Pop 48 METROPOLITAN BOROUGH OF POPLAR ABRIDGED INTERIM REPORT on the health of the Borough during 1942 W. ALLAN YOUNG, D.S.O,. M.D., Ch.B., D.P.H., Medical Officer of Health. « Public Health Department, Poplar Town Hall, Bow Road, E.3. 4th June, 1943. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Madam, Ladies and Gentlemen, In accordance with the Ministry of Health Circular 8773 (England) this Report for the year 1942 is, like those for the years 1939-1941, an abridged Interim Report. Summaries of the principal vital and other statistics are included. Population. For reasons of notional security the estimate of the population is not to be published; therefore rates which are calculated on that estimate are not given either Instead, the average rates for the five years 1937-1941 are given in parentheses with comments as to the comparability of the appropriate rates for 1942. At will be seen that the Birth Rate and the Death Rate are both above average, as also is the death rate from Tuberculosis,, Infant Mortality. The rate of 34 is the lowest since 1931 when the abnormally low figure of 31 was recorded. Infectious Disease. Generally, infectious disease was less prevalent than in 1941, a very satisfactory feature being the extremely low attack rate of Diphtheria. On the other hand, the Scarlet Fever attack rate was nearly trebled but, even so, was below the figures for pre-war years. Measles was very prevalent throughout England and Wales from October onwards and reached its "peak" in February, 1943. Typhus Fever. A number of the staff who had volunteered for work in connection with the scheme for disinfestation of contacts of Typhus Fever were inoculated at the London Hospital. Clinics. Additional clinics have been opened during the year and are referred to in the appropriate sections of the Roport. Vaccination. Consequent upon the resignation of Dr. H, J. O'Brien and the relative shortage of medical men available in Poplar, a re-arrangement of vaccination Districts and re-grouping of Public Vaccinators was approved by the Ministry of Health as a war-time measure. The Borough was divided into two parts with the Limehouse Cut forming the boundary - Dr. MacRae and Dr. cotter serving the northern and southern portions respectively and each acting as Deputy for the other. I regret to have to record the recent death of Dr, Cotter who had been Public Vaccinator in association with the late Dr. O 'Brien for many years. Staff. One member of the Disinfecting Staff was discharged from the Army on medical grounds and resumed duty in the Department. Once again I have to thank the members of the Council for their continued support during the year. I am, Madam, Ladies and Gentlemen, Your obedient Servant, W. ALLAM YOUNG , Medical Officer of Health. -2- STATISTICS AND SOCIAL CONDITIONS. AREA. 2,136 acres. POPULATION, Census 1931 155,089 (The Registrar-General's estimate for 1942 is not to he published.) LIVE BIRTHS. Total, Males, Females. Legitimate 969 514 455 Birth rate above the 5 years average (16.0) Illegitimate 46 23 23 1015 537 473 STILL BIRTHS. Total. Males. Females. 23 16 7 Rate per 1,000 total births 22.2 (26.8) DEATHS. Total, Males. Females. 833 481 352 Death rate above the 5 years average (14.5) DEATHS FROM PUERPERAL CAUSES. Puerperal sepsis 3 ) Rate per 1,000 total Other maternal causes 2 ) births 4,82 (1.79) (Two of the three deaths from puerperal sepsis were of evacuees and occurred outside the Borough.) INFANTILE MORTALITY RATE. j J . All infants per 1,000 live births 34 (49) Legitimate infants per 1,000 legitimate births 35 Illegitimate infants per 1,000 illegitimate births 22 CLASSIFICATION OF DEATHS AT ALL AGES. The causes of deaths, classified by the RegistrarGeneral are as follows typhoid and paratyphoid fevers 0; cerebrospinal fever 2; scarlet fever 0; whooping cough 2; diphtheria 2; tuberculosis of respiratory system 70; other forms of tuberculosis 4; syphilitic diseases 8; influenza 2; measles 0; acute poliomyelitis and polioencephalitis 0; acute infectious encephalitis 0; cancer of (a) buccal cavity ana oesophagus 13; (b) uterus 8; (c) stomach and duodenum 20; (d) breast 9; (e) all other sites 86; diabetes 6; intracranial vascular lesions 64; heart disease 2111 other diseases of the circulatory system 36; bronchitis 76; pneumonia 52; other respiratory diseases 9; ulcer of stomach or duodenum 14; diarrhoea (under 2 years of ago) 1; appendicitis 4; other digestive diseases 20; nephritis 15; puerperal and post-abortive sepsis 3; other maternal causes 2; premature birth 5; congenital malformationss, birth injury and infantile diseases 13; suicide 4; read traffic accidents 3; other violent causes 27; all other causes 42. TOTAL DEATHS AT ALL AGES 833. -3- INFANTILE MORTALITY. There wore 35 deaths of infants under one year of age, the causes being as follows: - whooping cough 2; other forms of tuberculosis 1; diarrhoea 1, premature birth 5; congenital malformations 11; violence 1; other causes 3. