Hornchurch Urban District Council INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH 1940 ALFRED BALL, M.D., D.P.H., Medical Officer of Health, \V. & W. Ltd., Romford. 2 MEMBERS OF THE COUNCIL. Councillor W. G. Bunch, J.P., Chairman. (1) and (2) Councillor Mrs. F. Siierring, Vice-Chairman. (2) Councillor Mrs. E. M. Field. (2) ,, Mrs. A. J. E. King. (1) and (2) ,, Mrs. E. J. Reynolds. (1) and (2) Mrs. H. S. E. Williams. (3) ,, E. W. J. W. Bush. (1) ,, A. Ferguson. (1) ,, A.C.Holmes. (1) A. S. Hulkes. (1) ,, C. J. Josephs. ,, T. Martin. ,, J. W. Mathews, J.P. ,, W. H. F. Maunder. (1) ,, A. W. Pettit. ,, A. C. Salinger. ,, B. L. Tarr. ,, A. J. Twigger. H. H. Wake, J.P. W. H. F. Webb. (1) ,, T. F. Willoughby. (1) Member of the Public Health and Housing Committee. (2) Member of the Romford Joint Hospital Board. (3) Chairman of the Public Health and Housing Committee. OFFICERS OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: Alfred Ball, M.D., B.S. (Lond.), M.R.C.S. (Eng.), L.R.C.P. (Lond.), D.P.H. (R.C.P.S.) Lond. Sanitary Inspectors: L. Ager, San. Insp. Cert. R.S.I. Cert. Insp. of Meat and Other Foods. C. S. Smith, San. Insp. Cert. R.S.I, and S.I. Joint Board. Cert. Insp. of Meat and Other Foods. S. H. Beyer, San. Insp. Cert. R.S.I, and S.I. Joint Board. Cert. Insp. of Meat and Other Foods. A. Y. J. Hutciiings, San. Insp. Cert. R.S.I, and S.I. Joint Board. Cert. Insp. of Meat and Other Foods. Clerk: J. E. Blay, 3 COUNCIL OFFICES, HORNCHURCH, November, 1941. To the Chairman and Members of Ike Hornchurch Urban District Council. Mu. Chairman, Ladies and Gentlemen, I have the honour herewith to present in abbreviated form a report on the work of the Public Health Department for the year 1940. In accordance with the suggestion of the Minister of Health this is an interim report, and the fuller records, including the statistics supplied by the Registrar-General, will be preserved in order that after the termination of the war a report may be made dealing more fully with the period from the beginning of 1939 to the end of the last complete year, giving separate statistics for each year in order that the annual records may as far as practicable be continuous and complete. I wish to thank the members of the Council for the support which they have given me in my work and also to acknowledge the assistance which I have received from the staff of the Public Health Department and from my fellow, officers. ALFRED BALL, M.D., D.P.H., Medical Officer of Health. 4 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area in acres 19,768 Registrar-General's estimate of the resident population (mid-year) 1940 81,050 Number of inhabited houses (end of 1940) according to Hate Books 26,938 Rateable Value (September, 1940) £674,912 Sum represented by a Pennv Rate (September, 1940) £2,550 Social Conditions. Much of the district is residential and many of the inhabitants travel daily to work in other areas. There are, however, still large portions of the district in which agriculture is the main industry and in addition there are a few factories giving occupation to many persons. There are no conditions of occupation or environment which have had a prejudicial effect on health. Vital Statistics. Extracts from the Vital Statistics of the year. The figures of net births and deaths after correction for inward and outward transfers have been supplied by the Registrar-General. Live Births:— Male. Female. Total Rate. Legitimate 670 627 1,331 Illegitimate 18 16 Birth rate per 1,000 estimated mid-1940 population 16.4 Still Births Legitimate 21 12 34 Illegitimate 1 0 Rate per thousand total (live and still) births 0.41 Deaths 401 367 768 Death rate per ] ,000 estimated population 9.4 5 Deaths from Puerperal Causes:— Total. Rate. (a) from Puerperal Sepsis 2 (b) from other puerperal causes 0 (c) rate per thousand total (live and still) births 1.5 Death rate of infants under one year of age:— All infants per thousand live births 49 Legitimate infants per thousand legitimate births 48 Illegitimate infants per thousand illegitimate live births 88 Deaths from Measles (all ages) 0 ,, ,, Whooping Cough (all ages) 0 Diarrhoea (under 2 years of age) 4 Cancer (all ages) 117 There has been no unusual or excessive mortality during the year. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. (1) Laboratory Facilities. The comprehensive laboratory facilities included in the County scheme, which have been described in previous reports, were again available and were- much used. The pathological specimens examined by the County Bacteriologist during the year included:— 132 Throat swabs for K.L.B. 41 nasal swabs for K.L.B. 10 throat swabs for haemolytic streptococci. 215 sputum for tubercle bacilli. 16 specimens of urine. 3 samples of blood for Widal test. 5 samples for ringworm. 2 blood films. 13 samples of pus. 4 miscellaneous. (2) Ambulance Facilities. The Council ambulance has continued to serve the District adequately and the co-ordinated services with the Borough of Romford and with the Essex County Council have proved satisfactory. 