BAT 32 Metropolitan Borough of Battersea. ABRIDGED REPORT on the HEALTH of the BOROUGH in 1939 by G. Macdonald, M.A., M.B., D.P.H., Medical Officer of Health. Principal Figures for 1939. Area of Borough acres 2,163 Population (Registrar-General's ???24??? estimate)— For calculating birth-rate 139,200 „ „ death rate 131,600 Structurally separate occupied dwellings 28,225 Rateable value—£1,170,852. Sum produced by 1d. rate £4,720 Births—(live 2,003, still 40) 2,043 Live birth rate 14.39 Deaths—1,687. Death rate 12.8 Maternal deaths—4. Maternal death rate 2.03 Infant deaths—119 Infant mortality rate 61.66 2 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I present, herewith, an abbreviated report upon the health and sanitary condition of the Borough during the year 1939. The report is presented in this form in accordance with advice from the Ministry of Health. During the year the Borough Council's Maternity Hospital at 19/20, Bolingbroke Grove was closed. The steps leading up to this were fully stated in the report for 1938. The Council established an additional clinic for diseases peculiar to women, which opened at Southlands on the 6th June, 1939, under the control of Miss A. Bloomfield, m.d., f.r.c.s., f.r.c.o.g., and to which post-natal cases were also referred. The provisions of the Factory Act dealing with basement bakehouses came into operation during the year, but the number of premises affected in the Borough is small. The vital statistics set out in the following pages indicate, on the whole, satisfactory health conditions. The infant mortality rate, however, is somewhat high compared with the rate for the country as a whole and is due almost entirely to a particularly high death rate in the first quarter of the year. The maternal mortality rate was below the average, and the incidence of infectious disease was unusually low. The staff, on the outbreak ???ar, were to a large extent employed temporarily in Civil Defence work, chiefly in connection with one or other of the casualty services, but, in due course, normal duties were, in the main, resumed. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, (Signed) G. MACDONALD, Medical Officer of Health. Electric House, Lavender Hill, S.W.l l. January, 1941. 3 Vital Statistics. Population.—The population of the Borough at the middle of 1939 is estimated by the Registrar-General to have been 139,200, or 2,500 less than in 1938. On this figure is based the birth-rate, but for the calculation of the death-rate the Registrar-General has supplied a reduced figure of 131,600. Births.—Number registered in Battersea, 2,776. Of these, only 1,418 were of Battersea parents; add 585 Battersea children born without the Borough; total Battersea live births in 1939, 2,003 (975 males, 1,028 females). Live birth-rate 14.39 per 1,000 of the estimated population. Still births numbered 40—rate 19.6 per 1,000 births, live and still. Illegitimate births numbered 111, which included 8 among the still births. Of the 2,003 Battersea births, 1,810 were notified to the Medical Officer of Health under the Public Health (London) Act, 1936. Marriages registered in Battersea 1939, 1,710, a marriagerate of 24.6, nearly 30 per cent. above the average for 1934-38. Deaths.—Number registered in Battersea 1939, 2,728. Of these only 1,324 were of Battersea residents, and to these must be added 363 deaths of residents of the Borough registered elsewhere, giving a total of 1,687 (882 males, 805 females) and a death-rate (based upon the reduced figure mentioned above) of 12.82. The causes of death, arranged under the headings of the short list used by the Registrar-General were as follows:— 1. Typhoid (enteric) fever – 19. Bronchitis 84 2. Measles – 20. Pneumonia 71 3. Scarlet fever 2 21. Other respiratory diseases 8 4. Whooping cough 6 22. Peptic ulcer 25 5. Diphtheria 2 23. Diarrhoea, etc. 25 6. Influenza 17 24. Appendicitis 9 7. Encephalitis lethargica – 25. Cirrhosis of liver 3 8. Cerebro spinal fever 2 26. Other diseases of liver, etc 5 9. Tuberculosis (respiratory) 103 27. Other digestive diseases 22 10. Tuberculosis (other) 8 28. Acute and chronic nephritis 46 11. Syphilis 6 29. Puerperal sepsis 1 12. General paralysis of the insane 4 30. Other puerperal causes 3 31. Congenital debility, premature birth, etc. 49 13. Cancer, malignant disease 262 14. Diabetes 17 32. Senility 17 15. Cerebral haemorrhage, etc. 42 33. Suicide 15 16. Heart disease 590 34. Other violence 57 17. Aneurysm 10 35. Other defined diseases 111 18. Other circulatory disease 64 36. Causes ill-defined or unknown 1 Infant Mortality.