The reports were produced each year by the Medical Officer of Health (MOH) of a district and set out the work done by his public health and sanitary officers. The reports provided vital data on birth and death rates, infant mortality, incidence of infectious and other diseases, and a general statement on the health of the population. As the work of public health departments expanded, so too did the reports: by the 1930s we are given details on such matters as:
- numbers visiting maternity and child welfare clinics
- pints of free milk dispensed
- statistics for use of venereal disease clinics
- numbers of tubercular children attending open-air schools
- Poor Law infirmaries and municipal hospitals.
While over time the data that was to be included in annual reports was standardised, there was still a large degree of leeway. Consequently the reports show diversity both between different areas at the same time, and for the same place at different times. On top of this, even standard statistics - such as maternal mortality rates - might be presented in various forms by different MOHs, meaning that direct comparisons can be difficult. Furthermore, the permissive nature of the legislation meant that reports varied greatly in length: while interwar Poplar's commonly ran to over 120 pages, those of wealthy Richmond were less than a third that.
In 1888 the London County Council (LCC) was created. It rapidly came to see itself as the exemplar in British local government.
One result of this, for historians, is not just that its annual reports offer a rich insight into everyday life in the capital, but that its aggregation of data for all London's authorities allows some sense of comparative performance across the city. In addition, we have the legacy of annual Local Government Board reports and, from 1919, Ministry of Health reports giving the national picture for England and Wales - as well as the statistics compiled by the Registrar General. Therefore someone interested in knowing how Stepney's or Hammersmith's health or services looked can set the relevant MOH reports alongside the LCC report for the same year, or indeed that of the Ministry of Health.
Despite attempts at standardisation, the reports nevertheless are revealing of each MOH's particular strengths, interests or even idiosyncrasies. So, Mile End's first MOH, Dr Freeman, spent some time in his final report (1865) not only discussing the emergence of a new wave of cholera in Egypt but also using this as a springboard to argue for the importance of reducing poverty, poor housing and inadequate diets in preventing epidemics. His successor, Dr Corner, produced very different reports: their bulk was taken up with listing the considerable numbers of vestry members and setting out the accounts for the year; he left any detailed consideration to his Surveyor, who provided a wealth of detail on street paving, the costs of hiring horses for scavenging and the effects of removing the toll on Mile End Road. Clearly, then, the personality of the individual MOH could be a significant factor in the health of a district.
Find out more
- The Library holds printed MOH reports from across the rest of the United Kingdom. Search the Library catalogue for ‘medical officer of health’ and the town or borough e.g. ‘medical officer of health birmingham’.
- The Public Health subject guide to archives in the Wellcome Library lists many sources, including the papers of the Society of Medical Officers of Health and the personal papers of some individual medical officers.
- Harris, B. The origins of the British welfare state: society, state and social welfare in England and Wales, 1800-1945. Basingstoke: Palgrave Macmillan; 2004. Available in the Wellcome Library.
- Hardy, A. The epidemic streets: infectious disease and the rise of preventive medicine, 1856-1900. Oxford: Clarendon Press; 1993. Available in the Wellcome Library.
- Porter, D. Health, Civilization and the State: A History of Public Health from Ancient to Modern Times. London: Routledge; 1999. Available in the Wellcome Library.