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. NURSING IN THE HOME, The number of visits paid to cases by the nurses from nurding associations was 8,184. WELFARE CENTRES at 31st. December 1942. Clinics (Maternity and Child Welfare) (a) Borough Council: Ruston Street Ante-natal: Tuesday mornings and alternate Monday mornings. Infant Consultations:Thursday mornings, Dental Wednesday mornings. Sunlight: Monday afternoons; Friday mornings, Simpsons Road: Infant consultations: Monday afternoons. Sunlight: Monday mornings. 54 West Furry Road: Infant Consultations: Wednesday afternoon,; Ante-natal: Friday afternoons. (b) Royal College of St. Kathorine: 1 Bazeley Street: Ante-natal: Tuesday mornings. Trinity Hall: Infant Consultations: Wednesday mornings Children's House: Infant Consultations: Thursday mornings. St. Michael's Hall: Infant Consultations: Friday mornings. The numbers of attendances at the Maternity and Child Welfare Centres were :- Borough Council. Royal College of St. Katharine. 6,253 Total. 12,321 18,574 VISITS PAID BY HEALTH VISITORS. The number of visits paid by Health Visitors were Borough Council. Royal Collage of St. Katharine. Total. 21.393 21,304 42,697 CHILD LIFE PROTECTION. Visits to Foster Mothers and Children Foster Mothers under supervision during 1942 ) Nil. Foster Children " " " ")Nil STERILE MATERNITY OUTFITS. No outfits were issued during the year. OBSTETRIC CONSULTANTS. It was not necessary to call in a Consultant during the year. CONVALESCENT TREATMENT. 16 convalescent cases were sent away suring the year through the agency of the Invalid Children's. Aid Association. -4- CLOTHING COUPONS FOR EXPECTANT MOTHERS. The arrangements made in 1941 for the distribution of clothing vouchers for expectant mothers were continued in 1942. MILK SCHEME. (Maternity and Child Welfare). 810 applications for free milk were received and 775 were granted, Orders for 4,380 pounds of dried milk were issued. In addition 5,173 packets of dried milk wore supplied at cost price. DISTRIBUTION OF COD LIVES OIL AND FRUIT JUICES. The scheme arranged with the Local Deputy Food Executive Officer in 1941 was continued, WAR TIME DAY NURSERIES. War-time Day Nurseries for the accommodation of children between the ages and two and five years were established by the London County Council at the following Rest Centres:- Coborn School - Day Nursery opened 23rd September, 1942. Tidey Street- Day Nursery opened 5th October, 1942. Coborn School. Tidey Street„ Numbers on Registers at 31.12.42 18 18 Total attendances to " 526 692 Average attendance 6.6 11.1 SANITARY CIRCUMSTANCE OF THE AREA. As in the previous year, full routine work could not be maintained with many of the staff assigned to other duties but 24,226 inspections and reinspections were made by the District and Lady Sanitary Inspectors Visits to air raid shelters numbered 10,863. Disinfestation: number of rooms disinfested 2,293; number of articles disinfested 17,442; total number of inspections 2,634. HOUSING. The Housing Inspectors, like the District Inspectors, were assigned to duties in connection with the Casualty Services. When not so engaged they assisted the District Inspectors. Two war-damaged areas were surveyed with a view to post,-war housing development on the sites. INSPECTION AND SUPERVISION OF FOOD, The Meat and Food Inspectors made 2,880 inspections of premise where food is prepared, stored or sold. REPORT OF THE PUBLIC ANALYSTS. The number of samples examines!: was 734 and the number adulterated was 20, a percentage of 2.7. The average numbers examined and percentage of adulterated samples for the ten years 1933-1942 were 750 and 4.0 respectively. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. Measles and Scarlet Fever, and to a lesser degree Whooping Cough, were more prevalent than in 1941. -5- NOTIFICATIONS ( corrected for ''altered diagnosis" cases) Cases, Deaths. Scarlet fever 97 " Diphtheria 25 2 Typhoid and paratyphoid fevers 2 " Erysipelas 24 2. Puerperal fever 4 3x Puerperal pyrexia 9 " Cerebrospinal fever 6 2 Ophthalmia Neonatorum 2 " Measles 421 " Whooping cough 204 2 Primary pneumonia 52 7@ Influenzal pneumonia 2 1@ Dysentery 8 1 Zymotic enteritis 7" 863 x 2 occurred outside the Brough. IMMUNISATION AGAINST DIPHTHERIA. notified cases only. The London County Council arranged to carry out immunisation of school children through the school medical services at schools in the Borough as a supplementary service to the Borough Council's weekly clinic. - Sallowing upon the issue of Ministry of Health Circular 3713, arrangements were made for Health Visitors to follow up all children between the ages of one and five years who had not been imunised (the Health Visitors had already been doing this work in a slightly different form). In order to save travelling expenses of mothers on the Isle of Dogs who have children under five years of age and no elder children attending school, the London County Council Divisional School Medical Officer kindly arranged for such children who live on the Isle of Dogs to be dealt with through the School Organisation. Number of immunisations carried out At Borough Council Clinic 749 At L.C.C. School Clinics 1510 TUBERCULOSIS. Dispensary clinics. From Jan. 1st to December 31st Tuesdays & Thursdays 2 p.m. Fridays 10 a.m. From 30th March to September 21st „. Monday 6-7 p.m.