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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 in respect of the
year 1953, this being the twentieth yearly review I have presented on
the health of the Urban District.
After such an interval of time it might not be inappropriate to
look back over the last two decades and note what changes have
occurred for better or for worse in so far as they are evidenced by
statistics.
The birth rate in 1934 was 16.5 per thousand population. In the
intervening period, like the national index, it has shown a downward
trend, though not without a somewhat violent fluctuation due to the
second world war. It now stands at 12.5.
The death rate, always a favourable one compared with that for
England and Wales, is little changed now at 8.4 per thousand from
1934, when it was 8.6. In the last twenty years it has varied within
the limits of 6.6 and 9.5 and has always been below 10, whereas the
national figure has always been above that level. Since the 1930's we
have had the advantage, as a result of rapid development, of a young
resident population, probably the youngest in Surrey. With the virtual
cessation of housing development within our boundaries, the average
age of the population must inevitably increase at an accelerating rate
and in future the death rate will have to contend with this factor.
What of the causes of mortality, the contenders for pride of place at
the head of the list of "the captains of the men of death"—the chief
killing diseases? More than any, cancer has more firmly established its
position among the leaders and now kills twice as many people as it
did twenty years ago. Tuberculosis, on the other hand, has fallen
before the continued onslaught of the anti-tuberculosis schemes and is
now only half as dangerous a mortal enemy. One of the prices of increasing
longevity is the greater risk of dying from degenerative conditions of the
heart, a natural process, to some extent, of wear and tear. It is not
surprising, therefore, since the mean age at death has risen from below
50 to its present level of 65.9 yrs., that heart disease continues to be the
chief cause of death. The greater proportion of such deaths in recent
years, due to coronary disease of the heart, may well be a reflection of
the increasing stress and tempo of modern life.
Perhaps in no field of Public Health do the statistics reveal a
more marked advance than in the saving of infant life and the experience
of the last twenty years is only a continuation of the rapid progress
which followed the institution of Maternity and Child Welfare Schemes.
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