library pop ^1 METROPOLITAN BOROUGH OF POPLAR . ABRIDGED INTERIM MEPOET on the health of the Borough during 1943 by W. ALLAN YOUNG, D.S.O. , M.D. , Ch.B., D.P.H. , Medioal Officer of Health. Public Health Department, Poplar Town Hall, Bow Road, E.3. 1st June, 1944. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Madam, Ladies and Gentlemen, In accordance with the Ministry of Health Ciroular 10/44 (England) this Report for the year 1943 is, like those for the years 1939-42, an abridged Interim Report. Summaries of the principal vital and other statistics are included. Population. The Registrar-General's estimate of the population is not to be published. Rates calculated on that population are not given either, but average rates for the preceding five years arc given in parentheses, with commonts as to the comparability of the appropriate rate for 1943. Births. There wns an increase in the number of live births, the birth rate being the highest since 1925, Deaths. The number of deaths at all ages was higher than in 1942, the increase being due mainly to diseases of the circulatory system and cancer. On the other hand, 'there was a slight decrease in the death rate from Tuberculosis. Maternal Deaths. These numbered three, two of them following abortions. Infant Mortality. Respiratory disoases and premature Tirth were mainly responsible for the some what higher infant mortality, one-half of the total deaths under one year of age being aligned to these causes. Infectious Disease. Scarlet fever was abnormally prevalent in 1943, but it is interesting to note that during the past five years there has not been one Poplar death attributed to this disease. The Measles epidemic referred to in my report for 1942 continued during the early months of 1943, but the number of deaths was relatively low. Tuberculosis. There was a slight increase in the number of new cases notified but, as mentioned above, the death rate was lower than that of the previous year although above the average for five years. Influenza. The Influonza epidemic which occurred in the latter part of the year did not call for any special action in this Borough. Staff. Three members of the staff, Messrs. Barnett, Donovan and East, were called up for military service. The Council arranged that during the absence of Mr. Donovan the duties of Vaccination Officer should be oarried out by Mr. May, one of the Sanitary Inspectors. The Ministry of Health raised no objection to this on the understanding that the sanitary inspection work was not prejudiced thereby. Public Vaccinators. Dr. M. J. B rne was appointed Public Vaccinator for the southern portion of the Boro ugh in place of the late Dr? Cotter Dr. 17. Feldman, the Medical Superintendent of Mile End Hospital, was appointed Public Vaccinator for St. Clement's Hospital, vice Dr. Pinhey who had resigned. Gcnoral. Circulars on various matters wore received from the Ministry of Health during the year and the necessary action has been taken thereon Once ggain 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. ALLAN Y0UNG, Medical Officer of Health. -2- STATISTICS A1TD SOCIAL CONDITIONS. (The figures in parentheses are the averages for the 5 years 1938-42.) AREA. 2,136 acres POPULATION. Census 1931 • • • • • • 155,089 The Registrar-General's estimate for 1943 is not to be published. LIVE BIRTHS. Total. Males. Females. Legitimete Illegitimate 1095 67 569 34 526 33 Birth rate above the average (16.6). 1162 603 559 STILL BIRTHS. Total. Males. Females. 24 11 13 Rate per 1,000 total births 20.7 (25.7) DEATHS. * Total. 922 Males. 546 Females 376 Death rate above the average (15.2) DEATHS FROM PUERPERAL CAUSES. Puerperal sepsis f., 2 ) Rate per 1,000 total Other maternal causes 1) births 2.53 .(3.34) DIE AFT MORTALITT RATE. All infants per 1,000 live births 47 (43) Legitimate infants per 1,000 legitimate births 48 (42) ILLegitimate infants per 1,000 illegitimate births 30 (91) CLASSIFICATION OF DEATHS AT ALL AGES. The 922 deaths at all ages were classified by the RegistrarGeneral as follows Cerebrospinal fever 1; Whooping cough 1; Diphtheria 5; Tuberculosis of respiratory system 64; other forms of Tuberculosis 7; Syphilitic disease 14; Influenza 17; Measles 3; Cancer of: (a) buccal cavity and oesophagus 14; (b) uterus 6; (c) stomach and duodenum 19; (d) breast 7; (e) all other sites 106; Diabetes 6; Intracraniql vascular lesions 51; Heart disease 256; other diseases of' circulatory system 18; Bronchitis 79; Pneumonia 52; other respiratory diseases 7; Ulcer of 3tomach and duodenum 