Disparities in outcomes from chronic disease

Impaired patient-physician partnerships may be an important cause in minorities

Papers pp 962, 967

Recent developments in basic biomedical research offer the great promise that we will increasingly understand factors that underlie risk and expression of disease and, with further advances in genetic engineering, translate this knowledge into highly individualised treatments to reduce the burden from both acute and chronic diseases. Two studies in this issue, however, remind us that this idealised world of risk prediction and tailored treatments will have to succeed in the real world of cultural and ethnic diversity and imbalances in socioeconomic status.

Chalmers et al (p 967) report findings from a cohort study examining the relations between socioeconomic status and chronic disease and mortality in Scotland.1 Consistent with studies in other patient populations, 2 3 individuals in the …