FRI 24 FRIERN BARNET URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. FOR THE YEAR 1 9 4 6 W.W, MILLEN. M.B. Ch.B. MEDICAL OFFICER OF HEALTH. . FRIERN BARNET URBAN DISTRICT COUNCIL. Public Health Department,. Town Hall. N.11. 31st. October., 1947. TO THE CHAIRMAN AND MEMBERS OF THE FRIERN BARNET URBAN DISTRICT COUNCIL. Mrs. McCarthy and Gentlemen, Again I have the privilege of presenting to you a report upon the health conditions in your district for the year ending December 31st. 1946. The report is drawn up in the abbreviated form in accordance with Circular 13/47 issued by the Ministry of Health, and is little more than a factual record of statistics. Generally speaking, the health of the district is very good. The death-rate shows a slight increase, while the infantile mortality rate is practically the same as that for the previous year. The birth-rate is the highest for over twenty years, and is considerably higher than the average for the pre-war years. The infectious sickness rate was slightly higher, but as this was accounted for by the increased number of cases of Measles and Whooping Cough, this fact has very little practical significance. Brief comments on various aspects of the work carried out by the Department will be found in the report, together with the usual tables of statistics. I am, Mrs. McCarthy and Gentlemen, Your obedient Servant, 17. W. MILL JIT . M.B., Ch.B. Medical Officer of Health. PUBLIC HEALTH COMMITTEE. at 31st. DECEMBER 1946. Councillor. A.C. Henry. (Chairman), Councillor. C.F. Simmonds.J.P. (Chairman of the Council). Councillor. C.H. Sparks. (Vice-Chairman of the Council). Councillor. J. Foley. Councillor. E.W. Moson. Councillor. Mrs. H.E. Mo.Carthy. Councillor. L.W. Mc. Clene. Councillor. G.E. Mead. Councillor. F. Plant. PUBLIC HEALTH STAFF. Medical Officer cf Health. W.T7. Millen. M.B.Ch.B. Chief Sanitary Inspector. A.G. Harman.(Retired 31/3/46). W.R. Jackaman (Appointed 1/4/46). Additional Sanitary Inspector. S. Caine. (Appointed 22/7/46). General Assistant. J. wilson. (Returned from H.M. Forces 18/3/46). Assistant. Miss. E. Glasscock. Rodent Operative, Miss. I. Cope.(Appointed 3/7/46). STATISTICS OF THE AREA. Area (in acres) 1341.2. Registrar General's estimate of population 28,210. (District 25,930). (Friern Hospital 2,280). Number of separate dwellings. 7,328. Rateable Value. £280,911. Sum represented by a penny rate. £1, 130. -1- EXTRACTS FROM VITAL STATISTICS. Male. Female. Total. LIVE (Legitimate). 240 228 463 BIRTHS. (Illegitimate). 15 8 23 Totals 255 236 491 BIRTH RATE per 1000 of the estimated population 13.9. Male. Female. Totel. STILL (Legitimate). 7 6 13 BIRTHS. (Illegitimate). - Totals 7 6 13 STILL BIRTH RATE per 1000 Births (Live & Still) 26.5 DEATHS from all causes and at all ages. Male. Female. Total. 115 146 261. DEATH RATE per 1000 of the estimated population 10.0. DEATHS of Women in childbirth From Puerperal Sepsis 0. From other maternal causes 2. DEATH RATE per 1000 Births (Live & Still) 4.0 DEATHS OF INFANTS under 1 year of age:- Male. Female. Total. Legitimate. 10 10 20 Illegitimate. - - - Totals 10 10 20 DEATH RATE of Infants under 1 year per 1000 Births 41. DEATHS from MEASLES (all ages) 0. DEATHS from WHOOPING COUGH (all ages) 0. DEATHS from DIARRHOEA (under 2 years of age) 0. -2- BIRTHS The total of births during the year was 491, an increase of 125 over the preceeding year. Of these 255 were males and 236 females. The Birth- Rate for the year was 13.2 per 1000 of the population. The corresponding Birth-Rate for England and Wales was 19.land for London 21.5. Births and Birth-Rates for the past five years have been as follows:- No of Births. Friern Barnet. Birth-Rates. England & Wales. London. 