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9a2e214b-ef57-417d-acac-a7be39a2f3de | ACT65 1917 Urban District of Acton. Annual Report of the Medical Officer of Health For the Year 1917, 1017 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1917. Council Offices, Acton, London, W,3. To the Chairman and Members of the Urban District Council of Acton. Miss Smee and Gentlemen, I beg to submit my Annual Report for the year 1917. The Report is again condensed and presented in tabular form. Two estimates of the population are made by the Registrar General—one for death-rate purposes and the other for the birth-rate. The former is an estimate of the civil population only, whilst the latter includes the men on military service. The civil population is estimated at 58,507, and the population for birth-rate purposes is estimated at 65,219. Both the estimates are approximately correct. |
1ec4239f-fd84-40ce-93d2-f78969df7c35 | Over 58,000 sugar cards were issued and there are over 7,000 Acton inhabitants on military duty. 1917 4 A lowered birth-rate was expected, but it is doubtful if we were prepared for the great reduction that has occurred. Coupled with a greatly reduced birth-rate, we have a higher infantile mortality. Although the infantile mortality was lower than that of 1915, it was considerably higner than that of 1916. Space will not permit me to enter into all the causes of this increased mortality, but I ought to point out some factors which were beyond our control. Five newly born children were found dead in open and other spaces in the district, and probably these children did not belong to Acton. The illegitimate birth-rate was higher last year, and, in spite of a^l efforts, the infantile mortality remains higher amongst those born out of wedlock. |
e7a44f23-f6c9-4999-869c-283baac9264a | 60 illegitimate births were registered last year, and 23 of the deaths under 12 months were of illegitimate children, giviug an infantile mortality of 371 per 1000 births. The death-rate in 1917 was slightly lower than in 1916, but an examination of Table 1 will show that from at least two of the principal diseases, Acton shows up badly. From Measles the death rate in Acton was '67 per 1000 inhabitants compared with '30 in the whole of England and Wales. The question was discussed by the Health Committee earlier in the year and negotiations were opened with the Committee of the Cottage Hospital It was hoped that arrangements could be made with the Cottage Hospital for the home nursing of cases of Measles, but, unfortunately, the Committee of the Cottage Hospital did not see their way clear to undertake the work. 1 he Council should again consider the question, and a scheme will shortly be placed before the Health Committee. |
50628f63-539a-407c-b1cb-4970d20e2509 | 1917 5 The Infants Clinic and the Ante-natal Clinic at the Cottage Hospital were opened in February. Difficulties have been encountered on account of the exceptional circumstances of the war, and the arrangements are only temporary. One of the most satisfactory features of the statistics is the low incidence of infectious disease. The notifications of Scarlet Fever received were the lowest on record for any year since the introduction of • compulsory notification. Not only the notification rate was the lowest on record, but the actual number of notifications was the lowest. There is also a steady decline in the incidence of Diphtheria, and the number of deaths from this disease was lower than that in any year since 1907. Your obedient servant, D. J. THOMAS 19 17 TABLE 1. BIRTH-RATE, DEATH-RATE, AND ANALYSIS OF MORTALITY DURING THE YEAR 1917. (ProvisionaTfigures. |
a58f947c-6f90-4add-b155-2397d9449773 | Populations estimated to the middle of 1917 have been used for the purposes of this Table ) Birth-rate per 1,000 total population. Annual Death-Rate per 1,000 Civilian Population Rate per 1,000 Births Percentage op Total Deaths. All Causes. Enteric Fever. Small-pox Measles. Scarlet Fever. Whooping Cough. Diphtheria Violence. Diarrhoea & Enteritis under 2 yrs. Total D'ths under 1 vear. Deaths in Public Institutions. Certified Causes. Inquest Cases. Uncertified Cause of Death. England and Wales 17.8 14.4 0.03 0.00 0.30 0.02 0.13 0.13 0.62 12.18 97 25.7 91.6 7.0 1.5 90 Great Towns, including London. |
45193132-13c8-428b-b376-22eabd9c5376 | (Census populations exceeding 50,000) 18.1 14.6 0 02 0.00 0.41 0.03 0.16 0.18 0.63 16.14 104 31.2 91.5 7.6 09 148 Smaller Towns (census! |
3ffbf081-93e9-49ce-90ec-0a009ee8b07f | population 20,000—60,000) ' 18.0 13.2 0.03 — 0.30 0.02 0.16 0.13 0.45 10.08 93 17.5 92.8 6.4 1.8 London 17.5 16.0 0.02 — 0.48 0.02 0.13 0.14 0.59 18.70 103 47.1 90.5 9.4 0.1 Acton 21.0 11.8 — — 0.67 — 0.13 0.05 0.4 28.8 96 37.5 100 6.8 — Non-Civilians ate included in these figures for England and Wales, but not for other areas. 7 1917 TABLE 2. |
5048f02d-e74d-4d58-bc15-cce8cfaffebd | VITAL STATISTICS FOR WHOLE DISTRICT DURING 1917 AND PREVIOUS YEARS. Year Population estimated to Middle of each Year. Births Total Deaths Registered in the District Transferable Deaths Nett Deaths belonging to the District Uncorrected Number Nett Under 1 Year of Age At all Ages Number Rate of Non-residents registered in the ' District of Residents registered outsi le District Number Rate per 1,000 Births Number Rate per 1,000 Inhabitants. Number Rate 1912 59,000 1,477 1.517 25.7 468 7.9 7 179 107 70 640 10.8 1913 60,000 1,486 1,522 25.3 508 8.4 12 197 127 83 693 11.5 1914 61,000 1,474 1,504 24.6 518 8. |
f9a561b1-3eef-43f2-add6-0d23eed34ce4 | 5 16 191 138 91 693 11.3 1915 62,000 forb'th late 58,238 ford'th ratr 1,390 1.414 22.8 587 96 11 204 148 104 780 13.3 1916 63,010 forb'th rate 57.913 ford'th rate 1,288 1,324 21.0 504 8.7 21 204 102 77 687 11.8 1917 65,219 forb'th-rate 58 507 for d'th rate 936 972 14.9 480 8.2 18 225 94 96 687 11.7 19 17 8 TABLE 3. BIRTHS. (a).—Registered in the District Total 936 Males 473 Females 463 Illegitimate 46 (b. |
07261f40-ae38-4df8-9e61-5fa76a3e103c | )—Registered odtside District :— Total 36 Males 21 Females 15 Illegitimate 14 TABLE 4 NOTIFICATION OF BIRTHS. Live Births notified 945 Still „ „ 14 Births registered but not notified 73 Ward Distribution op the Births notified :— North Fast. North West. South East. South West. 230 154 211 350 Ward Distribution of the Births Registered but not notified :— North East. North West. South East. South West. 17 15 21 20 Notifications were received from: — Doctors 467 Midwives 367 Nurses 30 Parents 54 Number of Births visited 599 Number of visits paid to homes of Infants 4523 1917 9 TABLE 5. CAUSES OP, AND AGES AT, DEATH DURING YEAR 1917. Causes of Death Ages at death 1917. c Institutions in District, |
44071f44-6f8c-4413-9e18-17473fe64888 | Resident and NonResident All Ages Under 1 year 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Measles 39 6 14 17 2 — — — — 3 Scarlet Fever — 1 Whooping Cough 8 2 1 5 — — — — Diphtheria and Croup 3 — — 1 2 — — — 10 Influenza 7 — — 1 — — 1 3 2 — Erysipelas — — — — Phthisis (Pulmonary Tuberculosis) 63 — 3 9 32 19 2 Tuberculous Meningitis 11 1 — 3 4 1 2 1 Other Tuberculous Diseases 9 — 1 1 3 2 2 Cancer, malignant disease 67 — 1 — — |
aa32ce9c-78b1-4d71-98f4-cac96911c994 | 7 31 28 4 Rheumatic Fever — — — — Meningitis 5 1 1 1 1 1 Organic Heart Disease 67 — 1 1 4 4 11 24 22 2 Bronchitis 53 5 4 3 1 — 12 28 1 Pneumonia (all forms) 43 8 7 3 3 2 6 9 5 3 Other Respiratory diseases 9 2 — 2 1 1 2 1 Diarrhoea and Enteritis 28 23 5 — — — — — — 1 Appendicitis and Typhlitis 4 — — 1 1 — 1 1 2 Cirrhosis of Liver 1 — — — — — 1 — Alchoholism 2 — — — — — 1 1 Nephritis and Bright's Disease 10 — — 3 2 5 |
331f30f5-9382-46eb-af84-77624057c0d2 | Puerperal Fever 1 1 Other Accidents and Diseases of Pregnancy and Parturition 3 — — — — — 3 — — — Congenital Debility and Malformation, including Premature Birth 35 32 1 1 — 1 — — — — Violent Deaths, excluding Suicide 23 2 5 4 1 3 5 3 4 Suicide 1 — — — — — 1 — — Other Defined Diseases 193 12 3 3 7 1 13 41 113 9 Totals 687 94 38 43 34 23 86 154 210 41 1917 10 TABLE 6. TOTAL DEATHS—WARD DISTRIBUTION, 1917. Causes of Death. North East North West South East South West Total Measles 2 — 6 31 39 Scarlet Fever — — — — — Whooping Cough 3 2 — 3 |
2379affb-cf82-44a4-9cb1-512788b54eeb | 8 Diphtheria and Croup 1 — 2 — 3 Influenza 3 1 1 2 7 Erysipelas — — — — — Phthisis (Pulmonary Tuberculosis) 14 9 15 27 65 Tuberculous Meningitis ' 4 1 3 3 11 Other Tuberculous Diseases 1 1 3 4 9 Cancer (Malignant Disease) 16 17 11 23 67 Rheumatic Fever — — — — — Meningitis 1 2 1 1 5 Organic Heart Disease 16 12 16 23 67 Bronchitis 10 7 9 27 53 Pneumonia (all forms) 12 9 10 12 43 Other Respiratory Diseases 3 1 — 5 9 Diarrhoea and Enteritis 2 9 2 15 28 Appendicitis and |
