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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 my Report on the Vital Statistics of the Borough and
the work of your Public Health Department during the year 1913, this being the twenty.
first report prepared by me.
The foundation of vital statistics being the annual estimate of the population of the
Borough, the correctness of such estimate is a matter of first importance. The estimated
population for the middle of last year which has been used in this report has been obtained by
the use of well.recogniscd formula; which involve the assumption of a persistence of the rate of
change in the population observed at the last census. Such method has given an estimate of
142,261 persons, showing a decrease of 290 persons since April, 1911. There are, however,
grounds for thinking that the population in the Borough has increased and not decreased since
that date. The principal argument in favour of that view is the reduction in the number of
empty properties which has been recorded by the Borough Treasurer. On page 15 there will be
found described a method of estimating the inhabitants of the Borough which allows for the
reduction in "empties" referred to. Briefly the use of such method gives an estimate for last
year which is 4,430 persons in excess of that obtained by the accepted method, and shows an
increase of 4,140 persons since the census. Having regard to the total population, the difference
between the two estimates is not very great at the present time (equal to 3T per cent. for 1913),
but the run of the figures given on page 16 suggests that the error arising from the old method
will be very considerable before the next regular census is taken unless the present tide of
immigration undergoes a notable check. Reasons are given in the report for abstaining from
the use of the estimate obtained by the new method in the calculation of the various rates, but it
will be of interest to note here the differences between the birth and death rates (fully corrected)
obtained from the use of the two estimates, "A" rates being those given by the estimates
calculated in the usual way, and "B" rates those given by estimates based on numbers of
occupied ratings.
1911. 1912. 1913.
Birth.rate A 20.88 21.01 20.87
B 20.70 20.60 20.24
Death.rate A 13.51 12.44 13.68
B 13.39 12.70 13.27
As regards the birth.rate, it can only be said that there are no indications of any check in
its reduction. In the next report I hope to be able to show the extent to which the recorded
reduction in the fertility is independent of changes in age at marriage, and proportion of fecund
women in the population of the Borough.
Last year the following diseases were unduly prevalent, viz., diphtheria, scarlet fever,
measles and whooping cough, but in the case of the first disease evidence is adduced (page 32)
which minimises the significance of the recorded number. "Return cases" of scarlet fever
continue to occur, and the proportion of secondary cases due to this cause is dealt with on
page 38. Measles has during the past four years been exceptionally prevalent, and the usual
periods of exemption have been almost entirely absent. Two tables will be found in the
Appendix (Tables XI. and XII.) which show as clearly as can be exhibited without the use
of diagrams the fluctuations in the numbers of known cases occurring week by week since 1903.
Last year the fatality of the disease was considerably above the average.
It has been necessary to devote a considerable amount of space to tuberculosis, and there
will be still further expansions in future reports when the "tuberculosis scheme" has come into
operation. In the account of the working of the "Sanatorium Benefit" provisions of the
National Insurance Act given on page 71, I have indicated the need of closer co.operation
between the Insurance Committee and your Public Health Department. I would direct your
attention to the paragraphs dealing with "Institutional Treatment of Pulmonary Tuberculosis,"
where the question of the part played by the segregation of the tuberculous (page 74) in producing
the reduction in the mortality from pulmonary tuberculosis (phthisis or consumption) is
discussed. There can be little doubt that such segregation has been, so far, a factor of insignificant
influence. The success of the proposed schemes of treatment of tuberculosis will depend almost
entirely on the patients coming under treatment in the earlier stages of their disease. The
figures (page 73) showing the average intervals between notification and death indicate that to
secure the much to be desired success the disease must be recognised and declared much earlier
than has been done (on the average) since notification became operative. This is a matter for
which the general public rather than the medical profession are responsible.
The increase in mortality from the malignant diseases included under the generic title
"Cancer" has been prominently before the public for some years. Paddington has long had
a death.rate from " cancer " higher than the rates of most of the metropolitan districts. Part of