FR118 LIBRARY FRIERN BARNET URBAN DISTRICT COUNCIL ANNUAL REPORT ON THE MEDICAL OFFICER OF HEALTH FOR THE YEAR v 19 4 0 G. PENNANT EVAN8. M.R.C.S.; L.R.C.P. MEDICAL OFFICER OP HEALTH. i -1- FRIERN BARNET URBAN DISTRICT COUNCIL Public Health Department, Town Hall, FRIERN BAR1IET, N.ll. 20th August 1941 To the Chairman and Members of the Friern Barnet Urban District Council. Gentlemen, This report is prepared in accordance with Circular 2314 of the Ministry of Health, and at this time is without the Registrar General's estimates of population, and birth corrections which are likely to be delayed. I feel that the interest of an annual report is diminished by late publication, and as our estimates of population are based on the very reliable data supplied by the Pood Control, National Registration and Billeting and Rehousing Offices, it is as near the truth as possible, and the rates based on population can be accepted as reliable. The year apart from the war has been un-eventful, and the general health of the district is good. Dr. D. Catchpool resigned in July, and evacuated herself and child to Canada. For two months the district was without a Medical Officer of Health. My partner, Dr. W.W. Millen was appointed on the 22nd August, and commenced duties on 1st September. He was called up for military service on December 12th 1940 since when I have the privilege of holding the position of your Medical Officer of Health. The casualty and first aid medical services in connection with civil defence, have been organised and worked by Dr. W. J. Poole, separately from the public health services. The billeting and rehousing of foreign refugees, and persons rendered homeless by enemy action has been organised by and is being worked under the supervision of your Sanitary Inspector, who is also superintendent of the war casualty mortuary. G. Pennant Evans. Medical Officer of Health. -2- Public Health Staff. Medical Officer of Health G. Pennant Evans, M.R.C.S., pro tom L.R.C.P. Sanitary Inspector, Chief Billeting Officer, Albert Harman. & Mortuary Superintendent. Rehousing Officer. James Wilson. Billeting Officers. Messrs W.H.F. Parker and N.J. Dinham. Clerks. Misses E. Glasscock and E. Hathaway, Mr Jackaman additional Sanitary Inspector was called to H.M. Forces at the outbreak of hostilities. STATISTICS OF THE AREA. Area in acres - 1341.2. Registrar General's estimate of population - not available. Medical Officer of Health's estimate of population Resident at middle of year 25,200. Number of inhabited houses according to Rate books. 7400 hereditaments. Rateable value. £281,284. Sum represented by a 1d rate (1940) £1,170. EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Live births Registered 320 Birth rate 12.3 Still births " 6 Rate per 1000 births 19.3 Deaths (Nett) " 238 Death rate (corrected) 9.3 No. of women dying in childbirth - from Sepsis - 0 other causes - 0 Death of infants under 1 year per 1000 births - 46.6 Legitimate - 15 Illegitimate - 0 Total 15. Deaths from measles (all ages) - 0. -3- Deaths from Whooping Cough (all ages) - 0. Deaths from Diarrhoea and Gastro-enteritis (under 2 years) - 2. POPULATION. I estimate the population resident at the middle of the year at 25,200. This figure is based on information available from the National Registration, the Food Control, and Civil Defence offices, and should be, as close an approximation to the population actually resident, as is possible under war conditions. In any case we are now so far removed from a census, and the building operations have been so intensified in the district since the last census in 1931, that rates based on any estimate of population must be taken as provisional only. BIRTHS. The number registered in the district was 320, giving a crude birth rate of 12.3 per 1000. The number of still births was only 6, giving the remarkably low rate of 19.3 per 1000 live births, compared with 38.0 for 1939, 24.0 for 1938 and 48.6 for 1937. DEATHS. Table 2 gives full details of the registered cause of deaths, their distribution in wards, and particulars of inward and outward transfers. The nett deaths were 238, giving a crude rate of 9.5 and a rate corrected for age and sex distribution 9.3. The infantile mortality rate is a little higher thai in 1939 being 46.6 against 40.0., but it is still very satisfactory and below the average for England and Wales. Affections of the heart and circulatory system, still continue to be the principal cause of death, and affect those past middle age. Cancer continues to be a major cause of death and it too occurs principally in. those over 45. In this district it would appear that cancer and affections of the circulatory system are the