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It is possible that the population has been under estimated for
this sub-district, whose boundaries have been altered since the
census, with the coincident release of some of the poorer districts,
and errors are thus likely to obtain. But at the same time the
comparatively small number of deaths registered has often been a
matter of speculation, and I am inclined to think that the decrease
is due not so much to a special factor, as to the healthier conditions
of housing and prosperity which prevail in the district as now defined.
Infantile mortality again shows a decrease, amounting to 65
on the previous year, of which decline whooping-cough and measles
are responsible for 41. As the Council are aware, no action has
been taken in the way of the adoption of the Notification of Births
Act, so the reduction cannot, therefore, be ascribed to any special
efforts in the way of health visiting that have been made in this
regard. The effects of such efforts, if they were really of use, would
be shown chiefly in the reduction of deaths from atrophy, &c.,
which is intimately bound up with improper feeding; to a less
degree in diarrhoea, which is also associated with such a cause; in
bronchitis and pneumonia, which often occur through the neglect of
some simple precaution. In the case of diarrhoea and bronchitis,
however, the influence of the weather is so much more powerful
than anything else that all other factors, whether in raising or
lowering the mortality, become relatively almost insignificant in
effect.
Twenty-three more infants under one week old died in the past
year. The increase appears under the following headings : 17 from
premature birth, 2 from congenital defects, 3 to injury at birth, and
1 from want of breast milk; and there was some shifting about
of the numbers in the other causes. The total number of deaths
due to the classification atrophy, debility, &c., is 12 less than in
1907, and there is also a decrease of 14 in the tuberculous diseases.
There were 13 fewer deaths from scarlet fever, with a decrease
of 500 in the notifications.
The recorded case mortality is thus practically the same as last
year, but the notifications I think do not nearly represent the prevalence
of the disease. Several times during the year I have
received notice from the school authorities that children have been
discovered attending school while they were peeling. On enquiry, it
was found that they had been suffering from slight indisposition,
hardly worthy to be entitled illness, and certainly not to demand
medical treatment, the child attending school the whole time and
mixing unrestrainedly with all the other young people in the neighbourhood.
Added to these are the instances where the parents on
their own initiative keep the children at home and subsequently
discover evidence of peeling.
The deaths showed a great decrease in St George's and North
Peckham, while there was an increase of 9 in South Peckham.
The deaths from diphtheria are practically equal to those of last
year, but considering the number of cases notified, the case mortality
is low, a result which can almost certainly be attributed to the