ISL 78 METROPOLITAN BOROUGH OP ISLINGTON ANNUAL (INTERIM) REPORT OF THE MEDICAL OFFICER OF HEALTH, G. CLARK TROTTER, H.D. , D.P.H., F.R.S.E., for the year 1939. -1- METROPOLITAN BOROUGH OF ISLINGTON ANNUAL (INTERIM) REPORT OF THE MEDICAL OFFICER OP HEALTH for the year 1939• POPULATION. Registrar-General's estimate of (a) resident population, mid 1939 288,100 (b) average population appropriate to the calculation of death rates 272,300 Total M. F. LIVE BIRTHS. Legitimate 3,923 1,986 1,937 Birth Rate per 1,000 esti- IllegitiMate 245 118 127. mated resident population 14.47 STILL BIRTHS. Legitimate 120 68 52 Rate, per 1,000 Total Illegitimate 10 5 5 (live and still births) 30.24 DEATHS. 3,485 1,813 1,672 Death Rate per 1,000 mated average population. 12.79 DEATHS FROM PUERPERAI, CAUSES: Deaths Rate per 1,000 total (live and still) births. • Puerperal Sepsis 2 0.49 Other puerperal causes. 4 0.98 Total. 6 1.47 DEATH RATE OF INFANTS UNDER ONE YEAR Of AGE All infants per 1,000 live births 50 Legitimate infants per 1,000 legitimate live births 47 Illegitimate infants per 1,000 illegitimate live births 90 NOTIFICATION OF BIRTHS: The total number of notified births including stillbirths, from all sources was 3,579. Of this number, 398 were not notified by midwives. CLASSIFICATION OF DEATHS: The causes of deaths (3,485) were as follows: Typhoid and Paratyphoid Fevers 0, Measles 0, Scarlet Fever 0, Whooping Cough 12, Diphtheria 10, Influenza 50, Encephalitis Lethargica 6, Cerebrospinal fever 3, Tuberculosis of respiratory system 225, other Tubercalosis diseases 29, Syphilis 10, General paralysis of the Insane 15, Cancer 509, Diabetes 38, Cerebal haemorrhage 116, Heart disease 930, Aneurysm 21, other circulatory diseases 199, Bronchitis 152, Pneumonia 238, other respiratory diseases 25, Peptic Ulcer 53, Diarrhoea 62, Appendicitis 18, Cirrhosis of Liver 6, other diseases of liver 15, other digestive diseases 70, Nephritis 67, Puerperal Sepsis 2, other puerperal causes 4> Congenital Debility, Premature birth, malformations etc. 93, Senility 68, Suicide 42, other Violence 152, other defined diseases 245, Causes ill defined or unknown 0. INFANT MORTALITY: There were 204 deaths of infants under one year of age. The causes of deaths were as follows:- Diptheria 1, Nonpulmonary Tuberculosis 1, Cerebro-spinal feVer 1, Bronchitis 4, Pneumonia 33, Congenital Malformations, Premature Births, Malformations etc. 92. Whooping Cough 7, Influenza 3, Syphilis 1, Canccr 2, Diarrhoea 44, Other digestive diseases 5,Other violence 7, Other defined diseases 3. -2- PROVISION OF HEALTH SERVICES IN THE BOROUGH BACTERIOLOGICAL EXAMINATION: The number of bacteriological and other examinations carried out were 1,186 for the bacillus associated with Diphtheria, 293 for Tuberculosis, and 24 for Enteric Fever. NURSING IN THE HOME: The following payments were made to the North London Nursing Association:- Opthalmia Neonatorum £1. 17• 6d. Maternity & Child Welfare Visits £23.2. 6d. Public Heath. £18. 6. 3d. CLINICS AND TREATMENT CENTRES: The grants to the four voluntary infant elfare centres to March 1939 were:- North £5,809 (includes special grant of £54) South -£2,776 East £2;l43.3.6d. £6. 