/ LIBRARY LEW 29 METROPOLITAN BOROUGH OF LEWISEAM ABRIDGED REPORT of the MEDICAL OFFICER OF HEALTH for the year 1941 John W. Miller, M.B., Ch.B., D.P.H., Medical Officer of Health Public Health Department, Lewisham Town Hall, Catford, S.E.6. October, 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 1941. The report has been prepared on the lines indicated by the Ministry of Health, and, like those for the previous two years, is in abridged form but contains the principal vital statistics for the year. The birth and death rates for the years 1938 to 1941 were as follows, and are included for purposes of comparison 1938 1939 1940 1941 Birth Rate 13.9 13.6 14.7 13.9 Death Rate 10.5 10.79 15.8 14.36 Infant Mortality Rate 47. 42. 45. 35. The figures contained in this report indicate satisfactory health conditions generally, but the increase in the number of now cases and deaths from Tuberculosis in the Borough, although not alarming, do give cause for some anxiety, as do those for the whole of the country. The sanitary administration of the Borough has been satisfactorily maintained in spite of the difficult war conditions and the many additional duties placed upon the Department. Staff. On the 5th June 1941 Dr. Rose Jordan retired from the Council's service on attaining the age limit. Her resignation was received with much regret as she had rendered nearly 26 years eminent service to the Council, being the first Tuberculosis Officer to be appointed for the Borough when the Council's Tuberculosis Dispensary scheme was inaugurated in 1916. During her term of office considerable developments occurred in the administration of the Tuberculosis scheme. A new Dispensary was built and the staff re-organised and increased, with which work Dr. Jordan was closely associated. Her relations with her patients were always cordial and I feel sure that they and the Council will wish her every happiness in her retirement. Her place was filled by the appointment of Dr. John Everard Stokes, M.D., D.P.H., formerly a Tuberculosis Officer to the Essex County Council. I tender thanks to the members of the Council for the support and consideration which have been extended to my, and to the staff of the Department I desire to express my appreciation of their loyal co-operation. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, joha la mailee Medical Officer of Health. - 2 - SUMMARY OF VITAL STATISTICS Area of the Borough 7,015 Acres, Population Census 1931 219,953. In compliance with the instructions of the Ministry of Health, the Registrar General's estimate of the population of the Borough at June 1941 is not published. Live Births BIRTHS Total Males Females Legitimate 1975 949 1026 Illegitimate 93 46 47 2068 995 1073 Birth Rate per 1,000 of the estimated population 13.95 (Rate for London) 8.9 Number of Stillbirths Males Females 28, Total 63 Rate per 1,000 total (live and still) births 30.4 DEATHS Total 2128. (Males 1102; Females 1026). Death Rate per 1,000 of the estimated population 14.36. (Rate for London) 16.3. Deaths from Puerperal Causes. Deaths Rate per 1,000 (live and stillbirths) Puerperal Sepsis 2 1.28 Other Puerperal Causes 2 1.28 Death rate of Infants undor 1 year of age All Infants per 1,000 live births 34.65 Legitimate Infants per 1,000 legitimate live births 33.40 Illegitimate ” ”illegitimate live births 54.90 Deaths from Measles (all ages) 1 ” ” Whooping Cough (all ages) 9 ” ”Diarrhoea (under 2 years) 2 ” ” Cancer (alloages) 298 ” ”Tuberculosis 156 - 3 - CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING THE YEAR 1941 List No. 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 Age 1. Tvphoid and Paratyphoid . . . . 1 . 1 2. Cerebro Spinal Fever 1 2 . 1 1 1 6 5. Scarlet fever . . . . . . . 4, Whooping cough 3 6 . . . . 9 5. Diphetheria . 3 5 . . . 8 6 Tuberculosis of Respiratory System . 1 . 