STPAN 11 METROPOLITAN BOROUGH OF SAINT PANCRAS ANNUAL REPORT (Abridged) on the HEALTH OF THE BOROUGH for the year 19 4 2 by MAITLAND RADFORD, M.D., B.S., D.P.H., Medical Officer of Health 0000000O0000000 page 2 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Saint Pancras. Sir, Ladies & Gentlemen, This Report for the year 1942 is the 86th Annual Report that has been submitted, and the ninth that I have had the honour to prepare. It is, in accordance with instructions received from the Ministry of Health, an abridged report from which everything except essential statistical information has been excluded. The rise in the birth rate reported in the last Annual Report is repeated during the year under consideration, while there has again been a fall in the death rate. With the satisfactory progress of the war, thoughts have turned to post-war planning, and the Public Health Committee have commenced consideration of the all Important question of improving housing conditions in the Borough as soon as possible after the cessation of hostilities, I am, Sir, Ladles & Gentlemen, Your obedient Servant MAITLAND RADFORD Medical Officer of Health Page 3 STATISTICS FOR THE'YEAR 1942 POPULATION The estimated mid-year population Is slightly higher than in 1941 - hut in accordance with Instructions, no figure is quoted. Ll'vE BIRTHS M F Total Legitimate - 815 782 1597 Illegitimate - 105 83 188 920 865 1785 STILL BIRTHS Legitimate - 21 19 40 Illegitimate - 6 2 8 27 21 48 DEATHS All ages - 935 795 1730 DEATHS FROM PUERPERAL CAUSES Rate per 1,000 total live & still births Puerperal Sepsis - 5 2.73 Other puerperal causes - 3 1.63 Totals - 8 4.36 DEATH RATE OF INFANTS UNDER 1 YEAR OF AGE All Infants per 1,000 live births 66. Legitimate infants per 1,000 legitimate live births 59. Illegitimate Infants per 1,000 illegitimate live births 117. NOTIFICATIONS OF BIRTHS The total number of notified births of St.Pancras children was 1629, Including 69 still-births. Of this number 70], were notified by Midwives. (Comparable figures for the preceding 3 years:-) Notifications Midwives 1939 - 1942 1733 1940 - 1668 1484 1941 - 997 962 page 4 CLASSIFICATION OF DEATHS, WITH AGE DISTRIBUTION CAUSES OF DEATH under 1 year Ages - Both sexes Sex 1 and under 5 and under 15 15 and under 45 45 and under 65 65 and upwards Totals M. F. All causes 117 20 6 180 490 917 935 795 1. Typhoid & paratyphoid — — — — — — — — 2. Cerebrc-spinal fever - — — .— — -— — — 3. Scarlet fever — — — — — — — — 4. Whooping cough 3 3 — — — — 3 3 5. Diphtheria — 1 - — - — 1 — o. Tuberc.of respir. system 1 1 — 59 55 18 92 42 7. Other tuberculosis — 4 5 1 3 5 8 8. Syphilitic diseases — - 3 9 4 10 6 9. Influenza 1 — — — 4 3 3 5 10. Measles — — — — — — — - 11. Ac.poliomyelitis & polioencephalitis — — — — — — 12. Ac,infectious encephalitis — — — 2 3 1 3 3 13. Cancer - buccal cavity and Oesoph CM); Uterus (F) — — — — 20 24 25 19 14. Cancer - stomach & duodenum — - - 1 19 19 22 17 15. Cancer - breast — — — 2 10 10 — 22 l6. Cancer - all other sites 1 — — 9 71 69 91 59 17. Diabetes — — — 1 2 5 5 3 18. Intracranial vas.lesions — - — 3 33 92 49 79 19. Heart diseases — — - 17 77 304 206 192 20. Other circulatory diseases — — — 1 15 41 26 31 21. Bronchitis 6 2 — 4 37 81 84 46 22. Pneumonia 12 3 — 7 36 60 60 58 23. Other respiratory diseases 1 1 1 4 8 6 15 6 24. Ulcer - stomach & duodenum — — — 4 7 15 18 8 25. Diarrhoea (under 2 years) 23 1 — — — — 12 12 2b. Appendicitis ' — - 1 — 3 2 1 5 27. Other digestive diseases « 1 — 2 11 21 18 17 28. Nephritis — — — — 9 14 17 6 29. Puerperal & post-abortive sepsis _ — _ 4 1 _ _ 5 30. Other maternal causes — — 3 — — — 3 31. Premature birth 27 — — — — 17 10 32, Congenital malformations, birth injury & infant disease 29 s — — 1 2 1 20 13 33. Suicide — - - 5 6 4 7 8 34. Road traffic accidents — 1 5 4 6 12 4 35. Other violent causes 6 1 2 7 12 31 33 26 36. All other causes 7 1 2 31 35 83 80 79 page 5 PROVISION OF HEALTH SERVICES IN THE BOROUGH Treatment Centres and Clinics Welfare Centre Expectant Mothers Children Total Consultations Total Attendances Consultations, Attendances Under 1 1-5 Total St.Pancras School for Mothers (Ampthlll Square) 13 148 151 2327 1083 3410 Camden Town 51 711 252 3949 2822 6771 Kentish Town 76 984 151 3680 1696 5376 North St.Pancras School for Mothers(Queens Crescent) 52 752 • 152 3189 1520 4709 Somers Town 12 158 128 2487 1837 4324 South Highgate - ~ 103 2418 1182 36OO University College Hospital 148 3477 101 462 187 649 Royal Free Hospital 104 830 43 15 21 36 Totals - 456 7060 1081 18,527 10,348 28,875 Artificial Light treatment — — 95 96 1300 1396 Dental Treatment Ampthjll Square Camden Town Sessions - 26 77 Attendances - 114 1041 The Borough Council also made a contribution during the year of £57. 4s. towards the total cost of £105. 14s. 6d. for dentures supplied to nursing or expectant mothers* page 6 Gynaecological Clinic Sessions are held weekly, and during the year there were 335 attendances, of which 127 new cases received attention. Comparable figures for this Clinic since the date of opening 1939 - 67 attendances —67 women 1940 - 184 " 79 " 1941 - 260 " 90 " Health Visitors "The total number of visits made by Health Visitors was Council's To Expectant mothers - 3,383 Post Natal - 349 Children - 18,265 Child Life Protection - 166 Infectious diseases &c - 1,928 Other visits - 2,o03 26,694 U.C.Hospital 53 12 572 1 16 10 664 Total 361 18,837 167 1,944 2.613 27,358 . Comparable figures for 1941 were:- 25,056 772 25,828 Nursing in the Home The "following District Nursing Associations undertake the nursing of cases of illness occurring in expectant and nursing mothers, and children under 5 years of age. An annual block grant is made to each Association in respect of nursing for certain specified diseases. Block Grant Number of £ Cases Visits Hampstead 30 93 1,154 Metropolitan 250 111 1,140 North London 25 44 333 Supplementary Clothing Coupons for Expectant Mothers This Scheme came into operation on August 1941, to enable expectant mothers to purchase materials for garments which should be made for a baby before the birth. During the year a total of 2,399 expectant mothers, resident in the Borough, were issued with supplementary coupons on the production of a medical certificate complying with Board of Trade Regulations. The Issue during 1941 was 339. page 7 Home Helps An annual grant of £250 is made by the Council for use in respect of maternity cases only, 69 cases were dealt with during the year, 65 being maternity and 4 sickness cases. Diphtheria Immunisation "The Immunisation of children progressed very favourably during the year, as will be seen by figures given below, through the various schemes now operating. Immunisation is carried out by General Practitioners; at the Council's Welfare Centres; the Wartime Day Nurseries and by the London County Council Medical Officers at their day schools. The total number immunised since the inception of the Scheme in 1936, amounts to 4,672. To show the progress made in this work, the numbers are set out year by year:- 1936- 233; 1937- 617; 1938- 302; 1939- 158; 1940- 78; 