FR 113 FRIERN BARHET URBAN DISTRICT COUNCIL. March 25th 1922. To the Chairman and Members of the friern Barnet Urban District Ccunoil. Miss Donald and Gentlemen, I beg to present to you my report for the year ending 31 at December 1921. In accordance with the instructions, Cire. 269, received from the Ministry of Health, this report will be known as an "Ordinary Report" and will be confined within the limits set out in paragraph 5. In accordance with paragraph 3, only reports of full and detailed character will be required at intervals of not more than five years, those reports are designated by the Ministry as"Survey Reports". The primary object of future "Survey Reports" will be to review the needs of the area in tho relation the the protection of Public Health an d the progress made in meeting these needs since the date of tho proceeding "Survey Report". Special instructions are to be issued In regard to the preparation of the next "Survey Report", which will be for the year 1925. I have pleasure in expressing to the Members of the Council my appreciation of their unfailing courtesy and assistance during the past year and to your Sanitary Inspector, Mr. A. Harman, ( a summary cf whose activities is attached to this report in Table 6.) who has prepared the statistical data and memoranda and rendered valuable assistance generally in the preparation of this report., I am, Miss Donald and Gentlemen, Your obedient servant, FRANK A. SPREAT. Medical Officer of Health. AREA OF THE DISTRICT. The total area of the District is 1304 acres. of which approximately 488 acres are built upon, 300 acres under grass or allotments, 63 acres arable or used for market gardening purposes, 73 acres are parks or public open spaces, 86 acres of golf links, 152 acres occupied by the Colney Hatch Mental Hospital and remaining 188 acres not yet fit for building upon. POPULATION, The Census of the District was taken on the 19th June. The figures from the Registrar-General's preliminary report being:- Friern Farnet (excluding Asylum) Males 6520 Females 8006 Total 14496 Asylum Males 1093 Females l762 Total 2885 Totals for the whole District Males 7613 females 9768 Total 17381 The Genius figures for the separate wards, together with the number of separate occupiers, are not yet available, They may be taken as the same as the separate number of assessments. In a memorandum from the Registrar-General it is pointed out that the Consua of 1921 was taken at a time when soma holiday movement was already in progress and that this movement was reflected in the consus Returns. The Registrar has therefore estimated the population of friern barnet at the middle of the years aa 17510. For the purpose of compiling the Death and Birth Returns, which are based on population, I am using the figure 14500, whioh is the nearest figure we can arrive at for the District alone. BIRTHS. These number 293, giving a birth rate of 20.4 per thousand, a drop of nearly 5 per thousand on the preoeeding year, The Registrar-General gives the birth rate of England and wales as 22.4; the 96 Great Towns, including London, 23.3; 148 Smaller Towns, 22.7; London, 22.3, The number of illegitimate births was 7, The number of births notified to the Medical Officer of Health under the Notification of Births Act was 276, this is a percentage notification of 94,5. The best yet recorded. which are as follows:- Occupied un-Occupied. North ward 678 9 Central ward 1046 16 South Ward 1261 12 2985 37 Deaths The total number of deaths registered as belonging to the District was 147, giving a death rate of 10.1 per thousand, 43 of these deaths were of residents who died outside the District and 4 were of non-residents, making a nett number of deaths belonging to the District of 143, and a nett death's rate of 9.9. This compares very favourably with the deaths rate of the past five years for the District.The registrar-General gives the death rate of England and Wales as 12,1? 96 Great Towns, 12,3; 148 Smaller towns,11.3, London, 12,4, but in such comparisan One must bear in mind that the death rate 9.9 is not Corrected for the age and sex distribution and until the Census reports are available showing the number of deaths in England and wales under the various age and sex groups used in table 3, such correcotion cannot be applied. The correcting factor varies slightly at each census. The only available factor is based on the inter-genral year 1891-1901, which is to old to be INFECTIOUS DISEASE. The total number of notifications received under the notifications acts and the various Orders made under section 130 of the public health act 170. DYSENTARY. Those numbered 19 and all occurred in the mental hospital. Those cases were of the type that ordinarily oocur In a metal hospital and should be differentiated from the Dysentery which oceurd in tropical and sub -tropical regions. ENOSTHALISIS ????. Two cases were