What is Malnutrition

By Lt. –Col. FREDERIC HARVEY, R.A.M.C. (Ret), M. R. C. S., L. R. C. P., L. M. S. S. A., D.P.H., D. T. M. & H., etc., Barrister-at-Law, Fellow Incorporated Society Medical Officers of Health and late A. D. M. S. H. M. Forces

            Malnutrition is not merely an affair of the insufficiency of certain protective and other food stuffs. Although these play a large part, malnutrition is a complex of factors. There is, for example, the lack of calcium and other minerals, owing to a hyper-soft water supply, or the lack of iodine, which is generally present at the seaside ; or the lack of sunshine, the presence of excessive fog from factory chimneys, a surplus of rain, cold and damp. In other cases factors in malnutrition are the lack of open download, or of generous open building spaces. Or there may be a deficiency of freshly grown and sold local agricultural products, drab treeless streets, slum standard homes, a poor heredity, the absence of gardens, and the mentally and socially depressing influences of continued employment.

It is the sum total of all these things that spells malnutrition in the mass, and produces the startling differences in the health, disease, life and death rates between a depressed Northern industrial town and a South Coast seaside health resort.

The “stumpy northerner” idiom is merely a synonym for curved and slightly shortened long bones, producing that reduction of stature so noticeable in many of the industrial areas of the North. In other words –rickets of bones and tissues, though not of the disposition, which is most often unusually generous and lion-hearted.

The remedies are obvious, and include a measure of emigration, modern electrically powered factories (and homes), industrial garden cities, ample holidays at the country and seaside, increased employment, higher wages, physical culture collated with education as to simple food values. The right agricultural products in plenty, including fish and milk, and panel medicines, and more available skilled preventive treatment, commencing, above all, with the paternal mother.

These things are dependent on scientific knowledge time, money and public opinion. The facts are all known, tabulated, recognized and labeled as economic problems!.”

The only real problem is how to obtain them kindly enough. Vast progress has, and is being made, but is it sufficiently fast to save the undermining of our gloriously free democracy by that political impatience, which, if it once flames forth, may pitiably throw back the clock of our civilization for many and many decades?

Some striking comparisons are tabulated below.

A WELL-KNOWN HEALTH RESORT ON THE SOUTH COAST.

Sunshine, sea air, spaces, open downloads. Fresh fruit, vegetables, milk, meat, fish, etc., locally produced.

“Rickets nil,” and no adult cases seen. Measles and whooping cough –“The borough was comparatively free from serious cases ; no deaths.”

OFFICIAL FIGURES FOR 1935

Population (approximate) ……………………………….      57,000

Rateable value ……………………………………………………      £864,430

Birth rate (per 1,000) ………………………………………      10.59

Death rate (per 1,000) ……………………………………..      12.78

Owing to immigrants and elderly invalids, an older population, so that when corrected by the Registrar-General for age ………………………….. 10.22

Infantile mortality (per 1,000) ……………………….      33.6

Maternal mortality (per 1,000) ………………………      0

No. of Cases                        Deaths

Scarlet fever ……………………………             30                   0

Diphtheria ………………………………             20                   0

Totals …………………………….             50                   0

 

NEW CASES, 1935.

Tuberculosis (pulmonary and non pulmonary) ………………      63

Deaths ……………………………………………………………………………………..       28

These numbers are artificially loaded with a constant immigration of invalieds with chest complaints who come, stay, and die.

*NUTRITION OF SCHOOL CHILDREN.

Slightly under-nourished (per cent)                        13.7

Definite malnutrition  (per cent)                   2.97

A DEPRESSED URBAN DISTRICT IN THE CENTER OF THE COTTON INDUSTRY.

Fog, smoke, cold, damp, factories, unemployment, slum dwellings, cheap foods, stale vegetable produce, poor milk, fish and chips, tins, etc.

“Prevalent and asthma, rheumatism, rickets, bronchitis and pneumonia. Acute adult rickets is so common as to excite little or no comment. Measles and whooping cough, serious epidemics, and several deaths.”

OFFICIAL FIGURES FOR 1935.

            Population ……………………………………………………………..  28,000

Rateable value (relatively much poorer) ……….     £143,793

Birth (per 1,000) ……………………………………………….     11.4

Death rate (per 1,000) ………………………………………     13.6

(A difference of, say, 3 in 50,000 population =150 deaths.) Everyone who can emigrates, and population is declining.

Infantile mortality (per 1,000) ………….         63

Maternal mortality (per 1,000) ………..          14.74

No. of Cases.           Deaths.

Scarlet fever ……………………          106                1

Diphtheria ………………………          39                   4        

Totals …………………….          145                5

 

NEW CASES, 1935.

            Tuberculosis (pulmonary and non-pulmonary) ……….  37

Deaths ……………………………………………………………………………….  11

Everyone who can, with chest complaints, etc., emigrates.

*NUTRITION OF SCHOOL CHILDREN.

Slightly under-nourished (per cent)                        18.22

Definite malnutrition(per cent) …………        3.23

___________________

*This evaluation depends on the personal factor of the medical. But all the other figures are facts! They speak from themselves. If only the practical sympathy of the more fortunately placed areas could be enlisted on behalf of these others, things might be speeded up a bit.

New Health.