Domestic Food Consumption and Expenditure, 1950, with a Supplement on Food Expenditure by Urban Working Class Households, 1940–49

i6o " kitty " and with an established technique for continuing and expanding the process. May I just finish on a personal note ? ProL Frazer has b e e n k i n d n g s s i t s e l f to m e as a c o l l e a g u e . H e is a m a n for whose integrity, knowledge and personality I have the h i g h e s t r e s p e c t . I a m p r o u d to h a v e h a d t h e o p p o r t u n i t y o f w o r k i n g w i t h h i m d u r i n g t h e last f o u r a n d a h a l f y e a r s a n d it is w i t h t h e u t m o s t s i n c e r i t y t h a t I w i s h h i m t h e v e r y best of good things in his well-earned retirement. DiscussiON T h e President ( D r . K. K . W o o d ) asked Dr. B r a d b u r y if he had a n y suggestions to offer regarding t h e keeping of a green belt r o u n d a small authority. Prof. Frazer t h o u g h t it was a good t h i n g to have a young, fresh architect f r o m time to time a n d h e h a d b e e n fortunate in h a v i n g t h e o p p o r t u n i t y of co-operating with s u c h a m a n as Dr. B r a d b u r y . W h e n he took u p duties in Liverpool in 1981 he was faced with the two p r o b l e m s of hospital re-organisation a n d s l u m clearance. U p to 1939 h e inspected personally about 14,000 h o u s e s a n d h a d h o p e d he would have t h e h o n o u r of c o m p l e t i n g s l u m clearance in Liverpool, a privilege w h i c h h a d b e e n denied h i m by t h e outbreak of war. H e h a d h a d t r e m e n d o u s assistance f r o m Dr. B r a d b u r y in t h e post-war years, particularly on t h e subject of t h e a c c o m m o d a t i o n of old people, and a n e w h o m e was to be o p e n e d in Liverpool in J u n e . Dr. Bex~r s u g g e s t e d that t h e p r o b l e m in a small authority 9 s u c h as Wallasey was different a n d really difficult i n a s m u c h as so m a n y of t h e cleared sites were too small to p e r m i t any largescale u s e of t h e m . D r . Metcalfe B r o w n t h o u g h t that despite t h e difficulties of land, labour a n d t h e like, h o u s i n g was a fundamental p r o b l e m a n d m u s t be cleaned up. H e m e n t i o n e d specifically t h e p r o b l e m of trying to do s o m e t h i n g a b o u t houses that were falling down, a p r o b l e m that was giving anxiety in M a n chester, a n d referred to the difficulties of s u b - s t a n d a r d families a n d s u b - s t a n d a r d houses. Dr. B u r n e t t developed this point by referring to the pre-war conditions w h e n a n a b u n d a n c e of h o u s i n g enabled families on t h e u p g r a d e to m o v e to better housing, whilst those o n the d o w n grade m o v e d into poorer property, whereas to-dayl with h o u s e r o o m being in s u c h s h o r t supply, t h e s u b - s t a n d a r d families t e n d e d to be evicted a n d h a d n o alternative a c c o m m o d a t i o n to t u r n to other t h a n t e m p o r a r y a c c o m m o d a t i o n provided u n d e r the welfare services. H e considered that it was impossible to apply effective m e a s u r e s of rehabilitation to p r o b l e m families w h e n these families so frequently lacked a h o m e of their o w n a n d felt that it was essential that local authorities s h o u l d have a n adequate supply at t h e p r e s e n t time of s u b - s t a n d a r d houses that could be utilised for t h e difficult cases that were u n s u i t e d to t h e m o d e r n council house. H e e n q u i r e d f r o m Dr. B r a d b u r y h o w Liverpool tackled such a problem. I n reply, Dr. B r a d b u r y suggested that a green belt s h o u l d never be allowed to b e c o m e a green corset a n d that the conflict b e t w e e n agriculture a n d h o u s i n g o u g h t to be resolved quickly. l i e agreed with Dr. Berry that there were difficulties about t h e d e v e l o p m e n t of very small cleared sites, b u t nevertheless in Liverpool they h a d a d o p t e d the policy of in_filling with wide fronted n a r r o w d e p t h cottages, often w i t h o u t a garden, a n d there was a persistent d e m a n d for this a c c o m m o d a t i o n . In Liverpool there were, of course, m a n y p r o b l e m families and this was a very difficult issue, b u t fortunately t h e Liverpool Corporation possessed s o m e 2,700 old properties built before the first world war a n d these were u s e d for this purpose, t h o u g h even this was n o t nearly e n o u g h to m e e t t h e city's difficulties. Dr. Gawne, in felicitous vein, expressed on behalf of t h e m e e t i n g his very great pleasure at being able to t h a n k Dr. B r a d b u r y for the very stimulating address to w h i c h we h a d j u s t listened. H e k n e w personally Dr. B r a d b u r y ' s sterling qualities a n d was pleased to say that there was the happiest a n d closest liaison b e t w e e n t h e speaker a n d h i m s e l f over the p r o b l e m s of overspill h o u s i n g d e v e l o p m e n t in the adjacent c o u n t y areas. He was h a p p y indeed, as a Liverpool m a n , to congratulate Dr. B r a d b u r y on the work he was doing for that city.

