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REPORT OF THE MEDICAL OFFICER
OF HEALTH
To the Chairman and Members of the Urban District Council of
Harrow.
Mr. Chairman, Mrs. Roberts and Gentlemen,
I beg to submit the Annual Report on the Health and Sanitary
Circumstances of the District for the year 1943.
The health of the district during the year was again most satisfactory,
even though some of the rates were not as low as in the previous year,
notably the infant mortality rate which rose from 31.5 to 38.0 (a figure
which nevertheless compared very favourably with the national rate of
48.0) and the maternal mortality rate which rose from the exceptionally
low level of 1.50 in 1942 to 2.57, a figure which, most unusually, was
slightly higher than the rate for the country as a whole. The birth rate
figure at 18.2 is the highest recorded for this district, while the death rate
at 9.1 remained the same as the average for the war years.
The incidence of scarlet fever showed a further increase but as the
distribution was fairly even throughout the year with no epidemic
prevalence, no difficulty was experienced in arranging admission to
hospital of all patients whose removal was requested. The severity of
the illness was again of the slightest. Diphtheria incidence remained at
its usual low level. There was a further fall in the figures of cerebrospinal
fever and of dysentery, two diseases which have been more common
during the war than in the pre-war years ; while the number of cases of
tuberculosis was a further decline on the figures for the previous years.
There was a minor prevalence of influenza in the earlier months of the
year, but nothing compared with the epidemic incidence to which this
district, in common with the rest of the country, was subjected in the last
few weeks of the year. This infection was the outstanding cause of
death at that time, particularly amongst the elderly.
The maternity and child welfare services have been maintained with
little change. The increase in the number of births to an average of
seventy per week, or another five babies every week added to those for
whose supervision each health visitor is responsible, indicates perhaps the
need for a substantial increase in the health visiting staff, more especially
as their duties are so steadily embracing so very much more than the
advice to the mother on the care of her baby, or even on the care of
children up to five years of age. The future of the health visitor as a
general family advisor must soon force a decision as to whether her
training with its disproportionate amount of time spent in hospital will
not have to be radically amended so that, without increasing the total
time in training, substantially more can be devoted to the sociological
and educative aspects of her work. Public health rests so largely on
environmental hygiene and on health education, and health education
so very largely is the responsibility of the health visitor.
Three more nurseries were opened during the year, and in general