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bf94f822-c85f-47bf-8199-14c70d130181 | On the re-opening of the schools after the Christmas holidays, several cases were reported from different schools. The epidemic lasted up to Easter and as stated 14 deaths occurred. MATERNITY AND CHILD WELFARE. Notification of Births Act. 1042 live births and 16 stillbirths were notified. The improved conditions and the lowered percentage of non-notified cases are referred to on a previous page of the report. It is satisfactory to note that last year over 98 per cent. of the births were notified within the statutory period. 779 of the births were visited by the Health Visitors, and the number of visits paid to the homes was 8,463. Infantile Mortality.—65 deaths occurred in children under one year of age. This number corresponds to an infantile mortality of 56 per 1,000 births. This is the lowest infantile mortality recorded in the district; on no other occasion has it been below 60 per 1,000 births. |
7840ad22-d363-4f33-8a34-cb48723cf10d | The rate for England and Wales was 75, for the 105 Great Towns 80, and for London 71 per 1,000 births. In the year, four unknown babies were found in the district 2 in the allotments near St. Dunstan's Avenue, I near Victoria Road, and 1 in a field near Old Oak Lane. If these were deducted, the infantile mortality would be 52 per 1,000 births. The Ward distribution of the infantile deaths was as follows:— North-East. North-West. South-East. South-West. 20 9 8 28 The Ward infantile mortality was:- North-East. North-West. South-East. South-West. 59 35 34 68 The infantile mortality of the North-East Ward is unduly high on account of the 4 dead infants found in the district and which really did not belong to Acton. |
ad141666-0327-4ae8-9cd3-a65216213491 | All four were found in the North 15 East Ward. Deducting these, the infantile mortality of the North East Ward was 44 per 1,000 births. Although the infantile mortality of the South West Ward is higher, it shows even a greater improvement than that of the other wards. Health Visiting. During the year, 779 of the births were visited by the Health Visitors, and 8463 visits were paid to the homes of the children. In addition, 225 expectant mothers were visited, and 454 re-visits were paid in respect of this service. It has been explained that the Council does not distribute free milk as a routine proceedure; only in exceptional circumstances is milk provided free. An arrangement was made with the Guardians for the distribution of dried milk at two pence a packet under cost to children under 3 years of age. |
446f300b-b3a3-45dd-96e0-3c8111312756 | The Council, in exceptional circumstances, distributes free milk to expectant mothers, and last year 40 expectant mothers were supplied with 414 packets of dried milk. Maternal Mortality. A reference to Table III will show that 7 deaths of women occurred in child-birth-2 from Puerperal Sepsis and 5 from other accidents and diseases of pregnancy and parturition. Considerable attention has been paid in the past year to this important matter and the Ministry of Health issued a Circular to local authorities dealing with the question of Maternal Mortality associated with childbearing. The Circular was based upon Dame Janet Campbell's report on Maternal Mortality which was publi hed earlier in the year. This was the third report by Dr. Janet Campbell on the subject of Maternal Mortality, and dealt with the general subject of the causes of an excessive maternal mortality and the means of its reduction. |
9dbce960-dd49-42e6-a491-84c61f179483 | Sir George Newman in his prefatory note to the report summarizes its outstanding features as follows:— 1.-Matornal Mortality is relatively excessive in England and Wales In respect of the proportion of Maternal Mortality, England and Wales compares unfavourably with Germany, Norway, Italy, Sweden and Holland. 2.-Since 1902, Maternal Mortality has not declined proportionately in the same degree as the general death-rate or the infantile mortality. The child-bearing mother is not sharing equally with the rest of the population in the improved public health. 3.—The risks to women in their first confinements are greater than in most subsequent confinements. 4.—The decline in the birth-rate has exerted a relatively small effect upon the degree of maternal mortality. |
19540977-14ba-4f15-ac8b-ee3f8e02d681 | 16 5.—Maternal deaths are due principally to sepsis (puerperal fever) and to other complications of pregnancy, but deaths due to the former have shown a greater decline since 1902 than those due to the latter cause. 6.—Excessive rates of maternal mortality are found in the aggregate in the most rural areas, and in highly industrial areas. Critical examination of the statistics pertaining to maternity and child welfare has brought to light the uncomfortable fact that although there has been in recent years an enormous saving of infant life, there has been no material alteration in the maternal death-rate.. No doubt the concentration of attention upon the infant and the remarkable results achieved have, in a measure, detracted attention from the maternal side of the question, but that is no reason why equal care should not be bestowed on both parties. |
9929770f-09d7-48aa-a0e7-d67c52f35a31 | One of the most striking characteristics of our mortality returns has been the steadv and continuous decline in the death-rate, and one of the most hopeful features of our sanitary history is that at certain ages—most noticeably in infancy—the rate of advance is not slacking, but even accelerating, while for certain diseases, especially tuberculosis, the temporary set back associated with the war-period is being overcome. But in the matter of death in childbirth, the mother has not shared equally with her child in the improvement of public health. The maternal deaths throughout England and Wales have varied from 3.55 per 1,000 births in 1918 to 4.81 in 1900. In Acton they have varied from .33 in 1901 to 7.52 per 1,000 births in 1916. Too much reliance should not, of course, be laid upon occasional local variations in mortality, but if we take any extended periods for comparison, the conditions cannot be regarded as favourable to this district. |
ec29bd33-4342-4f8e-9921-3c79ccf92263 | Prior to 1905, the figures for Acton are not reliable, as no outside deaths were included in the returns for the years 1898—1905. If we divide the period 1905-1924 into 5 periods of 4 years, the figures would be as follows:— 1905—1908. 3.74 maternal deaths per 1000 births. 1909—1912. 2.7 1913—1916. 4.53 ” ” ” 1917—1920. 4.59 ” ” ” 1921—1924. 4.6 ” ” ” 1924. 6.04 ” ” ” Compared with that of the whole of England and Wales, and with that of the Metropolitan Boroughs, the maternal mortality here is high. An examination of the distribution reveals some puzzling figures and does not lead to a definite conclusion. |
cafacf21-fdf2-4aac-9e1a-3f013f70d328 | In the poor working class Metropolitan Borough of Shoreditch, the rate of mortality in 1919-22 (2.55) was the lowest but two of all the Metropolitan Boroughs, surpassed only by the City of 17 London-a very special district-1.66 and the working class Borough of Stepney (2.42). Both Hampstead and Lewisham with the lowest rates of infant mortality of the metropolis had higher maternal mortality rates than Shoreditch (with the highest rate of infant mortality). Maternal mortality does not seem to bear much relation to the percentage of married women engaged in extra-domestic duties. In the Metropolitan Boroughs, the lowest mortalities are in those districts which have the highest percentage of married women engaged in some extra-domestic occupation. In last year's report, figures were given showing the position of Acton in this respect. The relationship between these two factors has been discussed, but no definite conclusion can be drawn. Certain kinds of employment may be harmful. |
3a805f2e-b778-40d1-bc64-082021d72dcf | The nature of the work may be such as to exert a harmful effect upon pregnancy and child-bearing, as, for example, certain processes necessitating the use of lead; or the work may involve heavy lifting or abdominal strain or pressure, as in some operations in the tinplate industry or in weaving. In Acton there is no work which can be considered directly harmful. In spite of changes, the industry which employs most of the married women is the laundry industry, and in no part of the process are there conditions which can be regarded as directly or indirectly harmful. The effect of general sanitation and housing upon maternal mortality is not quite obvious. A sanitary wholesome dwelling is of obvious importance at the time of confinement, quite apart from its effect upon the general health of its inmates. One would expect the incidence of puerperal infection to be high under conditions of overcrowding, defective lighting, ventilation and drainage. In point of fact, insanitary conditions appear to have a less injurious effect upon maternal mortality than might be supposed. |
3fca887d-f40d-4ef8-abf6-76a380d1a797 | Domestic uncleanliness and lack of facilities and conveniences add enormously to the difficulty of applying effectual antisepsis and to the risks of operative procedure. Hence, in abnormal labours, every endeavour should be made to remove the patient to an institution before attempting instrumental delivery. It is desirable to refer to the clinical cause to which the majority of deaths are attributable, but it is important to lay emphasis upon the fact that the actual deaths form only a part, and perhaps a comparatively small part, of the whole problem of maternal mortality and morbidity. For every mother who dies, there are many more who are injured more or less seriously, more or less permanently. These preventable sequelae of child-bearing cannot fail seriously to reduce the health and capacity for work, to say nothing of the comfort and happiness of many working class women, and the elimination of such causes of sickness and disability is of little less importance than the reduction of the mortality. |
