Cohort analysis of fertility in England and Wales, 1939-50.

The relevance to social medicine of changes in the age-structure of a community needs little amplifica tion. A previous communication (Taylor, 1951) demonstrated the importance of adequate provision for a community in which survival to a level pre viously entitled "old age" would be commonplace. Since mortality is so low in the middle age ranges, this communication focuses on the other end of life and seeks to interpret the recent rapid changes in the birth rate with a view to appropriate provision of hospital and ancillary services, the need for which depends on the current number of maternities. Though the issue is of importance in other spheres, e.g. in the demand for educational services, it has special relevance to the National Health Service, if we reflect upon the cost of maternity and child welfare services before, during, and after birth.