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now constitutes a problem which has to be dealt with by this generation and the next.
It is not possible, unfortunately, to dispose so easily of out-of-date buildings as it
seems to be of many diseases now made out-of-date. There is still great housing congestion
in the Borough, in spite of the comparison with 50 years or even 25 years ago,
and many problems of mental ill-health arise which are associated with congested
housing conditions.
As the proportion of elderly persons in the Borough increases, health and
social problems are created, as young children created related problems to our predecessors.
The Borough Council, together with the health and welfare departments
of the County Council, the local hospitals, the local representatives of the Assistance
Board, and many voluntary organisations are co-operating to help elderly persons
maintain their health, useful activities and happiness as long as possible. The Borough
Council has borne its share by appointing special visitors to keep in touch with
elderly persons most needing advice and help, setting up a substantial disinfecting
and laundering service for elderly persons with incomplete physical control, and by
granting considerable financial help to many voluntary bodies for a "Meals-onWheels
" service, chiropody clinics, and for enabling elderly persons to take holidays
when they could not otherwise have them.
Although we no longer have to face major hazards from the principle infectious
diseases of a century ago, such as smallpox, cholera, typhoid fever and even diphtheria
and measles, there are non-infectious diseases which are increasingly coming to the
fore as a cause of death and which appear to be related to social conditions and
environmental circumstances including personal habits, and which are, therefore,
preventable. Such diseases are lung cancer, certain types of heart and circulatory
disease such as coronary thrombosis and high blood pressure ; chronic catarrh of the
respiratory system, especially chronic bronchitis (which is unduly prevalent in this
Country), mental ill-health and deaths and injuries due to accidents on the road
and in the home. Although the Medical Officer of Health has not the same statutory
obligations at present in regard to the prevention of these causes of ill-health and
death as he has for infectious diseases, they constitute problems of prevention which
must be faced if progress in health is to be continued. There is still great work to be
done, and only the Medical Officer of Health and his preventive team, including the
Health Visitor and Public Health Inspector (former Sanitary Inspector), have been
trained in the preventive outlook. They must, surely, therefore, have as large a part
to play in the future as they have done in the past and are doing at present. Humanitarian
considerations apart, the economic saving that could be effected by the prevention
of ill-health and avoidance of premature death is no less important now than it
was when Dr. Harris made his calculations in 1911. The nation may yet decide that
prevention is cheaper than cure.
V. FREEMAN,
Medical Officer of Health.
September, 1956.