T h e a p p o i n t m e n t s of Q u e e n ' s H o n o r a r y Physicians recently a p p r o v e d by H e r M a j e s t y include t h o s e of t h r e e Fellows of t h e Society, n a m e l y , D r . G . E. G o d b e r , D e p u t y C h i e f Medical Officer, M i n i s t r y of H e a l t h ; D r . E. K . Macdonald, Medical Officer of Health a n d School Medical Officer, City of L e i c e s t e r ; and D r . R. J. Peters, D e p u t y C h i e f Medical Officer, D e p a r t m e n t of Health for Scotland. W e congratulate all three on this wellm e r i t e d distinction.

PUBLIC HEALTH,

JuLy,

I953

BOOK REVIEWS D o m e s t i c F o o d C o n s u m p t i o n a n d Expenditure, t9So j w i t h a S u p p l e m e n t on F o o d E x p e n d i t u r e by Urban W o r k i n g Class H o u s e h o l d s , x94o-49. R e p o r t b y t h e National F o o d Survey Committee. (Pp. 131. Price 4s. 6d.) L o n d o n : H . M . S . O . 1952. T h e National F o o d S u r v e y C o m m i t t e e , w h i c h began its operations for t h e M i n i s t r y of F o o d in 1940, has issued its second report, for t h e year 1950, following u p o n t h e first report, covering the years 1940-1949, w h i c h appeared in 1951. T h e c o m m i t t e e u n d e r the c h a i r m a n s h i p of N o r m a n C. W r i g h t h a s included a m o n g its m e m b e r s Sir Jack D r u m m o n d , Dr. H . G. Magee, Miss I. Leitch (Director of the C o m m o n w e a l t h B u r e a u of A n i m a l Nutrition) a n d Professor E. F. N a s h of the D e p a r t m e n t of Agricultural Economics, University College of Wales. T h e tragic d e a t h of Sir Jack D r u m m o n d occurred after the completion of t h e second report. T h e work of the survey c o m m i t t e e for t h e first nine years was chiefly concerned with working class h o u s e h o l d s in the m a i n u r b a n areas of Great Britain a n d t h e " sample h o u s e h o l d s " were visited m o n t h l y . T h e national food survey was w i d e n e d out in 1950 to include all social classes a n d both u r b a n a n d rural areas a n d visits to t h e samples have been reduced to two each quarter with a quarterly analysis. T h e classification of social class is by p r i m a r y income A~s a week or o v e r ; B - s 1 6 3 a week; C s 10s.-s a week, a n d D = l e s s t h a n s 10s. T h e grading so acbieved is closely related to occupation, indeed in s o m e instances i n c o m e has been obtained or inferred direct f r o m occupation. R o u g h l y Class A is R e g i s t r a r - G e n e r a l ' s Class I ; B is RegistrarG e n e r a l ' s Class II ; C, R e g i s t r a r - G e n e r a l ' s Classes I I I a n d IV, a n d D R e g i s t r a r - G e n e r a l ' s Class V. Several social stratifications, for the p u r p o s e s of particular social s u r v e y s in Britain, have been devised, as for example that of the Population Investigation C o m mittee a n d the M e r s e y s i d e Survey. T h e s e in general resemble that of t h e R e g i s t r a r - G e n e r a l in being based upon a prestige estimation of occupation 9 I n the c i r c u m s t a n c e s it is to be regretted that t h e National F o o d Survey C o m m i t t e e did n o t adopt the Registr a r - G e n e r a l ' s stratification. T h i s w o u l d have helped to relate t h e findings to m o r b i d i t y and mortality studies 9 I n 1950 4,723 h o u s e h o l d s were included in the sample (3,837 u r b a n a n d 886 rural ; of!the u r b a n h o u s e h o l d s all b u t 503 were " working class "). 