A new study published in the Lancet this week has shed light on ‘startling’ variation in premature mortality rates, with many causes of heart and circulatory disease being major risk factors in early deaths in England.
The comprehensive analysis of health at a local, national and regional level across the UK paints a varied picture of health outcomes. Rates of premature mortality from all causes were more than two times higher in the most deprived local authority areas in England, such as Blackpool, compared to the most affluent, such as Wokingham in Surrey.
The inequalities were even more pronounced for heart and circulatory disease deaths. Coronary heart disease was also the leading cause of premature death in 2016, with rates being two times higher in men than women.
The study, from the Global Burden of Disease Initiative, and co-authored by researchers at Public Health England and University of East Anglia, found while overall death rates have improved since 1990, half of all premature deaths in the UK are linked to a range risk factors including high blood pressure, alcohol, obesity and diet.
Declining death rates, but a more complicated picture
Across the UK, the study found that death rates have fallen, and people are now living with long term, frequently multiple conditions.
“As death rates decrease, people continue to live with long-term, often multiple, conditions,” says Professor Nicholas Steel, lead author, University of East Anglia.
“Our findings show a significant shift from mortality to morbidity, yet our health services are still designed to deal with the big killers. Today, conditions such as back and neck pain and anxiety and depression are huge causes of disability in the UK.”
A chance to change the picture
The NHS in England is currently planning for the next ten years, and the British Heart Foundation believes this is a vital chance to tackle not only health inequality, but also ensure that increased multiple-morbidity is better managed.
Commenting on the study’s findings, Simon Gillespie, Chief Executive at the British Heart Foundation said: “Progress is stalling in reducing death rates from heart and circulatory diseases and little has been achieved in closing the gap in health outcomes between those in the wealthiest and most deprived areas of the country. The depressing reality is that where you live and your wealth can still have a significant bearing on how long you live.
“Preventing the causes of heart disease is an essential part of tackling this startling inequality, which belongs in the Victorian era. This means ensuring that conditions such as high blood pressure and diabetes are diagnosed and managed at an early stage. We also need bold action – including commitments from industry and Government – to address lifestyle factors such as poor diet and smoking. The NHS’s plan for the next ten years is a singular opportunity to address this grave situation.
“This research is also a stark indication of the unprecedented pressure our health system is facing from an ageing population with multiple chronic conditions. Nine in ten heart patients are living with at least one other long-term condition, often requiring multiple appointments with different doctors. Research can help us find new treatments for these people, and we also need to test innovative ways of giving patients personalised care in the NHS that isn’t focused on their individual illnesses.”