notified, both in the south and but no connection between them could be traced.Both were children, fhe girl was removed to southgate. Hospital and safe a good recovery. The boy was too ill for removal to hospital and the case -proved rapisly fatal. A report on each case was prepared with the assistance of the notifying practitioner and forwarded to the iniatry of health. ENTERIC FEVER. Sight cases were notified, six of which occurred in the Asylun. One oocurred in the south ?? and was removed to hospital, he made a good recovery. Not history of the source of infection could be traced. One case occurred in the North ward, a girl who contracted the disease whilst on holiday. She was treated at home and made a good recovery. The widal test in this case proved positive. DIPHTHERIA Twenty-saven cases ware notified, spread avanly throughout the year. nineteen cases ware ramoved to hospital.The disease was of a mild tyre, two deaths occurred, giving a death rate of 0.138, The attack rate for this disease is 1.86. SCARLET FEVER. Seventy-five cases were notified, the majority of which occurred in the spring and early summer and lata autumn and inter. The prevalence of the disease if the highest since 1908, but did not reach epidemic conditions at any time. Seventy cases were removed to hospital. There were two deaths from this disease giving a death rate of 0.138. The attack rate for this disease is 5.175. SMALL- POX. One case was notified and prompt measures were taken to isolate the contacts, and the case was removed to hospital at Yeading. after a few days in hospital the case was shown not to be small pox. PUE???? TUBEROLESIS Seventeen cases were notified, ten of which received sanatorium treatment. DRYSISELAS Eight cases were notified, sevan in the District and one in the mental hospital. INFLUENZA. This disease was prevalent to some extant during the year. On the whole it waa not of a severe type. There were two deaths, one at each of the age periods 45-65 and 6 5 and oyer. It was mainly characterised- by one of the three following types:- (1) A very painful condition of the throat, (angina) associated with acuta middle ear trouble. (2) Digestive symptoms, accompanied with, in a few cases, sub-acute peritonitis of the upper abdominal regions. (3) In the later stages affections of the larger joints, knee, ankle,with a tendancy to a very slow recovery. HOSPITALS AND AMBULANCE Our agreement with southgate for the use of 12 beds at their isolation hospital. Tottenhall road, Palmers Green, continues. The beds have been fully utilised and at timeshave been insufficient for the needs of the district. We have however been able to abtain beds at the London Fever Hospital for our overflow cases and I wish to ewms my thanks and appreciation of the kindness of the authorities at this hospital in so promptly and courteously meeting our requests. The cost of maintenance of patients in hospital has greatly increased and it has been necessary to modify the arrangements entered into with the Sothtgate Council in 1909. The ambulance for the removal of infectious disease is that belonging to the finchley Council. The sanitary Inspector personally arranges for and removes these cases. Priern Barnet not having a hospital staff it is practically impossiblie to keep an ambulance for its work. The neighbouring district of southgate has a well equipped ambulance with an efficient staff for dealing withi/cases other than those of an infectious nature, and Friern farnet can have tho use of this ambulance at the charge necessary to cover the costs of running. This on the average works out at about 17/- per Journey. This ambulance was used 13 times during the year at a total cost to the District of £4-4-0, the balance being paid by the users. MIDVIVES. The County Council is the supervising authority for the midwives in this District. There are two midwives on the register who are working in this District. CLINICS AND TREATMENT CENTERS. There are two in the District. One conneotod with the education Authority under the control of the Middlesex County Council and one in the South ward provided by the narishioners of the St. Peter's Parish. SMALL POX. Frriern barnet is one of the authorities constituting the Middlesex Joint small-box Hospital Board. LABORATORY WORK. This is carried out by the Clinical Research Association. Every medical practitioner, residing in the District, is supplied with a sterile swab, in metal screw case, direct from the laboratory and also with a sputum bottle properly packed in metal case. Widal outfits and additional swabs and sputum outfits are kert at the Public NOTIFIABLE FECTCOUS DISEASES. The number or notifiable infectious diseases (apart from Tuberculosis) reported during the year was 80. This shows a great reduction irom last year when the number was 74. The reduction in chiefly in the cases or Diphtheria and the Pneumonias. There