1942. 375 16.6 15.9 14.0 1943. 415 16.5 16.5 15.8 1944. 382 17.6 17.6 15.0 1945. 366 14.2 16.1 15.7 1946. 491. 18.9 19.1 21.5 DEATHS. The number of deaths accredited to this district was 261, 28 more than in the preceeding year. Of these 115 were males and 146 females. 160 deaths or 61% were of persons above the age of 65. The chief causes of death at all ages were Heart Disease 74, and Cancer 47, The Death-R:te was 10.0. per 1000 of the population, compared with a Death-Rate for England & Wales of 11.5 and for London 12.7 The Deaths and Death-Rates for the past five years have been:- No. of. Deaths. Friern Barnet. Death-Rates. England & Wales. London. 1942. 258 10.8 11.6 13.9 1943 256 11.1 12.1 15.0. 1944 274 10.6 11.6 15.7 1945 233 9.4 11.4 13.8 1946 261 10.0 11.5 12.7 There were 20 deaths of infants under 1 year of age, giving an Infantile Death-Rate of 41 per 1000 births, compared with 14 deaths and a rate of 38 in 1945. The comparative rates for England and Wales and for London were 43 and 41. Of the 20 infant deaths 12 occurred during the first week of life. 9 of these were due to prematurity. -3- SANITARY SERVICES. SANITARY INSPECTIONS. Visits to premises, housing inspections, complaints, and works in progress. 2784. Visits in connection with Infectious Disease. 70. Visits to shops, and places where food is prepared, stored or sold. 178. Visits to Factories. 19. Visits to petroleum installations. 29. Visits in connection with infestations, verminous premises and rodent control. 3563. 6643. SERVICE OF NOTICES. Total informal notices served. 440. Total informal notices complied with. 341. Total statutory notices served. 23. Total statutory notices complied with. 15. SUMMARY OF DEFECTS REMEDIED AS A RESULT OF ACTION BY THE DEPARTMENT. WATER SUPPLY. Store cisterns provided, repaired or cleansed. 5. Fittings and services renewed or repaired. 23. DRAINAGE. Drainage systems repaired or cleansed, 28. Inspection chambers constructed or repaired. 11. Soil and vent pipes provided. 1. New sinks provided. 3. Sink waste pipes provided or repaired. 17. SANITARY ACCOMMODATION. W.C. pans and traps fixed. 15. W.C. pans and traps repaired. 4. W.C. compartments repaired. 5. Walls and ceilings cleansed. 6. W.C. flushing cisterns provided or repaired. 36. FLOORS. Renewed or repaired, 52. ROOFS. Renewed or repaired. 144. Guttering renewed or overhauled, (houses) 50. CLEANSING. Walls repaired,cleansed and redecorated. 138. Celings renewed, repaired and redecorated. 103. WINDOWS. Sashes and frames renewed or repaired. 33. Sills renewed or repaired. 23. Sashcords provided (houses). 15. -4- BRICKWORK, Damp-proof courses provided (houses) 2. Brickwork repaired. 11. Chimney stacks rebuilt or repaired. 6. Dampness in walls remedied (houses) 11. Walls re-pointed or rendered (houses) 39. WOODWORK. Doors renewed, repaired or rehung. 16. GENERAL. Dustbins provided. 95. Accumulations of refuse removed. 1. New ranges or grates provided. 9. Ranges or grates repaired. 32. Wash-boilers renewed or repaired. 9. Verminous rooms cleansed. 