—There were 119 deaths of infants under 12 months of age, giving an infant mortality-rate of 61.66* per 1,000 births. This may be compared with a rate for the previous 5 years (1934-38) of 61.91. The deaths of illegitimate infants numbered 10, giving an illegitimate infant death-rate of 90.9. * This figure is by direction of the Registrar-General based on a total of 1930 births 4 Maternity & Child Welfare. Infant Welfare Centres.—712 sessions, 31,468 attendances. Ante-Natal Clinics.—235 sessions, 2,864 attendances. Mothercraft Classes.—299 meetings, 3,683 attendances. 845 cases were referred to hospitals, etc., from the Welfare Centres, and 2,859 visits were paid at the request of various hospitals. Milk.—180,636 pints of liquid milk, and 3,156 pounds of dried milk were supplied to 1,902 persons, 78.4 per cent, free, and 21.6 per cent. at reduced prices. Cost involved £3,099. Dental Clinic.—252 sessions, 2,837 attendances, 393 new patients. Unmarried Mothers.—The usual grant of £150 was made to the Southwark Diocesan Association. 16 Battersea mothers were admitted to their Homes and stayed for 1,574 days. Home Helps.—8 cases. Cost to Council, £9 13s. Od. Maternal Mortality.—4 deaths (1 from puerperal sepsis and 3 from other puerperal causes), giving a maternal mortality rate of 2.03 per 1,000 births, live and still. St. Thomas's Babies Hostel.—Transferred to Wiltshire on the outbreak of War. Test feed cases 164, Total attendances 485, In-patients 29 (11 mothers, 18 babies). Nursing.—The District Nurses under contract with the Council paid 6,075 visits to 666 cases, of which 290 were patients suffering from infectious disease. Artificial Light Treatment.—113 Sessions, 88 Patients, 2,290 attendances. Massage.—152 sessions, 1,219 attendances, 55 new patients. St. Margaret's Day Nursery.—Evacuated on the outbreak of War with 29 children, including those from the Guest House. From January to August the number of children admitted was 54, and they made 3,491 attendances. Toddlers' Clinics were continued until the outbreak of War. Up to that date 729 cases were seen, and of these, 215 showed defects; defective teeth not being counted for this purpose. Child Life Protection.—95 foster-mothers were still on the register at the end of 1939, but only 33 of these had nurse-children (to the number of 41) in their care. The Health Visitors paid 725 visits to foster-mothers. 5 Infectious Diseases. The incidence of infectious disease was notably low in 1939. In the ordinary course of events, the biennial epidemic of measles was due, but this did not materialise. There were only 1,801 cases notified, made up as follows:— Diphtheria 128 (338) Erysipelas 38 (66) Enteric fever – (7) Scarlet fever 177 (388) Puerperal fever 9 (6) Meningococcal meningitis 7 (4) Puerperal pyrexia 23 (17) Ophthalmia neonatorum 22 (23) Polio-myelitis, etc. 7 (5) Encephalitis lethargica 1 (–) Dysentery 6 (6) Pneumonia (acute primary) 166 (232) Pneumonia (acute influenzal) 36 (45) Whooping cough 811 (541) Measles 191 (1,608) Tuberculosis (all forms) 179 (230) 1,801 (3,516) For the purposes of comparison, the average number of cases notified in the five years, 1934-1938, is inserted in brackets. Schick Clinic.—The diphtheria immunisation clinic was continued throughout the year, and attended by 376 patients (225 new). 214 were immunised and 12 found to be immune on primary test. Tuberculosis.—Beside 179 cases notified, there were otherwise reported 17, making a total of 196 new cases. The dispensary was carried on throughout the year as in normal times, but it is impossible to give the usual detailed figures of the work carried out owing to the destruction of the dispensary and the current records by enemy action. Deaths from tuberculosis numbered 111, of which 8 were of the non-pulmonary form. The death-rate was 0.84 per 1,000 of the population, as compared with an average of 0-86 during the 5 years 1934-38. Extra nourishment was provided for 78 necessitous dispensary patients at a cost of approximately £349. Cancer.—262 deaths of Battersea residents were recorded, being at the rate of 1.99 per 1,000 population, the average rate for the preceding 5 years being 1.76 per 1,000. 