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Health Office,
Gentleman's Row,
Enfield,
Middlesex.
To the Mayor, Aldermen and Councillors of the London Borough of Enfield.
I have pleasure in presenting my report on the health of the borough for the
year 1968.
It has again been found convenient to present it in three main sections : namely
personal health, environmental health and school health, each of which has shown
a steady progression with a general increase in the volume and scope of work.
The vital statistics of the borough compare favourably with the national rates.
In keeping with the national figures, the birth rate was somewhat lower than last
year and the illegitimate rate (6.6% of total live births) was also slightly lower.
The percentage of persons dying at or over the age of 75 years rose to 46% (550
males and 942 females).
In the past I have on occasions commented on the appalling loss of life and the
amount of disability resulting from road accidents. I have expressed the view that
the real cause of many road accidents is associated with haste, impatience, selfishness
and downright bad manners by all categories of road users—all factors well within
the bounds of prevention. To this formidable list must now be added what has come
to be referred to as " motorway madness"—apparently a form of suicidal and
homicidal indifference to obvious road dangers in spite of adequate warning.
My views would appear to be confirmed in the foreword to the Report, issued
during the year, of the Medical Commission on Accident Prevention. Dealing with
medical aspects of fitness to drive vehicles it states that the causation of accidents
appears to be largely in the field of human behaviour although a great reduction
can undoubtedly be obtained by improvement in the environment.
Further confirmation appears in a statement in the Report that present evidence
suggests that medical conditions in a driver are responsible for only a small proportion
of road accidents, possibly of the order of one per cent or less, whereas
personality and behavioural abnormalities may be responsible for large numbers.
The Commission was of the opinion that only a very small percentage of road
accidents is due to defective visual acuity or other ocular abnormalities such as
restricted field of vision, defects in stereoscopic vision and depth perception, defective
colour vision or dark adaptation, and muscle imbalance. In Enfield, however, we
have always paid particular attention to possible medical conditions, including
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