152 ( 3 % ) were in Class A ; 603 (13%) in Class B ; 2,733 (58%) in Class C a n d 1,254 (35%) in Class D ; of t h e Class D h o u s e h o l d s 9 % were those of old age pensioners. In each h o u s e h o l d surveyed the housewife was asked to keep a record for one week of all food p u r c h a s e d for t h e family a n d of all food f r o m garden a n d allotments a n d otherwise obtained w i t h o u t actual cash p a y m e n t . She recorded a b r i e f description of each meal served a n d listed any meals t a k e n outside by any m e m b e r ; age, sex, occupation and visitors were also recorded. Visits by specially trained w o m e n investigators (employed by an i n d e p e n d e n t firm of market research) preceded by introductory letters were m a d e to explain t h e u s e of t h e log book recording for weight a n d cost of food. D u r i n g the week of t h e s u r v e y at least two visits were m a d e to e n s u r e that t h e housewife was keeping correct records and food stocks were w e i g h e d immediately before and after the survey week. T h i s survey s h o w s that t h e 1950 diet declined in value (as an a n n u a l average) f r o m 21s. 4d. in Class A to 15s. 3d. in Class D (21s. 4d., 18s. 6d., 16s. 2d., 15s. 3.). A comparison of expenditure on individual foods s h o w e d that milk declined from 6.3 pints in Class A, 5.4 in Class B, 4.7 in Class C to 4.4 in Class D, with an average for all h o u s e h o l d s of 4.4 p i n t s ; shell eggs declined f r o m 4.2 via 3.9, 3.4 to 3.0 with an all h o u s e h o l d average of 3.1. Clearly Classes A a n d B c o n s u m e substantially m o r e milk a n d eggs t h a n the other classes. In contrast c o n s u m p t i o n of meat and fats varied little whereas that of potatoes a n d bread was m u c h higher in Class D (together 117.0 oz. in Class D, 95.7 oz. in Class A) a n d that of fresh green vegetables a n d fruit m u c h lower (expenditure together 12s. 5d. in class D a n d 27s. 0d. in Class A). T h e h o u s e h o l d diet for 1950, with m a n y a n d proper reservations, has been c o m p a r e d with that of pre-war days. T h e broad c o m parison p r e s e n t e d by the 1950 National F o o d S u r v e y with that of Crawford a n d Broadley (1936/1937) is as follows : Average food expenditure has risen f r o m 8s. ll 89 per week to 14s. 689 All classes s p e n t m o r e in 1950 on fresh milk, m a r g a r i n e and fresh fruit a n d slightly m o r e on potatoes, bread a n d flour. T h e difference between classes h a d narrowed considerably (10s. 10d. prewar falling to 4s. l d . in 1950). T h e report says " this substantial reduction in social class differences was achieved largely by t h e levelling up of expenditure on the part of the lower class." Class D s p e n t m o r e a n d Class A probably less on eggs, butter, fresh meat and fresh vegetables. In particular Class A s p e n t three times as m u c h as Class D prewar on eggs, butter and fresh meat, whereas (largely

