LIBRARY Pop 50 METROPOLITAN BOROUGH OF POPLAR . ABRIDGED INTERIM REPORT on the health of tho Borough during 1944 by G. 0. MITCHELL, M.D., M.R.C.P., D.P.H., Acting Medical Officer of Heolth. public Health Department, Ponlar Town Hall, Bow Boad, E.3. 6th July, 1945. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Poplar. Madam, Indies and Gentlemen, It falls to me to present my first annual report as Acting Medical Officer of Health owing; to the unfortunate retirement of Dr.. W. Allan Ybung, Medical Officer'of Health in July,1940 In accordance with the Ministry of Health Circular 49/45 (England) this report is, like the reports for the years 1939-43, an abridged Interim Report. How that the ban ofl the publication 'of population figures has been removed It is possible to give some statistics which had hitherto been withhold, and on page 2 will be found a summary of statistics for the years 1938 to 1944, The higher death rates in the years from 1940 onwards are partly accounted for by the inclusion of deaths due to enemy action, particularly in 1940, 1941 and 1944, Population. The Registrar-GeneralTs estimate of the civil population is 54,030, the highest for several years. Births. There was a slight decrease in the number of but the b'irth rate (30.7) was the seoond highest since 1926. Deaths. The number of deaths at all ages was 891, somewhat less than the figure for 1943, and the death rate of 16.5 is below the average for the preceding five years. Of the 891 deaths no fewer than 123 were of people over 80 years of age, and of these 11 were over 90 years old. Once again there were no deaths from Scarlet fever and, for the first time on record, no doaths from Diphtheria. Nor were there any deaths from Measles. Materna1 Mortality. There were four deaths from Puerperal causes. The death ratd per 1,000 total births was 3.49 which is rather above the average for the previous five years. Infant Mortality. The infant mortality rate was 41, slightly above the five years average, but a satisfactory figure when compared with the London figure of 61. Infectious Disease. Infectious diseaso gensrally was much loss prevalent. Tuberculosis. The number of ndw cases of Pulmonary Tuberculosis (147) was slightly loss than in 1943. The death rate from this cause, however, showed a slight increase on the preceding year but w^e below tho five years average. Influenza. An opidemic of Influenza which started in the late months of 1943 continued into 1944 but did not reach such proportions as to call for special action. The number of doaths from influenza was 8. Staff . Following upon the retirement of Dr. Young, I was appointed Acting Medical Officer of Health and Dr. L. D. Richards was appointed Acting Tuberculosis Officer and Acting Deputy Mcclical Officer of Health. It is with regret I have to record tho death of Mr. E. A. May, Sanitary Inspector, who had also been acting as vaccination Officer. Mr. G. L. Bolshaw, Sanitary Inspector, was appointed acting Vaccination Officer in addition to his normal duties. Mr. T.C.B.Rose, -2- another Sanitary Inspector, was seconded to the Borough Engineer and Surveyor's department for duties in connection with war damage. Miss E. James, Health Visitor, who commenced duty hero on 1st May, 1944, was, at the roquost| of the Ministry of Health, loaned to help in a maternity homo in Blackpool from 25th July to 9th October, 1944. At the time of writing there are 19 members of the public health department staff serving with H. M. Forces. General. During the year circulars on various matters wore recoived from the Ministry of Health and other Government Departments and the necessary action has been taken. In conclusion, I wish to thank the members of the Council for the way in which they have supported me in my new position, and the staff of the public health deportment for their loyal co-operation. I am, Madam, Ladles and Gentlemen, Your obedient Servant, G. 0. MITCHELL Acting Modica1 Officer of Health. STATISTICS AND SOCIAL CONDITIONS. AREA. 2,136 acres. POPULATION". Census 1931 ... 155,089 r ~ 1 1 ' 1 ■ 11 ■ ■ ' • ' . • ■ ■■ Bogistrar-Goneralts estimated Civil Population 1944 f 54,030. The following figures, some of which have not been published hitherto, are inserted for comparison with the figures for the last pre-war year, 1938 1938 • 1939. 