were 5 cases of Diphtheria against 17, and 8 cases of Acute Primary Pneumonia against 19 last year. There were no cases of Influenzal Pneumonia, of which there were 6 last year There were II cases of Scarlet Fever against 7 last year : This increase being due to the large number of cases from one house, Greenwood Cottage, Haydon. There was a solitary case of Enteric Fever reported from Writhlington, the origin of which could not be traced, and one case of Orththalmia Neonatorum at beclcingxon. The following table will show the distribution cf the cases - Sub-District No.I Diphtheria Scarlet Fever Erysipelas Malaria Pneumonia Enteric Longleat 1 Standerwick 1 Beckington 2 4 & 1 case of Ophthalmia nernat-orum Wanstrow 1 1 1 sub-District no.2 Forscote 1 Holcombe 1 Writhlington 1 Haydon 5 1 1 Coleford 1 4 Highbury 1 Leigh on Mendip 2 5 11 3 1 8 1 See also Tables in Appendix. TUBERCULOSIS. The number of cases of Pulmowary Tuberculosis (phthisis) notified was 15, the same number as last year and 2 cases of Tuberculosis of other parts of the body. There were 4 deaths from Phthisis but only one of these was in the District:The other three were former residents in the District, who died elsewhere and whose deaths were transferred by the Registrar General. Notification of cases of Tuberculosis is thoroughly carried out by the Medical Practitioners of the District and no un-notified case has been discovered. The number of notified cases still resident in the district at the end of the year was:- 1. Pulmonary cases 38 2. Non-Pulmonary cases 3 41 See also Tables in appendix. (5) LABORATORY WORK:— During the year 29 swabs were sent to the county Laboratory for examination; of these, 6 were reported "positive", and 24 "negative," One specimen or spatum was sent for examination. This was negative as regards Tubercle Bacilli. A supply of fresh Diptheria Anti-Toxin is always Kept on hand hy me, and has been promptly distributed to the Medical practitioners whenever required. EPIDEMICS:- No disease has heen epidemic during the year. The district has, indeed, been remarkably free rrom disease or all Kinds; due in great measure, no doubt, to the long continued sunny, dry weather. HOSPITALS:- The number cf patients from tne Rural District treated in the Victoria Hospital, Frome in 1921 was 29. The number treated in the Froce- Infirmary was 19. The temporary Isolation Hospital at Colerord was still open at the beginning of the year with one Diphtheria patient - admitted last December. Tnere were 4 other Diphtheria cases admitted this year, 1 in Jaruary and three in february. The Hospital was closed on march the 12th and reopened in June, and again in August for the Scarlet Fever cases form Groverwood Cottage, Hayden -5 in all. These cases had all recovered, and the Hospital was closed finally on November 7th. (6) HOUSING. THE NEW COUNCIL HOUSES.- The 52 houses under construction last year have been completed, with the change of health Ministry and the cutting off of Government grants which were to have been built in the Spring , had to be abandoned - at least for the present. The 52 houses completed are situated as follows Mells 24: Highbury (Coleford) 24; Haydon 4. All these are in the mining part or the district, and were intended to provide accommodation for the miners; while the remaining 37 were intended for the Agricultural labourers, It is doubtful, however, if the ??heme has been a success, in spite of its great expense, in relieving the condition of the people it was intended for. There appear to be only about 10 miners among the tenants, many of the rest being drawn from quite a different class and coming from places outside the district, and even outside the County. Many of the houses are vacant, swing to the difficulty of finding t enants able to pay the rent and rates. If the other houses had been built, i think it would have been very hard, indeed to have found even one agricultural labourer with a family able to have paid even half the rent asked. The usual rents paid by the latter are 1/6, or , at in the most 2/- per week. As a result there are many houses in the ai strict on the unfit list, which must continue to be in habited, because or the lack of near and better buildings which could be rented at possible rents. OVER CROWDING:- There wore 7 cases in all reported during the year 1 in No.2. sub-District. 6 in No.l. sub-District. Of these latter cases two refer to the same family which was the cause cf overcrowding first at Ridgeway, then at Holwell, they finally settled in a house at Cloford where they have sufficient room. 2. EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Male Female Births Legitimate 119 108 Birth rate 22.4 Illegitimate 8 7 Deaths 56 84 Death rate 11.1 3 „ NOTIFIABLE DISEASES DURING- THE YEAR. Case Vision unimparea . Vision impared Total Blindness Deaths Ophthalmia Neonetorum. Notified At Home Treated In Hospitals. 