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PUBLIC HEALTH DEPARTMENT,
TOTOI HALL,
GREENWICH,
5.E.10.
July, 1959.
To the Mayor, Aldermen and Councillors,
Metropolitan Borough of Greenwich.
Ladies and Gentlemen,
I am pleased to report on the health and environmental
circumstances of Greenwich for 1958,
The population continues to increase each year and the
birth rate is slightly raised. Deaths show a small increase
but the Infantile Mortality rate at 14.98 is the second
lowest in the history of the Borough. As would be expected
both the neo-natal and peri-natal rates also show corresponding
reductions. For the second successive year we had one
maternal death which was the subject of a Coroners' Inquest.
In analysing the causes of death, both cancer and heart
and circulatory troubles are as usual the most common.
There were 55 notifications of pulmonary tuberculosis, which
is the lowest figure recorded since Greenwich became a
Metropolitan Borou^i.
In common with the rest of the country there has been a
complete change in the pattern of disease in the last 25
years. Communicable disease is no longer of vital consequence,
although periodic outbreaks of such infections as
poliomyelitis, dysentery and food poisoning - which shows an
increase of 22 over last year - Indicate the continued need
for vigilance. This is also borne out by troublesome
outbreaks of antibiotic resistant staphylococcal infection in
hospitals. It is therefore important that the immunisation
and preventive services should be used by the vulnerable
groups in the community to the maximum extent. Antibiotic
drugs should also be used with discretion and with intelligence
In order that the development of resistant strains of
organisms can be kept to a minimum.
Preventive and palliative measures have now to be
directed towards the degenerative diseases and the ailments
associated with the stress of livingo Direct preventive
action is impeded by an imperfect understanding of the
underlying causes of ageing and the mechanisms of adaptation
to stress but, as with the infectious diseases in the early
days, action is being taken along sound empirical lines until
more precise etiological principles have evolved. The
services which are being progressively promoted for improving
the conditions of old age and adjustment to advancing years
illustrate this tentative and empirical approach. Genetical
and biochemical research is also gradually revealing
important contributory factors in the development of circulatory
and heart disorders, and the mysteries of malignancy and
of congenital defects may have a complex chemical basis
within the nucleus of developing cells which may have
practical preventive possibilities in the future. All this
is, of course, speculative but the next great break-through
in preventive medicine will almost certainly relate to the
causation of malignancy in its many forms, to the basic
processes of ageing, and to the underlying factors which predispose
to congenital malformations arising during pregnancy.
It would be surprising if future discoveries did not have
practical applications on a broad community basis.