Borough of Heston and Isleworth ANNUAL REPORT of the Medical Officer of Health 1942 Public Health Department, 92, Bath Road, HOUNSLOW. To the Mayor, Aldermen and Councillors of the Borough of Heston and Isleworth. I Ladies and Gentlemen, I beg to.submit my Annual Report for the year 1942. As in recent years it is presented as a tabulated summary and the various items have been selected to show broadly the various activities of the Department. Certain vital statistics are given below which permit a comparison with the four years prior to the outbreak of war:- Year Birth Rate Death Rate Infant Mortality Rate Maternal Mortality Rate Still-birth Rate(per 1000 live & still-births) 1935 15.8 8.6 40.8 4.7 36 1936 15.7 9.1 48.2 1.9 30 1937 14.9 9.0 39.8 3.3 23 1938 14.2 8.6 45.9 2.7 30 1939 14.9 8.8 49.9 3.4 26 1940 13.7 12.3 58.1 2.3 25 1941 12.9 10.3 60.5 2.4 35 1942 14.6 10.2 72.1 2.8 32 The steady downward trend of the birth rate has been interrupted and there is no increase in the proportion of illegitimate births. The number of domiciliary confinements has not increased and the additional need due to the increased birth rate was met by hospitals and maternity homes. Apart from 1940, when enemy action was a significant cause of death, the death rate has remained very stable. It must be remembered that the large number of young men and women serving in the Forces is excluded from the population on which the rate is based. In other words the civilian population toiay contains a larger proportion of the young and old in whom the natural risks of death are high, but despite this the death rate shows little change. In 1942, 52 per cent of the deaths occurred in persons aged 65 years and over. The steady increase in the infant mortality rate during the last four years is a matter of some concern. The chief causes of infant deaths in 1942 were, gastro-enteritis, prematurity, pneumonia and congenital malformations. The first and third of these are preventable but only if young children are protected against infection and scrupulous cleanliness is maintained in regard to their feeding and general hygiene, An outbreak of infantile gastro-enteritis in West Middlesex Hospital contributed to the increase of deaths from this cause recorded in 1942. The maternal mortality remains at a low level and there are no indications of any adverse effect due to the present war conditions. The still-birth rate shows little change. Scarlet fever, measles and tuberculosis were more prevalent than in 1941. Deaths from tuberculosis were less than in 1941. Only 11 cases of diphtheria were notified and this is the lowest number of cases In the 47 years for which records are available. The attendance at the diphtheria immunisation clinics was the highest on record. At the beginning of the year clinics for the treatment of scabies were opened. Afternoon and evening sessions were held at Hounslow and Isleworth Health Centres but the attendances at l3leworth were so poor that in March all treatment was concentrated at Hounslow Health Centre, In May the evening sessions were discontinued as the number of persons attending was very small. Of 1317 persons summoned under the Scabies Order only 623 attended and the defaulters were chiefly fathers and sons and daughters in employment. On the advice of their doctors or voluntarily a further 916 persons attended. The total number of cases of scabies treated was 992 from 403 households. Owing to re-infeotion a further course of treatment had to be given to 105 persons. The present indications are that scabies is becoming less prevalent. Much time and energy was devoted to the provision of wartime day nurseries. On 2nd February, 1942,a nursery with accommodation for 55 children was opened in Hounslow and on 1st July a nursery for 35 children was opened in Isleworth, Parents make a contribution of 1/- per day, and the balance of the cost is borne by the Ministry of Health. Mothers and children continue to take advantage of all the maternity and child welfare facilities and increases are recorded in the attendances at ante-natal and infant welfare clinics. The municipal midwives attended 568 cases as compared with 531 cases In 1941. The issue of dried milk and vitamin preparation through the welfare centres Increases steadily. The school canteens and municipal restaurants provided by the Authority continue to be well patronised. In general it may be said that the general health of the civilian population is being maintained but some of the matters referred to above will require to be kept under constant review. A re-allocation of certain Civil Defence duties has permitted the Sanitary Inspectors to devote more time to their normal duties and this is reflected in the records of work done. Shortage of labour and materials and high costs are curtailing considerably the remedying of housing defects and deterioration