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These figures speak for themselves, and give some indication of
the tremendous progress which has been made in improving public
health over the years. We can, I think, read a little deeper, and it is
not difficult to imagine the conditions which must have existed in those
days, one hundred years ago. It would be wrong to allow the obvious
evidences of improvement to lull us into a false sense of complacency.
Public health and social well-being, which in many ways are terms
synonymous with the progress of the human race, can never be static:
if they do not progress they must go back, and while many problems
have at least been partly solved, other new ones arise. I made some
reference in my previous report to the steps to be taken to reduce still
further the infant mortality rate.
Other problems which, if they did exist a hundred years ago, must
have been submerged in the more obvious and pressing questions of
the day, are the so-called "stress" diseases, about which much has
recently been written, particularly as to what extent the prevention of
these diseases may be a public health matter. One does not wish to be
technical here, and opinion is by no means unanimous, but by "stress"
diseases is generally meant such conditions as high blood pressure
(hypertension) and diseases of the heart blood vessels (coronary arterial
disease) which in some ways may possibly be associated with the stresses
and strains of modern urban civilisation. It is certainly the case that
coronary arterial disease, for instance, must now be reckoned as an
important cause of death in men, and to a lesser extent in women, in the
most productive period of life. This disease is most fatal in the age
group 45 - 65, which in many ways is the most important period of
life from the economic, social and productive point of view. How this
and other similar problems can be tackled by Public Health Department
as they now exist, it is not easy to say. The cause of the condition.
and why it is more predominant in men, can be little more than a
matter for conjecture, although a great deal of research work is now
being undertaken. It is at least possible that there may be social and/or
enviromental conditions to account for the considerable preponderance
of deaths from this disease in this age group in men.
If Public Health Departments are to carry out their primary
tion of safe-guarding the health and well-being of the public, it may be
that we should be considering how to tackle this problem of coronary
arterial disease. This brings me back to the point made above, that
public health is not static, but constantly changing. It changes as the