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131
Report of the County Medical Officer—Education.
Relative physique and incidence of disease in school children with reference to environment and social status.
Dr. Scott Pinchin has paid special attention to the differences found amongst children inspected
at schools under his care, classified into different types according to the social conditions of the homes
from which the children come. He points out that since his enquiry was commenced a report on
somewhat similar lines has been made by Dr. Neave on conditions found in Manchester—in which
it was shown that whilst the children in the better class schools approximated to the anthropometric
standard, in the poor class schools they were considerably below the standard.
For the purposes of the present enquiry a series of schools extending over a large area in the
South-West of London was taken ; the pupil population being about 22,000. The schools vary from
some counted as being amongst the best class elementary schools in London to some of the worst; at
the same time it is possible that worse results might be obtained from the schools in crowded districts
in inner London. The parents of the best class are of the clerk and small shopkeeper type, mostly
living in separate houses; those of the worst are labourers and casuals of all sorts, living in small
houses, (in many cases several families in the same house) in a very poverty-stricken neighbourhood
around the River Wandle.
About 5,000 children have been examined and their defets relative to age, sex and environment
tabulated. The schools have been divided into good, medium and bad, represented below by
A, B, and C respectively. The numbers taken in the calculation of the height and weight averages
do not comprise the whole of the children examined owing to the fact that children suffering from any
marked disease have not been included in any of the groups. These figures are compared with the
anthropometric standard allowing a regular increase in height and weight for each month.
Differences such as Dr. Neave found in Manchester in the 13-year-old age group obtain, but to
a much smaller extent; and this would appear to be far more satisfactory; for if the child is taken
into hygienic airy surroundings and fed if necessary, there should not be such a vast difference between
the three classes.
The maximum difference in weight in boys and girls of 12 is approximately 2 kilograms in each
case, as against 5.3 boys and 3.5 girls in the Manchester series. The maximum difference in height is
4.2 c.m. in boys and 2.0 c.m. in girls, as against 11.7 and 7.8 cm. in Manchester schools.
In the C schools the height and weight in each group are both considerably inferior; but comparing
A and B schools with one another there is not such a big class difference, as every A school has
a considerable number of B class children and vice versa, but a difference is still to be traced, except
that in the case of bovs asre 12 and girls ace 8 there is a slightly better result in the B schools.

The falling off in growth as compared with the anthropometric standard shows as follows
during the vears 8—11.
Boys. A 2.7 c.m. Girls. A 2.8 c.m.
B 1.3 c.m. B 2.9 c.m.
C 4.0 cm. C 5.2 cm.
These figures show that the B schools are the more normal in this respect.
Both the A and C schools show a great falling off in growth between 8 and 11 years, and in the
C schools this is half as much again as in the A schools. It is thus seen that among the better schools
the rate of growth is much increased during the first three years of school life with a larger decrease
during the next three years.
18820
r 2