[Report 1929] / Medical Officer of Health and School Medical Officer of Health, Swindon Borough.

  • Swindon Borough Council
Date:
1929
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1929] / Medical Officer of Health and School Medical Officer of Health, Swindon Borough. Source: Wellcome Collection.

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    late. They will be dealt with in the earty part of 1930. From Table II B. it would appear that there is an increase of children routine-inspected found to require medical treatment and that this is specially so in the ‘ entrants ’ of whom 26% are reported as requiring attention. This table is, however, utterly misleading, as it draws no distinction between conditions which are of little significance and those which are grave. The percentage of children which are referred for treatment depends more upon the facilities available for treatment and upon the standard of efficiency aimed at, than upon the actual conditions present and the urgency for their relief. We shall gain a better insight into the prevalence of disease and defect in school children from the treatment tables, for practically all children who require treatment obtain it either from or through the school medical department. We find from the minor ailment statistics that 1526 children were treated in this department. All of these would be considered as children found to require treatment at routine inspection, but their ail¬ ments were, with few exceptions, temporary and trivial. It is indeed extremely difficult to form an idea of the health of the school child without considering the work of the school medical depart¬ ment as a whole. The tables of exceptional children tell us the numbers of those so seriously and permanently crippled as to be practically useless as citizens. The number of these is fortunately not great, though the number of mentally defectives, namely 71, is disquieting and it is certainly an under-estimate. Another and more formidable difficulty in comparing the health of one child population with another, is the wide variation in the standard adopted by different observers, for the slightest tightening or slackening of standard may cause differences which swamp everything which is real. As extreme examples of this may be given cases of suspected tuberculosis of the lungs, disease of the heart, rickets and rheumatism. To take the first, the writer of this report only suspected tuberculosis of the lungs in six children out of 150,000 ; whereas another observer in a contiguous district reported over 10% of the children as having doubtful tuberculosis of the lung. Much the same wide differences occur in the other conditions mentioned. As a consequence of this, the change of one school medical inspector may make the returns of one year incomparable with those of another. Differences in fashion also introduce discrepancies. For instance, if certain small nodules which occur about the elbow are looked upon as evidence of rheu¬ matism, the percentage of children with rheumatism is increased twenty-fold, and if certain other signs be considered as evidence of rickets, the proportion of Swindon children with rickets rises immediately from about one in three hundred to fifty per cent ! In the present state of our knowledge it is impossible to overcome the difficulties introduced by variations of standard, though where
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