- Heart disease drops dramatically but gap between rich and poor widens
- People in deprived areas are more likely to be hit by heart problems
- Health cuts must not affect screening and treatment, say experts
By Sam Webb
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Heart disease in the UK has halved since 1982 but the rate of improvement varies widely between poorer and richer regions, according to a new study.
Health experts said the decline in heart disease deaths is because of a combination of better prevention and treatments.
But a map of England released as part of the study has highlighted a widening North-South divide in death rates from heart disease - with younger people up to four times more at risk.
Deaths among men 30-64. Areas in the north have improved but a higher number of deaths are still clustered in urban areas
Deaths among women 30-64. Deaths have dropped across England but some areas in the North west, North East and in London are still lagging behind
Cardiovascular deaths among men 65 and older between 1982-1986 and 2002-2006: Areas with a greater number of deaths are shown in darker colours
Deaths among women 65 and older. Deprived areas have much higher incidences of heart disease
And scientists warn the link between deprivation and Britain's biggest killer could become even more acute as the Government's austerity measures eat into health budgets.
They estimated mortality for heart and circulatory conditions in each electoral ward between 1982 and 2006.
Although numbers fell in most places, for elderly people the decline was smaller in the worst-off communities, meaning the gap between the working and middle classes grew.
Cardiac divide: A study found that younger people in deprived areas are up to four times more at risk of heart problems
Between 2002 and 2006 those aged 30 to 64 in the least affluent wards were four times more likely to die from heart disease than those in the wealthiest.
For people 65 and older living in the same area the risk was almost double.
Previous research has shown social deprivation can affect health because a lack of money leads to bad diets and more smoking and drinking.
The study published in the International Journal of Epidemiology showed a strong link between heart disease mortality and the socioeconomic status of the ward including income, employment and education levels.
Broadly, the places with the highest death rates were in areas around Manchester and Liverpool, in parts of Yorkshire, around Birmingham and in deprived boroughs of London.
Outside of London, death rates were generally low in southern England
The researchers at Imperial College London warned the declining trend in deaths from heart disease could be threatened in some areas if the economic downturn and Government cutbacks affect poor communities disproportionately.
Changes in the health system, such as the devolution of public health responsibilities to local authorities, may also put some communities at risk of falling behind, they suggest.
Study author Dr Perviz Asaria said: 'It is clear that both social conditions and the quality of the health service strongly affect heart disease mortality.
'The Health and Social Care Act, which allows private companies to provide care under the NHS, and the extraordinary pressure on the NHS to make savings might jeopardise health services, including the crucial role of GPs, in poor communities.
'And if people's jobs are less stable, they may be forced to change their diet, or drink and smoke more. So we need to be concerned about these issues if we are going to carry on bringing death rates down.'
Heart and circulatory disease mortality fell from 1982 to 2006 in almost every area, yet geographical discrepancies remain
Although heart and circulatory disease mortality fell from 1982 to 2006 in almost every area, it increased for women aged 65 or over in 186 out of 7,932 wards
Co-researcher Professor Majid Ezzati said: 'These results are a valuable measure of the performance of the health system at a local level, which includes the NHS and public health services as well as other prevention strategies.
'We know how to reduce cardiovascular mortality. We have to reduce major risk factors like smoking, and provide good health services that help both with prevention through high-quality GP services and with treatment.
'We need to focus on putting these into practice in places that are behind.'
Mortality from cardiovascular disease has more than halved since the 1980s in England, but it remains the leading cause of death.
Prof Ezzati added: 'Notwithstanding the hotspots in London, the map does show a north-south divide with paradoxically the gap between rich and poor in death rates from heart disease getting wider at a time when there is an overall improvement.
'We can do the tests to prevent heart attacks and stroke now but many people are still not getting their blood pressure checked early and often enough, and eating unhealthily as well as smoking and drinking.
Emergency: Deprivation can lead to poor diet and more smoking and drinking, increasing the risk of heart disease
But health inequalities implicate psycho-social factors, community physical environment, health behaviours and healthcare access and quality.
Prof Ezzati said: 'Clearly, the roles of these factors are not independent, as deprivation, stress and poor working and living environments may themselves be causes of hazardous health behaviours or lower-quality healthcare.'
Mubeen Bhutta, policy manager at the British Heart Foundation, said: 'The overall decline in heart disease death rates should be something to celebrate but, worryingly, that improvement has not benefitted everyone equally.
'If we are going to make a proper job of tackling England's biggest killer, eradicating inequalities must be at the heart of the Government's new cardiovascular disease strategy.
'The communities that need help the most must not be forgotten and targeted interventions in the poorest neighbourhoods will help address a problem which has dogged this country for decades.'
It's been known for a long time that there is a close correlation between low rates of heart disease and hard water areas. (Try Googling it). Maybe that's all we are seeing here. - James , Farnham, 05/11/2012 21:27>>>>>>>> And lower rain fall! And higher average temperatures! And proximity to France!
- John S , Bromley, United Kingdom, 05/11/2012 23:20
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