LIBRARY LEW 31 Metropolitan Borough of Lewisham ABRIDGED REPORT of the MEDICAL OFFICER OF HEALTH for the year 1943 John W. Miller, M.B., Ch.B. D.P.H., Medical Officer of Health. Public Health Department, Lewisham Town Hall, CATFORD, S.E.6. PREFACE As in the four preceding years the Annual Report on the Health of the Borough for the year 1943, is, in accordance with the instruction of the Ministry of Health, in an abridged form but contains summaries of the principal vital and other statistics. The figures indicate that the state of the public health in Lewisham remained satisfactory. Although there was no serious outbreak of infectious disease during the year the incidence of scarlet fever and measles was greater than in the previous year. The Birth Rate was 18.69 per thousand and the Death Rate 13.97 per thousand, compared with the mean of the previous five years of 14.6 and 12.6 per thousand respectively. The Infant Mortality Rate increased from 37,7 in 1942 to 42.5 in the year under review, compared with the average of 41 in the previous five years. The Maternal Mortality Rate of 3.08 per thousand births showed a slight decrease on the figure of 3.26 for the preceding year. Comparable rates for London, England. Wales and Lewi sham. London England & Wales Lewi sham Birth rate 15.8 16.5 18.7 Death rate 15.0 12.1 13.9 Infantile Mortality 58 49 42 The sanitary administration of the Borough has again been satisfactorily maintained notwithstanding the difficult war conditions and staff depletion. 0 October, 1944. 1 SUMMARY OF STATISTICS FOR THE YEAR 1943. Area of the Borough 7015 Acres Population Census 1931 219,953 The Registrar-General's estimate of the population for 1943 is not to be published. Rateable Value £1,788,601 Estimated Product of Id. Rate £6,300 BIRTHS Number of live births 3,151 Males Females Totals Legitimate births 1539 1477 3016 Illegitimate births 71 64 135 1610 1541 3151 Birth rate per thousand of the estimated population - 18.69 Total still-births 82 (a) Legitimate 75 (b) Illegitimate 7 Still-birth rate per thousand (live and still) births 25.3 DEATHS., Number of deaths 2359 (Males - 1191 Females = 1168) Death rate per thousand of the estimated population 13.97 Number of Infant deaths 134 (a) Legitimate 125 (b) Illegitimate 9 Infant Mortality Rate (a) All Infants per 1000 Births 42.5 (b) Legitimate Infants per 1000 Legitimate41.4 Births. (c) Illegitimate Infants per 1000 Illegi timate Births. 66.6 Number of Maternal Deaths 10 (a) Puerperal Sepsis 3 (b) Other Maternal Causes = 7 Maternal Mortality Rate per thousand total live and still births 3.08 Number of deaths from Measles (all ages) 4 " " " " Whooping Cough 8 " " " " Diarrhoea under 2 years) 24 ,r w " " Tuberculosis 150 " " " " Cancer 369 2, CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING THE YEAR 1943. Causes of Death. Ages at Death 10-1 ' 1-5 5-15 15-45 45-65 Over 65 All Ages Typhoid & Paratyphoid Fevers r i— - i - - - - - 1 1 Cerebro-Spinal Fever 1 - - -- - 1 Scarlet Fever - - 1 -/ - - 1 Whooping Cough 3 5 - - - - 8 Diphtheria - - - - " - ~ Tuberculosis of Respiratory System - 2 - 82 38 6 128 Other form of Tuberculosis - 2 4 13 2 1 22 Syphilitic Diseases - - - - 15 5 20 Influenza 2 1 1 1 13 40 58 Measles 3 1 - - _ - 4 Cancer, Buccal Cavity & Oesophagus (M), Uterus (F) _ - — 1 16 15 32 Cancer, Stomach & Duodenum - - - 5 25 34 64 Cancer, Breast - - - - 27 10 37 Cancer, all other sites - 1 1 17 93 124 236 Diabetes — - - 3 4 11 18 Intra-Cranial Vascular Lesions - - - 3 50 155 208 Heart Diseases - - 1 21 117 444 583 Other Circulatory Diseases - - 1 8 