1. LIBRARY MiT8 BOROUGH OF 13ITCHAM Anonal Report of the Medical Officer of Health The Mayor, Aldermen and Councillors Borough of Mitchan. Sir, Ladies and Gentlemen, In accordance with the Ministry of Health Cir:ular 2067 ny report for the year 1939 is confined to essential and urgent natters which have affected the public health during the year. Until August 1939 the public health department carried out all its functions in spite of the extra duties entailed by Air Raid Precautions Acts and Orders. During the last four months of the year the staff of the department was depleted by the calling up of several members and the remainder was engaged almost exclusively upon A.R.P. work. In consequence it was possible to attend only to essential public health natters. I should like to pay a tribute to the members of my staff for the excellent and cheerful manner in which they carried out their duties, and for their willingness in working long hours under rather difficult circumstances. Owing to the evacuation of part of the population of Mitchan an alteration has been made in the computation of the Birth and Death Rates. Up to 30th September 1939 the pre-war practice of transference to areas of the mothers usual residence has been maintained. From and after October 1st the primary assignment for the purpose of calculating birch rates is in accordance with the prewar practice, but for the purpose of calculating Infant and Maternal Mortality a secondary assignment is made, vis. to the area in which a mother nay be temporarily residing as a result of the war. With reference to deaths up to September 30th, 1939 the pre-war practice of transference to area of usual residence has beer, maintained. From and after October 1st, in a case of a person temporarily residing away from hone on account of the war, the death is not transferred to the area of usual residence but is assigned to the area of tenporary residence. Two population figures are therefore given (a) 66,570 for calculating the Birth Rate and (b) 64,730 for calculating the Death, Infent Mortality and Maternal Mortality Rates. Statistics and Social Conditions. Area (in acres) 2935 acres. Population, Census 1921 35,119. „ „1931 56,856. " (N.R. night) 53,436. „ December 31st, 1939 (N.R.) 62,404. " Registrar-General (a) 66,370. „ „ „ (b) 64,730. Number of inhabited houses 17,513 Rateable Value 1939 £485,960. Sun represented by ld. rate £1,953 2. Births. Live Births. Male. Female. Total. Legitimate 497 4 37 984 Illegitimate 13 12 25 Total 510 499 1009 Rate 15.2 per 1000 popluation. Still! births. Male. Female. Total. Legitimate 18 15 33 Illegitinate 1 1 Total 19 15 34 Rate 0.51 per 1000 total births. Deaths. Male. Female. Total. 318 249 560 Deaths Rate 8.6 per 1000 population Maternal Mortality. From Puerpexal Sepsis 1. From other Perrpeal Causes 2. Total. 3. Rate per 1000 births. 3.0 Death- rates of infants under one year of age:- All infants per 1000 live births. 31. Legitimate infants per 1000 legitimate live births. 29. Illegitimate infant per 1000 imegitimate live births. 30. Deaths from, Cancer (all ages) 73 Measles (all ages) 0. Whooping Cough ( all ages 3. Diarrhoea (Under 2 years of age). 2. 3- Birth-rates, Death-rates, Analysis of Mortality, Maternal Mortality and Case notes for certain Infectious diseases in the Year 1959 Provisional figures based on Weekly and Quarterly Returns. Mitcham England and Wales 126c.Bs. and Great Towns including London. 148 Smaller Towns Resident Pop. 25,000 50,000 1931 Census. London Adn. County England and Wales. 