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Just as earlier generations of Medical Officers of Health laboured to reduce the amount
of harmful substances and organisms to which their communities were exposed, the Community
Physician of tomorrow must employ every effort to reduce mental stress which is one of the
most noxious elements in modern life. Diseases known to be induced or exacerbated by stress,
hypertension with 56 deaths (66) and coronary thrombosis with 577 (646) were significantly
lower than 1970, as was lung cancer with 187 against last year's record of (205). However,
deaths from all causes, 2,847 (3,017) were down by 170 or 5.66% while the population fell by
only 1,080 to 233,960 (235,040) approximately 0.4%.
Allowing for the very slightly smaller population at risk the reduction in the deaths
from these three diseases, all of which predominantly affect cigarette smokers, tempts one
to hope that all the effort expended in recent years to combat this fatal habit are beginning
to take effect. Certainly there has been no major advance in their treatment nor any general
lessening of stress. Prospective surveys since 1952 into causes of death among doctors show
that over a period of ten years the odds against dying from lung cancer, for those who stop
smoking, fall progressively from I in 8 for heavy smokers to approach the non-smokers
I in 300. Prospective studies, that is predicting and then recording the fates of a selected
group of individuals over a given period, are the most accurate way of proving cause and
effect relationships and for diseases of the lungs, heart and arteries cigarettes stand
convicted beyond all reasonable doubt.
The Community Physician of the future may have more use for a computer than a
microscope but the clouds of preventable illness and unnecessary premature deaths are not
lacking from his new horizons.
CHILD HEALTH SERVICE - PREPARATION FOR INDEPENDENCE
Dr.Gwyneth Richards, Senior Medical Officer, writes
When the baby is born it has already been developing for some months and although it
is a complete and separate person there is still a long way to go before that child becomes an
independent individual. All who work with children aim to help the child to develop into a
person who is sound in mind and body and able to make full use of his or her abilities. When
one reads newspapers, listens to the radio or watches television, one needs to be reminded
that the majority of children develop into normal, healthy adults and it is only the minority
who cannot cope with life. Our work in the Child Health Service is to help the development of
wholeness.
Ante-Natal
The health of the new-born child is dependent upon the health of the parents and this
dates back even to their childhood. Their health has been guarded, defects corrected and they
have in many cases been immunised against rubella to prevent the mother getting german
measles during pregnancy and perhaps giving birth to a handicapped child. Genetic counselling
is also arranged for parents with handicapped children. The future mother is supervised during
the pregnancy and at the birth of the child by our colleagues to prevent problems developing
which would affect the new life. Despite all this care one cannot attain full perfection. Some
babies develop from defective cells and are already imperfect from conception, others develop
abnormally and others cannot change from a completely dependent to a separate life
successfully. Some of these would die and some would live with handicaps. The miracle
remains, however, that after all the hazards the developing baby has negotiated the majority
are born healthy. Handicapped children are discussed so much at present one tends to forget
that the number of normal children exceeds the number of children who are severely
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