(additional) From Jan. 1st to March 7th and ) Saturday 2-4 p.m. (monthly) October 3rd to December 31st ) Instead of Monday evenings. Number of now cases and contacts examined 306 (Tuberculous 88; non-tuberculous 202; diagnosis incomplete 16) Number of attendances at the Dispensary 1955 Number of visits to homes by Health Visitors 5486 Number of sputum specimens examined 270 Number of X-ray examinations at St. Andrews Hospital 242 Additiona1 statistics: In addition to the 5,486 visits paid by the Heath Visitors for dispensary purposes, 232 "non-dispensary" visits were paid under the Public Health (Tuberculosis) Regulations, 1930. Reports to Chairman of Medical Boards 38 Patients sent away for institutional treatment 147 Patients in receipt of extra nourishment from Dispensary during the year 41 Patients in receipt of extra nourishment from Dispensary on Dec. 31st. 38 —6— Reports on child contacts to Divisional School Medical Officer 14 Letters to General Practitioners concerning patients 270 Reports to General Practitioners on official forms 45 Progress Reports received from General . Practitioners 0 Clinical Reports to London County Council 61 Reports to Ministry of Pensions 1 Shelters on loan during year 0 Shelters on loan December 31st 0 Beds and bedding on loan during year 1 Beds and bedding on loan on December 31st 1 During the year 16 new cases and 21 old cases have attended Brompton, Colindale, London Chest and St. Andrews Hospitals for 429 artificial pneumothorax refills. During the year 1 child was boarded out under the London County Council Contact Scheme. Dental Treatment (at St. Andrews Hospital) No. of patients referred 2 No1 of attendances 4 No. of extractions 86 No. of local anaesthetics 8 No. of general anaesthetics 8 NUMBER OF NEW CASES AND DEATHS. The number of new cases notified and of deaths during the year were New gases. Deaths. Pulmonary 140 70 Other forms 21 4 161 74 The death rate was above the average for the five years 1957-1941: Pulmonary (5 years average) 0:87 Other forms do. 0.09 Total 0.96 The number of cases of Tuberculosis on the Register at December 31st 63. The number of cases on the Tuberculosis Dispensary Register : Definitely Tuberculous 399 (T.B. plus 205) Diagnosis not completed 17 416 «% TYPHUS FEVER. A scheme for dealing with cases, of Typhus Fever was prepared in co-operation with Stepney. It provides for disinfesting and disinfecting of typhus contacts and their homes by stepney while Poplar undertakes the cleansing of,Scabies patients and verminous persons and disinfection after the ordinary infectious diseases for both Boroughs. The cost of the combined scheme is to be allocated between the two Boroughs on a basis to be arranged. The Sanitary Inspectors and disinfecting staff (preferably the younger ones) were Invited to form a team in order to supplement the ordinary Stepney staff and seven of the Inspectors and four of the Disinfecting Staff volunteered and have since been inoculated. Special house-proof over alls have bee obtained for the staff, The Medical Officer of the port of London Sanitary Authority has made arrangements for dealing with Typhus at the south lof the river and the unknown of ordinary and popular has been obtained to include and boat with Typhus aboard which night arrive at the cocks in unknown of the Boroughs. -7- SCABIES. In order to give persons at work on opportunity of receiving treatment at the Council's Cleansing Station, arrangements were made for the Station to be open on two evenings per week (Mondays and Tuesdays) until 9.30 p.m. In view of the few persons who took advantage of this service it was reduced to one evening per week (Tuesdays). The following-up of school children suffering from Scabies is now carried out by the Borough Council's staff instead of the London County Council School Nurses. The number of treatments, given during the year at the Cleansing Station was 7,150 Adults 1,793; Males 827; Females 966. Children 5,357: "2665; " 2692. 428 premises and 134,482 articles were disinfected. PUBLIC EDUCATION IN HEALTH. 186 lectures were given, the attendances totalling 9,461.