f69e0c80-6976-4158-9634-663fd737a43f | Typhilitis 3 — 1 — 4 Cirrhosis of Liver — 1 — — 1 Alcoholism — — 2 — 2 Nephritis and Brights Disease — 3 3 4 10 Puerperal Fever — — 1 — 1 Other Accidents and Diseases of Pregnancy and Parturition 1 — 1 1 3 Congenital Debility and Malformation, including Premature Birth 10 2 9 14 35 Violent Deaths (excluding Suicide) 4 3 4 12 23 Suicide — — 1 — 1 Other Defined Diseases 47 39 40 67 193 Totals 153 119 141 274 637 11 1917 TABLE 7. INFANTILE MORTALITY DURING THE YEAR 1917. Ward Distribution. Causes of Death. |
b5270a4c-5a95-456f-8149-0a3b50bbcef6 | North East North West South East South West Total Measles 2 1 3 6 Scarlet Fever — — — — — Whooping Cough — 1 — 1 2 I'iptitheria and Croup — — — — — Tuberculous Meningitis — — 1 — 1 ( ther Tuberculous Diseases — — — — — Vening'tis mot Tuberculous) — 1 — — 1 Convulsions — — I 1 2 laryngitis — — — — — Bronchitis — 2 1 2 5 pneumonia (all forms) 2 — 2 4 8 Diarrhoea 1 3 — 3 7 Enteritis 2 3 1 10 16 Syphilis — —. |
aba339f5-3eb8-40a6-845d-40a926c2c162 | — 2 2 Suffocation, overlaying — — 1 — 1 Injury at Bijth 2 2 2 1 7 Atelectasis — — 1 — 1 Congenital Malformations 2 — 1 — 3 Premature Birth 3 — 4 6 13 Atrophy, Debility and Marasmus 4 2 1 7 14 Other Causes 1 — 1 3 5 19 14 18 43 94 1917 12 TABLE 8. INFANTILE MORTALITY DURING THE YEAR 1917. Deaths from stated causes in Week and Months under One Year of Age. Causes of Death. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. 1-3 months 3-6months| 6-9 months| 9-12mnths| Total deaths un der 1 yen Measles |
a5cdcf7b-d2a8-4fde-8a68-068c2b2fae86 | — — — — — — 2 4 6 Scarlet Fever — — — — — — — — — Whooping Cough — — — — 2 — — 2 Diphtheria and Croup — — — — — — — — — Tuberculous Menengitis — — — — — — 1 — l Other Tuberculous Diseases — — — — — — — — Meningitis (not Tuberculous) — — — — — 1 — — l Convulsions 1 — — — — — 1 2 Laryngitis — — — — — — — — Bronchitis — — — — 1 2 — 2 5 Pneumonia (all forms) — — — — 2 3 1 2 8 Diarrhoea — — — — 2 1 2 2 7 Enteritis — — 1 — 5 5 4 1 16 Syphilis — 1 — — — — |
35e38939-9211-4339-9230-4295729e13fa | 1 — — Suffocation, overlaying — — — — 1 — — — 1 Injury at Birth 7 — — — — — — 7 Atelectasis 1 — — — — — — — 1 Congenital Malformation — — — — 1 2 — — 3 Premature Eirth 10 — 1 1 1 — — — 13 Atrophy, Debility and Marasmus 2 1 2 7 2 — 14 Other Causes — — — — 2 2 1 — 5 Totals 21 2 4 1 24 18 13 11 9. 13 TABLE 9 CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1917. Notifiable Disease Cases Notified in whole District Total Cases Notified in each Ward Removed to Hospital. At Ages—Years At all Ages North-East North-West South-East South-West Under 1 1 to 5 |
d8e5f175-65c9-46b8-9b90-8ad1f3fab1f9 | 5 to 15 15 to 25 25 to 45 45 to 65 65 & upwards Measles and German Measles 48 602 627 109 58 11 — 1455 341 285 282 547 8 Scarlet Fever 1 6 30 6 2 — — 45 20 14 7 4 26 Diphtheria — 14 46 2 2 3 — 67 24 10 24 9 54 Enteric (Typhoid) — — 1 1 1 1 — 4 — — 3 1 2 Puerperal Fever — — — — 1 — — 1 — — 1 — Erysipelas — — 6 2 4 6 2 20 5 5 3 7 — Ophthalmia Neonatorum 6 — — — — — — 6 2 1 — 3 |
e07bc47d-4b03-4aff-b240-a9eb996aef3d | 2 Tuberculosis (Pulmonary) — 1 7 29 76 21 5 139 31 16 38 54 19 (Other) 2 4 11 10 1 1 29 9 4 7 9 97 Totals 57 627 728 159 145 43 7 1,766 432 335 365 634 208 1917 14 TABLE 10. OUTSIDE DEATHS AND PLACE OF OCCURRENCE. Isleworth Infirmary 134 Middlesex Cpunty Asylum 20 West London Hospital 12 Middlesex Hospital 4 Children's Hospital, Great Ormond Street 4 St. George's Hospital 3 St. Mary's Hospital 3 Royal County Sussex Hospital 3 The Northern Hospital 9 Victoria Hospital 3 St. |
4f545513-f374-4206-8dc5-8f2403d3ff26 | Bartholomew's Hospital 2 Hostel of God 2 Chiswick Hospital 2 33, Hardwick Road, Southgate 1 Stoathes Hall Asylum 1 In River Thames, off Bishop's Road, Fuliiam 1 Union Workhouse. Isleworth 1 16, Grange Park, Ealing 1 Holborn Infirmary 1 Grand Junction Canal, Wembley 1 London Hospital 1 Chelsea Infirmary I Camberwell House 1 12, York Road, Kingston 1 St. |
3deb6d2a-f847-4fb7-9ff3-eeac42522d5b | George's Home 1 David Lewis Epileptic Colony, Marthall 1 Queen Charlotte's Hospital 1 Electric Light Station, Prince Consort Road, Westminster 1 69, Matthias Road, Islington 1 The Mansion, The Park, Beckenham 1 8, Elliott Road, Chiswick 1 F.dmonton Temporary Infirmary I Wyke House, Isleworth 1 Croydon Mental Hospital 1 West Suffolk General Hospital 1 University College Hospital 1 On the way to the Middlesex Hospital 1 Clare Hall Sanatorium 1 Uxbridge Road, Hammersmith 1 Royal Sea Bathing Hospital, Margate 1 The General Hospital, Nuneaton 1 Clavering Avenue, Barnes I 73, Oxford Road. |
b3c9103c-5bc4-4655-9474-c200fadc10c2 | Chiswick 1 Grand Junction Canal, Brentford 1 County Lunatic Asylum, Barnwood, Gloucester 1 Claremont, Florence Road, Boscombe, Bournemouth 1 Royal Free Hospital 1 385, High Road, Chiswick 1 Devon Nook, Barrowgate Road, Chiswick 1 Melbourne Road, Newbury 1 Northcote College Crescent, Hampstead 1 Total 232 15 1917 TABLE 11. DEATHS FROM TUBERCULOSIS. Pulmonary Tuberculosis 65 Other forms of Tuberculosis 20 Males 45' Females 40 Total 85 Pulmonart Tuberculosis. Occupation prior to death. Males. Females. |
c725f924-4450-4fa4-8e4a-f44ae7b4e1ac | Clerk 7 Household 19 Labourer 3 Schoolgirl 3 Painter 2 Laundress 2 Carman 2 Housekeeper 1 Glass Blower 2 Housemaid 1 Electric "Wireman 1 Greengrocer 1 Ticket Collector- 1 Railway Checker 1 Platelayer 1 Pedlar 1 Knife Grinder 1 Printer 1 Bayonet Bar Fitter 1 Sand Blaster at Sword Factory 1 Engineer's Fitter 1 Blacksmith 1 Stoker 1 Engineer's Miller 1 Baker 1 Watchmaker 1 Photographer's Assistant 1 Licensed Victualler 1 Grocer 1 Stained Glass Window Designer 1 Commission Agent 1 Journalist 1 No occupation 1 TABLE 12. NOTIFICATION OF TUBERCULOSIS. |
3238ee8f-d10e-460a-a218-461dbacddebf | Pulmonary 139 Other forms of tuberculosis 29 Pulmonary -139 Cases 229 Notifications The Notifications received were from the following:— Infirmaries 43 Private doctors 62 Sanatoria 59 Hospitals 52 Poor Law Doctors 8 Other Institutions 4 Military Authorities 1 Insured cases—90. Non-insured—49. 1917 16 Mode of Treatment. Insured. Non-insured Sanatoria 44 9 Hospital 22 5 Infirmary 9 24 Applying for Sanatorium 2 — Not applying for Sanatorium 6 3 Applied for Sanatorium treatment, but died before receiving it 1 — Discharged from Sanatorium and died at home — 2 Refused Sanatorium treatment — 1 6 5 Occupations. Males. Organ builder 1 Females. Discharged Soldier 14 Bar fitter 1 Household duties 17 Labourer 14 Shirt cutter 1 Laundress 9 Clerk 10 Storekeeper 1 |
e1354b9e-a7e6-4c4f-b169-c2137f44c5df | Munition Worker 6 Engineer 2 Printer 1 Domestic Servant 4 Draper 2 Aeronautical Inspector 1 Schoolgirl 3 Warehouseman 2 Mechanic 1 Telephonist 1 Photographer 2 Traveller 1 Needleworker 1 Grinder 2 Tram Driver 1 Dispenser 1 Engineer's Turner 2 Draughtsman 1 Milliner 1 Garage Cleaner 2 Accountant 1 Dressmaker 1 Schoolboy 2 Commission Agent 1 Fur toy-maker 1 Barman 2 Ganger 1 Dyer 1 Coal Merchant 1 Sand blaster 1 Laundry Packer 1 Manager 1 Postman 1 Art Student 1 Shop assistant 1 Shoemaker 1 School Teacher 1 Harness maker 1 Pedlar 1 Not any 5 Dentist 1 Not known 2 Night watchman. 1 Not any 4 Non-Pui.monary Tuberculosis. Males—16 Females—13 Situation of Disease. Males. |
34aea9d2-ee57-445d-baa6-c1f519aaeb7b | Females. Meninges 3 Meninges 3 Hip 3 Glands of Neck 2 Spine 2 Knee-joint 3 Glands 2 Hip and Spine 1 Throat 1 Hip 1 Wrist and Back 1 Spine 1 Knee-joint 1 Elbow-joint 1 Tendon of right arm 1 Ankle-joint and Skin 1 Hip and Spine 1 General 1 General 1 17 JQ 17 TABLE 13. DEATHS FROM MEASLES. Antrobus Road ... 5 Osborne Road ... 1 Bollo Bridge Road 4 Meon Road 1 Hanbury Road 3 Ramsay Road ... 1 St. |
baa6c4dc-df77-4ca8-b143-a42d20fe7076 | Margaret's Terrace 3 Strafford Road ... 1 Palmerston Road 3 Pretoria Terrace 1 Rothschild Road 3 Bollo Lane 1 Park Road North 2 Seymour Road ... 1 Colville Road 2 Shakespeare Road 1 Junction Road ... 2 Midland Terrace 1 Packington Road 2 Evelyn Road TABLE 14. INFANTS' CONSULTATIONS. Priory School. Palmerston Mission. Health Visitors' Attendances 100 100 Number of Children who attended ... 292 227 Number of Attendances made by Children 1777 1673 Children under 1 year of age 131 133 Children over 1 year of age 161 94 Ages of Children who commenced attendance in 1917:— Priory School. Palmerston Mission. |