1 1 0 1 0 0 0 Disease Total Cares Notified Case g Admitted to Hospital Total Deaths. Diphtheria 5 4 0 Scarlet Fever 11 5 0 Erysipelas 3 0 0 Pneumonia 8 0 6 Malaria 1 0 0 Enteric Fever 1 0 0 Tuberculosis:- (a) pulmonary Males 6 0 6 Females 9 15 Co ) Non-pulmonary Males 2 Females 0 2 7 GENERAL STATISTICS. Area (acres) 51,448 Pipulation (1921) 10,730 Number of inhabitated house (1921) 2,740 Rateable Value *97,043, 6.5 Sum represented by a penny rate. 278.11. 4 Number of women dying in, or in consequence of childbirth:- From sepsis 0 " other causes; 0 Deaths Number of infants under one year of age per 1000 births:- Legitimate 61.2 Illegitimate, 0 Total. 61.2 Death3 from Measles (all ages) 0 " " Whooping Oough (all ages) 0 " " Diarehea (under 2 year of age ) 2 ' '• - ■ ■ 4. CAUSES OF SICKNESS. Nothing noteworthy under this head. 6 . LABORATORY WORK. Issue Of Diphtheria Anti-toxin etc. already mentioned. List of Adoptive public Health Acts and Bye-laws in force in the district. 1. Part III. P.H.A.A. 1890 ( So far as applicable to Rural districts) 2. Infectious Diseases Prevention Act 1890. 3. Dairies Cowsheds & Milkshops Regulations. 4. Slaughter House Bye-laws. 5. Temporary relaxation of Building Bye-laws 1920 No. 2128 Order. 7. SARITARY ADMINISTRATION. See pages 3 and 4 of Report. 8 PUBLIC HEALTH STAFF. 1. Medical Officer of Health 2. Two sanitary Inspectors. The following engaged on Housing work:- 1. Clerk 2. Architect. 3. Clerk of the works. 9. HOUSING. Number of new houses erected during the year (a ) Total (b) As part of District council 52 housing scheme 52 1. Unfit dwelling Houses. Inspection:- (1) Total number of dwelling houses inspected for housing defects (under public Health or Housing Acts) 350 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations 1910 195 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 17 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 89 11 Remedy of Defects without service of formal notice. Number of defective dwelling house rendered fit in consequence of informal action by the Local Authority or their Officers 30 (5 still in progress III. Action under statutory lewers. Proceedings under Section 28 of the Housing, Town Planning etc. Act 1919 0 (I) Number of dwelling houses in respect of which notices were served requiring repairs 14 (8) (2) Number of houses which were rendered fit:- (a) by owners 14 (b) by Local Authority In default of owners 0 (3) Number of dwelling houses in reject of which Closing orders became operative in pursuant of declar ations by owners of intention to close. 0 B. Proceeding a under public Health Acts . (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied. 22 (2) Number of dwelling houses in which defects were remedied:- (a) By owners. 2 (b) By local authority in default of owners. 0 C. proceedings under sections 17 and. 18 of the Housing Town Planning etc. Act I919. 0 In conclusion i beg to thank the Council and its Officers for the invariable courtesy I have received from them, and the assistance they have rendered md in my work for the Public Health, and in the preparation of this report. I have the honour to be Gentlemen, Your Obedient Servant, H. E. CODD M.R.C.S. L.S.A. Medical Officer of Health to the Frome Rural District Council. NUNNEY FROME. February 28th. 1922. (9) TABLE 6. SUMMARY OR INSPECTIONS & VISITS MADE DURING 1921. Number of Inspections on Complaint 190 Visits re Cases of Infectious Disease 306 Periodical Inspections 10 House to House Inspections 51 Re-ispections 348 Visited by request (to see owner etc.) 34 Visits re Suspected Slaughtering 16 Visits re Slaughtering & Examination of Caresses 23 Inspections under Rent Act 31 Re-ins-inspections do. 3 Inspections re Petroleum 17 Visits for Disinfection only (Vermin Etc.) 32 Attendances at Court 6 Total of Inspections & Visits 1127 ' . . .. TABLE 7, SUMMARIES REQUIRED UNDER APPENDIX OF CIRCULAR 269. (1) GENERAL STATISTICS. AREA OF LIGTRICT STRICT 1304 acres. POPULATION 1921 District 14496 (Census) Asylum 2885 (Census) Total 17381 Registrar-General's Estimate 17510. NUMBER OF INHABITED HOUSES 2917 (Estimated from List of Electors) NUMBER OF FAMILIES OR SEPARATE OCCURIERS 2985 (Estimated from Bate Book, Census figures not available RATEABLE VALUE Land . £713-0-0 £100771-10-0 Houses Etc. £100058-10-0 Sum represented by a penny rate £400 (2) EXTRACTS FROM VITAL STATISTICS OF THE YEAR. M. F. BIRTHS. Legitimate 138 148 Birth Rate E.G. 16.8 (x) (x) This is misleading as it is based on the population of the District plus that of the Asylum. Illegitimate 3 4 141 , 152 Total 0293. DEATHS. 