Mexborough and Swinton Times April 20, 1928
Health Hints.
Wombwell M.O.’s Valuable Report
Vital Questions.
Birth Rate’s Downward Plunge.
The annual report of the Medical Officer of Health for Wombwell (Dr. J. C. Pickup) has been issued this week.
The report covers the year 1927. The Medical Officer reviews the hospital problem from Wombwell’s point of view, and outlines the circumstances under which the desire for an isolation hospital locally has developed. Touching upon ambulance facilities, he says: “The various general hospitals at Sheffield and Barnsley provide ambulances for conveying such of the Wombwell inhabitants as contribute to the 1d. in the £ scheme. But there is a considerable portion of the inhabitants which does not come under the scheme. For them there is no ambulance provision, and they have to go to hospitals or nursing homes in taxis. This method, in urgent and acute cases, is most unscientific. The provision of a proper ambulance is long overdue, and efforts should be made without delay to remove the blot on this aspect of public health.
Hospital Provision.
“Hospital provision is inadequate to meet the demands of all sections of the community. It is not that the accommodation is insufficient, but that it is badly distributed. At all the voluntary institutions there are long lists of patients awaiting admission, whilst the accommodation in the poor law infirmary is only partially occupied. Expressed in another way, this means that the pauper element of the population is provided for to an extent beyond its requirements, whilst the needs of the non-pauper class, where the family income falls below a figure high enough to permit of treatment in a nursing home or private institution are only partially met. It is perfectly obvious even to those most anxious to retain the voluntary principle of hospital provision, that there are not sufficient funds to provide the necessary extensions to the existing institutions, even if such extensions were desirable in face of the fact that the poor law hospitals are partially empty.
Some of the latter are buildings of comparatively modern structure, well situated, and well equipped, and would make ideal hospitals for the treatment of the sick of all classes of the community, including those who are able to pay a reasonable fee for their treatment. The way out of the difficulty is therefore clear. It is to open the doors of the poor law infirmaries to the whole community. This would necessitate an alteration to the existing law, hut it would be much easier to do that than to build new hospitals or extend existing ones.
How, it may be asked, would a system of voluntary and rate-aided institutions be managed? The best way would probably be by the formation of a Hospital Board which, whilst it would not interfere with the autonomy of the component institutions, would act as a co-ordinating link between them, and so prevent overlapping and duplication of effort.
Certainly things ought not to continue as they are. The present system altogether fails to provide the service which the health of the community demands.”
Decline In Birth Rate.
The number of births registered during the year was 412 (204 males and 208 females), a decrease of 46 on the previous year. The birth-rate was 19.9, compared with 22.3 for 1926, and an average rate of 21.6 for the previous five years. The descent of the birth curve has continued since 1920, but in recent years it had lost its steepness and was gradually flattening out, but in 1926 and 1927 (periods of trade depression) it had become steeper again. Whether the rate will continue to drop depends very largely on how soon the economic conditions of the country return to normal, and trade revives to such an extent as to relieve the population of the present burden of unemployment. The housing shortage is also a factor of some importance–the rents of the new houses are so high that many people live in lodgings instead of having a new house to themselves—conditions which are altogether unsuitable for the rearing of children.
“Of the total births, 14, or 3.39 per cent., were registered as being illegitimate. The number of illegitimate births (though 5 less than last year) is to be deplored, the ratio of illegitimate to legitimate being 1 to 28. The probability of survival of the illegitimate child is ‘usually one-half of the legitimate.
Valuable Help Neglected.
“It is very disappointing that we have so few attendances of ante-natal cases at the clinics. The solution of the problem of maternal mortality which is causing so much anxiety in medical circles lies to a large extent in the proper treatment of the mother during pregnancy. If every expectant mother could be under skilled observation for a long period before her child is born, the number of babies dying before birth, and in the first month of life, as well as the number of childhood fatalities, would be reduced greatly.
It is only by educating the young girl in the years before she enters the marriage state ‘in the principles of mothercraft and the hygiene of pregnancy that she will be able to understand the facilities provided for securing the health of herself and her baby.
