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Press releases Saturday 30 April 2005
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(1) HEALTH INEQUALITIES CONTINUE TO WIDEN, DESPITE GOVERNMENT RHETORIC
(2) OBESITY IN MIDDLE AGE INCREASES RISK OF DEMENTIA IN LATER LIFE
(3) NO EVIDENCE
THAT CALCIUM AND VITAMIN D PREVENT FRACTURES
(4) DAY CARE IN
INFANCY PROTECTS AGAINST CHILDHOOD LEUKAEMIA
(1) HEALTH INEQUALITIES CONTINUE TO WIDEN, DESPITE GOVERNMENT RHETORIC
(Health inequalities and New
Labour: how the promises compare with real progress)
http://bmj.com/cgi/content/full/330/7498/1016
Health inequalities in Britain have continued to increase, despite the government's commitment to tackle the problem, argue researchers in this week's BMJ.
Inequalities in health widened in the 1980s and 1990s, and the current government has repeatedly expressed its intention to reduce these inequalities. In February 2001 it announced national targets to reduce the gap in infant mortality across social groups and to raise life expectancy in the most disadvantaged areas faster than elsewhere by 2010.
But the new 10-year analysis shows that inequalities in life expectancy have continued to widen in the early years of the 21st century, alongside a general trend of widening inequalities in income and wealth.
Life expectancy continues to rise in the most advantaged areas of the country at a greater pace than in the poorest areas. Among men, for example, the difference between the local authority with the lowest life expectancy (Glasgow City) and the one with the highest (East Dorset) has risen to 11 years. Since Victorian times, such inequalities have never been as high, write the authors.
The Slope Index of Inequality for life expectancy, according to decile of poverty, which the authors argue is a more appropriate measure than the official target, increased from 3.71 in 1992-94 to 3.87 in 2001-03.
Income inequalities also rose markedly in the 1980s and have been sustained throughout the 1990s and into the 2000s, although encouragingly a fall in income inequalities in the most recent time period can be seen. However, income inequalities are such that the poorest 10% in society now receive 3% of the nation's total income, whereas the richest 10% receive more than a quarter.
Wealth (which can be financial, such as savings, or other assets, such as house ownership) is more unequally distributed than income. Since the 1970s wealth inequality has increased, particularly so since 1995-6. Between 1990 and 2000 the percentage of wealth held by the wealthiest 10% of the population increased from 47% to 54%, and the share of the top 1% rose from 18% in 1990 to 23% in 2000.
Wealth inequalities better reflect the accumulation of lifetime (dis)advantage, and the growing inequalities in wealth seen in recent years do not bode well for future trends in health inequalities, say the authors.
According to the 2002 British Social Attitudes Survey, 82% of people thought the gap between those with high incomes and those with low incomes was too large. Although New Labour has succeeded in raising the living standards of some of the poorest people in Britain, inequalities in wealth have continued to grow and are likely to be transmitted to the next generation, they add.
More substantial redistributive policies are needed that address both poverty and income inequality, they conclude.
Contacts:
Mary Shaw, Reader in Medical Sociology,
Department of Social Medicine, University of Bristol, UK
Email: mary.shaw@bristol.ac.uk
Danny Dorling, Professor of Human
Geography, Department of Geography, University of Sheffield, UK
George Davey Smith, Professor of
Clinical Epidemiology, Department of Social Medicine, University of Bristol,
UK
(2) OBESITY IN MIDDLE AGE INCREASES RISK OF DEMENTIA IN LATER LIFE
Online First
(Obesity in middle age and future risk of dementia: a 27 year longitudinal
population based study)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38446.466238.E0
Obesity in middle age increases the risk of dementia in later life, finds a study published online by the BMJ today.
The study involved 10,276 members of Kaiser Permanente medical care programme in California who underwent detailed health checks from 1964 to 1973 when they were aged 40-45 and who were still members of the health plan in 1994.
Information was collected on demographics, medical history, medical conditions, body mass index, and skinfold thickness in the subscapular (shoulder) and tricep (back of the upper arm) area.
In 1994, dementia was diagnosed in 713 (7%) participants. Obese people (body mass index 30 or above) were 74% more likely to have dementia, while overweight people (body mass index 25-29.9) were 35% more likely to have dementia compared with those of normal weight (body mass index 18.6-24.9).