PUBLIC HEALTH,

z6z

JULY, 1953

no d o u b t on account of rationing) 1950 figures showed little difference. T h e class differences for milk, fresh vegetables a n d fruit, a l t h o u g h still appreciable in 1950, were m u c h less t h a n before the war. In t e r m s of adequacy of the diet as m e a s u r e d b y t h e B . A . M . ' s r e c o m m e n d a t i o n s the report says t h a t " d u r i n g t h e s u r v e y period in 1950 all h o u s e h o l d s except those of Class D reached t h e standard for all nutrients. T h e whole of class D was below the s t a n d a r d for calories a n d old age pensioners' h o u s e h o l d s were also below for iron." T h e greatest significance s h o u l d be attached to variations in e x p e n d i t u r e on foods of h i g h protective value in h o u s e h o l d s c o n t a i n i n g varying n u m b e r s of children. Prewar surveys, e.g. that in W e s t Sussex (Brockington, ffournat of Hygiene (1938) 40), s h o w e d a m a r k e d decline in e x p e n d i t u r e o n animal protein foods in working class h o u s e h o l d s as the n u m b e r of children in the family increased. S u b s e q u e n t surveys (e.g. in Salford a n d W e s t Riding of Yorkshire d u r i n g W o r l d W a r II) s h o w e d that this adverse circ u m s t a n c e h a d been m u c h reduced. T h e National Food Survey findings for 1950 are u n f o r t u n a t e l y n o t conclusive on this point since averages are given for all social classes together a n d the average figures do n o t allow any precise c o m p a r i s o n for working class families with varying n u m b e r s of children. T h u s , of the h o u s e h o l d s with one adult male a n d one adult female, those with no children contain 1 7 % of classes A a n d B, those with one child 21%, those with three children 1 6 % a n d those with four or m o r e children 8 0 . W i t h this in m i n d t h e r e is a m a r k e d difference for fresh milk, eggs, meat a n d fresh green vegetables and fruit. Milk declined f r o m 5.5 pints a week in childless couple families to 4.3 pints in families with four or m o r e children ; shell eggs f r o m 4.0 to 2.7 ; fresh rationed m e a t f r o m 17.3 oz. to 10.1 oz. In contrast butter, m a r g a r i n e a n d cooking fat together declined f r o m 12.9 to 10.5"oz., potatoes from 64.9 oz., to 59.3 oz., bread f r o m 58.5 oz. to 53.9 oz. I n t e r m s of expenditure t h e average weekly expenditure on food per head fell f r o m 18s. 2d. in childless couple families (excluding old age pensioner households) to l l s . 3d. where there were four or m o r e children u n d e r 14 years. T h e average expenditure rose with t h e presence of adolescent children to 17s. 7d. (with adolescents only) a n d 13s. l l d . with adolescents a n d children. A l t h o u g h the h o u s e h o l d s with four or m o r e children h a d the benefit of cheap milk their weekly c o n s u m p t i o n per head over t h e year was still less t h a n that of the childless h o u s e h o l d by as m u c h as 1.2 pints per head per week ; d u r i n g J u l y a n d A u g u s t t h e difference was 1.7 pints per head per week. O v e r the year childless h o u s e holds c o n s u m e d an average of 1.2 m o r e eggs per head per week a n d d u r i n g t h e flush season childless h o u s e h o l d s c o n s u m e d 2.4 m o r e eggs p e r head per week t h a n those w i t h four or m o r e children. T h e 1950 survey has converted weight a n d e x p e n d i t u r e figures into an estimate of essential n u t r i e n t s c o n s u m e d . In order that a c o m p a r i s o n can be m a d e with the B . M . A . (1950) r e c o m m e n d a t i o n s allowances have been m a d e for spoilage a n d wasteage, age a n d sex, a weighting included for meals taken away f r o m h o m e a n d an arbitrary allowance m a d e for work a n d activity. T h e following table gives a c o m p a r i s o n of t h e average n u t r i e n t value of t h e diet o f childless couple h o u s e h o l d s a n d t h o s e w i t h four or m o r e children (without adolescents) : -