6 ERRATUM - Page 6, 4th paragraph lines 3-4:for the words "decreased by 1 to 13" read ''remained at 14". Sanitary Circumstances. The normal work of the department was carried on up to, and to a slightly diminished extent following, the outbreak of war. The following table gives the number of some of the items dealt with :— Complaints received 3,471 Water closets provided, etc. 73 House inspections 31,034 Smoke observations 71 Shops Act inspections 27 Notices served— Factory, &c., inspections 2,015 Intimation 2,581 Gipsy van inspections 31 Statutory-Sections 197 and 220 1,474 Drains— Fifth Schedule, etc. 1,459 Smoke tests 216 Persons cleansed (including 2,820 school children) 3,354 Water tests 1,711 Relaid 66 Premises disinfected 1,969 Repaired 240 Articles disinfected 40,112 Plans received 160 Mortuary— Water supply— Bodies received 528 New houses certified 160 P.M. examinations 475 Additional to tenement houses 34 Inquests 254 Legal proceedings to enforce various requirements or for the recovery of penalties incurred by the breach of statutory requirements were taken in 116 instances ; fines were inflicted amounting to £70 5s. 0d., and costs to £48 19s. 6d. Factories and Homework.—The number of factories in which mechanical means are used decreased by 5 to 289, and of nonmechanical factories by 19 to 202. Inspections of these premises numbered 1,286. The number of homeworkers increased by 5 to 181. Bakehouses numbered 51 at the end of the year, as at the beginning, but two were closed during the year and two new ones opened. The number of underground bakehouses decreased by 1 to 13. Five of the 51 premises do not rank as factories since only the proprietor works on the premises. 121 inspections of bakehouses were made during 1939. Protection of the Food Supply.—1,200 samples (of which 443 were informally taken) were analysed by the Public Analyst. Of these only 5 (one informal) were certified as being adulterated, which gives a percentage of adulteration of 0.4, which is a new low record. 750 of these samples were of milk, the percentage of adulteration among which was 0.5. There were 109 dairies (milk shops) regisgistered at the end of the year. 48 licences to sell tuberculin tested milk and 60 for pasteurised milk were valid during 1939. 256 premises (excluding street stalls) were on the register for the manufacture, storage or sale of ice cream, and 170 for the sale of preserved foods and 69 as fish shops. Street stalls from which food was sold numbered 146. 7 Housing. Statistics. Number of new houses or tenements erected during the year 160 Number of houses demolished during the year 66 Total number of dwelling houses inspected for housing defects 4,115 (27,193 inspections) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation—- (i) Dealt with under Housing Act 155 (ii) Dealt with under Public Health (London) Act 1,947 Total 2,102 Number of defective dwelling-houses rendered fit by informal action 158 Number of dwelling-houses in respect of which Statutory Housing Act notices were served requiring repairs 71 Number of appeals against such notices (Settled by agreement) 1 Number of dwelling houses which were rendered fit after service of formal notices 3 Number of dwelling-houses in respect of which Public Health Act notices were served requiring defects to be remedied 1,947 (2,393 intimation notices) Number of dwelling-houses in which defects were remedied after service of formal notices— (i) By owners (2,548 intimation notices complied with) 2,063 (ii) By Local Authority in default of owners 6 Number of separate tenements or underground rooms in respect of which Closing Orders were made 39 (contained in 23 houses) N umber of basement rooms which were rendered fit 124 (contained in 64 houses) 8 Overcrowding— (a) New cases reported during the year 47 (b) Cases relieved during the year 128 (c) Number of cases on register at the end of the year 1,144 Housing accommodation provided by the London County Council for Battersea families 412 (66 of which were recommended for preferential consideration) Staff. The staff of the Public Health Department remained as at the end of 1938, with the exceptions following:— Dr. Stanley King, m.d., m.r.c.p., d.p.h., resigned his appointment of Deputy Medical Officer of Health and Tuberculosis Officer in May on obtaining the appointment of Medical Officer of Health of the Borough of Stoke Newington. In July the Council filled the vacancy thus caused by appointing Dr. J. G. S. McQueen, m.d., d.p.h., after public advertisement. Miss D. Heap resigned her appointment of Health Visitor in March on her marriage, and was succeeded by Miss W. M. Llewellyn. Mr. F. H. White and Mr. E. G. Wren were appointed Grade A clerks in February, to fill vacancies caused by the resignations of Mr Carter in 1938 and Mr. F. W. Pedrick in January 1939. In January the Council appointed Dr. G. B. Shirlaw, l.r.c.p., l.r.c.s.(Edin.), a temporary Assistant Medical Officer of Health, whose time was to be divided equally between the Air Raid Precautions service and the work of the Public Health Department. The appointment was made with the approval of the Home Office and was to be reviewed after 12 months. wightman & Co., Ltd., Dugdale Street, S.E. 1.