rates for tuberculosis and other infectious diseases and low mortality during childbirth. Their low death rates contrasted with the high rates in girls under 15 years. CONCLUSIONS--Large numbers of young women had migrated into London from agricultural counties in southern England and went into domestic service, where the diet was usually very good. Recent findings suggest that a mother's nutrition and health has a major effect on the risk of cardiovascular disease in the next generation. The low cardiovascular mortality in London is consistent with this, and contrasts with the high mortality from other common diseases.