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Tuberculosis shows a small reduction with 79 notifications (84) but this is mainly due
to the fall in immigrant cases - from (44) to 38. One hopes that this may indicate a change in
the rising trend of recent years which, hitherto, has shown a progressive increase in the proportion
of cases occurring in the relatively small (about 9%) immigrant fraction of the community.
Percentages of immigrants to total notifications annually 1965/70 were; 27.7%, 34%,
33%, 50% and now 48.1%. Lack of inherited racial resistance, proneness to overcrowding and,
perhaps, to sub-optimal nutrition may combine to render immigrants so liable to develop
tuberculosis and to have it in such an acute and progressive form as they often do. Unfortunately
these factors apply equally to the children, even those born here and it may take several
generations before they can become acclimatised to the infinitely variable English weather.
No wonder it is a standard opening gambit for conservation. It is, however, reassuring to find
a rising awareness of the need for B.C.G. vaccination of all schoolchildren against T.B. Our
target is 100% acceptance. Last year I drew attention to the almost total eclipse of T.B. and
other infectious diseases as important causes of death by the rapidly increasing death rate
from Lung Cancer, Ischaemic Heart Disease and Bronchitis with Emphysema. In the space of
only one year deaths from smoker's cancer have risen by over 121/2% for men 169 (150) and by
over 16% for women 36 (3I). Approximately half the deaths occurred in the age group 35 to
64 years. What a price to pay for cigarettes!
This is no chance variation in the figures but a steadily progressive increase affecting
all countries of the world where cigarettes are smoked. Taking a longer view of local
epidemiology (the populations of the old boroughs of Leyton and Walthamstow together approximate
to that of Waltham Forest) the following tables show how, within the lifetime of most of
us, infectious diseases have been brought firmly under control but that deaths from diseases
associated with smoking and with mental and emotional stress are increasing with great rapidity
in our Borough.

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