82 38 16 137 7. Other Tuberculosis 1 5 5 7 1 . 19 8. Syphilitic Diseases . . . 3 14 2 19 9. Influenza 2 . . 5 3 5 15 10. Measles . 1 . . . . 1 11. Ac. Poliomyelitis and Polioencephalitis • 2 1 1 • . 4 12. Ac. Infectious Encephalitis (Lethargic) . . .. 3 1 . 4 13. Cancer, Buccal Cavity and Oesophagus . . . . 13 15 28 14. Cancer, Stomach and Duodenum . . . 3 24 30 57 15. Cancer, Breast . . . 5 15 8 28 16. Cancer, all other sites . 1 1 8 86 89 185 17. Diabetes . . . 1 5 8 14 18. Cerebral Vascular Lesions . . . 2 46 111 159 19. Heart Diseases • . . 12 93 334 489 20. Other Circulatory Diseases . . . 1 13 39 53 21. Bronchitis 1 1 . 1 32 100 135 22. Pneumonia 14 4 1 11 21 39 90 23. Other Respiratory Diseases . 1 . 5 10 16 32 24. Ulcer, Stomach and Duodenum . . . 6 15 8 29 25. Diarrhoea (under 2 years) 2 . . . . . 2 26. Appendicitis . . 1 2 1 1 5 27 . Other Digestive Diseases 1 2 . 2 12 18 35 28. Nephritis . . 1 9 13 27 50 29. Puerperal and Post Abortive Sepsis . . . 2 • . 2 30. Other Maternal Causes . . . 2 . . 2 31. Premature birth 14 . . . . . 14 32. Congenital informations, Birth Injury, Infantile Diseases. 12 . 5 1 1 . 19 33. Suicide . . . 4 5 2 11 34. Road Traffic Accidents . . 5 4 3 4 16 35. Other Violent Causes 3 13 13 114 65 46 254 36. All other causes . 2 1 27 32 134 196 TOTALS ALL CAUSES 54 44 39 324 564 1103 2128 - 4 - INFECTIOUS DISEASES. Number of cases notified (omitting Tuberculosis) and Deaths during the year 1941. Disease. Total cases Notified. Cases admitted to Hospital. Total Deaths. Cerebro-Spinal Fever 31 31 6 Diphtheria 83 80 8 Dysentery 13 10 - Encephalitis Lethargica 2 2 - Enteric Fever 11 11 1 Erysipelas 60 29 - Food Poisoning 13 2 . Measles 726 128 1 Ophthalmia Neonatorum 4 1 - Pneumonia 148 . 22 90 polio myelitis 1 1 - Puerperal Fever 2 2 2 Puerperal Pyrexia 19 19 2 Scarlet fever 98 93 - Whooping Cough 415 92 9 TOTALS 1625 523 119 - 5 - TUBERCULOSIS The number of new cases notified during the year 1941 and the number of deaths (together with comparative figures for the previous year) wore as follows:- NEW CASES NOTIFIED DEATHS 1940 1941 1940 1941 Pulmonary 214 261 129 137 Non-pulmonary 48 54 20 19 TOTALS 262 315 149 156 Tho age distribution of the New Cases notified and the Deaths from Tuberculosis are shown in the following table :- NEW CASES DEATHS Pulmonary Nonpulmonary . TOTALS Pulmonary Nonpulmonary TOTALS M F M F M F M F Under 1 year . . 2 1 3 . . . 1 1 1 to 5 yea'rs 3 1 3 2 9 . 1 4 1 6 5 to 10 ” 4 1 2 3 10 . . 2 3 5 10 to 15 ” 4 1 3 2 10 . . . . . 15 to 20 ” 19 23 4 9 55 150 32 2 5 89 20 to 25 ” 25 to 35 ” 22 29 23 27 1 6 5 52 65 35 to 45 ” .25 17 2 2 46 45 to 55 ” 26 7 1 1 35 32 6 . 1 39 55 to 65 ” 14 3 . 1 18 65 and upwards 6 6 . . 12 11 5 . . 16 TOTALS 152 109 22 32 315 93 44 8 11 156 - 6 - PROVISION OF HEALTH SERVICES IN THE BOROUGH Maternity and Child Welfare, The Maternity Home was closed on the outbreak of war, but otherwise the Maternity and Child Welfare Services were maintained practically on the pre-war basis. The Council's Home Help scheme continued to function and Home Helps were, supplied in cases of confinement to 178 instances at a cost of £820, towards which £140 was contributed by the applicants. The Ministry of Food Scheme for the supply of Milk to Expectant and Nursing Mothers and Children under five years of age continued in operation and National Dried Milk was issued from the Centres. In order that young children should not suffer because of shortage in their daily intake of Vitamins, the Ministry of Food, in consultation with the Ministry of Health, towards the end of the year made available free issues of Fruit Juices and Cod liver Oil, sufficient to meet the needs of all children under two years of age. These preparations were also distributed, from the eleven Maternity and Child Welfare Centres. At the request of the Board of Trade arrangements were made during the year for the