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Annual Report of the Medical Officer of Health—1895.
37
Workers in the first two classes, which have relatively a much greater death-rate,
are notoriously heavy drinkers. They stop at many public houses in the course of
their daily rounds, and they receive many offers of drink. Moreover, although their
work is out-door it is to a great extent sedentary, and exposure under those conditions
throws such a strain upon the circulation that it is perfectly natural they should
seek a physiological restorative in the shape of a pleasant cardiac stimulant. Next
compare the mortality of these two classes with that of the private grooms and
coachmen, who work under almost similar conditions as to exposure, but who have
shorter hours and less opportunity of indulging in alcohol, Indeed, it is obvious that
heavy drinking habits would soon throw them out of employment. We find that
their mortality is far less than that of the carters and carriers, and again than that
of the cabmen and omnibusmen. It cannot be argued that the higher death-rate of
the two last-named classes is due altogether to their greater consumption of alcohol.
They are handicapped by longer hours of work, and they suffer in consequence to a
much greater extent than private servants from rheumatism and other diseases due
to exposure.
In this bird's-eye view of the relation of environment to drink the chief aim has
been to map out a few of the more striking outlines. The following broad statements
may be appended in the hope that they may have a suggestive value to future
workers:—
1. An excessive mortality prevails among the working population of towns as
compared with (a) that of country labourers, or (b) of mixed classes in the wealthier
urban districts.
2. The town mortality is swelled by an excessive infantile death-rate, and by the
dusty and otherwise injurious trades carried on in crowded centres.
3. Overcrowding is rife in towns, especially in manufacturing districts.
4. Many town occupations are unskilled and attract men of inferior stamp.
5. Urban labour competition is keener than rural, with consequent increase of
poverty and starvation.
6. Alcohol is consumed in larger quantity in towns, in part, possibly because of
the greater temptations to indulgence. It is also taken freely in the fifteen occupations
that have the highest death rates.
7. Systematic house drainage, with its attendannt risks, is in the main a
distinctive feature of towns. Or, to put the matter in a different form:
A. The stress of preventable mortality falls on the infantile and working
population of our great towns.
B. The conditions more or less peculiar to the town labourer are (a) the temptation
to indulge in alcohol, (b) trade dangers, (c) bad drains.
A Short Summary and Report of Proceedings in
relation to Proposed Visits by the Officer of
Health to Sick Employes of the Vestry.
When I had the honour of being appointed as Medical Officer of Health to St.
George's, I agreed to obey the Order under the Public Health (London) Act relating
to the duties of Medical Officers of Health. At the same time I consented to carry
out a certain additional duty:—namely, "to attend, if required, the sewermen,flushers,
and employes during sickness." This agreement I signed on the strengh of the understanding
that the particular duty had received the sanction of the Local Government
Board. I was requested later on to visit several sick employes of the Vestry
without the knowledge of their medical attendants. This I respectfully declined to