a3b8d859-d585-4f3b-86b1-9a5beb8880ca | Under 3 months 90 62 Between 3 and 6 months 22 23 „ 6 and 9 months 13 25 „ 9 and 12 months ... 6 23 ,, 1 and 2 years 16 18 „ 2 and 3 years 13 16 „ 3 and 4 years 14 10 ,, 4 and 5 years 4 7 Of tne above Children :— 1 had attended for the first time in 1912. 9 „ „ , 1913. 15 „ 1914. •24 „ „ 1915. 108 1916. 362 „ „ 1917. 1 PI 7 18 The attendances which these children made were as follows :— Date at which they first attended. |
8f3672a5-1e33-47f5-9683-a75b18a8b33e | 1912 1913 1914 1915 1916 1917 1 occasion — 7 4 4 23 83 9. occasions — 1 5 3 8 48 3 — — 1 8 7 39 4 — — . — 2 5 40 5 1 — 1 — 8 21 6 — 1 — 1 12 18 7 —- — 1 1 4 14 8 — — — 1 1 12 9 — — 1 2 6 10 » — — 2 1 2 13 11 —> — — —- 1 9 12 — — — 1 3 6 13 — — — — 3 8 14 ft — — — — 2 3 15 — —; |
732926c4-0577-4cf5-b8d4-b5f9fdaab138 | 1 — — 5 i« — — — — 3 6 17 — — — — 2 3 18 — — — 1 3 19 — — — — 2 2 20 — — — — 2 1 21 „ — — — 1 1 — 22 — — — — 4 6 23 , — — — — 1 1 24 — — — — 2 5 25 — — — - — 2 26 r — — — — 1 — 27 S — — — — 1 — 28 — — — — 2 1 30 — — — — — 2 31 1 32 — — — — 1 1 34 — — — — 1 l 35 — — — 1 — 36 — — — — 1 1 40 — — — — 1 1 Expectant Mothers. |
7f3d76ba-0bb3-4ea8-8c7f-32c291b5cd22 | Number of Mothers visited 122 Number of Visits 406 Number attended Ante-natal Clinic 26 Number of visits to Clinic 51 Infants Clinic. Number of Infants attended 45 Total number attended Clinic 78 1 9 1-7 19 TABLE 13. ISOLATION HOSPITAL. Remaining in Hospital. January 1st, 1917 26 „ ,, 1st. 1918 23 Admitted during Year Civilian 176 Military 49 Discharged during Year ... 215 Deaths IS Diseases Treated, &c. Residents. Non-residents. Scarlet Fever 26 31 Diphtheria 54 60 Measles 5 37 Other Cases 1 11 TABLE 16. INQUESTS. Held in the District 43 Cause of Death. |
95f8a0c9-d2d4-481b-8323-8ca6cb44afc7 | Heart Disease 6 Accidental fall from a balcony 1 Pneumonia 5 Injury at birth 1 Run over by a motor vehicle 4 Homicide 1 Want of proper attention at birth 4 Suicide 1 Burns 2 Overlying 1 Aortic Aneurism 2 Accidentally drowned 1 Accidentally kicked 2 Pthisis . 1 Bronchitis and Pleurisy 2 Ptomaine Poisoning 1 Scalds 1 Congenital Debility 1 Fall of shell on foot 1 Epilepsy 1 Fractured skull 1 Cerebro Spinal Fever 1 Fall out of a box 1 Disease of I.iver 1 Inquests on- those who Died outside the District, 10. Cause of Death. Fractured Skull 5 Run over by a motor car 1 Found Drowned 1 Fall from a canal boat 1 Crushed by machinery 1 Empyema 1 20 bacteriological laboratory. |
f912be98-a8bd-4e5e-b80f-c70a3e164ef0 | 563 Swabs from the Throat and Nose were examined :- 112 were positive and 451 were negative. The specimens were from— Doctors private patients 125 Hospital cases 356 School contacts 27 School Sore Throats 43 Convalescent cases prior to school attendance 12 |
f58a6694-7833-4aac-b93a-8305202d5f67 | 1938 TCT 21 The Urban District of Acton. Annual Report OF / The Medical Officer of Health For the Year 1918. i 1918 ANNUAL REPORT op the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1918. Council Offices, Acton, W.3. July, 1919. To the Chairman and Members of the Urban District Council of Acton. Ladies and Gentlemen, I beg to submit my Annual Report for the year 1918. The Report is again condensed and only some features are commented on. The remaining subjects are set forth in tabular form. In previous reports it was stated that the Registrar General made two estimates of the population—one for deathrate purposes and the other for the birth-rate. The former is an estimate of the civil population only, whilst the latter includes the men on military service. I have discarded both estimates. |
2f92ba08-6564-460d-a084-a8118b4b5291 | For 1917, the Registrar General estimated the civil population at 58,507 and the total population at (55,219. In last year's report I stated that both these estimates were approximately correct. In 1917, over 58,000 sugar cards were issued and there were over 7,000 Acton inhabitants on military duty. For the year 1918, the Registrar General estimated the population at 57,221 for death-rate purposes and 64.114 for birth-rate purposes. These figures were based upon returns of 1918 4 Ration Cards sent to the Ministry of Food last July. |
ef3e0270-82fc-45b2-9e1a-05c444b61a9b | The figures on the returns were incomplete as the returns were sent out soon after the issue of the ration books and did not include the ration books issued to those who had omitted in the first instance to fill in their addresses, &c. I pointed out this discrepancy to the Registrar General, and though it is obvious that an under estimate had been made, it was too late to remedy it in time for the Registrar General's report. It is evident that if the same procedure has been adopted throughout the kingdom a considerable error has occurred in the estimates of the population. In order to ascertain to what extent the population has been underestimated by the Registrar General I examined the ration book applications corrected for October. The figures would possibly be slightly different to those of July as corrections were made for removals into and out of the district and also the corrections made for births and deaths. These corrections would not be sufficient though to alter the figures of July very appreciably. |
640eef11-b91e-4213-bc0b-f176f5d9af1e | There were no houses tr» let in July or October and the births did not greatly exceed the deaths. I have received the permission of the Ministry of Food to use these figures. The number of ration books in use in the district last October was 58,957. In addition, there are two public institutions in the district, for the staffs of which no ration books were issued. I estimate the civil population at 59,000, and the total population at 60,000. The civil population was divided as follows :— Under 1-2 2-5 5-10 10-15 Over 15 years. 1 year . years . years. years. years. Males. Females. |
8e59d0b2-9c05-41e3-b887-2881c633b674 | 872 1,031 3,487 6,057 6,050 14,881 26,579 Possibly, the figures for males and females over 15 years of age may appear abnormal, having in view the fact that the number on military service was about 7,000, but they are quite consistent with the Census figures. The figures at the Census were:— Over 15 years .Under 5 years. 5-10 years. 10-15 years. Males. Female. 6,423 5,722 5,008 17,747 22,197 1918 5 With the exception of the age-period 5-10 years and, of course, the males over 15 years of age, the increase in the population has been curiously even. Under 5 years of age the increase was 19'3 per cent.; between 5 and 10 years, 6 per cent. |
5efcf6a0-81ed-4509-8f7e-bc1cde941621 | ; between 10 and 15 it was "20 per cent.; and in females over 15 years of age, 19'5 per cent. If the male population over 15 years of age had increased in the same ratio, it would show that 6,415 men were on active service. The Ward population in 1918 was as follows :— North East. North West. South East. South West. 15,367 12,209 15,091 16,290 There was an increase in the population of the three Wards—North East, North West, South East, and a decrease in the population of the South West Ward. There are two explanations for this phenomenon. At the Census the South West Ward was almost entirely built over, and any new buildings erected between 1911 and 1914 were in the other three Wards. |
cd8e8102-9332-47ed-950b-00a770059ced | But that is not the only reason, as the number of houses built between the Census and the beginning of the war was small. The increase is in the same ratio as the excess'of women over men at the Census in the different Wards as the following table shows:— ' Population at Census :— North East. North West. South East. South West. Male ... 6,732 4,919 6,651 8,083 Female 7,644 6, 573 7,948 8,798 There are other slight discrepancies between the figures supplied by the Registrar General and those given in this report. The difference between the two figures are very slight and it arises from different causes. Thus for the birthrate the Registrar General bases his figures upon the number of births registered in the district during the year, whilst I 1918 6 have given the number of births notified in the year, together with those registered in the year, but not notified. |
2fb7ce77-87d5-4ef9-83b3-6d34da3386b1 | The Registrar General's figures is 965 and mine is 954. The Registrar General gives the number of deaths here in 1918 as 970 ; mj figure is 972. The possible explanation for this difference may be in the fact that I have included two deaths which occurred outside the district on December 28th and December 31st, 1917, and were not received in time for them to be included in the 1917 returns. There are many features of interest in the vital statistics. The birth-rate is the lowest on record, but the decrease as compared with 1917 is not a considerable one. In 1917 the birth-rate was 14 9, and in 1918 it was 14 5 per 1,000. The effect of the war was not made very manifest on the birthrate in Acton until 1917. |
