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9
Ilford, Barking and Coronary Disease.
Deaths due to disease of the coronary arteries (the arteries supplying
blood to the heart muscle) are rapidly becoming numerically the most
formidable cause of mortality in Western Countries; although not higher
than the death rate from cancer, it is higher than the rate for cancer of any
individual organ.
This disease is unusual in that it is more prevalent amongst the more
prosperous. For instance, the rate in the U.S.A. is 201 deaths per 100,000,
in Ilford it is 125, and in Barking 91. That Ilford should have a rate so
much higher than in Barking is a matter of some interest, and cannot be due
to different standards of diagnosis, for our respective patients go to more or
less the same hospitals, and finally, in cases of sudden death (which is often
the end result of coronary disease) come to the notice of the same Coroner's
Pathologist. As coronary disease is mainly a disease of the aged, perhaps
it is because we have a higher proportion of old people than Barking. This
is so, for in Ilford the percentage over 65 in 1947 was 9-5, and in Barking 6-5.
In actual numbers we had 17,158, and Barking but 5,030. Over the age
of 85 the difference is still greater, Barking having less than a quarter of
those in Ilford, a point of great importance when we are informed that
problems of the aged are not so urgent in Barking as here (maybe coupled
with the suggestion that relatives in Ilford are less considerate towards their
elders). However, the greater proportion* of old people in Ilford is not the
complete answer, for further study of the figures show that amongst the aged,
coronary disease is more prevalent in Ilford than in Barking. For those
over 75, in Ilford 137 and in Barking 115 per 10,000 die of the disease, thus
confirming the relationship with prosperity.
There is much research and discussion in progress as to what factor of
prosperity is responsible for a high coronary death rate. General practitioners
suffer more than other doctors and doctors as a whole have a high rate. As
it is usually doctors who theorise about the causes, many naturally choose
those most commendable to themselves, and the theory has got around
(with little or no proof) that stress and strain of the modern world is the cause,
especially stress suffered by the independent man, who does not depend on
the State for help. This is very self-satisfying, but means that modern
Americans suffer more from stress than those in Ilford, and those in Ilford
more than those in Barking.
A less complimentary theory, but based on far more evidence, is that
the more fats one consumes the more one is liable to coronary disease, and
the more money one has in one's pocket, the more one eats fats (such as are
present in eggs, milk, cheese, bacon, butter and margarine).
Which General Hospitals Serve Us?
I greatly doubt if any authority is aware of the answers to the following
two questions: (a) to what extent does King George Hospital cater for the
needs of Ilford residents, and (b) to what extent do Ilford residents patronise
other hospitals of a comparable standard to King George Hospital ?
These questions are of great importance when hospital planning is
considered, for in Ilford much help is obtained from hospitals outside the
area, especially the London Hospital and the facilities afforded by the great
teaching hospitals must always be considered when local expansion is planned.
As a "second best" method of approach, information obtained from
death certificates is of help, as thereby we can tell in which hospitals Ilford
residents have died. This method has some disadvantages in that it gives
little information about patients with trivial complaints, minor surgical
conditions, skin diseases, etc., but only about those with severe disorders
from which death may occur. Of the deaths in 1951, in King George Hospital
65 per cent, were of Ilford residents. Only 8-4 per cent, came from Barking,
and the rest, some 26.6 per cent., from elsewhere. These figures show that
the King George Hospital is truly an Ilford Hospital, and although the only
general hospital in the Ilford and Barking Group, caters very little indeed
for Barking. One wonders if Ilford interests are similarly represented in its
management.