FRI 25 LIBRARY FRIERN BARNET URBAN DISTRICT COUNIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1947 W.w. MILLEN. M.B., Ch.B. MEDICAL OFFICER OF HEALTH. FRIERN BARNET URBAN DISTRICT COUNCIL. Public Health Department, Town Hall. N.11. 1st. July, 1948. The Chairman and Members of the Friern Beret Urban District Council. Mr. Chairman, Ladies and Gentlemen, I have the honour to present my report upon the health conditions in the district for the year ending December 31st, 1947. The report is again drawn up in the abbreviated form in accordance with Circular 170/47 issued by the Ministry of Health. It is little more that a factual record of statistics, although opportunity has been taken to make such comments as are called for throughout the report. Study of the vital statistics show that the health of the people of Friern Barnet has been well sustained. The death-rate and infantile rate both show a slight decrease compared with last year. The birth-rate again shows a small increase, is the highest for over twenty years, and considerably higher than the average for the pre-war years. The infectious sickness rate showed a decrease, but this was almost entirely due to the fact that the number of cases of Measles was considerably less than the previous year. Unfortunately, one cannot say the same in regard to the incidence of Tuberculosis, there having boon a sharp increase in the number of now eases. The policy of Diphthoria immunisation is now being reflected in the incidence of the disease. No cases of poliomyolitis -1- occurred, in the district. I should like to express to the Chairman and Members of the Public Health Committee my sincere thanks for their consideration and support, I am, Mr. Chairman, Ladies and Gentlemen, Your obedient servant, W.W. MILLEN M,B.,CH.B. Medical Officer of Health. -2- PUBLIC HEALTH COMMITTEE. At 31st. December, 1947. Councillor A.C. Henry (Chairman) " C.A. Sparks,J.P (Chairman of the Council) " A. Richardson (vice- Chairman of the Council) " 3. Draper " J. Foley " W.H. Martin,J.P. " R.P. Matthews " Mrs. H.E. MeCarthy " G.E.J. Mead " J.E. Pickering, J.P. " M.R. Tarlton Public Health Staff. Medical Officer of Health. Chief Sanitary Inspector. Sanitary Inspector. Assistant Assistant. Rodent Operative. W.W. Millen,M.B.,Ch.Bc W.R. Jackaman. S. Caine. J. Wilson. Miss E. Glasscock. Mrs. I. Shields (Resigned 27.9.47). STATISTICS, OF THE AREA. Area (in acres) 1341.2 Registrar General's estimate of population 28,940 (District - 26,340 ). (Friern Hospital- 2,100 ). Number of separate dwellings 7438. Rateable Value (31.12.47) £283,880. Sum represented by a penny rate £1,140. -3- EXTRACTS FROM VITAL STATISTICS. Male. Female. Total. LIVE BIRTHS. (Legitimate) 244 248 492 (Illegitimate) 7 11 18 (Totals) 251 259 510 BIRTH RATE per 1000 of the estimated population 19. 0 Male. Female. Total. STILL BIRTHS. (Legitimate) 9 9 13 (Illegitimate) - (Totals) 9 9 18 STILL BIRTH RATE ner 1000 Births (Live and Still 55.5 Ma1e. Female. Total. DEATHS (From all causes 133 151 264 and at all ages) . DEATH RAPE our 1000 of the estimated population 9.9 DEATHS OF WOMEN IN CHILDBIRTH. From Pusrperal Sepsis 0 From other maternal causes 1 DEATH RATE per 1000 Births (Live and Still) 1.9 DEATHS OF INFANTS under 1 year of age:- Male. Female. Total. Legitimate. 15 4 17 Illegitimate 112 Totals 14 5 19 DEATH RATE OF INFANTS under 1 year per 1000 Births. 37. DEATHS FROM MEASLES (all Ages 0 DEATHS FROM WHOOPING' COUGH (a11 Ages 1 DEATHS FROM DIARRHOEA (under 2 years of Age) 5 -4- BIRTHS. The total of births during the year was 510, an increase of 19 over the preceding year. Of those 251 wore males and 259 females. The Birth- Rate for the year was 19.0 per 1000 of the population. The corresponding Birth-Rate for England and Wales was 20.5 and for London 22.7 . Births and Birth- Rates for the past five years have been as follows No.of Births. Birth- Rates. Friern Bnrnet. England & Wales. London. 