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Showing posts from May, 2011

Under-diagnosis of cardiovascular disease in England

Despite financial incentives to encourage general practices to register new cases, there is still under-diagnosis of cardiovascular disease (CVD) in England. In a paper published recently in BMC Cardiovascular Disorders, Michael Soljak colleagues compared the modelled (expected) and diagnosed (observed) prevalence of three cardiovascular conditions- coronary heart disease (CHD), hypertension and stroke- at local level, their geographical variation, and population and healthcare predictors which might influence diagnosis. They found that  9,682,176 patients were on practice CHD, stroke and transient ischaemic attack, and hypertension registers. There was wide spatial variation in observed: expected prevalence ratios for all three diseases, with less than five per cent of expected cases diagnosed in some areas. They concluded that despite access to universal, free primary healthcare, there may be substantial under-diagnosis of CVD across England.

Does the BMA really care about inequalities?

The British Medical Association prides itself on its supposed commitment to tackling societal inequalities, particularly inequalities in health. One of the key drivers of health inequalities is income inequalities. In a letter published in the BMJ by one of the BMA's staff, the BMA claimed that it pays all its staff well above the minimum wage. However, it did not state what staff whose services were contracted out - such as catering staff - were paid. What the BMA representative seemed to be saying in her letter was that the BMA had subcontracted the employment of workers who are most likely to receive the minimum wage to external companies and had no idea (and perhaps doesn't care?) what they are paid. In a follow on letter also published in the BMJ, I asked for further clarification from the BMA on this point. Nearly three months after publication of my letter, there has been no further response from the BMA. Does the BMA really care about inequalities - or  are its comment…