The aim of this research project was to assess and compare cardiovascular disease (CVD) risk in black males and females from an urban, working population in the Makana (Grahamstown) region of the Eastern Cape, South Africa. Two-hundred and ninety one individuals (males: n = 143, females: n = 148) with a mean age of 42.6 (±8.1) years were voluntarily recruited from the greater urban Makana (Grahamstown) area. Eight Cardiovascular disease (CVD) risks were assessed: stature and mass were obtained in order to calculate body mass index (BMI) (mass/stature2). Obesity, defined as a morphological risk, was classified according to the World Health Organisation (WHO) BMI criteria (BMI>30kg.m-2), as well as according to measures of waist circumference (WC) and body composition. Hypertension, hypercholesterolemia and type II diabetes, were grouped as cardiovascular (CV) risks. Hypertension was defined as a blood pressure greater than 140/90mmHg (JNC-7); hypercholesterolemia, as total cholesterol greater than 6.2mmol.L-1 (NCEP); and type II diabetes, as total glucose greater than 12mmol.L-1 (WHO). Physical activity, diet, tobacco use, and alcohol consumption and dependence were grouped as lifestyle-related risks. These were assessed by means of self-reporting through the use of various validated questionnaires. Finally, self-reporting of obesity, hypertension, hypercholesterolemia and type II diabetes was assessed, in addition to perception questions on individuals’ perceived body shape and size (Ziebland figures). Self-reported and perceived responses were then compared to actual measures. Females were significantly (p<0.001) heavier than the males (92.7kg compared to 72.1kg) and had significantly (p<0.001) higher BMIs than their male counterparts (37.6kg.m-2 compared to 25.7 kg.-2). They also recorded significantly (p<0.001) higher waist circumference (WC) values and had significantly (p<0.001) higher percentage and total body fat. Significantly (p<0.001) more females were obese (81%) compared to males (17%). While a higher percentage of males (25 % compared to 22%) presented with stage I hypertension (≥140/90mmHg, <160/95mmHg), significantly (p<0.05) more females (14% compared to 8%) presented with stage II hypertension (>160/95mmHg). The prevalence of hypercholesterolemia at a high level of risk (>6.2mmol.L-1) was relatively low (2.1 % of males, 3.4% of females), but notably more participants (22% of males and 26% of females) presented with the condition at a moderate level of risk (>5mmol.L-1). Type II diabetes was the least prevalent CV risk factor, with no males and only 3% of females presenting with the condition. Males consumed significantly (p<0.05) more in terms of total energy intake (9024 vs. 7234 kJ) and were significantly (p<0.05) more active (3315 compared to 2660 MET-mins.week). A significantly (p<0.05) higher percentage of males smoked (51.1% compared to 3.4%), consumed alcohol (73.4% compared to 46.6%) and were alcohol dependent (40% compared to 33.5%). Both males and females tended to be ignorant of their health status, with both samples under-reporting obesity, hypertension and hypercholesterolemia, while over-reporting type II diabetes. Furthermore, obesity was significantly (p<0.05) underestimated, with both male and female individuals perceiving themselves to be notably smaller than they actually were. Physical activity and diet were important determinants of CVD risk in this black urban sample of individuals. Obesity, in particular central adiposity, was the most notable risk (particularly in females), followed by hypertension (particularly in males). Although some risks presented at a moderate level of risk, a clustering of risk factors was evident in both samples, with 12.6% and 41.2% of males and females presenting with two risk factors, and 2.8% and 8.1% of males and females respectively presenting with three risks.