1943 415 16.5 16.5 15.3 1944 332 17.6 17.6 15.0 1945 366 14.2 16.1 15.7 1946 491 13.9 19.1 21.5 1947 510 19.0 20.5 22.7 DEATHS . The number of deaths accredited to this district was 264, being 3 more than in the preceding year. Of These 133 were males and 131 females. 160 daths or 60% ere of persons above the age of 65. The chief causes of death at all ages wore Heart Disease 83, and Cancer 51. The Death-Rate was 9.9 per 1000 of the population, compared with a Death-Rate for England & WaIes of 12.0 and for London 12.3. The Deaths and Death-Rates for the past five years have been: No.of Deaths. Death-Rate. Eriern Barnet. England & Wales. London. 1943 256 11.1 12.1 15.0 1944 274 10.0 11.6 15.7 1945 233 9.4 11.4 13.3 1946 261 10.0 11.5 12.7 1947 264 9.9 12.0 12.8 There were 19 deaths of infants under 1 year of age, giving an Infantile Death-Rate of 37 per 1000 births, compared with 20 deaths and a rate' of 41 in 1946. The comparative rates for England and Wales and for London were 41 and 37. Of the 19 infant deaths 7 occurred during the first week of life, and 5 of these were due to prematurity. -5- SANITARY SERVICES. SANITARY INSPECTIONS. Visits to premises on complaint 723 Visits in connection with infectious disease 46 Visits to shops,and places where food is prepared stored or sold.131 Visits to dairies and milkshops 38 Visits to shops under the Shops Act 136 Visits to factories under the Factories Act 21 Visits to petroleum instillations under the Petroleum Regulations.21 Visits under the Housing Act, for appointments, and to works in progress 2592 Visits re infestation and disinfestation. of verminous premisos. 6 Visits for the purpose of rodent control 544 visit of mens 4 Visits to Piggeries 64 Attendance at Court 1 4332 Visits by Rodent Operative in connection with rodent control 4217 Total 3549 SERVICE OF NOTICES. Total number of informal notices served 493 Total number of informal notices complied with 404 Total number of statutory notices served 14 Total number of statutory notices complied with 11 The following is a summary of the (Sanitary improvements and defects remedied during the year as a result of action by the Public Health Department Water. Store cisterns provided, repaired, cleansed, or covers provided 12 Fittings and services repaired 46 -6- Drainage. Drains cleared or repaired 24 Inspection chambers reconstructed or repaired 10 Inspection covers provided 8 Soil and vent pipes provided or repaired 4 New sinks provided 6 Sink waste-traps provided or repaired 21 W. C's. W.G. pans and traps fixed 25 W.C. pans and traps repaired 10 W.C. seats, doors, windows, floors renewed or repaired 10 Walls cleansed and distempered 7 Ceilings cleansed and distempered 3 Flushing cisterns provided 2 Flushing cisterns repaired or regulated 23 Floors. Floors renewed or repaired 51 Roofs. Stripped and renewed. 10 Roofs repaired 220 Gutters and downspouting renewed or repaired 112 Cleansing. Walls repaired, cleansed and redecorated 251 Ceilings renewed or repaired 187 Windows. Sashes and frames renewed or repaired 85 Sills renewed or repaired 53 Sashcords provided (number of houses) 21 Brickwork. Damp-proof courses provided 4 Brickwork repaired 39 Chimney stacks rebuilt or repaired 16 Walls re-pointed or rendered 62 Woodwork. Doors renewed, repaired or rehung 13 Yards. Yard paving repaired or renewed 4 Refuse. Dustbins provided 61 Accummulations of refuse removed 3 General. Now ranges or grates provided 14 Ranges or grates repaired 51 Wash boilers repaired or renewed 11 Verminous rooms cleansed 1 Other defects (unclassified) remedied 50 -7- WATER SUPPLY. The water supply to tho district is provided by the Barnet District Gas & Writer. Company and has boon satisfactory in quality and quantity. All houses in the district are provided with a piped