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3
Public Health Department,
117, Mortlake High Street,
S.W.14.
To the Mayor, Aldermen and Councillors of the Borough of Barnes.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to present my Annual Report on the health of
the Borough during the year 1946.
Although this report is presented by me, the Medical Officer of
Health during the period under review was in fact Dr. W. F. Twining
McMath.
As this report is the only one for whose presentation I shall be
responsible and as far-reaching changes will occur in the near future,
it may be appropriate to refer briefly to the past and to existing unsolved
problems.
THE PAST.
As we glance through some 50 years of reports we find we
have now pure water, improved conditions of sale of food,
better standards of child care, better housing, all the concern of the
Public Health Department. From its early concern with " smells,
drains and fevers," the public health service has expanded to interest
in every aspect of health, and to the provision of facilities unknown
to the pioneers—ante-natal clinics, child welfare clinics, immunisation,
a special section for housing, the provision of food supplements, day
nurseries, home helps and the associated medical care of the school child.
In 1897, the death rate under 1 year per 1,000 live births was 145'9;
in 1898 it was 182.3 ; in 1946 the rate was 36. In the report of the
Medical Officer of Health for 1902 we find mention of cesspools
" still in use," milk kept by the sellers " in the scullery or fowl
house " and " the cans washed in the family wash tub " ; some
houses " still supplied by wells." He forecasts that " typhoid fever
is certain to become more frequent as the district becomes more
urban." The conditions to which he refers no longer exist, and
typhoid fever is now a rarity,
The vital statistics, improved living conditions, lowered incidence
of most infectious diseases, are objective indications of what has been
accomplished.
THE PRESENT.
Infant Mortality. Mortality among infants under one year of
age has been so much reduced that the main problem now remaining
is death and disability due to congenital defects, the importance of
which is seen in Table V. Research into this aspect of infantile