DECLARATION
This work has not previously been accepted in substance for any degree and is not
being concurrently submitted in candidature for any degree.
Signed___________________________(candidate)
Date ____________________________
STATEMENT 1
This thesis is the result of my own investigations, except where otherwise stated.
Other sources are acknowledged by footnotes giving explicit references. A
bibliography is appended.
Signed____________________________(candidate)
Date _____________________________
STATEMENT 2
I hereby give consent for my thesis, if accepted, to be available for photocopying and
for inter-library loan, and for the title and summary to be made available to outside
organisations
Signed____________________________(candidate)
Date _____________________________
Prifysgol Cymru
SUMMARY OF THESIS
University of Wales
This summary sheet should be completed by the candidate after having read
the notes overleaf. The completed sheet should be submitted by the candidate to
his/her Head of Department together with two copies of the thesis, two notices of the
Notice of Candidature form and a certificate regarding financial
obligations/matriculation.
Candidate’s Surname: Thompson
Candidate’s Forenames: Steven David
Candidate for the Degree of: Ph.D.
Full title of thesis:
Institution/College at which study pursued:
University of Wales, Aberystwyth
Summary:
This thesis examines patterns of mortality in interwar south Wales and
assesses the relative influences of various social factors in determining those patterns.
Chapters on income, expenditure, housing, environment, diet and medical services
describe and evaluate the material conditions of life for working-class families in the
different communities of interwar south Wales. A consideration of the effects of
economic depression on these material aspects of people’s lives is an integral aspect
of these chapters. The impact of unemployment and poverty is assessed so as to
understand their significance in the everyday lives of working-class people. In this
way, the thesis addresses the shortcomings in the historiography of the ‘healthy or
hungry’ nature of the interwar period by anchoring the consequences of
unemployment in the realities of everyday experience.
The second section of the thesis consists of demographic studies of mortality
and infant mortality. Various mortality indicators are examined so as to identify
patterns of mortality in the different communities of south Wales. These mortality
indicators are disaggregated according to age, sex, social class, occupation and
location. The specific patterns revealed by this analysis are examined in the light of
the material aspects of working-class life outlined in the first section of the thesis so
as to determine the social determinants of mortality and the precise effects of
economic depression on patterns of mortality. This detailed and systematic
examination of mortality in interwar south Wales addresses the weaknesses in the
Welsh historiography that has consisted of impressionistic interpretations of the
effects of economic depression on standards of health.
Therefore, the thesis examines the levels and trends of mortality in interwar
south Wales and considers the factors that determined them. Secondly, it assesses the
extent to which the economic depression of the interwar period affected these patterns
of mortality.
ii
A Social History of Health in Interwar South Wales
Steven David Thompson
Thesis submitted in fulfilment of the requirements of the degree of Ph.D.
Department of History and Welsh History
University of Wales, Aberystwyth
2001
iii
Acknowledgements
I have incurred many debts in the completion of this thesis. I would like to
thank the librarians and archivists of the National Library of Wales, Aberystwyth; the
Hugh Owen library of the University of Wales, Aberystwyth; the West Glamorgan
Archive Service, Swansea; the Glamorgan Record Office, Cardiff; the Gwent Record
Office, Cwmbran; the Public Record Office, London; the Museum of Welsh Life at
St. Fagans, Cardiff; and the South Wales Miners’ Library, Swansea. I would also like
to acknowledge the help of Elisabeth Bennett, the archivist of the South Wales
Coalfield Collection at the University of Wales, Swansea; the Director and staff of the
Centre for Advanced Welsh and Celtic Studies, Aberystwyth; Professor Richard
Moore-Colyer of the Institute of Rural Studies, University of Wales, Aberystwyth;
and the members of staff of the Department of History and Welsh History at the
University of Wales, Abersytwyth. I was fortunate early in my research to benefit
from the advice of Dr. Mari A. Williams, Dr. Robert Smith and Dot Jones of the
Centre for Advanced Welsh and Celtic Studies and their references, comments and
general advice proved especially valuable. I am grateful to Professor Geraint H.
Jenkins for providing me the use of a computer in the Centre when I broke an arm.
