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1
Public Health Department,
Town Hall, N.l.
To the Mayor, Aldermen and Councillors
of the Metropolitan Borough of Islington.
The Annual Report which I have the honour to present on the health of the
Metropolitan Borough of Islington for the year 1957 records steady if unspectacular
and unco-ordinated advances in the environmental health services contributing to
the health and welfare of the people. New Acts and new Regulations, such as those
mentioned in the body of this Report, not only affect the work of the staff of the
Public Health Department but also the well-being of citizens in ways of which they
are probably not normally aware until an event occurs which affects them personally,
bringing this Department into action, or less frequently, unfortunately, they take a
deliberate interest in what may appear to be the somewhat humdrum health or other
services of the local authorities.
The vital statistics for the year continued the favourable trend, with exceptions.
The birth-rate has continued to increase slightly, the death-rate to decrease slightly
and the infant mortality rate remains at the same low level as last year, although as
indicated in the comments on vital statistics there is still scope for the further saving
of infant life. Deaths due to tuberculosis of the lungs were also fewer in number
than ever previously recorded, although this in itself should be no reason for complacency—still
less should there be complacency yet in regard to the number of new
cases of pulmonary tuberculosis. These, unfortunately, are not lessening as speedily
as the reduction of deaths from this cause. Although modern forms of treatment
give much better hope of recovery, especially when the disease is diagnosed in the
early stages, treatment is still long-term and the disturbance in the normal life of the
patient, and probably his family, remain a problem. Prevention, therefore remains
the main objective and there is no one single answer to this. All possible means of
prevention and early diagnosis must be employed, including Mass X-ray (and Islington
is fortunate in having had a Static Mass X-ray Unit in the Borough for several
years now), inoculation with B.C.G. to groups considered to be at more than
average risk (carried out by the London County Council, and Chest Physicians of
the Regional Hospital Board), and, of course, personal attention to good hygiene,
nutrition and housing.
The outlook when we come to consider deaths due to malignant growths of the
lung and bronchus, however, can only be termed disquieting. The number ascribed
to this cause for 1957 was the highest on record so far, at 152. The Minister of
Health formally accepted some time ago the conclusion that there was a causal
relationship between the development of lung cancer and heavy cigarette smoking,
and although no-one is prepared to state that there would be no lung cancer cases
in the absence of tobacco smoking, there is increasing evidence that a high proportion,
perhaps two-thirds or even three-quarters of all lung cancers are preventable
Pollution of the atmosphere may contribute in some smaller degree to lung cancer,
but no evidence has so far been brought forward which seriously contraverts
cigarette smoking as the principal factor responsible for the increase over a long term.
Another major group of deaths in Islington is ascribed to bronchitis and the
Islington and London rates are well above the National average. Evidence is
accumulating that bronchitis incidence is closely related to atmospheric pollution and
this being the case, much bronchitis should be preventable with an improvement