488f5f74-1ed6-4286-9d15-e514228f0803 | 18 The chief cause of death is Puerperal infection or Puerperal Fever, or Puerperal Sepsis. Puerperal Sepsis not only easily ranks as the prime cause of death amongst women in child-birth, but also leads to more subsequent injury in the case of survival than any other complication of child bearing. As it is in the nature of an external infection, it ought to be well within the scope of prevention. The discovery of the specific germ of septic infection by Pasteur and the development of the principles and practice of antisepsis by Lister, made possible the definite progress in the control and management of puerperal fever. The application of the new knowledge has led to the practical disappearance of puerperal fever from lyingin hospitals which were formerly devastated by epidemic infection. Similar success has not followed in the private practice of midwifery. |
f08a520e-1dc7-4170-bf7f-b82f5f1fdbbd | Puerperal Fever is one of the compulsory notifiable infectious diseases, but it is well known that the system of notification as far as puerperal fever-is concerned has broken down and is worthless. It is probable that not more than 5 per cent. of the cases are notified. In some districts the deaths exceed the notifications. In this district the figures have been as follows in the last 3 years:— Year. Notifications. Deaths. 1924 5 2 1923 3 3 1922 2 1 The causes of this failure are probably many and complex. Some difficulty arises in defining clearly what is meant by puerperal fever as was shown by the discussion on this subject at the Royal Society of Medicine, and it is admitted that at an early stage it is not always possible to decide as to the cause of a rise of temperature. |
aa640121-e094-4fdf-ae8a-57c0553cadc6 | The chief cause of the breakdown of notification lies in the want of any means by which effective assistance can be rendered to the patient. The main object of notification is not so much to acquire statistical information, helpful though it may be at times, but to secure specialised treatment for the patient and to permit the early exercise of preventive measures. With the exception of the Infirmary, there is no provision for the institutional treatment of puerperal sepsis. Beds in maternity homes are mainly intended for non-infectious cases, and the facilities for isolation are limited. There is an objection on the part of patients to avail themselves of the facilities offered by the Poor Law authorities. The most important instrument within our reach to reduce maternal mortality is ante-natal care. This is true not only of puerperal sepsis, but more so of causes other than sepsis. |
df7ce3ea-ac0d-4903-b068-3dbbae032a12 | Until ante-natal supervision is accepted by patients and their advisers as the invariable duty of the professional attendant engaged for the confinement, substantial progress towards the reduction of 19 nal death and injury will not be made. It is the key to success in any scheme of prevention, and it must be insisted upon in and out of season until it is no longer ignored or looked upon as a luxury for the well-to-do woman, but is recognised as a necessary and integral part of the management of every confinement case. The special value of ante-natal care, as far as puerperal sepsis is concerned, is to reduce the number of difficult labours, which always involve manipulation, and especially emergency operations. These render patients particularly liable to sepsis, partly from opportunity of infection, and also from damage to the tissues. Ante-natal examination also affords an opportunity for treating before the confinement septic infections from which the woman may suffer. |
3a6fe566-fd28-4a4a-9bc0-d9cdabfb0448 | It is disappointing to find how few patients, even primiparae, are examined before labour in the course of ordinary practice. The Council does not possess a maternity home. Some years ago the Council had an agreement with the authorities in charge of the Salvation Army lying-in-hospital in Clapton. The hospital is an excellent one and was very popular with the mothers who were confined there. Its popularity though, interfered with its utility, as far as Acton was concerned, on account of the big waiting list. Admission of Acton women became almost an impossibility and the agreement was terminated, or rather, it lapsed because no mothers were admitted. The Guardians established a private ward for confinement cases at Warkworth House, and a charge of two guineas a week was was made for cases admitted into these wards. For some reason or other, these private wards have been discontinued. |
05304da3-485b-43d2-84e5-f9f966a4289e | Chiswick and Haling have a joint maternity hospital established in what was formerly the Chiswick Fever Hospital. At the start, outside cases were admitted, and some Acton mothers went there. This hospital now has a waiting list, and it is most difficult, if not impossible, for cases outside Chiswick or Ealing to be admitted. The Infirmary at Isleworth and Queen Charlotte's lyingin-hospital are the principal public institutions which receive cases from the district for normal confinements. Occasional confinements take place in other general and lying-in-hospitals. Of the measures suggested in the report, the Council has already adopted a scheme for ante-natal supervision, the provision of beds for complicated cases and the provision of nursing assistance in necessitous cases. As necessity arises, this part of the Council's scheme can be developed. The ante-natal supervision can be extended, and efforts made to encourage ante-natal hygiene through the centre. |
48279b9d-d888-46f7-98c6-2502bd61816a | The 20 average numbers attending are small, but as the centre becomes better known to the midwives, probably more mothers will attend. The service for complicated cases at the Acton Hospital is efficient and quite satisfactory, and no cases have been refused admission. For administrative purposes, admission has had to be limited to those cases who have attended the ante-natal centre. The Council has no maternity Home. Maternity beds have been provided in various places, and have proved of undoubted value. The provision of beds for straight-forward or uncomplicated cases, owing to housing and other difficulties would supply a want which is present here. An Ante-natal clinic is held every other Thursday at the School Clinic buildings. The medical officer is Dr. Bell, and in 1923, 63 expectant mothers attended the clinic, making a total of 123 attendances. In addition, the Health Visitors visited 200 expectant mothers in their homes. |
f97179f6-949f-4d4d-893a-99ee7b7b57ed | In 1924, 59 expectant mothers attended, making a total of 98 attendances. Examination and advice will be of little use if the advice cannot be followed because of lack of hospital beds, or ready access to skilled medical or nursing aid. An agreement between the Council and the Acton Hospital has been in force for some years. Under this agreement abnormal cases are admitted into the hospital and last year 6 cases were admitted. The Council agrees to pay according to the following scale:-Ceasarean section, six guineas; Major operations, six guineas; Minor operations, three guineas. These sums are in addition to the maintenance free of five pounds per week. During the last 4 years, the following sums have been paid:— £ s. d. |
56234e9c-443e-4da4-a8a6-b2cc49e3bba0 | 1924—1925 98 17 4 1923—1924 109 1 0 1922—1923 151 0 3 1921—1922 62 17 0 1920—1921126 13 0 The Council also pays under certain conditions the fees of midwives; in 1923 the fees were paid in seventeen instances, and in 1924 in 10 instances. There is one other sphere which is becoming more popular, and that is, the provision of Dental treatment for expectant and nursing mothers. Extractions and stoppings are carried out on special days at the School Clinic, and through the kind instrumentality of Miss Loretz, the School Dental Surgeon, dentures are supplied at a very low cost. The dentures are paid for by the patients themselves. During 1924, 22 mothers were treated and 5 dentures supplied. |
debaf4b8-79b3-457e-9945-6f9dc0707881 | 21 Day Nursery.-The Municipal Day Nursery is situated in Bridge Road. Practically no change has occurred in the general policy of the Council in respect of the Nursery. The Nursery was open on 211 occasions. On account of illness amongst the staff the Nursery was closed for a week. 304 children attended, and the total number of attendances was 3,224. Isolation Hospital.-During the year, 188 patients were admitted into the Hospital. On January 1st, 1924, there were 37 cases under treatment and on January 1st. 1925, 24. 194 patients were discharged and there were 7 deaths. The children's Hostel at Park Royal was opened during the year for the accommodation of school children visiting the Empire Exhibition at Wembley, and the Council entered into an agreement to receive cases of infectious disease which might occur among the children. |
51482787-188b-4065-a8ca-696991eb8002 | During the year, 9 cases were admitted from the Hostel3 scarlet Fever, 2 Mumps and I each Measles, Chicken-pox, Stomatitis and Tonsilitis. It speaks well for the organisation of the method of obtaining information from Sanitary authorities to achieve This result—only 9 cases of proved and doubtful infectious illness in a total of over 70,000 children that visited the exhibition and stayed at the Hostel. During August, Hoy Scouts were camped in Wembley paddocks and for a few nights some companies were lodged in the Action Wells School. Three cases of Scarlet Fever, 1 case of Mumps and I case of Urticaria were treated at the Hospital. The following table gives the number of admissions:- Scarlet Fever. Diphtheria Mumps. Measles. Chicken Pox. Stomatitis. Urticaria. Croup Tonsilitis. Scarlet Fever and Measles. |
