View report page

128
The foregoing suggestions, if carried into effect would, I realise,
cost money, but I doubt if well-run schemes of employment
subsidising a man's reduced earning powers would be as costly
as keeping him and his family in complete unemployment. Rehousing
on a large scale also entails heavy expenditure of money,
as a number of families would be unable to pay an economic
rent, and it would be futile to supply improved accommodation
if there are increased demands in this direction on an already
restricted income.
In estimating the cost of any re-housing scheme it is important
to remember, apart from any consideration of the individual
patient, that if the incidence of tuberculosis is to be further substantially
reduced, a reasonable segregation, with at least the
provision of a separate bedroom for the infectious, is essential.
The mortality from Pulmonary Tuberculosis has shown a
steady decline for a great number of years, the death rate in
the period 1920—30 being only a quarter that of the rate recorded
in 1851—1860. It has been found, however, that the fall in the
mortality rates has not been uniform for the different age groups,
and the study of statistics has revealed the interesting though
alarming fact that in spite of the general decline, taking the
country as a whole, there has actually been a slight rise in the
death rate in females of the age group 15 to 25. The mortality
among males of the same age, though not showing an increase,
has declined at a slower rate than among other age groups. This
adverse condition is more marked in urban than rural areas.
Various theories have been put forward in an attempt at an
explanation. Dr. Bradford Hill, in a paper read before the
Royal Statistical Society, sums them up as follows :—
1. A decline of immunization in childhood as a result of the
fall in the general death-rate from tuberculosis producing
a lower level of infection in early life ;
2. Changes in the occupational environmental conditions of
young adults, especially the entry of young females into
new occupations ;
3. Changes in the regional distribution of population of young
adult ages through the slackening migration from country
districts to the towns.
It would be interesting to test these various theories, but with
our comparatively small number of cases it is doubtful if any
data of real value could be obtained. More especially is this the
case as, unlike the majority of London Boroughs, some of which
show an increase of as much as 200% in the deaths from Pulmonary
Tuberculosis of young people of 15 to 25 during the years 193032
compared with the years 1911-13, Bethnal Green and Hackney
figures have actually fallen.