18; Diarrhoea (under 2 years) 4; Appendicitis 1; other digestive diseases 18; Nephritis 12; Puerperal and post-abortive sepsi.3 2; other maternal oauses 1; Premature birth 12; Congenital malformations, etc. 14; Suicide 3; Road traffic accidents 5; other violent oauses 42; all other causes 57. INFANTILE DEATHS. There were 55 deaths' of infants under one year of age, the oauses of death being as follows l- Whooping oough 1; Tuberculosis of respiratory system 2; other forms of Tuberculosis 1; Influenza 1; Measles 2; Bronchitis 5; Pneumonia 13; Diarrhoea 4; other digestive diseases 1; Premature birth 12; Congenital malformations, etc. 11; all other causes 2. -3- General Provision of Health SerVices In the Area. NURSING IN THE HOME. The number of visits paid to cases hy the nurses from nursing associations was 1541. WELFARE CENTRES at 31st December 1943. Clinics (Maternity and Child Welfare) (a) Borough Council: Rustoh Street: Ante-natal: Tuesday mornings and alternate Monday mornings. Infant Consultations: Thursday mornings and afternoons. Dental: Wednesday mornings. Sunlight: Monday afternoons; Friday mornings Simpsons Road: Infant Consultations: Monday afternoons. Sunli ght: Monday morn ings. 54 West Fdfry Road: Infant Consultations: Wednesday afternoons. Ante-natal: Friday afternoons. (b) Royal College of St. katharine 1 Bazeley Stroot: Ante-natal: Thursday mornings. Trinity Hall: Infant Consultations: Wodnesday mornings. All Hallows: Infant Consultations: Tuesday afternoons. St. Michael's Hall: Infant Consultations: Monday afternoons. The numbers of attendances at the Maternity and Child Welfare Centres were Borough Council. Royal College of St. Katharine. Total. 15,654 6,714 22,368 VISITS PAID BY HEALTH VISITORS. Tho numbers.of visits paid by tho Health Visitors were . Borough Council. Royal College of St. Katharine. Total. 23,505 21,510 45,015 CHILD LIFE PROTECTION. Visits to Foster Mothers and Children 15 (by H.V's.) Foster Mothers under supervision during 1943 3 Foster Children " " " 4 STERILE MATERNITY OUTFITS. No outfits were issued during the year. OBSTETRIC CONSULTANTS. It was not necessary to oall in a Consultant during the year. CONVALESCENT TREATMENT. 15 convalescent cases were sent away during the year through the agency of the Invalid Children's Aid Association. CLOTHING COUPONS FOR EXPECTANT MOTIISRS. The arrangements made in 1941 for the distribution of clothing vouchers for expectant mothers were continued until July when the issue of vouchers was transferred to the Local FoodA offices. With the transfer of this service the Maternity and Child Welfare lost the great advantage it had in being able to make early and personal contact with the expectant mothers. This matter was -4- referred to the Metropolitan Boroughs Standing Joint Committee who took up the question with the Ministry of Food and Board of Trade, and after considering" replies to their representations thought that no useful purpose could "be served by pursuing the matter further. MILIC SCHEME (Maternity and Child Welfare). 117 applications were received and granted. Orders for 726 pounds of dried milk were issued. In addition, 1,567 packets of dried milk were supplied at cost price. NATIONAL MILK SCHEME. As from 7th February the National Milk and Vitamins Scheme was finally merged into the general work of the Food Office. The milk office at the Town Hall, therefore, became redundant and with the transfer of the scheme to the Local Food Office no officers of tho Publio Health Department have been involved in this work since 7th February,1943. DISTRIBUTION OF COD LIVER OIL AND FRUIT JUICES. The soheme of distribution arranged with the Local Deputy Food Officer in 1941 was continued. WAR TIKE DAY NURSERY: As the result of disoussions with the Ministries of Health and Labour, the Borough Council took over the Queen Mary Day Nursery which had been used by the. London County Council as a Day Nursery for children aged 2-5 years. After minor alterations to the building had been made to meet the requirements of the Ministry of Health the reception ago was extended to one year and, in exceptional circumstances, to under one year. Responsibility for the premises was assumed by the Borough Council as from 13th September. There were some difficulties in connection with staff, and with the approval of the Council's Civil Defence Committee women personnel from one of the First Aid Posts now assist daily at the Day Nursery. SANITARY CIRCUMSTANCES OF THE AREA. SANITARY INSPECTORS WORK. With many of the staff assigned