principal causes of death occurring in people over 45. The deaths from pulmonary tuberculosis has again increased, the rates for the past 10 years being:- 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 0.47 0.39 0.57 0.61 0.54 0.53 0.45 0.17 0.34 0.51 There has been a marked tendency for persons suffering from pulmonary tuberculosis to taken up their residence in this district, due probably to its favourable situation on the northern heights, and extent and beauty of the open spaces accessible to the public. The deaths from respiratory diseases were considerably less than last year 'end as usual occurred in persons past middle age. GENERAL PROVISION OF HEALTH SERVICES. The arrangements set out in previous reports continue to function satisfactorily. SANITARY CIRCUMSTANCES OP THE AREA. There has been no variation of the circumstances during the year. -4- SANITARY INSPECTION OF THE AREA. Tables of inspections made and defects remedied through the action of the Sanitary Inspector, will be found later in this report. The amount of sanitary improvements to dwelling houses is much less than in previous years due to depletion of inspectorial staff, the great difficulty of obtaining building materials and labour, and the engagement of your sanitary Inspector in billeting and rehousing. The experience of the last war i.e. for owners of working class property to with old repairs in war-time has been repeated, and there has been a steady deterioration of the working class property, which is specially noticeable in The Avenue area, Pembroke, Sydney and Cromwell Roads. This property is poorly constructed, old and worn out, and was under the supervision of your Sanitary Inspectors, and kept up to a reasonable standard of comfort, by continued action under the Public Health and Housing Acts. Where property of this type has been subjected to blast by enemy action, the dilapidations due to age have been aggravated. War repairs must be looked upon as palliative and temporary only. There does not seem any possibility of getting repairs executed in a proper and workmanlike manner, until suitable materials and skilled workman are once again available for this purpose after the war. NO. OF DWELLING-H0USES INSPECTED (separate primary inspections only). (1) On Complaint 251 (3) On notification of infectious disease 74 (3) He Tuberculosis 16 (4) House to House 10 Visits to Foodshops 51 " " Dairies and Milkshops 30 " " Slaughterhouses 0 " re Shops Acts 3 " to Factories and Workshops 43 " re Petroleum Acts 29 " to Watercourses 30 " for disinfection 61 " re Sanitation of Public Halls 30 " " Housing Act 1936 7 " " Billeting 1007 " " Disinfestation and to verminous premises 27 " " Rat Infestation 21 " " Hawkers premises 0 Appointments and special visits 303 Re-inspections and visits to works in progress 722 Attendances at Court (Petty Sessions and County Court) 5 2345 Total visits and inspections for 1939 2344 " " " " " 1938 2753 " " " " " 1937 3192 " " " " " 1936 3013 " " " " " 1935 2222 HOUSING. Number of new houses erected during the year:- (a) Total - 13 houses and 7 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 -5- 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) 365 (b) Number of inspections made for the purpose 402 2. (a) Number of dwelling-houses (included under sub-head (1) above, which were inspected and recorded under Housing Consolidated Regulations 1925 0 (b) Number of inspections made for that purpose 0 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 respects reasonably fit for human habitation 88 2. Remedy of defects without service of formal notice:- Number of defective dwelling-houses rendered fit in consequence of informal action- by the Local Authority or their offices 82 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 2 (2) Number of dwelling-houses which were rendered' fit after service of formal notices:- (a) By owners 2 (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 wore served requiring defects to be remedied 18 (2) Number of dwelling-houses in which defects were remedied after service of formal notice:- (a) By owners 11 (b) By Local Authority in default of owners 1 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:- No action was taken in regard to the, occupation of underground rooms or tenements as there are none in the district which fall within the statutory definition. 