12 48 64 Bronchitis 5 1 - 5 28 117 156 Pneumonia [ 22 6 1 11 25 46 111 Other Respiratory Diseases - - - 7 13 9 29 Ulcer, Stomach & Duodenum - - - 5 15 12 32 Diarrhoea under 2 years) 24 - - - - - 24 Appendicitis - - - 2 4 - 6 Other Digestive Diseases 2 1 1 7 9 22 42 Nephritis - - - 8 16 22 46 Puerperal & Post Abortive Sepsis - - - 3 •• - 3 Other Maternal Causes - - - 7 - - 7 Premature Birth 32 - - - - - 32 Congenital Malformations, Birth Injury, Infantile Diseases 28 1 1 3 1 1 35 Suicide - - - 7 6 2 15 Road Traffic Accidents - - - 1 1 6 8 Other Violent Accidents 7 5 39 30 22 30 133 All other causes 5 - 5 23 34 129 196 TOTAL ALL CAUSES 134 26 56 268 586 1289 2359 3 PREVALENCE AND CONTROL OVER INFECTIOUS DISEASE. Number of cases notified (omitting Tuberculosis) and Deaths during the year 1943. Disease. Total cases Notified. Cases admitted to Hospital. Total Deaths. Cerebro-Spinal Fever 8 8 1 Diphtheria 26 26 0 Scabies 515 0 0 Dysentery 23 23 0 Enteric Fever 1 0 0 Erysipelas 57 22 0 Food Poisoning 2 0 0 Measles 1270 127 4 Ophthalmia Neonatorum 17 8 0 Pneumonia 176 63 111 Puerperal Fever . 1 1 0 Puerperal Pyrexia 20 20 3 Scarlet Fever 683 * 656 1 Whooping Cough 219 89 8 TOTALS. 3018 1043 1 128 Scabies was notifiable from 1st August, 1943. 4. IMMUNISATION AGAINST DIPHTHERIA Tear Number Immunised No. of cases of Diphtheria Notified. No. of Deaths from Diphtheria 1935 836 314 14 1936 448 247 4 1937 1,027 328 11 1938 1,406 469 23 1939 686 137 8 1940 220 78 6 1941 3,100 82 8 | 1942 5,104 55 I 1 1 1943 5,359 26 0 NOTE; The Diphtheria Immunisation Scheme was adopted by the Council in March 1935. TUBERCULOSIS. The number of new cases notified during the year 1943 and the number of deaths (together with comparative figures for the previous year) were as follows M CASES NOTIFIED DEATHS. 1942 1943 1942 1943 Pulmonary 284 327 118 128 Non-pulmonary 70 76 13 22 TOTALS 354 403 131 150 5 The age distribution of the New Cases notified and the Deaths from Tuberculosis are shown in the following table:- NEW CASES DEATHS Pulmonary Non pulmonary TOTALS Pulmonary Non pulmonary TOTALS M F m F M F M F Under 1 year - 1 - - 1 - - - - - 1 to 5 years 6 8 4 5 23 1 1 2 - 4 5 to 10 ,, 6 3 3 4 16 - - 3 1 4 10 to 15 ,, 4 3 2 6 15 - - - mm +* 15 to 20 ,, 23 22 4 8 57 20 to 25 ,, 30 37 4 5 76 39 43 9 5 96 25 to 35 ,, 29 38 3 8 78 35 to 45 ,, 38 16 5 6 65 45 to 55 ,, 25 9 2 2 38 55 to 65 ,, 17 1 - 2 20 32 6 - 1 39 65 & Upwards 7 4 - 3 14 5 1 - 1 7 TOTALS 185 142 27 49 403 77 51 14 8 150 6. PROVISION OF HEALTH SERVICES IN THE BOROUGH NOTIFICATION OF BIRTHS The total number of births notified in the Borough was 3124. Of this number 68 were still births. NURSING IN THE HOME The number of visits paid to cases by nurses from Nursing Associations at the Council's expense was 5,236 at a cost of £472 lbs. 6d. HEALTH VISITORS. The following is a brief summary of the visits made during the year:- TOTAL VISITS To Expectant Mothers 2330 To Children under 1 year 8106 To Children 1 to 5 years 16,313 Infestation by Head Lice. During 1943 a special effort was made by the Health Visitors to examine the Heads of children attending the Clinics and Welfare Centres of the Borough and wherever possible in the hones A total of 5,416 heads were examined, of which 5,399 were found to be clean and only 17 showed evidence or nits and lice. INFANT WELFARE CENTRES The number of attendances at the Maternity & Child Welfare Centres were as follows:- Infant Welfare Centres Babies 2488 Children 1 to 5 years 5227 ANTE-NATAL AND POST-NATAL CLINICS Total Attendances 2795 CHILD LIFE PROTECTION The number of Foster Mothers on the Register at the end of the year was 100 and the number of children on the Register was 120. 