AC4366 Report for 1943 BET 48 Public Health Department, Town Hell, Bethnal Green,E.2. May,1944. To the Mayor, Aldermen & Councillors, of the Metropolitan Borough of Bethnal Green. Lsdies and Gentlemen, In pursuance of the war time practice I submit herewith a brief interim report on the health of the Borough and the work of the Public Health Department during 1943. Comparative figures for recent years are added to enable the Council to note some of the changes which have taken place. VITAL STATISTICS As indicated in previous years, the considerable alteration in the age and sex composition of the population, as well as its reduction in number, render the calculation and interpretation of vital statistics somewhat difficult. It should be borne in mind that the following war time figures relate solely to the civilian population in the borough. 1936-8 average 1939 1940 1941 1942 1943 Death rate 12.2 11.5 20.1 20.5 14.8 20.2 Infant death rate 70 + 51 50 62 46 70.3 Birth rate 13.7 12.8 15.1 17.0 19.3 18.7 Maternal mortality rate 1.9 1.7 Nil 1.5 1.0 2.2 + greatly influenced by abnormally high rate of 98 in 1936. The main reason for the considerable rise in general mortality for the year was the Tube Shelter disaster, although there were also small increases in Influenza, Cancer, Heart disease, Bronchitis and Diarrhoea. With regard to infant deaths, the increase is almost wholly attributable to Diarrhoea. The Registrar General has given 47,920 as his estimate of the civilian population in 1943. MATERNITY AND CHILD WELFARE. The reduced staff of 7 Health Visitors carries on its essential work for maternal and child welfare in the homes, whilc the four weekly sessions of the Maternity Clinic and Infant Consultations, conducted by Dr. H. Andrews, the part time Medical Officer, have also continued throughout the year. Evacuation and return and other war circumstances are reflected in the following changing statistics of this work : Attendances at Welfare Centres. 1936-8 average 1939 1940 1941 1942 1943 Babies (0-1) 10,332 9851 5745 3599 5542 6372 Children (1-5) 7,427 6832 3551 883 785 758 Mothers Ante-natal 1,337 1247 813 687 1172 1734 „ Post-natal 345 185 7 - 8 16 -2- Visits of Health Visitors. 1936-8 1939 1940 1941 1942 1943 Babies (O-l) 12,577 8,993 9,757 4,109 4,764 7,646 Children(l-5) 13,880 10,044 13,317 7,580 4,826 6,730 Mothers ante natal 1,374 1,157 674 256 317 850 " post natal 367 128 75 37 49 98 Total visits & revisits: 31,242, 21, 476, 23, 356, 13,841, 11,415, 17,04 Although there are fewer mothers end children to deal with as compared with 1939 end earlier years, it must be remembered that the work in the homer and at the Welfare Centre is much more complicated end difficult as a result of war conditions. In these circumstances, it is particularly creditable to the staff that the attendances at the Welfare Centre, and the visits in the homes should be brought to such a comparatively high level. The re-organisation of the work in 1942 end the return of the remainder of the staff to health visiting have no doubt also contributed to this. DISEASE In the absence of fuller information as to the illness among the community, 1 can only furnish the limited facts which come to me as Medical Officer of Health concerning the infectious diseases. The following figures show the general trend throughout the war, but it will be borne in mind that the years 1939-41, were considerably affected by the evacuation of a large part of the child population : 1933-38 1939 1940 1941 1942 _1943 Measles (average) ( 254) + (1143) 23 187 489 786 357 Whooping Cough ( 410) ( 250) + 312 10 345 160 193 Tuberculosis 134 101 82 96 116 101 Other infectious Disease 951 566 272 309 288 478 + In view of the biennial incidence of these diseases, separate figures for 1957 and 1938 are given instead of the triennial average. The biennial fall in the incidence of Measles was counterbalanced by a small increase in Whooping Cough, Pneumonia, and Dysentery. 3 FOOD 1956-58 (average) 1959 1940 1941 1942 1945 Unsound Food Seizures 2 1 5 Surrenders 19 16 41 45 ■l 76 204 Samples of Food taken 724 690 559 557 578 520 % of adulteration (all samples) 5-9 5.9 5.2 6.5 5.9 5.1 % of adulteration (inilk samples) 2.6 2.7 5.8 5.5 0.7 Nil The increase in the number of unsound food surrenders and the larger amount involved do not represent any deterioration in the conduct of the food trades but are mostly due to the facts that retailors have to surrender any unfit food, however small the quantity, in order to recover the points value under the rationing orders and that so iuuc'h more canned food, which has often to be stored for long periods, is now being consumed. SANITATION Notwithstanding the smaller number of houses and population in the borough and the further reduction in the staff available the sanitary work is still kept at a high level as the following figures show. 1936-53 1939 1940 1941 1942 1943 Infectious disease and food poisoning 2074 865 404 663 930 1221 Complaints 4756 4293 3625 3305 4226 3947 House to house inspection 672 451 - 4 - - I'otal Visits 44,608 44, 954 32,627 51,277 36,363 35,092 Premises where nuisances absted 5657 4658 5592 3172 3585 5184 Preliminary notices 5575 6234 4312 3585 4280 3675 Nuisance notices 2474 3109 1878 1647 1623 1355 DISINFECTION The Personal. Cleansing Station continues to be very well used for the treatment of cases of Scabies, as many as 195 men, 502 women, and 446 children attending for this purpose and having a total of 2405 treatments. The disifecting staff also sprayed 713 rooms and disinfected 34,049 articles. -4- WAR-TIME NURSERIES A substantial addition to the work of the Department has been made in the establishment and maintenance of the 4 nurseries which are now in operation in the borough. During the year, the extension of the University House Nursery required by the Ministry of Health was completed and it came into use at the beginning of 1944. Considerable difficulty has been experienced in obtaining adequate and suitable staff but despite this and other adverse circumstances, the nurseries are now in good working order and are performing a useful function in child care and nurture. The past year saw the publication of the County of London Plan. This great and practical vision of the future' is bound to influence profoundly the development of the health services and the location of health institutions in the reconstructed Bethnal Green of tomorrow. On some of the details, such as the considerable preponderance of tenement buildings, some of great height, there may be ground for criticism but taking the plan as a whole, there can be little doubt that although it is not primarily a health measure it will do more eventually to promote the health of the people than many of the Acts of Parliament which have professed that object. It is to be hoped that high among the priorities for reconstruction building in the borough will be the provision of adequate Maternity and Child Welfare premises which has been for many years an urgent need. VYNNE BORLAND, MEDICAL OFFICER OF HEALTH.