1941- 590; 1942- 2694. War-time Day Nurseries Commencing the year with one Nursery in operation, five others were put Into use at varying times from May to December. They are sited throughout the Borough to meet the needs of the parents as far as possible. The accommodation provides for 360 children In the six Nurseries, with staffs totalling 73. In addition to these Nurseries, the London County Council, in co-operation with the Borough Council, opened, during the period March to August,1942, four others at Rest Centres situated in their schools, with a total capacity of 80 children, The number of Day Nurseries under the control of the Council is still expanding to keep up with war-time requirements. Small-pox and Vaccination Of the 929 births dealt with by the Vaccination Officer during 1941 a total of 405 (43.6%) were successfully vaccinated. Figures for 1942. are not yet available. The number of births referred to above do not include those births transferred to St. Pancras from other Boroughs. Comparable figures for 1930, 1939 and 1940 were 43.9% 41.8% and33.4% respectively. Page 8 SANITARY CIRCUMSTANCES IN THE BOROUGH Sanitary Inspectors During the year, 25,518 visits and inspections (including re-inspections) were made by 11 of the Council's inspectorial staff. Of these 4,716 were made by the 2 Food Inspectors, and 6,878 by the 2 Factory Inspectors. Under the general direction of the Housing Inspector, the remaining Sanitary Inspectors have been wholly engaged on the supervision of work in connection with first-aid repairs to war damaged houses in the Borough, with the assistance of 8 technical assistants, A total of 1,521 Intimation Notices (including 244 by the Factory Inspectors); 341 Statutory Notices and 5 Notices under the Rent Restriction Act were served during the year. No Notices were served under the Shops Act. There were 3 prosecutions under the Public Health (London) Act 1936 in respect of general sanitary work, and 11 under the Food and Drugs Act 1938. Defects found under the Factories Act numbered 332, all of which were remedied. There was 1 prosecution under this Act. Section 224 of the Public Health (London) Act 1936 authorises the removal to a Home or Institution of certain aged, diseased or infirm persons living under insanitary conditions. During the year 6 persons were so dealt with. Infectious diseases Notifications Cases admitted to Hospital Total deaths Under 1 1 & Over Total Acute influenza and influenzal pneumonia , 26 26 — 8 Acute primary pneumonia 4 85 89 27 118 Anterior poliomyelitis & polioencephalitis — 2 2 4 — Cerebro-splnal meningitis 2 12 14 14 — Diphtheria & membranous group 11 90 101 94 1 Dysentery 5 49 54 54 — Enteric or typhoid fever 1 2 3 3 — Erysipelas 1 55 56 43 — ■ Food poisoning — 2 2 — — Measles 91 1401 1492 1392 — Ophthalmia neonatorum 21 — 21 18 — Puerperal fever — 8 8 8 — Puerperal pyrexia — 29 29 23 — Scarlatina or scarlet fever 4 169 173 167 — Whooping cough 85 395 480 81 6 page 9 Cleansing Station The total number of attendances in 1942 was 9,959, as compared with 6,149 in 1941, the increase being attributable to a larger number of scabies cases. Number of attendances during the year were:- Women (& St.Pancras Ex St.Pancras Men children School School Total under 5) Children Children Vermin 824 78 1,552 416 2,870 Scabies 1023 2,484 2,686 896 7.089 1,847 2,562 4,238 1,312 9,959 Disinfection The number of articles disinfected or destroyed at Camley Street on account of verminous conditions and infectious diseases are as follows:- Destroyed - 61 Disinfected - 12,581 Figures showing the number of disinfections carried out after Infectious diseases are set out below:- DISEASE No. of cases No. of houses No. of rooms contents disinfected or destroyed No. of rooms sprayed and fumigated Cerebro-spinal meningitis 17 17 3 17 Diphtheria 114 114 81 83 Dysentery 27 27 M 27 Enteric fever 2 2 2 2 Erysipelas 47 47 42 47 Measles 19 19 3 19 Pneumonia — — — — Polio-myelitis 1 1 — 1 Puerperal fever 12 12 9 4 Scabies 711 6l6 609 — Scarlet fever 182 l6l 181 174 Tuberculosis 134 134 134 116 Vermin 409 382 88 409 Other diseases 190 179 62 17 Totals 1865 1711 1214 916 Housing Work under the Housing Act 1936 has been at a standstill owing to the war. page 10 INSPECTION AND SUPERVISION OF FOOD Milk supply Tremlses on the Register at the end of the year:- Dalrles - 163 Itinerant purveyors - 69 Sealed containers only - 229 The Inspectors made 627 visits, and 323 formal samples were taken and submitted for analysis - only 1 of which fell below the limit required by the Board of Agriculture Regulations. Milk (Special Designations) Orders 1936 and 1938 The number of licences granted during 1942 was supplementary Licences Licences Tuberculin tested 13 7 Accredited' 1 — Pasteurised ; 42 12 Meat and Other Foods (1) Public Health (Meat) Regulations 1924 Periodical visits of inspection were made as follows Slaughter houses - 7 Meat Depots - 278 Butchers' shops and meat stalls - 675 Prepared meat premises - 422 .(i1) Inspection of other premises where food is prepared or offered for sale The Food Tnspectors have kept all such premises under regular and frequent observation, 526 inspections being made for the purpose. Adulterations &c. A total of 800 samples (396 formal and 404 Informal) were submitted for analysis by the Public Analyst, of which 20 formal and 14 informal were found to be adulterated. Prosecutions were undertaken under the Food & Drugs Act 1938 in 11 cases. page 11 TUBERCULOSIS. Tubcrouloals Dispensary. Number of definite cases of tuberculosis on the Dispensary Registers at the end of the year:- Pulmonary Adults Children M. F. M. F. 348 178 19 12 Non-Pulmonary Adults Children M. F. M.F 39 23 25 18 Totals Adults Children M. F. M. F. 387 201 44 30 Total attendances 3,293 X-Ray examinations 618 A.P. Refills 1,399 Visits by Tuberculosis Visitors 3,687. Sputum examinations 478Finsen Light Treatments' Admissions to Institutions 312. NEW CASES Non- pulmonary Pulmonary M F M F DEATHS Non- Pulmonary Pulmonary M F M F Primary notifications Deaths reports Transfers Other sources I36 59 15 14 11 8 4 6 42 16 2 1 2 Ages 0 1 - 5 15 25 35 45 55 65 and upwards TOTALS 1 1 5 25 55 34 26 30 14 191 15 2 1 30 19 10 11 4 6 83 4 4 5 3 1 1 2 1 21 - 6 3 5 3 1 2 1 21 1 - - 8 11 13 20 26 13 92 - 1 - 10 9 8 6 3 5 42 - 2 - - 1 1 1 5 - 2 - 1 1 1 1 - 2 8 Notification Register on 31st December 1942:Pulmonary - 722 Non-Pulmonary - 126 page 12 Tuberculosis Care Committee. An account of the work of this Committee., which is more than ever necessary under war conditions, is omitted owing to lack of space, except for the following details Income from Seal Sales and other sources £ll2.19.4d. Expenditure on clothing, coal, removals, pocket money etc. for patients £99.12.6d. Extra nourishment (provided by the Borough Council) - number of patients 6l, cost £275.7.5d. Dental treatment (also provided by the Borough Council) - number of patients 4, cost £10.18.3d. BACTERIOLOGICAL. EXAMINATIONS Positive Negative Total For Diphtheria bacilli 32 467 499 Tubercle bacilli 20 155 175 Haemolytic streptococci - 2 2 52 624 676