Poor Britain

Living conditions, inequalities in health, human rights and security: a European perspective in a global context

This paper examines the living conditions and inequalities affecting health, human rights and security in developed Western countries. Possible remedies based on experience in Sandwell Health District, West Midlands, are considered and analogies drawn with global initiatives.

All together now: why social deprivation matters to everyone

Inequalities in health in the United Kingdom are widening as a result of economic policy. By focusing on specific diseases, health policy fails to address why less prosperous groups die earlier from most major categories of death. By concentrating on actions which can be taken by individuals and local communities health policy ignores actions which require the support and involvement of society as a whole. Clinicians see the consequences of health and economic policy in their everyday practice and could contribute more effectively to public debate.

Geographical mapping of diabetic patients from the deprived inner city shows less insulin therapy and more hyperglycaemia

To determine whether or not economic and social deprivation were associated with different diabetic treatment and metabolic control, data of patients from deprived inner city wards and prosperous wards were compared. A database was obtained for 1528 patients attending our hospital Diabetes Care Centre. Demographic data and postcodes were used to construct geographical maps of disease and deprivation. Blood glucose and glycated haemoglobin were measured. Inner city patients were less likely to be taking insulin, but if they were, they were more likely to have higher blood glucose values (p = 0.02) and higher glycated haemoglobin values (p = 0.02), compared to patients from prosperous wards. Insulin-treated patients from socially and economically deprived wards had worse diabetic control than patients from more prosperous wards. The study emphasizes the needs to target deprived patients for education and motivation to understand diabetes, and to optimize metabolic control.