I was very fortunate to have Dr. Paul O’Leary of the Department of History
and Welsh History of the University of Wales, Aberystwyth as my doctoral
supervisor. His comments were at all times useful, his suggestions fruitful and his
criticisms insightful, constructive and thought provoking. I readily acknowledge my
debt to him. Gwenno Ffrancon Jenkins provided constant support and encouragement
throughout the time of my research, aided me in the translation and interpretation of
Welsh-language sources and nursed me after I broke my arm – twice! Diolch, cariad.
The completion of this thesis would not have been possible without the moral and
financial support of my parents, David and Janice Thompson. Their commitment to
my education, and that of my brother, has been considerable and beyond the call of
parental duty. I dedicate this thesis to them with love and respect.
Steve Thompson.
iv
Contents
Abbreviations.
vi
List of figures.
vii
List of tables.
viii
List of appendices.
ix
Maps.
xi
Introduction.
1
Chapter 1: Obtaining an income: Wages, benefits and household strategies.
17
Chapter 2: ‘The garment has to be cut according to the cloth’:
Balancing the budget in working-class households.
58
Chapter 3: ‘Fair clemmed’?: Diet and nutritional status.
104
Chapter 4: ‘Heart break houses’?: Housing conditions and house building.
144
Chapter 5: ‘Leprous towns’: Environment, sanitation and leisure.
191
Chapter 6: The mixed economy of medical services.
239
Chapter 7: Mortality.
269
Chapter 8: Infant Mortality.
316
Conclusion.
354
Appendices.
367
Bibliography.
496
v
Abbreviations
AC – Administrative County.
BMA – British Medical Association.
BMJ – British Medical Journal.
CB – County Borough.
CC – County Council.
Gazette – Ministry of Labour Gazette.
Gwent RO – Gwent Record Office.
Glam RO – Glamorgan Record Office.
MB – Municipal Borough.
ME – Merthyr Express.
MRC – Medical Research Council.
NAMH – National Association of Medical Herbalists.
NHS – National Health Service.
NLW – National Library of Wales.
PAC – Public Assistance Committee.
PRO – Public Record Office.
RD – Rural District.
RMOH – Annual Report of the Medical Officer of Health.
RSMO – Annual Report of the School Medical Officer
SWCA – South Wales Coalfield Archive, University of Wales, Swansea.
SWDN – South Wales Daily News.
SWEE – South Wales Evening Express.
SWMF – South Wales Miners’ Federation.
UAB – Unemployment Assistance Board
WBH – Welsh Board of Health.
West Glam RO – West Glamorgan Record Office.
WM – Western Mail.
WNMA – Welsh National Memorial Association.
vi
List of figures
1.1
1.2
2.1
2.2
3.1
3.2
4.1
4.2
4.3
4.4
4.5
5.1
6.1
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
7.9
7.10
7.11
7.12
7.13
Average annual range in unemployment percentage, 1927-1939.
36
Percentage of unemployed persons at each local employment exchange
claiming unemployment benefit as opposed to unemployment assistance
or transitional payments, 26 June 1936.
39
Advertisement for a Merthyr grocer that appeared in the Merthyr Express,
April 1929.
64
Rent arrears of the tenants of the Merthyr County Borough council,
1925-1935.
80
Cartoon publicising the importance of nutrition during childhood, 1927. 137
Estimated daily per capita milk consumption in the Rhondda Urban
District, 1915-1939.
142
Houses built in the Tredegar Urban District and ‘passed as fit for
occupation’ in the Rhondda Urban District, 1898-1940.
147
Temporary dwelling erected beside the road between Bedwas and
Llanbradach in the Caerphilly Urban District and occupied by a miner,
his wife and child, January 1923.
166
Total houses built by local authorities in England and Wales 1919 to
31 March 1940.
172
Houses built by local authorities in south Wales, 1920-1938.
175
House building rates of Glamorgan and Monmouthshire administrative
counties, 1920-1939.
177
Poster published by the Caerphilly Urban District Council emphasising
the ‘Fly Peril’.
230
An infectious disease notice distributed by Caerphilly Urban District
Council to infected houses.
248
Standardised death rates of England and Wales and the administrative
counties of Glamorgan and Monmouthshire, 1921-1939.
274
Standardised death rates of England and Wales and the county
boroughs of Cardiff, Merthyr, Swansea and Newport, 1921-1939.