3. 6d. West - £2,154. The total attendances at the Evening ante-natal and post-natal clinics were 66. 17 Sessions were held. The Naternity Consultation Day-Clinic closed in May 1939. The total attendances were 15. 9 ante-natal and 4 post-natal were seen at the 6 sessions. Details of the centres' work etc. is found later in the report. HEALTH VISITORS: The total number of visits made by the Health Visitors was 25,736. CHILD LIFE PROTECTION: 1193 visits (including miscellaneous visits) were made to foster mothers. Number of persons receiving children at end of year 50. Number of children at end of year 83. HOME HELPS: 178 Cases were attended by the Home Helps - the nett cost to the Council being £516. 9. 5d. SUPPLY OF MILK TO MOTHERS AND YOUNG CHILDREN: The total quantity of milk supplied was as follows: 481,710 pints at a cost to the Borough Council of £6,695. 8. 2d. The number of recipients was 20,199. SANITARY CIRCUMSTANCES AND ADMINISTRATION During the year 38,646 inspections (including re-inspections) were carried out by the Sanitary Inspectors. The number of inspections of Factories, etc., was 6,763. 874 defects were found and remedied in 848 instances. RATE & NICE (DESTRUCTION) ACT, 1919. WORK OF SANITARY INSPECTORS DURING YEAR 1939. No. of complaints 152 Private houses visited 215 Shops and Factories 45 TOTAL promises inspected 260 No. of streets visited 113 No. of promises found rat infested 90 " " " " mice " 9 No. of notices served 6l Defective drains repaired 20 (cause of rat trouble) -3- DISINFECTION: During the year 1,046 disinfections were carried out after cases of infections or other diseases. Of these 175 were rooms which had been occupied by tuberculous persons. In addition 106 rooms and 38 bundles of bedding were disinfected for the presence of vermin. At the disinfecting station 45,018 articles of bedding etc., were disinfected. CLEANSING STATION: The number of adults cleansed or treated at the station was 178. Under the scheme arranged with the London County Council 4,896 children attending elementary schools were cleansed at the Station. HOUSING The total number of dwelling houses inspected for housing defects was 483, the number found not to be in all respects reasonably fit for human Habitation being 483. OVERCROWDING: Whenever possible, arrangements are made with the London County Council for the provision of accommodation for over-crowded families. Further, when vacant tenements become available in the Borough Council's dwellings, preferential treatment is as far as possible given to cases of overcrowding. FITNESS OF HOUSES: The general standard of housing in the Borough is satisfactory. INSPECTION AND SUPERVISION OF FOOD MILK: The number of milk premises on the Register is 637 and 1,275 inspections were made. 36 Notices were served and 17 warning letters sent, requiring rectification of defects. 