BAT 40 Metropolitan Borough of Battersea. ABRIDGED REPORT on the HEALTH of the BOROUGH in 1941 by G. Macdonald, M.A., M.B., D.P.H,, Medical Officer of Health. 2 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I present herewith my report upon the Health and Sanitary conditions of the Borough during the year 1941. In accordance with the instructions of the Ministry of Health, the report is an abridged one and is mainly a statistical review. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, G. MACDONALD, Medical Officer of Health. Principal Figures for 1941. Area of Borough acres 2,163 Structurally separate occupied dwellings 26,462 Rateable value—£1,086,648. Sum produced by Id. rate £4,084 Births—(live 1,292, still 42) 1.334 Deaths 1.505 Maternal deaths—2. Maternal death rate 1.88 Infant deaths—65. Infant mortality rate 63.35 3 Vital Statistics. Births registered in Battersea numbered 1393. Of these, only 685 were of Battersea parents, but there were 607 Battersea children born outside the Borough, and the total number of Battersea live births in 1941 was therefore 1,292 (651 males, 641 females). Still births numbered 42—rate 31.49 per 1,000 births, live and still. Illegitimate births numbered 89, which included 8 among the still births. Of the 1,292 Battersea live births, 977 were notified to the Medical Officer of Health under the Public Health (London) Act, 1936. Marriages.—1,128 marriages were registered in Battersea during 1941, over 500 less than in 1940. Deaths.—2,353 deaths were registered in Battersea during 1941. Of these only 1,101 were of Battersea residents, but there must be added 404 deaths of residents of the Borough registered elsewhere, giving a total of 1,505 (799 males, 706 females). For the 5 years 1936-40 the death-rate was 13.6 per 1,000 Population, the average number of deaths per annum having been 1.821. The causes of death, arranged under the headings of the short list used by the Registrar-General, were as follows:— 1. Typhoid and paratyphoid fevers — 18. Intra cranial vascular lesions 83 2. Cerebro-spinal fever 3 19. Heart disease 444 3. Scarlet fever — 20. Other diseases of circulatory system 50 4. Whooping cough 5 5. Diphtheria 2 21. Bronchitis 119 Tuberculosis of the respiratory system 87 22. Pneumonia 72 6. 23. Other respiratory diseases 12 7. Other forms of tuberculosis 18 24. Ulcer of stomach or duodenum 25 8. Syphilitic diseases 22 9. Influenza 14 25. Diarrhoea (under 2 years) 2 10. Measles 3 26. Appendicitis 6 11. Acute polio-myelitis and Polio-encephalitis — 27. Other digestive diseases 29 12. 28. Nephritis 27 13. Acute infective encephalitis — 29. Puerperal and post-abortion sepsis 1 Cancer of buccal cavity and œsoP h a g u s (m): uterus (f) 15 30. Other maternal causes 1 31. Premature birth 25 14. 32. Congenital malformations, birth injuries, infantile diseases 12 Cancer of stomach and duodenum 46 200 15. 16. Cancer of breast 21 33. Suicide 10 Cancer of all other sites 118 34. Road traffic accidents 15 17. 35. Other violent causes 111 Diabetes 11 36. All other causes 96 4 Infant Mortality—There were 65 deaths of infants under twelve months of age, giving an infant mortality-rate of 63.35* per 1,000 births. This may be compared with a rate for the previous five years (1936-40) of 57.9. The deaths of illegitimate infants numbered 6, giving an illegitimate infant death rate of 77.23. Maternity and Child Welfare. The activities of the Council under this heading were continued during 1941 with only a few variations noted below. Grants.—No variation was made in the grants which the Council were accustomed to pay to various bodies carrying on work ancillary to the scheme for maternity and child welfare. Infant Welfare Centres—718 sessions, 19,763 attendances. Ante-Natal Clinics.—182 sessions, 2,029 attendances. Mothercraft Classes.—293 meetings, 3,579 attendances. Dental Clinic.—Following the destruction of the Dental Clinic by enemy action, arrangements were made with the London County Council for dental treatment to be carried out at St. James's Hospital, this service commencing in March, 1941. By the end of the year 180 mothers and 73 children were referred to the clinic, and of these 55 mothers and 39 children had attended. Hospitals.—437 cases were referred to hospitals, etc., from the Welfare Centres, and 2,547 visits were paid at the request of various hospitals. Milk—The Government scheme for the supply of milk at cheap rates to expectant and nursing mothers and children under 5 years of age continued in force during the year. Dinners.