FRI 17 FRIERN BARNET URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1939. DOROTHY M. CATCHPOOL, M.B., D.P.H., MEDICAL OFFICER OF HEALTH. FRIERN BARNET URBAN DISTRICT COUNCIL. Public Health Department, 20, St. John's Villas, Friern Barnet, N. 11. To the Chairman and Members of the Friern,Barnet Urban District Council. Gentlemen, Herewith I present to you my Annual Report and vital statistics for the year 1939. The Ministry of Health have issued instructions to the effect that the Annual Reports of Medical Officers of Health should be curtailed as far as possible, and that they should be confined to the presentation of essential material, together with such comments as appear necessary. The Report has been delayed, owing to the fact that the Registrar Generals figures only became available a few weeks ago, and also th the additional work placed on the department in relation to Civil Defence. The health of the district was good throughout the whole year, and the infantile mortality rate very satisfactory. I am, Gentlemen, Your obedient servant, DOROTHY M. CATCHPOOL. M.B., D.P.H. Medical Officer of Health. 2. PUBLIC HEALTH DEPARTMENT STAFF. Medical Officer of Health. Dorothy M. Catchpool, M.B.,B.S.,D.P.H. (part time, but not engaged in private practice). Chief Sanitary Inspector. Albert G. Harman. Qualified in Practical Sanitary Science, Royal Sanitary Institute. Qualified as Inspector of Meat & Other Royal Sanitary Institute. Foods, Qualified as Sanitary Inspector, Royal Sanitary Institute. Diploma Worshipful Company of Carpenters and Honoursman Building Construction. (whole time). X. Additional Sanitary William R. Jackaman, M.S.I.A.,A.R.S.I., Inspector. Qualified as Sanitary Inspector, Sanitary Inspectors1 Joint Board, (whole time). Clerk. James Wilson. X, Mr. Jackaman was called up to H»M. Forces at the outbreak of hostilities. STATISTICS OF THE AREA. Area in acres - 1341.2 Registrar General's estimate of Resident Population 1939:- (a) For calculation of Birth-rate - 27370 (b) „ „ „ Death-rate - 26880 Number of inhabited houses (end of 1939) according to Rate books:- - 6615 Rateable Value (1939) - £277693 Sum represented by a 1d. rate (1939) - £1085 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total M. F. Legitimate 336 162 174 Live Births Birth-rate - 14.0 Illegitimate 7 3 4 Still Births 11 8 3 Rate per 1000 Births - 38.0 Deaths (Nett) 221 83 138 Death-rate (corrected) - 9.2 No. of women dying in childbirth - Fran Sepsis - 1. Other causes - 1. Death of infants under 1 year per 1000 births - 40.0 Legitimate - 12. Illegitimate - 2. Total - 14. Deaths from Measles (all ages) - 0. 3 Deaths from Whooping Cough (all ages) - 0. Deaths from Diarrhoea and Gastro-enteritis (under 2 years) - 1. POPULATION. The Registrar General's estimate of the population at the middle of 1939 was 27370. This is taken as the population of the District for the purpose of the calculation of the Birth-rate, while the figure of 26380 is given as the estimate of the civilian population for the calculation of the Death-rate and the incidence of notifiable diseases. Whilst accepting these figures, I am of opinion that they are too high. BIRTHS. The number registered in the district was 150, and the number assigned to the district by the Registrar General 343, and this gives a birth-rate of 14.0. The infantile mortality rate is calculated on the number of births assigned to the district by the Registrar General. The still-births during the year numbered 11, giving the rate of 38.0 per 1000 