126 C.Bs. and Great Towns including London 148 Smaller Towns Resident Pop. 25,000 - 50,000 1931 Census. London Adm. Counter Mitchan. Rate,3 per 1,000 Population:- Rates per 1,000 Live Births:- Live Births 15.2 15.00 14.6 15.6 12.3 Deaths under 1 year of age. Deaths from 50 53 40 48 31 Still Births 0.51 0.59 0.59 0.57 0.44 Deaths Diarrhoea and Enteritis under 2 years of age Maternal Mortality:- (???) Sepsis others Total 4.6 6.3 3.0 8.2 1.8 All Causes 8.6 12.1 12.0 11.2 11.9 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 0.00 Small-pox - - - - - 0.77 1.0 Measles 0.00 0.01 0.01 0.01 0.00 2.16 Not available 2.0 Scarlet Fever 0.00 0.01 0.00 0.00 0.00 Whooping Cough 0.01 0.03 0.03 0.02 0.03 2.93 3.0 Diphtheria 0.01 0.05 0.05 0.04 0.02 Rates per 1,000 Total Births (Live and Still) Influenza 0.09 0.21 0.19 0.20 0.18 Notifications:- Maternal Mortality Puerperal Sepsis Others Total 0.74 0-9 Snall-pox — 0.00 —* — Scarlet Fever 0.9 1.89 1.96 (???) 1.53 2.08 Not available 1.9 Diphtheria 0.3 1.14 1.21 1.16 0.98 2.82 2.8 Enteric 0.00 0.04 0.03 0.04 0.03 Erysipelas 0.3 0.34 0.04 0.31 0.37 Notfications:- Pneunonia 0.3 1.02 2.1 0.89 0.99 puerperal Fever „ Pryexia 14.35 17.26 12.99 3.3 14.2 4.2 4 (???)during the Year,1939. Cause of Death Males Females Total. Typhoid and paratyphoid ... ... ... Measles ... ... ... Scarlet Fever ... ... ... Whooping Cough 1 2 3 Diphtheria 2 ... 2 Influenza 3 3 6 Encephai(???) lethargica ... ... ... Cerebro- apual Fever ... ... ... Tuberculosis of the Respiratory Syatem 21 13 39 Other Tuberculosis Diseses 2 1 3 Syphilis 1 ... l General (???) of the insane tabes General dorsalis 4 ... 4 Cancer, (???) 19 34 73 Diabetes 3 3 12 Cerebral Haemorrhage 12 10 22 Heart Disease 73 74 147 Ansurisn 1 ... 1 Other(???) ... 13 30 Bronchitis 19 5 23 Pneumonia (all forms) 25 10 35 Other Respiratory Disease ... 2 2 Peptic Ulcer 7 1 8 Diarrhoea, etc. (under two (???) l 1 2 Appendicitis 2 1 3 Cirrhosis of the Liver 1 ... l Other Diseases (???) 7 1 2 Other (???) 6 6 12 Acuta and Chronie ??? 7 8 15 Puerperal Sepsis ... 1 1 Other Puerperal causes ... 2 2 Congenita] Debility Premature Birth Malformartions, etc 13 4 17 Senility 3 8 11 Suicide 5 3 8 Other Violence 18 4 22 Other Defined or unknown 25 26 51 Causes ill-dsfin-d or unknown ... ... ... Diarrhoea (over two years) ... 2 2 Total 311 249 560 5- General Provision of Health Services for the Area. Laboratory Facilities. Bacteriological examinations for this district are carried out at the Wandle Valley Isolation Hospital. The following number of specimens from this borough have been examined during the year:- Swabs for diphtheria 304 Sputa for tubercle 116 Total 420 •Hospital Facilities. See my report for 1938• Ambulances. For General and Accident Cases. The Borough has the ambulances for the removal of general and accident cases. Since the outbreak of war these ambulances have been under the control of the Public Health Department. For Infectious Disease cases. The Wandle Valley Joint Hospital Board provide two ambulances for the removal of infectious disease cases. Midwlves- There are four munisipal midwives practising in this Borough. The Surrey County Council is the Local Supervising Authority. Health Visiting Five health visitor are employed in this Borough. The Superintendent Health Visiter al 30 acts as. Infant Life Protection. Vint tor. During 1939 10.428 visit were made by the Health Visitors, 553 of these visits were paid to expectent others ,3,971 visit to children under 1 year of age, and 4,324 visit to children between one and five years of age. In addition visits ware pail to cases of tuberculosis. Nursing in the Hope. There eve throe nursing associations in the Borough. The following are the ??? from each association for the year ended December 3st, 1938. Association No. of nuses. No._ of Patients Visitis No. of Visits made. No . of children under5 yrs. of No. of Expsetant mothers nursed. No. of Puerperal Cases nursed. St. Barnabes 1P.T 147 3.15 15 none none Mitobam South & East 2.P.T 412 8.896 100 4 14 ??? 