FINC 23 BO R 0 U G H OF FINCHLEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1942. To the Mayor, Aldermen and Councillors of the BOROUGH OP FINCHLEY. July, 1943. I have the honour to submit my Annual Report on the health of the Borough for the year 1942. The Report is prepared In accordance with the instructions contained in the Ministry of Health Circular 2773 and in consequence is curtailed in scope. As regards the Vital Statistics, it is regrettable to have to record an Infantile Mortality Rate which is much higher than in the previous year and also higher than the Finchley rate usually is in relation to the rate for England and Wales. There Is no evidence to show that this Is due to any impairment of the health of expectant mothers or to any lack of care during pregnancy or during or subsequent to confinement. There was only one maternal death. I am inclined to think that the increased Infantile Mortality Rate can safely be attributed to ''statistical oscillation". There has been a welcome and substantial increase in the Birth Rate and the Death Rate shows a slight decrease. (2) The Measles Epidemic which started in 1941 continued throughout 1942 and the disease remained mild in character# Scarlet Fever, also of a mild type, was prevalent, while the incidence of Diphtheria was remarkably low. Infection with Scabies showed no sign of abating but, as a rule, patients were found at an earlier stage of the disease and were more easily treated. The supervision of food, milk, water supply, housing and sanitary conditions generally has been well maintained, I am indebted to the whole staff of the Department for their conscientious work and loyal co-operation throughout the year. SOCIAL CONDITIONS. Area (in acres) 3,477 Number of inhabited houses (end of 1942) 18,641 Rateable Value 900,993 Sum represented by a penny rate £3,754 EXTRACTS FROM VITAL STATISTICS, Live Births: Total. Males. Females. Legitimate 849 439 410 Illegitimate 42 20 22 Birth rate, 14.9 per 1,000 estimated resident population Deaths. Total. Males. Females. 751 335 416 Death rate, 12,5 per 1,000 estimated resident population. Stillbirths. Total. Males. Females. 34 17 17 Rate, 36.8 per 1,000 total (live and still) births. (3) EXTRACTS PROM VITAL STATISTICS (continued) Deaths. from diseases and accidents of pregnancy and ohildblrth» From sepsis Nil. From other causes 1 Death rate of infants under one year of age: All infants per 1,OOO live births 53.9 Legitimate infants per 1,000 legitimate live births 42.4 Illegitimate infants per 1,000 illegitimate live births 285.7 Deaths frorm Cancer (all ages) 144 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 7 Deaths from Diarrhoea (under 2 years of age) 3 THE BIRTH RATE. The number of registered live births in 1942 was 891, Only on one occasion since 1920 has this number been exceeded. The birth rate is 14.9 per 1,000 of the estimated population, a marked increase over the rate for 1941 which was 12.42. There was no increase in the proportion of illegitimate to legitimate births. THE DEATH RATE. In 1942, there were 751 deaths giving a death rate of 12.5 per 1,000 of the estimated population as compared with a rate of 12.65 in 1941. The number of deaths from tuberculosis of the lungs (33), one less than in 1941, is still considerably higher than in pre-war years, while the deaths, attributable to disease of the kidneys on the other hand, have shown a progressive decline throughout the war (4) period reaching the low figure of 4 in 1942 as compared with 18 in 1938. No other disease calls for special comment. INFANTILE MORTALITY. In 1942, there were 48 deaths of children under the age of one year as compared with 15 in 1941, the corresponding infantile mortality rates being 53.9 and 21.8. The rate for 1941 was not only by far the lowest ever recorded in Finchley but was also easily the lowest in all the "large towns" in England and Wales for that year. It was not expected that such a low rate would be maintained for any length of time nor was it anticipated that the pendulum would 3wing so rapidly and so far in the other direction, although such violent oscillations are frequently encountered in statistics relating to comparatively small numbers. Nine of the 48 deaths wore of children from Nazareth House, 6 due to Whooping Cough, 2 to Broncho-pneumonia and 1 to Enteritis. If these deaths are excluded, the infantile mortality rate for Finchley children is 44.8. The rate for England and Wales was 49. As all these nine children were illegitimate and as only one other illegitimate child died, the mortality rate for illegitimate children is quite misleading. Of the 39 Finchley children who died in 1942, 22 died before they wore 4 weeks old. Of these no loss than 20 died in a hospital or maternity homo where the mother was confined, whereas only 2 died whose mothers were confined at home. These figures are very remarkable since as many as 40% of the total births took place at home. (5) The causes of death were as follows Congenital Malformations 11 Premature Birth 6 Birth Injury 4 Pneumonia 1 When it is remembered that nearly all the complicated cases and most of the mothers with their first babies go to hospital, there can bo no suggestion that it is les3 safe as far as the baby is concerned for confinement to take place in hospital than at home. Of the 17 deaths between 1 month and 12 months, 11 took place in hospital and 6 at home, The causes of death were as follows Pneumonia 5 Meningitis 2 Tumours 2 Enteritis 2 Whooping Cough, Marasmus, Bronchitis, Abscess of Lung, Cellulitis of Back and Appendicitis, 1 each. After giving very careful consideration to all the facts, I am unable to give any cogent reason for the increased infantile mortality rate in 1942. MATERNAL MORTALITY. It is gratifying to be able to state that only one mother died, giving a maternal mortality rate of 1.08 per 1,000 births. The rate for England and Wales was 2.01. INFECTIOUS DISEASES. The following table shows the numbers of notifications of the principal infectious diseases received during 1941 and 1942:- (6)  1941. 