76 66 DEATH RATE. R.G. 8.05 (x) Total = 142. DEATHS OF INFANTS UNDER ONE YEAR OF AGE, per 1,000 births. Legitimate 71.4 Illegitimate 143.0 Total 75.0 DEATHS from Measles Ml. Mhooping Cough nil. Diarrhoea (under 2 years of age) 6. (3) NOTIE TABLE DISEASES. See Table 2. DEATHS from Scarlet fever 2 Diphtheria 2 ORHTHALAHA NEOEATORUM Nil notified. (9) HOUSING, Number of new bouses erected during the year, (a) Total 8 (b) As part of a Municipal Homing Scheme 76 UNFIT DHELLING HOUSES. Total number of houses inspected for housing defects (under public Health or Housing Acts) 547 Number of houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 51 Number of dwelling houses found. to be in a state so dangerous or injurous to health as to be unfit for human habitation 11 Number of dwelling houses (exclusive of those referred to under the preceeding sub-heading) found not to be in all respects reasonably fit for human habitation 163 REEDY OF DEFOCTS KITHOUT SERVICE OF FORMAL NOTICE. Number of defective houses rendered fit in consequence of informal action by Local Authority. ACTION UNDER STATUTORY PODERS. Proceedings under sec. 28 of the Housing, Town Planning &c. Act, 1919. Lumber of houses in respect of which notices were served requiring repairs Number of dwelling houses which were rendered fit, (a)B, owners (b) By Local Authority in default of owners Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Proceedings under Public Health ets. Number of dwelling houses in respect of which notices were served requiring defects to bo remedied 163 Number of houses in which defects were remedied, (a) By owners 140 (b) By Local Authority in default of owners 1 Proceedings under sees. 17 &. 18 of the Housing, Town Planning, &c. Act, 1909. number of representations made with a view to the making of Closing Orders 6 Number of dwellings in respect of which Closing Orders were made 2 Number of dwelling houses in respect of which Closing Orders were determined, the houses having been rendered fit Number of dwelling houses in res nee l of whioh Demolition Orders were made Lumber of dwelling houses demolished in pursuance of Demolition Orders FROME RURAL DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1921. GENTLEMEN,- I "beg to submit the following Report on the Public Health and Sanitary Administration of the Frome Rural District for the Year ending December 31st, 1921. In instructions received for preparing the Annual Reports for this year the Minister of Health has revised the particulars required in ordinary Reports,- omitting details which do not vary from year to year. Annual Reports of a full and detailed character,- such as last year's Report - will be Known in future as Survey" Reports, and will "be required at intervals of five year. In the intervening years the shorter Reports required will be Known as “Ordinary Reports". The Annual Report for 1931 will accordingly "be an ordinary Report. VITAL STATISTICS. THE BIRTH RATE.- The number of Births registered during the year was 240 - 125 boys and 115 girls, This is 2 more than last year, when the number of Births was exceptionally large. The Birth Rate per 1000 population is The Birth Rate for the last "8 years was as follows 1921. 19 20. 1919. 1918. 191 7. 1918. 22.4 22.2 15.9 14.2 12.78 19.8 The Rate for England and Wales for 1921 is 22.4 The Infant, Mortality that is. Deaths under 1 year of age is 13. This gives a rate per 1000 Births registered of 54. The rate for the last 6 years was as follows:1921. 1920. 1919. 1918, 1917. 1916. 54 63.02 53.8 78.01 127.65 52.2 The Rate for England and Wales for 1921 is 83. The CAUSES of DEATH under 1 year of age were as follows:- (1) Bronchitis 2 Pneumonia. 1 Diarrhoea and Enteritis 2 Haemorrhage 1 Convulsions 3 Premature Birth 4 Acute in testinal Obstruction 1 13. Deaths under 1 year analised:- One to seven day's 2 One to four weeks 6 One to six months 3 Six to twelve months 2 13. THE DEATH RATE.- The number of Deaths registered in 1921 was 97. The number corrected for inward and outward transfers - 120; consisting of 56 males and 64 females. This number is four less than last year, and 44 less than the year before, THE DEATH RATE ( after correction for transfers) is 11.1 per 1000 living. THE DEATH RATE for the last six years was as follows:- 1921 1920 1919 1918 1917 1916 11.1 11.5 15.7 13.8 13,76 15.4 THE DEATH RATE for England and Wales for 1921 is 13.1. The ages at which Death occurred were as follows:- Under 1 year 13. 1 and under 3 years 1. 3 do 5 " 1 . 5 do 15 0. 15 do 25 “ 2. 25 do 45" 11. 45 do 85 18. 65 and upwards 70. 118. REGISTERED DEATHS classified according to causer:- Influenza 3 Phthisis 6 Cancer and malignant diseases 11 En cephalitis Lethargica 1 carried forward 31 (2) Org anic Heart Disease heads the list, as it usually does but here again there were only 21 oases against 38 last" year. Brought forward 21 Organic Heart disease 21 Bronchitis 11 pneumonia 5 Other diseases of the respiratory organs 3 Diarrhoea and Enteritis 2 Cirrhosis of liver 2 Nephritis and Bright's disease 3 Congenital Debility and premature birth 3 Violent deaths (other than suicide) 2 Other defined diseases 33 Cerebral Haemorrhage 9 Arteriosclerosis 5 120. REMARKS Off DEATH RATE:-The Death Rate is again Tower than even the low rate of last year, which was the lowest since 1914. The deaths from Infectious diseases with the exception. of Phthisis. were lower also; there "being only 3 from Influenza,, and none from Diptheria or Scarlet fever. There were 3 deaths from Phthisis this year.