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7
Public Health Department.
Town Hall,
High Holborn, W.C.I.
June, 1961
To the Mayor, Aldermen and Councillors of the
Metropolitan Borough of Holborn.
Your Worship, Ladies and Gentlemen,
Herewith I beg to present a report upon the health and sanitary conditions of the
Borough for the year 1960.
In June Dr. Struthers retired as Medical Officer of Health, having given literally a
lifetime of service to Holborn. He took office in 1934, but for the previous eleven years
he had been medical officer to the tuberculosis dispensary. Paradoxically this quarter
of a century which has been among the most troubled in our history, has also witnessed
an outstanding improvement in the public health. Dr. Struthers with his intimate
knowledge of the borough and its people, kept Holborn in the van of this advance.
Indications of the changing circumstances of the borough are given in the statistics
recorded year by year in the Medical Officer's Annual Report. In 1934 the recorded
population was 36,000. By 1960 this figure had fallen by some 40% to 21,000 yet the
number of inhabited houses fell by only 5%.
In 1934 the birth rate was 8.58 per thousand of the resident population and in 1939
it fell to the unprecedented low figure of 6.85. After a big rise in the immediate post-war
years, the rate is settling and in 1960 was 9.86.
The infant mortality rate is usually a sensitive indicator of the well being of the
community. In Holborn, however, this is vitiated by the fact that infants with grave
conditions come from all over the world to the Hospital for Sick Children. Inevitably
some few of them fail to recover and the deaths of those who are domiciled outside England
and Wales are " credited " to Holborn. Thus the infant mortality rate of 77.29 per
thousand live births for Holborn for 1960, which appears to compare unfavourably with
the rate of 21.6 for the whole of London is calculated from the deaths of sixteen infants,
only six of whom were truly resident in the borough.
The crude death rate which, for 1960 was 12.71 per thousand of the population, has
shown little significant variation over the years. Taking into account the increasing
proportion of elderly people in the population however, it is evident that there has been
(except during the war years) a real decline in mortality. Diseases of the heart and circulatory
system remain the most frequent causes of death, although within this group
coronary artery disease has become more common. In 1960 only one person in Holborn
died of tuberculosis (32 persons did so in 1934). The death rate from cancer, however,
has nearly doubled during the same period, and the increase in cancer of the lung is particularly
alarming. In 1960 this disease was responsible for one-third of all cancer deaths.
Bronchitis, " the English disease," also causes twice as many deaths now as it did twentyfive
years ago. These diseases offer a new challenge to preventive medicine.
Changes have also occurred in the prevalence of infectious disease. The number
of new cases of tuberculosis notified has fallen to less than half of the 1934 figure, but there
is much to be done before this disease ceases to be a public health problem.
The decline in the incidence of diphtheria has been dramatic. In 1934 there were
74 cases with four deaths; in 1960 no cases were notified. Outbreaks of the disease which
occur from time to time demonstrate, however, the continuing need for children to be
effectively immunised.
The incidence of poliomyelitis has fluctuated greatly since it first assumed epidemic
proportions in this country in 1947. The greatest number of cases experienced in Holborn
in any one year was 17 in 1953. In 1960 two cases were notified. Vaccination confers
very considerable protection against this disease, and is now freely available to everyone
under the age of forty.
Food poisoning and dysentery have become more prevalent since the war because
more people now have meals in restaurants and canteens. Only a small proportion of
cases receive medical attention or are notified. By regular inspection and supervision of