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BMJ No 7124 Volume 316

Press Releases Saturday 3 January 1998


Embargoed: 00.01 hrs 2 January 1998 UK time

Women later regret early loss of virginity
The new NHS primary care groups can't have their cake and eat it!
Childhood health improved by adherence to infant feeding guidelines
Preventing disease doesn't reduce health care costs

Women later regret early loss of virginity

(First sexual intercourse: age, coercion and later regrets reported by a birth cohort)

In many developed countries there has been a substantial lowering of the age at first sexual intercourse over the past 30 years. A study undertaken in New Zealand by Dickson et al reported in this week's BMJ, aimed to investigate the circumstances of first sexual intercourse and to determine how these correspond to views in early adulthood about its timing.

Dickson et al found that on average women were 16 years old at first intercourse and men were 17 years. Women commonly reported being forced at first intercourse, especially those who experienced intercourse before the age of 14 years. 16 per cent of men and 54 per cent of women thought that they "should have waited longer before having sex with anyone". Being "curious about what it would be like" was the most common reason given by both sexes for first intercourse. Ten per cent of both sexes reported the main reason as being "a bit drunk at the time".

Sexually transmitted diseases were reported by nearly a third (28 per cent) of women who had intercourse under 16 years. The risk of early and unwanted pregnancies are also borne by women. The authors conclude that most women regretted having sexual intercourse before age 16 years. First intercourse at younger ages is associated with risks that are shared unequally between men and women.

See Paper p 29

Contact:
Dr Nigel Dickson, senior research fellow
Department of Preventive and Social Medicine,
University of Otago Medical School

tel: 00 64 3479 7201
fax: 00 64 3479 7298
ndickson@gandalf.otago.ac.nz

The new NHS primary care groups can't have their cake and eat it!

(Taking equity seriously: a dilemma for government from allocating resources to primary care groups)

The Labour Government is aiming to remedy the inequities of access to health care in the NHS caused by fundholding - by abolishing it. In this week's BMJ, Bevan argues that there is a conflict between the Government's policies that aim to produce equal waiting times for hospital treatment and equal funding for local populations.

Using a fictitious example based on primary care groups, Bevan illustrates the dilemma for Government policies on equity caused by variations in GP referral rates. He shows that if these groups are funded equitably, this will result in dramatically unequal waiting times, or if they are granted equal waiting times, this will result in inequitable funding.

The author concludes that the Government will have to decide whether people in these groups are either to be funded equitably or have equal waiting times.

Contact:
Mr Gwyn Bevan, Reader in Policy Analysis
Department of Operational Research,
London School of Economics and Political Science.

Mr Bevan will be on holiday wc. 29 December 1997, but will be contactable on:

tel: 00 33 4 5002 3112
email: G.Bevan@lse.ac.uk

Childhood health improved by adherence to infant feeding guidelines

(Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study)

Evidence has shown that adult disease may be related to nutritional factors originating in the womb and during infant life. Infant feeding practices within the UK vary widely, but national recommendations suggest that children should receive breast feeding exclusively for the first four months and that no solid foods should be introduced during this time. In this week's BMJ, Wilson et al report that children in Dundee whose diet most closely met the national recommendations, had less respiratory illness, were leaner and had lower blood pressures. The authors conclude that their results underline the importance of adhering to the national infant feeding recommendations.

See Paper (abstract only) p 21

Contact:
Dr Stewart Forsyth, consultant paediatrician
Department of Child Health,
Epidemiology and Public Health and Obs and Gynae,
Ninewells Hospital and Medical School,
Dundee

tel: 01382 632974
fax: 01382 633921
email: stewart.f@dth.scot.nhs.uk

Preventing disease doesn't reduce health care costs

(Preventing fatal diseases increases health care costs: cause elimination life table approach)

The fact that if a disease is prevented, it will no longer need treating, has led to the widespread opinion that preventing disease might contain the rapidly rising costs of health care. In this week's BMJ Bonneux et al observe that prevention (particularly through health promotion) avoids not only morbidity, but also mortality from fatal diseases. Although this is obviously a highly desirable consequence, in countries with low mortality it will add life years predominantly to old age. In old age, prevalence of disabling degenerative conditions of the brain, bones and joints increases steeply. While the treatment costs of prevented diseases are avoided, the need for expensive long term nursing care increases, argue the authors.

Bonneux et al conclude that the aim of prevention is, in fact, not to save money but to save people from avoidable death and disease and that the possibility of lowering health care costs through prevention of non-fatal diseases is a bonus and not a requirement.

See Paper (abstract only) p 26

Contact:
Dr Luc Bonneux, Medical Epidemiologist
Department of Public Health,
Erasmus University,
Rotterdam

tel: 00 31 10408 7722
fax: 00 31 10436 6831
email: bonneux@mgz.fgg.eur.n1


Embargo: 00.01 hrs Friday 2 January 1998

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