- the same as in 1919,- while last year there was only one, 11 other causes of death were fewer. Those from Cancer were only 11 against 14 last year, General Sanitary Condition of the District. WATER.- The number of Public water supplies in the district remains the same as last year. As regards the Mells Water Supply nothing definite has been done up to the end of the year. The new council houses are getting their supply from the old source. QUANTITY and QUALITY:- In spite of the severe and prolonged drought the supply has been sufficient; although, in October and November the Coleford supply was getting low, and the water had to be cut off between the hours of 6 p.m. and 6.a.m. to allow the reservoir to fill up. The only other supply that was affected was Wans trow, where a good deal of water was required for the milk Factory: and the supply had to be out off at night from June to the end of the year. The quality of the water in all public supplies has been good. WATER AND STREAMS:- Twelve samples Of drinking water from various wells and springs were examined by myself. In five cases the water was baa, and not 'it for use. The other sever, samples were good RIVERS AND STREAMS:- The only case of pollution was the stream at Norton St philip, polluted by whey from the Milk Factory. Since cheese malting hat- ceases here there has been no nuisance from this cause. DRAINAGE AND SEWERAGE:- The number of sewerage systems in the district remains the same as last year. The Nunney sewerage system was affected by the drought the river at Nunney being almost dry for some time. There was a complaint of a nuisance at Highbury caused by sewerage flowing over some land, and a Committee was appointed to investigate the matter. SANITARY INSPECT I OF DISTRICT. SUB-DISTRICT No.l, Number of premises visited about 300 Number of defects or Nuisances discovered:- as follows 14 Defective drains 7 Defective closets 3 Defective Roofs and Walls 4 14 (3) SUB-DISTRICT No ,2. Number of premises visited 325 Number or defects or nuisances discovered. 60 as follows:- Defective drains 13 Defective closets 8 Defective closets 2 Defective floors 4 Defective roofs 24 Damp walls 5 Other nuisances 4 60 All these have been remedied. SCHOOLS:- New School have been built at Highbury, Coleford, by the County Council to replace the Wesley an School. They are not yet occupied. The Sanitary condition. all Schools in the District is good, the water supply is sufficient end of good quality* The following Schools were closed during the year on account of the prevalence of Infectious diseases and consequently diminished attendance and disorganisation of the work:- Cloford wesleyan.- Infants from April 8th to May 2nd -Whooping “ “ (Extension) from April 30- " 7th Cough. “ “ ( “ “ May 7th to May 14 do Buckland Dinham from May 23rd to May 30th Mumps. Norton St Philip from November 14th to Dec. 5th " Farleigh Hunger ford from February 22nd to March 7th " Norton St Philip (extension) from Dec, 5th to Dec 12 “ It will be seen from the above that the Schools of the district were free from serious Infectious diseases, FOOD. Milk supply,- There are about 310 licences in force in the District including 4 new ones in No,1. district. The Dairies, cowsheds etc have been regularly inspected and their sanitary condition is satisfactory. MILK DEPOTS.-There are no new depots in the district. There was again nuisance at Norton st Philip from leakage of whey, which was accentuated by the dry weather. This nuisance ceased when cheese making stopped. MEAT.- There are 11 licensed Slaughter Houses; 7 in No,1.Sub-District including 1 new one at Beckington. 4 in No.S Sub-District, There are also 2 Knacker's yards, both in No.l. sub-District. The licences of these places have all been renewed. The premises have been frequently inspected, whitewashed and Kept in a clean and sanitary con dition. MEAT INSPECTIONS.- There was one at the end of the year at Beckington, consisting of some mutton infected with "black fungus" and some "beef Bone tainted" This was condemned and destroyed. BAKEHOUSES.- The number is the same as last year, 12. They are all in good sanitary condition. No defects or nuisances have been reported during the year. FACTORIES.workshops etc.