—Women and children were still sent for dinners to the dining rooms of the Women's League of Service at Southlands. The Invalid Kitchens Association, whose premises in Henley Street were closed down in April, 1940, resumed their activities during the year from a kitchen established in Balham, the dinners being delivered at the home of the patient. Maternal Mortality.—2 deaths (1 from puerperal sepsis and 1 from other puerperal causes), giving a maternal mortality rate of 1.88 per 1,000 births, live and still. Unmarried Mothers.—The usual grant of £150 was made to the Southwark Diocesan Association. 7 Battersea mothers were admitted to their Homes and stayed for 452 days. Home Helps.—1 case. Cost to Council, £3 17s. 8d. St. Thomas's Babies Hostel.—Transferred to Wiltshire on the outbreak of War, and remained there during 1941. Mrs. Alderman Bowler was re-appointed to represent the Council on a Committee formed to promote the revival of the hostel's activities. Work done.—In-patients 14 (6 mothers, 8 babies), total stay 724 days. The annual grant of £400 per annum was continued by the Council. *This figure is, by direction of the Registrar-General, based on a total of 1,026 births. 5 Nursing.—The District Nurses, under contract with the Council, paid 3,706 visits to 360 cases, of which 169 were patients suffering- from infectious disease. The St. Margaret's Day Nursery, which was evacuated on the outbreak of war, remained at Horsham throughout 1941 and was used, in common with other evacuated nurseries, for evacuees selected by a central committee. The Council continued its financial grant. The premises formerly occupied by the day nursery were taken over by the Council with a view to establishing a war-time nursery. Child Life Protection—47 foster-mothers were still on the register at the end of 1941, but only 22 of these had nurse-children (to the number of 26) in their care. The health visitors paid 341 visits to foster-mothers. Infectious Diseases. The incidence of infectious disease was higher than in 1940, this being almost entirely as a result of an increase in measles and whooping cough, but was below the average of the past five years. The following table shows the number of cases notified:— Diphtheria 89 (183) Pneumonia (acute primary 122 (194) Erysipelas 42 (57) Scarlet fever 64 (232) Pneumonia (acute influenzal) 22 (42) Enteric fever 3 (5) Puerperal fever 4 (6) Whooping cough 490 (480) Puerperal pyrexia 11 (17) Measles 576 (1080) Meningococcal meninggitis 31 (10) Tuberculosis (all forms) 166 (207) Ophthalmia neonatorum 8 (22) 1639 (2545) Polio-myelitis, etc. 3 (4) Malaria — (1) Dysentery 8 (5) For the Purposes of comparison, the average number of cases notified annually in the five years, 1936-40, is inserted in brackets. Schick Clinic.—The diphtheria immunisation clinic was continued throughout the year. Its activities were extended as, by arrangement with the London County Council, children who had as inoculated by the School Medical Officer, attended for testing as to immunity. The clinic was attended by 1,346 patients (736 39 and 538 who had been inoculated by school medical officers). in were found to be immune on primary test, and 835 on test after inoculation. The increase in the number of attendances may be due to the national propaganda which included the exhibition of the film "Defeat Diphtheria." Tuberculosis.-—Beside 166 cases notified, there were otherwise reported 30, making a total of 196 new cases. The Dispensary was carried on throughout the year as in normal times. Deaths from tuberculosis numbered 105, of which 18 were of the non-pulmonary form. Although the number of deaths attributed to Pulmonary Tuberculosis was lower than that for the 6 preceding- year, owing- to the smaller population, the death rate increased by approximately 5 per cent. In the case of NonPulmonary Tuberculosis, the number of cases was higher and the death rate was more than doubled. Extra nourishment was provided during the financial year ended 31st March, 1942, for 36 necessitous dispensary patients at a cost of approximately £100. The number of new patients attending- at the Dispensary was 409. Of these 263 were discharged as "non-tubereulosis,'' 126 were found to be suffering from the disease and 20 were still under observation. The total number of attendances during- the yearwas 3,715. Home visits, to the number of 4,029 were paid (272 by Tuberculosis Officer and 3,757 by the nursing staff). Seventyeight patients received institutional treatment, the average length of stay being 100 days. The Handicraft Class was held on 50 occasions during theyear with an average attendance of 7. Typhus-.