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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 present to you my Report for the year 1923 as required by Section 106
of the Public Health (London) Act, 1891, and Article 14 (3) of the Sanitary Officers (London) Order,
1922. I have in general followed the plan of earlier Reports, omitting many tables formerly included.
Such omission has been made for the sake of economy, but I cannot help feeling that it has involved
a sacrifice of clarity. Perusal of the proofs has convinced me that many paragraphs of the Report
would be more easily understood had the tables on which such paragraphs were based, been included
in the Report.
The birth-rate was again lower, being 5.81 per 1,000 less than the rate for 1920. For the three
years 1921-23 the mean rate was 18.78 per 1.000, as compared with a mean of 21.17 for 1911-13.
The latter period has been chosen for the comparison as it was for 1911 that the first complete return
of births belonging to the Borough but taking place in out-lying districts, was received from the
Registrar-General. In looking up the data for that comparison, I have been struck by the changes
which have taken place in the numbers of births transferred both outwards and inwards. During
1911-13 162 births registered within the Borough were marked for transfer to other districts, which
total increased to 859 during 1921-23. In the former period the inward transfers numbered 739,
and in the latter 1,449. The inward balance for 1911-13 was 577 births, that for 1921-23, 590, an
insignificant variation. In the Report (p.3) I call attention to the increased proportion of births
which take place away from the mothers' homes, and to that fact, in part at least, must be attributed
the increases in numbers of transfers.
The death-rate (11.77 per 1,000) was below the rates for the two preceding years but above that
(11.40) for 1920—the minimum rate on record. The mean rate for 1911-13 was 13.21 and that
for 1921-23/' 12-28—a difference of 1.93 per 1,000, while the difference between the mean birth
rates for the two periods was 2.39 indicating that the decline in the death-rate did not keep pace
with the decline in the birth-rate. To express that fact in another way, in the earlier three years
the natural increment in the population amounted to 3,311 persons, and that in the later, to 2,942—
representing a deficiency of 369 new lives.
The infantile mortality (69 per 1,000 births) was the same as in 1922 and the lowest on record.
All rates recorded before 1911 were overstatements, as the corrections for births in outlying districts
were incomplete. Since that year rates in excess of 100 per 1,000 births have been recorded on five
occasions, viz., in 1911 (126), 1913 (101), 1915 (117), 1917 (135) and 1918 (116). Years with hot
dry summers have in the past been characterised by an excessive infantile mortality. The two
periods used above for the purposes of comparison were both signalised by summers of exceptional
heat and drought. For 1911-13 the mean rate was 110 per 1,000 births, and that for 1921-23, 71—
a reduction of nearly 35 per cent. I think that the whole of that reduction may be claimed to have
been brought about by the combined operations of the Council's Public Health Department and of
the Welfare Organisations. On page 29 of the Report, under Diarrhœa, I call attention to the
altered seasonal distribution of the mortality from diarrhoea at ages under 2 years.
With the exception of whooping cough and chickenpox, all infectious diseases showed lessened
prevalence. Although there was a considerable epidemic of the former disease, the fatality, as
determined from the data in the possession of the Department, was not excessive (see p. 28). The
decision of the Board of the Children's Hospital, Paddington Green, to discontinue the special clinic
for this disease, is a matter for much regret.
Although there was an increase in the number of cases of tuberculosis notified during the year
(p.15), the records for that disease were satisfactory. The mortality has declined to below pre-war
level (see p. 18). The Borough Tuberculosis Care Committee began their work in the spring of last
year, and the note on their activities (p. 18) will, I venture to say, be found to promise useful results.