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

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London County Council 1956

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

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It is assumed that the reason for the higher percentages of problem families among the
'mixed' ones is that they are probably larger and/or poorer so that the mother cannot
cope—there seems to be a limit to the difficulties with which a stable but dull parent
can compete after which one further adversity will produce a complete breakdown in
domestic management.
Families with no children under five years of age (education department)—Among the
families cared for through the education care committee organisation were 427
potential problem families and 99 hardcore problem families. It is proper to note
that an attempt had to be made by the care committee organisers to award points
for the various factors as revealed by the case histories in the office files and, whereas
the families where children had been reported to the N.S.P.C.C. or the education
officer's problem case conference were reasonably well documented, full data was not
usually available in other cases. The assessment of families into the two categories was
therefore somewhat subjective.
Overall the percentages, based on an estimated number of families, were of the
order of 0.21 for potential problem families, 0.05 for hardcore and 0.26 for both. The
overall rate is about 2/5 of that for families with children under five years of age only
or 1/10 of these for families with children over five also. As the families reported on
by the care organisers were not increasing and the children were all benefiting from
the school and school health services it might have been expected that the percentage
would be below that for the mixed families. The numbers reported may, because of
the reliance mainly on case papers, be an understatement—i.e., in some households in
which the children are all of school age the mothers' responsibilities arc lessened and
the more obvious evidence of neglect may tend to disappear but there is a tendency for
other manifestations of neglect such as truancy or juvenile delinquency to take their
place, whilst factors such as low intelligence or housing difficulties remain.
Families in Homeless Family Units and short stay accommodation (Welfare Department)—
Within this select group of families the wardens of the Homeless Family units chose
those which appeared to come within the definition of potential and hardcore problem
families. There were in a total of 645 homeless families, 18 considered to be potential
and 22 hardcore problem families. In terms of percentages therefore potential problem
families amounted to 2.8 per cent, of the total, hardcore families to 3.4 per cent, and
the two together 6.2 per cent. These figures are obviously not comparable with those
obtained by more exact standards but it is interesting to note that the incidence of
problem families so selected was slightly more than four times as high as that ascertained
in the Public Health Department of families living in their own home.
Total numbers—From all departments, there was reported a total of 3,022 families,
2,456 from those with a child or children under school age, 526 from those with children
of school age only and 40 in welfare establishments. Details are in Table II below:

Table II— Total numbers of potential and hardcore problem families

Problem familyChildren under five onlyChildren under and over fiveChildren all over fiveIn welfare homesTotal
Potential5691,225427182,239
Hardcore1465169922783
Total7151,741526403,022

In five recent surveys in other parts of the country the figures of incidence range
from 1.2 to 6.2 problem families per 1,000 total families—the bases of the various
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