HEALTH in Waltham Forest is continuing to improve, but it is still behind the rest of London and there are worrying signs that it may get worse in the future, according to an influential study.

Waltham Forest Primary Care Trust (PCT) yesterday launched its annual health report, which is used to set the PCT's programme of work for the coming year.

Entitled Gateways to Health and written by PCT director of public health Dr Pui-Ling Li, the report shows the overall health in the borough is improving and death rates for all the major causes, including cancer, heart diseases and strokes are falling.

But it also said: "The magnitude of change was not sufficient to elevate the health status of our local people to a level comparable to the average for London and for England and Wales.

"The increase in the latest infant mortality rate, the performance of the cancer screening programmes and the high hospitalisation rates for heart diseases are a few indicators that show we must step up our work with local partners to promote health and reduce deprivation, as well as improving the quality of care."

The report said the death rates of people aged under 75 from circulatory diseases (heart disease, strokes, and hypertensive disease) has fallen for the sixth successive year to 101.3 in 100,000 people.

Premature cancer deaths (those under 65) has dropped to 69.05 deaths per 100,000 people.

But the borough has a high rate of hospital admissions for circulatory disease.

There were 3096.82 admissions per 100,000 people between 2006-2007, significantly higher than the average for England (2559.21).

It also now has the fifth highest infant mortality rate in London (up from ninth) and has the second highest colorectal cancer rate in London (123 per 100,000).

The rate of tubercolosis in Waltham Forest has increased, remaining higher than the rate for London and childhood obesity remains a serious problem throughout the borough.

Tuberculosis (TB) is at its highest rate in Waltham Forest for decades.

TB now affects 53.1 out of every 100,000 people in the borough and has been steadily increasing from 17.19 in 1982.

Waltham Forest's rate is above the London average (44.8) and dwarfs the England and Wales figure of 15.

The findings shows a direct link between overcrowded housing and TB.

The most overcorwded wards, such as Leyton and Cathall, Leytonstone, recorded the highest levels, while the areas which are sparsely-populated , such as Endlebury and Hatch Lane, Chingford, were least affected.

Members of the council's planning committee have repeatedly called for the authority's policy to be changed to allow them to reject more flat conversions.

Childhood obesity remains a "significant and escalating" problem in Waltham Forest, said Dr Li, a year after the Guardian first highlighted the shocking extent of the problem.

Nearly 4,500 primary school children in the borough were surveyed.

The findings showed that more than one in four of the borough's children aged four to five or ten to 11 was obese or overweight, according to a formula that compares body mass index and growth curves.

The percentage of ten and 11-year-old boys who were obese is double that for children aged four to five.

Dr Li said: "This increase in obesity prevalence with age points to the importance of tackling obesity at an early age as well as targeting the ten to 11-year-olds to halt further increase.

"Interventional programmes need to be applied across Waltham Forest because there is no geographical concentration of overweight or obese children.

"There were as many overweight or obese children living in the more wealthy northern part of the borough as in the more deprived areas south of the borough."

Smoking remains the "single most important preventable cause of circulatory disease", said Dr Li.

One in three male cancer deaths in Waltham Forest is attributed to smoking and for women, the figure is one in five.

Dr Li said the PCT's smoking cessation service has been successful, meeting its targets this year.

She added: "Banning smoking in enclosed public places last year encouraged many people to give up."

For advice on stopping smoking contact the Waltham Forest Stop Smoking Service on 8430 7443.