45 samples of milk were submitted for bacteriological examination. MILK (SPECIAL DESIGNATIONS) ORDER: Two licences to sell "Accredited" milk, 28 to sell "Tuberculin Tested" milk, 111 to sell "Pasteurised" milk and 12 Supplementary licences were granted during the year. PUBLIC HEALTH (MEAT) REGULATIONS 1924: 12 Traders were warned during the year. INSPECTION OF OTHER PREMISES WHERE FOOD IS PREPARED OR OFFERED FOR SALE: The Inspector keeps under frequent observation all such premises. 3,461 inspections were made. UNSOUND FOOD: Food destroyed totalled 3 tons 4 ewts. 1 Qtr. 3 lbs. FOOD AND DRUGS ACT: During the year 1,140 samples were submitted to the Public Analyst for analysis. Of these 524 were taken as "formal" and 6l6 "informal". INFECTIOUS DISEASE AND OTHER DISEASES NOTIFIABLE DISEASES AND DEATHS DURING THE YEAR 1939. DISEASE. TOTALS . Total Cases removed to Hospital. ScarletyFever Notified Deaths 444 402 Diphtheria Notified 254 252 Deaths 10 10 Enteric Fever Notified 6 6 (including Paratyphoid) Puerperal Fever Deaths Notified 8 6 Deaths 2 2 Puerperal Pyrexia Notified Deaths 69 62 Acute Primary & Notified 176 65 Influenzal Pneumonia Deaths 16 11 Opthalmia Neonatorum Notified Deaths 17 9 Cont'd. -4- INFECTIOUS DISEASE AND OTHER DISEASES (Cont'd): DISEASE. TOTAIS. Totsl Cases removed etc hospital. Eneephalitis Lethargica Notified – – Deaths 4 4 Cerebro Spinal Fever Notified 10 10 Acute Poliomyelitis Deaths Notified 3 3 Deaths Dysentery Notified 7 7 Deaths 2 2 Malaria Notified 3 2 Deaths 2 - Erysipelas Notified 111 62 Deaths 5 5 Chicken Pox Notified 185 35 Deaths Measles Notified 46 9 Deaths Whooping Cough Notified 485 59 Deaths 12 9 SMALIPOX AND VACCINATION: No case of smallpox was notified. Of the 3,874 births registered in Islington during 1938, 1,706 were successfully vaccinated. (Figures for 1939 arc not yet available). TUBSRCULOSIS: There were 448 new cases of pulmonary and 8.1 of non-pulmonary tuberculosis. The total number of deaths from all forms of Tuberculosis was 254, the death rate being 0.93 per 1,000 of the average population. TUBERCULOSIS NEW CASES AID MORTALITY DURING 1939. NET/CASES DEATHS Age Periods Respiratory Non-Respiratory Respiratory Non-Respiratory M F M F M F M ] 0- 2 – 1 – – – 1 – 1- 3 3 8 2 – - 3 2 5- 6 7 11 10 - 2 1 1 15- 56 69 7 13 15 19 6 3 25- 61 55 8 9 35 27 2 2 35- 34 24 3 1 27 10 2 1 45- 48 16 - 2 21 10 1 - 55- 32 17 1 2 32 9 - 2 65 and upwards 13 2 2 1 15 3 2 – 255 193 41 40 145 80 18 11 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. The total number of eases of tuberculosis in the Borough on 31st December, 1939, was 1,952. (Pulmonary Hales 843, Females 685, Non-pulmonary - Males 201, Females 223). DISPENSARY CASES: 293 specimens of sputum were examined. Diagnosis Pulmonary Non-Pulmonary TOTAL GRAND Adults Children Adults Children Adults Children TOTAL M. F. M. F. M. F. M. F. H. F. M. F. D. Number of definite cases of Tuberculosis on the Dis- 560 457 43 38 53 81 49 47 613 538 92 85 1,328 pensary Registers at the end of the year. -5- ARTIFICIAL PNEUMO–THORAX TREATMENT: 94 pationts received treatment. The total cost (£384. 6. 0.) was borne by the Council. EXTRA NOURISHMENT: 138 cases received extra nourishment as part of their treatment. The total cost (£359.6.11d.) was borne by the Council, LIGHT TKBATtSEHT: One patient received treatment, the Borough Council making a contribution of £1. 