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PREFACE
To the Chairman and Members of the
Carshalton Urban District Council.
Mr. Chairman, Ladies and Gentlemen,
I have the honour to present my Annual Report for the year 1946.
It has been my pleasure, year by year, to lay before you a record
of the public health of the district which has been consistently satisfactory,
and particularly so when measured by national standards. The
experience of 1946 provides me with yet another opportunity of doing so.
Although somewhat irregular, the general trend has always been
progressively towards improvement, so much so that each year one has
come to expect at least one, if not more, vital statistics establishing new
favourable records.
For 1946 the birth rate of 17.8 per thousand population is the
highest for 18 years and is provided by a number of births which, for the
first time in our history, has exceeded 1,000 per annum. The crude death
rate, invariably appreciably lower than that for England and Wales, is
again a low one, namely 7.2 per thousand population compared with
11.5 for the country as a whole. Infant mortality reached the remarkably
low level of 18 per thousand live births, much the most favourable
index of child care yet experienced. It compares with a rate of 41 for
England and Wales. More than a thousand women were safely conducted
through childbirth without a single maternal death, thus
repeating the achievement of the year before.
Of the individual causes of death, cancer figured less prominently,
the rate falling from 1.6 to 1.0 per thousand. In spite of a higher level
in the known incidence of tuberculosis, it is gratifying to note that the
mortality from this disease is the lowest for twenty years. The relative
steady increase in deaths from diseases of the heart is paradoxically
a favourable feature. A limit is set to all forms of life by natural
" wear and tear " and the final act in such a process is most frequently
exhaustion of that vital organ. The mortality rate for heart disease is
mainly due to deaths arising as a result of the degenerative changes
associated with advancing years.
There was no serious visitation by infectious disease, and the only
significant changes were of a favourable nature. Scarlet fever, measles,
diphtheria, and dysentery among the resident population were less
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