Prevention Matters

A major review of health inequalities in England says the National Health Service must spend much more on preventing illness and focus more attention to giving every child the best start in life.

The Marmot Review calls for NHS spending on preventing illness at a level much higher than the current 4%, with more money going to initiatives such as providing statins and helping people to stop smoking. It says people in England's poorest neighborhoods are likely to die seven years earlier than people in the richest areas - and a greater portion of those shorter lives will be spent unwell. The report estimates up to 202,000 early deaths could be avoided, if everyone in the population enjoyed the same health as university graduates.

Suzanne Bohan and Sandy Kleffman write in the Contra Costa Times about  "unprecedented — yet uncontroversial — disease prevention initiatives whose inclusion has been lost in the rancorous debate over health care reform legislation working its way through Congress."

Such initiatives provide federally funded security guards at dangerous neighborhood parks and federal grants to poor neighborhoods to build grocery stores or to keep school gyms open after hours.

"The prevention provisions mark a victory for advocates and federal lawmakers who for years have unsuccessfully sought more federal funding to close the gap in health disparities and life expectancies between richer and poorer Americans," Bohan and Kleffman write.

The heart attack gap between men and women is narrowing in good and bad ways for women. Two new studies show that the number of heart attacks is rising among middle-aged women and falling among men, but the risk of death after a heart attack is improving more for women than for men.

Research in developed countries has long shown that income disparities translate into significant gaps in health and longevity. But a new study shows that smoking obliterates any such advantage. According to its authors, the extra years of life that, on average, come with being in the highest social brackets are more than wiped out by smoking. The finding is based on tracking of mortality rates over a 28-year period among 15,000 men and women entering into old age.