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1
Public Offices,
Enfield, Middlesex.
July, 1947.
ANNUAL REPORT OF THE MEDICAL OFFICER
OF HEALTH, 1946
To the Chairman and Members of the Urban District Council of
Enfield.
I have pleasure in presenting my Annual Report on the Health
and Sanitary circumstances of the district for the year 1946.
The incidence of infectious disease was low throughout the
year, the most marked reduction on the previous year being in
respect of measles, but it is gratifying to note also the reduction
in cases of tuberculosis. In connection with cases of tuberculosis
the paramount importance of satisfactory housing conditions in
the prevention of the spread of infection must be realised,
especially in those cases where there are young children in the
household and the patient is awaiting admission to a Sanatorium.
As detailed elsewhere in my report, the residents of Enfield were
given the opportunity of investigation by the Mass X-Ray Unit
of the Middlesex County Council, and the response to the public
sessions as organised by the Enfield Council was most satisfactory.
There were only three cases of diphtheria during the year—
a remarkably low figure. These occurred in children, two of whom
were sisters who contracted the disease concurrently, and none
of the three children had been immunised. Unfortunately, two
cases proved fatal. There still remains scope for a much greater
acceptance of diphtheria immunisation, especially in the matter
of reinforcing doses to maintain a high level of immunity throughout
school life.
The birth rate shows an appreciable increase over the previous
year, having reached a figure of 20.86, there being 468 more births
than the previous year, and the municipal midwives having attended
323 more cases. A new record in the Enfield municipal midwifery
service was reached with the midwives having attended a total of
1,123 cases.
The still-birth rate, death rate and maternal mortality rate all
showed decreases, whilst the infant mortality rate of 33.17,
comparing very favourably with that of England and Wales of
43.00, was only slightly higher than the two previous years when
the figures were the two lowest recorded this century. Prematurity
is associated with a large proportion of the infant deaths, and in
the successful prevention of premature birth lies one of the best
prospects of reducing infant mortality, although, of course, special
attention is at present directed to the care of premature infants.
During the year the Health Department co-operated with the
Joint Committee of the Population Investigation Committee and
the Royal College of Obstetricians and Gynaecologists in an