1940. 1941. 1942. 1943... Average 5' years 1944. 134,400 population 31200a 34100b 97,410 52,570 51,260 52,890 54,030 a - for birth rate. b - for death rate. 14.9 Birth rate; Live births 15.7 17.3 18.4 19.8 22.0 17.9 20.7 0.49 Still births . 0.40 0.43 0.40 0.45 0 .45 0.42 0.48 11.4 Death rate 12,4 19.7 22.2 16.2 17.4 16.9 16.5 0,73 Tuborculosis Death"rate: Hospiratory 0.74 1.12 1.35 ' ; . . ; \ . 1 1.36 1.21 1,07 1.24 0.08 Other forms 0,02 0.13 0.19 0.08 0.13 O.ln 0.06 0.81 All forms 0.76 1.25 1.54 1.44 1.34 1.17 1.30 60 Infantile Mortality rate 31 41 48 34 47 39 41 2.42 Maternal Mortality rate... 2.42 1.26 1.47 4.82 2.53 3.12 3.49 -3- 1944. LIVE BIRTHS. Total. Males Females. Legitimate 1055 567 488 Birth rate per 1,000 Illegitimate 64 41 23 population 20.7 1119 608 511 STILL BIRTHS. Total. Moles. Females. Rate per 1,000 total 26 15 11 births 22.7 DEATHS. Total Males. Females. Death rate per 1,000 891 521 370 population 16,5 DEATHS FROM RJERP^L CAUSES. Puerperal sepsis 1 ) Rate per 1,000 total Other maternal causes 3 ) births 3.49 INFANT MORTALITY RAPE. All infants per 1,000 live births 41 Legitimate infants per 1,000 logitinate births 40 Illegitimate infants per 1,000 illegitimate births 63 CLASSIFICATION OF DEuTHS AT ALL AGES. The 891 deaths at all ages were classified by the Registrar General as follows Cerebrospinal fever 2; Whooping cough 3; Tuborculosis of respiratory system 67 ; other foms of tuberculosis 3; Syphilitic disease 7; Influenza 8; Acute encephalitis lethargies 3; Cancer of: (a) buccal cavity and oesophagus 7; (b) uterus 3; (c) stomach and duo do nun 31; (d) breast 12; (e) all other sites 73; Diabetes 4; Intracranial vascular lesions 51; Heart disease 238; other diseases of circulatory system 44; Bronchitis 52; Pneumonia 35; other respiratory diseases 7; Ulcer of stomach and duodenum 15; Diarrhoea (under 2 years) 6; Appendicitis other digestive diseases 18; Nephritis 14; Puerperal and post-abortive sepsis 1; other maternal causes 3; Premature birth 9; Congenital malformations etc. 10; Suicide 5; Road traffic accidents 8; other violent causes 110; all other causes 42 INFANTILE DEATHS. There wore 46 deaths of infants under one year of age, the causes of death being as follows « ■ • * - • * . * * • •Cerebrospinal fever 1; Whboping-cough 3;- Bronchitis 1; pneumonia 11; ■Diarrhoea 4; "other digestive diseases 1;- Premature birth 9; congenita malformations, etc, 8; other violent causes 3; all other causes 5. • - t. GENERAL PROVISION OF HEALTH ST^VICES IN THE AffEA. NURSING IN THE HOI.ffi. The number of visits paid to cases by the nurses from nursing associations was 637. ♦ >..»' - « - . . ■' ■ i.. . WELFARE CENTRES at 31st December, 1944. ■ ■< ' 9 » » 'I 7 Clinics (Maternity and Child Welfare) (a) Borough Council: Ruston Stroct: „ ... . Ante-natal: Tuesday rornings and Wednesday afternoons. Infant Consultations: Thursday morning and afternoons. Sunlight: Monday afternoons and Friday mornings. Wellington W&y: Dental: Wednesday mornings. —4-— 134 poplar High Street: infant Consultations: Monday afternoons 1 Bazeley Street: Ante-natal: Tuesday mornings. 54 West Ferry Road: Infant Consultations: Wednesday afternoons. Ante-natal: Friday afternoons. (b) Royal College of St. Katharine: 1 Bazeley Street: Ante-natal: Tuesday Thursday mornings. Trinity Hall: Infant Consultations: Wednesday 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 Clinics were Borough Council. Royal College of St. Katharine. Total. 12,619 5,362 17,981 VISITS PAID BY HEALTH VISITORS. The numbers of visits paid by the Health Visitors were Borough Council. Royal College of St. Katharine. Total. 22,047 24,768 46,815 ADDITIONAL INSTITUTIONAL ETERNITY x^CCOIJ-IOD^TION. The London County Council allocated seven maternity beds at Poplar Hospital for the use of patients resident in Poplar. The maternity ward was opened on 26th October, 1944. EAST END MATETRNITY HOSPITAL. Since a number of Poplar mothers continue to take advantage of the service afforded by this hospital the Council have agreed to nake an annual contribution of one guinea for each Poplar mother confined, thore during the year, as from 1st November, 1944. CARE OF PREMATURE INFANTS. (Ministry of Health Circular 20/44). A brief outline of the arrangements for the care of premature infants is as follows :- 1. a space has been provided on the birth notification card for the weight at birth to be inserted. 