FINC 22 BOROUGH OF FINCHLEY. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1941. To the Mayor, Aldermen and Councillors of the Borough of Finchley. July,1942. I have the honour to submit my Annual Report on the health of the Borough for the year 1941. It has been prepared in accordance with the instructions contained in the Ministry of Health Circular 2604 and in consequence is much abbreviated in scope. The vital statistics are very favourable, the outstanding feature being the extremely low infantile mortality rate which affords great encouragement to all those who have responsibilities in connection with the welfare of mothers and young children. Apart from measles and whooping cough the incidence of infectious diseases was low and in none was the fatality rate at all high. Scabies and certain types of uncleanliness caused some anxiety and a great deal of extra work but there is reason to believe that in both cases the worst phase has passed. The birth rate shows a tendency to rise again while the death rate - apart from an increase in the mortality from pulmonary tuberculosis - does not call for special comment. Adequate supervision of food, water supply, housing and sanitary conditions generally has been maintained. (2) The whole staff of the Department have worked well throughout the year and have accepted their ever increasing responsibilities in an admirable spirit. SOCIAL CONDITIONS. Area (in acres) 3,477 Number of inhabited houses (end of 1941) 18,146 Rateable Value £901,401 Sum represented by a pennv rate £3,489 EXTRACTS FROM VITAL STATISTICS. Live Births: Total. Hales. Females. Legitimate 683 361 322 Illegitimate 38 26 12 Birth rate, 12.42 per 1,000 estimated resident population. Stillbirths: Total. Males. Females. 20 13 7 Rate, 27 per 1,000 total (live and still) births. Deaths: Total. Males. Females. 734 337 397 Death rate, 12.65 per 1,000 estimated resident population. Deaths from diseases and accidents of pregnancy and childbirth; From sepsis Nil. From other causes 2 Death rate of infants under one year of age: All infants per 1,000 live births 21.8 Legitimate infants per 1,000 legitimate live births 18.47 Illegitimate infants per 1,000 illegitimate live births 76.9 Deaths from Cancer (all ages) 1ll Deaths from Measles (all ages) Nil Deaths from Whooping-cough (all ages) 3 Deaths from Diarrhoea (under 2 years of age) 1 (3) THE BIRTH RATE. The birth rate in 1941 was 12.42 for 1,000 of the estimated population. This is a little higher than in 1940 when it was 12.1 but is still considerably lower than in 1939 when it was 14.46. The decline in the birth rate in Finchley has been much greater than in the country as a whole but considerably less than in the County of London where the rate for 1941 reached the low level of 8.9. On the other hand the birth rate for the aggregate of the smaller towns has shown an appreciable rise. There is little doubt that, owing to the temporary migration of expectant mothers away from Greater London, many births fail to be allocated to their proper area. THE DEATH RATE. The death rate in 1941 was 12.65 per 1,000, an improvement on 1940 when it was 13.4 but higher than in 1939 when it was 11.1. The total number of deaths was only 29 more than in 1939 but the death rate is greater because it is calculated on a smaller estimated population, INFANTILE MORTALITY. The infantile mortality rate was 21,8 per 1,000 live births as compared with 37.97 in 1940. This is easily the lowest rate ever recorded in Finchley, the next lowest being 32,4 in 1927. The Finchley rate is also substantially the lowest in all the County Boroughs and Great Towns. The corresponding rates for England and Wales and London were 59 and 68 respectively. In Public Health text books it is stated that the infantile mortality rate is one of the best indices of the state of the health of a community and, if that is so, Finchley has no reason to be dissatisfied, especially when it is remembered that we are dealing with the second complete year of a world war. (4) INFECTIOUS DISEASBS. The following table shows the numbers of notifications of the principal infectious diseases received during 1940 and 1941:- 1940 1941 Diphtheria 42 38 Scarlet Fever 58 51 Enteric Fever 0 6 Cerebro-spinal Fever 9 8 Pneumonia 33 51 Measles 51 647 Whooping Cough 33 376 It will be seen that measles and whooping cough were prevalent in 1941. Measles fortunately was mild in character and did not cause any deaths but three children, all under four years of age, died from whooping cough. The six cases of enteric fever were all Paratyphoid B. and none was fatal. The incidence of scarlet fever was again low and there were no deaths. Diphtheria was less prevalent than in 1940 and there was one death. When diphtheria was more common than it is now, it was looked upon as a children's disease - at least 75% of the cases being under fifteen years of age but, owing to the fact that a large proportion of the children have been immunized against the disease, children under fifteen now furnish no more than 50% of the cases. In 1941 there was a considerable increase in the number of children immunized. Eleven hundred and forty seven completed their injections and 231 had commenced. Eleven hundred and forty eight children were Schick tested and 1,108 were found to be adequately protected. Between sixty and seventy per cent of the children under 15 years of age have now been immunized. A number of children who were treated in 1935 and 1936 have been re-tested and it has been found that approximately 25% have lost their immunity and have been (5) re-injected. I have now decided to give one injection of 0.5c,c. A.P.T. to all children on the expiration of 5 years from the time at which they were first immunized. TUBERCULOSIS. Since the beginning of the war there has been an increase in the number of deaths from tuberculosis of the lungs throughout England and Wales and, in this respect, Finchley is no exception. The following table shows the numbers of the notifications and the deaths for the past 4 years Notifications Deaths Males Females Total Males Females Total 1938 47 27 74 13 9 22 1939 34 30 64 16 7 23 1940 28 21 49 16 10 26 1941 34 38 72 18 16 34 The notifications for 