acd66bf5-ed35-4964-bb3c-a1431fc78f8b | Total. Acton 81 37 — 20 - - - 1 1 - 140 Wembley 14 12 - 4 - - - - - - 30 Kingsbury 1 1 - - - - - - - - 2 Hendon - - - - - - - - - 1 1 Park Royal Hostel 3 - 2 1 1 1 - - 1 — 9 Scouts (Exhibition) 3 - 1 - - - 1 - - - 5 Wembley paddock (Army) - - - 1 - - - — - - 1 188 Patients Admitted During 1924. 24 patients remaining in Hospital on January 1st, 1925. 22 Supervision of Food Supply. The Middlesex County Council is the authority for the administration of the Food and Drugs Acts in the area, and I am indebted to Mr. |
bc0bd77a-b42d-4ee4-ac8e-2c6ba2f37786 | Robinson, the Chief Officer of the Public Control Department for the following figures relating to Acton. List of samples taken during the year ended December 31st, 1924:— Article. Taken. Adulterated. Milk 242 6 Milk, separated 6 — Cream 5 — Butter 9 Beer 2 — Cocoa 1 — Coffee 3 — Cream of Tartar 1 — Potash, Bicarbonate of . 1 — Potash, Chlorate of 1 — Prepared Chalk 1 — Sauce 2 1 Vinegar 3 — 277 7 The figures given for adulterated samples include some adulterated informal samples in respect of which no proceedings could be taken. Milk Supply.—There are one cowshed and 88 dairies and milkshops on the register. |
6a21368e-7105-48d0-9672-a33ad2b5c076 | Of the 80 premises from which milk is retailed, 8 are branches of one firm, and 2 of another firm; lfi of the registered purveyors have shops and rounds, Hi have rounds only, 12 are dairy shops, 4 are primarily caterers of food, 38 have general shops, and 2 are general shops, but each has a round attached to the business. Slaughterhouses and Butchers.-There are 1 registered and 2 licensed slaughterhouses in the district. In the autumn of 1924, arrangements were made for the thorough inspection of all carcases slaughtered in the district. During the latter part of the year, the inspection of all carcases in one of the slaughterhouses took up most of the time of one inspector and another man to assist him. The importance of this work may be gauged from the following table, in which is given the quantity of food seized at the slaughterhouses. |
42eec7db-67ec-4010-8b69-e58e2d83202c | About 8 per cent, of the pigs slaughtered are affected with local tuberculosis; the most usual sites of infection are the glands of the head and the inguinal glands. When the submaxillary or cervical glands are affected the whole head is seized. It is a significant fact that the 23 centage of carcases affected with tuberculosis is higher in the case of pigs reared in dairying districts. As far as this district is concerned, it may be claimed that the inspection of the carcases is efficient and the complaint received is that it is rigid and stringent compared with the inspection made in some districts where sausages are made and bacon curing is carried on. In view of the experience obtained here and other places where systematic inspection is carried out, the laxity displayed in some areas is disconcerting. It is known that frequently, in the cooking of sausages, complete sterilization does not take place. |
9ac211b2-813e-40cc-a8b5-0ffea644ccaf | On account of the tendency of the pig to generalized tuberculosis, it is urged that inspection of slaughterhouses where swine are killed should be efficient and st ingent. Where the carcases are converted into sausages, the necessity becomes more urgent. The following table gives the quantity of unsound food seized or surrendered during the year:- 303 pigs' heads. 40 pigs' carcases. 2 cows' carcases. 2 lambs' carcases. (j legs of Pork. 2 Fore quarters of Pork. 2 Trunks of Haddocks. 4 Fore quarters of Beef. 4 Hind quarters of Beef. 2 sets pigs' lungs. 1 cows' head. 9 cows' livers. 13 sets cows' lungs. 1 cows' heart. 1 cows' messentery. 1 Hind quarter of Pork. 2 kidneys. 22 bottles Chilli Sauce. |
fbf4eb4c-488f-4990-84d5-bacebe4fd90e | Bakehouses.-There are 35 bakehouses in the district; 8 of these are underground. Inspection of Nuisances, Sanitary defects, etc. The table at the end of the report gives a detailed list of the inspections carried out during the year. Owing to the pressure of other work, houseto-house inspections were made only in 353 instances. Owing to the difficulties arising out of the shortage of houses, it is impossible to enforce rigidly the bye-laws made in respect of overcrowding. A larger number of houses was erected in 1924 tha..., any year since the War, but the supply does not meet the demand. The most urgent cases of overcrowding were remedied, and in every instance, the bye-laws relating to the separation of the sexes were enforced. TABLE 1. COMPARATIVE RATES OF MORTALITY. Birth Rate per 1,000 Total Population. Annual Death Rate per 1,000 Population. |
750d9d22-3702-468b-912e-751b35e640c7 | Rate per 1 000 Births. Percentage of Total Deaths. All Causes Enteric Fever. Small Fox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence Diarrhoea and Enteritis under 2 years. Total Deaths under 1 year. Causes of Death certified by Registered Medical Practitioners. Inquest Cases. Uncertified Causes of Death. England and Wales 18.8 12.2 0.01 0.00 0.12 0.02 0.10 0.06 0.49 0.44 7.3 75 92.3 6.6 11 105 County Boroughs and Great Towns, including London. 19.4 12.3 0.01 0.00 0.18 0.03 0.12 0.08 0. |
cc1891b5-296d-4074-8715-bfb27a1badbc | 45 0.40 9.2 80 92.5 6.9 0.6 157 Smaller Towns (1921) Adjusted Populations 20,00050,000) 18.9 11.2 0.01 0.00 0.08 0.02 0.09 0.06 0 50 0.36 6.2 71 93.3 5.5 1.2 London 18.7 121 0.01 0.00 0.29 0.03 0.11 0.12 0.36 0.44 8.4 69 91.3 8.6 0.1 Acton 18.4 11.2 0.00 0.00 0.25 0.01 0.03 0.08 0 34 0.19 4.3 56 94. |
c9e14270-a95c-4971-80e3-dd5d91a1533a | 7 6.3 0.0 24 25 TABLE 2. VITAL STATISTICS FOR WHOLE DISTRICT DURING 1924 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. Nett. Under 1 year of Age. At all Ages, Number Rate of Non-Residents Regi...............stered in the District. of Residents Registered outside District Number Kate per 1,000 Births. Number Rate per 1,000 Inhabitants. Number Rate 1919 64,306 for b'th rate. 01,732 for d'th rate. |
caca8bed-2bf0-4854-9c9c-efe18fd701de | 1096 17.1 436 7.0 12 222 72 65 646 10.4 1920 61,000 1541 25.3 560 9.2 16 217 100 64 671 11.0 1921 62,000 1314 21.1 445 7.1 ... 205 92 70 658 10.4 1922 62,390 1203 19.3 404 6.5 14 214 75 62 032 10.1 1923 62,720 1171 16 6 368 5.8 11 243 77 65 599 9.5 1924 62.900 1158 18.4 488 7.7 8 235 65 56 715 11.2 26 table 3. |
9c35b634-4e83-4bdc-bc21-87f5c79e9828 | AGES AT DEATHS, AND WARD DISTRIBUTION OF D EATHS IN 102' Causes of Death. All Ages Under 1 year 1 and under 2 2 and under 5 5 and under 15 15 and under 25 36 and under 45 45 and under 65 65 and upwards North East North West South East South West Measles 16 2 7 6 1 . . . . 1 1 6 8 Whooping Cough 2 2 . . . . . . . . 1 . 1 Diphtheria 5 . . 1 3 1 . . . 2 . . 3 Scarlet Fever 1 . 1 . . . . . . . 1 . . Influenza 22 . 1 . . . 2 11 8 6 9 3 4 Phthisis (PulmonaryTuberculosis) 47 . . . . |
8851e448-ce2d-4d0c-8ca1-924c64cb77b2 | 5 28 14 . 14 8 11 14 Other TuberculousDiseases 8 . 2 . 1 2 2 . 1 1 3 2 2 Cancer, Malignant Disease 92 . . 1 1 . 6 33 51 33 16 22 21 Kheumatic Fever 4 . . . 2 2 . . . 1 . 1 2 Diabetes 4 . . . . . 1 2 1 . 2 1 1 Cerebral Haemorrhage 46 . . . . . 3 15 28 16 11 8 11 Organic Heart Disease 71 . . . . 2 13 25 26 25 15 14 17 Arterio-sclerosis 19 . . . . . . 6 13 3 8 4 4 Bronchitis 57 7 i . . |
ab39d9fe-9d5d-4e61-8581-0217ab39b606 | 1 2 13 33 34 7 11 25 Pneumonia (all forms) 65 13 11 4 . 2 5 13 17 13 8 15 29 Other Respiratory Diseases 10 . 2 . 1 . 3 3 1 2 2 3 3 Ulcer of Stomach and Duodenum 6 . . . . 1 . 4 1 1 1 2 2 Diarrhoea (under 2 years) 5 4 1 . . . . . . 1 1 . 3 Appendicitis '2 . . 1 . . 1 . . 1 . 1 . Cirrhosis of Liver 1 . . . . . . 1 . 1 . . . Nephritis (Acute and Chronic) 17 . . . . . |
f8bbc297-96fa-482b-908b-d2a0b7e81de6 | 4 7 6 1 7 4 5 Puerperal Sepsis 2 . . . . . 2 . . 1 1 . . Other Accidents and Diseases of Pregnancy and Parturition 5 . . . . 1 4 . . 2 . 2 1 Congenital Debility and Malformation, Premature Birth) 26 26 . . . . . . . 6 5 2 13 Suicide 6 . . . . 1 2 3 3 1 . 2 Other Deaths from Violence 12 . 1 2 1 1 1 2 4 4 1 1 6 Syphilis 1 . . . . . . 1 . . . 1 . Polioencephalitis 1 1 . . . . . . . 1 . . . Emcephalitis Lethargica 2 . . . . . 1 1 1 . . |
9a3efd5c-6f7d-4702-a83a-e45d1d84332f | 1 Other Defined Causes 159 10 3 3 6 7 9 25 96 54 45 26 34 Causes ill-defined or unknown 1 . . . . . . 1 . . . 1 . Totals 715 65 30 18 21 26 89 180 286 208 154 141 212 table 4. INFANTILE MORTALITY DURING THE YEAR, 1924. Deaths from stated causes in Weeks 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 3-6 months 6-9 months 9-12 months Totai. Wards. North East. North' West. South East. South West. Measles . . . . . . 2 . 2 1 . . |
56932b02-4918-491f-8f3d-9cea023e7e34 | 1 Whooping cough . . . - . 1 1 . 2 . 1 . 1 Bronchitis . . . - 4 2 . 1 7 5 . . 2 Pneumonia . . 1 - 6 2 2 2 13 3 1 4 5 Diarrhoea . . . . . 3 1 4 1 I 2 Injury at Birth 8 . . . . . . . 8 3 1 1 3 Congenital malformation 3 2 1 . . 2 . . 8 . 2 1 5 Premature Birth 9 . 2 . 2 . . . 13 4 2 . 7 Atrophy, Debility and Marasmus . . . 3 2 . . . 5 2 1 1 1 Policencephatitis . . . . . . . 1 1 . 1 . . |
794b3076-dd74-4309-af59-676ff03b6fc9 | Basal Meningitis . . . . . 1 . . 1 . . . 1 Other Defined . 1 . . . . . . 1 1 . . . Totals 20 3 4 3 14 11 6 4 g5 'AO 9 8 28 TABLE 5. CASES OF INFECTIOUS DISEASES NOTIFIED DURING THE YEAR, 1921. Notifiable Disease. Cases notified in whole District At Ages—Yeats. Total cases notified in each ward. At all Ages. Under 1. 1 to 5. 5 to 15 15 to 25 25 to 45 5 to 65 65 and upwards. North-East. North-West South-East. South-West Scarlet Fever 105 24 65 10 6 . . 38 18 25 24 Diphtheria 45 11 22 11 1 . . |
3b0b0dcf-2ad6-4919-be54-a8c84ed4c2e7 | 19 2 17 Enteric Fever . . . . . . . . . . . . Pneumonia 54 19 6 6 12 7 1 5 2 30 17 Puerperal Fever 5 . . . 3 2 . . 2 . 2 1 Cerebro Spinal Fever l . . 1 . . . . 1 . . . Acute Poliomyelitis l . . . . 1 . . . 1 . . Encephalitis Lethargica 6 . . . 1 3 2 . 3 . . 3 Ophthalmia Neonatorum 4 . . . . . . . 2 1 . 1 Erysipelas 22 . 1 2 5 3 9 2 3 6 5 8 Tuberculosis, (Resp.) |
a654ca33-f2bc-4036-a512-5ba323fbf609 | 85 ... ... 1 19 46 18 1 30 13 11 31 Tuberculosis, (Other) 9 ... 4 1 2 2 ... ... 5 ... ... 4 Total 337 7 59 98 57 76 36 4 108 48 75 106 28 29 table 6. CASES REMOVED TO HOSPITAL, 1924. N.East. N. West. S. East. S. West. Total. |
