Unjustified support for NHS reforms using French/UK comparisons of cardiovascular disease
Editor, in my rapid response of 4 February, critical of what I saw as
dubious interpretation of differences in cardiovascular mortality in
France and England/Wales, I wrote 'If the French paradox is correct all-
cause mortality should be comparatively low in France given very low rates
of circulatory disease.' I provided reference to unpublished work, which
the Secretary of State's advisers would not have had access to. I have now
accessed evidence published in 2008 that all-cause mortality in French men
is actually higher than in men in England and Wales, although the opposite
applies for women.(1) It can hardly be concluded that the NHS needs to be
reformed so men in England and Wales can enjoy the higher levels of
mortality in France. Advocating NHS reforms using such comparisons has
been widely criticised, in both academic and mass media. Those providing
briefings for the Secretary of State should be better informed both on the
availability, and interpretation, of data.
Reference List
(1) M?ller-Nordhorn J, Binting S, Roll S, Willich SN. An update on
regional variation in cardiovascular mortality within Europe. Eur Heart J
2008 May 1;29(10):1316-26.
Competing interests:
No competing interests
21 March 2011
Raj S Bhopal
Prof
Centre for Population Health Sciences, The University of Edinburgh
Rapid Response:
Unjustified support for NHS reforms using French/UK comparisons of cardiovascular disease
Editor, in my rapid response of 4 February, critical of what I saw as
dubious interpretation of differences in cardiovascular mortality in
France and England/Wales, I wrote 'If the French paradox is correct all-
cause mortality should be comparatively low in France given very low rates
of circulatory disease.' I provided reference to unpublished work, which
the Secretary of State's advisers would not have had access to. I have now
accessed evidence published in 2008 that all-cause mortality in French men
is actually higher than in men in England and Wales, although the opposite
applies for women.(1) It can hardly be concluded that the NHS needs to be
reformed so men in England and Wales can enjoy the higher levels of
mortality in France. Advocating NHS reforms using such comparisons has
been widely criticised, in both academic and mass media. Those providing
briefings for the Secretary of State should be better informed both on the
availability, and interpretation, of data.
Reference List
(1) M?ller-Nordhorn J, Binting S, Roll S, Willich SN. An update on
regional variation in cardiovascular mortality within Europe. Eur Heart J
2008 May 1;29(10):1316-26.
Competing interests: No competing interests