Urban District of Wood Green. REPORT OF THE Deputy Medical Officer of Health For 1917. W. E. PORTER, M D , D.P H., Deputy Medical Officer of Health. 22nd July, 1918. CRUSHA SON, Printers, Tottenham and Wood Green. Urban District of Wood Green. REPORT OF THE DEPUTY MEDICAL OFFICER OF HEALTH For 1917. Sanitary Department, Town Hall, Wood Green, N. 22. 22nd July, 1918. Mr. Chairman and Gentlemen, My Annual Report for the year 1917 is considerably curtailed, and only includes the details which are requested by the Local Government Board. Population. The Registrar-General has supplied me with the estimated civil population for the year 1917, which is, for the purposes of birth-rate, 51,996, and for the death-rate 46,645. The estimated population for each Ward, based on the above figures, is as follows:— Birth Rate. Death Rate. Town Hall 11,770 10,625 Bowes Park 7,930 7,100 Alexandra Park 7,500 6,700 Central 10,886 9,700 Noel Park 13,910 12,520 51,996 46,645 2 Births. There were 882 births, as against 1,017 in 1916. The births were:—379 males and 403 females; of these, 33 were illegitimate, viz., 10 males and 23 females; this corresponds to an annual rate of 16.96, compared with 18.68 per thousand in 1916, and 19.82 in 1915. The birth-rate for England and Wales was 17.8. The following table shows the number of births registered within and without the district and the birth-rate for each Ward:— Births Registered. Birth Rate. Town Hall 192 16.31 Bowes Park 151 19.04 Alexandra Park 128 17.06 Central 202 18.55 Noel Park 209 15.02 882 16.96 Deaths. The total number of deaths was 540, including residents dying within and without the district; the death-rate is therefore equal to an annual rate of 11.57 per 1,000 of the population, as compared with 14.4, the death-rate for England and Wales for the same period. The number of deaths in 1916 was 512, an annual rate of 10.23 per 1,000 of the population. The following are the number of deaths and death-rate per 1,000 in each Ward.:— 3 Ward No. of Deaths. Death Rate. Town Hall 135 12.70 Bowes Park 95 13.38 Alexandra Park 68 10.14 Central 113 11.64 Noel Park 129 10.30 540 11.57 There were 49 deaths of children under one year, which corresponds to a death-rate of 55.55 for every 1,000 births, against 66, or a rate of 64.89, in 1916, in comparison with a rate of 97.00 for the whole of England and Wales (93.00 in smaller towns). The deaths of children under five years were 79, which corresponds to a rate of 1.69 per 1,000 of the general population, against 102 deaths, or a rate of 2.00 per 1,000 in 1916. Zymotic Diseases. The seven principal diseases caused 41 deaths, which corresponds to an annual rate of .87 per 1,000 of the population, against .39 per 1,000 in 1916. The following are the numbers of deaths from each of these liseases:— Disease. No. of Deaths. Small Pox — Scarlet Fever — Diphtheria 6 Enteric Fever — Measles 7 Whooping Cough 4 Diarrhoea 24 41 4 Cases of Notifiable Diseases. Ward. Diphtheria. Scarlet Fever. Enteric Fever. Cerebrospinal Fever. Town Hall 36 10 — — Bowes Park 19 4 — 1 Alexandra Park 5 12 — 1 Central 9 9 1 1 Noel Park 30 13 1 — 99 48 2 3 Ward. Erysipelas. Ophthal. Neonatorum. Measles. German. Measles. Town Hall 3 1 194 96 Bowes Park 3 1 131 59 Alexandra Park 7 — 112 59 Central 3 2 217 34 Noel Park 4 — 316 99 20 4 970 347 Pulmonary Tuberculosis. Other Tuberculosis. Puerperal Fever. Town Hall 15 5 1 Bowes Park 9 3 — Alexandra Park 12 1 — Central 11 3 — Noel Park 13 8 — 60 20 1 5 Infectious Cases Removed to Hospital. Ward. Diphtheria. Scarlet Fever. Cerebrospinal Fever. Enteric Fever. Town Hall 34 10 — — Bowes Park 15 2 1 — Alexandra Park 3 8 1 1 Central 9 8 1 1 Noel Park 28 10 — 1 89 38 3 3 Error in Diagnosis 1 89 38 3 2 Erysipelas. Total. P.c. of cases removed. Town Hall — 44 95.65 Bowes Park — 18 74.10 Alexandra Park 1 14 56.00 Central — 19 90.47 Noel Park — 39 84.09 1 134 87.58 Error in Diagnosis 1 1 133 87.58 6 Age Periods of Infectious Disease. Disease. At all Ages. Under 1 Year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Diphtheria 99 — 20 64 11 4 — — Scarlet Fever 48 — 6 32 8 2 — — Enteric Fever 2 — — — 1 — 1 — Cerebro-Spinal Fever 3 — — — 1 2 — — Erysipelas 20 — — 1 1 7 6 5 Ophthal. Neonatorum 4 4 — — — — — — Measles 970 19 216 650 55 26 4 — German Measles 347 8 46 203 61 27 2 — Pulmonary Tuberculosis 60 — — 8 6 35 11 — Other Tuberculosis 20 — 3 9 4 4 — — Puerperal Fever 1 — — — 1 — — — 1574 31 291 967 149 107 24 5 7 Total Cases and Deaths for the Whole District for the Years 1916 and 1917. Disease. No. of Cases. No. of Deaths. Incidence of Disease. 1917. 1916. 1917. 1916. 1917. 