There is a lack of evidence regarding the preparedness of general practitioners (GPs) to respond to pandemic influenza. A postal questionnaire survey was conducted to explore the self-perceived pandemic preparedness of GPs in the West Midlands, United Kingdom, and to determine differences between urban and non-urban GPs. The postal questionnaire was sent out to 773 GPs in November 2005, and a reminder was sent in January 2006. In all, 427/773 (55%) questionnaires were returned, and 56% of respondents were aware of influenza pandemic preparedness plans. Approximately one-quarter of respondents (28%, 114/401) thought the response of their practice to a pandemic event would be very poor/poor. Non-urban GPs were significantly more likely to rate the response of their practice to a pandemic as likely to be poor (OR 3.01, 95%CI 1.03-8.76) and were less likely to be aware of pandemic preparedness plans (OR 0.62, 95%CI 0.39-0.99). Non-urban GPs were also significantly more likely to feel less confident in their ability to explain to their patients what to do and why during an influenza pandemic than GPs based in urban areas (OR 4.68, 95%CI 1.78-12.31). GPs rating of the odds of a pandemic affecting the United Kingdom did not differ significantly by geographic location. The results of this paper can be used to inform and influence public health policy and as evidence of a need to provide additional education and training to improve pandemic preparedness among GPs, in particular those in non-urban areas.

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Women's Health VictoriaTaylor's article on small area population disease burden concluded that users of burden of disease studies' data need to examine the methodology and assumptions carefully before accepting the results. 1 This is a timely contribution to the current health policy developments in Victoria where Primary Care Partnerships (PCPs), local integrated primary health care service groups, are compelled from July 2001 to produce community health plans, and one of the most readily accessible data sets on which to base evidence for these plans is the Victorian Burden of Disease (BOD) Study.Women's Health Victoria shares a number of concerns about the BOD methodology that have been raised by its critics. 2 These concerns centre on what aspects of health are being measured by BOD, the lack of consultation in determining the disability weights, and the appropriateness of BOD as a resource allocation or priority setting tool.In addition, there are a number of specific concerns about whether BOD adequately measures the disease burden of women. The BOD methodology fails to capture the differential health effects of gender (as opposed to mere sex disaggregation). For example, social determinants of ill-health such as physical/sexual abuse and discrimination are not considered, the caring responsibilities of women are not taken into account, and preferences for different health states have been assumed to be the same for women and men. There is also a strong reliance on epidemiological studies, recognised as often being gender-blind, 3 to determine incidence levels and the disability weights.All population health status measures have their strengths and limitations. Our immediate concern with BOD is around how the methodology is being used in Victoria. We are the only State in Australia to have BOD data available at the local government area (LGA) level, and within Victoria, BOD data are among the most readily accessible at the LGA level. The influence of these data are clear in the recently released Community Health Plans from the 32 PCPs in Victoria. 4 Our concern is that many PCPs do not have well-developed skill levels for data analysis, or ready access to additional data sources and that prioritisation and resource allocation decisions will be made based on only a fraction of the 'full picture'. There is a notable omission in the Community Health Plans, for example, of a gendered focus.Although the Department of Human Services promotes that planning decisions should not be based on BOD alone, anecdotal evidence is that individual services are changing service delivery to women because BOD shows that men's health is worse than women's health. This is true overall, however, some dimensions show women's health as worse than men's health. The central issue here is not whether women or men are more unhealthy, rather, it is that service delivery is being changed based on a methodology that is problematic. Furthermore, the very service model that is being changed may be the reason for women's good health. We