Body mass index predicted dementia more strongly among women. For example, obese women were 200% more likely to have dementia than women of normal weight, while obese men had a non-significant 30% increase in risk.
Both men and women with the highest skinfold measurements had a 60-70% greater risk of dementia compared to those with the lowest measurements.
There were no significant race interactions between body mass index and risk of dementia.
Obesity and overweight in middle age is strongly associated with an increased risk of dementia in old age, regardless of the presence of cardiovascular disease and diabetes in mid and late life, say the authors.
To date, this is the first study to determine the contribution of mid-life adiposity and skinfold thickness on risk of dementia, they add. If these results can be confirmed elsewhere, perhaps treatment of obesity might reduce the risk of dementia.
Failure to contain the present epidemic of obesity may accentuate the expected age related increase in dementia, they conclude.
Contact:
Dr Rachel Whitmer, Gerontological
Epidemiologist, Kaiser Permanente Division of Research, Oakland California,
USA
Email: raw@dor.kaiser.org
(3) NO EVIDENCE THAT CALCIUM AND VITAMIN D PREVENT FRACTURES
(Randomised controlled trial
of vitamin supplementation with calcium and cholecalciferol (vitamin D) for
prevention of fractures in primary care)
http://bmj.com/cgi/content/full/330/7498/1003
A study in this week's BMJ finds no evidence that calcium and vitamin D supplements reduce the risk of fractures in older women living in the community.
The researchers identified 3,314 women aged 70 and over and at high risk of hip fracture from primary care clinics. The women were randomly split into two groups.
The treatment group received advice from a practice nurse on how to reduce the risk of fracture and were given calcium and vitamin D tablets to take daily. The control group received only a leaflet on diet and prevention of falls. All women were monitored for an average of two years.
Over the monitoring period, fracture rates were lower than expected but did not significantly differ between the groups. There was no evidence that supplements reduced the risk of fractures or falling, or improved quality of life.
Putting this study in the context of other trials suggests that calcium and vitamin D supplementation may not be an effective intervention for reducing fractures in primary care, conclude the authors.
Contact:
David Torgerson, Director of York
Trials Unit, Department of Health Sciences, University of York, UK
Email: djt6@york.ac.uk
(4) DAY CARE IN INFANCY PROTECTS AGAINST CHILDHOOD LEUKAEMIA
Online First
(Day care in infancy protects against childhood leukaemia)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38428.521042.8F
Day care in infancy and risk of childhood acute lymphoblastic leukaemia: findings from UK case-control study
Please note, the embargo for this study will be lifted at 11.30 am UK time on Friday 22 April 2005, to coincide with a causes of leukemia press briefing at the Science Media Centre, 21 Albemarle Street, London, W1. The study will also be posted onto bmj.com at this time.
Children who attend day care centres on a regular basis in the first few months of life are less likely to develop leukaemia than children who do not, finds a study published online by the BMJ today.
These results support the theory that reduced exposure to common infections in the first year of life increases the risk of developing acute lymphoblastic leukaemia (ALL).
The study involved 6305 children (aged 2-14 years) without cancer, 3140 children with cancer (diagnosed 1991-6), of whom 1286 had ALL. Parents were interviewed about day care and social activity with children outside the family during the first year of life.
Increasing levels of social activity outside the home were associated with consistent reductions in risk of ALL. However, the greatest reduction in risk of ALL was seen in children who attended formal day care during the first three months of life (defined as attendance at a day nursery or nursery school at least once a week, or at least two half day sessions a week at a playgroup, mother and toddler group, or at a childminder with a minimum of four children attending).
Results were similar for cases diagnosed between 2-14 years and for cases diagnosed between 2-5 years.
"Our results provide further support that social activity with other infants and children during the first few months of life protects against subsequent risk of ALL," say the authors.
The most plausible interpretation is that this protection comes from exposure to common infections. Similar associations have been reported for type 1 diabetes and allergies in children.
"Whether early exposure to one or more specific infections, or to a spectrum of non-specific agents, protects against each of these disparate diseases remains to be clarified. Nevertheless, we conclude that some degree of early exposure to infection seems to be important for child health."
Contact:
Sonya Corbett, Senior Press Officer,
Leukaemia Research Fund, London, UK
Email: scorbett@lrf.org.uk
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