AC4366 Report for 1942 BET 47 Public Health Department, Town Hall, Patriot Square, Bethnal Green, E.2. July, 1943. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Bethnal Green. Ladies and Gentlemen, In accordance with the practice for the last three years, I furnish, a brief interim report on the health of the borough and the work of the Public Health Department in 1942, which I hope will be followed by a full account after the War. Comparative figures for recent years are given to enable the Council to note the extent of some of the changes which are taking place. VITAL STATISTICS. Comparing the war years with the average of the 3 preceding years, we have the following figures:- 1936 - 8 (average) 1939 1940 1941 1942 Death Rate 12.2 11.5 20.1 20.5 14.8 Infant-Death Rate 70 + 51 50 62 46 Birth Riate 13.7 12.8 15.1 17.0 19.3 Maternal Mortality Rate 1.9 1.7 Nil 1.5 1.0 + Greatly influenced by abnormally high rate 01 90 for l936. Both the shifting of the population and its altered age composition make the calculation and interpretation of vital statistics difficult in war time. The general death rate figure,shows considerable improvement on those for the past 2 years and although it is above the rate for London (13.9) it would probably not be materially different from the average for 1936-38 if corrected for the changed age level of the population. The infant and maternal mortality rates are satisfactory and no doubt partly reflect the health value of the special provision for maternal and child welfare in the food rationing and distribution control which have arisen out of the war. The Registrar-General has given 47,410 as his estimate of the civilian population for the year 1942. MATERNITY AMD CHILD WELFARE. During the year, the Maternity and Child Welfare work was to some extent reorganised, the full-time medical officer leaving and being replaced by a part-time doctor engaged on a sessional basis, one health visitor leaving about the same time, and two health visitors being returned to normal duty from first aid post service. At the end of the year only one health visitor remained in the latter service and she has since been transferred back to her ordinary work. All the essential services have been maintained throughout the war period. It is worthy of note that the Home Helps service, which is now receiving some public attention, has been in active operation in this borough since 1927 and despite wartime difficulties is still being carried on. Attendances at Welfare Centres. 1939 1940 1941 1942 1936-38 (average) Babies (0-1) 10,332 9851 5745 3599 5542 Children (1-5) 7,427 6832 3551 813 883 785 Mothers: Ante-natal 1,337 1247 687 1172 " Post-natal 345 185 7 -- 8 Visits of Health Visitors. 1936-38 1939- 1940 1941 1942 Babies (0-1) 12,577. 8,993. 9,757. 4109 4764 Children (1-5) 13,880. 10,044. 13,317. 7580 4826 Mothers: Ante-natal 1,374 1,157 674. 256. 317 ,, Post-natal 367. 128. 75. 37. 49 Total visits & revisits : 31,242. 21,476. 23, 356.13, 84111,415. DISEASE. The main facts with regard to the trend of, infections disease may be seen from the following figures: 1936-38 1939 1940 1941 1942 Measles (average) ( 254) + (1143) 23 187 489 786 Whooping Cough ( 410) ( 250) + 312 10 345 160 Tuberculosis 134 101 82 96 116 Other Infectious disease. 951 566 272 309 288' + In view of the biennial incidence of these diseases, separate figures for 1937 and 1938 are given instead of the triennial average. It will be seen that the unfavourable, trend with regard to Tuberculosis still continues and that' there was a substantial epidemic of Measles during the year. FOOD. The following figures illustrate the work done to ensure the purity and soundness of the borough food supply, more than ever important in war time: 1936-38 1939 1940 1941 1942 (average) Unsound food Seizures 2 1 1 3 Surrenders 19 16 41 45 176 Samples of Food taken 724 690 559 557 578 % of adulteration (all samples) 3.9 3.9,, 3-2 6.5 3.9 % of adulteration (milk samples) 2.6 2.7 3.8 3.3 0.7 - 3 - Ihe exceptional increase in unsound food surrendered is no doubt due to delay in the disposal of food arising from wartine controls and to the fact that retailers require to surrender any unsound food, however small the quantity, in order to recover the points value. As in the previous year, there were some prosecutions for the misdescription of food to the prejudice of the purchaser and another for the keeping of a bakehouse in a dirty condition, substantial penalties being imposed upon the dealers in question. SANITATION. Ihe sanitary inspecting staff continue to maintain all the essential work of sanitary supervision of the borough and the following figures show that in many respects this work is increasing rather than diminishing notwithstanding the smaller number of houses and population in the borough- and the reduction in the staff available: 1956-38 1059 1940. 1941 1942 Infectious disease and food pbisoning 2074 865 404 663 950 Complaints 4756 4295 3625 5505 4226 House-to-house inspection 672 451 - 4 - Total visits 44,608 44,954 52,627 51,277 56,368 Premises where nuisances abated. 5657 4658 3592 3172 5585 Preliminary notices 5575 6254 4512 5585 4280 Nuisance notices 2474 5109 1878 1647 1625 DISINFECTION. I referred rather fully to this subject in my last report. The Personal Cleansing Station continues to be very well used for the treatment of cases of Scabies, as many as 216 men, 451 women and 412 children attending for this purpose and having a total of 2298 treatments. The disinfecting staff also sprayed 729 rooms and disinfected 40,415 articles. WAR-TIME NURSERIES. During the year, 5 nurseries were established at the request of the Ministry of Health for the purpose of caring, during the daytime, for the children of women engaged in industrial employment. Ihe first, opened in June, is situated at St.Jude's Vicarage, Ireadway Street, and accommodates 40 children. The other two, opened in October and November respectively, occupy the former Infant School at Pritchards Road and the Nursery School at Columbia Market; both accommodate 70 children. The voluntary nursery at University House opened in July, 1941, was transferred to the Council in November. A nursery has also been established by the London County Council at the Wolverley Street Rest Centre. Ihe adaptation, equipment, staffing and management of these nurseries have made a considerable addition to the work of the department. At the close of the year, the nurseries were not fully staffed or used. / - 4 - The more favourable turn of the war since Last year makes it reasonable for one to hope that schemes of reconstruction will soon be well on the way. I make no apology for reiterating the opinion expressed in my last report that this period and this task call for a much bigger scope and vision than have hitherto been applied to social welfare. It is not merely a matter of picking up the threads of our pre-war plans of development, but rather one of looking at public health and kindred subjects from the new point of view of planning so as to realise the full potential of a democratic community. Before the war, we were struggling with, the legal and financial difficulties which handicapped these improvements of housing and the. maternity and child welfare and tuberculosis services which we knew to be necessary. Now it is to be hoped that these barriers, if not removed, will be easier to surmount with a broader outlook in public life and our former plans for improvement" must be merged in far more comprehensive and far-reaching plans of "reconstruction." I take pleasure in expressing my appreciation to the Council for support and sympathetic consideration of difficulties and grateful thanks to the staff for loyal co-operation in trying circumstances. Medical Officer of Health.