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to his worship the mayor, the aldermen and councillors of the
borough of paddington.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to submit to you my Report on the health of the Borough—as
evidenced by the official statistics—and the work of your Public Health Department during the
past year.
The census (1911) data relating to the Borough published at the time of preparation of this
Report are given in a brief form under population. The information as to the housing of
the inhabitants appears to confirm the provisional estimate of the total loss of population
(approximately 16,000 persons) which I gave in my last Report. It would also appear from the
particulars at present available that the standard of housing, judged by the size (number of
rooms) of the individual tenements, has improved since 1901. Not only has the size of the
average tenement increased, but the average number of persons per tenement has decreased.
The changes, it is true, are but small, but they are in the right direction.
The birth-rate again showed a shrinkage, last year's rate being the lowest on record. The
subject of the reduction in apparent fertility is one of the first importance to the Nation. It is
satisfactory to observe that we are supplying the needs of population in our Dependencies
beyond the seas, as otherwise those countries would be occupied by other nations. We need,
however, a greater supply of new lives at home to make good the draft of emigrants, to
maintain our manufactures, and to defend our shores. It is much to be desired that public
opinion should be very definitely directed to the question.
Of the infectious diseases, diphtheria was expected to be unusually prevalent during the
past year, and there was a considerable increase in the number of notified cases. The number
reported is, however, in one sense misleading, as several "carrier" cases were notified. Such
cases are not clinical diphtheria, and it is doubtful if the presence of the Klebs-Löffler bacillus is
dangerous to the patient. "Carrier" patients are, however, undoubtedly a source of danger to
the public. Under "schools" will be found an account of the special work with reference to
such cases in the public elementary schools. The account is far from complete, and it is hoped
that a more complete history may be published at a later date. Return cases of scarlet fever are
of too frequent occurrence. There was a very considerable reduction in the number of cases of
enteric fever during the year. Very few cases of puerperal fever are now reported, but evidence
is adduced to show that the mortality in childbed does not appear to be decreasing to the extent
generally supposed. For the first time all cases of pulmonary tuberculosis—except those in
lunatic asylums—were notifiable. A complete list of the streets from which new cases were
reported during the year is given in Appendix B.
The total mortality recorded in 1912 was the lowest on record, but the figures given in this
Report have still to be corrected for the changes in the sex-age constitution of the population.
The Registrar-General in his Annual Summary for 1912 gave the nett mortality at 12 33 and
the factor corrected rate as 12.26, the nett rate being 1.05 and the corrected l.04 less than the
averages for 1907-11. The most striking change in the mortality rates from individual diseases
was the decline in the mortality from pulmonary tuberculosis (phthisis), the decline being
however, limited to the form which is not described as "acute" in the death certificate. The
mortality from "acute phthisis" was higher in 1912 than 1911.
Infantile mortality was at a low rate last year, viz., 99, as compared with 129 in 1911 and an
average of 109 for the five years 1907-11. By far the greater part of the decrease was observed
among females. The mortality from the diarrhœal diseases recorded last year was in striking
contrast to that recorded in 1911. Attention should be directed to the very small share in the
reduction of mortality recorded at ages under one month. From figures (1891-1910) taken from
the Annual Reports of the Registrar-General evidence has been obtained to show that the
mortality during the first year of life in England and Wales from prae-natal causes has increased,
although the total infantile mortality has decreased. The question of prae-natal causes of
mortality demands serious consideration.
The proportion of deaths in institutions to all deaths continues to increase. Some of the
increase has been due to the Hospitals of the Metropolitan Asylums Board being made available
for more diseases. At the same time there has been a fairly large increase in the proportion of