distribution of Clothing Coupons at the Health Centre to enable expectant mothers to purchase materials for the making of baby garments. Diphtheria ;Immunisation In order to assist in the Government campaign, an effort was made during the year to secure the immunisation of as many as possible of the children remaining in the Borough. With this object in view the existing scheme, under which the work was only undertaken by Medical Practitioners at their, surgeries, ' was extended. With the approval of the School Medical Officer - 7 - of the London County Council an arrangement was entered into under which a doctor in the employ of this Council immunised school children in the schools. During the year 46 sessions were held in schools under this arrangement and the immunisation of a very large number of children was thereby obtained. Total number of children immunised during the year :- Under 5 years of age 824 5 years and over 2,276 TOTAL. 3,100 Health Visitors.- Summary of Visits Infants under one year 5,609 Children 1-5 years 9,112 Ante-natal cases 944 Re Infectious Disease 916 Infant Welfare Centres. Attendances - Babies 1,440 Children 1-5 years 3,873 New Cases-Babies 1,660 Children 1-5 years 1,050 Ante-Natal Clinics Total Attendances 1,298 - 8 - Sanitary Inspection The following is a brief summary of the Sanitary Inspectors work during the year. Inspections After Infectious Disease 692 Drainage work 937 Rat infestation 414 Overcrowding 18 Factories and Workshops 1,056 Outworkers 412 For other nuisances 1,004 Air Raid Shelters 753 Food Shops 119 Pharmacy and Poisons Acts 74 Miscellaneous 1,319 Re-inspections 5,070 Notices Served Intimation Notices 587 Statutory Notices 73 Rent Restrictions Acts certificates 4 Rat Infestation With a view to discovering the extent of rat infestation special inspections of all food shops and stores were carried out during the year. Advice was given on the matter, and where it was considered necessary the services of a professional Rat Catcher, employed by the. Council, were provided to assist occupiers to rid their premises of this pest. A wastage of valuable food has thereby been reduced. In addition, with a view to preventing the infestation of premises adjoining bombed sites, the drains of demolished or damaged properties have been sealed off. Housing. No action under the statutory provisions of the Housing Act 1936 was taken during the year. A fresh survey was, however, undertaken of the older properties in the Borough, with a view to inclusion in possible future clearance schemes of houses seriously damaged by enemy action. The information gained as a result of this survey has been useful when giving consideration to the question of repairs to be carried out following air raid damage. - 9 - Inspection and Suporvision of Food. Number of samples purchased and submitted under the Food and Drugs Act to the Public Analyst for examination 958 Samples found to be adulterated Formal samples 10 Informal Samples 15 The inspection of Moat was carried out daily at the largo Government Meat Depot in the Borough. This Depot also serves adjoining Boroughs. In the course of those inspections 5 tons 9 cwts. of Meat and offals were condemned as unsound. Owing to the centralising of slaughtering only occasional killings of animals took place at the licensed Slaughter Houses in the Borough, where 115 carcases wore examined. It was necessary during the year for a considerable amount of foodstuffs in shops and stores to be examined and sorted after damage by enemy action. In addition the following food was surrendered as unfit for human consumption and sent away for salvage 10 cwts. Fish; 7 cwts. Meat; 9 cwts. Potatoes; 50 dozen Eggs; 18 cases Rabbits; £ cwts. Oranges. Milk 46 Licenoes for the sale of Pasteurised Milk and 11 licences for the sale of Tuberculin Tested Milk were granted during the year.