FINC 24 BOROUGH OF FINCHLEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1943 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF FINCHLEY. September, 1944. I have the honour to submit my Annual Report on the health of the Borough for the year 1943. The Report is prepared in accordance with the instructions contained in the Ministry of Health Circular 10/44 and its scope is reduced to the minimum. The Infant Mortality Rate for the second year in succession has been disappointingly high - it was the highest for nine years. I am unable to give any satisfactory explanation of this increase in infant deaths, but I am convinced that it is not due to any defect or falling off in the Council's services nor to any lack of care on the part of the mothers. The fact that the Still Birth Rate and the Maternal Mortality Rate are both very satisfactory does not in any way help us to find the solution. The Birth Rate has gone up again. It is the highest since 1921, and for the first time it has exceeded the corresponding rate for the country as a whole. Apart from the fact that scarlet fever of a mild character was very prevalent, the position regarding infectious diseases was satisfactory. The supervision of food, milk, water supply, housing and sanitary conditions in general has been fully maintained. Once again I have to acknowledge the good work and loyal services of the whole staff of the Department throughout the year. -2- SOCIAL CONDITIONS. Area (in &cros) 3,477 Number of Inhabited hou3es (end of 1943) 18,897 Rateable Value (1st April 1943) £902,981 Sum represented by a penny rate £3,762 EXTRACTS FROM VITAL STATISTICS. Live Births: Total. Males. Females. Legitimate 989 498 491 Illegitimate 46 26 20 Birth Rate, 17.05 per 1,000 estimated resident population. Stillbirths: Total. Males. Females. 29 17 12 Rate, 27.2 per 1,000 total (live and still) births. Deaths. Total. Males. Females. 790 373 417 Rate, 13.01 per 1,000 estimated resident population. Deaths from diseases and accidents of pregnancy and childbirth: From sepsis 1 From other causes Nil. Death-rate of infants under one year of age: All infants per 1,000 live births 55.07 Legitimate infants per 1,000 legitimate live births 49.5 Illegitimate infants per 1,000 Illegitimate live births 173.9 Deaths from Cancer (all ages) 130 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 2 Deaths from Diarrhoea (under 2 years of age) 4 - 3 - THE BIRTH RATE. The number of registered live births in 1943 was 1,035, as compared with 891 in 1942. The birth rate 17.05 per 1,000 of the estimated population - the highest since 1921. The corresponding rate for England and Wales was 16.5. ILLEGITIMATE BIRTHS. There were 46 illegitimate births, the same number as in 1938, when the total births, legitimate and illegitimate, were 925. STILL BIRTHS. There were 29 still births, giving a rate of 27.2 per 1,000 total (live and still) births, which is a satisfactory figure. THE DEATH RATE. There were 790 deaths in 1943 as compared with 751 in 1942. The death rate was 13.01 per 1,000 of the estimated population. The corresponding rates for England and Wales and the London County Council Area were 12.1 and 15. There were increases in the numbers of deaths from pneumonia, bronchitis, influenza and premature birth, and decreases in deaths from tuberculosis of the lungs, cancer, suicide and violence. INFANTILE MORTALITY. In 1943, there were 57 deaths of infants (7 illegitimate) under one year of age, as compared with 48 in 1942. The infantile mortality rate was 55.07 per 1,000 live births - the highest rate for 9 years, and one which must be considered to be far from satisfactory. The rate for England and Wales was 49 and the London County Council Area 58. -4- Of the total of 57 infant deaths, no leas than 51 were due to five conditions as follows:– Prematurity 19 Congenital Malformations, Birth Injuries and Infantile Diseases. 16 Pneumonia 10 Gastro Enteritis 4 Whooping Cough 2 The ages at death were as follows:– Under 24 hours 12 1-7 days 11 1-4 weeks 9 1-3 months 10 3-6 months 3 6-9 months 10 9-12 months 2 Total 57 Forty three infants died in hospital or nursing home and 35 died in the institutions whore they were born. The Medical Officers who conduct the Antenatal Clinics are satisfied that there has been no falling off in the health and nutrition of the expectant mothers and that war work has not adversely affected them to any appreciable extent, nor is there and evidence that mothers have taken less care of their infants than in 1941 when our infantile mortality rate was the lowest of all the groat towns in England and Wales. On the other hand, Maternity Hospital Accommodation has been inadequate - wards have been crowded, staffs have been short and patients have had to bo discharged, in some cases, before they were properly fit. MATERNAL MORTALITY. There was only one maternal death, giving a maternal mortality rate of 0.92 per 1,000 births. The rate for England and Wales was 2.29. - 5 - INFECTIOUS DISEASES. The following table shows the number of notifications of the principal infectious diseases received during the past three years:- 1941 1942 1943 Diphtheria 38 19 9 Scarlet Fever 51 141 194 Enteric Fever 6 1 1 Cerebro-Spinal Fever 8 4 3 Pneumonia 51 42 60 Measles 647 593 364 Whooping Cough 376 116 78 Scarlet Fever continued to increase in prevalence but, fortunately, it remained mild in character and there were no deaths. There was a rise in the number of cases of pneumonia, largely \ due to the influenza epidemic. The notification of pneumonia is still very incomplete as is shown by the fact that there were 77 deaths and only 60 notifications. Measles and whooping cough were less common than in the two previous years; there were 2 deaths from the former and 1 from the latter, all of children under 1 year of age. There were only 9 cases of diphtheria and no deaths. Immunisation was carried on at a satisfactory rate during the year and 1292 children were treated. TUBERCULOSIS. There was a distinct drop in the number of deaths from tuberculosis of the lungs but an increase in deaths from other forms of tuberculosis. There was little change in the number of notifications of new cases. The following table shows the numbers of notifications and deaths for the past 5 years:– - 6 - Year. New Cases. Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary M F M F M F M F 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 5 14 19 1 1 1943 41 39 7 5 14 11 3 5 SCABIES. There has been an improvement in the position regarding scabies in that there have been fewer cases and the disease has been more amenable to treatment. All the cases have been treated at the First Aid Posts by Civil Defence personnel. HEAD VERMIN. Fewer cases of uncleanliness have been discovered in 1943 than during the previous two years. In response to Ministry of Health Circular 2831 of the 2nd July, 1943, the Health Visitors redoubled their efforts to reduce the number of dirty heads in children under school age and in girls who have left school. The results have been gratifying. MATERNITY AND CHILD WELFARE. Two thousand, four hundred and ten children - 827 of them under one year of age - made 23,836 attendances at the Infant Welfare Centres during the year. In 1942, the attendances were 19,598. The members of the Voluntary Association did much valuable work during the year. The Antenatal Clinic was attended by 799 expectant mothers in 1943 as compared with 820 in 1942. One hundred and forty two women attended the Postnatal Clinic. – 7 – The shortage of Maternity Accommodation was more acute than over and representations were made to the County Council, with the result that two houses were acquired in the Bishops Avenue to serve as an annexe to the maternity section of the North Middlesex County Hospital. Out of a total of 974 births, of which the place of birth was known, 610 took place in hospitals and nursing homes and 564 at home. Two hundred and seventy cases were attended by the Council's Midwives. Vitamin preparations were distributed from the First Aid Posts and the Welfare Centres, and the proportion of mothers taking advantage of those valuable preparations provided by the Ministry of Food has considerably increased. HOME HELPS. The Council adopted a scheme for the provision of Home Helps in April, 1945. Two whole-time and three part-time Helps were appointed and they were employed for varying periods in 35 homes before the end of the year. DAY NURSERIES. The Day Nursery at the Health Centre was well attended throughout the year. Children up to 3 years are admitted and in due course are transferred to the Nursery Class at the Martin School. There were 8,077 attendances. A third War-time Nursery was opened towards the end of the year and quickly filled up to capacity. A total of 24,832 attendances were made at the three nurseries during the year. The attendances were affected from time to time by the common infectious diseases - measles, whooping cough, chickenpox, mumps and colds, and it was only on rare occasions that none of the nurseries was in quarantine. On the other hand, the great majority of the children who – 8 – attended for any length of time showed a marked improvement in health. FOOD. The quality of the meat inspected at the Meat Distributing Depot has generally been of good standard, only 428 lbs. having been condemned during the year as compared with 1074 lbs. in 1942 and 4514 lbs. in 1941. The amount of tinned and miscellaneous foods inspected and condemned has again increased, 3238 tins etc. and 9451 lbs. having been dealt with as unfit for human consumption. A considerable amount was salvaged and used for animal feeding purposes. No food was damaged by enemy action during the year. The occupiers of the four private slaughterhouses in the Borough applied for, and were granted, licences and the premises were used only for occasional slaughtering on licence granted by the Ministry of Food. Thirteen samples of designated milks were taken during the year and generally found to be satisfactory. A number of complaints were received regarding the bad keeping quality of milk apparently due to the difficulty and delay in transport before reaching the dairies, and the length of time bottles were exposed on vehicles after leaving the bottling establishments and before being delivered to the customers, there being only one delivery each day. WATER. Samples of water have been taken from time to time and all have been entirely satisfactory. HOUSING. Toward the tend of the year, the position with regard to labour and material was considerably better and a general - 9 - improvement was noticed in the amount of repairs carried out privately by owners and the repair of war damaged premises. Six hundred and forty five premises were inspected at which defects were found and dealt with. Housing accommodation is still totally inadequate for the District and although there was only a small increase in the number of families statutorily overcrowded, many applications have been received and investigated from persons unsatisfactorily housed. Houses occupied by evacuees have been inspected and action taken to prevent overcrowding. GENERALLY. A considerable amount of drainage work has been carried out during the year, including the replacement of old drains by new, the provision of sanitary accommodation in factories, alterations and repairs. Drains on the sites of promises destroyed or demolished as a result of enemy action have been sealed off and a plan of the work done kept for record purposes. All matters of an urgent character connected with infectious diseases, verminous premises, drainage defects, sanitary accommodation in 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.