2. equipment has boon loaned to mothers of premature infants; Treasure cots with detachable linings (3) Rubber hot water bottles {3) Weighing scales (1) Warm and suitable clothing where necessary. 3. expressed breast milk has been supplied (l) 4. premature infants are closely followed up by the Health Visitors. 5. close co-operation is maintained between the maternity unit at St, Andrew's Hospital and the Public Health Department. CARE OF ILLEGITIMATE CHILDREN (Ministry of Health Circular 2866). With the approval of the Ministry of Health, the Council adopted a scheme of guaranteed payments to foster mothers. The Metropolitan Boroughs' Standing Joint Committee submitted a scheme of increased financial assistance to voluntary "associations and Poplar's contribution , based on rateable value, is £64. The Council adopted the scheme, subject to its acceptance by all tho constituent Councils. -5- CHILD IIFE PRO TACTION- Visits to foster mothers and children 12 poster mothers under supervision during 1944 1 Foster children 2 STERILE MATERNITY OUTFITS. No outfits were issued during the year. OBSTETRIC CONSULTANTS. :It was. not necessary to call in a Consultant To any case during the year. CONVALESCET TREATEIENT.. 18 convalescent cases were sent away during th!e year-through the agency of the Invalid Children's Aid Association. SUPPLY OF SHEETS FOR EXPECTANT MOTHERS. (Ministry of Health Circular 154/44). Arrangements were made for the issue of priority dockets to expectant mothers in accordance with the scheme outlined in the Circular. MILK SCHEME (Maternity and Child Welfare). 34 applications were received and all were granted. Order for 182 1b of dried milk were issued. In addition, 253 packets of dried milk were gold at cost price. D1STRTBUTI0N OF COD LITER 0IL AND FRUIT JUICES. The arrangements made with the Local Deputy Food Officer were -continued. WAR TIME DAY NURSERY. The War Tine Day Nursery in Tidey Street continued to function during the year. At the end of the year the number of children on the register was., the highest attendance on any one day being. It was found impossible to obtain non-resident probationers, and in view of this the Ministry of Health approved the appointment of an additional nursery assistant. Owing to the fact that the nursery does not admit infants under the age of one year, arrangements were made with the Medical Officer of Health for Stepney for the resident probationers to receive training, with a 0-1 year group at the Stepney Day Nurseries. NURSING STAFFS IN DAY NURSERIES AND TUBERCULOSIS. Following upon the Issue of the Ministry of Health 'Circular 111/44, arrangements were made for the nursing staff at the Tidey Street Day Nursery to be examined at the Council's Tuberculosis Dispensary, and the Medical Officer of Health, Essex County Council, agreed to arrange for the examination of the staff at Queen llory Day nursery at Gaston House, Little Hallingbury. SANITARY CIRCUMSTANCES OF THE AREA. SANIARY INSPECTORS' WORK. With some members of the staff assigned to part-time Civil Defence duties full routine work could not be resumed, but 19,550 inspections and reinspections were made by the District and Lady Sanitary Inspectors. The number of visits to air raid shelters was 478 and the number of inspections 1,465. 1,295 intimations, 483 notices and 163 final notices were served regarding nuisances. Legal proceedings were necessary in only one instance. , DTSINFESTATION. Number of rooms disinfested 1,109; number of articles disiniested 3,548. Total number of inspections and visits 1,589. Nq disinfestation by HGH was done during the year. HOUSING. The Housing Inspectors, like the District Inspectors, were assigned to part-time duties in the Casualty Services and when not so assigned they assisted the District Inspectors. Consequent on the death of Mr. E. A. May, Mr. Belshaw was appointed acting vaccination Officer. -6- RENT PTi^TFRICTION CERTIFICATES. Certificates under the Rent Restriction etc. Hcts were issued as follows to. Tenants 109 to Owners 60 RODENT CONTROL. As mentioned in last year's annual report the Council authorized the organisation of a contributory scheme to cover the whole of the Borough. Up to the end of the year 71 firms had agreed to participate and the total number of treatments at their premises was 407. Treatments at dwelling houses numbered 221. The following statement oh treatment of sewers was included in a report submitted to the Committee after the third treatment ' 1st treatment. 