Official figures showing a rise in diseases linked to poverty, such as gout, TB, measles, malnutrition and whooping cough are a barometer of failure and neglect
According to a recent Health and Social Care Information Centre report, we are seeing a return of diseases common in the Victorian era.
The report highlights five conditions: gout, tuberculosis, measles, malnutrition and whooping cough. It has a longer listing of rarer conditions, which also conjure the image of bygone pestilence and depravity – scurvy, mumps, rickets, scarlet fever, cholera, diphtheria and typhoid.
In a time of global public health disasters of biblical proportions, in west Africa and the Middle East, it appears an indulgence perhaps to be concerned about these conditions. We may be tempted to dismiss the report as a novelty. But that would be wrong: a civilized nation with an advanced economy and health system should see some conditions as markers for the failure of its public health policies or services. But which markers?
The NHS has "never events" as quality of care markers. Never events are serious, largely preventable patient safety incidents. They include wrong site surgery, wrong route chemotherapy administration and suicide during psychiatric admission. The time has perhaps come for us to develop never events in public health.
In the HSCIC report, gout is the strongest contender for a returning Victorian disease – it may well be linked to an ageing population, epidemic obesity and excess alcohol consumption; 70% of cases are in the over 60s. There were 86,870 hospital admissions where gout was coded, an increase of 78% on the same period in 2009-10 (48,720). There were 13.5 gout admissions per 100,000 population in the 10% most deprived areas, 8.3 gout admissions per 100,000 population in the 10% least deprived areas, in 2013-14. Formerly the disease of kings, gout is now very clearly associated with deprivation.
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