ecee4f88-aa43-49bd-92df-5efc4c321a9b | Scarlet Fever 31 15 22 17 85 Diphtheria 17 6 2 16 41 Pneumonia l 1 3 2 7 Puerperal Fever 2 — 2 1 5 Cerebro Spinal Fever 1 - — — 1 Acute Poliomyelitis — 1 — — 1 Encephalitis Lethargica 1 — — 1 2 Ophthalmia Neonatorum — 1 — 1 2 Erysipelas 2 — — 1 3 Tuberculosis (Resp.) 23 9 8 19 59 Tuberculosis (Other) 5 — — 3 8 83 33 37 01 214 table 7. births. Total Births. Males. Females. Legitimate 537 587 Illegitimate 14 20 551 607 Notified Births in District. N.East. |
0a63f53b-db1c-4b32-bab2-458dec05affc | N.West. S.East. S.West. Total. 288 145 214 395 1042 Still-births—16. Births Registered, but not Notified. Males. Females. Total. 9 10 19 N.East. N.West. S.East. S.West. Total. 11 I 5 2 19 Notifications week Received from:— Doctors. Midwives. Nurses. Parents. 556 434 74 21 Notifications of births received from Medical Officers of Health of other districts:— N.East. N.West. S.East. S.West. 38 6 16 16 Included in the Registrar General's figures, but of which no intimation was received during the year 21 Number of Births visited 779 Number of Births revisited 8463 Table 8 infant welfare centres—1924. |
cc4f3f8b-d7ac-493e-89b3-7cb947108b8a | Health Visitors Attendances 211 Number of Children who attended 1606 Number of attendances by children 11505 Number of Children under 1 year of age 844 Children who attended Clinic for the first time 762 Children who attended Clinic for the first time 724 Children treated at Dental Clinic 58 30 ANTE-NATAL CLINIC. Number of times the Clinic was held 21 Number of expectant mothers who attended 59 Number of attendances made by expectant mothers 98 Number of cases admitted to Acton Hospital 3 Mothers referred for dental treatment to Clinic 22 Mothers supplied with dentures 5 Midwives fees paid 10 Expectant mothers to whom dried milk was supplied 40 Numbei of packets of dried milk supplied 414 INQUESTS—Residents only. TABLE 9. |
1857b2e9-a683-445e-82e4-e50c3414b35c | Fatty degeneration of Heart 8 Heart disease—unspecified 6 Cerebral Haemorrhage 2 Pneumonia 2 Ruptured Gastric or Duodenal Ulcer 2 Rupture of Aorta 1 Infantile Convulsions 1 Arterio-sclerosis 1 Found dead in bed 1 Accidental fall 6 Suicide 5 Want of attention at birth 4 Run over by motor car 3 Accidental drowning 2 Accidental strangulation 1 BACTERIOLOGICAL EXAMINATIONS. TABLE 10. Positive. Negative. Total examinations (626) 59 567 Sent by Medical Practitioners 13 200 Sent from Isolation Hospital 22 156 Contacts 14 128 Of these Positive Contacts:— 12 were positive on the first occasion only. 1 was positive on the second occasion only. 1 was positive on the third occasion only. School Sore Throats. Positive. Negative. |
db49b30a-700c-477b-8e80-53dacf2a3358 | Cases 10 83 Four of the Positive Sore Throat eases had sufficient clinical symptoms to warrant removal to Hospital. Defects found in Factories, Workshops and Workplaces. Particulars. 1. Number of Defects. Found 2. Reinedied 3. Nuisances under the Public Health Acts:- Want of cleanliness 46 46 Want of drainage of floors 12 12 Unsuitable or Defective sanitary accommodation 78 78 Total 136 130 31 Home Work. Outwokkehs' Lists, Section 107. Nature of Work. 1. Lists received from Employers Sending twice in the year. Lists. 2. Outworkers. 3. Wearing Apparel— (Making, cleaning, washing, &c.) 2 59 Brush - making 2 4 Stuffed Toys 2 21 Total. |
e38656b4-92eb-4edb-89fb-0775ba288b29 | 6 84 TABULAR STATEMENT OF INSPECTIONS AND DETAIL OF WORK CARRIED OUT BY THE SANITARY INSPECTORS. Number and nature of Inspections made. House-to-house inspections 353 After infectious disease 203 On complaint, &c 1223 Premises under periodical inspection 592 Re-inspections after notice served 8520 Enquiry visits on notification of infectious disease 238 Classified statement of the number of premises under periodical inspection. Workshops and workplaces 220 Slaughterhouses 3 Public House urinals 37 Common Lodging Houses 1 Houses-let-in-lodgings 103 Butchers shops 37 Fish shops 24 Premises where food is manufactured 40 Milk purveyors 80 Cowsheds 2 Piggeries 4 Rag and Bone dealers 4 Mews and Stables 12 Schools 11 Show Grounds 2 Houses dealt with under Section 28 Housing Acts. |
6544e17d-3f3a-4a30-b768-384b782e23f0 | Houses in respect of which Notices were served 443 Rendered fit by owners 443 Rendered fit by local authority nil Premises dealt with under Public Health Acts. Premises in respect of which Notices were served 971 Premises in which defects were remedied by owners 963 Premises in which defects were remedied by Local Authority 8 32 Detail of work carried out. Sanitary dustbins provided 733 Yards paved or yard paving repaired 247 Insanitary forecourts remedied 154 Defective drains repaired or reconstructed 63 Defective soil pipes and ventilating shafts repaired or renewed 67 Defective fresh air inlents repaired or renewed 86 Defective gullies removed and replaced by new 61 Rain water downpipes disconnected from drain 19 Dishing and curb to gullies repaired and new gratings fixed 153 Defective W.C. pan and traps removed and replaced by new 02 Defective W.C. |
5b7a43eb-9406-4b27-a73c-6ba1016441e8 | flushing apparatus repaired or new fixed 312 Defective W.C. |
48f7b4d8-ccb7-41f0-af34-12f25616d77a | seats repaired or new fixed 185 Defective flush pipe connections repaired 97 Insanitary sinks removed or new fixed 33 Sink waste pipes repaired or trapped 270 Insanitary wall surfaces over sinks remedied 124 Ventilated food cupboards provided 9 Drinking water cisterns cleansed 209 Defective covers to drinking water cisterns repaired or new fixed 51 Insanitary sites beneath floors concreted 11 Spaces beneath floors ventilated 163 Dampness in walls from defective damp-proof course remedied 154 Dampness from defective roofs, rain water gutterings, ' &c., remedied 651 Defective plastering repaired (number of rooms) 914 Rooms where dirty walls and ceilings have been cleansed and redecorated 3019 Defective floors repaired 266 Defective or dangerous stairs repaired 53 Defective doors and windows repaired 387 Defective kitchen ranges and firegrates repaired 383 Defective washing coppers repaired 136 Coal cupboards provided 24 New W.C. |
dc2d17ea-c77e-4476-9061-1201e7099088 | apartments provided 7 Accumulations of offensive matter removed 28 Drains unstopped and cleansed 221 Overcrowding nuisances abated 19 Drains tested, exposed for examination, &c. 122 Smoke observations taken 104 Smoke nuisances abated 27 Nuisances from pigs and other animals abated 25 Notification of waste of water sent to Metropolitan Water Board 291 33 STAFF TO WHOSE SALARY CONTRIBUTION IS MADE UNDER THE PUBLIC HEALTH ACTS OR BY EXCHEQUER GRANTS. D.J. Thomas. m.b.c.s., l.r.c.p., d.p.h., Medical Officer of Health. (Medical Superintendent of the Isolation Hospital and School Medical Officer.) M. W. Kinch. Member of the Royal Sanitary Institute, holds Meat Certificate; Senior Sanitary Inspector. (Inspector under Diseases of Animals Acts, and the Rag Flock Act.) J.J. Jenkins. Cert. |
52e13684-1186-4b9c-aa44-60a7a5c2a46a | Sanitary Institute; holds Meat Certificate. Sanitary Inspector. (Inspector under Fabrics Mis-description Act. E. W. Brooks. Cert. San. Inst. Sanitary Inspector. J. J. Matthews. Cert. San. Inst. Sanitary Inspector. Miss A. Cooksey. Cert. San. Inst. Health Yisitor. Miss J. Welsh. Cert. San. Inst, c.m.b. Health Visitor. Mrs. Light. Clerk. I beg to thank all the members of the staff in the Public Health Department, not only for assistance in the compilation of the report, but for a record of conscientious service throughout the year. I am, Your obedient Servant, D. J. THOMAS. Woodgates & Sons, Printers, South Acton, W.3. |
8d49e3cb-5586-4b90-8106-6126c7b22817 | Act 28 1925 Borough of Acton ANNUAL REPORT of the Medical Officer of Health FOR THE YEAR 1925. 1925 1925 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1925. Municipal Offices, Acton, W.3. June, 1926. To the Mayor, Aldermen and Councillors of the Borough of Acton. Ladies and Gentlemen, I beg to submit the Annual Report for the year 1925, on the health of the Borough, together with the work of the Public Health Department. The report is a Survey Report which has to be submitted every five years. The Ministry of Health has issued a Memorandum as to the contents and arrangement of the report, and as far as possible the suggestions contained in the Memorandum have been adopted. For these reasons the Report is longer than the ordinary Annual Report, and certain activities of the Council have been considered at length. |
3c475e5a-a763-4db2-8a35-45e4117cda50 | The following table is a summary of the vital and other statistics for the year 1925. Population (Census, 1921) 61,299 Population (Estimated, 1925) 63,110 Area of Borough 2,305 acres Assessable Value (District Rate) £489,535 Net Produce of a Penny Rate £2,021 Birth Rate 16.6 per 1,000 inhabitants Death Rate (all causes) 10.6 „ „ Tubercular Death Rate 9 „ „ Death Rate from Pulmonary Tuberculosis 74 „ „ Cancer Death Rate 1.25 „ „ Infantile Mortality 76 per 1,000 births No. of inhabited houses (1921) 11,503 No. of families or separate occupiers (1921) 14,941 1925 4 POPULATION. The Registrar-General estimates the population at the end of June, 1925, to be 63,110, an increase of 180 on the population of the previous year. |
d0067f8e-cb78-4752-a38c-0bc15ee58844 | At the Census which was taken on June 19th, 1921, the actual number Enumerated in the district was 61,299. Owing to the abnormally fine weather in the summer of that year, some holiday movement was already in progress, and the RegistrarGeneral, from figures at his disposal, made certain adjustments in the population of certain districts. The adjusted figure for Acton was 62,000. The estimated increase in the population since the Census is 1,110. It is always difficult to estimate a population, and under present conditions estimation is made increasingly difficult. With a falling birth-rate, one would naturally expect a smaller average number of persons living in each house, but in the intercensal period 19111921, this expectation was not fulfilled. It is true that the average number of persons per family was 4.05 in 1921, as compared with 4.41 inl911. |