2nd treatment 3rd treatment. (13.12.43 to 17.1.44) (18.1.44 to 11.2.44) (24.4.44 to 20.5.44) Manholes inspected 1848 1803 1761 Manholes baited 1702 1658 1665 Manholes poisoned 923 341 394 Poison "takes" 713 224 351 Dead rat found. 328 9 140 Estimated kill 11445 285.2 6051 WATER SUPPLY. Generally, the service is provided by the Metropolitan Water Board direct from the mains, and examinations are carried out by the Board. No complaints were made to the Public Health Department during the year. The certificate issued in 1938 under the Factories Act, 1937, regarding the well at the Bow Common Works of the Gas, Light and Coke Company was cancelled after the conversion of all domestic supplies of water at these works to the Metropolitan Water Board supply. INSPECTION AND SUPERVISION OF FOOD. The Meat and Food Inspectors made 3,238 inspections of premises whore food is prepared, stored or sold. BASEMENT BAKEHOUSES. In accordance with section 54 of. the Factories Act, 1937, the, five remaining basement bakehouses in the Borough were re-surveyed. In one case the certificate of suitability was continued. In the other four cases appeals against notices to discontinue wore adjourned sine die. REPORT OF THE PUBLIC ANALYSTS. The number of samples examined was 692 and the number found to be adulterated was 28 - a percentage of 4.0. During the ten years 1935-44 the average number examined was 717 and the percentage adulterated was 3,6. PREVALENCE OF AND CONTROL OVER, INFECTIOUS DISEASES. Infectious disease was much less prevalent than in 1943. The number of cases notified (corrected for "altered diagnosis" cases) and the number of deaths were:- Cases. Deaths. Scarlet fever 81 • Diphtheria 5 • Typhoid and paratyphoid fevers • • Erysipelas 25 • Puerperal fever 1 1 Puerperal pyrexia 13 • Cerebrospinal fever 2 2 Ophthalmia neonatorum. 1 • Measles 192 * Whooping cough 184 3 -7- Primary pneumonia 90 4@ Influenzal pneumonia 13 2 @ Dysentery 17 • Zymotic enteritis 13 6 Malaria 5 x • Acute Poliomyelitis 1 • 643 Scabies 856 * 1499 @ notified cases only. x 3 non-civilian cases and 2 induced for therapeutic purposes. There wore 3 deaths from chronic encephalitis lethargica. One case was notified in 1933, a second had been notified elsewhere, and the third was an innate of a mental hospital outside London. SMALLPOX CONTACTS. As a result of a case of Smallpox occurring at the Mount Vernon Hospital, several possible contacts were kept under surveillance but no cases occurred in the Borough. IMMUNISATION AGAINST DIPHTHERIA. The immunisation clinic at the Council's Tuberculosis Dispensary continued throughout the year. A supplementary clinic was hold at Simpson's Road M.& C. W. centre from 31st January 1944 until 7th August, 1944, when the premises wore badly damaged by a "fly" bomb. To deal with the children in the Isle of Dogs area a session was commenced at the M.& C.W. clinic at 54 West Ferry Road on 9th Octobor. Summary of all immunisations :- (a) at Borough Council clinics 432 (b) at London County Council centres 210 (c) by Private Practitioners 9 TUBERCULOSIS. Dispensary Clinics. From January 1st to December 31st and in addition:from 9th March to December 31st 80th March to December 31st 1st January to 5th March Tuesdays & Thursdays 2 p. m. Fridays 10 a.m. Thursdays 10 a.m. Mondays 6-7 p.m. Saturdays 8-4 p.m. (monthly - instead of Monday evening Number of new cases examined 309, contacts 176 = 485 Tuberculous 94; non-tuberculous 373;diagnosis incomplete 18) Number of attendances at the Dispensary 8658 Number of visits to homes by Health Visitors 5574 Number of sputum specimens examined 