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INEQUALITIES GOES GLOBAL
In this issue we have a number of contributions from various parts of the world on health inequalities, perhaps reflecting the evolution of the journal itself: an issue that once was very much a British tradition is now being pursued vigorously in most regions of the world.
Michael Marmot, one of the contemporary torch-bearers of the English school that goes back over a 100 years, reviews the progress of the Blair administration in asking whether, at last, inequalities in health are being taken seriously. A very specific aspect—ethnic inequalities in campylobacter infection—is reported on in Birmingham, UK, and the uptake of domestic smoke alarms in disadvantaged areas is explored in a paper from London (the main barrier to using smoke alarms turns out to be the distress caused by false alarms). Overall, despite Marmot’s cautious optimism about progress in policies to tackle inequalities, the evidence for widening disparities in premature mortality in Britain is not good; while Asthana and colleagues find that the Health Survey for England reveals that age effects of inequality overshadow social class, except for mental health. See pages 262, 278, 280, 296, 303
This month’s menu includes contributions from Korea, Bangladesh, Finland, and Hungary, where social capital research was found to be a significant predictor of mortality, and Pennsylvania, USA, where racial segregation heralded higher intentional injury rates. See pages 340, 346
But this issue is not exclusively about inequalities. John Reid, in an Editorial, asks of the celebrated British general practitioner/epidemiologist, WH Pickles, “will you still need me when I’m 64?” Pickles’ classic study, Epidemiology in Country Practice, was published in 1939 and is perhaps only now achieving its centre stage relevance. With another hat on, as Regional Director of Public Health in the North West of England, I am keen to promote a collaborative initiative of epidemiology in primary health care based on Pickles’ trail-blazing work. Any takers elsewhere? See page 263
The JECH Gallery asks, “is smallpox in again?”, and celebrates the pioneering work of Professor Yiqun Wu in occupational health in China. The Continuing Professional Education section addresses the ever topical issue of causal effect, and concludes that the limitations of randomised studies are the reason why methods for causal inference from observational data are needed. Ever pushing the boundaries, we seek to stretch our readers’ understanding of the publishing business with a Glossary on peer review. See pages 279, 285, 265, 272
Other highlights include:
report of a somewhat traditional outbreak of gastroenteritis from a non-chlorinated water supply;
a report on the impact of injecting drug use on compliance with antiretroviral therapies;
a randomised controlled trial of fruit and vegetable dietary advice and its impact on plasma flavonol concentrations;
a review of trends in avoidable mortality in Europe;
a study of area of residence and physical and mental health;
a report from the Lebanon of changing body image and ideal body weight among young men and women in this globalised age.
Hygieia carries a series of messages from our sister journal Injury Prevention that could well do with greater currency in the wider public health world. A larger menu of Hygieia pieces is also to be found from this month on our web site at http://www.jech.com See page 356
And one of our readers takes issue in the Letters page with public health being over-modest. See page 354
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