852d3bb6-4a81-4062-856c-f508b195607a | But the average number of persons per house probably did not undergo much change in that period because although there was an increase of only 810, or 7.5 per cent. in the number of total dwellings in the district, there was in the same period an increase in the number of private families of 2,012, or 15.6 per cent. Between April 1st, 1921, and October, 1925, 853 dwellings have been erected ; that is, more dwellings have been erected since the Census than were erected in the intercensal period 1911-1921. The increase in the population during the last intercensal period was 3,802 inhabitants. There is another method of estimating the value of the Registrar-General's estimates of the population. |
63fcf881-35c9-4a3b-93b8-8efeace78acf | The following table gives the increase in the total number of Parliamentary electors since 1921 :— 1921 30,350 1922 30,425 1923 31,394 1924 31,999 1925 32,776 Between the autumn of 1921 and the autumn of 1925, there has been an increase of 2,426 in the number of Parliamentary electors. 1925 5 It is possible that an increase in the number of persons living at a certain age-period may be disproportionate to the increase in the rest of the population. Both a falling birth-rate and migration in and out of a district might have the effect of an altered distribution in the population at different age-groups. These two factors are in operation in this district, but not to such an extent as to limit the increase of population to one age-period. The probability is that the estimate of the Registrar-General is too low, and that the population of the district exceeds 63,110. GENERAL AND SOCIAL CONDITIONS. |
f8c0feea-7feb-4497-9b72-833babb181e4 | The district is divided into four Wards—North-East, Northwest, South-East and South-West. Almost all the area included in the South-East and Southwest Wards has been developed and the available space built upon. There is some undeveloped land in the North-East and North-West Wards, but it is being rapidly developed for residential as well as factory purposes. The whole district has a density of about 27 persons per acre. In the North-East Ward there are 16 persons to the acre; in the North-West 17; in the South-East 60; and in the South-West Ward 97 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. The North-West and South-East Wards are almost entirely residential in character. The South-East Ward comprises Bedford Park and there are only a few factories in the Ward and these are along its borders. |
217a4fb3-8c41-487e-bb45-04bf535aa928 | The North-West Ward is also almost entirely residential, and most of the factories are situated in the extreme north-west corner of the Ward, 1926 6 The South-West Ward contains most of the laundries of the district, and though the laundry industry is not now the most important and in which the highest number is employed, it still is an important factor in the social and industrial conditions of the district. The industry at the time of the Census gave employment to 286 men and 1,827 women. Most of the large factories are situated in the North-East Ward. In the Vale are situated large engineering and dyeing works, and in the northern part of the Ward, engineering and other works have recently been established. The Ward has a large number of workers engaged in transport work. The following table gives the principal occupations of the inhabitants of the district in June, 1921 :— Males. Females. |
c9432d12-6bf4-463a-8ba7-891c18db194c | Metal Workers 2,768 — Transport Workers 2,729 152 Commercial and Financial Occupations 2,413 843 Clerks, Draughtsmen, Typists, etc. 1,597 1,437 Builders, Bricklayers 934 - Public Ad ministration and Defence 901 439 Wood and Furniture Workers 851 - Persons employed in Personal Service 866 4,160 Professional Occupations 748 617 Electricity—makers, fitters, etc 544 - Makers of Textile Goods and Articles of Dress 341 693 POOR RELIEF. I am indebted to Mr. Harmsworth, the Clerk of the Guardians, for the figures relating tc Poor Law Relief. |
77b716a8-a9ec-4699-b5cc-d86166e25c57 | The amount of out-door relief given by the Guardians for the Parish of Acton in the year ended December 31st, 1925, was :— £ s. d. Ordinary Relief 7,568 18 4 Unemployed Relief 982 16 0 £8,551 14 4 1 92 5 7 HOSPITAL PROVISION. General.— The Acton Hospital, Gunnersbury Lane, provides for the treatment of Medical and Surgical cases of both sexes. It is maintained chiefly by voluntary subscriptions, and the number of beds is 50; 983 in-patients and 4,940 out-patients were treated in 1925. Owing to our proximity to London, probably the general hospitals of London are utilised by the residents to a greater extent than the Acton Hospital. Last year 63 residents died in the general hospitals of London compared with 37 deaths of residents in the Acton Hospital. |
144c920b-f556-4877-9f71-5dd13d3c1197 | The 63 deaths were those which occurred in voluntary hospitals in London and did not include those who died in public hospitals such as Tuberculosis Sanatoria, Mental Hospitals, Infirmaries or Nursing Homes ; 260 deaths or nearly 39 per cent. of the total deaths occurred in public institutions. This number does not include deaths in nursing homes. The tendency in the district is to utilise Hospitals and Nursing Homes to a greater extent in every succeeding year. In most instances this is due to want of accommodation in the homes. Even where the family occupies the whole house, there is not sufficient accommodation in many of the houses which are now being built, for the efficient nursing and treatment of severe illnesses. Fever.—The Council has its own fever hospital, which has accommodation for 80 patients. The Borough is one of the constituent bodies which form the Middlesex Joint Smallpox Board. The Board owns Clare Hall Sanatorium which can be utilised in case of epidemics. |
ca9b65c6-1ddc-4ffd-bbf6-3c0836aac37b | The Joint Board has an arrangement with the Metropolitan Asylums Board for the treatment of occasional cases of Smallpox. Tuberculosis.—The Tuberculosis scheme is administered by the Middlesex County Council, which has Sanatoria at South Mimms and Harefield. Poor Law.—The district is in the Brentford Poor Law Union, and the Infirmary is at Isleworth. 1925 8 Clinics and Treatment Centres.— Child Welfare Consultation Centres—(a) Church Road. (b) Palmerston Road. Every Monday and Wednesday afternoon at 2. i Ante-Natal Consultation Centre—-School Clinic every other Wednesday morning at 11. Day Nursery—Bollo Bridge Road. School Clinic—Adjoining Municipal Offices. The above are provided and maintained by the Borough Council. Tuberculosis Dispensary—School Clinic on Tuesday and Thursday. Treatment Centres for Venereal Diseases—Various hospitals in London. The two latter are provided by the Middlesex County Council. |
2c4d9cf4-a117-4843-a2ac-e91f67102fba | J " . PROFESSIONAL NURSING IN THE HOME. General.—There are two district nurses employed by the Acton Hospital. One of them is primarily engaged in district nursing and during the year 89 persons availed themselves of her services. The other is engaged to nurse patients who have been discharged from the hospital. When the second nurse was engaged, it was understood that her services would be available, on suitable terms, for the nursing of Measles cases. During the late epidemic, her services were not called upon, as the Council was able to treat in the Fever Hospital any cases, the home conditions of which were, in the opinion of the doctor attending, such as rendered removal to hospital desirable. Midwives.—There are six midwives practising in the district. The Council pays the fees of the midwives in certain necessitous cases, and last year £6 19s. 6d. was paid in fees to midwives. |
94ec2271-3424-4042-aa09-d1d4f5c51056 | 1925 9 AMBULANCE FACILITIES. (а) For Infectious Cases.— The Council has a Motor Ambulance in which all cases of infectious disease are removed to hospital. The ambulance is housed in a garage at the Fever Hospital. (b) For Non-Infectious and Accident Cases.—Last year the Council obtained its own ambulance for the removal of accident and non-infectious cases. Previously there was an arrangement for the use of the Chiswick Council Ambulance, and subsequently for the use of the Ealing Council Ambulance to remove cases of street accidents to hospital. The frequency of street accidents, especially in the main streets, compelled these Councils to terminate their agreements, and the Council provided its own ambulance. The Ambulance is housed in a garage at the Fire Station, and is available at all hours. |
8728c9f9-45c5-4616-bc52-af2f7e149db3 | Between March 1st and December 31st, the Ambulance was used on 301 occasions—140 cases of street accidents were removed, and the ambulance was hired on 161 occasions for the removal of cases of illness to or from hospitals, nursing homes, etc. HOUSING. Owing to the changing character of the population of the district the housing problem has become a more difficult and complex one. In former years, with the exception of the Laundry trade, there was no industry in the district which employed any considerable number of people. Like most extra Metropolitan areas, Acton was a dormitory of London. In the large majority of districts around London, the net movement in the day is outward. Acton is a notable exception to most of the districts in Greater London. It is the only area with a population of over 50,000 inhabitants in the Home counties outside the Metropolitan area where more people come in daily to work than go ouc. |
cda32e8c-6344-4f64-b5c5-e8e43f191622 | At the Census, 13,346 residents left the district daily to follow their usual occupations, and 14,575 came in for the same purpose. Owing to the development of the northern part of the town for factory purposes, this phenomenon has become more marked since the Census. These figures alone tend to show that the Council's scheme would not solve the housing problem as it exists in Acton, and emphasise the necessity of a larger and more comprehensive scheme, which would include not only Acton, but also the other neighbouring authorities. There is no doubt as to the shortage of houses, and the Health Department constantly comes across cases of overcrowding, but in many instances these cases result from the emigration of people into the district to follow their employment. 1925 10 The district is not a self-contained one, and a study of the Census figures would show that the action of the Council would not solve the housing question. |