885 Number of X-ray examinations at St. Andrew's Hospital 410 -8- Additional Statistics. In addition to the 5574 visits paid by the Health Visitors for Dispensary purposes 169 "non-Dispensary" visits wore paid under the Public Health,(Tuberculosis) Regulations, 1930. Reports to Chairmen of Medical Boards 34 Patients sent away for institutional treatment 92 Patients in receipt of extra nourishment from Dispensary during the year 65 Patients in receipt of extra nourishment from Dispensary on 31st December 31 Beports on child contacts to Divisional School Medical Officer 24 Letters to General Practitioners concerning patients 319 Reports to General Practitioners on official forms 48 Progress Reports from General Practitioners 3 Clinical Reports to London County Council 74 Reports to Ministry of pensions 6 Shelters on loan during the year 0 Shelters on loan at 31st December 0 Beds and bedding on loan during the year 6 Beds and bedding on loan at 31st December 5 During the year 11 new cases and 25 old cases have attended Brompton, Colindale, London Chest and St. Andrew's Hospitals for 534 artificial pneumothorax refills. During the year 16 children were boarded out under the London County Council contact scheme. Dental Treatment at St. Androw's Hospital. Four cases -were referred to St. Andrew's Hospital for dental treatment during the year. Tuberculosis allowances. The scheme for the provision of allowances for person's giving up Work to undergo treatment of pulmonary tuberculosis has continued to operate as part of the Dispensary service. The Tuberculosis Assessment Officer (Miss U. Simoon) has hold 52 sessions during the year"and 484 cases have boon submitted to her. Of these, 69 were now applications from patients certified by the Tuberculosis Officer as medically eligible for allowances and 415 were cases brought up for review. On 31.18.44, 41 patients were in receipt of allowances. The existence of the allowance scheme has proved a helpful factor in persuading patients to agree to early treatment of tuberculosis, and to remain in sanatorium for prolonged periods. NUMBER OF CASES DEATHS. The numbers of new cases and deaths reported' during the year were :- New cases. Deaths. Pill mo nary 147 67 Other forms 17 3 Tig The death rates for the years 1938-1944 are given on page 2 (some of the figures were not given in previous reports). The percentage of non-notified oases to total deaths was 8.6 . The number of cases of Tuberculosis on the Register at 31st Dec. was 658 The number of cases on the Tuberculosis Dispensary Register was: Definitely Tuberculous 464 (T. B. plus 229) Diagnosis not completed 21 25 485 -9- MASS MINIATURE RADIOGRAPHY. The London County Council intimated that it was proposed to install a mobile mas miniature radiography unit in Hackney from the beginning: of October to servo the Bo roughs of Bethnal Green,AShoreditch, Stoke Newington and Poplar. The date of opening was subsequently altered to 13th November. Poniard quota was from 1500 to 2000. cases, to be choser from the larger industrial concerns in the Borough and from the Borough Council staff. 1043 volunteers took advantage of the scheme, the Borough Council being responsible for the cost of' transport which was provided, by the London County Council. SCABIES. 856 cases of Scabies were notified during the year under the County of London (Scabies) Regulations, 1943. The total number of visits by the Lady1.Sanitary Inspector and seconded Health Visitor was 1,603. 8,639 treatments were given at the Council's Cleansing Station and of those 56 were given at 41 evening sessions. Owing to a breakdown at the Cleansing Station it became necessary to refer 34 adult cases to Bethnal Green and Stepney, where treatment was given by the courtesy of the Medical Officers of Health. Adults: 665 (261 males; 404 females) . Children: 1974 (878 " ;1096") 65 premises and 37,464 articles were disinfected. CLOSING OF VERMINOUS PERSONS AND CHILDREN. The total number of cleansings carried out at the Council Cleansing Station was 630. Adults: 66 ( 32 males; 34 fe&ales) Children: 564 (180 " ; 384" " " ) PUBLIC EDUCATION IN HEALTH. 226 lecures were given at 14 contres. the' total attendances being 10,841.