2. 0. towards the cost. BEDS & BEDDING: Five patients have been provided with beds and bedding under this scheme. DENTAL TREATMENT: Two patients received treatment. TUBERCULOSIS CARE C0MMIITEE: The Committee helped 130' cascs during the year. SUMMARY OF PROSECUTIONS DURING YEAR 1939. TOTAL Prosecutions. Success ful. Dismissed. Withdrawn. Amount of Penalties. Costs received. £ s. d. £ s. d. Public Health (London) Act 1936. 43 41 – 2 51. 9. 6. 53. 0. 0. Food & Drugs (Adulteration) Act 1928. 7 6 1 – 4. 0. 0. 4. 12. 6. Food & Drugs Act, 1938. 1 1 - - 1. 0. 0. Pharmacy & Poisons Act, 1933. 2 2 – – 2. 0. 0. 2. 0. 0. Agricultural Produce (Grading & Marking) Act, 1928. 1 1 – – 2. 0. 0. 2. 2. 0. Merchandise Marks Act, 1887 to 1926. 1 1 – – 10. 0. –• –• –• Rats & Mice(Destruction) Act, 1919. 1 1 –. –. 5. 5. 0. 5. 5. 0. Housing Act, 1936. 5 2 –. 3 2. 0. 0. 4. 2. 0. 61 55 1 5 £68. 4. 6. £71. 1. 6. VOLUNTARY WELFARE CENTRES & DAY NURSERIES. SUMMARY OF WORK. North South East West Total 1. PRE-NATAL CLINICS:- Number hold weekly 3 2 *1 1 *7 of expectant mothers who attended 485 135 216 188 1,024 2. POST-NATAL CLINICS:- Number held weekly 1 2 *1 *1 *5 " of mothers who attended. 131 119 81 57 388 3. CONSULTATION'S FOR CHILDREN UP TO 5 YEARS OF AGE:- Total number of children who first attended at the centres during year, and who, on the date of their first attendance were:- (i) Under 1 year 980 571 501 615 2,667 (ii) 1-5 years 176 50 1ll 108 445 Cont'd. -6- VOLUNTARY WELFARE CENTRES & DAY NURSERIES. (Cont'd): North South East West Total 4. HOME VISITING-:- Number of visits made to:(i) iixxijctant mothers- (a) first visits 333 94 192 139 808 (b) Total visits 1852 261 817 292 3222 (ii) Children under 1 yearTotal visits 4563 3551 2652 14906 (iii) Children 1-5 years 5529 7261 459O 4432 21812 5. Number of children who attended at the Centres during the year, and who, at the end of year, were:- (i) Under 1 year 812 503 332 497 2144 (ii) 1-5 years 1597 1402 739 1122 4860 * Last Centre - 1 Clinic weekly + 2 others per month. † East and West Centres. Post-Natal Clinics arc held with their pre-natal clinics. MIRIAM PRICE COLEMAN DAY NURSERY ATTENDANCES 1939. Whole day Half day To cal January 567 137 704 February 610 133 743 Manoh 372 125 997 April 712 52 764 May 800 51 851 June 1067 87 1154 July 1010 87 1097 August 450 -49 "lf.99 September Day-nursery closed. (Wednesday August- 30th, 1939) WAR. Octobcr November Dccombor 6088 721 6809 SUNLIGHT CLINIC 1939. ATTENDANCES: Children Adults January 219 ~ February 252 11 March 309 19 April 254 23 May 103 11 (last clinic May 12th) 1137 64 HOSPITAL GRANTS - 1939. Contributions for maternity cases admitted to beds at Matcrnity Hospitals at the rate of 10/- per case were:- City of London Maternity Hospital - £30. 10. 0. Royal Free Hospital - 3. 10. 0 University College Hospital - 23. 0. Q. £57. 0. 0. 