6132ea7a-8f58-449b-ad1a-e1a30b61d6f1 | There was a decreased rate of 1'8 per 1,000 in 1915 as compared with 1914, and a similar drop in 1916 as compared with 1915. In 1917 the birth-rate was 61 per 1,000 lower than in 1916. Since correct) records have been kept for the district the death-rate has, for the first time exceeded the birth-rate. The actual number of births registered was higher than the deaths credited to the district, but the death returns do not include the deaths of soldiers on active service, and the birth-rate is basrd on a higher population than the death-rate. The death-rate is the highest in the district since 190 >. The high death-rate is mainly due to the epidemic of Influenza. INFLUENZA. In the realm of public health the outstanding feature has l>een the virulent epidemic of Influenza which occurred in the autumn mouths. |
920fc412-6063-49c7-b066-f6bd9c1ddf34 | Two epidemics were experienced and although the summer one was extensive as regards number of cases, the mortality was not a high one. It is possible that in this district, the second epidemic wave did not attack so many persons as the first, but it produced more severe illness and a much higher fatality. From inquiries made in the large .factories in the district, the absentees on account of illness were in most instances greater in July than in October and 1918 7 November. In only one large factory did the absentees reach 10 per cent, of the total in the autumn, whilst several reached this figure in July. In one large factory the absentees reached barely 5 per cent, in the autumn and over 10 per cent, in the summer. In comparison with the autumn epidemic, the cases in the summer were comparatively mild. In the third quarter of the year only 9 deaths occurred, compared with 177 in. the last quarter. |
2896351a-5a24-4d8d-9cec-b051203fedce | The difference in the type of disease possibly accounted for the fact that the doctors were not so overwhelmed with work in July as they were in October. In the summer epidemic most of the patients went to the doctor's dispensary, were sent home to bed for a couple of days and went back again on the third or fourth day. In the autumn epidemic the patients were so bad that they had to send for the doctor, or if they went to the dispensary they were sent home and visited. It may be stated roughly, that in this district the number of houses on a doctor's visiting list in the autumn epidemic would be three or four times the number in the summer one, but the number of cases seen in the surgery in the summer epidemic largely exceeded those seen under similar conditions in tho autumn one. It appears that this sequence of events usually follows in Influenza epidemics. The secondary wave is usually more virulent than the first. |
385d0068-35ca-46f0-bf52-e76446c12d32 | It is not my intention to discuss the various theories which have been advanced as to the cause of the outbreak. We have already been deluged with literature on the subject, and volumes will probably again be written on the causation of the late outbreak ; but a protest may be raised against some of the absurd theories which have been advanced and evidently very widely believed in. It is certain that no cause which is local in its operation can account for the origin of the disease. Some of the theories have been advanced by interested persons, and the press has been utilized to urge upon the Government measures which it is asserted, if adopted in time would have averted the epidemic. Some of the theories have been fantistic and ludicrous. The two theories which have obtained most 1918 8 credence were the food shortage and alcoholic shortage, more especially whiskey. It is not explained how these affected people in the most vigorous years of their lives. The universal prevalence of the disease is sufficient to refute these theories. |
998ec3c0-9ed5-4a22-8279-cd1a8e8b6ead | Its name, as suggesting the country of its origin—Spanish Influenza, should have been sufficient to show that food regulations had no connection with its causation. Food and fruit have been plentiful in Spain during the war. No part of the earth seems to have escaped the epidemic. Countries far removed from the seat of war have suffered far more severely than this country has. South Africa suffered severely and in India the deaths were nearly five millions. In two islands of the Samoan group nearly '20 per cent, of the population succumbed ; out of a total population of 37,000 there were over 7,000 deaths. Severe as the outbreak was in this country its mortality bore no comparison with that of the epidemic in these countries. .From October 12th to December, 1918, the deaths in the 9G great towns registered as due to Influenza were 44,">37. |
b397a18c-f3bd-4991-85c4-ad6cb7dc91c8 | These towns had a population of over 16$ million inhabitants and the death-rate was 269 per 100,000 inhabitants. ' Higher rates, over 400 per 100,000 occurred during thispeiiod in some of these great towns. The death-rate from Influenza in Acton during the same period was about 300 per 100,000 inhabitants. We are informed that this outbreak has been identical, both in itself and its complications, including pneumonia, with that in 1890. In view of this statement, it is interesting to look up the records of that epidemic in Acton and compare it with the present one. The epidemic made its appearance towards the end of December, 1889, and retained its virulence until the beginning cf 1890. During the height- of the epidemic the temperature of the air was alternately warm and cold, the earth saturated with moisture, and the atmosphere damp, foggyjand stagnant. |
1ab13838-16f4-4a15-a42d-2d7e738794b8 | No actual death occurred from Influenza itself, but it is probable that it was the primary cause of some deaths attributed to diseases of the respiratory organs. With the exception of the atmospheric conditions the former epidemic had very little in common with the present one. 1918 9 In the first quarter of 1918, no death occurred, and the district was almost free of the disease ; in the second quarter, a death which occurred on April '23rd was registered as due to the disease. Towards the end of June, a very extensive -outbreak occurred, and as previously stated some of the factories reported a higher percentage of absentees than in the autumn epidemic. The first death occurred on July 2nd, and 7 deaths occurred in July, 1 in August and 1 in September, the latter death occuring on September 6th. An interval of over one month elapsed before the next death occurred, 2 deaths occurring on October 9th and 2 on October 11th. |
aa584d66-cf62-4934-abb3-446b8c792137 | The epidemic reached its height duriug the fir.it week in November and gradually subsided. The deaths in the remaining weeks of the year were as follows :— Week ending Oct. 19th 4 Week ending Nov. 30th 20 „ 26th 13 „ Dec. 7th 9 „ Nov. 2nd 35 „ 14th 10 „ 9th 35 „ 21st 2 „ 16th 20 „28th 1 „ „ „ 23rd 28 Of the total deaths 81 were,of males and 106 of females. When we consider the age-distribution of the deaths it will at once be evident that the disease was not more fatal in females than in males. As far as this district is concerned males suffered comparatively more severely than females. Age Distribution of the Deaths. Under 1 year 1—2 years. 2—5 years. 5—10 years. 10—15 years. |
faabc045-04ca-47b9-87dc-e2e10a94d76d | 15—18 years. 18—25 years. Males 3 8 7 4 4 7 5 Females 0 2 7 6 10 1 17 25—30 years. 30—35 years. 35—40 years. 40—45 years. 45—50 years. 50—65 years. over 65 years. Males 5 7 11 6 3 7 4 Females 22 13 6 3 7 5 8 1918 10 Under the age of 18 there were 33 male deaths and 25 female. Between the ages 18 and 50 years there were 37 males and 68 females, and over the age of 50, 11 males and 13 females. The most fatal age-period was between the ages of 19 and 35 years. |
f3e329e3-f1cc-4f06-a983-6a7fe8f62c13 | In that age-period 52 female deaths occurrred, or nearly one-half the total female deaths. The doctors practising in the district very kindly answered a series of questions which I asked them concerning their experience of the epidemic, and the opinions expressed here summarize the experience of almost all the doctors practising iu the district. There was no undue incidence of the disease amongst women except to the extent that there was an abnormal proportion of females living in the district between the ages of 15 and 45 years. One doctor with a very large practice stated that amongst his earlier cases 75 per cent, of them were boys between the ages of 8 and 12 years of age. Taking the epidemic as a whole there was a concensus of opinion that very young and old people escaped. There was a difference of opinion as to the incidence of the disease amongst the different occupations. |
