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130
Economic conditions and anamia. The question of anaemia as a sequel to undernourishment
was further investigated under the heading of unemployment amongst the
families observed total anaemic cases, 478; totally unemployed, 51; partially
employed, 30; fully employed, 342; no record available, 55. This gives a percentage
of 10.7, total, and 6.3 partial, unemployment amongst the anaemic cases. The figure
for total unemployment amongst the insured population of Woolwich as a whole is 11.7;
the figures for partial unemployment are not available. The statistics given, however,
would suggest that the general ill-effects of unemployment have no particular bias in
the production of anaemia (on grounds of poorer quality food, poorer housing, etc.),
since the degree of unemployment amongst the anaemic families is less than amongst
the population as a whole.

This gives an average of 60 per cent of all the children noted as anaemic living in families
where the family was in sole occupation of the house, taking accommodation in the form
of a house, house and yard, or house and garden, as equivalent to sole occupation. The
remaining 40 per cent live in rooms. Thirty-nine per cent of all the families in Woolwich
share dwellings so that the figures for the anxmic children more or less correspond to
those for the community as a whole and show no obvious relation between housing
problems and the production of anaemia.
Hours of sleep. It was noted in a previous report (see Annual Report of Medical
Officer of Health, 1930, page 116) that unwise management in regard to sleep seemed
to account for a certain percentage of nervous difficulties amongst the children attending
the clinic. It was particularly noted that, not only lack of sufficient sleep at night amongst
the younger children, but long hours spent in bed during the day amongst certain
groups, were factors likely to produce symptoms as a result of confinement, lack of air
and sufficient exercise and light. The practice of noting the total 24 hours' sleep
periods for each child examined is still carried out at the clinic and, in the case of the
anaemic children, the daily amount of sleep averaged 13 hours, including an average
mid-day rest of just over an hour. No fault can be found with this (on the grounds of
undue confinement) taking it that the average includes a majority of children at the age
of 2 rather than 4. But on the other hand it was clear in a number of cases that long
rest periods during the day (including many of 3 hours and some even longer times)