London's Pulse: Medical Officer of Health reports 1848-1972

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Islington 1861

[Report of the Medical Officer of Health for Islington, Parish of St Mary]

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8
including servants, unmarried sons and daughters, and other dependents,* together
with the number of persons at an advanced age, is considerably larger than in the
third group, where marriages are commonly contracted earlier in life, and, as some
would say, less prudently, where the head of a family has as much as he can do
barely to support his wife and children, and where the elderly members of families
too oflen have to take refuge in the workhouse, the mortality of which is excluded
from calculation in all my District Tables. The second group is intermediate
between these two. Regarded thus, there will be no difficulty on the part of those
who know our Parish well in believing that the third group is that which is the
most uniform of all in its social and domestic character, and it is that which on all
accounts interests us most in a sanitary point of view.
8. And in this third group there were probably to be found, at any moment
during the last year, 1109 families in which one of their few working adult members
was unable, on account of sickness, to assist in supporting the family which depended
upon them for subsistence, and of these, one-third were persons not only unable to
work, but who never will be able to work again. And considering the improvident
habits of this class of people, the burthen of making up the deficiency from this
cause has fallen mainly, directly or indirectly, upon the poor rates. If we only
calculated the earnings of such people at a shilling a day, (and twice that amount
would be nearer the truth,) the amount which it has been necessary to make up,
either from this source or from private or public charity during the year could not
have been less than i. 17,355. To this maybe added, at least, half as much again, for
those parts of the districts of the 1st and 2nd groups as shelter a similar population.
And even then we shall have arrived at an amount of loss which must be regarded as
far below the truth. I do not say that all this sickness and all this public loss of
money is due to causes over which a Vestry has control, but some of it is. Part is
doubtless due to a damaged constitution arising out of a neglected infancy passed
years ago under unsanitary conditions, part to the permanent ill health formerly
contracted elsewhere, part to the construction of streets and courts in former times
in older parts of the Parish, when the free circulation of air in and about them was
the last thing it was thought of to provide, and when the air and light of heaven were
taxed for the necessities of the state. But I do say emphatically, that much might have
been avoided, and much money thus saved to the public purse, had these persons all
of them been lodged in sweeter dwellings, had there been no crowding, even in
the older houses, of whole families day and night into one solitary room, had
they been always fed with wholesome food, had their workshops, both here and
elsewhere, been provided with proper sanitary appliances, had their trades been carried
on with the precautions necessary for the avoidance of trade diseases, had they been
instructed in the value of fresh air, both in their dwellings and workshops, both by day
and by night, had they been taught to estimate personal and domestic cleanliness, and
supplied with public and private means of maintaining it, and had they all been
impressed with the fallacy of the notions which drive so many to seek oblivion in drink,
of their anxieties, unhappiness, and of the discomfort and misery of their homes. I
* That this is the case, comes out remarkably on calculating the proportion of females (the more
dependent sex) to every ten families in the groups of sanitary districts.
In the 1st group it varies from 20.0 to 37.9 to ten families, the mean being 29.5
.. 2nd 19.4 to 28.6 22.8
.. 3rd 20.1 to 26.3 21.6