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TO HIS WORSHIP THE MAYOR, THE ALDERMEN AND COUNCILLORS OF THE
METROPOLITAN BOROUGH OF PADDINGTON.
Mr. Mayor, Ladies and Gentlemen,
Since my last Report some of the results of the Census of 1921 have been issued. The population
of the Borough as reported (144,261 persons) is likely to be questioned by those intimately acquainted
with the housing conditions in the Borough. The number of assessments reported vacant in June,
1921, was insignificant in comparison with the number so reported in June, 1911, and a large number
of houses, which in 1911 were occupied by one family, were in 1921 occupied by two or more families.
It was anticipated that the population of the Borough in 1921 would show an increase over that
enumerated in 1911 of more than 1 per cent., which is the amount shown by the published figures.
The tables relating to housing conditions show that very important changes have taken place
since 1911—actually, of iourse, since 1914. The Census Report gives no information of the conditions
prevailing in the individual Wards. It would be instructive to compare the housing data for the
Wards for 1901 and 1911—which are in the possession of the Department—with those for 1921. I am
particularly desirous of examining the changes which have taken place in Maida Vale and the two
Lancaster Gate Wards. In previous Reports I have referred to the indications of a lowered standard
of housing in the Lancaster Gate Wards which have been furnished by the rates of morbidity and
mortality.
If the doubt as to the completeness of the last enumeration be well founded, the birth and
death rates given in this Report are overstated. As regards the latter, correction for any overstatement
will make the comparison with previous years even more favourable than appears in the
Report. Attention may be called to the comparisons instituted between the average numbers and
mean rates for the two triennia 1910.12 and 1920.22. In connection therewith I desire to refer to the
increase in mortality (from all causes) observed in males during 1920.22 at ages 15.25. That increase
is in marked contrast to the reductions recorded at other ages. There was also a slight increase in the
mortality of females at the same ages. The causes of such increases ought to be inquired into more
closely, but having no knowledge of the sex.age.distribution of the populations of the Wards, I am
unable to find out whether such increases are common to all the Wards, or limited to one or more of
them. After the Census of 1901 and that of 1911, tables of the sex.age.distribution were obtained for
each Ward. Similar tables for the last Census would yield valuable and instructive information when
compared with those in the possession of the Department.
The infantile mortality recorded last year (69 per 1,000 births) was a very satisfactory one. In
part, no doubt, that low rate was due to the absence of fatal summer diarrhoea. I think that that
happy incident is not to be attributed to climatic causes alone. The Council can, I am convinced,
claim that their Child Welfare Work has been successful in lowering the mortality during the first
year of life. It is not sufficient, however, to reduce the number of deaths unless the survivors
are reared with a good prospect of a healthy after.lifetime. At present no evidence can be adduced to
show definitely that that result has been achieved.
The risk of an epidemic of smallpox appears to be increasing, not a cheerful prospect, having
regard to the increasing neglect of vaccination. While the vigilance of the health authorities has, up
to the present, been successful in circumscribing the spread of the disease, it is to be feared that with
the continued occurrence of sporadic cases in widely separated areas a time will come when such
vigilance will prove unequal to the task of coping with the danger arising from the presence of unrecognised
cases in a population very imperfectly protected by vaccination.
The prevalence of both scarlet fever and diphtheria shows signs of abating. We are still in the
dark as to the factors producing cyclical outbursts of these diseases. The mere fact of an increase in
the numbers of susceptible individuals is insufficient to explain such periodical outbursts. Sydenham
postulated an "epidemical constitution" of the atmosphere, by which it may be presumed that he