The National Health Service in the UK may be regarded as one of the best in the world, but with improvements in diagnosis, treatment and prevention, and altering social circumstances, healthcare priorities are constantly changing. Liver cirrhosis and autism are two conditions that are throwing up significant challenges to public health.

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Professor David Leon and Dr Jim McCambridge, a Wellcome Trust Health Services Research Fellow, looked at the rate of cirrhosis mortality in 12 European countries between 1955 and 2001. While a decline in the mortality rate was seen in most countries from the 1970s onwards, the rate in the UK increased, and continues to rise steeply. The problem is most acute in Scotland, where the mortality rate more than doubled between the periods 1987–1991 and 1997–2001. The most likely cause is the UK’s rising consumption of alcohol.

Prompted by reports suggesting a rise in the prevalence of autism and autistic spectrum disorders (ASDs), Professor Gillian Baird and colleagues studied nearly 57 000 nine- and ten-year-olds from South Thames, UK.

ASDs were present in around 1 per cent of the children studied, one-third of whom had autism as defined by World Health Organization criteria. It is unclear whether these findings represent an actual increase in autism, better detection of the disorder or changes in the way it is diagnosed.

Accurate data on disease prevalence are vital for effective public health planning and the development of education programmes to try to avert greater problems in the future.

Image credit: iStockphoto

External links

• Leon DA, McCambridge J. Liver cirrhosis mortality rates in Britain from 1950 to 2002: an analysis of routine data. Lancet 2006;367(9504):52–6.
• Baird G et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). Lancet 2006;368(9531):210–5.

Professor David Leon received programme grant funding in 2005/06 to study alcohol use and low life expectancy among Russian men.