Infant welfare in Amsterdam
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6 PUBLIC and circulatory diseases and the epidemic of induenza during the abnormally severe weather in the months of February and March. The death-rate for the March quarter rose to 20.9, or no less than 5-8 per 1,000 above the average for the first quarter of the eight preceding years, while the rate for the remainder of the year was slightly below the corresponding average for the same period. The deaths of infants under one year of age were equal to a rate of 74 per 1,000 live births, or nine per 1,000 above that recorded during 1928. Here again the excess was due to the high mortality during the March quarter. With the exception of the pandemic of 1918-19, the epidemic of influenza was the most severe experienced in this country since the disease reappeared in 18.90-91, the mortality being equal to 734 per million living against 196 in 1928. The mortality from respiratory diseases rose from 1,507 in 1928 to 2,104 per million, but the latter figure had been exceeded in 1920, 1922 and 1924. The mortality from circulatory diseases reached the record figure of 3,030 per million, due largely to the deaths of elderly persons during the cold weather of the first quarter of the year. The death-rate from cancer was 1,437 per million living, against 1,425 for the previous year, thus continuing the steady though slight increase over all recent years, and being the highest crude rate recorded. The increase affected both sexes, but was rather greater for females than for males. The mortality of women from puerperal sepsis and accidents of pregnancy and child- birth was 4.33 per 1,000 live births, compared with 4.42 in the previous year: the improve- ment was not in respect of puerperal sepsis, which increased slightly, i.e., from 1"79 to 1.80, but in " other accidents of pregnancy and child- birth," which improved from 2.63 to 2"53. Although lower than that in 1928, the com- bined rate is still above the experience of the seven years, 1921-27. The rate for suicide, which had declined in 1928, showed in 1929 a rise to 126 per million, the highest figure on record, the rate for females (73) being the highest on record, and for males (18.3), only one per million less than the male record in 1927. Deaths returned by H.M. Coroners as result- ing from accidental injury by mechanical vehicles on roads increased from 4,492 in 1927, to 5,251 in 1928, and 5,799 in 1929. Exclusive of collisions between two different types of HEALTH. OcTOBeR, vehicles, the deaths caused by motor-cars increased from 1,550 to 1,660, and those by motor-cycles from 1,043 to 1,162, while in respect of motor vails, lorries, etc., the figures rose from 938 to 1,162. * . * * .x- Infant Welfare in Amsterdam. F EW critics will deny the educational power and value of infant welfare; and it was largely because this work serves as a means to raise the cultural level of the popu- lation that the project was taken over in 1920 by the town council in Amsterdam. In his foreword, Dr. L. Heijermans, Director of the Municipal Health Service, points out that it is, indeed, striking to notice the educating influence which emanates from infant welfare; and the very good results which have already been obtained make a pleasing obiect lesson. This is more particularly praiseworthy because it has never been the practice to entice mothers by promising premiums or giving food pre- parations, although the allowance of milk to nursing mothers in certain cases is permitted. That half of the mothers in Amsterdam make full use of the infant welfare organisation is due entirely to the confidence which this division has created for itself. A review (in English)* is given of the work done for children who were born in the years 1922-1926 inclusive; there are now some seventy-two consultations held weekly, a fact which indicates the steady expansion, still proceeding, from the early voluntary start in 1903. The organisation includes a whole- time chief of this division, with a number of part-time infant welfare doctors, full-time infant welfare nurses, municipal midwives and social nurses, regular, meetings of the staff being held to discuss points connected with the work. Approximately half the children born in the municipality attend the welfare centres, and this figure is increasing, while there is an admirable increase in the average time during which each child remains under the control and influence of the centre. The number of children who were only taken once has sharply fallen to a very low level. On the whole, almost three-fifths of all the welfare children are fully breast-fed for at least three months; one-fifth are mixed-fed and one-fifth are artificially fed or the method is not known. * FIVE YEARS OF MUNICIPALINFANTWELFARE, 1922- 1926. Municipal Health Service of Amsterdam (Medi- cal Statistical Department). Amsterdam: H. J. Paris, 1929. pp. 29. Price ls. net.