1916. Diphtheria 99 78 6 5 2.12 1.55 Scarlet Fever 48 122 2 1.02 2.42 Enteric Fever 2 6 — — .04 .11 Cerebro-Spinal Fever 3 3 12 2 .06 .05 Erysipelas 20 22 2 — .42 .43 Measles & German Measles 1317 351 7 1 28.23 7.01 Pulmonary Tuberculosis 60 68 43 46 1.28 1.35 Other Tuberculosis 20 20 10 6 .42 .39 Puerperal Fever ... 1 — — — .02 .00 Cerebro-Spinal Fever. Three cases were reported during the year (the same number as in 1916); all the patients were adults. No source of infection could be traced in any of the cases. In one case there was an element of doubt, as the bacilli were not definitely identified, while some of the usual symptoms were not present; but after communicating the facts to the Local Government Board, it was decided that the case should be treated as one of Cerebro-Spinal Fever. The ages of the patients were 21, 40 and 34 respectively. All were employed outside the District, and the attacks came on suddenly. 8 Enteric Fever. Three cases were notified, but one, after observation at the Isolation Hospital, proved to be appendicitis, and was removed to the Passmore Edwards' Hospital for operation One patient, aged 21, was employed in a munition factory in an adjacent district, while the second, aged 55, had been visiting her soldier son in Hospital with "Nephritis," but no source of infection could be traced in either case. I am glad to report that both patients made good recoveries in the Isolation Hospital. Puerperal Fever. One case was reported in the Town Hall Ward. The patient was confined of a still-born child, only a relative being present at the birth. Maternity and Child Welfare. It was found necessary, owing to the increase in the numbers attending the White Hart Lane Centre, to open an additional Child Welfare Centre in more convenient and commodious premises. These were found at the Congregational Hall, Lordship Lane, which is fairly central for the Noel Park land the Southern part of the Town Hall and the Central Wards. From the figures given below I am sure the Council will agree that this was absolutely necessary, and has more than justified the extra accommodation provided. I again take the opportunity of calling attention to the work of the voluntary helpers at the Child Welfare Centres, and to their regular attendance thereat. Without their assistance it would have been impossible to deal with the numbers of mothers who avail themselves of the Centres, 9 A rota is arranged, so that the helpers know on which date they are to attend, and a meeting of all the lady helpers is held monthly. I have found the suggestions which they have made from time to time, very useful. This meeting brings the voluntary helpers into closer touch with each other, and with the lady members of the Maternity and Child Welfare Committee, and is a source of enthusiasm in connection with this important work. Number of Births Registered within the District 776 Number of Births Notified within the District 687 Notifications equal 88.53 per cent, of births registered within the District, against 850, or 83.54 per cent, in 1916. Number of visits paid to homes (birth cases) 2,911 Number of visits paid to homes (pre-natal cases) 83 Enquiries into deaths of children (under 1 year) 12 Enquiries into Ophthalmia Neonatorum 18 Special Visits to Sick Children 48 Visits to Creche 11 Special) Visits to Surgical Case 2 Special Visits to Mental Case (Birth) 2 Special Visits to Puerperal Fever 4 3,091 During the period under review, 72 pre-natal cases were under our care; 54 babies were born, leaving 18 pre-natal cases at the end of the year. Twenty of these visited the Centre, and made a total of 79 attendances. 10 Attendances at Maternity and Child Welfare Centres. 1917. 1916. January 184 218 February 280 204 March 377 262 April 272 246 May 366 295 June 390 346 July 426 329 August 359 115 September 549 279 October 377 322 November 411 344 December 310 153 4301 3113 Number of Babies Visiting Centres 317 272 Number of Children Visiting Centres from ages 1 to 5 years 292 132 Number of Pre-Natal Cases Visiting Centres 20 61 629 465 11 Babies. Children, Ages 1—5 Total Attendances 62 73 Made 1 Attendance 135 33 40 ,, 2 Attendances 146 22 28 . ,, 3 ,, 150 26 23 ,,4 „ 196 23 18 ,, 5 ,, 205 19 14 ,, 6 ,, 198 13 19 ,, 7 ,, 224 15 10 ,, 8 ,, 200 10 10 „ 9 „ 180 4 1 ,, 10 ,, 50 5 5 „ 11 „ 110 9 5 ,, 12 „ 168 76 46 Over 12 ,, 2260 317 292 4222 Attendances by pre-natal cases 79 317 292 4301 The number of still-births during the year was 18 Attended by Medical Practitioners 9 Attended by Midwives 9 I am, Gentlemen, Your obedient Servant. W. E PORTER, M.D., D.P.H., Deputy Medical Officer of Health.