London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
City of Westminster 1921
[Report of the Medical Officer of Health for Westminster, City of]
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36
financial year we have just gone through may tell in the next few years,
for in a disease like tuberculosis the effects do not show themselves
immediately.
I have already referred to the effect upon the death rate produced by
the increased number of females in the population. With regard to
tuberculosis, this factor also has to be taken into account as part of the
explanation in the reduction of cases of Pulmonary Tuberculosis, as males
suffer to a greater extent than females. Consequently, an increase of
females in the population results in a smaller number of cases in the
aggregate. Thus in 1920 the new cases among males in Westminster was
2.7 per 1,000 (2.3 without Common Lodging House cases) and of females
1.65.
This is shown more particularly in St. George's Division, where
females are in greater excess. There the male cases in 1920 were 2.07,
the females 1.11 per 1,000, making a rate of 1.60 for the total population.
Had the males and females been equal in numbers the rate would have
been 1.9.
The Abbey Division, where the proportions are more nearly equal,
had 2.88 cases per 1,000 males and 1.80 per 1,000 females, equal to
2.30 for the Division. Deducting Common Lodging House and homeless
cases the rates stand at 2.35 for males, 1.70 for females and 2.00 for the
Division.
In 1921, the incidence for the City was 2.5 per 1,000 for all males
(1.9 without Common Lodging House and homeless cases) and 1.4 for
all females.
Comparison with the pre-war year 1913 shows that there has been a reduction in the incidence of the disease in both males and females in Westminster in the general population:—
| Males. | Females. | |
|---|---|---|
| 1913 | 2.9 | 2.6 |
| 1920 | 2.3 | 1.6 |
| 1921 | 1.9 | 1.4 |
Infection of children is derived from two sources, directly from a
human source, indirectly from a bovine source, through milk containing
the bacillus. Though infection from human sources is much the more
common form, yet the danger from tuberculous milk cannot be disregarded.
In children, the infection, in a proportion of instances, is rapidly fatal,
but in the greater number the tubercle bacilli are disseminated to various
parts of the system where they may remain latent until some period of
lowered health, with perhaps local injury, occurs, when they may be
stimulated to activity.