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BOROUGH OF WILLESDEN
Health Department,
54, Winchester Avenue,
Kilburn, London, N.W.6.
July, 1953.
To the Mayor, Aldermen and Councillors
of the Borough of Willesden.
Mr. Mayor, Ladies and Gentlemen,
I beg to submit the Annual Report on the health and sanitary circumstances of the Borough for the
year 1952.
The population has increased slightly, partly owing to the increase in the birth rate and the reduction
in the general death rate, but in the main it is due to the fairly large-scale movement of population into and
out of the district, with more coming in than leaving. The increase in the population only aggravates the very
serious overcrowding in the area.
The welcome reduction in infant mortality is slightly offset by the increase in the numbers and
mortality of illegitimate infants. The increase in the stillbirth rate has resulted in a loss of life, for the first
time, actually greater than in infants under one year of age. On the whole there has been a marked reduction
in the loss of infant lives as compared with before the war, owing to improvements in nutrition and antenatal
care. These have also led to an exceptionally low maternal mortality rate in the past few years.
However, there is room for further improvements in ante-natal care and for research on the cause of congenital
malformations and general morbidity in infants. Also, more attention could usefully be given to
the care of illegitimate children.
The decrease in the mortality for cancer cannot, by itself, inspire us with confidence that the
disease is being conquered; there are no figures for the actual numbers of cases and these might well have
increased, so leading to a higher mortality in the future.
Although there has been a slight reduction in the mortality from cancer of the uterus and stomach,
a marked increase for cancer of the breast is a bad sign and points to an urgent need for encouraging people
to obtain advice and treatment early. The difficulty in cancer publicity is to achieve this aim without
producing unfounded or exaggerated fears.
The general reduction in the mortality from respiratory diseases, particularly influenza, pneumonia
and bronchitis, conceals the temporary striking increase at the end of the year when there was severe fog.
This suggests that atmospheric pollution may be an important factor in promoting diseases of the respiratory
system; it may also be responsible for the increase in the incidence and mortality of cancer of the lung.
The common infectious diseases such as measles, whooping cough and scarlet fever no longer
present a problem of mortality, but they still contribute to much illness in the area. There was no epidemic
of poliomyelitis in 1952, but it probably accounted for one death. Both diphtheria and typhoid can now be
classified as rare diseases, but dysentery has become much more prevalent in the last few years. Cleaner
food handling and better food hygiene standards could help to reduce its incidence, and renewed efforts are
being made by the Council for more extensive health education, and improvements in food storage, preparation
and distribution.
Tuberculosis still remains the most important infectious disease in the borough, and although there
is a rapid decline in the mortality, there is no diminution in the number of cases discovered. Tuberculosis
presents both social and medical problems. Modern scientific medicine can nearly always save life or at least
prolong it, but there must be improvements in both housing and nutrition before tuberculosis can be finally
conquered.
The continuing high rates for coronary diseases and hypertension, and the increase in mortality
from ulcer of the stomach, reveals the need for further research into these disorders which are so often caused
by social conditions. Until there is a unified service it will be difficult to combine the efforts of epidemiologists,
specialists, general practitioners and other health workers for overcoming these very prevalent
disabling disorders.
Home accidents continue to levy a heavy toll, and education of the public has been intensified, but
is must be remembered that the risk is greater in overcrowded, badly constructed homes and among the
lower income groups.
It has become impossible to compare health conditions in the different wards with previous years
because of the changes made in their boundaries in 1952. Nevertheless there is again sufficient evidence to
show that the spending of money on improving living conditions in the overcrowded wards of Roundwood,
Carlton and Stonebridge, would pay dividends in reducing the incidence of tuberculosis, measles, whooping
cough, pneumonia and other respiratory diseases. Overcrowding still remains the main social problem in
the area and this must affect the health of the inhabitants by spreading infection and provoking mental
disturbances.
The problem of repair of obsolescent and dilapidated property was tackled vigorously by the
Council during the year and there is no doubt that the policy of preventive repairs will save many houses
deteriorating into slums.
There are no figures for estimating the standard of nutrition of the people in the area, but it is
doubtful whether with the rising costs of living it has improved or perhaps even been maintained.
It is disappointing to record that although five years have passed since the introduction of the
National Health Service, there has been no marked expansion of the health services in the area, and administrative
difficulties still crowd in and hamper the efficient running of the health services. This problem
cannot be solved until there is one health authority administering all the services in the area.
By re-establishing the health committee and incorporating the Housing (Standards of Fitness)
Sub-committee, the Borough Council provided excellent opportunities for the smoother running of the
Health Department. There have been great advances in improving housing conditions, food hygiene, health
education and the care of the aged, and the councillors, members of the staff and the sanitary inspectors
have all made valuable contributions to the successes that have been achieved during the year.
I have the honour to be,
Your obedient servant,
S. LEFF,
Medical Officer of Health.