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WELbeck 7766
Public Health Department,
Town Hall,
St. Marylebone, W.1.
To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to present to you this Annual Report on the health of the Borough during 1960,
having succeeded Dr. Briscoe-Smith as Medical Officer of Health towards the end of August of that
year. At the request of the Minister of Health the report retains its usual form and also contains full
details of the water supply, sewerage and public swimming baths in the Borough.
Public health throughout the year was generally good, there being comparatively little infectious
disease. No epidemic of any note occurred. Measles, which accounted for 145 of the 326 notifications
of infectious disease, is chiefly responsible for the periodic fluctuation in the annual figures for notifiable
infectious diseases. The current predominance of this disease in the yearly returns may well disappear
if the vaccine at present under trial in the United States proves to be effective. The absence of
smallpox in St. Marylebone for some three decades and of diphtheria for the past dozen years coupled
with the recent decline in the incidence of acute poliomyelitis—only one case being notified in 1960—
bears striking testimony to the efficacy of active immunisation in providing specific protection against
these serious infections. In spite of the great advances made in this century in the control of
communicable disease there can be no grounds for complacency. A vigilant watch has to be maintained
and this is well illustrated by the action described on page 25 which followed the discovery of a case
of smallpox in an adjoining Borough.
The resident population continued to decline slowly—the preliminary report on the 1961 Census
revealing a decrease of almost one-tenth during the previous ten years—although the very low birth
rate did increase from 7.55 to 8.30 (standardized) per thousand population and stillbirths fell from
14.45 to 8.10 per thousand total births. The standardized death rate rose slightly from 11.34 to
11.58 per thousand population and infant mortality appreciably from 14.67 to 26.99 per thousand
live births ; the latter increase reflects the small population group involved in which a small variation
in the number of deaths causes a sharp fluctuation in the mortality rate. In fact the 20 infant deaths
in 1960 represented an increase of 9 on the previous year, when the total was the lowest ever recorded
in St. Marylebone, and of this number no fewer than 18 occurred in the first month of life when the
influence of pre-natal factors, of which our knowledge is as yet far from complete, is particularly felt;
much research is taking place in this field.
Among adults the,main causes of death were diseases of the cardio-vascular and respiratory systems
and various forms of cancer. These reflect the increased expectation of life which has stemmed from
a steadily improving standard of living ; a healthier environment in the form of better sanitation,
housing, working conditions, food and water ; the control of the major communicable diseases;
and last but not least the great advances which have been made in medicine, surgery and anaesthesia.
Today the prospect of attaining the Biblical span has indeed become a reality for the new-born babe.
In St. Marylebone approximately one-fifth of the residents are of retirement age and, with the
proportion of old people growing from year to year, the Department is becoming more and more
concerned with the welfare of the elderly. In this field it works in close co-operation with hospitals,
family doctors, the personal health and welfare services of the London County Council, and in
particular with the St. Marylebone Old People's Welfare Association, an extract from whose annual
report appears on page 6. I should also like to draw attention to the summary of services available
for old people on page 43 of the appendix to this Report. One aspect of this sphere of activity which
is receiving increasing attention is the prevention of accidents in the home and much informal personal
advice on safety measures is given by the field staff. Of course, awareness of potential danger in the
home needs to be constantly fostered in all age-groups and, in this connection, it is regrettable that
a loop-hole in the provisions of the Heating Appliances (Fireguards) Act, whereby auctioneers (when
acting on behalf of a client whose normal business is not the sale of heating appliances) can legally
sell such appliances even though they do not comply with the Regulations, is also to be found in the
new Oil Burners (Standards) Act.
In view of the undoubted association between chronic bronchitis and lung cancer and atmospheric
pollution, it is especially pleasing to record the steady progress, reported on page 13, which has been
made in the Clean Air Campaign in the Borough. A further substantial contribution to the cleanliness
of St. Marylebone is being made by the introduction of the " dustless litterless " system of refuse