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TO HIS WORSHIP THE MAYOR, THE ALDERMEN AND COUNCILLORS OF THE
METROPOLITAN 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
activities of your Public Health Department during the past year. It is to be regretted that no
Report of the final results of the Census of last year has been published, although more than twelve
months have elapsed since the actual enumeration of the population. Morbidity and other rates
are the only sure tests of the sanitary state of the community, but such rates require population
data which are not available at present, the upheaval of the late war having rendered the usual
methods of estimating the numbers living quite unreliable. For want of better measurements,
resort has been had to Index Numbers which give fair indications of the changes in the morbidity,
etc., from year to year when, as is believed to be the case in the Borough, the population is
approximately stationary. Index Numbers are, however, of little or no use for comparing district
with district, and they suffer from a further disadvantage in that it is practically impossible to
adequately gauge the variations due to the changes in the sex-age constitution of the population.
The increase in fertility which followed the Armistice has passed away. It remains to be seen
whether the birth rate will, as it is feared, fall to the low level of the years immediately preceding
1914. The losses incurred during the war have been by no means made good.
Scarlet fever and diphtheria were both unduly prevalent during the year, but the fatality rates
(per 100 cases) were low, notably that of the former disease. The records of notified diphtheria
were swollen by the numerous instances of bacteriological diphtheria. The same fact was
observed in 1920, and it is becoming evident that the notification of diphtheria needs modification
to provide for the distinction between "bacteriological" and "clinical" diphtheria. I am not
prepared to recognise the former as of no importance from a public health point of view, and
therefore not worth the cost of notification. At the same time I think that there is no need to send
all cases to isolation hospitals.
The new cases of tuberculosis reported annually continue to diminish in number, as also do
the deaths from that disease. It is too early to say how far the administrative methods recently
adopted have helped to reduce the prevalence of this disease. The mortality from pulmonary
tuberculosis had begun to decline long before any special administrative measures had been
initiated.
The deaths ascribed to cancer show no signs of diminution. Until information as to the sex
and age constitution of the population be available, it is impossible to say definitely what the
actual increase in the mortality has been. Figures will be found in the Report showing the changes
in the proportions of the total deaths from cancer and from all other causes of death.
Infantile mortality was low—far lower than was to be expected from past experience. In part
the low mortality was due to the non-epidemicity of measles, but more to the absence of summer
diarrhoea. Looking back over the years, the diminution in the mortality from that cause is striking.
The contrast between the diarrhoea mortalities of 1911 and 1921 gives food for much speculation