Transcript of Infant welfare in Amsterdam
6 PUBLIC
and circulatory diseases and the epidemic of induenza during the abnormally severe weather in the months of February and March. The death-rate for the March quarter rose to 20.9, or no less than 5-8 per 1,000 above the average for the first quarter of the eight preceding years, while the rate for the remainder of the year was slightly below the corresponding average for the same period.
The deaths of infants under one year of age were equal to a rate of 74 per 1,000 live births, or nine per 1,000 above that recorded during 1928. Here again the excess was due to the high mortality during the March quarter.
With the exception of the pandemic of 1918-19, the epidemic of influenza was the most severe experienced in this country since the disease reappeared in 18.90-91, the mortality being equal to 734 per million living against 196 in 1928. The mortality from respiratory diseases rose from 1,507 in 1928 to 2,104 per million, but the latter figure had been exceeded in 1920, 1922 and 1924. The mortality from circulatory diseases reached the record figure of 3,030 per million, due largely to the deaths of elderly persons during the cold weather of the first quarter of the year.
The death-rate from cancer was 1,437 per million living, against 1,425 for the previous year, thus continuing the steady though slight increase over all recent years, and being the highest crude rate recorded. The increase affected both sexes, but was rather greater for females than for males.
The mortality of women from puerperal sepsis and accidents of pregnancy and child- birth was 4.33 per 1,000 live births, compared with 4.42 in the previous year: the improve- ment was not in respect of puerperal sepsis, which increased slightly, i.e., from 1"79 to 1.80, but in " other accidents of pregnancy and child- birth," which improved from 2.63 to 2"53. Although lower than that in 1928, the com- bined rate is still above the experience of the seven years, 1921-27.
The rate for suicide, which had declined in 1928, showed in 1929 a rise to 126 per million, the highest figure on record, the rate for females (73) being the highest on record, and for males (18.3), only one per million less than the male record in 1927.
Deaths returned by H.M. Coroners as result- ing from accidental injury by mechanical vehicles on roads increased from 4,492 in 1927, to 5,251 in 1928, and 5,799 in 1929. Exclusive of collisions between two different types of
HEALTH. OcTOBeR,
vehicles, the deaths caused by motor-cars increased from 1,550 to 1,660, and those by motor-cycles from 1,043 to 1,162, while in respect of motor vails, lorries, etc., the figures rose from 938 to 1,162.
* . * * .x-
Infant Welfare in Amsterdam.
F E W critics will deny the educational power and value of infant welfare; and
it was largely because this work serves as a means to raise the cultural level of the popu- lation that the project was taken over in 1920 by the town council in Amsterdam. In his foreword, Dr. L. Heijermans, Director of the Municipal Health Service, points out that it is, indeed, striking to notice the educating influence which emanates from infant welfare; and the very good results which have already been obtained make a pleasing obiect lesson. This is more particularly praiseworthy because it has never been the practice to entice mothers by promising premiums or giving food pre- parations, although the allowance of milk to nursing mothers in certain cases is permitted. That half of the mothers in Amsterdam make full use of the infant welfare organisation is due entirely to the confidence which this division has created for itself.
A review (in English)* is given of the work done for children who were born in the years 1922-1926 inclusive; there are now some seventy-two consultations held weekly, a fact which indicates the steady expansion, still proceeding, from the early voluntary start in 1903. The organisation includes a whole- time chief of this division, with a number of part-time infant welfare doctors, full-time infant welfare nurses, municipal midwives and social nurses, regular, meetings of the staff being held to discuss points connected with the work. Approximately half the children born in the municipality attend the welfare centres, and this figure is increasing, while there is an admirable increase in the average time during which each child remains under the control and influence of the centre. The number of children who were only taken once has sharply fallen to a very low level. On the whole, almost three-fifths of all the welfare children are fully breast-fed for at least three months; one-fifth are mixed-fed and one-fifth are artificially fed or the method is not known.
* FIVE YEARS OF MUNICIPAL INFANT WELFARE, 1922- 1926. Municipal Health Service of Amsterdam (Medi- cal Statistical Department). Amsterdam: H. J. Paris, 1929. pp. 29. Price ls. net.