in general housing conditions is taking place. Repair is restricted largely to keeping houses "wind and weatherproof and while present conditions continue nothing further can be done. At the end of the year 50 houses condemned as unfit for human habitation were still occupied. The volume of work falling to the Department and the difficulties in carrying it out continue to grow but the staff have loyally cooperated in keeping the wheels turning smoothly and efficiently, and in this respect I have been fortunate. I desire to express my thanks to the Chairmen and Members of the Committees for their support and consideration and to my colleagues in other departments for their ready co-operation. I remain, Your obedient servant, A.ANDERSON. Medical Officer of Health. GENERAL STATISTICS. 1942. 1941. Population (Registrar-General's estimate). 95,600 93,990 Number of inhabited houses (rate books). 27,521 26, 850 (estimated) Number of houses erected during year. - - Rateable value of Borough. £929,684 £941,043 Sum represented by a penny rate. £3,676 £3,792 (estimated) Live Births - legitimate - male. 679 586 - female . 662 579 illegitimate - male. 27 28 - female. 32 24 Birth rate per 1,000 population. 14.64 12.95 Birth rate per 1,000 population (England and Wales). 15.8 14.2 Still Births - legitimate - male. 22 23 - female. 23 18 - illegitimate - male. 1 1 - female. 1 2 Still Birth Rate per 1,000 (live and still) births. 32.48 34.89 Deaths - male. 516 476 - female. 454 492 Death Rate per 1,000 population. 10.2 10.3 Death Rate per 1,000 population (England and Wales) . 11.6 12.9 Infant Mortality Rate. 72.1 60.5 Infant Mortality Rate (England and Wales). 49 59 Maternal Mortality Rate. 2.76 2.43 Maternal Mortality Rate (England and Wales) 2.01 2.23 Out-relief disbursed to Heston and Isleworth residents. £16,908 £17,644 5. GENERAL PROVISION OF HEALTH SERVICES. 1942. 1941. Laboratory facilities - specimens examined. 583 702 District Nursing - visits paid. 32,519 30,832 Infant Welfare Centres - no. of sessions. - attendances, 557 561 (a) under 1 year. 17,274 15,046 (b) 1-5 years. 10,500 11,252 (c) all ages. 27,774 26,298 Ante-natal and Post-natal Clinics. Routine clinics - sessions. 259 229 - attendances. 4,847 3,965 Consultant clinics - sessions. 49 51 - attendances. 648 874 Total attendances. 5,495 4,839 Artificial Sunlight Clinic - children treated. 45 46 Orthopaedic Treatment - children treated. 24 8 Refraction Clinic - children examined. 45 56 Minor Ailments Clinic - children treated. 30 58 Speech Clinic - children treated. 3 1 Midwives - number notifying Intention to practice 49 50 - cases attended as midwife. 520 495 - cases attended as maternity nurse. 313 206 - percentage of cases where medical aid summoned. 37 37 - fees paid to medical practitioners. £238 £248 Municipal Domiciliary Midwife Service. No. of municipal midwives. 8 8 No. of cases booked - as midwife. 544 571 - as maternity nurse. 104 97 No. of cases completed - as midwife. 480 463 - as maternity nurse. 88 68 No. of visits - ante-natal. 3,391. 3,365 - post-natal. 9,928 9,479 6. 1942. 1941. Home Helps - no. of cases where home help provided. 46 54 Convalescent Homes - no. of mothers sent. - 1 - no. of children sent. 2 3 Health Visitors - no. employed. 12 12 - attendances at M.& C.W. clinics, etc. 1,972 1,547 - visits to mothers and children. 12,033 13,846 Child Life Protection. No. of foster children on register. 62 71 No. of visits by Health Visitors. 475 499 Dental Treatment of Mothers and Children. Total attendances of mothers and children. 2,554 2, 895 No. of extractions - mothers. 1,732 1, 633 - children. 384 882 No. of fillings - mothers. 470 335 - children. 262 215 No. of dentures supplied to mothers. ±±3 211 208 Milk and Other Poods Supplied Free or at Reduced Cost. Dried milk (lbs.). 1,314 799 National Dried Milk (lbs.). 4,135 5,554 Virol (lbs.). 10½ 39 Groats (tins) . 82 90 Cod liver oil (4 oz.). 17 204 Cod liver oil emulsion (8 oz.). 61 348 Cod liver oil and malt (lbs.). 36 131 Lactagol (tins). 272 265 Bemax (tins). 283 163 Adexolin (½ oz.). 186 414 Cod liver oil & malt with iron (lbs.). 122 328 Kalzana (tablets). 3,330 1,630 Celin (pkts. containing 34 tablets). - 80 Value of sales at cost price. £2, 279 £1,865 7. 1942 1941. Vitamin preparations distributed under Ministry of Food Scheme. Orange juice (bottles). 25,985 _ Black currant puree (tins). 11,496 2,670 Black currant juice (bottles). 1,920 475 Cod liver oil (bottles). 12,767 1,231 Municipal Restaurants. 2 2 Meals supplied at British Restaurants. 225,916 101,804 Nursing Homes. No. registered at end of year, - nursing homes. 1 1 - maternity homes. 1 1 - nursing and maternity homes. 1 1 Superannuation Acts. No. of employees examined. 15 18 Wartime Day Nurseries. No. of nurseries provided. 2 - Accommodation for children (0 - 5yrs.). 90 - Average daily attendance. 