3. Other defects (unclassified) remediede 31. WATER SUPPLY. The water supply of the district, provided by the Barnet District Gas & Water Company has been satisfactory in quality and quantity. All houses are provided with a piped supply, and there have been no complaints of unsatisfactory or insufficient supply. No bacteriological or chemical examinations of the water were carried out by the Department. Reports on samples taken are regularly received from the supplying Company, and the following is characteristic:- "This is a very satisfactory water. It is clear and bright in appearance and of the highest standard of bacterial purity, indicative of a pure and wholesome water suitable for the purpose of a public supply"* INSPECTION AND SUPERVISION OP FOOD. MILK SUPPLY. The following licences were granted under the Milk (Special Designations) Regulations 1936/46 :- Pasteuriser's Licence 1 Dealer's Licences 4 Supplementary Licences 11 Numerous samples were taken and for the most part the milk was shewn to be of satisfactory quality. In a few instances where samples failed to satisfy the prescribed tests, the matter was taken up with the appropriate authority with the desired result. -5- MEAT AND OTHER FOODS. Frequent inspections were made of butchers, fishmongers, grocers and bakers shops,and other food premises. A large quantity of food was examined and the following was condemned as unfit for human consumption:- Beef. 445 lbs. Mutton. 30½-lbs. Offals. 323 lbs. Tripe. 42 lbs. Rabbit. 110 lbs. Bacon. 8 lbs. Butter or Margarine. 13 lbs. Flour. 102 lbs. Prunes. 4 lbs. Bananas. 3 lbs. Biscuits. 3 1bS. Chocolate. 10 lbs. Skate. 15 Stone. Cod. 8 Stone. Kippers. 2 Stone. Corned Beef. 592 lbs. Tinned Milk. 171 Tins. Tinned Vegetables. 35 Tins. Tinned Meat. 25 Tins. Tinned Fish. 35 Tins. Tinned Fruit. 8 Tins. Dried Milk. 9 Tins. Tinned Soup. 3 Tins. Pudding Mixture. 60 lbs. Cheese. 12 lbs. Oranges. 3½ Cases. RATS AND MICE.(DESTRUCTION) ACT. 1919. The Council became the Authority for the Administration of this Act in 1944. In addition to work carried out under this enactment, the Council adopted a scheme for the systematic inspection of, and treatment against rats on all private premises, and work on this scheme was commenced in the later part of the year. The results achieved to date have been most satisfactory. during the year 290 premises were successfully treated. Of those infestations 168 were revealed as a result of the survey. The work is continuing. Plans were also prepared for treatment of the district sewers, but although many of the preliminary arrangements were completed, for a number of reasons it was not practicable to carry out the actual treatment, which was subsequently completed in 1947. A number of complaints of infestation by mice were investigated, and advice and assistance given with considerable success. -6- FACTORIES ACT. 1937. Inspections were made of the various factories, with particular regard to those matters with which the 'local authority is charged under this Act. As a result of these inspections the sanitary accommodation at four premises was found to be either insufficient or unsatisfactory. Following representations these conditions were remedied, INFECTIOUS DISEASE. NOTIFICATIONS - 34-3 casos of Infectious Disease were notified during the year,, details of which are set out in Table 1. This figure was in excess of the notifications received during 1945, and was largely accounted for by an increase in the number of cases of Measles - 194 compared with 100 during 1945, and Whooping Cough - 52 compared with 15. The incidence of Diphtheria remained low 4 cases, and there were fewer cases of Tuberculosis - 23 compared with 30 during 1945. IMMUNISATION AGAINST DIPHTHERIA . 325 children were immunised during 1946. It is estimated that 43% of the children below the age of 5 years have now been immunised against Diphtheria, and 44% of the children between the ages of 5 and 15 years These percentages do not. include those children privately immunised by their own doctors. SCABIES, The arrangements made with the Medical Officer of the Joint Isolation Hospital for the treatment of cases as out-patients continued throughout the year. 57 cases received treatment. -7- TABLE 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES NOTIFIED DURING THE YEAR ENDING 31st. DECEMBER. 