Nutrients E n e r g y Value (cal) .. Protein (g.) . . A n i m a l Protein (g-i Fat (g.) .. C a l c i u m (mg.i -. Iron (rag.) . . . . V i t a m i n A (i.u.) .. V i t a m i n B (mg.) .. Riboflavin (rag.) Nicotinic Acid (mg.i Vitamin C (mg.) .. Vitamin D (i.u.) ..

Families with more Childless Households than three children 2,804 91 47 118 1,212 15.9 3,949 1.17 2.17 15.4 102 167

2,168 65 30 86 959 11.3 3,201 1.33 1.43 10.4 61 201

I n t e r m s of the B . M . A . r e c o m m e n d a t i o n s , the diet of families with over three children was ' marginal.' Both protein a n d calc i u m were below s t a n d a r d at all seasons of the year ; v i t a m i n C fell below in April a n d M a y ; after t h e lowering of t h e extraction rate of flour, iron a n d riboflavine fell below t h e s t a n d a r d in October a n d N o v e m b e r . T h e average c o n s u m p t i o n of m o s t if not all, n u t r i e n t s m u s t have b e e n raised appreciably by the 8 % of class A a n d B families with four or m o r e chiIdren. W e are, therefore, left with little d o u b t that the average diet of working class families with m o r e t h a n three children in 1950 was only on t h e borderlioe o f sufficiency. T h e extent of the defficiency in these larger families h a s clearly declined since prewar days. Fraser Brockington.

SOCIETY O F M E D I C A L O F F I C E R S O F H E A L T H NOTICES M A T E R N I T Y A N D CHILD W E L F A R E G R O U P Post-Graduate W e e k - e n d , London, October 3rd a n d 4 t h , x953 T h e M a t e r n i t y and Child Welfare G r o u p will be h o l d i n g their p o s t - g r a d u a t e week-end in L o n d o n on Saturday and S u n d a y , O c t o b e r 3rd a n d 4th, 1953. T h e p r o g r a m m e will include lectures on Health E d u c a t i o n a n d Child P s y c h o l o g y and a visit to the Medical R e s e a r c h Council laboratories. T h e registration fee is s Is. DORIS A. CRAIGMILE,