76c3c5eb-a142-44a8-a300-e74adf768615 | The building of the houses in East Acton enabled a certain number of residents to obtain a better type of house than they had hitherto enjoyed, but it cannot be said to have relieved the overcrowding, or overcome the shortage. The houses vacated by the fortunate few who obtained houses in East Acton were at once occupied by others, in some instances by people living up to that time outside Acton, and to this extent the building of the houses has attracted a certain class cf residents to the district, but has not contributed towards satisfying the demands of every type of resident. It may quite fairly be stated that employers of labour and others have done practically the satire thing. The Great Western Railway Company have erected 100 houses, and have 15 more in course of erection. Mond, Nickel Company have completed 16 houses, and have 4 more in course of erection. The Goldsmith Company propose to erect dwellings for people engaged in clerical work. |
63c94eb6-754a-486e-baab-5e8be0dcf175 | All these Companies have a definite object in view, the accommodation of certain men who are engaged in a particular occupation, or of a certain social position. It is doubtful if the houses can be built at an economic rent. At any rate, it was contended that the Council could not build the type of houses originally intended at an economic rent. These, and possibly other considerations, caused the Council to abandon the idea of completing the development of the-estate which was bought in East Acton, and most of the undeveloped land has been rented or sold to private individuals. The Council from the commencement, adopted the policy of renting or selling the land at North Acton. On the East Acton estate the Council erected 320 houses, together with 9 army huts. The Council also bought and converted 3 flats in Bollo Bridge Road. So that altogether the Council erected 332 dwellings. |
9cf4d9a3-1e21-4b76-89bf-465c0fe839d2 | At the housing inquiry which was held last year, the following table was submitted to the inspector of houses erected in the district since the War:— By the Council under the Housing Acts 332 By private enterprise on Council land 152 By private enterprise on other land 490 1925 11 The sale of the land to private individuals does not mean any slackening in the rate of building ; in fact, since the Council has ceased operations, the erection of houses has proceeded at a greater pace. It would be unfair to assume that the acceleration in the erection of houses lately has resulted simply because the Council has ceased building. Other factors have come into operation. It may be interesting, though, to show the comparative activities of the Council and private individuals at different times. |
acae3e57-5514-4068-af4e-ff0cb26f9bf4 | Houses erected 1918 None 1919 None Council Private April 1st, 1920, to April 1st, 1921 81 59 April 1st, 1921, to April 1st, 1922 133 34 April 1st, 1922, to April 1st, 1923 106 13 April 1st, 1923, to April 1st. 1924 12 97 April 1st, 1924, to April 1st, 1925 - 248 April 1st, 1925, to October 31st. 1925 - 190 OVERCROWDING. |
186ceb0f-a105-4594-81d3-5cf62b096feb | (a) Extent.— There is no serious overcrowding in the district, but in the course of house to house inspection of the working class houses, cases are found occasionally of one or two children sleeping in a room in excess of the standard prescribed by the houseslet-in-lodgings bye-iaws, namely, 300 cubic feet of free air space for adults, and 150 cubic feet for each child under 10 years. (b) Causes.—The cause is found to be due to the shortage of suitable accommodation for this class of person. (c) Measures taken.—Where any case of overcrowding is found to be serious, the facts are reported to the Public Health Committee, who authorises the service of a Statutory Notice for its abatement. To comply with the Notice, usually the only practical remedy found is for the parents to rearrange the sleeping accommodation, and where this is not possible, to arrange for some of the children to sleep at the houses of relations or friends. |
c64d4f6e-6cab-42b6-91ac-567a656806e8 | (d) Principal Cases.—During the year there were 10 cases dealt with, the majority of which were abated in the manner indicated above. 12 FITNESS OF HOUSES. 1. (a) General Standard of Housing.— The general standard of housing in this district is, on the whole, good. (b) The principal defects found to exist are as follows :— Defective plastering and dirty walls and ceilings. Dampness from defective roofs, rain water gutterings, etc. Defective W.C.'s. Detective sinks and waste pipes. Defective yard pavings. Stopped drains. Defective dustbins. Defective fire grates and kitchen ranges. (c) In the case of working class property the rents in most cases are collected by Agents or Rent Collectors, most of whom take little interest in the condition of the premises, but are concerned primarily with the collection of rents. |
0d8914e4-599e-4e29-b8e3-ff66dcf8ca57 | The owners apparently seldom visit their property and appear to wait until they receive an intimation from the Sanitary Authority regarding any matters requiring attention. Many of the minor defects found are doubtless due to the rough usage of the property by certain of the poorer class tenants. 2. General Action Taken.—(a) Notices are served under Sections 36 and 91 of the Public Health Act, 1875, and under Section 82 of the Acton Improvement Act to remedy insanitary conditions. (b) Notices are also served under Section 3 of the Housing Acts wherever possible, and a considerable amount of work has 1925 13 been carried out thereunder. In fact, it is the only Section under which the cleansing of walls and ceilings can be asked for, for the reason that it is not necessary to prove that they are in such a state as to be a nuisance, as is required under Section 91 of the Public Health Act, but that " the premises are not in all respects reasonably fit for human habitation." |
27748059-d9f4-4744-9b91-5a18907d22bf | (For details as to the action taken under these Acts, see tabular statement of work done by the Sanitary Inspectors). 3. The principal difficulty found in getting the Council's Notices complied with arises wherever many houses belonging to the same owner are concerned. In such cases, the owner usually contends that it is unreasonable to require him to expend so much money at one time, and frequently he produces in support of his contention a statement showing his net income from the property. Often this income is but a very poor return on the property, and therefore extra time has to be granted for the carrying out of the work, or the less important items are not insisted on at the time, although the owners are pressed with regard to these after a reasonable period has elapsed. In the inspection of houses from house-to-house, an endeavour is made to avoid, as far as possible, inspecting all the houses belonging to one owner at the same time, so as not to embarrass him financially. |
3f4f33e3-870c-437d-8a51-d9046e4b15c6 | It is found much more satisfactory in practice to return .to the property after a short time, and deal with the houses which did not come under our operations on the former inspection. LEGISLATION IN FORCE. The following local acts, special local orders, general adoptive acts and byelaws relating to Public Health are in force in the district:— Adopted Infectious Diseases (Notification) Act, 1889 1889 Public Health Amendment Act, 1890 1890 Infectious Diseases Prevention Act, 1890 1893 Notification of Births Act, 1907 1907 Public Health Act, 1907 (Clause 50) 1921 Public Health Act, 1925 (Sections 2, 3, 4 and 5) 1926 The Acton Improvement Act, 1904 1925 14 BYELAWS. |
2e7650d8-2acf-4c50-8dc2-90e0a4393fb9 | New Street and Buildings 1925 Removal of House Refuse 1899 Common Lodging Houses 1898 Slaughter Houses 1898 Nuisances, etc. 1924 Offensive Trades 1903 Tents, Vans and Sheds 1906 Removal of Offensive or Noxious Matters 1908 Houses let in Lodgings 1925 Cleansing of Cisterns 1912 Employment of Children 1920 SANITARY CIRCUMSTANCES OF THE AREA. Water.— All the inhabited houses are supplied with water from the mains of the Metropolitan Water Board. There are a few deep wells in the district, but the water from these is used entirely for industrial and similar purposes. For instance, the Public Swimming Baths are supplied with water from an artesian well, and the supply seems to be practically inexhaustible. Even in the driest summer the level of the water is not affected. An analysis of the water from the well at Messrs. |
e4a2c3b4-1579-43b5-920d-51dbf7a9a022 | Eastman, showed the water to be of a very high degree of purity. Drainage and Sewerage.—Under the Acton Sewage Act the sewage is discharged into the sewers of the London County Council. In cases of storm the overflow is filtered and emptied into the Thames. Closet Accommodation.—There are no privy or earth closets in the district. All the water closets are connected with the Council's drainage system and there are no cess-pools. Scavenging.—The collection of the House Refuse is carried out directly by the Council, and the whole of the house refuse is burnt in the Council's Refuse Destructor. Last year 15,687 tons of house refuse were collected. 1925 15 TABULAR STATEMENT OF INSPECTIONS AND DETAIL OF WORK CARRIED OUT BY THE SANITARY INSPECTORS. Number and Nature of Inspections made. House-to-house inspections 237 After infectious disease 214 On Complaint, etc. |
