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does not appear to give any further reasons which would lead one to
suppose that the views in the letter can be regarded as correct.
Objection can be made that in the complaining letter no mention is
made of the fact that in 1907 Hampstead's death rate was 69 per
thousand births, compared with 115 for Camberwell. In 1908 the
Hampstead rate remained the same, while Camberwell dropped to
104. In 1909 Hampstead rose to 75, whilst Camberwell declined to
100. From a return made by Hackney, based on replies received
from Medical Officers of Health, I see that in 1907, at all events,
the lady Sanitary Inspector at Hampstead did a certain amount of
health visiting, so that although one was only officially appointed in
1910, a visitor had already been at work for a year or two. The
rate for all times for Hampstead, while the conditions remain as
they are, is certain to always be much lower; the births are fewer,
and the district as a whole free from the poverty of which we
have much. A point is also made in the letter that in the first year
of that Borough's employment of an official health visitor the
death rate dropped 15 per thousand, whereas in Camberwell's there
was only a reduction of (i per thousand. If this be a valid argument,
how will it be explained that in 1911, which Councillor Lucas
would, I presume, say is the second year of employment of a health
visitor, the rate in Hampstead went up 18 per thousand births (from
60 to 78), whereas in Camberwell it only went up 15 per thousand
(from 94 to 109), while in Lambeth and Bermondsey—to both of
which he refers—it went up from 94 to 123, and from 126 to 156
respectively, yet Lambeth has had a milk depot and health visitor
since 1908, and in 1910 had a rate of 94, the same as ourselves?
These three Boroughs mentioned in the letter as making out a
good case for the appeal can hardly be said to have shown their
great superiority to Camberwell in a trying year. There were in all
eighteen Boroughs which had a higher rate in 1910 than we,
Camberwell being equal to Islington and Lambeth. In 1911 there
were 21 higher than we were, and Camberwell had then the
sixth place, tying with Chelsea. We were third on the list of South
London Boroughs, being excelled only by Lewisham and Woolwich,
and for the rest of London, Westminster, St. Marylebone, Hampstead
and Stoke Newington were the only districts to make a better
showing, so that Camberwell, which in the terms of the letter has no
health visitor, no municipal milk depot, no school for mothers, &c.,
has come fairly well through the ordeal of last year, and does not
compare unfavourably with the Boroughs who have these agencies
in their midst. Either, therefore, the appointment of a health visitor
has not done much, or else in Camberwell there' must be alternative
explanations of the actual statistical fact that we have come off
as well as our neighbours. These may be that either the general
sanitary condition of Camberwell is so much better that it makes
up for the deficiency of a health visitor, that the children of
Camberwell are of a more resistive order and better able to withstand
disease, or lastly that the mixed organisms which give rise to
the disease have here a diminished virulence.