to other duties full routine work could not be maintained, but 26,032 inspections and reinspections were made by the District and Lady Sanitary Inspectors. Visits to air raid shelters numbered 5,455. DISINFBSTATION. Number of rooms disinfested 1,925; number of articles disinfested 6,278; total number of inspections and visits 1,932. Disinfeslation by HCN was carried out in one case. HOUSING. The Housing Inspectors, like the Distriot Inspectors, were assigned to duties in connection with the Casualty Services. When not so engaged they assisted the District Inspectors. In November Mr. May took over tho duties of Vaccination Officer in addition to his work as Sanitary Inspector. RODENT CONTROL SCHEME. Following upon the issue by the Ministry of Food of "The Infestation Order, 1943", conferences were oalled by the Ministry and the intentions and proposals for carrying out the Order were explained. Later, the Ministry issued a Direction to the Borough Counoil to prooeed with the initial survey and, after consideration of this Directipn, cjrtain suggestions concerning administration and prooodure were adopted. During July conversations took place with Dr. M. T. Morgan, Medical Officer of the Port of London, regarding a scheme of control in the dock area and the possibilities of a combined scheme botween the Port of London Health Authority and the Poplar Borough Council for the Isle of Dogs. Dr. Morgan gave details of the Scheme of Rodent Control which had been inforce in the Port during the last two years, which scheme was on a contributory basis. Dr. Morgan offered to assist in a scheme for tendering the foregoing part of the Borough free from rats and mice. -5- A special comprehensive report was submitted to the Finance and Emergency Administrative Committee in September and the Council adopted Resolutions authorising (1) the appointment of staff, (2) co-operation with the Port of London Health Authority and (3) the organization of a contributory scheme to operate in that part of the Borough south of East India Dock Road. (This last was extended to cover the whole of the Borough later when firms outsido the original area asked to be included in the scheme.) On receipt of Directions to proceed with all necessary action, the scheme was put into operation. INSPECTION AND SUPERVISION OF FOOD. Tho Meat and Food Inspectors made 3,626 inspections of preaises where food is prepared, stored or sold. REPORT OF THE PUBLIC ANALYSTS. The number of samples examined was 725, and the number found to be adulterated was 25, a percentage of 3.45. . During tho ten years 1934-43 the average number examined was 743 and the percentage adulterated was 3,9 . PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. Measles, Scarlet fever and Pneumonia were more' prevalent than in 1942. NOTIFICATIONS (corrected for "altered diagnosis" cases). Cases. Deaths. Scarlet fever 222 . Diphtheria 47 5 Typhoid and paratyphoid fevers • . Erysipelas 25 . Puerperal fever 6 2 Puerperal pyrexia 7 . Cerebrospinal fever 5 1 Ophthalmia neonatorum 1 . Measles — 809 3 Whooping cough 184 1 Primary pneumonia 111 8@ Influenzal pneumonia 18 2 @ Dysentory 20 . Zymotic enteritis 8 4 Malaria 1 X . Acute Poliomyelitis 2 . 1466 . Scabies (from 1st August 1943) 472 . 1938 © notified oases only. x induced for therapeutio purposes. IMMUNISATION AGAINST DIPHTHERIA. As a result of Circular 2753 issued by the Ministry of Health on 6th January, 1943, medical practitioners wore invited to co-operate in tho immunisation of infants and young children, the prophylactic being supplied free of charge and a fee of 5/- being paid for each case immunised (two injections) on condition the practitioner completed an official card for each case which is seen when application is made for the prophylactic. 11 cases were immunised by practitioners during the year. Summary of immunisations:- (a) at Borough Council Clinic 499 (b) at L.C.C. Centres 1200 (c) by Private Practitioners 11 1710 -6- TUBERCULOSIS. Dispensary Clinics. From 1st Jan. to 31st Dec. Tuesdays and Thursdays, 2 p.m. Fridays, 10 a.m. From. 29th March to 27th Sept. Mondays, 6-7 p.m. (additional) From 1st Jan. to 6th March ) Saturdays, 2-4 p.m. (monthly) and 2nd Oct. to 313t Dec. ) instead of Monday evenings. Number -of new cases and contacts examined 294 - - ' (Tuberculous 97; non-tuberoulous 182; diagnosis incomplete 15) Number of attendances at the Dispensary 2561 Number of visits to homes by Health Visitors 6016 Number of sputum "specimens examined 284 Number of X-ray examinations at StiAndrew's