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to 3,944 in the previous year. The drop was mainly in the age period
one to three, and could have been caused in part by its becoming
known that there was a very slightly greater risk of a child who had
been recently immunised developing poliomyelitis than there was in a
child who had not been immunised. This risk, however, is very small
indeed and is only apparent when there are many cases of poliomyelitis
about. While, therefore, until the exact size of the risk has been estimated
(an investigation is now being carried out by the Medical Research
Council) a parent, if seeking advice, would probably have it suggested
to him that his child should be immunised in the first half of the year,
thus avoiding the main months when poliomyelitis is more frequent,
he would also be advised that the risk of the child getting diphtheria,
if non-immunised, was considerably higher than the risk of the child
developing poliomyelitis through being immunised. It is not possible
of course to balance exactly risks of this nature, but rather than put off
diphtheria immunisation permanently it would certainly seem much
better to take the slightly added risk of having a child done during the
second half of the year; the best advice of all of course, which cannot
be emphasised too much, is to have the child immunised against
diphtheria as soon as practicable after it is four months or so of age, but
preferably in the first half of the year.
Old people
Comments on the position in 1950, and in particular on the help
which the borough council was able to give to old people's organisations
in the area, are made on page 35. Some real progress in the care of old
people was made, but with this increasing problem ("naturally"
increasing because of the relative increase in old people and the decrease
in young people in the community) a very great deal more is required.
It may be that this will be obtainable from voluntary effort, but it may
be that the local authorities will be required, as time goes on, to increase
their support of voluntary organisations financially and otherwise, or
even to take over certain parts of the work themselves.
Social medicine statistics
In section A, vital statistics, I have included some comments on
and statistics of social classes in relation to births and deaths. In
future years these may be enlarged to cover analysis of the type of house
involved. I commented on social class statistics in the last annual
report and pointed out that although there are several hundred occupations
which persons may follow, these can very approximately be
grouped into five different social classes:—
I The professions, service officers and welltodo people concerned
in finance, shipping, etc.
II Intermediate, between class I and the skilled workers.
III The skilled workers.
IV Intermediate, between skilled and unskilled workers.
V The unskilled workers.
(A baby or child of course is put into the class in which its
parent is).