274
Standardised death rates, 1920-1924.
277
Standardised death rates, 1935-1939.
277
Proportion of deaths in different age-groups, Glamorgan Administrative
County, 1920-22.
279
Proportion of deaths in different age-groups, Glamorgan Administrative
County, 1937-39.
280
Proportions of deaths from various causes, Monmouthshire Administrative
County, 1920-24.
295
Proportions of deaths from various causes, Monmouthshire Administrative
County, 1935-39.
295
Pulmonary tuberculosis death rates, 1921-1939.
301
Average annual death rates from tuberculosis (all forms) in south Wales,
1930-1936.
302
Respiratory tuberculosis mortality in the Rhondda Urban District, Merthyr
Tydfil County Borough and England and Wales as a whole, 1920-1938. 305
Sex- and age-specific mortality from pulmonary tuberculosis, Cardiff and
Swansea County Boroughs and England and Wales, 1931-33.
306
Sex- and age-specific mortality from pulmonary tuberculosis, Merthyr
County Borough, Rhondda Urban District and England and Wales,
vii
8.1
8.2
8.3
8.4
8.5
8.6
8.7
1931-33.
Average infant mortality rates, 1920-24.
Neonatal mortality rates for selected areas of south Wales and England
and Wales, 1920-1939.
Stillbirth rates for large administrative areas of south Wales and England
and Wales, 1928-39.
Stillbirths in selected districts of south Wales, 1920-39.
Stillbirth rates in Rhondda Urban District and Swansea County Borough,
1901-1939.
Death rates from prematurity, Cardiff Country Borough and Rhondda
Urban District, 1920-39.
Birth rate and infant mortality rate in Glamorgan Administrative County,
1920-1939.
307
320
324
326
327
328
331
352
List of tables
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
2.1
2.2
2.3
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
3.10
Number of days lost annually at the Lady Windsor colliery, Ynysybwl,
1930-1936.
Percentage of applicants for benefit (aged 16-64) in regions of Britain
unemployed for a year or more, 1937-1939.
Duration of unemployment in Wales, June 1937 to August 1939.
‘Wholly unemployed’ and ‘temporarily stopped’ unemployed in ‘South
Wales’, 1928-1929.
Percentages of unemployed insured persons (aged 16-64) applying for
insurance benefit, unemployment assistance (UAB) or other relief in
Britain, 23 March 1936.
Average annual unemployment insurance benefits, 1920-1939.
Birth-rates in south Wales and England and Wales, 1920-1939.
Persons per family in south Wales and England and Wales, 1911-1951.
Share capital and savings of members of Glamorgan and Monmouthshire
co-operative societies, 1920-1939.
Range of arrears of the tenants of Cardiff County Borough and Rhondda
Urban District councils at 31 March 1928.
Monthly expenditure of employed and unemployed Rhondda families on
various necessities, July 1936.
Diets of Cardiff and Reading families surveyed by Cathcart, 1928.
Diets of Cardiff families according to income groups, 1928.
Budgets and food expenditure of selected Cardiff families, 1936.
Average weekly expenditure of Cardiff families, 1936.
Average number of calories obtained from various foodstuffs by the
Cardiff families, 1936.
Incidence of infectious diseases among Cardiff children, 1936.
Incidence of respiratory diseases among Cardiff children, 1936.
Per capita expenditure on different foodstuffs in employed and
unemployed Rhondda households, July 1936.
Diets of seven unemployed families from Cardiff as compared to
Cathcart’s sample as a whole, 1928.
Some cases assisted by the National Birthday Trust Fund in the Rhondda.
26
30
31
32
38
43
45
46
69
83
93
115
115
116
117
118
119
119
123
124
129
viii
3.11
3.12
4.1
4.2
7.1
7.2
7.3
7.4
7.5
8.1
8.2
8.3
8.4
8.5
8.6
John Boyd Orr’s classification of the population of England and Wales by
income groups and food expenditure per person.
Typical diet of Eileen Baker’s family, Ystalyfera during the interwar
period.
Houses built in south Wales and England and Wales, 1919-1939.
Increases in local authorities’ slum clearance schemes in south Wales,
1933 to 1938.
Crude death rates in the major administrative areas of south Wales and
England and Wales, 1920-1939 (deaths per 1,000 population).