supply, and there have boon no complaints of unsatisfactory or insufficient supply. Bacteriological and chemical examinations of the rncrninfiy carried out by the supplying Company and reports on such examinations are supplied to the Department. The following is typical of such reports:- "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". RATS AND MICE (DESTRUCTION) ACT, 1919. The Council is the authority for the administration of this Act. In conjunction with action under this enactment a survey of private premises was carried out and control measures adopted wherever evidence of infestation was found. In the course of the survey 5902 premises were visited, and treatment was carried out in 255 instances. During the year throe treatments of the district sowers were carried out with satisfactory results. Of 612 manholes examined at the commencement of the year, 55 shewed evidence of use by rats f As a result of subsequent treatments this number has been reduced to 16. INSPECTION AND SUPERVISION OF FOOD. MILK SUPPLY. The following licences were issued under the Milk (Special Designations) Regulations 1936/46:- PaStOUriSOr'S 1 Dealer's Pasteurised 3 Tuberculin Tested 1 SuppIomen tary:- Pasteurised 6 Tuberculin Tested 5 During the year 41 samples were taken, and on 7 occasions milk obtained from one particular source failed to satisfy the proscribed tests. The circumstances were fully investigated and revealed certain defects at the farm of production. The matter was referred to the appropriate licensing Authority and arrangements made for the milk to bo pasteurised. Subsequent samples were satisfactory. MEAT AND OTHER FOODS. Frequent visits were paid to butchers', fishmongers', grocers' and bakers' shops, and other food premisos. A largo quantity of food was examined of which the following was condemned as unfit for human consumption:- Beef 437½ lbs. Mutton 2 lbs. Offal 12¾ lbs. Bacon 7¾ lds . Butter, Margarino or Lard 5 lbs. Fish 1190 lbs. Corned Beef 106 Tins. Tinned Milk 157 Tins. Tinned Vegetables 91 Tins. Tinned Meat 73 Tins. Tinned Fish 220 Tins. Tinned Fruit 11 Tins. Tinned Mincemeat 3 Tins. Tinned Soup 5 Tins. Jam 16 Jars. Fruit 3 Jars. Herrings 14 Jars. Tangerines 17 lbs. Tomatoes 2 Boxes. INFECTIOUS PISEAS5, Notifications. 301 cases of infectious disease were notified during'the year, details of which are set out in Table 1. This figure showed a decrease compared with 1946, when 343 notifications were received, and was accounted for by a reduction in the number of cases of Measles - 125 compared with 194 during 1946. The incidence of Diphtheria again remained exceptionally low - 3 cases, compared with 4 during 1946. There was a substantial increase in the number of Tuberculosis cases - 37, compared with 23 during 1946. In addition 5 persons have taken up residence in the district, who had previously been notified as suffering from the disease. IMMUNISATION AGAINST DIPHTHERIA. 319 children were immunised during 1947. It is estimated that 45% of the children under 15 years of ago have now been immunised against Diphtheria. These figures do not include 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, and 25 cases received treatment. In addition 9 cases were treated at home, after receiving advice and the necessary medicament from the Department. -9- REPORT OF MEDICAL OFFICER REQUIRED BY SECTION 123 (3) OF THE FACTORIES ACT, 1937. Inspections for purpose of provisions as to health. Number on Register. Number of Inspections. Written notices. Occupiers prosecuted. (1) Factories in which Sections 1,2,3,4,& 6 are to be enforced by Local Authorities. 22 15 1 - (2) Factories not included in (1) in which Soc.7 is enforced by Local Authority. 44 6 - - (3) Other promises in which Sec.7 is enforced by the Local Authority. 6 — — - Total 72 21 1 - Outworkers (Sections 110 and 111. Section. 110. Section. 