9b66ec00-587b-4844-bb96-0f844dacc737 | Most of the doctors w£ie of opinion that indoor occupations suffered most severely, but the police surgeon on the other hand said that the constabulary suffered more severely in comparison than those employed in indoor occupations. There was an unanimous opinion that those who lived in overcrowded and ill-ventilated houses suffered most severely. At one large factory in July the munition workers extensively suffered, and the absentees averaged about 10 per cent, weekly, while the clerical staff escaped almost entirely, but in the autumn epidemic the munition workers escaped and seldom did the absentees number 2 per cent, in a week, but the clerical staff suffered severely, and over 75 per cent, of them were attacked. Laundry workers also were particulary liable to attack. Second attacks were comparatively rare. Most of the doctors stated that very few of those who were attacked in the 1918 11 summer suffered again in the autumn. |
71a780b5-48c1-4bf3-93be-429ec1970755 | Five doctors had had no cases in the autumn amongst, the patients who suffered in July, and all the other doctors stated that an attack in July in the vast majority of instances conferred an immunity and the patient did not suffer again in the autumn. When a second attack occurred the patients had always shewn a special tendency to suffer from Influenzal attacks. Contrary also to the usual experience in Influenza, relapses were rare; when a relapse did occur the initial attack was mild, but the relapse was of a more severe character. In the opinion of most of the doctors, the incubation period was a short one. In the majority of cases the incubation period was about two days, but undoubted instances of a period of only 36 hours were recorded and in other cases the incubation period was lengthened to five or six days. No opinion was expressed as to the effect of a shortened or lengthened incubation period upon the severity or otherwise of an attack. |
1ea3ecad-98fe-4cb8-b945-7a76330247f0 | Most of the doctors also were cf opinion that the infectious period was a short one; probably less than a week from the onset of the initial symptoms. Evidently the most infectious period was during the early stages of the disease, and the disease was spread by coughing and sneezing, but these acts were not essential to its spread; even the act of speaking when in close contact was sufficient. Apart from lung complicatious the disease was not of long duiation, but where lung complications supervened, the duration of the disease, of course, depended on the nature of the complication. The lung complications varied considerably ; most of them were lobar pneumonia, or lobular pneumonia. A large number had congestion of the bases, but no consolidation. The most dreaded complication was a type of toxic pneumonia, where the patient died with all the symptoms of septicaemia aud the consolidation was slight. The lung complications occurred early and late and usually the most fatal cases were those where the lung symptoms appeared early. |
f2d3ad5d-2eeb-4ca0-8ac9-c5e7f73567de | All the doctors complained of the lack of nursing facilities in the home. Private nurses were almost unobtainable, but 1918 12 even if it were possible to obtain private nurses it is doubtful if these would be available for the majority of the inhabitants. One doctor stated that the Deed was not so much of trained nurses, but of women who could visit the homes, clean up the house and sick rooms, make bids ard prepare food. In a large number of instances trained nursing was not absolutely essential. An instance was given of the difficulties met with. This doctor called in a certain house where 4 families lived. These families consisted of 14 members, and all the persons in the house were down with Influenza at the same time. Possibly, it would have been impossible to obtain skilled nursing for every case in the last epidemic, but much suffering would have been prevented if domestic helps working under a trained nurse had been available. |
39c341ed-c06b-49bf-9005-9a1e1c0269df | Institutional treatment also waj entirely insufficient iu this district, but it- is doubtful if it would be possible to arrange for the institutional treatment of all those who require it in epidemics of an explosive character like Influenza. A selection of the cases could be made and early cases removed to hospital, especially where isolation of the patient could not be carried out in the home. INFECTIOUS DISEASES. 674 cases of Infectious Diseases weie notified, but of these 417 were cases of Measles and German Measles and 149 Tuberculosis cases. ENTERIC FEVER. Only three cases were notified, but everyone proved fatal. In every instance, probably, the disease was contracted outside the district. SCARLET FEVER. In no year since the introduction of the notification of Infectious Diseases Notification Act, has the number of cases of Scarltt Fever notified been so low, and for the second successive year no death was recorded. |
4106e6e5-fd0e-44ef-9c12-f2c33ef6f18c | The continued low incidence of Scarlet Fever throughout the country is encouraging, though an explanation is not readily forthcoming. 1918 13 Undoubtedly, the discussions which took place some years ago on the phenomena of the return case and the prolonged infection of some cases have proved of value. The causes of the return case were investigated and attention was focussed more upon the individual and less upon his belongings and surroundings. The importance of enlarged tonsils and adenoids and unhealthy nasal passages was recognised ; operative measures are being taken to remedy any unhealthy conditions of the upper respiratory passages; a strict examination is made of every convalescent child before resumption of school attendance. It is on these lines that success will probably be attained in the prevention of such diseases as Scarlet Fever and Diphtheria, and not upon the elaborate ritual of disinfection which has been observed in the past. During the past four years the amount of disinfection which we have carried out after Scarlet Fever has been reduced to a minimum. |
afeaedf8-cea4-4be8-bbb6-2d829ad3b6bd | Formerly all the clothing and bedding were removed to the steam disinfector, the rooms were elaborately and systematically sprayed and fumigated. Now, we simply disinfect those articles which have been exposed to the infection of the fomites, and the fumigation done is more for the sake of obtaining a thorough cleansing of the room than with the object of destroying any pathogenic germs. An inquiry was carried out in Providence U.S.A., in 1903-1909, and Dr. Chapin, the Health Officer there, came to the conclusion that the elaborate disinfection which was carried out there was unnecessary. It is unfortunate that an inquiry on a large scale is not made by a central authority into the efficiency of disinfection as carried out by local authorities. Large sums of money are being spent annually, not only on disinfectants but also on labour. If a simpler method is sufficient, then a vast sum of money is unnecessarily spent by local authorities. Diphtheria. |
1551cf55-8f54-4f4f-afbf-d3c2226cb92e | There is again a decrease both in the number of cases uotified and in the number of deaths. From an examination of the history of the disease in the district, fours years ago, I predicted that we were probably entering then on a period of minimum prevalence and we may expect this period to continue for another '2 or 3 years. For about 40 years the 1918 14 disease has exhibited very regular periods of maximum and minimum prevalence, these periods extending to about 7 years. One gratifying feature in this periodicity is the fact that the peak; tend to become flattened and the troughs to be more depressed. This is more particularly noticeable in the deathrate from the disease as compared with the case-rate, and is undoubtedly due to the introduction of anti-toxin. MEASLES AND GERMAN MEASLES. The Measles epidemic was a continuation of the epidemic which made its appearance late in 1917. TUBERCULOSIS. |
