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indicates that a high proportion is due to prematurity and congenital
abnormality. It is clear that this hard core of deaths will have to
be reduced and it behoves all having responsibility for ante-natal
care and for the maternal services to ensure that the highest possible
standards are maintained. Unfortunately, as yet, only a few of
possibly many factors predisposing to premature birth and developmental
aberration are known and it is certain that major
fundamental causes have still to be more clearly defined. In
contrast, it is pleasing to report another year without a maternal
death.
Although there are reports from other parts of the country
that the lung cancer death peak may be receding, there is no con—
firmation of this tendency in this area. Total cancer deaths increased
by 42 and cancer of the lung and bronchus by eight. Notwith—
standing the mental gymnastics of some statisticians and even a few
scientists (who are not wholly disinterested) to prove that black is
white, there can now be no reasonable doubt that the correlation
between heavy ciearette smoking and the incidence of lung cancer
is a direct one. Whatever other aetiological factors there may be,
whether of heredity, of temperament, of constitution or of internal
cytology or chemistry, this one fact is incontrovertible and the
consumers of tobacco should make their choice in the knowledge
that they are consuming a substance which is an irritant and a
proven carcinogenic agent.
The other main causes of death show decreases, especially
diseases of the heart and circulatory system, and bronchitis and
other respiratory diseases.
The total number of notified infectious diseases decreased by
894, due almost entirely to a decline in measles. On the other hand,
there were 234 fewer cases of dysentery and three cases of para—
typhoid fever occurred. There were an additional nine cases of
notified tuberculosis, three of which were pulmonary, but a compre—
hensive and realistic check of the tuberculosis register has enabled
the number on that register to be reduced from 1.036 to 811
pulmonary and from 86 to 51 non-pulmonary. Details of other
notified diseases are included in the report.
The main legislation passed during the year was the Housing
Act of 1964. This Act gives valuable additional powers to the local
authority to compel the improvement of dwellines and more effective
control over houses in multiple occupation, which in certain areas
have become a serious public health and social problem. The
Protection from Eviction Act, 1964, although of public health
interest, will not place very many additional burdens on health
departments but will be more of a legal concern.