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To the Mayor, Aldermen and Councillors of the
Metropolitan Borough of Battersea.
Mr. Mayor, Ladies and Gentlemen,
I beg herewith to present to you the Annual Report on the health
and sanitary conditions of the Borough for the year 1954; the third year
for which I have had the privilege of being responsible for the health
services in this area. As in previous reports, most aspects of our work
are covered, and in this introduction, I refer mainly to one or two of the
more interesting features of the work as they appeared during the year.
In my last report, I drew attention to the slight reduction in the
population of the Borough. In 1954, this decrease continued by 500
to 114,300. In the previous year, the reduction in the population
amounted to 1,600 so that the curve of decrease is now less steep than
previously. The birth rate was 15.21, a slight reduction over the
previous year, while the death rate was 10.07, which was over 2 points
lower than in 1953. This figure is 1 point lower than the death rate
for England and Wales. The infant mortality rate was very slightly up,
compared with the previous year—18.99 as against 18.56. The total
number of infant deaths (that is the number of infants who died before
reaching one year of age), remained the same, the slightly increased
rate being due to the smaller number of live births on which the infant
mortality rate is calculated. This was substantially lower than that for
England and Wales during 1954, which was 25.5, and also lower than the
rate of 20.7 for the County of London.
In studying these infant deaths more closely, one or two factors
emerge which, while quite in line with the generally accepted facts
about infant deaths, nevertheless are not without some interest. Of the
33 infant deaths, 25 or 75.8 per cent, occurred within the first four weeks
of life, and 15 or 45.5 per cent, occurred within the first twenty-four
hours of life. It is well recognised that deaths within the first four weeks
of life and especially in the first twenty-four hours are most likely due
to factors operating before birth on the expectant mother and child.
It is clear, therefore, from the above figures that those deleterious and
harmful influences which are likely to have an adverse effect on the
child's life and well-being during the first year of life are now of less
importance than those influences which affect the expectant mother and
unborn child. This is borne out by a study of the causes of infant
deaths. The conditions which are most likely to cause death within
the first twenty-four hours of life and, less markedly, within the first
four weeks of life, are congenital malformations and certain ill-defined
diseases such as prematurity. It is seen that of the 25 babies who died
within the first four weeks of life, the cause of death of 16 was prematurity,
4 congenital malformations (probably incompatible with prolonged
life), and 4 other causes mainly obstetrical in character.
It is clear from these facts that a further reduction in the infant
mortality rate is to be brought about by an attack on those adverse
factors which affect the expectant mother and her unborn child. Unfortunately,
what these factors are, and how they act, are much less clearly
defined and understood than are the influences acting on the infant
during its first year of life, which in the main are associated with