births, compared with 24.8 for 1938, and 48.6 for 1937. DEATHS. Table 2 shpws in detail the registered causes of death in alphabetical order, their distribution in wards, and particulars of the inward and outward transfers. The number of deaths registered in the district was 239, giving a crude death-rate of 8.05. The nett deaths numbered 220, giving a rate (including institution population) of 8.30. Since the preparation of the death-table, the Registrar General has assigned 221 deaths in the district, and this will give the uncorrected deathrate of 9.4 per 1000. The correcting factor for age and sex distribution is 0.98, and this gives a corrected death-rate for comparative purposes of 9.2 per 1000. The infantile mortality rate has fallen considerably being 40.0 per 1000 births, compared with 55.0 for 1938. Affections of the Heart and Circulatory system continue to be the principal cause of death. Cancer was again the cause of many deaths in persons over the age of 45. There was only 1 death from Infantile Diarrhoea during the year. The deaths from Pulmonary Tuberculosis have increased. It is interesting to compare the death-rate each year for the past ten years from this cause. 1930 1931 1932 1933 1934 1935 i936 1937 1938 1939 0.21 0.47 0.39 0.57 0.61 0.54 0.53 0.45 0.17 0.34 GENERAL PROVISION OF HEALTH SERVICES. The arrangements set out in previous reports relating to the above continue to function satisfactorily. SANITARY CIRCUMSTANCES OF THE AREA. These were fully dealt with in the report of 1938, and this year has seen no variation. SANITARY INSPECTION OF THE AREA. Tables of inspections made and defects remedied through the action of the Sanitary Inspectors will be found later in this report. 4. The decrease in the work carried out was due to the loss of the services of Mr. Jackaman, called to H.M. Forces at the outbreak of war, and to duties abnormal to those of a sanitary inspector performed by Mr. Harman in connection with Civil Defence. HOUSING. Number of new houses erected during the year (a) Total - 42 houses, and 172 self contained flats (including those under (b) ). (b) With State assistance under Housing Act: (1) By the Local Authority 0 (2) By other Bodies of persons 0 HOUSING STATISTICS. 1. Inspection of Dwelling-houses during the year:- 1. (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 286 (b) Number of inspections made for the purpose 298 2. (a) Number of dwelling-houses (included under sub-head (1) above, which were inspected and recorded under Housing Consolidated Regulations, 1925 15 (b) Number of inspections made for that purpose 16 3. Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 0 4. Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respect reasonably fit for himan habitation 172 2. Remedy of defects without service of formal notices:- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 126 3. Action under Statutory Powers:- A.Proceedings under sections 9, 10 & 16 of the Housing Act 1936. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 7 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 7 (b) By Local Authority in default of owners 0 B.Proceedings under Public Health Acts.- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 35 (2) Number of dwelling-houses in which defects were remedied after service of formal notice.- (a) By owners 24 (b) By Local Authority in default of owners 6 C.Proceedings under sections 11 & 13 of the Housing Act 1936. (1) Number of dwelling-houses in respect of which Demolition Orders were made 0 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 0 D.Proceedings under section 12 of the Housing Act 1936. 