111. No.of outworkers on lists received. No. of instances of work in unwholesome promises. Notices served. 16 - - -10- Cases in which defects v^orc found. No.of cases in which defects wero found. Found. Remedied. Referred Prosecutions To H.M. Inspector. B:; H.M. Insoector. Want of cleanliness 2 2 - - - S' nitary conveniences (ri) insufficient 1 1 — _ - (b) Unsuitable-or defective 2 2 1 - Or-n-jr offences. 1 1 - - - Total 6 6 - 1 - TABLE 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES NOTIFIED DURING THE YEAR ENDING 31st. DECEMBER. 1940 DISEASE. NUMBER OF CASES NOTIFIED. kCASES IN EACH WARD. Friern Hospitsl No. Removed to Hosp. All. i Un.lf 1-5. 5-15. 15-25 25-45. 45-65. 65&0. North. South. Cent. 5 st West. Measles. 125 3 65 57 - _ - _ 32 6 15 39 33 - 2 Whooping Cough 56 8 30 14 - 4 - - 23 7 10 3 3 -i _ 1 Scarlet Fever 41 - 4 31 - 3 - - 10 10 6 9 6 - 22 Diphtheria 3 - - 1 1 1 - - i 1 - 1 - 3 Dysentery 14 - - - - 1 6 7 - — - - - 14 - Pneumonia 15 1 3 1 - 2 6 2 5 - 2 1 1 6 - Erysipelas 77 -i - - _1 3 1 2 3 1 1 1 1 - 5 Puerperal Pyrexia 2 -i - - - 2 _ - - -_ 2 ? - 2 Gastro-enteritis 1 - 1 - i - — - 1 - - 1 Pulm.Tuberculosis 36 1 - 2 15 11 7 - 6 11 10 3 6 - - Other Tuberculosis 1 - - - -j- 1 - - - _ _ - 1 - - TOTALS. J 301 13 103 106 20 23 20 11 80 36 46 62 57 20 36 TABLE 2. ANALYSIS OF TEE CAUSES OF AND AGES AT HEATH DURING THE YEAR 1947 FOR THE WHOLE DISTRICT. Cause of Death No. Reg. In Trans 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 4 - - - - - 3 3 3 - - - 3 4 _ 2 6 Appendicitis - 2 - 1 - -: 1 - - 1 - - 1 2 - 2 Arterio-sclerosis 1 1 - - - - - - 1 1 1 1 - 2 - 2 - 2 Bronchitis 5 3 - - - - - 1 2 5 i 1 1 2 - 4 2 6 8 Cancer 34 17 - - - - - 3 17 31 ll 12 15 4 9 25 26 51 Cerebral Haemorrhage 19 6 - - - - - 1 2 22 10 5 3 5 2 9 16 25 Cirrhosis of Liver - 1 - - - - - - 1 - 1 - - - - - 1 1 Congenital Debility 3 8 11 - - - -- - - - 2 - 6 - 3 3 3 11 Diarrhoea etc. - 5 5 - - - - - - - 1 - 1 1 2 3 2 5 Heart Disease 67 16 _ - - - 1 2 18 62 25 15 21 7 15 ] 46 37 33 Nephritis 2 4 - - - - 1 1i 3 1 2 i 2 2 — — 4 2 6 Other defined diseases 3 4 9 - — 1 1 - 5 6 3 4 1 3 2 9 4 13 Other digestive dis. - 3 _ """ 1 _ 2 _ l - 2 — _ 1 2 3 Pneumonia 3 11 3 - --- -- - - 3 8 - 6 4 3 1 7 7 14 Senility 12 6 - - - - - - - 13 9 3 3 2 1 5 13 18 Suicide 2 - - - - - - - 1 1- - - 1 ~ 1 1 1 2 Syphilitic diseases — 1 - - - - - - - 1 1 - - - - - 1 _ 1 Tuberculosis (Pulm) 4 8 - - - 3 6 2 1 2 5 1 1 3 5 7 12 Whooping Caugh 1 - - 1 - - - - - - 1 - - - - - 1 1 TOTALS 159 105 19 1 1 2 6 15 60 160 75 54 62 26 47 133 131 264 TABLE 5. ANALYSIS OF CASES OF TUBERCULOSIS NOTIFIED DURING 1947. 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 !_ - - - - - -~ 1-5 - - - - - - - 5-10 1 _ - - - - - 10- 15 1 _ - - - - - 15- 20 5 3 - - - 1 - 20- 25 2 5 - - - 1 - 25- 35 2 3 - - 2 4 - 35- 45 2 2 - 1 - 1 - 45- 55 3 2 - - 2 - - 55- 65 3 - - - - - - 65 & Over - - - - 1 - - TOTALS 21 15 - 1 5 7 - TABLE 4. REGISTER OF TUBERCULOSIS. PULMONARY NON- PULMONARY. TOTALS.. MALE FEMALE. MALE FEMALE, Cases on Register at 1.l.47 96 64 13 19 192 \ - Cases notified for first time 1947. 21 15 - 1 37 Other cases added to Register 1947 3 1 - 1 5 Cases removed from Register 1947. 25 26 3 3 57 Cases remaining on Register 31.12.47. 95 54 10 18 177 TABLE 5. INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE. 1947. Under 1 week. 1-2 weeks, 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 mohths 3 months and under 6 months 6 months and under 9 months 9 months and undor 12 monthSi Total under 1 years. All Causes Certified. 7 3 1 1 12 4 1 1 1 19 Un-Certified. - - - - - - --- — ~ — Atelectasis 1 - - - 1 - - - - 1 Gastro-enteritis. 1 - - - 1 3 1 - - 5 Haemorrhage of the Newborn. - - - 1 1 - - - - 1 Intracranial Haemorrhaga. -- 1 - - 1 - - - - 1 Meningococcal septicaemia, - - - - - - - - 1 1 Pneumonia. - 1 - - 1 1 - 1 - 3 Prematurity. 5 - 1 - 6 - - - - 6 Ureamia. - 1 - - 1 - - - - 1