1941, though not so high as in 1938, are appreciably higher than in the intervening years but this increase is partly due to the fact that a number of old cases of tuberculosis which had not previously been notified were discovered on following up the medical certificates which were issued to enable invalids to obtain an additional allowance of milk. On the other hand it will be observed that there is a definite rise in the number of deaths and, on further analysis, it is found that the increase is not in young adults as in the last war but in older persons. The inference to be drawn is that there has been no definite increase in new cases but there has been an increase in deaths of those already suffering from phthisis probably due to the increased stress and strain of wartime. SCABIES. This disease may be said to have assumed epidemic (6) proportions in 1941 when 300 cases were treated. The method of the spread of this disease is very obscure. It used to be considered as a dirt disease and, in the early stages of this outbreak, it was mostly confined to the unclean but now we find it among people who are accustomed to keep themselves and their clothes clean. Many new remedies have been advocated and we have tried most of them, It has quite definitely been proved that treatment cannot adequately be carried out by the patients themselves. Two hundred and seven cases were treated at the Health Centre, 59 at Northside First Aid Post, 25 at St. Mary's First Aid Post and 9 at the Disinfecting Station. Much work is involved In treating a case of scabies to its conclusion. The patient is thoroughly soaked in a hot bath and thoroughly washed and then, after drying, the appropriate preparation is applied ail over the body. This treatment is repeated on the two following days and the patient Is inspected at weekly intervals for some time in order to make sure that a cure has been effected. Disinfection of clothing and bedding is also carried out. I am very glad to say that nearly all the treatment has been done by the personnel at the First Aid Posts. VERMINOUS HEADS. There has been an unwelcome increase in the number of verminous heads which have come to the notice of the Department. Apart from children, this condition has been found mostly in young women. Some have been referred to us by Hairdressers and others by Factory Welfare Officers. All the Hairdressers have been visited by a Sanitary Inspector and a leaflet dealing with the subject has been sent to all the factories in the Borough. (7) MATERNITY AND CHILD WLFARE. The number of children attending the Infant Welfare Centres increased rapidly after the cessation of bombing. Five hundred and sixteen children under one year of age and 1434 between 1 and 5 years attended during the year. The members of the Voluntary Association continued to give valuable services at all three centres. Seven hundred and four women attended the Antenatal Clinics during the year, on increase of 114 over 1940. The problem of finding adequate maternity hospital accommodation becomes more acute as does the other problem of finding women who are willing to look after the households of mothers during their confinements. The three Municipal Midwives attended 254 confinements during the year and many appreciations of their services have been received from their patients. The supply of milk to expectant and nursing mothers and children under 5 years of age functioned smoothly. Cod liver oil and fruit juices were distributed by the Civil Defence Personnel at the First Aid Posts and by the voluntary workers at the Infant Welfare Centres. DAY NURSERIES. The Day Nursery at the Health Centre was well attended and by the end of the year it was full to capacity. There was a considerable demand for further nursery accommodation and a Wartime Nursery for 30 children was planned at 8, Moss Hall Crescent and was opened on the 20th October. It soon became evident that more room was needed and the adjoining house was requisitioned to provide extended accommodation for 70 children. (8) FOOD. All the meat for Barnet, Finchley and Hendon is distributed from the Depot at North Finchley. Inspection of all carcases and offal is carried out by the Finchley Inspectors. During the year, 4,514lbs. of unsound or diseased meat was condemned as unfit for human food. There has been an increase in the amount of tinned foods condemned and this has largely been due to damaged and corroded tins found in old stocks. No food was damaged by enemy action. Fresh licences were issued to the occupiers of four private slaughterhouses but they were used only occasionally for slaughtering on licence granted by the Ministry of Food. MILK. In spite of labour and blackout difficulties, the milk dealers have succeeded in maintaining the standard of purity and quality of the milk sold in the Borough. Samples have been taken from time to time and have mostly been satisfactory, WATER. All samples of water have been entirely satisfactory. HOUSING. Housing inspections have been kept up throughout the year, At 573 premises defects were found and remedied. In damaged houses where first aid repairs have been carried out and which have become defective on account of the weather, some difficulty has been experienced in prevailing upon owners to effect repairs of a more permanent character. In many cases, however, roofs have been adequately repaired and windows reglazed. (9) There is a shortage of housing accommodation suitable for the working classes and subletting has become more prevalent but little overcrowding has been discovered. Regular visits have been paid to houses occupied by evacuees. GENERALLY. Much routine work has been done and all urgent matters in connection with infectious diseases, drainage defects, complaints etc. have received prompt attention. Following the suggestions set out in London Region Circular 380 the work of sealing off the drains on the site of premises which have been destroyed has been taken in hand. Public Air Raid Shelters have been inspected from time to time. There has been a marked increase in the volume of disinfection of premises, bedding etc. largely due to the epidemic of scabies. A. A. TURNER. Medical Officer of Health. • • "' '