BAT 41 Metoropolitan Borough of Battrsea. ABRIDGED REPORT on the HEALTH of the borough in 1942 by G. Macdonald, M.A., M.B., D.P.H,, Medical Officer of Health. C4386 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 1942. 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 1942. Area of Borough acres 2,163 Structurally separate occupied dwellings 26,241 Rateable value—£1,070,739. Sum produced by 1d. rate £4,056 Births—(live 1,570, still 43) 1,613 Deaths 1,284 Maternal deaths—2. Maternal death rate 1.24 Infant deaths—84. Infant mortality rate 53.50 3 Vital Statistics. Births registered in Battersea numbered 1,976. Of these, only 1,004 were of Battersea parents, but there were 566 Battersea children born outside the Borough, and the total number of Battersea live births in 1942 was therefore 1,570 (782 males, 788 females). Still births numbered! 43—rate 26.66 per 1,000 births, live and still. Illegitimate births numbered 118, which included 6 among the still births. Of the 1,570 Battersea live births, 1,405 were notified to the Medical Officer of Health under the Public Health (London) Act, 1936. The birth rate for the year showed an increase of 16 per cent. over that of the previous year. Marriages.—963 marriages were registered in Battersea during 1942. Deaths.—2,359 deaths were registered in Battersea during 1942. Of these only 983 were of Battersea residents, but there must be added 301 deaths of residents of the Borough registered elsewhere, giving a total of 1,284 (651 males, 633 females), and the death rate was 18 per cent. lower than that for 1941. For the 5 years 1937-41 the death-rate was 14.8 per 1,000 population, the average number of deaths per annum having been 1,742. 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 _ 17. Diabetes 10 18. Intra - cranial vascular lesions 88 2. Cerebro-spinal fever 2 3. Scarlet fever — 19. Heart disease 388 4. Whooping cough 6 20. Other diseases of circulatory system 70 5. Diphtheria 8 6. Tuberculosis of the respiratory system 79 21. Bronchitis 109 22. Pneumonia 46 7. Other forms of tuberculosis 7 23. Other respiratory diseases 16 24. Ulcer of stomach or duodenum 13 8. Syphilitic diseases 13 9. Influenza 4 25. Diarrhœa (under 2 years) 8 10. Measles 2 26. Appendicitis 2 11. Acute polio-myelitis and polio-encephalitis 27. Other digestive diseases 20 28. Nephritis 21 12. Acute infective encephalitis 1 29. Puerperal and post-abortion sepsis 2 13. Cancer of buccal cavity and œsophagus (m): uterus (f) 22 197 30. Other maternal causes 31. Premature birth 25 32. Congenital malformations, birth injuries, infantile diseases 23 14. Cancer of stomach and duodenum 33 33. Suicide 6 15. Cancer of breast 20 34. Road traffic accidents 12 16. Cancer of all other sites 122 35. Other violent causes 23 36. All other causes 83 Infant Mortality.—There were 84 deaths of infants under twelve months of age, giving an infant mortality-rate of 53.50 per 1,000 births. This may be compared with a rate for the previous five years (1937-41) of 58.04. The deaths of illegitimate infants numbered 7, giving an illegitimate infant death rate of 62.5. 4 Maternity and Child Welfare. The activities of the Council under this heading were continued during 1942 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, 25,536 attendances. Ante-Natal Clinics.—182 sessions, 3,183 attendances. Mothercraft Classes.—248 meetings, 3,705 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. During the year 93 mothers and 66 children were referred to tha Clinic, and of these 46 mothers and 34 children had attended. Hospitals.—501 cases were referred to hospitals, etc., from the Welfare Centres, and 3,674 visits were paid at the request of various hospitals, etc. National Dried Milk and Vitamins.—Throughout the year, National dried milk and fruit juice and cod liver oil, supplied by the Ministry of Food, have been distributed to children and expectant mothers through the Public Health Department and the Welfare and Ante-natal Clinics. The totals issued during the year were: National Dried Milk, 6,951; Fruit Juice, 21,402; Codf Liver Oil, 6,221. Supplementary Clothing Coupons.—During the year, books of supplementary clothing coupons to the number of 1,650 were issued to expectant mothers by the staff of the Public Health Department. 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 also supplied meals during the year from a kitchen established in Balham, the dinners being delivered at the home of the patient. Maternal Mortality.—2 deaths, giving a maternal mortality rate of 1.24 per 1,000 births, live and still. Unmarried Mothers.—The usual grant of £150 was made to the Southwark Diocesan Association. 9 Battersea mothers were admitted to their Homes and stayed1 for 271 days. Home Helps.—1 case. Cost to Council, £1 1s. 6d. St. Thomas's Babies Hostel.