Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Kensington Borough]
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In cases with Class "C" incomes it will be seen that the number of "C" entries is so high that illness and
death were probably due, not to any one adverse factor, but to the effects of several unsuitable environmental
factors. These unsuitable conditions are mainly due in the first place to poverty, which must be the real cause
behind a number of these deaths.
In the cases with Class "A" and Class "B" incomes, unsuitable conditions are fewer—though illness
and death is still the answer, the equation is one with fewer variables—and it is these cases that the Committee
has thought it most useful to investigate carefully. Any conclusions come to in this way as to the relative
importance of certain environmental conditions can then be applied to these more obscure cases in families with
poor incomes.
The information required for such investigation has been obtained for the diseases causing most deaths
by taking the figures from Table I, and deleting from it the particulars of all cases with " C " incomes. In this
way Table III has been constructed, containing data of cases with "A" or "B" incomes only. (In the second
line the "Marasmus" figures are shown multiplied by 3 for ease of comparison with the "Bronchitis" figures.)
TABLE III.
Particulars of Cases, excluding those with " C" Incomes. | Housing. ABC | Income. ABC | Maternal Ante-natal. ABC | Employment. Post-natal. ABC | Feeding. ABC | Maternal Care. ABC | Foster-Care. ABC | Size of Family. ABC | Proximity of Open Spaces. ABC |
---|---|---|---|---|---|---|---|---|---|
Marasmus | 5 5 6 | 4 11 - | 8-3 | 9 -1 | 2 8 2 | 8 1 1 | - - - | 9 3- | 7 5 4 |
Marasmus X3 | 15 15 18 | 12 33 - | 27-3 | 6 24 6 | 24 3 3 | - - - | 27 9 - | 21 15 12 | |
Bronchitis | 20 14 3 | 23 14 - | 31 2 3 | 31 2 2 | 17 12 3 | 24 3 4 | 3 - 1 | 21 10 2 | 17 14 6 |
Enteritis | 5 2 1 | 7 1 - | 7 - 1 | 8 - - | 2 6- | 7 1 - | 1 - - | 4 4- | 5 2 1 |
Prematurity | 11 7 5 | 8 14 - | 14 1 7 | 8 - - | 4 5- | 11 2 1 | - - - | 20 - - | 9 12 2 |
It will be noticed that the omission from Table III of all cases with "C" incomes has not brought about the
entire disappearance from the Table of "C" entries under other headings, which might conceivably be a factor
in causing the deaths of these infants.
Accordingly Table IV has been constructed by leaving out the data of all cases with a "C" entry under
any heading, except under " Proximity of Open Spaces " as this is not wholly under the control of the parents.
TABLE IV.
Percentage of total Cases. | Housing. ABC | Income. ABC | Maternal Ante-natal. ABC | Employment. Post-natal. ABC | Feeding. ABC | Maternal Care. ABC | Foster-Care. ABC | Size of Family. ABC | Proximity of Open Spaces. ABC | |
---|---|---|---|---|---|---|---|---|---|---|
Marasmus | 16% | 2 3- | 2 3- | 2 - - | 2 - - | 1 3 - | 3 - - | - - - | 3 1 - | |
Bronchitis | 38% | 13 10 - | 18 7 - | 22 1 - | 22 1 - | 15 5 - | 20 1 - | 1 - - | 12 7 - | 12 9 2 |
Enteritis | 40% | 4 2- | 5 1 - | 6 - - | 6- - | 1 5 - | 5 1 - | 1 - - | 3 3- | 4 1 1 |
Prematurity | 38% | 8 6- | 6 8- | 13 - - | 6 - - | 2 3- | 8 1 - | - - - | 12 - - | 4 9 1 |
It will be noted that the numbers of cases remaining correspond to the numbers of "A" incomes shown
in Table I—exactly in the cases of "Bronchitis" and "Marasmus" and approximately in the cases of
"Enteritis." It appears, therefore, that lack of income is a large factor in producing the poor environment
which excludes the remaining cases from Table IV. (See also "Prematurity.")
In Table V similar information has been obtained in a slightly different way—by setting out particulars of
only such cases as have an " A " income.
TABLE V.
Housing. ABC | Income. ABC | Maternal Ante-natal. ABC | Employment. Post-natal. ABC | Feeding. ABC | Maternal Care. ABC | Foster-Care. ABC | Size of Family. ABC | Proximity of Open Spaces. ABC | |
---|---|---|---|---|---|---|---|---|---|
Marasmus | 2 1 2 | 5 - - | - 4 - | 3 - - | - - - | 4- - | 3 1 1 | ||
Bronchitis | 23 - - | 20 - 2 | 20 1 1 | 12 5 2 | 16 2 2 | 3-1 | 15 4 1 | 15 7 1 | |
Enteritis | 5 1 1 | 7 - - | 6 - 1 | 7 - - | 2 5 - | 7- - | 4 3- | 5 2- | |
Prematurity | 7-2 | 8 - - | 7-2 | 2 2- | 6 - - | - - - | 6 - - | 4 4- | |
In Table VI the data regarding "Bronchitis" and "Marasmus" cases, neo-natal and total, are contrasted. (Neo-natal cases are shown also multiplied by 4 for more easy comparison.) |
TABLE VI.
Housing. ABC | Income. ABC | Maternal Ante-natal. ABC | Employment. Post-natal. ABC | Feeding. ABC | Maternal Care. A BC | Foster-Care. ABC | Size of Family. ABC | Proximity of Open Spaces. ABC | |
---|---|---|---|---|---|---|---|---|---|
"Bronchitis" Totals. | 21 20 20 | 23 14 24 | 48 4 7 | 48 3 3 | 30 18 7 | 30 12 12 | 4-2 | 32 18 5 | 25 24 11 |
Cases. Neo-N.X4 | 16 20 20 | 20 8 28 | 44 4 8 | 40 1 - | 52 - - | 28 12 12 | - - - | 32 16 4 | 20 32 4 |
Neo-Natal | 4 5 5 | 5 2 7 | 11 1 2 | 10 1 - | 13 - - | 7 3 3 | - - - | 8 4 1 | 5 8 1 |
"Marasmus" Neo-Natal | 3 2 3 | - 5 3 | 2-4 | 4 - - | 1 3 - | 2 1 1 | - - - | 5 1 - | 4 3 1 |
Cases. Neo-N.X4 | 12 8 12 | - 20 12 | 8-16 | 16 - - | 4 12 - | 8 4 4 | - - - | 20 4 - | 16 12 4 |
Totals. | 6 9 16 | 5 11 15 | 17-9 | 19 - 5 | 4 14 7 | 12 4 7 | 21 6 - | 14 12 5 |