7fe1ab23-1274-4fba-a893-932570940960 | Although there is a slight decrease in the number of notified cases of Tuberculosis, there is an increase in the number of deaths. From Pulmonary Tuberculosis there were 91 deaths compared with 65 in 1917. For some years the death-rate from Pulmonary Tuberculosis has been on the increase,, but on inquiry into the methods of combating the disease is difficult owing to the dual control of the County and the local authority. ENCEPHALITIS LETHARGIC A. In the spring and early summer of 1918 cases of illness presenting a group of unusual cerebral symptoms occurred By some, the patients were said to be suffering from Botulism— a disease due to the consumption of food infected with the Bacillus botulimus of Van Ermengen. |
482d196a-62eb-4ec3-9b94-3236c457f865 | At a time of great difficulty with the food questions when some articles of food were rationed and others were of an inferior quality or difficult to obtain, this view attracted considerable attention, and sausages especially, were avoided by many people as an article of food. Inquiries were made by the Local Government Board, and it was soon established that food did not enter as a direct or an indirect factor in the causation of the disease. The disease has been described under different names, but it is now compulsorily notifiable as Encephalitis Lethargica. 1918 15 Last year the disease was not a notifiable one, but it is known that 5 cases occurred in this district, of which 1 was fatal. INFANTILE MORTALITY. 7(5 deaths occurred amongst infants under 12 months of age. ThiS( figure corresponds to an infantile mortality of 79 per 1,000 births. |
11e173ff-7e6f-4278-bab6-3fcdf85272cb | For 1917 there were 94 deaths and the infantile mortality was 96 per 1,000 births. On two previous occasions there has been a lower infantile mortality—in 1912 and 1916. The chief decrease was in deaths from Diarrhceal diseases. An examination of the Infantile Mortality Table will show that three-fourths of the deaths occurred from Respiratory diseases, Diarrhceal diseases and Developmental diseases. 252 of the babies born in 1918 attended the welfare centres, and of these 8 died, or a mortality of 32 per 1,000. It would not be fair, of course, to compare this figure with the infant mortality figure of the whole district. Only 80 or less than one-third of the babies attended the centre before they reached the age of one month. If we eliminate the deathfe of babies under one month the infantile mortality for the whole district was 51 per 1,000 births. |
99997f89-e661-49d3-92ec-e679f70de4c7 | If we eliminate the deaths under one month and take the babies who attended the centres and those who did not separately, the figures were 32 per 1,000 and 59 per 1,000, respectively. There are many other factors that should be taken into consideration when trying to estimate the value and the results of the work of the centres. The babies are drawn from districts which have shown a consistently high infantile mortality. On the other hand the mothers who bring their babies regularly to the centre are those who take an intelligent interest in their children, and this fact would counteract some of the deleterious conditions under which they live. Taking the figures of the district as a whole and comparing them with those of 20 years ago, the value of health visiting becomes at once apparent, and the results achieved have been immense. Your obedient servant, D. J. THOMAS. 1918 Table I. BIRTH-RATE. |
151cb2d1-6189-4175-8a3d-e7ed14e0fdc9 | DEATH-RATE, AND ANALYSIS OK MORTALITY DURING THE YEAR, 1918 (Provisional figures. Populations estimated to the middle of 1918 have been used for the purpose of this Table). Birth-rate per 1.000 total Population. Annual Death-Rate per 1,000 Civilian Population. Rate per 1,000 Births. Percentage ok Total Deaths. All Causes. Enteric Fever. Small Pox. Measles. ! ' Scarlet Fever. Whooping Cough. . Diphtheria Violence. Diarrhaea. & Enteritis under2yrs. Total d 'ths under 1 vear. Deaths in Public Institutions. Certi6ed j Causes | 1 Inquest Causes. Uncertified Causes of Death. England and Wales* . 17.7 17.6 0.03 0.00 0. |
a8d6171b-4622-4a7f-9130-10446b3a6136 | 29 0.03 0.29 0.14 0.49 10.99 97 24.3 93.3 5.4 1.3 96 Great Towns, including London (Census popula- tions exceeding 50,000) . ) 17.6 18.2 0.02 0.00 0.36 0.04 0.34 0.15 0.49 14.46 106 28.4 93.4 5.3 1.8 148 Smaller Towns (Census populations -20,000 to 50,000 17 9 16 1 0.03 . 0.25 0.02 0.25 0.14 0.38 9.73 94 15.4 94.5 3.9 1.6 London 16.1 18.9 0.02 . |
11e14f8c-0119-49e8-87f4-47d3de4c481f | ••• 0.42 0.03 0.43 0.17 0.56 15.67 107 45.0 92.5 7.3 0.2 Acton 14 5 14.7 0.05 ... 0.13 0.00 0.23 0.03 0.3 13.62 78 33.6 100. 5.9 0.0 •Non-Civilians are included in these figures for England and Wales, but not for other areas. 1918 17 Table 2. VITAL STATISTICS FOR WHOLE DISTRICT DURING 1918 AND PREVIOUS YEARS. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Under 1 year of Age. At all Ages. Uncorrected Number. |
65d08b0b-8945-47a4-ba1e-0acce871a3b6 | Nett. Number Kate of Non-Kesidents Registered in the District. of Resieents Registered outside Disi ict. Number Kate per 1,000 Births. Number Rate per 1,000 Inhabitants. Number Rate 1913 60,000 1466 1522 25.3 508 8.4 12 197 127 83 693 11.5 1914 61.000 1474 1504 24.6 518 8.5 16 191 128 91 693 11.3 1915 62,000 for b'th rate. for d'th rate. 1390 Y 1414 22.8 587 9 6 11 204 148 104 780 13.3 1916 63.010 for b'th rate. |
35563783-3735-4319-a3bb-f9036e2bca59 | 57.913 for d'th rate 1288 1324 21.0 504 8.7 21 204 102 77 687 11.8 1917 65,219 936 972 14 9 480 8.2 18 225 94 96 687 11.7 for b'th rate. 58,507 for d'th rate. 1918 66,000 923 954 14.5 611 10.3 16 277 76 78 872 14.7 for b'th rate. 59.000 for d'th rate. 1918 18 TABLE 3. Notified Births 840. North-East. North-West. South-Eist. South-West. 205. 131. 209. 295. Births Registered, bot not Notified 85. North-East. North-West. South-East. |
789d9676-fe66-48bf-be9a-112ee432efd6 | South-West. 25. 17. 27. 16. Births Notified Males 424 Females 416 Births Registered, but not Notified Males 43 Females 42 Total Registered in District Males 467 Females 458 Outward Transfers Males 10 Females 11 Inward Transfers Males 25 Females 25 Nett Births belonging to District Males 482 Females 472 954 Birth Rate 14.-5 per 1,000. Legitimate Births 902 Illegitimate Births 52 Still Births Notified 26. North-East. North-West. South-East. South-West. 10 2 5 9 Notifications were received from Doctors 396 Nurses 25 Midwijves 380 Parents 39 Number of Births visited 706 Number of visits paid to houses of Infants 3,753 l91 8 19 Table 4. |
22febfba-d8ae-4462-94c8-4ed880bd0df2 | CAUSES OF, AND AGES AT. DEATH DURING YEAR, 1918. Causes of Death. Causes of and Ages at Death, 1913. Public Institutions in District, Resident and NonResident All Ages Under 1 year 1 and under 2 2 and under 5 5 and under 15 15 and under 26 25 and ' under 45 45 and under 65 65 and upwards Measles 7 . 2 3 1 . . . . . Whooping Cough 15 6 6 3 . . . . . 1 Diphtheria . . . 2 . . 1 1 . . . . 5 Enteric Fever 8 . . . . 1 1 1 . 1 Influenza . 187 3 10 14 23 30 72 23 12 9 Phthisis (Pulmonary Tuberculosis) 91 . . |
05347156-e117-4e0e-94ec-21c431f6e5e3 | 1 7 20 37 22 4 . Tuberculous'^Meningitis 3 . . 2 1 . . . . 2 Other Tuberculous Discssc 9 1 1 . 2 3 1 1 . . Cancer,'MalignantDisease 63 . . . . 1 9 ?0 23 2 Rheumatic Fever 1 . . . 9 . . . . . Meningitis 10 1 1 . 3 . 1 1 1 1 Organic Heart Disease 67 . . 1 4 3 9 24 26 2 Bronchitis . 42 4 1 4 1 . 3 6 23 . Pneumonia (all forms) 59 8 1 9 6 3 11 12 9 3 Other Respiratory Diseases 10 . . . . . |
35f3c123-25b3-4a2e-b807-790f02f61eeb | 2 6 2 1 Diarrhoea and Enteritis 13 11 2 . . . . . . . Appendicitis and Typhlitis 6 . . 2 2 1 . i . 2 Cirrhosis of Liver 2 . . . . . 1 l . . Nephritis and Bright's Disease 15 . . . . 1 5 7 2 . Puerperal Fever . . . . . . . . . Other Accidents and Diseases of Pregnancy and Parturition 1 . . . . . . 1 . . Congenital Debility and Malformation, including Premature Birth 29 29 . . . . . . . 1 Violent Deaths, excluding Suicide 18 9 1 1 3 1 2 4 3 3 Suicide 10 . . . . . 6 3 1 . Other Defined Diseases 209 10 3 . |
727da7a1-ad61-44b5-86ef-626dd8227a40 | 8 3 13 54 118 6 Totals 972 76 29 42 C3 67 174 197 224 39 1918 20 Table 5. TOTAL DEATHS—WARD DISTRIBUTION. 1918. Causes of Death. North East North West South East South West Total. Measles 3 . . 4 7 Whooping Cough 2 8 3 7 15 Diphtheria . . 1 1 2 Enteric Fever 1 1 1 3 Influenza' 33 23 47 84 187 Phthisis (Pulmonary Tuberculosis 22 16 23 30 91 Tuberculous Meningitis . . 1 2 3 Other Tuberculous Diseases 4 . 2 3 9 Cancer (Malignant Disease) 16 15 19 13 63 Rheumatic Fever . . . |
