BMJ  2004;329 (7 August), doi:10.1136/bmj.329.7461.0-b

Access to medical care does not explain social gradients in heart disease

Differences in medical care are unlikely to contribute to social or ethnic differences in the epidemiology of coronary artery disease. Britton and colleagues (p 318), who followed up more than 10 000 participants in the Whitehall II study for over 15 years, found that South Asians and poorer people—who are more likely to have coronary artery disease—had the same access to cardiac procedures and medication as other social groups. The higher mortality from cardiac disease in poorer people and South Asians would have to be explained by other biological, behavioural, and psychosocial explanations, conclude the authors.

Credit: WILL & DENI McINTYRE/SPL

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Does access to cardiac investigation and treatment contribute to social and ethnic differences in coronary heart disease? Whitehall II prospective cohort study

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