SOUTHAMPTON MEDICAL SOCIETY

President: Dr Nigel Dickson FRCGP

A meeting of the Southampton Medical Society was held on the 1st March 2023.

The President was in the chair. The minutes of the last meeting were approved.

The President introduced our speaker, Prof. Sir Chris Whitty, Chief Medical Officer for England, whose lecture was entitled ‘Where is Health Going?’.

Sir Chris said we need to take the long view of health. In the short term it can look grim. But this was always so and for the last 3 years, due to the pandemic, especially so. The indicators we need to follow are mortality and disability.

Consider children under 5 years. In the last century, before the second world war, childhood mortality was very high. In the last 20 years childhood mortality has decreased enormously. The Far East has shown the most rapid improvement of all. Malaria mortality has reduced 50% in the last 70 years. Immunisation programmes have been preventing infections and improvements in water has played a part too. In the last 10 years respiratory deaths have reduced, and neonatal mortality has reduced as well.

The physical health of children over 5 years old has improved so much that they have a low probability of dying and the majority will live a long life. In most countries of the world there has been an improvement in life expectancy. For non communicable diseases, such as cancers, deaths under 50 years are rare. Even breast cancer is reducing. The exception is in mental health where there is a gap in our ability to do something about it. Covid made this worse.

For the over 50s things have got much better. Cancer deaths peaked in the 1950s since when there has been a steady decline. A 75% drop since 1975 is largely due to the reduction in cigarette smoking. There has been a decline in CVA mortality as well. This has been driven by the use of antihypertensives by primary care and the use of stents, surgery and thrombolytics in the hospital setting. There has been, he said, a series of incremental improvements resulting in a general decline in the mortality from most major cancers which is very positive.

However there are headwinds. Obesity is the big challenge. It starts in early childhood and is strongly linked with deprivation. Deprivation correlates to smoking, obesity and poor working conditions. It became worse during the Covid epidemic.

An ageing population produces new problems. When better off people retire they tend to do so to the country. Their children are left in the big towns and cities for work and are not able to support their parents if needed. Who is going to support them?

The incidence of dementia in men is half that in women and presents a care problem. The mortality in 80 year olds is improving whereas in 90 year olds it remains constant. However people in their 80s are getting multiple diseases and the medical profession cannot cope with this.

In conclusion he said that life expectancy has increased and the health of the population is improving at a remarkable pace.

The President thanked Sir Chris for a fascinating lecture and that it was a great honour for us to have such a high profile visitor. Sir Chris in response thanked the Society for their hospitality.

There being no other business the meeting was closed.