290e1689-4110-4a8d-84d0-2426302c5c77 | 1 1 Meningitis 2 2 3 3 10 Organic Heart Disease 23 15 12 17 67 Bronckitis 7 7 6 22 42 Pneumonia (All forms) 14 9 12 24 59 Other Respitatory Diseases 5 1 2 2 10 Diarrhoea and Enteritis 7 . 1 5 13 Appendicitis and Tvphilitis 2 . 1 3 6 Cirrhosis of Liver . . . 2 2 Nephritis and B ight's Disease 6 . 6 3 15 Puerperal Fever . . . . . Other Accidents and Diseases of Pregnancy and Parturition . . . 1 1 Congenital Debility and Malformation. |
05fb52e8-d0d2-4e39-a056-535a923b5b32 | including Premature Birth 2 7 9 11 29 Violent Deaths (excluding Suicide) 5 5 6 2 18 Suicide ... 0 4 3 10 Other Defined Diseases 49 54 43 63 209 Totals 203 161 202 306 872 l9l 8 21 Table 6. INFANTILE MORTALITY DURING THE YEAR. 1918. Deaths from stated causes in Week and Months under One Year of Age. Causes of Death. 0 Under 1 week. | 1-2 weeks. 2-3 weeks. 3-4 weeks. 1-3 months 3-6 montln 6-9 monthsj 9-12 mnthsl Total deaths un der 1 year Whooping Cough . . . . 1 3 1 1 6 Tuberculous Meningitis . . . . . . . . . Other Tuberculous Diseases . |
3240c78b-8fe6-455f-9cfe-5fb540b0f777 | . . . . 1 . 1 Meningitis (not Tuberculous) . . . . . . 1 . l Convulsions . . . 1 1 1 l . 4 Influenza . . . . . . l 2 3 Bronchitis . . . . 2 1 l . 4 Pneumnnia (All forms) . . 1 . 2 1 3 1 8 Diarrhoea . . . . 1 . . 1 2 Enteritis . . 1 . . 3 6 . 9 Suffocation, overlaying . . . . . . . 1 1 Injury at Birth .r 4 . . . . . . . 4 Congenital Malformation 1 1 . . . . . . 2 Premature Birth 10 l . 3 . . . 14 Atrophy. |
ba0bfb17-6f38-4503-b9ea-fe96f1d8701d | Debility and Marasmus 2 ... 2 ... 6 2 ... 1 13 Other Causes ... ... ... ... ... 2 ... 2 4 Totals 17 2 4 4 13 14 13 9 70 1918 22 Table 7. INFANTILE MORTALITY—WARD DISTRIBUTION. Causes of Deaths. North East North West South East South West Total. Whooping Cough 2 1 . 3 6 Tuberculous Meningitis . . . . . Other Tuberculous Diseases 1 . . . 1 Meningitis (not Tuberculous) . . 1 . 1 Convulsions 2 . . 2 4 Influenza . . 1 2 3 Bronchilis . 1 1 2 4 Pneumonia (All forms) 1 1 2 4 8 Diarrhoea . . . |
c631e0f1-844b-4d2a-8a20-3f557be79a31 | 2 2 Enteritis 4 2 3 . 9 Suffocation, overlajlng . . 1 . 1 Injury at Birth 1 . . 3 4 Congenital Malformations . . . 2 2 Atrophy Debility and Marasmus 1 3 2 7 13 Premature Uirths 1 4 7 2 14 Other Causes 1 . 1 2 4 Totals 14 12 19 31 76 23 1918 Table 8. CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR. 1918. Notifiable Disease. Cases notified in whole District. At Ages—Years. Total cases notified in each ward. At all Ages Under 1. 1 to 5. 5 to IS IS to 25 25 to 45 45 to 66 65 and upwards. North-East. |
b2c54533-a2f2-441c-a2d9-5e49b59faab9 | North-West South-Eait. South-West Measles and German Measles 417 8 141 286 17 14 1 . 121 112 116 69 Scarlet Fever 38 . 9 22 8 4 . . 12 11 7 8 Diphlhera 46 . 11 23 4 5 . . 16 20 5 6 Kntiric (Typhoid) 8 . . . 1 1 1 . 1 1 1 . 1'uerperal Fever . . . ' . . . . . . . . . Cert-bra Spinal Fever 1 . . 1 . . . . . . . 1 Acute Poliomyelitis 2 . 2 . . . . . 1 . . 1 Erysipelas 11 . . |
5b38e391-4aaa-4212-a9a5-ec44d2e2a4b7 | 1 2 3 4 1 3 2 2 4 Ophthalmia Neonatorum 7 7 . . . . . . . 2 . 5 Tuberculosis, Pulmonary 128 . 1 15 35 64 12 1 25 21 32 50 Tuberculosis, (Other Forms) 21 . . 11 4 3 1 2 6 4 2 10 Totals 674 16 167 309 66 94 19 4 183 173 164 154 1918 24 TABLE 9. CASES OF NOTIFIABLE DISEASES REMOVED TO HOSPITAL DURING 1918. |
69d8d822-245f-453e-a345-9f35b960db18 | Measles 4 Scarlet Fever 27 Diphtheria 30 Enteric Fever 1 Cerebro-Spinal Fever 1 Acute Poliomyelitis 1 Erysipelas 1 Ophthalmia Neonatorum 2 Pulmonary Tuberculosis 88 Other form of Tuberclosis 17 Total 172 TABLE 10. OUTSIDE DEATHS AND PLACES OF OCCURRENCE. Isleworth In6rmary 149 Middlesex County Asylum 28 St. George's Home, Chelsea 9 West London Hospital 13 Chiswick Hospital 5 Gt Ormond Street Hospital 4 St. Bartholomew's Hospital 4 Northern Hospital, Winchmore Hill 4 St. George's Hospital 8 University College Hospital 3 St. Mary's Hospital 2 Middlesex Hospital 2 St. |
3372c3a5-72c3-41cc-a036-870874ddf5e9 | Columbus Hospital 2 Clare Hall Sanatorium 3 Twyford Abbey 2 River Thames 2 Hackney Infirmary 1 Marylebone Infirmary 1 Military Hospital. Richmond 1 Inlant's Hospital, Westminster 1 Children's Hospital, Paddington Green 1 Guy's Hospital 1 National Hospital, Ventnor 1 King Edward's Memorial Hospital, Ealing 1 Essex County Hospital 1 Consumption Hospital, Kensington 1 London Hospital 1 Cancer Hospital, Chelsea 1 Elizabeth Garrett Anderson Hospital 1 St. Joseph Hospital 1 1918 25 TABLE io.—Continued. OUTSIDE DEATHS AND PLACES OF OCCURRENCE. |
51123d2c-fa04-4772-b52e-fea304c28aa9 | t,ity of London Asylum 1 Broadmore Asylum 1 London County Asylum 1 Broadwood Asylum 1 Darenth Asylum 1 Bethnal House Asylum 1 Northumberland House, Stoke Newingtcn 1 Maghill Epileptic Home 1 District Railway Turnham Green Station 1 Metropolitan Railway, near Notting Hill Station 1 One each in private houses in the following towns :— Blackpool. Wandsworth. Ealing, Bradford. Salisbury. West Bromwich, Southall, Hastings, Croydon, Marylebone, Merton. Chesterfield, Falmouth, Bath, Brighton, Shoreham and Dorchester. TABLE II. DEATHS FROM TUBERCULOSIS 1918. Pulmonary Tuberculosis 87 Other form of Tuberculosis 8 Total 95 Males 40 Females 55 Pulmonary Tuberculosis—Occupations Prior to Death Males. Females. |
dc415632-2e28-4c16-a754-7904d36f4636 | Clerk 6 Household Duties 17 Engineer 5 Schoolgirl 7 Labourer 3 Munitions 3 Schoolboy 2 Laundress 3 Wheelwright 1 Domestic Servant 2 Laundry man 1 Dyer 2 Engine Fitter 1 Dressmaker 2 C.as Fitter 1 Music Teacher 1 Plasterer 1 Waitress 1 Commissionaire 1 Typist 1 Surgeon Dentist 1 Soap Factory 1 Carman 1 Not any 10 Org&n Builder 1 Reporter 1 Hosier's Assistant 1 Engineer's Apprentice 1 Munitions 1 Tram Driver 1 Engine Cleaner ... 1 Brush Maker 1 Porter 1 Not any 2 1918 26 TABLE 12. NOTIFICATION OF TUBERCULOSIS. |
9baa5fdf-4471-4d70-be5c-abce8cc27e6e | Pulmonary 128 Other forms of Tuberculosis 21 The Notifications were received frcm the following :— Infirmaries 39 Private Doctors 30 Sanatoria 39 Hospitals 39 Military Authorities 4 Other Institutions 16 Tuberculosis Officer 1 Insured Cases 65 Non-Insured Cases 63 Mode or Treatment Insured Non-Insured Sanatoria 20 18 Hospital 12 16 Infirmary 12 10 Applying for Sanatorium 6 — Discharged from Sanatorium 6 1 Refused Sanatorium Treatment 1 Nursed at Home 6 11 Removed from District 2 3 Remo\ed to County Asylum — 1 Occupations prior to Illness. Males Females. |
81bface7-4f4b-41b6-bafa-257a8d244612 | Discharged Soldiers 24 Household Duties 22 Clerk Clerk 3 School Boy 3 Domestic Servant 3 Labourer 4 Laundress 1 Munitions 2 Munitions 5 Miner 1 Knitter 2 Errand Boy 1 Schoolgirl 7 Wheelwright 1 Typist 1 Brass Etcher 1 Dyer 1 Baker's Roundsman 1 Dressmaker 2 Auctioneer 1 Shop Assistant 1 Manager 1 Soap Factory 1 Pensioner 1 Not Known I Jeweller 1 Not any 7 Engineer's Apprentice 1 Motor Mechanic 1 Photographer 1 Potman 1 Traveller 1 Art Student 1 Accountant 1 Florist's Manager 1 Fitter's Mate 1 Tram Driver 1 Not Known 2 Not Any 4 1918 27 TABLE 12.— Continued. Non-Pulmosary Tuberculosis. Males 8 Females 13 Situation of Disease. Males. Females. |
5f38b65e-6b6f-40bb-94c1-55eae3dc9b39 | Glands 2 Peritoneum 4 Hip 2 Spine 2 Larynx 1 Knee-joint 2 Pleura and Rib 1 Pharynx and Larynx 1 Spine 1 Knee and Thigh 1 Knee-joint 1 Septum 1 Jaw and Arm 1 Generalised 1 TABLE 13. DEATHS FROM MEASLES St. Elmo Road 1 Larden Road 1 Newton Avenue 1 Cunnington Street 1 Hanbury Road 1 Malvern Villas 1 Bollo Bridge Road 1 TABLE 14. INFANT'S CONSULTATIONS. Priory Schools Palmerston Mission Health Visitors Attendances 99 99 Number of children who attended 349 303 Number of attendances made by children 3395 2,498 Children under 1 year of age 157 151 Children over 1 year of age 192 152 Ages of children who commenced attendance in 1918. |
646a47bb-0889-4cc3-a966-ef72fc83edf4 | Priory Schools Palmerston Mission Under 3 months 86 69 Between 3 and 6 months 50 18 „ 6 and 9 months 17 14 ,, 9 and 12 months 4 3 ,, 1 and 2 years 19 29 „ 2 and 3 years 24 14 „ 3 and 4 years 13 20 ,, 4 and 5 years 14 12 Of the above children 2 had attended for the first ime in 1913. 11 1914. 18 1915. 59 1916. 157 1917. 405 1918. 1918 28 TABLE 15. ANTE-NATAL CLINIC. Number of times the Clinic was held 27 Number of expectant mothers who attended 33 Number of attendances made by expectant mothers 65 Numberof cases admitted to Acton Hospital 7 Ante-natal Visits. |
a620bd6e-02ea-41d4-b0e5-d30994cf0357 | Number of mothers visited 145 Number of visits paid to mothers 441 TABLE 16. INQUESTS. Held in the District 48 Cause of Death. Suicide 9 Heart Disease 9 Injury at Birth 3 Influenza i Accidentally killed by a motor vehicle 3 Pneumonia 4 Overloaded stomach 2 Accidentally killed by an aeroplane propeller 1 Phthisis 2 Ptomaine poisoning 2 Scalds 1 Convulsions 1 Burns 1 Status Lymphaticus I Fracture of Skull 1 Ruptured Aortic Aneurism 1 Fall from Window 1 Diarrhoea 1 Wilful Murder 1 Deaths outside the District 14. Fractured Skull 3 Suicide 2 Burns 2 Found drowned 2 Run over by a train 2 Pneumonia 1 Heart Disease 1 Phthisis 1 TABLE 17. BACTERIOLOGICAL LABORATORY. |
