Comparing cancer mortality and GDP health expenditure in England and Wales with other major developed countries from 1979 to 2006

Rosenorn-Lanng

2015

Surg Neurol Int

Background:Have USA total neurological deaths (TNDs) of adults (55–74) and the over 75's risen more than in twenty Western Countries?Methods:World Health Organization TND data are compared with control mortalities cancer mortality rates (CMRs) and circulatory disease deaths (CDDs) between 1989–1991 and 2008–2010 and odds ratios (ORs) and confidence intervals calculated.Results:Neurological Deaths – Twenty country (TC) average 55–74 male rates per million (pm) rose 2% to 503 pm, USA increased by 82% to 627 pm. TC average females rose 1% to 390 pm, USA rising 48% to 560 pm. TC average over 75's male and female increased 117% and 143%; USA rising 368% and 663%, significantly more than 16 countries. Cancer mortality – Average 55–74 male and female fell 20% and 12%, USA down 36% and 18%. TC average over 75's male and female fell 13% and 15%, the USA 29% and 2%. Circulatory deaths – TC average 55–74 rates fell 60% and 46% the USA down 54% and 53%. Over 75's average down 46% and 39%, USA falling 40% and 33%. ORs for rose substantially in every country. TC average 75's ORs for CMR: TND male and females were 1:2.83 and 1:3.04 but the USA 1:5.18 and 1:6.50. The ORs for CDD: TND male and females TC average was 1:3.42 and 1:3.62 but the USA 1:6.13 and 1:9.89.Conclusions:Every country's neurological deaths rose relative to the controls, especially in the USA, which is a cause for concern and suggests possible environmental influences.

Section: Introductionmentioning

confidence: 99%

Neurological deaths of American adults (55-74) and the over 75′s by sex compared with 20 Western countries 1989-2010: Cause for concern

Rosenorn-Lanng

2015

Surg Neurol Int

“…Ratios of greater than 1.10 or lesser than 0.90 would be considered to be clinically and statistically significant (Guildford, ). However, in previous international comparative studies only ratios of greater than 1.20 or lesser than 0.80 were considered as indicating substantial change (Pritchard and Williams, ; Pritchard and Hickish, ; Pritchard and Wallace, ).…”

Section: Methodsmentioning

confidence: 99%

Under‐Fives Child Mortality and Child Abuse‐Related Deaths in the Former USSR: Is there an Under‐Reporting of Abuse‐Related Deaths?

Mirza

2014

Child Abuse Review

The study explores the former Union of Soviet Socialist Republics (USSR) countries’ under‐fives child mortality rates (CMR) and child abuse‐related deaths (CARD) since the end of the Soviet Union, and asks whether there has been an ‘under‐reporting’ of CARD? World Health Organization under‐fives mortality rates per million (pm) were extracted for 1988–90 and compared with 2008–10 for CMR and confirmed and possible CARD. Possible CARD are undetermined deaths (UnD) and ill‐defined signs and symptoms (IDSS) deaths as these categories have been linked to under‐reporting of CARD. CMR and CARD odds ratios were calculated and correlated to determine the possible under‐reporting of CARD. Seven countries met the United Nations International Children's Education Fund (UNICEF) objective of reducing CMR; five halving their previous USSR rate. The Russian CARD rate at 29 pm is the highest, but six countries’ rates were less than ten pm. UnD increased in Kazakhstan 13‐fold, Belarus eight times, Ukraine seven times and Russia more than four times. IDSS deaths trebled in Belarus, and rose more than 25 per cent in Kazakhstan, Georgia and Ukraine. CARD significantly correlated with UnD but not with CMR. Odds ratios of CMR to all three CARD categories were substantial, more than 4.1:1 in Belarus, Kazakhstan, Russia and Ukraine, indicating possible under‐reporting of CARD. Despite CMR improvements, this first‐ever study of the former USSR countries should alert the authorities of Belarus, Kazakhstan, the Russian Federation and Ukraine to the extent of possible child abuse. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Messages: This first‐ever study of child mortality and child abuse deaths in the former USSR found improvements in child mortality but unrecognised child protection issues. Child homicides ostensibly fell in every country but Russia. Major rises in undetermined and ill‐defined deaths in Belarus, Kazakhstan, Russia and Ukraine are indicative of under‐reporting but did not occur in the other former USSR countries. There is an urgent need to focus upon violence against children as either child abuse is not recognised, or it is being deliberately ignored.

“…5 More specifically, in reducing adult (55-74) total mortality and cancer deaths, the United Kingdom had the second biggest reduction in 20 years and was one of the most cost-effective systems in the world. 25,26 In addition, the United Kingdom met the UN Millennium goal of reducing child mortality, proving to be the eighth most cost-effective of Western countries. 27 In other words, in these key areas the health services in the United Kingdom still achieves proportionally more with comparatively less.…”

Section: Discussionmentioning

confidence: 99%

UK and Twenty Comparable Countries GDP-Expenditure-on-Health 1980-2013: The Historic and Continued Low Priority of UK Health-Related Expenditure

Harding

Int J Health Policy Manag

2016

It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health-related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a 'crisis' point on account of low levels of funding. Indeed, many state that currently the NHS has a sizeable funding gap, in part due to its recently reduced GDP devoted to health but mainly the challenges around increases in longevity, expectation and new medical costs. The right level of health funding is a political value judgement. As the data in this paper outline, if the UK 'afforded' the same proportional level of funding as the mean average European country, total expenditure would currently increase by one-fifth.