UK
North-South divide in death rates from coronary heart disease - UK
By British Heart Foundation
Jul 7, 2005, 18:18

The North-South divide in death rates from coronary heart disease in UK is not narrowing, despite fewer numbers dying from the disease year on year, BHF statistics reveal.

The premature - under-75 - death rate from CHD for men and women living in Scotland is 67% and 84% higher respectively than the South West of England.

The pattern is of a gradually increasing death rate the further north you go, although Wales is also a hotspot, with a higher rate than the England average.

The North-South divide increased in the 1980s and early 1990s, and has since remained stubbornly high.

For example, the difference in male premature death rate between Scotland and South West England was around 40% in the 1980s, but since 1992 it has fluctuated between around 50% and 70%.

Professor Peter Weissberg, Medical Director of the BHF, said: "The North-South divide in death rates has
been a problem for decades and it is concerning that the gap is not narrowing, despite efforts made in recent years to improve public health in those areas
most in need."

The extent of the problem is revealed in the BHF�s 2005 compendium of annual statistics. The report gives a comprehensive guide to the latest trends in the burden of CHD, treatment and major risk factors.

The statistics show that despite the falling death rate - largely as a result of healthcare advances - CHD is still the UK�s single biggest killer, taking nearly 114,000 lives in 2003.

That�s still nearly 3.5 times more deaths than lung cancer and over 5.5 times more deaths than those caused by injuries or poisoning.

And while fewer are dying from CHD, more are living with the disease. In just 10 years from 1994 to 2003, the number of men living with CHD has increased from 6% to 7.4% of the adult population.

In women, the prevalence of CHD has also increased over the same decade from 4.1% to 4.5%. This means there are now an estimated 2.6 million people in the UK facing life with heart disease.

Nearly 27,700 men died prematurely from CHD in the UK in 2003. This is equivalent to 189 premature deaths in every 100,000 men.

But there are huge geographical variations. Scotland tops the table, with 244 premature deaths per 100,000 men, while in South West England the equivalent figure is 146.

Professor Weissberg said: "It is a complicated issue and it is still not clear exactly why the disparities are so pronounced. It is likely to be due to a combination of factors, such as lifestyle, social inequalities and healthcare provision.

"The good news is that most of the risk factors are potentially modifiable, which provides hope that these inequalities can be tackled.

"The BHF is pleased to be contributing �1.25 million into the National Prevention Research Initiative (NPRI) over the next five years, which will help shed more light on the causes of CHD and possible prevention strategies."

Today's new statistics point to some of the factors that contribute to the problem:

* 35% of men and 28% of women in Scotland smoke, compared to 29% of men and 26% of women in Wales and 27% of men and 24% of women in England.
* People in Scotland, Wales, Northern Ireland and the North of England eat less fruit and vegetables than people in the south of England. For example, Scots eat on average 153 grams of fruit a day, compared to 198 grams a day in the South West.
* High levels of alcohol consumption - particularly in binges - increase the risk of CHD, and people in Scotland and the north of England drink more than the south of England. For example, 27% of women in Scotland drink more than the recommended daily maximum compared to 15% in London.

Professor Weissberg added: "Smoking is one of the big issues that needs to be addressed. Scotland and Wales' impending moves to smokefree workplaces, aimed at protecting workers, should have the welcome added affect of helping more smokers to give up, but still greater efforts are needed to reduce smoking rates across the UK."

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