2,275 visits and re-visits were made to foster mothers and foster children. HOME HELPS Under the Council's Maternity & Child Welfare Scheme Home Helps were provided to mothers during the lying-in period in 463 cases. SUPPLY OF MILK AND VITAMINS TO MOTHERS AND CHILDREN The arrangement made with the Ministry of Food for the distribution of Dried Milk, Fruit Juices and Cod Liver Oil at the Welfare Centres, continued to be in operation during the year. WAR-TIME NURSERIES The six war-tine Nurseries in the Borough continued to function throughout the year. The establishment and maintenance of the Nurseries has made a substantial addition to the work of the Department. BACTERIOLOGICAL EXAMINATIONS. The under-mentioned specimens were submitted to the St. John's Hospital Lewisham, laboratory for bacteriological investigations and the results were as follows:- Positive Negative Total Diphtheria 14 905 919 Tuberculosis 151 925 1076 Typhoid Nil 6 6 Miscellaneous 5 13 18 VACCINATION The Annual Return made by the Vaccination Officer to the Registrar General respecting the vaccination of children whose births were registered in the Borough during the year ended 31st December, 1942 shows that of the 1980 births so registered 1076 or 54.3 per cent were successfully vaccinated. PROVISION OF INSULIN On the 4th July, 1943 the Ministry of Health issued a circular (No.2734) empowering Local Authorities to provide Insulin to certain classes of persons, for whom no other public provisions is made. The Council authorised arrangements to be made for a supply of Insulin to be available for issue from the Town Hall in accordance with the terms of the Ministry's Circular and during the year eleven patients obtained a regular supply. 8 SANITARY CIRCUMSTANCES OF THE BOROUGH The following summaries indicate the work carried out by the Sanitary Inspectors and the Disinfecting Staff during the year:- Houses inspected re: Infectious Diseases 3428 ,, ,, re: War Damage 331 ,, ,, re: Overcrowding 39 ,, ,, re: Nuisances 1731 ,, ,, re: Vermin infestations 596 ,, ,, re: Rat Repression 757 Public Air Raid Shelters inspected. 291 Visits to Factories & Work Shops. 1177 Number of Intimation Notices served 1259 ,, ,, Statutory Notices served 310 ,, ,, Rent Restriction Acts Certificate issued 10 DISINFECTION Number of Premises disinfected 2745 ,, ,, Articles (bedding etc.) disinfected 33,934 DISINFESTATION Number of rooms treated 335 ,, ,, articles treated 1668 CLEANSING OF VERMINOUS PERSONS AT THE COUNCIL'S DEPOT Number of Verminous children cleansed 1026 ,, ,, ,, adults ,, 27 ,, ,, Baths given for Scabies 9691 9 INSPECTION AND SUPERVISION OF FOOD MILK The number of Dairy Premises on the Register is 117 and there are 234 Purveyors of Milk registered. 59 Licences for the sale of Pastuerised Milk and licences for the sale of Tuberculin Tested Milk were granted during the year. Routine inspections were made to these dairy premises and also to food shops and stores. At the Government Meat Depot situated in the Borough daily inspections were made. A good deal of work was also involved in the inspection of a considerable quantity of food surrendered as unfit for human consumption and where possible this was handed over to the Salvage Authorities. FOOD & DRUGS ACT 1938 During the year 1,144 samples were submitted by the Council's Sampling Officer to the Public Analyst for examination. Of these 25 were "formal" and 1119 "informal". Six samples were found to be adulterated. 10