- The same as last year with the exception of one new spar Factory at Nunney. No defects or nuisances at these places have been reported during the year. There are no Out-Workers in the District. (4) Health Office and are available at any time on application. Diphtheria anti-toxin is also kept at the public Health Office and at the residences of the Medical Officer of Health and Sanitary Inspector and can be had at short notice or application by medical practitioners. Summary of examinations made:- for 110. Diphtheria 56 Tuberculosis 29 Typhoid (water) 2 Typhoid (widal) 1 Ringworm fungus 5 HATERNITY AND CHILD WELFARE. This work is carried out in this District by the Public Health Department of the Middlesex County Council. Yous Medical Officer of Health being the Medical Officer of the two Infant Welfare Centres in this district. In considering the cases of deaths of infants under one year, one is struck by the foot that 10 of the infant deaths, or 45,4% are due to prematurity and congenital defeats. This is the highest percentage for a considerable number of years. It is difficult to account for this, as our experience at the Welfare Centres shows that the mothers take very good care of tham selves previous to the birth of their children. Dentition and convulsions were responsible for three deaths, half the total number of deaths of infants that occurred during 1920, No less than, five of the deaths were due to Diarrhoea and Enteritis. This disease is caused in the main by contaminated food, and then abnormally fine and hot summer was very favourable to the incidence of this disease. Another cause of this disease may be attributed to the absolute lack in a large number of working class houses of poper places for the storage of food. In a large number of instances food is stored in a dark and ill-ventilated cupboard and milk for the preparation of infants food kept in this condition it bound to give rise to intestinal disturbances and irritations leading to these diseases. These diseases too, prove rapidly fatal to infants, and skilled treatment is absolutely necessary. Often the child is seriously ill "before medical advice is sought and little can be done to prevent a fatal termination. During the year there was one death from Scarlet Fever in a child under one year. This is an extremely rare occurrence. An abnormal number of infants deaths together with a considerable decrease in the number of births has given us an infantile mortality rate considerably higher than the last two years. It is no less than 75 per thousand births, compared with .38 in 1920 and 42 in 1919. In this connection it is interesting to compare the mortality rate in infants under one year of age attending the Infant Welflare Centres with that in the District generally. During the year 222 infants under one year of age were attending the centres and there were six deaths, giving an infant mortality rate for the centres of 27 per thousand. Of these deaths one was from "wasting" from birth and hopeless from the beginning, one from CastroEnteritis and one from septic Scarlet Fever, the two latter dying in hospital. The Registrar-General give the infant mortality rate for England and Wales, as 83; Great Towns 87: Smaller Towns 84; and for London 80. I attach the tables and statistic a for the year, based on the scheme set out in the tables and blank forms formally issued by the Local Government Foard, together with the new particulars required by the Ministry and set out in the appendix of Circular 269. SAHITARY ADMINIDIRATION See Table 6. Number of Slaughterhouses - one licensed. This slaughter house is situated in the most closely built upon area in the District, but it is structurally very good and maintained in first class condition. It is about forty years old and for many years previous to the war was un-used. It was reregistered under the food control legislation and a license granted contrary to the advice of the Medical Officer of Health and Sanitary Inspector. However, after the license was granted, the whole place was replanned by your Sunitary Inspector and considerable alterations carried out to obtain (1) air use accommodation separute from the slaughter chamber, with independant ontrance, (£) Separate exit for meat, without passing it through lairage. (3) Blue briek chequered paring. (4) Tiled walla 6'6" high to slaughter chamber. (5) Improved light and ventilation. (6) An efficient winch and tackle (7) An improved water sunply. (8) Efficient drainage, (9) Sliding doors between lairage and slaughter chamber. (10) Artificial lighting by electricity. Unfortunately there is not sufficient room to provide a separate cooling chamber, and beef carcases have to bo retained in the slaughter chamber until they have set. They then guttered and removed to the various butchers' shops, The slaughterhouse in owned by one butcher, but satisfactory arrangements have boon made whereby any butcher in Extern Barnet may use the slaughter house, or any allotment holder may have his pig properly slaughtered by skilled men in a hygienic manner and there is no excuse for sluahgtering on unlicensed Premises in this District. The Sanitnry Inspector has made arrangements with the owner of the slaughterbouse