114bef5f-0d3c-48ee-9929-7a1b8fdda88d | 251 Swabs from the throats and nose were examined :— 58 were positive and 103 were negative. The specimens were from : — Doctors private patients 73 Hospital patients 156 School contacts 14 School sore throats 5 Convalescent cases prior 10 school attendance 3 1918 29 TABLE 18. ISOLATION HOSPITAL Remaining in Hospital, January 1st, 1918 23 1st, 1919 12 Admitted during year :— Civilian's Cases 125 Military 4 Residents 61 Non-residents 68 Scarlet Fever 59 Diphtheria 61 Measles 6 Mumps 2 Erysipelas 1 Deaths:— Diphtheria 3 woodgates and sons. printers (t.c.) south acton |
5447c0a1-18ad-477b-aeca-97d36c572d66 | ACT 22 Urban District of Acton. ANNUAL REPORT OF THE Medical Officer of Health For the Year 1919. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1919. Council Offices, Acton, W.3. June, 1920. To the Chairman and Members of the Urban District Council of Acton. Ladies and Gentlemen, I beg to submit the Annual Report on the work carried out by the Public Health Department, together with the Vital Statistics during the year, 1919. The Ministry of Health has issued a Memorandum as to the contents and arrangements of the Annual Reports of Medical Officers of Health and in an accompanying Circular urge the desirability to compile the Report upon the lines indicated in the Memorandum; the subjects therein specified are being dealt with as nearly as possible in the order there given. Population. |
feebb57d-1618-444c-9783-1bfb0a93b83a | For the sake of accuracy in our vital statistics, it is fortunate that we are approaching the period when a complete Census of the population will be made. The population of the district at the Census of 1911 was 57,497. Since the Census many other enumerations have been made, and estimates of the population have been based upon these enumerations. In this district the earlier enumerations were approximately correct. The first enumeration took place in August 1915 under the National 4 tration Act, and it included all persons over 15 years of age. In 1917, the Registrar General based his estimate of the civil population upon the number of sugar cards issued in that year, and probably his estimate was approximately correct. The Registrar General based his estimate of the civil population in 1918 upon the returns sent to the Ministry of Food in July of that year. |
b3629cef-0f5d-4625-afc0-168a19300ef9 | The figures on the returns in 1918 were incomplete as the returns were sent in soon after the issue of the ration books and did not include the ration books issued to those who had omitted in the first instance to fill in their addresses, &c. Evidently last year the Registrar General based his estimates of the civil population on the number of ration books issued in 1919. The number of ration books issued up to November 29th, 1919, was 62,237, and the Registrar General's estimate of the civil population on June 30th, 1919, is 61,732. The Registrar General's estimate of the population for birth-rate purposes is 64,236. I have accepted both these estimates for the purposes of this report, as they can be corrected, if necessary, after the Census enumeration. It is almost certain, though, that these figures are an underestimate of the actual population of the district. |
f04836e5-c427-4f31-9373-780491525222 | For another purpose, a comparison was made of the number of ration books issued in 1918 and 1919; and when the numbers issued to the different addresses were compared, it was found that a number of the families had not applied for ration books in the autumn of 1919, and it is reasonably certain that a considerable number of persons are now supplied with food, but have not taken the trouble to apply for ration books. Very few houses were vacant in 1918 or 1919, and where a marked decrease had occurred in the number of ration books which had been issued to an address, it was found that one of the families had omitted to apply for the ration books. General character of the district, social conditions including occupations, &c. The district is divided into four wards—-North East, North West, South East and South West. 5 Almost all the area included in the South East and South West Ward has been developed and the available space built over. |
d9de7dde-689f-43b6-a4cd-e40afb71af37 | In the North East and North West Wards, there is a considerable amount of undeveloped ground, but the land in these two wards is rapidly being developed for residential as well as factory purposes. The whole district has a density of about 28 persons to the acre. In the North East Ward there are 15 persons to the acre, in the North West 17, in the South East 63 and in the South West Ward 82 persons to the acre. The district is partly industrial and partly residential. At the present time, it cannot be said that one of the wards is entirely residential. Formerly, the South West Ward was regarded as industrial in its character and the three others were residential. The South East Ward which comprises Bedford Park is almost entirely residential in character, and there are only a few factories in the ward, and these are along the borders of the ward. |
deb8f31f-3f6b-4d70-a041-eba6fd1e47df | A considerable proportion of the inhabitants, and especially those of the North East, North West and South East Wards are employed outside the district. The oldest industry, and at one time the most important, and almost the sole one, is the laundry industry. This industry has been established in the district for nearly half a century, and absorbs a large number of workers. In August 1915, there were 1048 single and 1640 married women employed in the laundry industry. It is probable that this number was exceeded ten years ago, and it is likely that at the present time fewer persons are employed than in 1915. The introduction of labour saving machinery has had the effect of closing most of the hand laundries, and this fact alone would account for a diminished number of employees. But it is also possible that less work is now done in the laundries of the district than was the case ten years ago. |
94e58e6d-f0e4-463f-8881-d2476901ec1a | In addition to the small hand laundries, some factory laundries have recently been closed, and possibly, some of the causes which led to the introduction of the industry into the district may be operative in the establishment of new laundries in another district. Owing to the 6 introduction of machinery some of the factors operating half-acentury ago, have now become non-operative. Various theories have been advanced to account for the migration of the laundry industry from North Kensington, Kensal Rise and other districts to Acton, such as greater softness of the water, and that the Grand Junction Water Works Company offered special terms, &c. As far as can be ascertained these theories have no foundation on fact. The true cause probably was a far simpler one. Even now, the natural trend of traffic in London is from the east to west and west to east, and formerly the facilities for transport in these directions were greater than they were to the north and south of the central areas. |
c62000c8-ceb5-4ca3-8d03-502e388cd7a6 | From the west end of London the natural exit would be further westwards, and if conditions favourable to the washing and drying of clothes existed, the laundry industry would be established on the western outskirts. Before the introduction of machinery, the absence of factories and the existence of a comparatively open country would be necessary. The absence of factories would operate in two ways, the smoke nuisance would be less and female labour would be more plentiful. When the laundries were established along the western fringes—Kensal Rise, North Kensington, Hammersmith and Fulham—the two essential conditions would probably be fulfilled. As these areas were developed and factories established, the laundry industry moved further westward and Acton as the nearest suburb where the essential conditions existed was chosen. With the introduction of machinery, an open space is not necessary ; the drying is now entirely done indoors, and the presence of factory chimneys in the immediate vicinity is not detrimental to the laundry industry. |
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