994e4b50-40cf-4cff-9e8f-d331c84e8f94 | 1,412 Re-inspections after Notice served 7,452 Enquiry visits on notification of infectious disease 230 Number of Premises under Periodical Inspection. Workshops and Workplaces 212 Slaughterhouses 2 Public House Urinals 37 Common Lodging Houses 1 Houses-let-in-lodgings 26 Butchers' shops 38 Fish shops 25 Premises where food is manufactured 41 Milk Purveyors 85 Cowsheds Nil Piggeries 4 Rag and Bone Dealers 3 Mews 4 Schools 11 Show Grounds 1 490 Houses dealt with under Section 28 Housing Acts. Houses in respect of which Notices were served 271 Rendered fit by Owners 271 Rendered fit by Local Authority Nil 271 1925 16 Premises dealt with under Public Health Acts. Premises in respect of which Notices were served 1,099 Premises in which defects were remedied by Owners 1,099 Premises in which defects were remedied by Local Authority Nil Rent Restriction Act. |
3d3fd36d-bb3b-43bc-b8aa-edcdf3786038 | Number of Certificates granted 11 Number of Certificates refused 1 Detail of Work carried out. Sanitary Dustbins provided 460 Yards paved or yard paving repaired 141 Insanitary forecourts remedied 109 Defective drains repaired or reconstructed 58 Defective soil pipes and ventilating shafts repaired or renewed 77 Defective fresh air inlets repaired or renewed 73 Defective gullies removed and replaced by new 56 Rain water downpipes disconnected from drain 24 Dishing and curb to gullies repaired and new gratings fixed 122 Defective W.C. pan and traps removed and replaced by new 111 Defective W.C. flushing apparatus repaired or new fixed 297 Defective W.C. |
b7cada40-bdaf-467c-aadd-1f7ddcd46f1e | seats repaired or new fixed 154 Defective flush pipe connections repaired 63 Insanitary sinks removed or new fixed 29 Sink waste pipes repaired or trapped 165 Insanitary wall surfaces over sink remedied 110 Ventilated food cupboards provided 7 Drinking water cisterns cleansed 228 Defective covers to drinking water cisterns repaired or new fixed 42 Insanitary sites beneath floors concreted 6 1925 17 Spaces beneath floors ventilated 108 Dampness in walls from defective damp-proof course remedied 130 Dampness from defective roofs, rain water gutterings, etc., remedied 745 Defective plastering repaired (number of rooms) 722 Rooms where dirty walls and ceilings have been cleansed and redecorated 3,318 Defective floors repaired 153 Defective or dangerous stairs repaired 29 Defective doors and windows repaired 347 Defective kitchen ranges and fire grates repaired 294 Defective washing coppers repaired 95 Coal cupboards provided 10 New W.C. |
bc689b50-56ea-42ad-9507-787f700f2cb4 | apartments provided 6 Accumulations of offensive matter removed 23 Drains unstopped and cleansed 162 Overcrowding nuisances abated 10 Drains tested, exposed for examinations, etc. 87 Smoke observations taken 126 Smoke nuisances abated 18 Nuisances from pigs and other animals abated 14 Notifications of waste of water sent to Metropolitan Water Board 207 Defects found in Factories, Workshops and Workplaces— Number of Defects. Particulars. Found. Remedied. 1 2 3 Nuisances under the Public Healths Acts : Want of Cleanliness 52 52 Unsuitable or Defective Sanitary accommodation 63 63 Total 115 115 1925 18 Home Work. Outworkers' Lists, Section 107. Lists received from Employers. Sending twice in the year. Sending once in the year. Nature of Work. Lists. Workmen. Lists. Workmen. |
9dc51831-1050-4711-b28a-82b2726446da | Wearing apparel - - 2 34 (cleaning and washing) Brush-making - - 1 4 Stuffed Toys 1 34 - - Total 1 34 3 38 BIRTHS. Table VII gives particulars of the Births registered and notified in the district, and the Births registered outside the district. The total number of births belonging to the district was 1,047 and the birth-rate was 16.5 per 1,000 inhabitants, as compared with 18.4 in 1924. The birth-rate for England and Wales was 18.3, for London 18.0, and for the 105 County Boroughs and large towns 18.8. |
8ee6a1f9-bbd6-4fa3-a4e4-2977c41dd21f | Since the end of the war the birth-rates have been as follows :— 1919 17.1 1920 25.3 1921 21.1 1922 19.3 1923 18.6 1924 18.4 1925 16.5 1925 19 If we compare the total number of births in Acton during the 7 years before the war 1908-1914 with that in the seven years following the termination of the war, 1919-1925, there were 2,126 fewer births in the latter period, though the population had increased. The same phenomenon is observed through out the Kingdom, but the reduction in Acton has proceeded at a more enhanced rate than that observed throughout England and Wales. If the same factors continue to operate as far as this district is concerned, we are approaching the period when the death-rate will balance the birth-rate. |
b8865bbe-78e3-4980-9403-82803635c7f1 | The discussions on problems of population and birth control have excited considerable interest, but outside professional associations, considerable timidity is shown and the problem of population is shirked by many. In the view of most people interested in public health it is the biological aspect of contraceptive methods which is of importance in the realm of preventive medicine. It is difficult to view the question solely from the biological standpoint, and ignore the economic or even the ethical aspects. Because the evidence both ways bearing upon the biological side of the question is at present too scanty to enable a just conclusion to be reached, many think that the question of the birth-rate had better be left alone But the question forces itself upon our notice. Although we may be unable to make any suggestions, it would be fatuous if we entirely ignored its existence. There are no birth-control clinics in the district, but there are two close to the boundaries, and considerable propaganda is carried on. |
ba293fc0-7106-43da-b486-dcd0b48e5360 | In the case of one of them, pamphlets are distributed in a wholesale manner and quite indiscriminately in some parts of the district, advising women to attend the clinic, where advice will be given as to the best contraceptive methods. In some instances, accompanying the leaflet is a small booklet which is sold for threepence. A good deal of confusion has arisen over the use of certain terms, and many people imagine that birth-control and the use of contraceptives are synonymous terms. If we limit the term birth-control to the simple regulation of numbers, then birth-control has always been, is now, and will always be an absolute necessity. 1925 20 If numbers are not regulated, the population will increase to the actually possible limit, until the average income will just keep men from death by starvation. The necessity for limitation has always been present, only formerly the limitation was practised without a clear realisation of what was being done. There is no excuse for the attitude that no limitation of numbers by any method is required. |
fb25643f-8537-43a6-8cb3-f2211a41a3bb | The difficulties arise when any particular method is recommended, and it should be clearly understood that it is on this ground of method that objection has been raised by the Ministry of Health to the utilisation of Maternity and Child Welfare Centres for the purpose of birth-control propaganda. The answer which the Ministry of Health have given to the representation of the Edmonton Council, deals quite fairly with the objections to the utilisation of Maternity and Child Welfare Centres for the purpose. |
141872ea-afac-4127-bf94-46fdf20e5a5c | The answer of the Ministry of Health which is dated December 5th, 1925, is as follows:— "I am directed by the Minister of Health to refer to your letter of the 4th instant with regard to the subject of Birth-Control, and to state that the Minister has adopted the policy laid down by his predecessors with regard to this matter, which is set out in the following principles:— (1) That the Maternity and Child Welfare Centre should deal only with the expectant and nursing mother (and infant) and not with the married or unmarried woman contemplating the application of contraceptive methods. (2) That it is not the function of an Ante-Natal Centre to give advice in regard to birth control, and that exceptional cases in which the avoidance of pregnancy seems desirable on medical grounds, should be referred for particular advice to a private practitioner or hospital. |
cbde6824-fed3-4a59-9977-cc5a0e38abcc | "I am to point out that these centres are maintained out of public funds to which people of all opinions are required to contribute, and the Minister considers that without the express authority of Parliament he would not be justified in assenting to the use of the Centres for a purpose on which public opinion is so acutely divided." The last paragraph obviously refers to the objections from religious or moral motives. A large number of people are adverse to the use of contraceptives on moral grounds, and amongst some sections their use is considered one of the gravest of human crimes. 1925 21 We have two schools of thought. The first views the falling birth-rate with dismay and sees in it the decay of the race; the other regards the same phenomenon as the only solution to the danger of over-population. Neither the fear of race suicide nor that of over-population has much to do with the falling birth-rate. Other factors operate, and these are of such a character that under present conditions tend to perpetuate a low birth-rate. |
94275670-9028-4150-afe0-d6968404adee | Most people if they were asked what the normal condition has been throughout recorded history would reply that an increasing population was normal. As a matter of fact, the population of England and Wales increased very slowly for 700 years, and then in the nineteenth century shot up with a rapidity previously unparalleled. During the same period the same general tendencies were at work in the Continent of Europe. The causes are not difficult of explanation. Among primitive races, abortion and infanticide were prevalent. The Christian era witnessed a profound change. Abortion and infanticide were rendered illegal, but as the former practices went out so the postponement of marriage came in, and agencies were at work which enforced it, in part by legal enactment, but chiefly by the pressure of customs and conventions. In England in the Middle Ages not only were early marriages determinedly discouraged, but the opportunity for them did not exist. |