5. (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 0 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, they having been rendered fit 0 4. Housing Act 1936 - Part 4 - Overcrowding. A. (1) Number of dwelling-houses overcrowdedat end of year 16 (2) Number of families dwelling therein 16 (3) Number of persons dwelling therein 154 B. (1) Number of new cases of overcrowding reported during the year 0 (1) Number of cases of overcrowding relieved during the year 0 (2) Number of persons concerned in such cases 0 D. (1) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding 0 E. New f lats' to ' abate overcrowding,. Tho proposed new residences on the Sewage Works allotment land to abate overcrowding reported in 1936 are not yet provided". SANITARY INSPECTION OF'THE AREA. No. of dwelling-houses inspected (separate primary inspections chnly). (1) On complaint........ v 1. -.. 1 235 ^2) On notification of'infectious disease. 36 (3) Re Tuberculosis 2 t'4) House to House..... 13 Visits to Foodshops 47 " Dairies and Milkshops . 47 " " Slaughterhouses. 9 " 're Shops Acts........ „. 43 " to Factories and Workshops.... 21 " re Petroleum Acts. 76 n to Watercourses. 25 for disinfection... 42 •' re Sanitation of Public Halls..... 11- ?t " Housing Act, 1936 44 " " B&Ila.tfcng. 248 " " Disinfestation and to verminous premises 25 " " Rat Infestation 8 »» » Hawkers premises... .. 15 Appointments and special visits 290 Re-inspections and visits to works in progress 1100 Attendances at Court (Petty Sessions and County Court) 2 Total 2344 Total visits and inspections, for 1938.. .... 2753 » " " » 1937 3192 1 " " " M 1936 3013 " " "" " 1935.........i.... 2222 " " " » 1934. 2270 6. The following is a summary of the sanitary improvements and, defects remedied during the year.- Water. Store cisterns provided, repaired, cleansed, or covers provided. 5 Draw off cocks direct from main supply provided 1 Fittings and services repaired 10 Drainage. Drains reconstructed 4 Drains cleared or reDaired. 40 Inspection chambers constructed 0 Inspections chambers cleansed, repaired etc. 10 Soil and vent pipes provided 0 Soil and vent pipies repaired 1 New sinks provided 2 New sink waste pipes provided 5 Sink wastes repaired 2 W.C. W.C. pans and traps fixed 8 W.C. pans and traps repaired 3 W.C. seats, doors, windows, floors, renewed or repaired 12 Walls cleansed and distempered 2 Ceilings cleansed and distempered 2 Flushing cisterns provided 3 Flushing cisterns repaired or regulated 15 Floors. Floors renewed 3 Concrete over site provided 3 Ventilation improved 3 Floors repaired 15 Roofs. Stripped and renewed 7 Repaired 75 Gutters and. downspouts, renewed or repaired 58 Cleansing. Wall repaired, cleansed, distempered or papered 85 Celings repaired, cleansed and distempered 72 New ceilings 5 Windows Sashes and frames repaired or renewed 15 Cills- repaired or renewed 7 Sashcords provided (number of houses) 10 Brickwork. Damp proof courses provided 2 Brickwork repaired 2 Chimney stacks rebuilt or repaired 5 Dampness in walls remedied 4 Wall repointed or rendered 3 Total carried forward 504 7 Brought forward, from previous page 504 Yards. Yard pavings provided or renewed 0 Yard pavings repaired 5 Refuse. Justbins provided 23 Accumulations of refuse removed 4 Woodwork. Stairtreads renewed or repaired 2 Balusters and handrails renewed or repaired 3 Poors renewed, repaired or rehung 3 General. Now ranges and grates provided 4 Ranges and grates repaired 10 Now coppers provided 1 Coppers repaired 3 Houses repainted externally 2 Doorsteps renewed or repaired 1 O^her defects (unclassified) 32 Foodstores provided 0 Verminous rooms cleansed 3 Total 605 Total number remedied 1938 2404 „ „ „1937 2099 „ „ „1936 1377 „ „ „ 193 5 1022 INSPECTION AND SUPERVISION OF FOOD. MiIk The following licences were issued under the Milk (Special designations) Order, 1936.