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5
ANNUAL REPORT OF THE
MEDICAL OFFICER OF HEALTH
To the Chairman and Members of the Urban District Council
of Harrow.
Mr. Chairman, Ladies and Gentlemen,
I beg to submit the Annual Report on the Health and Sanitary
Circumstances of the District for the year 1951.
This last year has again been uneventful in that there were no
special occurrences or outbreaks of serious import. As in previous
years, the vital statistics are satisfactory. Even allowing for the fact
that because so much of the district is of recent development the age
constitution of the population is not that of the country as a whole, the
death rate is appreciably below that for England and Wales. In general,
too, the incidence of and the mortality from the various infections are
below the average for the country. Although appreciably higher than
last year's figure, the infant mortality rate is well below the average.
These are the figures accepted as indices of health of a district or country,
and on these bases the health of those in this district is better than that
of those for the average of the country. These indices have been accepted
as the recognised standards ; their validity for this purpose is, however,
now being questioned. Although the high incidence of many of the
grave infectious diseases which formerly invaded the country is now a
thing of the past, there are some diseases which are becoming more
common. These seem to have their origin not in bacteriological or
other forms of life in polluted water, food or air, but in conditions of living.
States such as duodenal ulcers or other psycho-neuroses are becoming
more common and point to the state of health of the population declining
rather than improving, as suggested by the older yardsticks. Other
indices of social health or ill-health may be the fall in the birth-rate, the
suicide rate, the incidence of juvenile delinquency, the industrial sickness
rate, and the extent of industrial absenteeism. To-day's conditions,
perhaps, favour such disturbances. The effects of the recent war in one
way or another will last for a very long time, perhaps for the life-time of
those who were children in those years ; while the effect of the war, the
overcrowding of houses and the economic disturbances, will play their
part for a long time, causing emotional disturbances and even bringing
about organic diseases. Preventive medicine is faced with a very
difficult task ; but yet, perhaps, not so vastly more difficult than the one
which faced those concerned with such matters in the later years of the
last century. Disturbances such as these which arrest the progress of
development and even financial crises may not be wholly disadvantageous
if they force those concerned to consider what is essential and what is not.
The law of diminishing returns operates in many fields. It is most
desirable that every child in every district should be immunised against
diphtheria. These days a large response can be obtained by the expenditure
of a reasonable amount of time, labour and money, a response sufficient
to ensure that there is unlikely to be any serious outbreak in a
district. Perhaps just the same sized effort is necessary to obtain the