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Causes of Death
Studies of mortality and morbidity can be profitable in directing
attention to measures necessary to prevent ill-health and to areas of need
for various services.
The commonest causes of death in the age-group 45 - 65 years
are still cardio-vascular disease (particularly coronary heart disease)
and malignant neoplasms (particularly malignant growths of the lung and
breast).
Large numbers of people have their lives cut off during their
most productive years by these diseases. Year by year repeated warnings
of the dangers of heavy cigarette smoking fall on heedless ears, although
there is some evidence to suggest that the number of non-smokers, particularly
in the younger age-groups, is increasing.
The majority of persons who die from cancer of the lung do so
directly because of heavy cigarette smoking and to this extent can be
regarded as dying from a self-inflicted disease. It is unlikely that anyone
reaches the age of maturity without being aware of the risk involved in
becoming a habitual heavy cigarette smoker, a risk with odds of something
of the order of one in eight, somewhat similar though less immediate in
their application, to those presented by the game of Russian roulette.
Not until cigarette smoking becomes socially unacceptable can we expect
to see a significant reduction in the numbers of people dying from this
disease. The adult image presented to adolescents is one which includes
cigarette smoking as an accepted part of adult behaviour. This is built-in
to the portrayal of glamorous cigarette-smoking adult behaviour on television
screens, strip cartoons, and cinema films. There is surely a nation-wide
responsibility not only on parents but also on advertisers and producers
of media for mass public entertainment to be aware of the impact they have
on the growing mind.
Progress has been made in the early diagnosis of cancers of the
womb and of the breast through screening clinics for well-women and the
distribution of information describing the technique of self-examination
of the breast. Early diagnosis of these conditions ensures early treatment
and increases the possibility of a successful outcome. Although during
1967 our scheme for cervical cytology was still at the pilot stage, increasing
laboratory facilities are allowing gradual expansion. Constant evaluation
of the effectiveness of schemes of this nature in reducing mortality rates
is necessary and this is being undertaken on a national basis. We do not
yet know if cytological screening can succeed in its aim of lowering the
death rate from cancer of the uterine cervix. It is, however, our growing
experience that many other conditions of a more minor nature are being
revealed at our well-women clinics.
Domiciliary Care
Wherever possible the sick, the frail, the elderly, the socially,
the physically and mentally handicapped are cared for in their own homes.
Successful home care depends upon many things, not least of which is the
provision of suitable housing accommodation within which the supporting services
can provide the help which is necessary.
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