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1
Public Health Department,
Town Hall,
Upper Street, N.l.
To the Mayor, Aldermen and Councillors
of the Metropolitan Borough of Islington.
In presenting the Annual Report (Abridged) on the public health of the
Metropolitan Borough of Islington for the year ended 31st December, 1948, the
opportunity has been taken of amplifying a little certain aspects of the work of
the Department.
The year 1948 marks a major transition in the health services administered
by the Borough since the responsibility for the personal health services, including
maternity and child welfare, vaccination and diphtheria immunisation, passed
from the Borough to the London County Council as the Local Health Authority,
and the Tuberculosis Dispensary Service to the Regional Hospital Board, on
5th July, 1948, under the National Health Service Act, 1946. Much important
health work, however, still remains to the Borough as, for example, the notification,
control and prevention of infectious disease, the recording and application of vital
statistics, and the supervision of the environmental health services concerned with
food hygiene and purity, housing and sanitary work under the Public Health,
Housing, and Factories Acts, and the education of the public in health matters
generally. The progress which has been made in the health of the people and the
reduction of infectious disease during the last thirty years or so, is remarkable, and
there can be no doubt that the services which have been administered by the Borough
have contributed considerably to this happy position. In order that there might
be some record in convenient form of work done by the Borough Council on services
transferred under the National Health Service Act, reports were presented to the
Public Health and Maternity & Child Welfare Committees of this Council, and the
more important sections of these reports have been set out in the form of appendices
to this Annual Report.
The general health of the Borough, insofar as it is possible to measure this by
the various statistics which are kept, continues to be satisfactory and, with one or
two exceptions, to improve still further. The birth rate, although still above the
pre-war level, is falling slowly from its post-war maximum, and the infant mortality
rate continues at a low level. At 35 deaths per 1,000 births, however, it is slightly
higher than the figure for 1947, which was 32, but with the continued vigilance
by doctors, health visitors, and the rising standard of personal care taken by the
mothers themselves, it is anticipated that the downward trend in the rate of infant
deaths will continue in the future. Infectious diseases generally were at a low level
with measles and whooping cough providing the majority of the notifications, as
usual, but, fortunately, with no undue proportion of severe cases. Poliomyelitis,
or infantile paralysis, was substantially lower than in 1947. Diphtheria is fast
becoming a rare disease, and, again in 1948, not a single death was ascribed to this
infection. Tuberculosis is the principal infection which gives rise to serious concern,
in particular, because of its social importance. It is the principal cause of death
in the adolescent and adult under the age of 45, and since the rate of tuberculosis
appears to be, at least partly, linked with adverse housing conditions—in particular,
overcrowding—the prevalence of tuberculosis presents a serious problem to be
dealt with from many aspects. Not the least of these is a reduction in the waiting
time of admission to hospital or sanatorium after the case has been diagnosed, with
the consequent removal of a source of infection to other members of the family,