4. Housing Act 1936 - Part 4 - Overcrowding:- No action was taken in regard to overcrowding, there is no doubt that at times,many houses were temporarily overcrowded, whilst -6- others were empty during the period of an attach on London, and we had mony London people use our public shelters during the same time, the overcrowding that took place did not have any ill effects on the health of the people, although it took place in the autumn and winter months, when one would expect such overcrowding to spread and increase the incidence of the respiratory diseases. The following is a summary of the sanitary improvements and defects remedied during the year:- Water Store cisterns provided, repaired, cleansed or covers provided 3 Draw off cooks direct from main supply provided 5 Fittings and services repaired 9 Drainage Drains reconstructed 1 Drains cleared or repaired 22 Inspection chambers constructed 0 Inspection chambers cleansed, repaired etc. 6 Soil and vent pipes provided 0 Soil and vent pipes repaired 0 New sinks provided 0 New sink waste pipes provided 6 Sink wastes repaired 5 W.C. W.C pans and traps fixed 3 W.C pans and traps repaired 1 W.C scats, doors, windows, floors, renewed or repaired 5 Walls cleansed and distempered 3 Ceilings cleansed and distempered 1 Flushing cisterns provided 4 Flushing cisterns repaired or regulated 4 Floors. Floors renewed 2 Concrete over site provided 2 Ventilation improved 1 Floors repaired 6 Roofs Stripped and renewed 4 Repaired 18 Gutters and downspouts, renewed or repaired 16 Cleansing. Walls repaired, cleansed, distempered or papered 23 Ceilings repaired, cleansed and distempered 22 New ceilings 0 Windows Sashes and frames repaired or renewed 6 Cills repaired or renewed 2 Sashcords provided {number of houses) 1 Brickwork Damp proof courses provided 3 Brickwork repaired 1 Chimney stacks rebuilt or repaired 5 Dampness in walls remedied 2 Walls repointed or rendered 4 Yards Yard pavings provided or renewed 0 Yard pavings repaired 5 -7- Refuse Dustbins provided 2 Accumulation of refuse removed 1 Woodwork Stair treads renewed or repaired 2 Balusters and handrails renewed or repaired 0 Doors renewed, repaired or rehung 2 General New ranges and grates provided 7 Ranges and grates repaired 4 4 New coppers provided 0 Coppers repaired 0 Houses repainted externally 0 Doorsteps renewed or repaired 0 Other defects (unclassified) 9 Foodstores provided 0 Verminous rooms cleansed 1 Total 224 3S Total number remedied 1939 605 „ „ „ 1938 2404 „ „ „ 1937 2099 1936 1377 INSPECTION AND SUPERVISION OF FOOD. Milk The following licences were issued under the Milk (Speoial Designations) Order 1936:- Pasteurised 7 Accredited 1 Grade A (Tuberculin Tested) 6 Pasteuriser's 1 Meat and other foods. There has been no slaughtering within the district, the meat supply of this area is distributed from two Centres, viz. one each at Southgate and Finchley, these depots are under the supervision of the Sanitary Inspectors of these Boroughs, and any meat that they consider should not be issued to the public is stopped. We have a large cold store for meat and cheese within the district, which is inspected from time to time and food of doubtful quality stopped from raching the public. Fairly close supervision of other food shops has been maintained and during the year the following foodstuffs were surrendered as unfit for human consumption, a very small quantity when one considers the difficulties of issue, storage and transport under war conditions 21 lbs Beef Tongues 4 lbs Margarine 14 lbs Dripping 412 lbs Flour (Splintered glass) 19½ lbs Lamb 49 lbs Pork livers 1 side of bacon 159 lbs Pig Carcase It was particularly noticable the number of complaints received about, food, particularly such foods as sausages and fish, the former undoubtedly contained an excessive amount of starch in the form of biscuit meal, flour, bread, potatoe or some such cereal, which would naturally swell and break the sausage skin when cooked, but as there was no standard for sausage composition, so long as the food was not unfit for human consumption no action to improve the quality of the commodity could be taken. -8- The high. price of fish and shortage of meat tempted many housewives to hay the low priced fish on the retailers slab, with the result, that on cooking its staleness and loss of flavour became apparent such fish is always expensive, and in every case of complaint this was pointed out to the purchaser, and she was advised on the points to look for that indicate staleness. in fish, or lack of meat in sausage. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. Small Pox- none notified. Scarlet Fever Twenty three cases notified, four less than in 1939, with no deaths. The disease remains extremely mild, and it is seldom one hears of complications leading to prolonged illness or death. The incidence of the disease too, is very low, the attack rate being less than l per 1000. The average attack rate for the five years 1931/35 was 2.64 for the five years 1936/40 1.66. Diphtheria There was a sharp increase in the incidence of this disease over that of 1939 and the Ministry of Health pursued the policy of pressing local authorities to carry out artificial immunisation against the disease. Acting on advice contained in the various circulars issued by the Ministry arrangements were made with the Southgate Borough Counoil for Friern Barnet residents and their children to use the Broomfield Park Clinic and after the outbreak of war, that at the Southgate Town Hall. The response was poor, only 32 persons being immunised during 1940. Early in 1941 the Council decided to carry out immunisation within their own district, which will be a matter for next years report. The disease was of a very mild type; the average stay in hospital being 38 days compared with 88 in 1939. There was one death, the child being ill for some days before the recognition of the disease and consequent removal to hospital. Particulars of the number of other notifiable diseases are to be found in Table 1. Table 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES NOTIFIED DURING THE YEAR ENDING 31st DECEMBER 1940 Disease NUMBER OF CASES NOTIFIED No. removed to hospital All Un.l 1-5 5-15 15-25 25-45 45-65 65 & 0 North South Central Friern Hospital Scarlet Fever i 23 — 2 12 4 2 - - 8 3 6 6 16 Diphtheria 31 - 8 12 7 4 - - 3 19 8 1 29 Pneumonia 18 - 2 3 1 3 7 2 1 7 3 7 — Measles 99 4 38 43 9 5 - - 19 22 57 1 3 Whooping Cough 2 - - 2 - - - - 1 1 - - — Cerebro Spinal Fever 6 - 1 1 2 2 - - 5 1 - - 6 German Measles 3 - - 3 - - - - 2 1 - - 3 Encephalitis Lethargica 1 - - - - 1 - - - - - 1 - Meningitis 1 - - 1 - - - - - - 1 - 1 Dysentry 3 - - - 2 - 1 - - 1 - 2 - Ophthalmia Neonatorum 2 2 - - - - - - 2 - - - - Impetigo 3 - - - 3 - - - 3 - - - 3 Scabies 6 - - - 6 - - - 6 - - - 6 Pulm. Tuberculosis 21 - - - 3 15 3 - 5 3 10 3 - Other Tuberculosis 8 - i 1 1 1 5 - - 5 - 1 2 - T0TALS 227 ! 6 52 78 38 40 11 2 60 58 86 23 67 I ' ' ' . ' * • « : TABLE 2. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAR 1940 FOR THE MOLE DISTRICT. Causes of death No. Regd. ! Out Tran. In Tran. M. F. Nett deaths 0-1 1-2 2-5 5—15 15-25 25-45 45-65 65 & 0 N. S. C. H. Appendicitis - - - - - - - 1 - - 1 - - - 1 - 1 1 Bronchitis 17 l - - - 1 3 5 12 5 4 8 5 5 5 10 12 17 Cancer 62 — - - - - 3 37 41 17 8 9 47 48 19 44 37 33 Cerebral Haemorrhage 23 1 — — — - - 5 20 5 6 8 7 8 3 11 15 18 Congenital Debility 5 8 - — — — - - - 2 - 4 2 2 3 2 6 6 Diabetes 3 - - — 1 - — 1 3 — — 2 3 3 2 3 2 2 Diarrhoea — 2 — — - — — — — 1 — 1 — - 2 1 1 2 Diphtheria - — — - 1 — - - - - - 1 - - 1 1 - 1 Encephalitis Lethargica 1 - — — — 1 - - - - - - 1 1 — 1 - - General Paralysis 5 — — — — - — 4 1 - - - 5 5 - 4 1 - Heart Disease 104 2 - - - 3 12 43 73 27 20 21 65 68 29 53 80 65 Influenza 1 - — - - - - - L - - 1 — - — - 1 1 Nephritis 20 - - - - - 5 8 8 - 1 3 17 17 1 9 12 4 Other Circulatory diseases 24 - - - - - 1 4 21 4 2 6 14 14 2 9 17 12 Other defined diseases 45 1 - - 1 1 19 14 17 4 6 5 38 40 8 32 21 13 Other digestive diseases - - — — - - 1 1 - - 1 1 - - 2 2 — 2 Other Tubercular diseases 2 - 1 - 2 - - - - 1 - - 2 2 1 - 3 1 Other Violence 8 - - - - 2 4 3 6 6 3 2 4 6 7 8 7 9 Pneumonia 50 4 1 - — 1 9 27 25 5 11 8 43 44 17 46 i 21 i 23 Senility 5 - - - - - - - 8 1 3 1 3 3 3 4 4 5 Syphilis 3 — — - — — 2 1 1 - - 1 3 3 1 3 1 1 Suicide 2 — - — — 1 1 1 - 2 - - 1 1 1 2 1 2 Tuberculosis of Respiratory system 13 1 - - - 4 11 2 2 5 4 1 10 10 7 6 14 10 War Operations 66 - - - 3 6 21 26 11 11 9 - 57 57 1 12 55 10 TOTALS 459 20 2 - 8 20 92 183 250 86 1 79 83 327 337 116 263 312 238 I 1 TABLE 3. ANALYSIS OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING 1940 AND THE MORTALITY FROM THE FROM DISEASE OYER 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 - - - 1 - - - - 5-10 - - - - - - - - 10 - 15 - - - 1 - - - - 15 - 20 3 - 1 - 1 1 - - 20 - 25 4 - 3 1 - - - - 25 - 35 4 5 1 - 1 3 - - 35 - 45 2 - - - 1 - - - 45 - 55 1 1 - - - - - - 55 - 65 1 - - - - - - 65 &. over - - - - - - 1 - TOTALS 15 6 5 3 3 5 - - TABLE 4. INFANTILE MORTALITY NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE 1940 Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 week 4 weeks and under 3 months 3 months and under 6 months 6 months and under 9 months. 9 months and under 12 months. Total under 1 year All Causes:- Certified 12 1 - 1 14 1 1 1 3 20 Uncertified — — - - - - - - - - Accident at Birth 1 - - - 1 - - - - 1 Bronchitis - - - - - - - - 1 1 Cerebral Haemorrhage 1 - - - 1 - - - - 1 Diarrhoea - 1 - - 1 1 - - - 2 Heart Disease 2 - - - 2 - - - - 2 Malformation 1 - - 1 2 - - - - 2 Other defined diseases 1 - - - 1 - - - - 1 Pneumonia 1 - - - 1 - 1 1 1 4 Pulm. Tuberculosis - - - - - - - - 1 1 Prematurity 5 - - - 5 - - - - 5