- Pasteurised 10 Accredited .1 Grade A (Tuberculin Tested) 6 Pasteuriser's .1 Meat and other foods. Butchers' shops are visited frequently, but there has been no slaughtering in the district during the year. There has been no need for the seizure of undsound food, and tfte amount surrendered has been extremely small:- 260 lbs Beef 1 box Herrings 24 lbs Sausages 5 Boxes Cod 4 lbs Butter PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. cDaa] 1-pox. ~ No cases of small-pox occurred in thc/district. during the year. Fever. "Twenty-seven cases v;ere notified during 1939, as compared 8. with 71 in 1933. The incidence of this disease was exceptionally low; the attack rates for the past eight years being as follows:- 1932 1933 1934 1935 1936 1937 1938 1939 2.3 2.4 2.9 3.9 1.7 1.8 2.9 1.0 Diphtheria. The incidence of this disease was exceptionally low, only 8 cases having been notified, against 48 in 1938. The type of disease was definitely more severe than usual, and the average stay in Hospital was 88 days. Erysipelas. Five cases of Erysipelas were notified during the year, compared with seven during 1938. Two were removed to hospital for treatment. Enteric Fever. One case was notified, as against two in 1938. Dysentry. One case of Dysentry was notified during the year. There wen no cases in 1938. Puerperal Pyrexia. One case was notified and made a satisfactory recovery. Tuberculosis. Sixteen cases of pulmonary and one case of non-pulmonary. tuberculosis were notified. In addition to the above 23 persons have taken up residence within this district, who had previously been notified as Suffering from Tuberculosis. Nonenotifiable diseases. Measles The district was practically free from this disease, only two notifications being received. Mumps There wore 84 cases notified by school teachers, The disease was of a mild type, and the cases were about equally distributed throughout the district. Whooping Cough There were only 14 cases notified, and the disease was again less prevalent than in recent years. The cases nearly all occurred at the Oakleigh M.C.C. infants school. Chicken-pox Some 73 cases were notified as against 33 last year. TABLE 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES NOTIFIED DURING THE YEAR ENDING 31st DECEMBER, 1939 DISEASE NUMBER OF CASES NOTIFIED CASES IN EACH WARD NUMBER REMOVED TO HOSPITAL AT AGES — YEARS WARDS All Unvl 1-5 5-15 151- 25 25-45 45-65 65 & C North South Cent. Friern Hosp. Scarlet Fever 27 1 9 11 5 1 - - 5 13 9 - 17 Diphtheria 8 1 2 3 1 1 - - 2 3 3 - 8 Pneumonia 20 - 2 - 2 4 7 5 4 5 2 9 - Erysipelas 5 - - 1 - - 2 2 2 - 1 2 2 Enteric Fever 1 - - - - 1 - - - - - 1 - Measles 1 - - - 1 - - - 1 - - - 1 i Dysentry 1 - - - - - 1 - - 1 - - - puerperal Pyrexia 1 - - - - 1 - - - 1 - - - Pulm Tuberculosis 16 - - 3 4 7 2 - 7 6 3 - - Other Tuberculosis 1 - - - - 1 - - - 1 - - - Totals 81 2 13 18 13 16 12 7 21 30 18 12 28 In additions to the above, the following cases were also removed to Hospital:- 1 Scarlet Fever ^proved to be Measles) 1 Diphtheria (proved not to be Diphtheria) 2 TABLE 2. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAR 1939 FOR TIE WHOLE DISTRICT. Causes of death No. Reg. At Ages Wards Out. tr. In tr M. F. Nett Deaths 0-1 1-2 2-5 5-15 15-25 25-45 45-55 65&0. N. S. C. F.H. Appendicitis - - - - - - 1 - - - - 1 - - 1 - 1 1 Bronchitis 9 - — — - - 3 4 5 4 3 2 3 3 3 3 9 9 Cancer 36 - - — - - 3 23 24 14 11 7 18 20 1 18 32 30 Cerebral Haemorrhage 20 - - - - - 2 5 16 5 4 8 6 6 3 6 17 17 Congenital debility etc. 3 6 - - - - - - - - 5 1 - - 3 3 3 6 Cirrhosis of Liver - — — — - - - 1 - 1 - - - - 1 1 — 1 Diabetes 3 — - - 1 — — 2 - — - 1 2 2 — 2 1 1 Diarrhoea — 1 - — — — — - — - - 1 - — 1 1 - 1 General Paralysis 3 - - - - - - 4 - 1 - - 3 3 1 2 2 1 Heart disease 47 - - - - 1 1 23 50 25 17 20 13 17 28 26 49 58 Influenza 4 - - - - - - 1 3 1 1 1 1 1 - - 4 3 Nephritis 16 - - - - - 6 6 12 2 3 4 15 15 8 9 15 9 Other circulatory diseases. 22 - - - - - - 3 23 2 6 4 14 15 4 6 20 11 Other defined diseases 22 5 - - 1 2 8 12 11 11 9 9 10 11 17 20 19 28 Other purperal causes. - - - - - - 1 - - - 1 - - - 1 - 1 2 Other violence 4 - - 1 1 1 2 1 2 1 2 2 3 3 4 6 2 5 Pneumonia 29 3 2 - - 1 7 15 14 2 10 5 25 25 13 25 17 17 Puerperal sepsis - - — — — - 1 - - - 1 — - - 1 - 1 1 Senility 6 - — - — — — - 7 3 1 3 - - 1 1 6 7 Suicide 3 — — — — — 3 2 - 3 1 1 - 1 2 3 2 4 Tuberculosis of resp. sys. 12 - - - 1 2 6 6 1 1 7 - 8 8 4 7 9 8 Typhoid Fever - - - - - - - 1 - - - 1 - - 1 - 1 1 Total 239 15 2 1 4 7 44 109 168 76 82 71 121 130 111 139 211 220 TABLE 3. ANALYSIS OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING 1939, AND THE MORTALITY FROM THE SAME DISEASE OVER THE SAME PERIOD. AGES NEW CASES DEATHS PULMONARY NON-PULMONARY PULMONARY NON-PULMONARY MALES FEMALES MALES FEMALES MALES FEMALES MALES FEMALES 0-1 - - - - - — — - 1-5 - - - - - - - - 5-10 2 - - - - - - - 10-15 - 1 - - 1 - - - 15-20 2 1 - - - - - - 20-25 1 - - - 1 - - - 25-35 1 3 - 1 - 2 - - 35-45 2 1 - - - 1 - - 45-55 - - - 1 - - - 55-65 1 1 - - - 2 - - 65 & over - - - - - - - - Totals 9 7 - 1 3 5 - - TABLE 4. INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE, 1939. Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 4 weeks and under 3 mths. 3 mths and under 6 mths. 6 mths and under 9 mths. 9 mths and under 12 mths. Total under 1 year. All causes.- Certified 6 — 1 — 7 3 1 - 3 14 Uncertified - - - - - - - - - - Asthenia - - - - - - - - 1 1 Atelectasis 1 - - - 1 - - - - 1 Convulsions 1 - - - 1 1 1 - - 3 Diarrhoea - - - - - 1 - - - 1 Icterus Gravis 1 - - - 1 — — — - 1 Marasmus - - - - - 1 - - - 1 Pneumonia - - 1 - 1 - - — 2 3 Prematurity 3 - - - 3 - - - - 3 TABLE 5. BIRTH-RATES, DEATH-RATES, AND ANALYSIS OF MORTALITY DURING THE YEAR 1939. THE FOLLOWING TABLE HAS BEEN SUPPLIED BY THE REGISTRAR GENERAL, AND IS USEFUL FOR COMPARATIVE PURPOSES Rate per 1000 potal pop. Annual death-rate per 1000 population Rate per 1000 live births Live-births Stillebirths All causes Enteric Fever Small-pox Measles Scarlet Fever Whooping Cough Diphtheria Influenza Diarrhoea and enteritis (under 2 years) Total deaths under one year England & Wales 15.0 0.59 12.1 0.00 - 0.01 0.01 0.03 0.05 0.21 4.6 50 126 County roughs & Great Towns, inc. London 14.8 0.59 12.0 0.00 - 0.01 0.00 0.03 0.05 0.19 6.3 53 148 Smaller Towns (est resident pop.25,000 to 50,000 Census 1931) 15.6 0.57 11.2 0.00 - 0.01 0.00 0.02 0.04 0.20 3.0 .40 London 12.3 0.44 11.9 0.00 - 0.00 0.00 0.03 0.02 0.08 8.2 48 I therefore recapticulate the figures for Friern Barnet already given in various paragraphs of report. Friern Barnet 14.0 0.40 9.2 0.04 0.00 0.00 0.00 0.00 0.00 0.12 2.9 40