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to his worship the mayor, the aldermen and the councillors of the
borough of paddington.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to submit my report of the vital statistics recorded and the work
accomplished by your Public Health Department during the past year.
The provisional census data so far published disclosed so large a loss of residents that I
concluded that it was useless to frame detailed estimates of the sex-age composition of the
population. Consequently a good many of the rates usually given in these reports will not be
found in the present issue. Owing to the method of publication of the census results which has
been decided on by the Registrar-General, it will be some two or three years before the complete
census figures for the Borough will be available. The provisional total population points to one
lesson with regard to estimates of population, viz., that the national increment of population
cannot be relied upon as a check to estimates of populations of individual localities.
The "clearing house" system for births and deaths which the Registrar-General has
established will ultimately be of great value. For the time being it has caused an interruption
in the annual series of figures which has necessitated correction by parallel tabulation. It is
very much to be desired that the particulars of transferred births should in future years be as
full as those of transferred deaths.
There is no sign of any slackening in downward progress of the birth-rate. Last year's rate,
that obtained from local registration, was 19 75 per 1,000, 0 63 per 1,000 less than the rate for 1910
and 9'0 less than that for 1871. The shrinkage in the fertility rate is now practically universal
among civilised nations. Even in Germany, where a high rate has persisted until quite recently,
the latest returns are so unsatisfactory that a special commission has been appointed to examine
the question and, if possible, to submit proposals for checking the evil.
As regards sickness, there was a marked reduction last year in the amount of scarlet fever
and a satisfactory freedom from enteric fever, but the prevalence of diphtheria was somewhat
greater. From its behaviour during the year I was led to fear that the last disease would be
notably prevalent during the current year. The only other diseases exceptionally rife during
the past year were measles, whooping cough and diarrhoea, to which diseases were due the
increase in infantile mortality and the slight increase in the total mortality. From the analyses
made of the causes of death—more particularly at ages under one year—it may, I think, be
anticipated that the increase in the total and infantile mortalities will prove to be transient only.
In each of the five or six years preceding 1911 notable reductions in the infantile mortality had
been recorded, and in the Reports for 1909 and 1910 questions were raised as to the possible
effect of a really hot summer on the apparently improved risk attaching to infantile life. The
experiment has been made, with I think very satisfactory results. The mean temperature of
the past summer was identical with that of 1899, and the total rainfall less. Prirnd facie the
diarrhoea mortality in the third quarter of last year should have been greater than in 1899.
Taking the infantile mortality in the third quarter of the year as a test of diarrhoea mortality,
the ratio of mortality rates in Paddington in 1899 and 1911 was 100 to 76.
In December last the Local Government Board issued a third series of Regulations re Pulmonary
Tuberculosis, whereby the notification of that disease is made complete from the
beginning of the current year. The records of notification of, and of deaths from, tuberculosis
are dealt with fully in the Report. Hitherto there has not been much scope for work by the
Department with regard to consumption—the greater proportion of the patients being under the
care of either the Dispensary for Consumption or the Poor Law. The extension of notification,