[Preface]:In 1862 Grahamstown acquired the dignity, pride and responsibility of full municipal status by its own Act of Incorporation. Ibis Act marked the consolidation of Grahamstown's era of local government by its vigorous and far-sighted Municipal Board of Commissioners, which was established in 1837 and has been examined in depth in K.S. Hunt's thesis on Grahamstown municipal government up to 1862. Clearly, the year 1862 is the logical beginning for a further study of Grahamstown's changing position in the Eastern Cape and its development in the practice of local government during the crucial decades of the 1860's and 1870's. But the choice of 1882 to mark the end of this thesis is in some ways arbitrary. 1882 does not appear to be a turning point, a year of major significance in either the history of Grahamstown or of the Colony as a whole. Besides the convenient time-span of twenty years, there are various factors which, taken together, explain why 1882 is a useful date of demarcation from which to take stock and review Grahamstown's economic, political, social and municipal position after two vital decades in its history. In the civic sphere,the opening of Grahamstown's Town Hall made tangible,in solid Victorian design,a long held ambition of the City Councillors. Buildings, in Victorian attitudes, throughout the British Empire, were regarded as very important civic symbols. One can learn much of Grahamstown Victorian attitudes from the lengthy process of attaining a Town Hall. A much more elaborate ceremony surrounded the opening of the Jubilee Tower, an occasion for assessing the influence of Grahamstown's Settler heritage on the development of the town. Municipal problems concerning finance, water and "native" locations remained thorny questions as they had throughout the period 1862-32. Generally 1882 was a year of transition for Grahamstown and the Colony as a whole. Economically it appeared to start prosperously but 1882 actually marked the beginning of a severe depression which lasted until 1386. It is important to consider how Grahamstown’s economic development relates to the overall economic picture of the Cape Colony at this juncture. Though ostrich feather prices remained high in 1882, the ensuing depression was caused partly by the rapid overexpansion of the industry but most important of all, by a reaction to an inflated era of confidence during the diamond boom years of the 1870's and their consequent easy Bank credit plus intense speculation. Politically 1882 also appeared a year of transition. How to maintain the uneasy peace after the Basuto war remained a constant challenge to Scanlen's ministry. The beginnings of active party conflict in the workings of responsible government were evident only in embryo. The rapid growth of the Afrikaner Bond was to change this. Specifically in relation to the practice of local government in the Cape Colony, the General Municipal Act No. 45 was passed during the Parliamentary session of 1882, enabling any town to seek incorporation. The query is raised as to how far the modus vivendi of the Grahamstown municipality helped frame the clauses of this general Municipal enabling Act. For these various reasons, as well as the additional one that twenty years was found to offer a manageable research unit, 1882 has been decided on as the limit of this thesis. This thesis aims, through a careful examination of Grahamstown's economic, political but particularly civic development, to determine and trace the nature of the Grahamstown community's response to the challenge of the gradual isolation of the 1860's and 1870's. Grahamstown's civic history provides fascinating insights into the structure of the entire community and its attitudes and values. Study has been made of the following major primary sources for the history of Grahamstown 1862-1882: the Grahamstown Municipality records, complete except for incoming letters and housed in the Cape Archives, und the Grahamstown newspapers for the period. The most prolific as well us the most valuable newspaper source of the period is The Grahamstown Journal, a newspaper with a tradition firmly bound up with the formulation of frontier as well as Grahamstown thought, kingpin of the network built up by the successors of Robert Godlonton, the "architect of frontier opinion". It has to be treated with caution as a source because of this very bias. The Council Minutes themselves, meticulously recorded in the Town Clerk's copperplate Victorian script, are scrupulously objective, recording blandly proposers, seconders and fates of motions. What might appear the bare bones of a detailed study of the municipal records yet reflects the economic climate of the town, political opinions, class and race attitudes, civic pride, concepts of public health and charity. The newspapers are a vital addition to the Municipal records themselves. The weekly meetings received faithful, accurate and very copious coverage from press-representatives present at every ordinary meeting. Indeed these reports give a vivid immediacy to the meetings and reveal opinions, pressure groups and lines of conflict within the Council, on issues important and trivial. These, at times lively and enlivening, sometimes stormy meetings, are reported with an authenticity which makes one suspect that often words of speeches were given verbatim - personalities of the Councillors certainly emerge distinctly. Full newspaper coverage is also given to the meetings of the Albany Divisional Council. The annual reports of the Civil Commissioners and Resident Magistrates, which appear in the Parliamentary Blue Books of the period, provide some valuable economic comment on the vicissitudes of life in the eastern frontier districts from 1862-1882. Such information builds useful background for a study of Grahamstown's economic and social development. Efforts have been made to locate probable sources of family papers of one of the most influential Grahamstown families of the period, the Wood family, but to no avail. If any exist they would without doubt have given interesting insight into the business connections of leading Grahamstown men and possibly given an indication of how far civic and political connections linked with religious and family influences in Victorian Grahamstown. Jim's Journal, manuscript in Cory Library, is a record of letters sent home to England by James Butler, while on a visit to the Cape,1876-79 for his health. He provides illuminating glimpses into the day to day life of Grahamstown from a Quaker viewpoint. Taken together, these sources provide considerable insights into the life and times of Grahamstown in the second half of the nineteenth Century. A municipal study examines an area in its totality: it encompasses a study of minutiae within the context of general trends. This fact alone suggests that there are many sources on the history of Grahamstown which have not yet been discovered, but this assessment is submitted on the basis of a thorough study of those which are currently available.