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

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London County Council 1913

[Report of the Medical Officer of Health for London County Council]

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Report of the County Medical Officer—Education.
149
the whole of the County, of children who had received treatment was 57.9. The best results were
obtained in the North and West of the County, where care committees are provided with numerous
workers. Thus the ten electoral areas in which the best results are shown comprise St. Pancras (W),
77.3 per cent., St. Pancras (N.) 74.7 per cent., Hackney (S.) 70.1 per cent., Hampstead 69.4 per cent.,
Kensington (S.) 69.2 per cent., Hammersmith 69.1 per cent., Fulham 67.6 per cent., Hackney (C.) 66 9
per cent., Kensington (N.) 66.5 per cent., Paddington (S.) 664 per cent.; while the poorest results
are obtained in areas confined to districts south of the Thames, with the exception of one area in the
far east, viz., Bow and Bromley, thus, Clapham has 49.6 per cent., Walworth 49.2 per cent., Southwark
(W.) 48 9 per cent., Battersea 48.4 per cent. Bermondsey 45.7 per cent., Newington (W.) 43.8 per
cent., Bow and Bromley 40.6 per cent.
Co-operation between School Attendance Officers and the Public Health Department.
During the Michaelmas term, 1912, an arrangement was made for the medical certificates concerning
children out of school for periods of three months and upwards on account of ill-health to be submitted
to the school medical officer by the attendance branch of the education officer's department. At the
expiry of six months the result of the experiment was found to be satisfactory, and it was decided
that the practice should be continued. During the year 1913 the procedure was placed upon a
permanent basis; particulars of all children out of school for a period of three months on account of
ill-health are reported each month to the school medical officer by the attendance department and a
card index for each child is kept in the public health department. An analysis of the causes of absence
relating to 3,560 such returns is given below.
Rheumatic conditions—
Acute rheumatism 119
Heart disease 229
Chorea 368
716 20.1 per cent.
Nervous conditions—
Paralysis 33
Epilepsy 60
Brain disease 31
Other nervous conditions 57
181 = 5.1 per cent.
Tuberculous conditions—
Lungs 377
Glands 68
Other organs 88
533 = 15.0 „
Diseases of chest (excluding phthisis) 225 = 6.3 „
Anaemia and debility 421 = 11.8 „
Ringworm 234 = 6.6 „
Various 87 = 2.4 „
Infectious diseases 181 = 5.1 „
Diseases of skin 165 = 4.6 „
Diseases of ear, nose and throat 103 2.9 „
Diseases of eyes 310 = 8.7 „
Diseases of. kidneys 28 = .8 „
Rickets, etc. . 15=.4 „
Scabies 42 = 1.2 „
Surgical conditions 168 = 4.7 „
Diseases of digestion 36 = 1.0 „
Illegible and unsatisfactory certificates 113 = 3.2 „
Specific disease 2 =.1 „
3,560 100.0 „
It will be seen that the rheumatic group of diseases forms the highest proportion—slightly over 20
per cent. of the total—among the causes that produce protracted absences from school. Next comes
tuberculosis in various forms, 15 per cent., and amongst other noteworthy conditions are ringworm,6.6 per cent., and diseases of the eyes, 8.7 per cent.

The analysis of the ages of the children given in the following table shows that at each age more girls are absent than boys.

Ages5678910111213
Boys15114981676351586569
Girls19917411699118108139175207
Total350323197166181159197240276

Number of
children
absent for
more than
three months
distributed
according to
age and sex.
The above table shows that at the ages of 5 and 6 an excessive number of children are
absent no doubt on account of the hesitation felt in starting school attendance in the case of delicate
children. Between the ages of 7 and 11 the number of children absent, both boys and girls, is
comparatively low. After the age of 11 the number rapidly rises, especially in girls. This is
probably due to the fact that girls at this age are useful at home, and a tendency, therefore,
exists to magnify the seriousness of complaints which at younger ages would not constitute a cause
for absence. This tendency no longer exists to the same extent in the case of boys, inasmuch as it is
exceedingly difficult with the present regulations for a boy out of school on medical grounds to be