1946. DISEASE. NUMBER OF CASES NOTIFIED. CASES IN EACH WARD. No. Removed to Hosp. All. Un.1. 1-5. 5-15. 15-25. 25-45. 45-65. 65&0. North. South. Cent. East West. Friern Hospital. Measles. 194 5 90 98 - 1 - - 37 68 45 17 27 - 6 Whooping Cough. 52 3 31 17 - 1 - - 11 16 14 3 8 - 6 Scarlet Fever 44 - 11 28 2 3 - - 12 17 9 3 3 - 29 Diphtheria. 4 — 2 - 1 1 - - - 2 1 1 - - 4 Dysentery. 8 2 - 1 - 4 1 - 5 2 - — 1 2 2 Pneumonia. 15 - - 1 - 5 3 6 3 - 5 — - 7 — Erysipelas. 3 - - - - - 2 1 1 1 1 - - - 2 Pulm. Tuberculosis. 26 - - 2 5 15 3 1 6 8 8 1 3 — — Para-typhoid. 1 - - 1 - - - - - 1 - — — - 1 Polio-myelitis. 1 - - 1 - - - - - - 1 - - - 1 TOTALS. 348 10 134 149 8 30 9 8 75 113 84 25 42 9 51 TABLE 2. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAR 1946. FOR THE WHOLE DISTRICT Causes of Death. No. Regd. In Tran. At Ages. Wards. M. F. Nett Deaths. 0-1 1-2 2-5 5-15 15-25 25-45 45-65 65&0 N. S. C. E. W. • Accident. 2 3 - - - - 1 - - 4 2 1 2 - - 1 4 5 Arterio-sclerosis. 5 2 - - - - - - - 7 2 - 3 1 1 3 4 7 Bronchitis - 1 - - - - - - 1 - 1 - - - - - 1 1 Cancer. 24 23 - - - - - 3 14 30 27 6 7 - 7 24 23 47 Cerebral-haemorrhage. 17 10 - - - - - - 5 22 5 5 12 2 3 9 18 27 Cerebro-spinal-fever. - 1 - - - - - - 1 - - - - 1 - 1 1 Congenital debility. 4 14 18 - - - - - - - 8 5 3 1 1 10 8 18 Coronary thrombosis. 2 - - - - - - - 1 1 - 1 1 - - 2 - 2 Diabetes. 1 1 - - - - - 1 _ 1 2 — - - -_ — 2 2 Hear Disease. 48 26 - - - - - 4 16 54 19 20 27 1 7 30 44 74 Influenza. 1 - - - - - - - - 1 - 1 - - - 1 1 Nephritis. 2 5 - - - - 1 1 1 4 1 2 4 - - 4 3 7 Other circulatory diseases. 3 3 - - - - - - 2 4 1 1 1 1 2 4 2 6 Other def. diseases. 3 14 1 - - 2 - 2 4 8 6 3 4 2 2 7 10 17 Other digestive diseases. — 3 - - - - - - 1 2 1 1 1 - - 1 2 3 Other poerperal causes. - 2 - - - - - 2 - - - 1 - - 1 - 2 2 Pneumonia. 4 14 1 - - 1 - 1 3 12 6 5 3 2 2 5 13 18 Senility. 8 2 - - - - - - - 10 5 1 3 1 - 3 7 10 Tuberculosis of Resp. system 6 7 - - - _ 2 8 3 - 3 5 5 - - 12 1 13 Totals. 130 131 20 - - 3 4 22 52 160 89 58 76 11 27 115 146 261. TABLE 3. ANALYSIS OF CASES OF TUBERCULOSIS NOTIFIED DURING 1946. AND THE MORTALITY FROM THE SAME DISEASE OVER THE SAME PERIOD. AGES. NEW CASES. DEATHS. PULMONARY. NON-PULMONARY PULMONARY. NON-PULMONARY. I MALES. FEMALES. MALES. FEMALES. MALES. FEMALES. MALES. FEMALES. 0-1 — — — — - - - - 1-5 — - - — — - — — 5-10 1 - - - - - - - 10- 15 2 - - - - - - - 15- 20 - 2 - - - - - - 20- 25 1 1 - - 1 - - - 25- 35 4 2 - - 2 - - - 35- 45 2 4 _ - 2 2 - - 45- 55 1 2 - - 3 - - - 55- 65 - - - - - - - - 65 & Over 1 - - - - - - - TOTALS. 12 11 - - 8 2 - - TABLE. 4. REGISTER OF TUBERCULOSIS. PULMONARY. Non-Pulmonary. Totals. Male. Female. Male. Female. Cases on Register at 1.1.46. 106 61 15 21 203 Cases notified for first time 1946. 12 11 - - 23 Other cases added to Register 1946. 2 2 - 2 6 Cases removed from Register. 24 11 2 3 40 Cases remaining on Register 31.12.46. 96 64 13 19 192 TABLE 5. INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE 1946. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 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. 14 1 - 1 16 1 2 1 - 20 Un-Certified. - - - - - - - - - - Accident at Birth. 2 - - - 2 - - - - 2 Atelectasis. 1 - - - 1 - - - - 1 Congenital Debility. - - - - - 1 - - - 1 Convulsions. 1 - - - 1 - - 1 - 2 Gastro-enteritis. 1 - - 1 2 - - - - 2 Marasmus. - - - - - - 1 - - 1 Pneumonia. - - - - - - 1 - - 1 Prematurity. 8 1 - - 9 - - - - 9 Other defined diseases. 1 - - -- 1 - - - - 1