to receive notice of any slaughtering contemplated outside the usual days of slaughtering and in no case is beef or park meat removed from the premises without proper inspection. PUBLIC HEALTH DEPARTMENT STAFF. MEDICAL OFFICER OF HEALTH. (Part time) F.R.C.S and D.P.H. also holds officer as Medical Officer of the Infant" Welfare Centres, under the Middlesex County Council and as Poor Law Medical Officer for the Whetstone District of the Parnet Union. A general medical practitioner. SANITARY INSPECTOR. (Whole time) holds certificates of Royal Sanitary Institute, as Inspector of Nuisances. Practical Sanitary Science and Inspector of Meat and Other Foods, Honoursman In Building Construction and Diplomee of Worshipful Company of Carpenters. CLERK. (Part time) from Clerk of the Council's department. i TABLE 1. URBAN DISTRICT OF FRIERN BARNET. VITAL STATISTICS OF THE DISTRICT (excluding the Asynlum) DURING1921, AND PREVIOUS YEARS. Year i Population estimated to the middle of each year. BIRTHS. Total DEATHS registered in the District. Transferable DEATHS. NETT DEATH BMLOHCINC TO THE DISTRICT. Uncorrected No. Nutt. Non-residents. Residents. Under I year At all ages. No. Rate. No. Rate Rate. No. Rate. 1916 15950 370 370 23.2 114 7.1 12 (x) 36 16 43.4 138 8.6 1917 14000 219 219 15.6 134 9.6 14 (x) 45 24 102.0 165 11.8 1918 13500 230 230 17.0 138 10.2 376 55 19 82.5 193 14.3 1919 15400 262 262 17.0 109 7.1 312 43 11 42.25 152 9.9 1920 15300 395 395 25. 0 97 3.1 190 45 15 38.0 142 8.9 1921 14496 (Census) L. 293 293 20.4 104 7.2 229(xx) 43 22 75.0 143 9.9 NOTE:- (x) For these years the deaths in the Asylum were omitted, they may be taken as the avreage number of deaths of non-residents not connected with the Asylum. (xx) Four of those deaths were of non-residents who died in the District. . . TABIE 2 URBAN DISTRICT OF FRIERN BARNET. ANALYSIS OF THE NOTIFICATIONS Rr.CLIV???D THE YEAR ENDING DECEMBER 31ST 1921. DISEASE NOTIFIED ALL NUMBER OF CASES NOTIFIED Age groups stated in years. NUMBER OF CASES NOTIFIED From each ward or locality. NUMBER OF CASES Removed to Hospital. Under 1 1-5 5-15 15-25 25-45 45-65 Over 65 North South Central Asylum DYSETTERY 19 - - - 3 10 6 - - - - 19 - ERCEPHAPITIS ???ETH. 2 - - 2 - - - - - 1 1 — 1 ENTRIC. 8 - - 1 3 4 - - 1 1 — 6 1 ERYSIPELAS 8 — - 1 - 4 2 1 2 4 1 1 - DlPHTHERIA 27 — 4 14 4 4 1 — — 13 12 2 19 PENUMONIA 11 — — 1 2 4 2 2 1 2 5 3 - MALARIA 1 — — - 1 - - - - 1 - — — SCARLET FEVER 75 1 6 53 12 3 - - 8 45 22 — 70 SMALL-POX 1 - - 1 - - - - - 1 — — 1 TUBERCULOSIS:- 17 — — 1 5 6 5 - 3 7 7 - 10 Pulmonary Other Forms 1 - - - - 1 - — - 1 - - - Ж This case subsequently proved not to be Small-Pox. TABLE 3. URBAN DISTRICT OF FRIERN BARNET.. Analysis of CAUSES and AGES at DEATH OF Persons belongings to the District for the year ending 31st December 1921. CAUSES OF DEATH ALL. Under 1. 1-2 AGE GROUPS IF YEARS. 45-65 65 & over. Asylum 2-5 5-15 15-25 25-45 DIPHTHERIA & CROUP 2 - _ 1 1 — — _ . SCARLET FEVER 2 1 - 1 — — - — — — ENTRIC FEVER - — — - - — - — — 2 INFLUENZA 2 — — - — - - 1 1 — WOOPING COUGH 1 — — 1 - - - — - — PHTHISIS 10 — - - 1 2 5 2 - 35 MENIGITIS 2 — 1 - - - 1 — - — CANCER 26 — — — - - 3 14 9 5 RHEUMTATIC FEVER 1 — — - - - - 1 - — HEART DISEASE 16 — — - - 1 3 4 8 27 BRONCHITIS 10 — — - — — 1 3 6 4 PNEUMONIA 10 1 — - 1 — 2 4 2 12 OTHER RESPIRATORY DISEASES 1 — — — — — — .1 — _ APPENDIOITIS — — — - - - 1 - — — NEPHRITIS 7 — — 1 - - - 3 3 8 PARTURITION 2 2 — - - - - — - — prematurity 7 7 — - — - - - - — VIOLENT (NOT SUICIDES) 3 — — 1 1 — — 1 — 2 SUICIDES 2 — — - - - 1 1 — 1 OTHER DEFINED DISEASES 18 6 — - 4 - 3 3 2 17 ???ILE DECAY 17 — — - — - - — 17 49 GENERAL, PARALYSIS 1 — — - - — _ - 1 57 DIARRHOEA & EITTEHITIS 6 5 1 - - — - - — 1 EIL'_p-Y - — - - - - - - _ 5 147 22 2 5 8 3 6 39 48 225 TABLE 4. URBAN DISTRICT OF FRIERN BARNET. DEATHS OF INFANTS UNDER ONE YEAR OF AGE FOR THIS YEAR ENDED 31ST DECEMBER 1921. DISEASE. No. SCARLET FEVER 1 PNEUMONIA 1 DIARRHOEA & FITTERITIS 5 PR???MATURITY 7 MARAMUS 3 DENTITION & CONVULSIONS. 3 OTHER ACCIDENTS & DISEASES OR PREGNANCY & PARTURITION. 2 Total:- 22 TABLE 5. FRIERN BARNET SEWAGE WORKS. METEOROLOGY. Month. Temperature of Air MEAN Temperature of the Air. RAIN Highest Lowest MEAN No. of days rain fell Amount Collected. Prevail ing Wind. of all Highest of all Lowest January 56 26 48.54 39.74 44.14 23 2265 WW February 58 24 46.07 32.47 39.27 4 .13 N March 65 26 53.12 37 45.06 14 1.43 sw April 71 27 55.76 36.96 46.36 9 1.56 NE May 79 33 64.45 42.39 53.42 14 1.18 w June 87 32 69.50 47.24 58.37 3 .31 N July 92 39 79.25 53.29 66.27 2 .08 w August 81 36 71.84 52.10 61.97 8 1.49 w September 86 32 69.40 46.90 58.15 6 2.62 w October 81 29 65.16 42.96 54.06 6 .78 W November 58 17 41.17 31.45 36.31 7 1.85 E December 55 26 46.20 37.20 41.70 14 1.20 W MEAN & TOTAL FIGURES 59.205 41.641 50.243 110 15.28 (Total) 1.2 733 (Aver. per mth.) j. iriiTumraTor. Sewape " orks I'lanager.