—Transferred from Wiltshire to Puttenham, near Guildford, in September. Alderman Mrs. Bowler was reappointed to represent the Council on a Committee formed to promote the revival of the hostel's activities. Work done—In-patients 27 (11 mothers, 16 babies), total stay 1,455 days. The annual grant of £400 per annum was continued by the Council. Nursing.—The District Nurses, under contract with the) Council, paid 4,726 visits to 510 cases, of which 196 were patients suffering from infectious disease. 5 The St. Margaret's Day Nursery, which was evacuated on the outbreak of war, remained at' Horsham throughout 1942, and was used, in common with other evacuated nurseries, for evacuees selected by a central committee. The Council continued its financial grant. War-time Nurseries.—Three war-time Day Nurseries were opened during the year. One, in the premises formerly occupied by the St. Margaret's Day Nursery, in January, and two others, at Sisters Avenue and Nightingale Lane, respectively, in July. These three Nurseries together have accommodation for 135 children, and the total attendances for the year were 18,915. Child Life Protection.—44 foster-mothers were still on the register at the end of 1942, but only 29 of these had nurse-children (to the number of 31) in their care. The health visitors paid 330 visits to foster-mothers. Infectious Diseases. The incidence of infectious disease was higher than in 1941, this being almost entirely as a result of an increase in measles and whooping cough. The following table shows the number of cases notified :— Diphtheria 65 (145) Dysentery 7 (8) Erysipelas 60 (52) Pneumonia (acute Scarlet Fever125 (157) primary) 156 (178) Enteric fever — (3) Pneumonia (acute Puerperal fever 5 (6) influenzal) 8 (38) Puerperal pyrexia 12 (16) Whooping Cough 526 (464) Meningococcal meningitis 15 (15) Measles 1405 (757) Ophthalmia neonatorum 20 (18) Tuberculosis (all forms) 204 (194) Polio-myelitis, etc. 1(6) Encephalitis lethargica 1 (—) 2611 (2058) Malaria 1 (1) [For the purposes of comparison, the average number of cases notified annually in the five years, 1937-41, is inserted in brackets.] Schick Clinic.—The diphtheria immunisation clinic was continued throughout the year. The arrangement with the London County Council, whereby children who had been inoculated by the School Medical Officer, attended for testing as to immunity, continued in force during the year. The clinic was attended by 2,645 patients (1,685 new and 638 who had been inoculated by school medical officers). Five were found to be immune on primary test, and 1,405 on test after inoculation. In accordance with the Minister of Health's circular No. 2713, a special campaign, aiming at securing the immunising of all children between the age of 1 and 5 was inaugurated. It was arranged for the Health Visitors- to make home visits of all children under 5, to ascertain if immunisation had already been carried out, and, if not, to encourage the parents to take the children to the Schick Clinic. The campaign was not completed by the end of the year. Tuberculosis.—Beside 204 cases notified, there were otherwise reported 22, making a total of 226 new cases. The Dispensary was carried on throughout the year as in normal times. 6 Deaths from tuberculosis numbered 86, of which 7 were of the nonpulmonary form. Death rates for all forms of tuberculosis and for the pulmonary form alone steadily increased from 1938 until 1941, but have dropped appreciably in 1942. With the exception of one year, the records show no death rate comparable with that of 1941 since the years immediately following the last war. Over the same period the death rate for the non-pulmonary forms of the disease shows the same trend except for an initial drop in 1939. Notification rates for all forms of tuberculosis and for the pulmonary form alone show a gradual increase since 1938, after an initial drop in 1939, and this increase is continued in 1942. The non-pulmonary notification rate has fluctuated but is considerably higher in 1941 and 1942 than in 1939 and 1940. In view of the changes which have occurred in the (population of the borough during the war, both in numbers and in age and sex distribution, it would be unwise to accept the statistics for these years as strictly comparable with the corresponding figures for pre-war years, yet it is obvious that there has been a considerable increase in the incidence of tuberculosis during the war and, while regarding with satisfaction the lower death rate for 1942, the continued increase in the notification rate must be borne in mind. It is satisfactory to note that there is no increased proportion of notifications among females aged 15 to 34, as might have been expected, with the increased entry of this group into industry, but it is noteworthy that