6 (3) Nursing in the Home. Owing to lack of financial support the Homchurch Nursing Association disbanded during the year. There are now only two nursing associations functioning in the Urban District, viz. (i) the Upminster and Cranham, and (ii) the Iiainham Association. The remaining parts ot the District which are not served by any scheme for nursing in the home contain about two thirds of the total population. (4) Treatment Centres and Clinics. Maternity and Child Welfare Clinics are carried on by the County Council which is the Welfare Authority at the following centres:— (i) North Street School. (ii) Church Hall, Park Lane. (iii) 61, Athelstan Road, Harold Wood. (iv) St. Lawrence Hall, Upminster. (v) Church Hall, Rainham. (5) Hospitals. An E.M.S. Hospital has been established in the precincts of the Hospital in this District which is owned by the County Borough of West Ham. This E.M.S. Hospital contains 500 beds and is staffed by a Medical Superintendent and three assistant medical officers. SECTION C. The Council recognising the importance of maintaining as far as practicable the general Public Health work in the District have decided that the Public Health staff should continue their normal activities as far as possible. Three of the Sanitary Inspectors have therefore spent most of their time on normal duties. Such additional work as paying visits to occupied houses to ascertain their suitability as billets for homeless persons; visiting public air-raid shelters; inspecting foodstuffs which may have been damaged in consequence of enemy action being added to their work. The fourth Sanitary Inspector has devoted much time to lecturing and other A.R.P. duties. 7 SECTION D. HOUSING. During tlie year, 66 houses were completed by private builders and housing certificates were issued. No houses were built by the Council. SECTION E. CONTROLLED TRADES. The inspection of dairy farms has been continued and endeavours made to overcome the difficulties in clean milk production caused by shortage of staff, black-out conditions, etc. An additional farm lias been licensed by the County Council for the production of accredited milk during the year. Meat. There are now 4 slaughterhouses in the District which under section 57 of the Food and Drugs Act are licensed annually. None of these premises is being used for slaughtering animals during the war, in accordance with the terms of the Livestock (Restriction on Slaughtering) Order, 1940, which came into operation on 15th January, 1940. Knackers Yard. The building in Cranham previously licensed for use as a slaughterhouse is now licensed by the Council as a Knackers Yard. The use of these premises has been kept under regular supervision and the carcases of the beasts killed which are sold for animal food have been inspected. Under the Livestock (Restriction on Slaughtering) (No. 2) Order, 1940, all meat derived from such animals not intended for human consumption must be coloured with a green colouring matter, as soon as practicable after slaughter. 37 bovine animals and 3 others have been killed during the year in the Knackers Yard, 8 SECTION F. PREVALENCE OF AND CONTROL OYER INFECTIOUS DISEASE. During the year there was a noteworthy outbreak limited m numbers of two diseases. Cerebrospinal Fevex and Typhoid Fever, which are of infrequent occurence in this District. Of the former, 17 cases, of which 2 were fatal, occured during the year. Their distribution in Wards was as follows: Emerson Park, 3; Harold Wood, 3; North-West, 3; Thameside, 3; Town, 3; Upminster, 2. All were removed to hospital. A girl, aged 4 years, died early on the second day of disease. The other death was that of a man, aged 35 years, who died on the seventh day of disease. No two cases occurred in the same house or in the same family. There were 17 cases of Enteric Fever, including 1 Typhoid and 16 Paratyphoid B. All were removed to hospital and made good recoveries. It was not found possible to elicit any common infecting agent for the cases comprising this small outbreak and no evidence pointed to milk or water as the vehicle of infection. Four cases occurred in one family but all the others were single cases. The incidence of Scarlet Fever was less but the number of Diphtheria cases was slightly more than last year when 214 cases of Scarlet Fever and 27 cases of Diphtheria were notified. Under the Measles and Whooping Cough Regulations, 61 notifications of the former and 10 of the latter were received. In the following table are shown the number of cases notified, removed to hospital, etc.: Disease. Total Number of Cases Died. Notified. Admitted to Hospital. Smallpox 0 0 0 Scarlet Fever 97 58 0 Diphtheria 42 42 2 Enteric Fever 17 17 0 Cerebrospinal Fever 17 17 2 Puerperal Pyrexia 7 3 2 Erysipelas 11 3 0 Pneumonia 67 26 34 Measles 61 2 0 Whooping Cough 10 0 0 Ophthalmia 5 2 0 Tuberculosis. During the year, 78 primary notifications of pulmonary and 13 of non-pulmonary Tuberculosis were received.