“The total deaths amounted to 234, including 52 deaths of residents dying outside the district and excluding g non-residents who died in the district. They consisted of 133 males and 101 females. The death-rate last year for England and Wales was 12.3 per 1000. The death-rate in the urban district of Wombwell was 11.3 per 1000- 1.5 higher than last year, but 1.6 less than the average for the last ten years.
“Density of population is an important factor in the causation of death—indeed it has been shown by several of our statisticians that there is a definite relationship between density and mortality which can the expressed in actual figures.
The Weather Factor
“In 1926 we had a sunny, comparatively dry summer, with an atmosphere from March to December purer than we had ever had.. Respiratory diseases contributed to the death-rate more than any other group. They are preventable, and chiefly attack those who live in small, ill-ventilated, overcrowded houses.
Heart Troubles.
“Organic heart disease continues to take a heavy toll of life. In the majority of instances it accompanies or follows an attack of acute rheumatism. Why the rheumatic infection should select the heart as its object of attack is not clear, but that it does so in almost every case where the disease exists in acute form is well authenticated. The cause of rheumatism itself is doubtful, but the consensus of opinion is that it is due to a specific germ which gains access to the body either by way of the alimentary canal or the mucous membranes of the nose and throat. In whatever way it enters, once established, it gives rise to symptoms chiefly resembling those which accompany other acute infections. Rheumatism should therefore be regarded as an infectious condition especially during the acute stage, and persons predisposed to the disease -should keep at a safe distance Climatic conditions are often blamed for causing rheumatism, and though they are undoubtedly an exciting factor, especially in sub-acute and chronic cases, they do not furnish a complete explanation of the disease in its acute form.
CANCER.
“The incidence of cancer continues to, increase. In 1927, six more, cases died of the disease than in the previous year (17 as against 11).
This of itself would be disquieting enough, but when one considers that the increase was more marked among persons living at the age group 25 to 45 than in the older age groups with which the disease is usually associated (45 to 65 and upwards), one’s anxiety for the future is grealy enhanced: In the absence of definite knowledge regarding the causation of the disease, it is useless to explain the increase —one must be content merely to record the fact. But one lesson it does teach, and that is the necessity for more intensive research at all the large centres of medical education in the country, in order that the source of the disease may be revealed, and effective measures taken to combat it in the early stages. In this the public have a part to play, by providing the funds necessary to enable this research to be carried on. After all it is their battle, and they must provide the munitions of war.
Disinfector Wanted.
“No facilities are available in the area for the cleansing and disinfection of verminous persons and their belongings. Baths arc. available at the Public baths, but we are very much needing a steam disinfector. The only reliable method of disinfecting clothes and budding is by “steam,” and I have advocated a disinfector strongly for several years, knowing full well that it would tend to a less incidence of infectious disease in the district. From a financial point of view we have only to look back to the recent epidemic of smallpox when we had to send the clothes and bedding of some 74 cases to, the Barnsley steam disinfector, at approximately- £1 per case. Nearly £74 spent and, no apparatus or share of an apparatus -to show for it. It is to be hoped your authority will allow for a distinfector in your next estimate.
Of the data relating to infectious diseases that dealing with smallpox is perhaps most interesting.The figures show. how thoroughly and systematically the scourge was tackled in Wombwell. The outbreak started in April, with 39 cases. In the succeeding months there were 7, 4, 12, 6, 3, and 3 cases respectively, while in the last two months of the year no case was reported.
Smallpox.
Dr. Pickup says: “There was a serious epidemic of smallpox during the year, and although all the cases were mild, yet it caused a lot of unnecessary suffering (on account of the lack of protection against the disease on the part of a large proportion of the inhabitants) and a substantial burden on the funds of the Council. Had prompt and persistent measures not been taken to stamp it out, one quakes to think with what amount the Council might have been saddled. .
“I should like once more to remind .the public of the risks they run both as individuals and as a community by persisting in their negative attitude towards vaccination. Wombwell, at the present time, may be said “to be an. unprotected district, the greater proportion of the younger people being unvaccinated. In this respect it is probably no worse, than any other part of the country., -but sooner or later .it may be called upon to face an outbreak of virulent form, when things will certainly go hard with the population, particularly the children.
“Eighty-two oases of scarlet fever were notified during the year, against 117 in 1926 and 180 in 1995. Cancer is extending its influences to the younger ago groups.