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42
between two important bodies, each of them having very definitely the duty of
grappling with the problem of tuberculosis imposed upon them.
It is a serious matter that in the one report which is supposed to deal with the Public
Health of the Borough, it is found impossible to give any idea of the extent of
the work which is being done in the case of so important a disease as consumption, or
to express an opinion as to the effect produced by what has been done.
The Medical Officer of Health is in a position to obtain information with regard
to the housing, surroundings, etc., of the consumptive, which, though practically
beyond the reach of the Insurance Committee, it is important they should have
before them in deciding as to the form of benefit appropriate to the cases under
consideration.
It is undoubted that nothing but advantage would result to the committee no less
than to the insured from proper co-operation between those responsible for the
administration of the sanatorium benefit and the Public Health Department of the
Borough, and it is unfortunate that arrangements for bringing it about have not yet
been made.
Deaths from Phthisis.—The deaths from consumption numbered 149—exactly
the same as in 1912. The rate per 1,000 was the same, viz., 1.2.
In Table IX below the numbers for each of the years 1900 to 1913 are given
and the distribution of the deaths throughout the Borough is also shown. With
regard to this last, it is interesting to note that Christ Church, though it still heads
the list, shows a very distinct reduction on the figures for 1912. Though it is the
most thickly populated district and that in which the majority of the inhabitants are
of the class most liable to infection and least capable of withstanding the ravages of
the disease, it is at the same time, the district in which most preventive work is done.
The official and other workers are more closely in touch with the inhabitants of
this part of the Borough than with those in any other; more educational work is done
in this district, and more frequent inspections are made and greater efforts are put
forth to obtain improvements in housing and sanitation.
Much of the work is, of course, done because of the character of the neighbourhood
and the circumstances of the inhabitants, nevertheless it preventive work is
capable of producing any effect, it is in this district that it should be seen.
In the last seven years, the work in connection with tuberculosis having been
more or less organised in 1906, the number of deaths has come down distinctly to
nearer 60 than 70 and even on two occasions to between 50 and 60. In the period
referred to the population has greatly thinned and the neighbourhood altered, and
these changes have doubtless played a part in the reduction in the numbers. They have
not been responsible for all, however. The vast amount of work carried out by the
Council and those acting with them has done its share, not so great perhaps as it would
have done had conditions amongst the people themselves been more favourable, but
still a share sufficiently great to encourage the workers to continue their efforts and
even to increase them.