05fa218c-329b-43c5-bc4d-66f82bd8e7dd | A labourer living in a cottage by himself was a rare exception to the rule ; and the work of the fields was performed generally by servants who lived in the families of the squire or farmer, and who, while in that position, commonly remained single, and married only when by prudence they had saved a sufficient sum to enable them to enter some other position. At the same period there existed in the towns a system of compulsory apprenticeship, and until the apprenticeship was terminated, youths could not marry. Thus in many ways a pressure was exercised upon the youth of the nation whereby they were discouraged, if not prevented, from marrying early. In addition, elimination played an important part. Warfare was constant; plagues and epidemics swept through all countries, and disease and famine assumed a great importance as an agent of elimination. 1925 22 In the nineteenth century these factors went out of operation. The age of industrialism brought about profound changes in social conditions. |
3ff803bb-7098-4416-980f-7674b910ec79 | All barriers to marriage in the shape of laws, customs and conventions vanished. In addition, sanitation and preventive medicine attacked the forces which formerly operated towards elimination. But these checks upon the power of multiplication were followed by the growth of another system which we know to be in operation to-day. Married people began consciously to limit the size of their families. The date when they began to do so, and the influences which brought them about may be doubtful, but it is unquestioned that it is conscious limitation and not abstinence from marriage or postponement of marriage which dominates the position to-day. The most celebrated attempt to review the whole problem of population was made by Malthus, who published the first edition of his famous book in 1798, but the views of Malthus can have had very little influence on the birth-rate, as the birth-rate did not decline until the fourth quarter of the nineteenth century. |
f0a62e7b-47fe-4961-89aa-6e1c83df0247 | The doctrines of Malthus were very similar to many expressed this year, and yet the doctrines of Malthus were founded upon assumptions which most people admit were erroneous. At any rate, his predictions were hopelessly wrong. Probably had Malthus known that in 1925 the population of Great Britain would be approaching 50 millions, he would have predicted destitution, starvation and general misery, and would have been considerably astonished to learn that in every particular, the conditions of life had steadily improved with the increasing population and that starvation which in his day was not uncommon, had become unknown. In spite of this, since 1880, there has been a revolutionary fall in human fertility, and the fall has been due mainly, if not wholly, to deliberate prevention. In the earlier part of the last century there was but little conscious limitation of the size of the family. In the latter part of the century the practice of limitation set in and has spread more and more widely through society. |
a0267c9d-b26d-4aea-bd32-8ee8a4c7e8e1 | In what circumstances and for what reasons did people, then, and do now, in the main limit their families ? There are some who consider that the sudden spread of the practice of prevention after 1880 cannot be connected with any change of economic conditions increasing the need for restricting 1925 23 families, and must be attributed to the invention of more effective means of prevention'— together with active propaganda. One of the causes is indirectly an economic one. What appears to happen is something of this kind. People in this country are bent upon maintaining and improving their standard of living. If a married man's income is stationary or does not materially increase, in his struggle to maintain his standard of living, he may decide to have fewer children. If his income increases, or his expenses fall, he may decide to have more children and thus remain at the old standard of living, or to have the same number of children and rise to a rather higher standard. |
47549491-e779-433c-8849-6369dd89dd97 | When faced with these alternatives, men in general tend to regulate their families so as to maintain or improve their standard of living. Another factor quite as potent is the improved status of women, which has been one of the chief characteristics of recent social evolution. Women have become better educated and more independent; their position has in every respect become more dignified. A new generation of women has sprung up—fitter, healthier and more normal in every way, but though the modern woman may be particularly fitted to be the mother of healthy children, she has acquired many varied interests in life and refuses to be bound down to the narrow confines of domestic life. There can be little doubt that the increasing dignity of women in society is a factor leading to the acceptance of the principle of family limitation. I cannot understand the anxiety of the Edmonton authority to obtain this power. It is unnecessary as far as one part of the population is concerned, and useless as far as a large proportion of the remainder is concerned. |
94f899dc-db4f-45a5-8bc9-03194421facf | As stated in a previous paragraph, propaganda in the interests of birth control has been going on, and the knowledge through voluntary birth control clinics and publications ,is within the reach of those who wish to utilise the knowledge. Those who have religious scruples will not use contraceptives. But, we have besides, those people who will not or cannot exercise any control over themselves or their actions. This lowest social class includes not only the mentally defective, but the improvident, the incapable, and the cast-off from other grades of scciety. It contains a large proportion of those who are inferior in vigour and in many of the desirable physical, mental and moral qualities. They exercise no self-control and it is amongst them that 1925 24 the birth-rate continues high. No propaganda and no voluntarymeasures will have any effect upon them. The continuous high birth-rate among the lowest social class, together with the continuous decrease in the higher social classes has made the birth-rate dysgenic. |
4f0e8bf6-89f8-4e29-bdd1-9a46a4d21348 | The class which has received most attention recently is the mentally defective. Although possibly not numerous, its members are a source of danger on account of the high birth-rate especially among the high-grade mentally defectives. Theoretically, the mentally defectives appear to be the easiest class of people to deal with. A short time ago there appeared a letter in the Press signed by ten of the most prominent members in the medical profession urging the nation to arouse itself to the ever increasing evil of mental deficiency, and advocating sterilization as a means of checking that evil. This authoritative statement was challenged a few days later by the Central Association for Mental Welfare. The latter body advocated segregation, but the main defect of its pleading is that it assumes that sterilization is put forward as a universal alternative to segregation. Needless to say, no sane person with any knowledge of the facts would make such a proposal. |
21d403eb-54db-4844-9869-18381e3e6527 | There are two quite distinct classes of defectives, the one consisting of persons who, if left at large, would be a danger to themselves and to the community, the others so slightly tainted that the only mischief they are likely to do is to pass on their defect to future generations by marrying or by producing illegitimate children. Sterilization does not mean castration, which is more or less serious on account of the alteration of the endocrine secretions ; it means operations which are supposed to have no effect beyond the production of sterility. Neither in the male nor female is the operation a serious one or attended with much danger. The attitude of the Ministry of Health may be deduced from a reply made to the Lutterworth Guardians : " That action cannot be taken unless public opinion is overwhelmingly in favour of it." The present dysgenic birth-rate will not be altered greatly if the question of the mentally defective be solved. |
f46c3104-ff6c-4bc8-9394-0f8604fec94d | There is at present still a higher birth-rate among the lowest social class, who are 1925 25 generally inferior both in physique and mental capacity. Many social workers expected the problem to be solved by the introduction of artificial methods of conception control, assuming that those least able to support a family would most readily avail themselves of the methods. Possibly this was the opinion of the members of the Edmonton Council when they circularised other Councils for support, but no propaganda will reach the class which it is intended to reach. The poorest and most ignorant of the population have not shown the necessary intelligence and prudence to use the methods effectively, whereas they are increasingly used by people whose children would be a national asset. The following figures may be of interest as showing the difference which exists in the size of the families of the unskilled labourer and skilled artizan. |
cde56a9c-a1a6-4235-911a-3fe96f94a26c | All the figures were obtained in the course of inquiries into births which occurred in 1925, and the figure in the first column refers to the number of families, and the figure in the second column refers to the number of children born in the family. For instance, in the case of unskilled labourers, of the births inquired into, in 38 instances it was the first child, and in one instance it was the 22nd child:— Unskilled Labourers. Fitters. 38 families 1st child 8 families 1st child 46 „ 2nd „ 1 „ 2nd „ 30 „ 3rd „ 1 „ 3rd „ 28 „ 4th „ 1 „ 4th „ 21 „ 5th „ 1 „ 5th „ 10 „ 6th „ 9 „ 7th „ Railway men. |
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