—Although no case of typhus has been notified in Battersea for over 50 years, in view of the prevalence of this disease upon the continent, the Ministry of Health advised the taking of precautionary measures and the setting up of an organisationcapable of dealing with a potential epidemic. Preliminary steps were taken in this direction, the neighbouring boroughs of Wandsworth, Lambeth, Camberwell and Southwark being linked with Battersea with a view to formulating a joint scheme. Cancer.—200 deaths of Battersea residents were recorded. Sanitary Circumstances. The Inspectorial staff were to a large extent engaged on special duties in relation to bombed dwellings, displaced tenants, air-raid shelters, etc. The number of dwelling houses inspected1 therefore shows an increase on previous years, but in general the usual work of the department in relation to sanitation shows a marked decrease,, as evidenced by the following table. Complaints received 2,587 House inspections 49,803 Shop Act inspections 109 Factory, etc., inspections 1,105 Gipsy van inspections 38 Drains— Smoke tests 107 Water tests 461 Relaid 21 Repaired 158 Plans received 36 Persons cleansed (including 5,456 children) 8,014 Premises disinfected 2,029 Articles disinfected 32,009 Water supply— New houses certified 91 Additional to tenement houses Water closets provided, etc. Smoke observations Notices served— Intimation 1,039 Statutory— Sections 197 and 220 1,228 Fifth schedule, etc. 403 Mortuary— Bodies received 372 P.M. examinations 372 Inquests 71 7 Vermin and Scabies.—An active campaign was taken to combat conditions arising from verminous infestation, and in October the Scabies Order (S.R. & O. 1941, No. 1724), which strengthens the hands of local authorities in dealing with the disease, was made. Legal proceedings to enforce various requirements or for the recovery of penalties incurred by the breach of statutory requirements were taken in 32 instances; fines were inflicted amounting to £70, and costs to £23 13s. 6d. Factories and Homework.—The number of factories in which Mechanical means are used decreased by 34 to 241, and of nonMechanical factories by 48 to 130. Inspections of these premises Numbered 639. The number of homeworkers decreased bv 37 to 142. Bakehouses numbered 45 at the end of the year, two being opened and six closed during the year. The number of underground bakehouses remained at 14. Three of the 45 premises do not rank factories since only the proprietor works on the premises. 59 inspections of bakehouses were made during 1941. Protection of the Food Supply.—1,200 samples (of which 533 were informally taken) were analysed by the Public Analyst. Of these 26 (6 informal) were certified to be adulterated, which gives a Percentage of adulteration of 2.2. 660 of the samples were of milk, the percentage of adulteration among which was 2.4. There were 85 dairies (milk shops) registered at the end of the year. 27 licences to sell tuberculin tested milk and 50 for pasteurised milk were valid during 1941. 136 Premises (excluding street stalls) were on the register for the Manufacture, storage or sale of ice cream, and 131 for the sale preserved foods and 34 as fish shops. Street stalls from which food was sold numbered 71. Housing. No. of new houses or tenements erected during the year 90 No. of dwelling houses inspected for housing defects 4,220 (43,229 inspections) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation— (i) Dealt with under Housing Act Nil (ii) Dealt with under Public Health (London) Act 872 Number of defective dwelling-houses rendered fit by informal action Nil Number of dwelling-houses in respect of which Statutory Housing Act notices were served requiring repairs Nil 8 Number of dwelling-houses which were rendered fit after service of formal notices Nil Number of dwelling-houses in respect of which Public Health Act notices were served requiring defects to be remedied (1,016 intimation notices) 872 Number of dwelling-houses in which defects were remedied after service of formal notices— (i) By owners (1,269 intimation notices complied with) 1,108 (ii) By Local Authority in default of owners 4 Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil Overcrowding— (a) New cases reported during the year Nil (b) Cases relieved during the year Nil (c) No. of cases on register at the end of the year 1,140 Housing accommodation provided by the London County Council for Battersea families 201 Staff. Dr. Shirlaw vacated the appointment of Assistant Medical Officer on entering- the Royal Army Medical Corps on the 8th November. Mr. F. H. White and Mr. E. G. Wren, Grade A clerks, entered the Royal Army Ordnance Corps on the 16th January and the NonCombatant Corps on the 11th December respectively. Miss I. B. Abbott and Miss B. E. Prager, Health Visitors, were seconded for duties in reception areas, the former to Cornwall in April and the latter to Northampton in May.