LIBRARY LEW 28 METROPOLITAN BOROUGH OF LEWISHAM REPORT of the MEDICAL OFFICER OF HEALTH for the year 1940 John W. Miller, M.B., Ch.B., D.P.H. Medical Officer of Health ---oOOo--- Public Health Department, Lewisham Town Hall, Catford, S.E.6. 16 MAY 1942 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lewisham. Mr. Mayor, Ladies and Gentlemen, I beg to submit my Annual Report on the health and sanitary conditions of the Borough for the year 1940. In accordance with the instructions of the Ministry of Health it is an abridged report, like that of the previous year, and records only essential vital and other statistics. The Registrar General's estimate of the resident population shows a considerable decrease - 192,540 compared with 220,300 in 1939 - which is no doubt due to evacuation and war conditions. The death rate increased from 10.79 in 1939 to 15.8 per thousand in 1940 and compares with 17.8 for the County of London. The increase is mainly attributable to the large number of deaths classified as "Other Violent Causes", which includes deaths due to war operations. The incidence of infectious disease was remarkably low, and no serious outbreak of epidemic disease of any kind occurred, although the risk of such outbreaks was considered to be serious owing to the adverse conditions associated with air raid shelter life, The number of cases of Tuberculosis notified was also lower than in 1939. Generally speaking the health conditions of the Borough were satisfactory, and not with standing the difficult war conditions all the essential services were maintained. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, JOHN W. MILLER, Medical Officer of Health. SUMMARY OF VITAL STATISTICS Area of the Borough 7,015 Acres. Population Census 1931 219,953. June 1940 (Registrar General's estimate) 192,540. BIRTHS Live Births. Total Males Females. Legitimate 2722 1393 1329 Illegitimate 111 55 56 2833 1448 1385 Birth. Rate per 1,000 of the estimated population 14.7 (Rate for London) 13.7 Number of Stillbirths Males 43, Females 27, Total 70. Rate per 1,000 total (live and still) births 24.7 DEATHS Total 2898.(Males 1448; Females 1450). Death Rate per 1,000 of the estimated population:Crude 15.05; Corrected 15.8. (Rate for London) 17.8. Deaths from Puerperal Causes. Deaths Rate per 1,000 (live and stillbirths). Puerperal Sepsis. 1 0.38 Other Puerperal Causes. 2 0.76 Death rate of Infants under 1 year of ago All Infants per 1,000 live births 45 Legitimate Infants per 1.000 legitimate live births. 41 Illegitimate ,, ,, ,, illegitimate live births. 140 Deaths from Measles (all ages) 1 ,, Whopping Cough, (all ages) - ,, ,, Diarrhoea (under .2. years) 21 ,, ,, Cancer (all ages) 342 ,, ,, Tuberculosis 149 - 2 - CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING- THE YEAR 1940. List No. Causes of Death. Ages at Death Under 1 year. 1 and under 5. 5 and under 15. 15 and under 45. 45 and under 65. 65 and upwards. TOTALS All Ages. 1.Typhoid and Paratyphoid . . . . . . . 2.Cerebro Spinal Fever 1 1 1 . . . 3 3.Scarlet Fever • . . • . . . 4.Whooping Cough . . . . . . . 5.Diphtheria • . 4 1 1 . 6 6.Tuberculosis of Respiratory System . . 1 91 35 2 129 7.Other Tuberculosis • 2 6 6 2 4 20 8.Syphilitic Diseases • . . 