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PUBLIC RELEASE DATE:
27-Sep-2011

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Contact: Dr Hilary Glover
hilary.glover@biomedcentral.com
44-020-319-22370
BioMed Central
@biomedcentral

Postcode lotteries in preventative health care -- not necessarily all bad news

There is much interest in the unequal health care caused by postcode lotteries. The area you live in can impact the treatment you receive for cancer treatment, surgery or GP care. Research published in BioMed Central's open access journal BMC Public Health shows that there are also geographic differences in the implementation of public health programs.

In 2009, the government introduced 'Health Checks' a national public health program with the aim of reducing the incidence of cardiovascular disease (CVD). This program is open to all 40-74 year olds with no prior history of CVD and aims to assess each person's risk of a cardiovascular event within the next 10 years and provide them with advice and medication if necessary.

Using an example of eight primary care trusts (PCTs) in North West London, researchers examined the amount of money each PCT spent on the program, how they recruited eligible people onto the program, what parameters they tested (including blood glucose levels, blood pressure, weight, alcohol intake, smoking and exercise) and what information and treatment was provided after the examination.

The results showed considerable variation across the PCTs including the amount of money spent per person. However, apart from one PCT, there was a general trend that PCTs responsible for more deprived areas, which traditionally have a higher burden of CVD, spent more per eligible person than PCTs responsible for more affluent areas.

For most PCTs, 'Health Checks' are carried out in GP practices. But flexibility in the scheme meant that the 'Health Checks' could also be carried out at local pharmacies, or at community events to include high-risk individuals who typically do not visit their GPs. This included football stadiums and job centers, to catch middle aged men in manual jobs, and people out of work.

Dr David McCoy from the Public Health Directorate said that, "This study shows both good and bad in the way in the 'Health Checks' Program is implemented. Better coordination and sharing of information between PCTs could help iron out inequalities, reduce costs and PCTs would be able to learn from the experience of others."

Dr McCoy continued, "A more serious problem we found was the lack of a common approach to evaluating the impact of 'Health Checks'. While we can count the number of health checks done, we currently don't know if this has a positive effect on unhealthy behavior or prevents CVD. Also there was no way of knowing whether uptake and impact of the program was the same for all sections of the population. The main point is to ensure that regardless of interpretation of guidelines, 'Health Checks' results in a real reduction in CVD risk."

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Notes to Editors

1. Postcode Lotteries in Public Health - The NHS Health Checks Programme in North West London Clare E M Graley, Katherine F May and David C McCoyBMC Public Health (in press)

Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central's open access policy.

Article citation and URL available on request at press@biomedcentral.com on the day of publication.

2. BMC Public Health is an open access journal publishing original peer-reviewed research articles in the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.

3. BioMed Central (http://www.biomedcentral.com/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.



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