1930. PUBLIC
The infant mortality shows a steady satis- factory decline, but it is evident how heavily the mortality in early infancy governs the whole rate. The deaths in the first few days have been reduced, and tfiis decline may be accentuated when the influence of ante-natal work reaches a fuller measure.
The statistical work was undertaken by Dr. C. J. Brenkman, Leader of the Medical Statistical Department, and the general review of a five-year period is most valuable when it is laid open and bare by the sober and reasoned judgment of the statistician. It gives those in authority the chance to check their bearings, correct if necessary their course, and progress through the next five years to even richer and more fruitful lands to be conquered.
Obituary.
W ' E record with great regret the death on August 25th of Dr. John Thomson
Wilson, formerly medical officer of health for the county of Lanark. Dr. Wilson was a native of Cambuslang, and graduated at Aber- deen University in 1891. He first assisted Professor H a y in Aberdeen, and afterwards was assistant to the medical officer of health of Shropshire. He was appointed as medical officer of health for the county of Lanark in 1894, and in subsequent years, prior to his retirement, initiated tIae big hospital and sana- toria schemes for which Lanarkshire is noted. In 1910, at the request of the Scottish Local Government Board, he prepared an exhaustive report on the housing of miners in Lanark- shire. The report, which embraced a mass of details, showing with exactitude how 55,000 miners and tfieir families were housed in the county, laid the foundation for the big im- provement that was latterly effected in the miners' l~ousing and environment in Lanark- shire. Dr. Wilson was a past president of the Scottish Branch of the Society of Medical Offi- cers of Health, and of the Incorporated Sani- tary Association of Scotland. He was examiner in public health for the University of Aberdeen, and for the University of Edin- burgh. On the occasion of his retirement he was presented with a substantial testimonial from the members and officials of Lanark county council. Dr. Wilson is survived bv his wife.
The Society also mourns the loss of Dr. Rowan McCombe, Medical Officer of Health
HEALTH. r
of Margate for the past sixteen years, who died on September l l th , after an illness of three weeks' duration, tn addition to holding that appointment he was also school medical officer and police surgeon. Formerly engaged in general practice in the town, he was a member of the honorary staff of the Cottage Hospital, and succeeded the late Dr. Bertram Thornton as medical officer of health in January, 1914, being the first whole-time official. Dr. McCombe, who was in his sixtieth year, studied for the medical profession in Dublin, and was a F .R .C.S . I . , and also held the D . P . H . of the Irish Royal Colleges. He possessed a kindly disposition and was highly respected in the borongh, taking a keen interest in his duties, particularly those con- nected with his work as school medical officer and medical officer of the maternity and child welfare centre. He will be much missed by teachers and parents, while the town council have lost a conscientious officer. Dr. McCombe leaves a widow and two children.
DR. RICHARD TOLEMAN has been appointed Assistant Medical Officer o,f Health and School Medical Officer for Bristol at a commencing salary of £600 per annum.
DR. C. METCALFE BROWN, Assistant County Medical Officer, w h o is leaving the service of the Leicestershire County Council to take up the appointment of Tuberculosis Officer at Kingston-upon-Hull , was, on September 5th, presented with a morning tea set, fruit dish, and ash tray, by Dr. Fairer, County Medical Officer, on behalf of the medical, dental, health visiting and clerical staff of the county health department.
THE Harben Lectures will be delivered in the Lecture Hall of the Royal Institute of Public Health, 37, Russell Square, London, W.C.1, by Professor William H. Park, M.D., LL.D., D.SC., Director of the Bureau of Labora- tories, Health Department, New York City, on " Pneumonia," as follows : Lecture I, October 6th, 4 p.m., " The Types of Pneumococci in Adults and Children and Their Significance." Lecture II, October 7th, 4 p.m., " The Epi- demiology. The Refining of Antipneumococcus Serum." Lecture l I I , October 8th, 4 p.m., " The Therapeutic Use of Vaccines and Anti- bacterial Sera." No ticket of admission is required.