2 9 8 19 9 . Influenza • 1 . 3 15 10 29 10.Measles 1 . . . . • 1 11.Ac. Poliomyelitis and Polioencephalitis . . . 1 . . 1 12.Ac. Infectious Encephalitis (Lethargic) . . . 3 . . 3 13.Cancer, Buccal Cavity and Oesophagus . . . . 20 18 39 14.Cancer, Stomach and Duodenum . . . 5 25 35 65 15.Cancer, Breast . . . 2 16 14 32 16. Cancer, all other sites . 1 1 17 84 103 206 17. Diabetes • . . 3 14 20 37 18 Cerebral Vascular Lesions . . . 4 34 137 175 19 .Heart Diseases . . 1 32 166 493 692 20.Other Circulatory Diseases . . . . 15 67 82 21.Bronchitis 1 . . 1 49 152 203 22.Pneumonia 21 2 2 10 25 54 114 23.Other Respiratory Diseases . 1 . 4 17 14 36 24. Ulcer, Stomach and Duodenum . . . 8 21 12 41 25. Diarrhoea (under 2 years) 20 1 . . . , 21 26.Appendicitis . 1 . 4 3 1 9 27.Other Digestive Diseases . 1 1 7 13 24 46 28.Nephritis • • 1 9 25 25 60 29.Puerperal and Post Abortive • . . • 1 . 1 30.Other Maternal Causes . • • 2 • • 2 31.Premature Birth 29 • . . • • 29 32.Congenital Malformations, Birth Injury, Infantile Diseases, 33 1 • 4 • • 38 33.Suicide . « * 5 9 3 17 34.Road Traffic Accidents . • 2 8 2 6 18 35.Other Violent Causes 9 17 44 187 134 99 490 36.All other causes 4 2 7 31 42 148 234 TOTALS ALL CAUSES. ■ 119 31 71 451 777 1449 2898 - 3 - I INFECTIOUS DISEASES. Number of cases notified (omitting Tuberculosis) and Deaths during the year 1940, Disease. Total cases Notified. Cases admitted to Hospital. Total Deaths. Cerebro-Spinal Fever 30 30 3 Diphtheria 78 76 36 Dysentory 7 6 - Enteric Fever 7 6 - Erysipelas 53 37 - Food Poisoning 4 - - Measles 119 32 1 Ophthalmia Neonatorum 7 3 - Pneumonia 113 42 114 Polio Myelitis 2 1 1 Puerperal Fever 1 1 - Puerperal Pyrexia 11 11 1 Scarlet Fever 109 105 - Whooping Cough 24 12 - TOTALS 565 362 126 The number of cases of Infectious Diseases notified in the previous year (1939) was 1563. DIPHTHERIA IMMUNISATI0N Number of Children immunised during the year Under 5 years of age 122 5 years and over 98 Total. 220 TUBERCULOSIS The number of now eases notified during the year 1940 and the number of deaths (together with comparative figures for the previous year) were as follows:- NEW CASES NOTIFIED DEATHS 1940 1939 1940 1939 Pulmonary 214 245 129 140 Non-pulmonary 48 56 20 19 TOTALS 262 301 149 159 The age distribution of the New Cases and the Deaths from Tuberculosis arc shown, in the following table Age Periods NEW CASES DEATHS Pulmonary */ Nonpulmonary TOTALS Pulmonary Nonpulmonary TOTALS M F M F M F M F Under 1 year - - - - - - - - - - 1 to 5 years 2 1 1 3 7 - - - 2 2 5 to 10 ,, 2 - 4 4 10 - 1 1 5 7 10 to 15 ,, 1 3 1 7 12 - - - - - 15 to 20 ,, 17 21 4 6 48 20 to 25 ,, 16 16 2 4 38 36 55 1 5 97 25 to 35 ,, 25 24 2 5 56 35 to 45 ,, 23 12 - 1 36 45 to 55 ,, 18 9 2 1 30 55 to 65 ,, 16 5 - - 21 24 13 4 2 43 65 and upwards 2 1 1 - 4 TOTALS 122 92 17 31 262 60 69 6 14 149 - 5 - GENERAL PROVISION OF HEALTH SERVICES Maternity and Child Welfare. The Maternity Home was closed at the outbreak of war. Otherwise there was no material change in the Maternity and Child Welfare services, details of which are shown in my report for 1937. Inspection and Supervision of Food. Samples purchased and submitted to the Public Analyst. 1020 Samples found to be adulterated:- Formal Samples. 8 Informal Samples. 24. - 6 -