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to year which are difficult to explain. It is apparent, however, that there
has been a substantial increase, in fact, a doubling in the number of
notifications. The average number received for the three years 1934
to 1936, when the average population was 145,000, was 198, a contrast
with the figure of 374, the average for the three years 1945 to 1947,
when the average population was 215,000.
This is a most disturbing increase and quite unexpected, as it is not
felt that there are any circumstances in the district which should lead to the
development of tuberculosis in the population here being higher than that
of the country as a whole. Of the specific circumstances which might
account for the statistical increase, the first that come to mind are the
transfer of population to new houses which results in swollen notifications
; the movements of population into other houses ; and the age and
sex constitution of the population.
(a) Movement of population to new homes. This, of course, applies
more particularly to those who have moved into the houses on the new
London County Council Headstone Estate. An extra number of
notifications might be expected from amongst this population than there
would have been in another population of similar size, because doubtless
special preference will have been given by the London County Council
in selecting their tenants for the new houses to those who need the improved
accommodation more particularly because a member of the
family is suffering from tuberculosis. In 1948, about 30 persons suffering
from tuberculosis were brought to the notice of the Authority amongst
those living on this estate ; in 1949 the figure was 51. These are notifications
which have been received, not because of the development of
any adverse factors operating in the district, but merely by the transfer
from London of the occupants of about 1,500 houses built by the London
County Council. This is one factor which did not operate before the
war and when comparing present-day with pre-war figures these numbers
should be deducted.
(b) There is a constant change in the population occupying the
houses in the district. Included in those who move will be some suffering
from tuberculosis. In respect of these, notifications are received. These,
then, swell the figures of notifications. As the population remains more
or less stationary, apart from the increase which is accounted for by
the natural increase in population (which is the excess of births over
deaths) the number of newcomers must be balanced by those who leave
the district. If the incidence of tuberculosis amongst those who come is
the same as of that amongst those leaving, the number of cases on the
register would remain the same, although the district would have received
that additional number of notifications. Whether this movement of
population is occurring on a greater or smaller scale than it was before
the war is unknown, so it is not possible to take this factor into account
when comparing the pre-war and the post-war notifications. But to
whatever degree it might have been or is operative the position is that
quite apart from those who moved into the London County Council
housing estate who had already been notified as suffering from the
disease, a further 43 persons moved into other houses in the district