Hon. Secretary'. MARY T . PATERSON,

Assistant lion. Secretary. REPORTS COUNCIL MEETING A m e e t i n g of the Council of the Society was held in the Council R o o m of t h e B . M . A . on Friday, M a y 22nd, 1953, at 10 a.m. Present : Dr. J. M. G i b s o n (in the Chair), Dr. A n d r e w T o p p i n g (President), Drs. F. A. Belam, R. T . Bevan, W. H. Bradley, Prof. C. Fraser Brockington, D r s . F. G. Brown, C. Metcalfe Brown, George B u c h a n , J. S. G. Burnett, H . D. Chalke, Sir J o h n Charles, Drs. T . M . Clayton, H. M . C o h e n , H. K. Cowan, C. K. Cullen, Sir Allen Daley, Drs. R. H. G. H . D e n h a m , M i r i a m Florentin, F. Gray, K a t h l e e n M . Hart, A. S. Nebblethwaite, G. E. H e r i n g t o n , J. H . H u d s o n , J. M a d d i s o n , M. M i t m a n , J. B. S. M o r g a n , A. A. E. N e w t h , Prof. R. H. Parry, Drs. G. H . Pringle, T . R u d d o c k W e s t , H. L. Settle, J. F. A. S m y t h , Esq., D r s . J. A. Stifling, F. R. W a l d r o n , E. J. G o r d o n Wallace, W . S. Walton, N o r a I. Wattle, A n n M o w e r White, N. C. M a u r i c e Williams, Prof. G. S. W i l s o n a n d Maj. G e n . T . Y o u n g . Dr. A. V. Kelynack, Secretary of t h e B . M . A . was also present. Apologies for Non-Attendance were received from Drs. W . G. Clark, F. M . Day, F. F e n t o n , J. D. K e r s h a w , Jean M a c k i n t o s h , J. B. M c K i n n e y , R. M . O r p w o o d , H u g h Paul, A. G. Reekie, W . Woolley a n d J. Yule. 104. W e l c o m e to N e w M e m b e r . - - A h e a r t y welcome was ext e n d e d to Maj. G e m T . Y o u n g w h o was a t t e n d i n g a m e e t i n g of the Council for t h e first time. T h e C h a i r m a n also expressed to Sir Allen Daley t h e C o u n c i l ' s pleasure at w e l c o m i n g h i m back after his visits abroad. 105. Minutes.--The m i n u t e s of t h e m e e t i n g of t h e Council h e l d on Friday, F e b r u a r y 20th, 1953 (Public Health, April, pp. 112114) were confirmed a n d signed by the C h a i r m a n . 106. Presidency of the Society for the Session 1953-1954.T h e Council received the following n o m i n a t i o n s for the election of President of the Society for the Session 1953-1954 : Dr. C. Metcalfe Brown, n o m i n a t e d by the N o r t h W e s t e r n Branch ; D r . J. D. K e r s h a w , n o m i n a t e d b y the C o u n t y District G r o u p ; D r . Charles F. White, n o m i n a t e d by t h e M e t r o p o l i t a n B r a n c h ; D r . J. G r e e n w o o d Wilson, n o m i n a t e d by t h e W e l s h B r a n c h . All the ballot papers, w h i c h h a d been distributed before t h e m e e t i n g , were colIected a n d , on t h e votes b e i n g counted, t h e C h a i r m a n declared that t h e n o m i n a t i o n of D r . C. Metcalfe B r o w n , M . P . H . M a n c h e s y e r C.B., s h o u l d be s u b m i t t e d for election by the O r d i n a r y m e e t i n g to follow. D r . Metcalfe B r o w n briefly t h a n k e d t h e Council for t h e h o n o u r w h i c h was to be bestowed upon him. 107. Officers of the Society for the Session 1953-1954.--The following were elected Officers of t h e Society for t h e Session 1953-1954 : - (a) Chairman of Council--Dr. J. M . G i b s o n . (b) Three Vice-Presidents--Drs. H . C. M a u r i c e Williams, W. G. Clark a n d A n d r e w T o p p i n g ; (c) Honorary Treasurer--Dr. C. H e r i n g t o n . (d) Honorary Solicitors--Messrs. Neish, Howell & H a l d a n e , 47 W a t l i n g Street, L o n d o n , E.C.4. 108. Co-option of Members to Serve on t h e Council for the Sesseion 1953-1954.--0n n o m i n a t i o n s b e i n g invited for t h e cooption of m e m b e r s to serve on t h e Council for the Session 19531954, the following n a m e s were s u b m i t t e d for ballot at the S e p t e m ber m e e t i n g of Council : Article 1 9 ( d ) - - D r s . C. Fraser Brockington, James F e n t o n , H u g h Paul a n d J. G r e e n w o o d Wilson. Article 190C)--Dr. George B u c h a n , Sir J o h n Charles, Sir Allen Daley a n d Prof. G. S. Wilson. 109. Presidency of the Society and Chairmanship of Council. - - T h e General Purposes C o m m i t t e e was asked to consider the advisability of the President of the Society being ex officio C h a i r m a n of Council.