Patients in deprived areas not accessing heart treatment

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PATIENTS in the most deprived parts of the country are not accessing treatment for heart problems, increasing their risk of ill-health and death, a conference has heard.

Scotland is considered to have the highest rates of heart disease in Western Europe, with large health inequalities between the richest and poorest, the EuroHeartCare Congress in Glasgow was told.

Dr Barry Vallance, lead clinician for heart disease in Scotland, said there was evidence that patients in the most deprived areas were not coming forward for treatment for potential heart problems.

Michael Matheson, public health minister, also told the meeting that deaths from heart disease were falling but more needed to be done.

Around 17,000 deaths a year in Scotland are caused by cardiovascular disease (CVD), which includes heart attacks and strokes.

Dr Vallance said: “Death rates from heart disease have fallen in Scotland, but it still remains the second highest cause of death after cancer.

“In Scotland, as in other parts of the world, there’s still a significant gap between the rich and poorest, with those living in deprived communities more likely to die prematurely.”

The doctor said no-one fully understood why people in deprived areas were more prone to CVD, but several factors were likely to be involved.

“Health is low on their list of priorities because they’ve so many other issues to contend with, and they consider vices like cigarette smoking and excess alcohol as pleasures,” Dr Vallance said.

“Furthermore, they’re less likely to be able to afford healthy activities like gym memberships and fruit and vegetables.”

He said that people from deprived areas in Scotland also appeared to be accessing less treatment for CVD.

Figures showed that in 2008-9 over 20 per cent fewer treatments than would be expected for angioplasty - surgery to unblock a blood vessel - and bypass surgery were carried out for people in the 10 per cent most deprived areas, compared to around 60 per cent more treatments in people from the 10 per cent wealthiest areas.

“The overall result is that people from deprived areas often present to health professionals with more advanced disease, leading to their having higher morbidity and mortality rates,” Dr Vallance said. “In a national health system, it’s not that we’re denying people from deprived areas health care, but that they don’t seek it out.”

“Our next step is to take a bottoms-up approach, educating children about CVD. We want people to start taking responsibility for their own health from an early age.”

“I am also pleased that we’re cutting coronary heart disease mortality rates fastest in the most deprived areas, which is vital if we are to improve health equality in Scotland.”