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TO THE VESTRY OF ST. MARY, ISLINGTON.
Gentlemen,
1. In estimating with accuracy the Sanitary condition of a district, and especially
in attempting to compare it with that of any other district, it is not enough to
enumerate the cases of sickness, or the deaths which take place in the course of
nature, or as the result of disease. It is true that such an enumeration is one
element, and an essential element in the problem, but there is a variety of other
Considerations which must be taken into account. Among the most important of
these are the number of persons inhabiting the district during the period embraced
in the inquiry, the relative proportion of the sexes, of the young, middle-aged, and
old, the occupations in which they are engaged, their wealth or poverty, etc. And if
it is necessary to take note of all these points in estimations relating to a large district
such as an entire parish, the necessity for it becomes still more urgent where smaller
portions are the subject of investigation, where for instance the sanitary state of one
street or group of streets has to be measured against another street or group of streets.
And yet, after all, this is the branch of inquiry which most closely concerns a Local
Board deputed to watch for and remove local sources of ill health. It is moreover
that which is most fruitful of practical suggestions to a Medical Officer of Health,
who has not only to point out where disease (fatal or otherwise) prevails, to lay his
finger on the very streets, courts, or houses, but also to say why it presents itself
where it does, to distinguish among its several causes those which the legislature has
empowered the local authority to remedy, and those which can only be removed or
guarded against by measures adapted to call into exercise the intelligence of the
people and to rouse them to individual effort for the private maintainance of health.
It is now nine years since a census of the population was taken, and while I found
it a most difficult task at the commencement of my period of office to form an
estimate of our numbers which might command general concurrence, I cannot now
venture upon the effort at all. No doubt the enumeration which will take place next
year will be all that I can desire, and it is to be hoped that such arrangements will be
made as will place in my hands all that minute imformation, as to individual localities,
which it is so important that I should possess, and such as will enable me to arrive at
juster and more accurate conclusions, as to our sanitary position, than any I have
hitherto been capable of attaining. I shall therefore content myself this year willi