1 P.T Christchurch, Mitchen, 1 P.T 169 3.406 2 none ??? 1 P.T 6. Clinics end Treatment Centres. Infant Welfare Clinics. Western Road (2 sessions per .month). No. of new cases registered during year - 78. No. of children under 1 yr. attending for first tine - 49 • No. of children between 1-5 years attending first tine - 29 • No. of children under 1 yr. on Dec. 31st 1939 - 120. No. of children between. 1-5 yrs. on Dec. 31st 1939 - 152. Total attendances - 762. Parish Room (2 sessions per month). No. of new cases registered during year - 165. No. of children under 1 yr. attending for first tine - 90. No. of children between 1-5 yrs. attending first tine - 75. No. of children under 1 yr. on Dec. 31st 1939 - 73. No. of children between 1-5 yrs on Dec. 31st 1939 - 146. Total attendances - 1243. Meopham Road (4 sessions per month). No. of new cases registered during year - 8l. No. of children under 1 yr. attending for first tine - 49. No. of children between 1-5 yrs. attending first tine - 32. No. of children under 1 yr. on Dec. 31st 1939 - 6l. No. of children between 1-5 yrs on Dec. 31st, 1939 - 268. Total attendances - 1226. Cavendish Road (4 cessions per month). No. of new cases registered during year - 190. No. of children under 1 year attending for first tine 154. No. of children between 1-5 years attending first tine 36. No. of children under 1 year on December 31st, 1939 - 79• No. of children between 1-5 years on December 31st, 1939 - 234. Total Attendances. - 2023. St. Barsabas (4 sessions per nonth).m No. of new oases registered during year - 190. No. of children under 1 year attending for first tine - 147. No. of children between 1-5 years attending first tine - 43. No. of children under 1 year on December 31-st, 1939 - 122. No. of children between 1-5 years on December 31st, 1939 - 314. Total Attendances - 2120. Sherwood House ( 4 sessions per month). No. of new cases registered during year - 114. No. of children under 1 year attending for first tine - 59. No. of children between 1-5 years attending first tine - 55. No. of children under 1 year on December 3lst, 1939 - 51. No, of children between - 5 years on December 31st, 1939 - 259. Total Attendances - 1311 Ante-Natal Clinics. No. of expectant mothers attending - Meopham Road - 36. Cavendish Road. 52. Mitcham Court - 72Miteham Court Midwives -317. Woodlane - 262. Post-Natal Clinic. No. of Mothers attending - 103 ??? of home Helps weir provided for 24 mothers. 7- Dental Clinic. No. of cases 6o. Gas extractions 33« Local extractions 6. No. of fillings 32* Impressions taken 9« Inspections 68. Attendjjaces for adjustment 32. Orthopaedic Clinic. Cases were referred for treatment during the year. X Ray Examinations. 27 expectant mothers were sent for X Ray examination during the year. Immunisation Clinic. 77 children v»ere immunised against diphtheria during the year. Infant Life Protection. No. of foster mothers on register Dec. 31s't> 1939 - 22. No. of foster children. 28. No. of visits paid by visitor. 295* V.oodlands /.'latej'-jivy Home. No. of beds. 15« No. of casew admitted. 254. No. of ;ases delivered by midwives. 224. No. of cases delivered by doctors. 30' No. of cases of puerperal pyrexia. 1. No. of infants not entirely breast fed. 3* No. of still births. 3'