71 - Scabies Clinics. No. of persons called for examination. 1,317 - No. of above who attended. 623 - Total no. of persons who attended. 1,539 - No. of persons found to be suffering from scabies. 1,049 - No. of persons who completed treatment, 4 (a) under school age. 121 _ (b) school children. 555 _ (c) over school age. 316 _ No. of persons who did not complete treatment. 57 _ No. of persons in whom scabies recurred. 105 _ SANITARY CIRCUMSTANCES OF THE AREA. There was no significant change in the sanitary circumstances of the area as compared with 1941. A summary of the work of the * inspectors in regard to general sanitation is given below :- 8. 1942. 1941. Visits and re-visits re complaint or remedy of nuisances. 9,699 7,649 Inspections of piggeries. 9 1 Inspections of stables. 29 _ Inspections of urinals. f 10 10 Visits re infectious disease. 1,072 415 Smoke observations. 7 25 Inspections re offensive trades. 17 17 Inspections of tents, vans and sheds. 66 4 Inspections of common lodging houses. 4 8 Inspections of shops re sanitary arrangements. 2 _ Inspections of factories, workplaces, etc. 325 166 Houses disinfested. 56 19 Inspections of canal boats. 21 4 HOUSING. 1942. 1941. No. of new houses erected - by private enterprise. _ _ - by local authority. _ _ No. of houses inspected for housing defects. 308 256 No. of houses found unfit for human habitation. 2 - No. of houses rendered fit by informal action. 273 246 No. of houses rendered fit by formal action. 14 29 No. of houses demolished in pursuance of Demolition Orders. - 4 No. of houses rendered fit in pursuance of undertaking. _ 1 No. of houses in respect of which Demolition Orders were made. 1 - No. of houses where undertaking not to re-let accepted. 1 - No. of underground rooms closed. - - No. of houses known to be overcrowded at end of year. 74 64 No. of new cases of overcrowding found during year. 16 1 No. of cases of overcrowding relieved during year. 6 6 No. of houses demolished voluntarily. - 1 INSPECTION AND SUPERVISION OF FOOD. 1942. 1941. Inspections of dairies, etc. 161 48 Inspections of ice cream premises. 30 12 Inspections of bakehouses. 52 2 9. 1942 1941 Inspections of slaughterhouses. 4 11 Inspections of premises where food is sold or manufactured, - meat. 293 175 - fish. 101 52 - provisions. 414 126 - greengrocery and fruit. 149 73 - hawkers. 4 2 - food preparation. 110 30 - other foods. 253 161 Unsound food seized or surrendered (lbs.) 7,462 7,127 Unsound tinned food surrendered (tins). 5,855 1,164 PREVALENCE OP INFECTIOUS AND OTHER DISEASES. 1942. Cases Notified. Deaths. 1941. Cases Notified. Deaths. Smallpox. - - - - Scarlet fever. 190 - 117 - Diphtheria. 11 1 37 3 Erysipelas. 16 - 20 - Pneumonia. 72 67 124 41 Cerebro-spinal fever. 12 1 34 2 Epidemic encephalitis. - - 1 1 Poliomyelitis and polioencephalitis . - - 1 Typhoid fever. 4 - 2 - Paratyphoid fever. 1 - 30 _ Dysentery. 2 - - - Tuberculosis, 200 70 172 78 Ophthalmia Neonatorum. 3 - 5 - Puerperal pyrexia. 58 - 22 1 Measles. 1,085 2 580 - Whooping cough. 243 4 286 1 Non-notifiable Infectious Diseases. 1942. 1941. German Measles. 18 8 Chicken pox. 673 460 Mumps. 1,032 352 Disinfection - no. of rooms disinfected. 255 192 10. 1942 1941 Hospital Treatment of Infectious Diseases. Total cases treated in hospitals. 248 370 Diphtheria Immunisation. No. of attendances at clinics. 16,098 12,846 No. given certificates after immunising. 2,089 1,989 No. submitted to primary Schick test. 2,986 3,094 - Schick positive. 2,751 2,916 - Schick negative. 235 178 No. of cases of diphtheria in immunised persons. — 3 No. of deaths from diphtheria in immunised persons. TABLE OF CAUSES OF DEATHS DURING 1942. (According to figures furnished by the Registrar General). Causes of Death. Civil Residents all ages. All causes Male. Female. 516 454 1 Typhoid and paratyphoid fever _ _ 2 Cerebro-spinal fever 1 _ 3 Scarlet Fever - _ 4 Whooping cough 3 1 5 Diphtheria 1 _ 6 Tuberculosis of respiratory system 34 23 7 Other forms of tuberculosis 7 6 8 Syphilitic diseases 6 2 9 Influenza 1 2 10 Measles 2 _ 11 Acute polio-myelitis and polio-encephalitis - _ 12 Acute infectious encephalitis - _ 13m Cancer of buccal cavity and oesophagus ... 7 _ 13f Cancer of uterus - 11 14 Cancer of stomach and duodenum 12 11 15 Cancer of breast — 16 16 Cancer of all other sites 54 37 17 Diabetes 4 2 18 Intro-cranial vascular lesions 50 50 19 Heart disease 117 97 20 Other diseases of circulatory system 18 18 21 Bronchitis 24 22 22 Pneumonia 32 29 23 Other respiratory diseases 6 3 24 Ulceration of stomach or duodenum 10 1 25 Diarrhoea under 2 years 13 15 26 Appendicitis 3 3 27 Other digestive diseases 10 7 28 Nephritis 7 18 29 Puerperal and post-abortive sepsis - 1 30 Other maternal causes _ 3 31 Premature birth 10 9 32 Cong, malformations, birth injury, etc. 14 5 33 Suicide 5 2 34 Road Traffic Accidents 5 2 35 Other violent causes 12 11 36 All other causes 48 47 11.