Hospital 394 Additional Statistics. In addition to the 6016 visits paid by the Health Visitors for Dispensary purposes, 183 non-Dispensary visits were paid under the Public Health (Tuberculosis) Regulations, 1930. Reports to Chairmen of Medical Boards" 47 Patients sent away for institutional treatment 100 Patients in receipt of extra nourishment from Disponsary during the year 56 Patients in receipt of extra nourishment from Dispensary on 31st Decembor 18 Reports on child contacts to Divisional School Medical Officer 35 Letters to General Practitioners concerning patients 334 Reports to General Practitioners on official forms 68 Progress Reports received from General Practitioners 2 ' Clinioal Reports to London County Council 97 Reports to Ministry of Pensions 2 Shelters on loan during"the year 0 Shelters on loan at 31St Deoember 0 Beds and bedding on loan during "the year 2 Beds and bedding on loan at 31St December 1 During the year. 11 now cases and 24 old cases havo attendod Brompton, Colindalc, London Chest and St. Andrew's' Hospitals for 528 artificial pneumothorax refills. During tho year 4 children wore boarded out under the London County Council Contact Scheme. Dental Treatment (at St. Andrew's Hospital) Number of patients referred 3 Number of attendances 5 Number of local anaesthetics Number of general anaesthetios 3 Tuberculosis Allowances. The scheme for the provision of allowances for persons giving up work to undergo treatment of pulmonary tuberculosis came into operation on 30th June, 1943. Arrangements were mado for the assessment of cases and payment of alloxvanoes at the Tuberculosis Dispensary. Miss U. Simeon., of the London County Council Welfare Department, was appointed Tuberculosis Adjudicating Officer and she holds a weekly session at the Dispensary. The cases are brought before the Adjudicating Officer by the Caro Committee Secretary who has previously interviewed the patients and assisted them, when necessary, in filling up the appropriate application forms. An officer of the Finance Department attends the Dispensary eaoh week to pay the allowances, the Care Committee Secretary beting present when the payments are made. -7- During the six months period 30/6/43 - 31/12/43 applications, wore received from 93 patients. Of these, 84 were granted allowances. (The regaining 9 will probably qualify on discharge from sanatorium.) On 31/12/43 40 patients were actually in receipt of allqwancos. Cases arc brought before-the Adjudicating Officer for periodical review and when there is any change of circumstances. In addition to the new cases assessed, 225 reviews were carried out during the six months ended 3l/l2/43. NUMBER OF NEW CASES AND DEATHS. The numbers of new cases reported and of deaths during the year were:- New cases. Deaths. Pulmonary 163 64 Other forms 16 7 179 71 The death rate was above the average for. the five years 1938-42 : Pulmonary (5 years average) 0.96 Other forms do. 0.09 1.05 The percentage, of non-notified oases to total deaths was 12.7 (12. The number of cases of Tuberoulosis on the Register at 31st Dec. 675 The number of cases on the Tuberculosis Dispensary Register: Definitely Tuberculous 425 (T.B. plus 214) Diagnosis not oompleted 28 45| 7 SCABIES. The County'of London (Scabios) Regulations, 1943, came into operation 1st August, 1943, and, subject to certain exceptions specified in the Regulations, require the notification of cases of Scabies by medical practitioners. Notice of the Regulations was given in the loo&l press and a copy of the Regulations sent to each registered medical practitioner practising in the district. 472 cases were notified. The number of treatments given at tho Cleansing Station during the year was 5093 of Which 145 were given at 51 evening sessions. Adults: 1,253: males 505; females 748. Children: 3,840:, 1771; " 2069. 244 premises and 27,896 articles were disinfected. Total number of visits by Lady Sanitary Inspector and seconded Health Visitor 2,067. INFESTATION BY HEAD LICE. A report'on the Ministry of Health Circular 2831, dated 2nd July, 1945, was submitted to the Committee. Arrangements ware made to give effect in- general to the reoommendatioris in the Circular. INSULIN. The Ministry of Health issued Ciroular 2734 referring to the arrangements under which Insulin may-be supplied either,free of cost or at a reduced price to persons suffering from Diabetes.:0ne application was dealt with during the year. RJBLIC EDUCATION IN HEALTH. 203 lectures were given at I61 centres and the attendances totalled 11,286.