7 VOLUNTARY DAY-NURSERIES:- No, of attendances Council Grant Year March 31st, 1940. (i) Lower Holloway Day Nursery 6010 £260. (ii) South Islington (Pro Patria) Day Nursery 12703 £600. (iii) St.Luke's Day Nursery (Closed April 19.39). PUBLIC HEALTH STAFF The staff of the Medical Officer of Health (G.CLARK TROTTER, K.D., D.P.H., F.R.S.E., ) is constituted as follows:- Assistant Medical Officer of Health VICTOR FREEMAN, M.R.C.S., L.R.C.P., D.P.H., Assistant Medical Officer KATHSRINE M. HIRST, M.B.; B.S.(Lond.) D.P.H., M.M.S.A., Superintendent of Public Health Department and Chief Sanitary Inspector (a.b.c.) GEORGE JAMEBBRIDEL, M.R.San.I., M.S.I.A., Sanitary Inspectors. (a. b. c.) T.H.Hancock (Housing) (c. d.) H.R.Homewood. (b. d.) S.P.Marks (c. d.) A.W.Haydock (inspector of Meat) (b) E.G.Holmes (Factories & (c. N.) Lightowlers. (b.d.) Bakehouses) (c) W.Riding. A.E.Wood. (c. d.) R.W.Norman (Dairies etc.) (b) H.H.Uren. (c) L.Nash. (b. d.) G.S.Green (Shops) (c. d.} H.P.Price (b.d.) C.W.S.Lewis (Pood & Drugs) (c.d.) R.B.Girling (b) L.H.Pearson B.V.Crycr (c) J.S.Ashworth (Housing) (c.d.) V.Croft. (c) A.Moxon. (c) A. K .D. Shattleworth (c. d.) V.C. Bartlett. (c) S.A.C. Lord. (c) J.W.Aiken. Inspectors of Factories, etc., vrhere females are employed. (b.e.f.) Miss E.H.Daniell. (b.e.f.) Mrs. S. Undery. Health Visitors. (e.f.g.) Miss L.Flower (e.f.g.} Miss E. Paley (e.f.g.) Mrs*A.Main (e.f.g.) Miss S.II.Prentice (e.g.) Miss E.Oliver (e.f.g.) Miss B.K.Anderson (Child Life (e*f.g.} Miss J. Devine Protection) (e.f.g.; Miss F.H.Harris (e.f.g.) Miss M.O'Sullivan (e.f.g.) Miss O'Riordan (Temporary) (g) Miss E.McGoldrick. Tuberculosis Visiting Nurse, (a) - Cert.Sanit.Inst. (e)= S.C.M. (b) = Cert.Sanit.Insp.Exam.Board. (f)= Cert.h.v. (c) - Cert.Sanit.Insp.Exam.Joint Board. (g)=S.R.N. (d) = Meat Inspector's Certificate. Miss K.I.C.Hadley, Secretary, Tuberculosis Care Committee. Clerical Staff: W.J.Wolfe (Chief Clerl:) C.M.Wheble, W.R.Causton, W.G.Bunch, A.R.Wittrick, C.J.Cridland, S.A.Brown, L.Edis, W.A.IjcAdam, A.E.Vanstone, lass D.Egginton, G.E.Borrett, Miss D.Francis, P.L.Regan, G.W.C.Cassidy, M.Crawford, D.Owen, C.J.Moore, E.W.C.George, Miss I.W.Yeowe11 and Miss J.B.D.Martin (Temporary Clerks). A.R.P. 8 Teraoorary Clerks in place of Messrs. Cassidy, Oravferd and. Moore, (on Military Service). T. Horsley, H.J• Rutland, 0.L. Themas. Staff Officer - Stretohe r Parties, Mr. S. H. P. James. Vaccina.tion Officers. J. Jennings. L. Stevens. Member-, of the Staff of the Miriam Price Coleman Day Nursery and Clinics Centre. Miss K.S. Edwards. Matron. S.R.N., S.0.M., lass N. Elliott- Senior 'Nurse. S.R.N., Miss K. Mulcare Staff Nurse. Mrs. Mant. Non-resident Cleaner. Miss B.Gammons Non-Resident General Domestic. Mr. P. Jaynoy. Noh-Resident Caretaker. Disinfecting Station. W.Hampshire (Engineer) W.G.Jollie (Handyman-, Stoker) Mrs.N.Hampshire (Caretaker. Shelter House) Mrs. A.H. Crook (Children's Bathing Attendant) G.Cooper (Motor Driver) S.G.Norman (Assistant Motor Driver). Disinfectors. A. Taylor. A.Starling. S.Gictingi. Dxsinfactor and Caretaker of. Mortuary. C.Holcombe. public Analyst. Alan W. Stewart, D.Sc., 23 Queen Square, W.C.l. Members of Staff of Public Health Department retired in 1939. Miss R.Palmer. Health Visitor. Mr.P.C.Green. Clerk. Mr .W. Handroick. • Disinfector. G. CLARK TROTTER. Medical Officer of Health. 28th October, 1940.