there has been, in 1942, a marked increase of notifications of tuberculosis (all forms) in children under 5 years of age, although, with such a small group, it is necessary as yet to view any deductions based upon the fact with reserve. Extra nourishment was provided during the financial year ended 31st March, 1943, for 39 necessitous dispensary patients at a cost of approximately £138. The number of new patients attending at the Dispensary was 717. Of these 424 were discharged as "non-tuberculous," 170 were found to be suffering from the disease and 123 were still under observation. The total number of attendances during the year was 5,208. Home visits to the number of 4,013 were paid (320 by Tuberculosis Officer and 3,693 by the nursing staff). 170 patients received institutional treatment, the average length of stay being 55 days. The Handicraft Class was held on 50 occasions during the year with an average attendance of 6. Cancer.—197 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 inspected therefore shows an increase on previous years, but in general the usual work of the department in relation 7 to sanitation shows a marked decrease, as evidenced by the following table. Complaints received 3,763 Water supply— House inspections 29,213 New houses certified — Shop Act inspections 43 Additional to tenement Factory, etc., inspections 2,263 houses 1 Gipsy van inspections 15 Water closets provided, etc. 6 Drains— Smoke observations — Smoke tests 18Notices served— Water tests 234 Intimation 1,682 Relaid 10 Statutory— Repaired 232 Sections 197 and 220 1,524 Plans received 30 Fifth schedule, etc.752 Persons cleansed (including Mortuary— 6,656 children 9,739 Bodies received 424 Premises disinfected 2,432 P.M. examinations 423 Articles disinfected 28,006 Inquests 135 Scabies and Vermin.—During the year the number of baths given at the Personal Cleansing Station was 8,583 (2,983 adults; 5,600 children), and for other verminous conditions 1,156 (139 adults, 1,017 children). Three notices were served under the Scabies Order, but in no case was it found necessary to institute legal proceedings. Legal proceedings to enforce various requirements or for the recovery of penalties incurred by the breach of statutory requirements were taken in 19 instances; fines were inflicted amounting to 10s., and costs to £8 19s. 6d. Factories and Homework—The. number of factories in which mechanical means are used increased by 10 to 251, and of non-mechanical factories decreased by 10 to 120. Inspections of these premises numbered 1,745. The number of homeworkers increased by 16 to 158. Bakehouses numbered 45 at the end of the year. The number of underground bakehouses remained at 14. Three of the 45 premises do not rank as factories since only the proprietor works on the premises. Ill inspections of bakehouses were made during 1942. Protection of the Food Supply.—1,200 samples (of which 586 were informally taken) were analysed by the Public Analyst. Of these 9 (4 informal) were certified to be adulterated, which gives: a percentage of adulteration of 0.75. 608 of the samples were of milk, the percentage of adulteration among Which was 0.5. There were 80 dairies (milk shops) registered at the end of the year. 23 licences to sell tuberculin tested milk and 38 for pasteurised milk were valid during 1942. 131 premises were on the register for the sale of preserved foods and 32 as fish shops. Street stalls from which food was sold numbered' 92. Housing. Number of new houses or tenements erected during the year Nil Number of dwelling-houses inspected for housing defects 3,469 (26,793 inspections) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation— (i) Dealt with under Housing Act Nil 8 (ii) Dealt with under Public Health (London) Act 1,421 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 Number of dwelling-houses in respect of which Public Health Act notices were served requiring defects to be remedied 1,421 (1,667 intimation notices) Number of dwelling-houses in which defects were remedied after service of formal notices— (i) By owners 1,243 (1,466 intimation notices complied with) (ii) By Local Authority in default of owners 2 Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil Housing accommodation provided by the London County Council for Battersea families 129 Staff. Mr. F. E. Ward, Chief Clerk, who had been in the Council's service for 46 years, retired on Superannuation for reasons of health on the 31st October. Mr. H. C. Godfrey, grade "C" clerk, was appointed to fill the vacancy thus caused. Miss B. L. Kaye, Health Visitor, grade "B," was promoted to grade "C," and designated Senior Health Visitor in November. Miss B. E. Prager, Health Visitor, who was seconded for duties in a reception area (Northampton), resumed duty with the Council in August.