Posted on Dec 09, 2013 by Ruth Loftus
Creating a healthier population isn’t just a matter of ensuring that the right treatment is readily available for people who fall ill. Instead, it is becoming an increasingly common realisation that good health is much more about prevention of sickness rather than intervention after it has developed.
Within the UK, responsibility for good public health has recently passed to local authorities which are now expected to take steps to improve the situation in their own area – particularly with regard to issues such as smoking and alcohol consumption, obesity and exercise. Local government will collectively receive over £5.4billion of additional funding over the next two years to address these problems.
Recent base line research has examined the variation in health and revealed just how grave the current variations actually are. Overall, it underlines the need for persistent action in this regard. The research investigated approximately 153,000 people who are annually classified as dying ‘prematurely’ in England. Causes of these death include cancer, heart attack or stroke, lung disease and liver disease. The basis of the analysis was the number of deaths occurring among people aged below seventy five.
The impact of such early death phenomenons is most marked in the more urban areas of the north west of England with areas such Manchester, Blackpool, Liverpool and Salford standing out significantly amongst the data. Although it seems clears that the socio-economic character of areas plays a major part in generating the differences, there is evidence to suggest that there are a number of other complicating factors at play.
An area such as Waltham Forest close to London ranks as the fifteenth most deprived area according to the general social picture, but it is ‘only’ fiftieth in the ‘early death’ tables.
The data has produced perhaps an element of squabbling among politicians across both national and local parties. The minister with overall responsibility for health described the picture revealed by the statistics as ‘shocking’, and he called on local government to take urgent action with new resources being made available.
Local government politicians expressed concern that the data ran the risk of oversimplifying the situation and ignoring complex socio-economic and cultural factors. They were also concerned to underline the fact that notwithstanding the new responsibilities placed on local authorities, public health was not the sole responsibility of local government and that the building of even more effective partnerships with government and the health sector were vital if the current situation was to be addressed properly.
The issue of regional variation in treatment and end results was also highlighted recently in the UK with regard to one very specific and very high profile condition – breast cancer.
A new research programme has suggested that deaths from breast cancer of poorer women are much higher than they should be. This came from a study undertaken at Cambridge and Leicester universities which investigated data from 20,738 women in eastern England who had diagnoses of breast cancer between 2006 and 2010.
The research looked specifically looked at the stage of the disease when the tumours were identified. As is almost always the case with cancer, an early diagnosis means that options for treatment are much more positive and so is the prognosis and possible outcome for the patient.
The Cambridge/Leicester study indicated that women from more affluent areas were being diagnosed at an earlier stage in the development of the condition – with all of the potential benefits that this presents.
Overall, the analysis which was presented at the National Cancer Research Institute conference suggested that some 450 deaths from breast cancer each year may be attributed to poverty levels and that late diagnosis was the principal issue. Essentially, if women from poorer backgrounds could match the diagnosis profile of the financially better off, mortality could be reduced by this level. The cause of this difference in behaviour is not entirely understood yet but it is believed that it’s a matter both of symptom awareness and also the action taken once a woman finds that there is something wrong. Women from more affluent backgrounds appear to recognise symptoms earlier and take the necessary action by involving their GP and then specialist support.
The actions arising from this research need to be even greater and efforts to boost awareness campaigns undoubtedly need to increase. One of the most urgent tasks not only to ensure that these women are able both to recognise the characteristics of the early stages of breast cancer, but also have sufficient confidence in the availability and effectiveness of treatment to seek the advice and help of the medical profession at the earliest stage.