1942. Diphtheria 38 19 Scarlet Fever 51 141 Enteric Fever 6 1 Cerebro-Spinal Fever 8 4 Pneumonia 51 42 Measles 647 593 Whooping Cough 376 116 It will bo soon that measles was almost as prevalent in 1942 as in 1941 and even in the early months of 1943 the numbers had not decreased appreciably. A measles Epidemic is usually sharp and comparatively short but this one, for some unknown reason, has been a long drawn out affair. Fortunately there has been only one death in the two years• Whooping Cough cases continued to occur throughout the year and seven deaths resulted, 6 in Nazareth House and one outside. Scarlet Fever of a mild character was prevalent, especially in East Finchley in 1942, but there were no deaths• Diphtheria was low in incidence and 11 out of the 19 eases occurred in persons over 15 years of age. One adult died from this disease. The response to the campaign for immunisation against diphtheria was very satisfactory, 1654 children being treated during the year. Immunisation was started in Finchley in 1935 and has been continued without interruption ever since with the very creditable result that over 80% of all children under 15 years of age are now protected. TUBERCULOSIS. There has been little change in the situation regarding tuberculosis of the lungs. The notifications are a little (7) higher than In 1941 and the deaths one less. For the first time the number of deaths of females exceeds that of males, but this may not have any significant meaning* The following table shows the numbers of notifications and deaths for the past 5 years:- Year New Cases. Deaths. Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F 1938 47 27 4 10 13 9 3 1 1939 34 30 6 8 16 7 2 - 1940 28 21 4 4 16 10 2 2 1941 34 38 5 7 18 15 2 1 1942 40 39 4 3 14 19 1 1 SCABIES. Cases of scabies were just as numerous in 1942 as in the previous year but, on the whole, they were easier to treat, as they were discovered at an earlier stage of the disease and presented fewer complications. All the cases were treated by the Civil Defence Personnel at the First Aid Posts. MATERNITY AND CHILD WELFARE. The number of children attending the Infant Welfare Centres continues to increase. Seven hundred and sixty three children under 1 year of age and 1557 between 1 and 5 years made a total of 19,598 attendances. The members of the Voluntary Association continued to give valuable service at all three centres. (8) The Antenatal Clinic becomes more popular every year. In 1942, 820 women made 3827 attendances, more than twice as many as attended in 1938. During the year a Postnatal Clinic was started at the Health Centre for the examination of women sometime after confinement, in order to detect any defects which may have developed as the result of confinement. Such defects, If discovered at an early stage, can usually be remedied fairly easily, but, If they are neglected, they may give rise to chronic suffering and ill health. The demand for hospital accommodation was greater than ever, and frequently great difficulty was experienced in finding places for women, whose circumstances were such that a home confinement was quite out of the question. Out of a total of 835 births, where the place of birth was known, 523 took place in hospitals and nursing homes and 312 at home. Two hundred and thirty two cases wore attended by the Council's Midwives. Vitamin preparations were distributed from the First Aid Posts and the Welfare Centres, and clothing coupons for expectant mothers from the Public Health Department. DAY NURSERIES. The Day Nursery at the Health Centre was well attended throughout the year. Children up to 3 years of age are admitted and, when they are three years old, they are transferred to the Nursery Class at the Martin School. The two War-time Nurseries, one In Moss Hall Crescent with 60 places and the other in Regents Park Road with 52 places, were well patronised, in fact, they would have been filled to capacity at all times had it not been for the frequent visitations of the common infectious diseases. Another Nursery is in course of erection in Torrington Park. (9) FOOD. The Inspection of food has occupied a considerable portion of the time of the Sanitary Inspectors and this branch of the work seems to be increasing. Meat inspected at the' Distributing Depot, which supplies the areas of Barnet, Finchley & Hendon, has generally been of good quality. One thousand and seventy four pounds were condemned during the year as compared with 4514 lbs, in 1941. The amount of tinned and miscellaneous food condemned has been much larger than in previous years, 2480 tins and 6617 lbs. having been found to be unfit for food. Arrangements were made with the Salvage Department of the Ministry of Food for the disposal of condemned food suitable for animal feeding purposes. No food was damaged by enemy action. Licences were issued to the occupiers of four slaughterhouses, whose premises were used only occasionally for slaughtering on licence by the Ministry of Food. MILK. The Milk (Special Designations) Regulations of 1941 permitted the use of the "High Temperature Short Time" pasteurising process, subject to the Local Authority being satisfied as to its efficient working and compliance with the Regulations. An application was received from one of the large dairy firms to install a plant. Check tests were applied in order to ascertain that it was working in accordance with the requirements of the Regulations, and various alterations carried out, after which a licence was granted. Samples taken from time to time have been satisfactory. (10) During the year 19 samples of designated milks have been taken and generally found to be satisfactory. WATER . All samples of water have been entirely satisfactory. HOUSING In spite of the increasing difficulties as regards labour and materials, a considerable amount of repair work has been carried out to property and many owners have been persuaded to have permanent repairs carried out to premises damaged by enemy action. At 670 premises, defects were found and dealt with. Sub-letting is still increasing as the housing shortage becomes more acute. Houses occupied by evacuees have been visited from time to time. GENERALLY. All urgent matters in connection with infectious diseases, verminous premises, drainage defects, factories, complaints etc. have received prompt attention, in addition to which much routine work has been carried out. A. A. TURNER Medical Officer of Health.