Standardised sex-specific death rates in selected industrial areas,
1920-1939.
Excess male and female mortality in ‘depressed areas’ over ‘rest of the
country’, 1934.
Standardised death rates of males in coal mining and dock work from all
causes and pulmonary tuberculosis, England and Wales 1921-23 (all
occupied and retired males aged 20-65 = 1000).
Housing conditions of 368 pulmonary tuberculosis sufferers in Cardiff
County Borough, 1923 compared to Cardiff population as a whole, 1921.
Quinquennial infant mortality averages, south Wales and England and
Wales, 1920-1939.
Infant mortality rates for ‘South Wales’ and Monmouthshire, 1861-1971.
Social class differentials in infant mortality in ‘Wales I’, ‘North I’ and
England and Wales, 1930-32.
Social class differentials in mortality of children aged 1 to 2 years in
‘Wales I’, ‘North I’ and England and Wales, 1930-32.
Methods of feeding of infants in Aberdare Urban District visited by
health visitors for first time after birth, 1924 and 1939.
Method and duration of feeding of 6,574 infants in Cardiff County
Borough, 1928 and 1929.
130
132
173
179
272
285
291
311
312
319
337
338
339
341
342
List of appendices
1.1
1.2
1.3
1.4
1.5
1.6
1.7
3.1
4.1
4.2
4.3
4.4
Average wage rates and minimum rates in industries in south Wales,
1920-1939.
Wage indices for various trades in south Wales, 1920-1939.
Cost of living index, Great Britain, 1920-1939.
Real wage indices for various trades in south Wales, 1920-1939.
Unemployment percentages at employment exchanges in south Wales,
1927-1939.
Ranges in unemployment percentages at employment exchanges in
south Wales, 1927-1939.
Unemployment benefits index and real benefits index, 1920-1939.
Heights and weights of schoolchildren in districts of south Wales,
1920-1939.
Estimated housing needs of local authorities according to surveys
carried out under the terms of the Housing Act of 1919.
Houses built by local authorities in Britain from the Armistice to 31
March 1940.
Houses built by local authorities in south Wales, 1920-1938.
Slum clearance schemes of local authorities in south Wales, 1933.
368
372
375
376
379
383
387
389
401
403
405
407
ix
5.1
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
7.9
7.10
7.11
7.12
7.13
7.14
7.15
7.16
7.17
7.18
8.1
8.2
8.3
8.4
8.5
8.6
8.7
8.8
Sanitary conveniences in certain urban districts of south Wales, 1911.
408
Statistical appendix.
409
Crude death rates, 1920-1939.
410
Quinquennial crude death rate averages, 1920-1939.
411
Standardised death rates (by direct method), 1920-1939.
413
Standardised death rates (by indirect method), 1920-1939.
414
Changing age-structure in England and Wales and south Wales,
1921-1939.
416
Crude sex-specific death rates, 1920-1939.
419
Crude male death rates expressed as a percentage of the crude female
death rate, 1920-1939.
425
Standardised (by direct method) sex-specific death rates, 1920-1939.
428
Quinquennial standardised (by indirect method) sex-specific death
rates, 1920-1939.
430
Age-specific death rates, 1920-1939.
434
Age-specific death rate averages, 1921-25 and 1931-35.
441
Age-specific death rates 1921-25 and 1931-35 expressed as a percentage of
the England and Wales rates.
443
Crude death rates from certain causes, 1920-1939.
445
Quinquennial crude cause-specific death rates expressed as percentage
of England and Wales, 1920-1939.
457
Age- and sex-specific causes of death, 1921-23 and 1931-33.
460
Pulmonary tuberculosis mortality, 1920-1939.
472
Standardised cause-specific death rates (cancer and heart disease).
473
Standardised occupational death rates, 1930-32.
474
Infant mortality rates, 1920-1939.
475
Quinquennial infant mortality averages, 1920-1939.
476
Infant mortality rate in south Wales expressed as a percentage of
England and Wales rate, 1920-1939.
478
Age-specific infant mortality rates, 1920-1939.
480
Quinquennial age-specific infant mortality averages, 1920-1939.
486
Stillbirths per 1,000 total births.
488
Cause-specific infant mortality rates, 1920-1939.
489
Birth rates, 1920-1939.
495
x