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Objective: To provide a targeted portrait of socioeconomic disparities in health care quality in four countries and how those disparities have changed over time.Design: Within each country, comparisons between the highest and lowest quintiles of socioeconomic status were made to determine if disparities exist and if any observed disparities have been decreasing over a 5-year period.Setting: Small geographic areas in Canada, England, New Zealand and the United States.Data Sources: Data were obtained by working with national health statistics agencies in each country.Results: There were socioeconomic disparities in health care quality and health status for most of the indicators studied in all four countries. The analysis included nine quality indicators in four countries, for a total of thirty-six observations. Twenty-six observations had a ratio of highest to lowest socioeconomic quintile of <0.95 or >1.05. These disparities generally persisted over time. The relative difference between the highest and lowest quintile decreased over time in eight of the twenty-one observations with time-series data available.Conclusion: The fact that disparities in a variety of indicators exist in four very different health systems underscores the importance of factors common to the four systems or factors outside the health system. Some successful strategies for reducing disparities could potentially be learned from the few examples of success in these countries. [ABSTRACT FROM AUTHOR]

Perinatal and postneonatal mortality among immigrants to England and Wales from India, Pakistan and Bangladesh (Asians) for the years 1982-85 showed significant differences not only between the immigrant and indigenous populations, but also among the different groups from the Indian subcontinent. Compared with the perinatal mortality rate of 10.1 per 1000 total births in UK born mothers, rates in infants of mothers born in India, Bangladesh, and Pakistan were 12.5, 14.3 and 18.8 respectively. In contrast, postneonatal mortality in infants of Indian and Bangladeshi origin (3.9 and 2.8 per 1000 live births respectively) was lower than in the indigenous population (4.1), with Pakistani infants experiencing the highest rate (6.4). Excess perinatal mortality in infants of Asian origin was apparent at most maternal ages and parities. Pakistani infants had the highest rates of perinatal and postneonatal mortality in all age, parity and birth weight groups. The Asian groups showed higher mortality from congenital anomalies in both the perinatal and the postneonatal period, the rates in Pakistani infants being almost double those in Indian and Bangladeshi infants. A significant finding was the lower rates of sudden infant death in all the groups of Asian origin. [ABSTRACT FROM AUTHOR]

CINI's work in rehabilitating the severely malnourished children living in the southern outskirts of Calcutta is well known amongst professionals in the field of child health. It also has a long-standing reputation for disaster relief activities. CINI's experience and expertise have led to new dimensions in its work. It has emerged as a major regional center for the training of health workers, governmental and non-governmental, and is involved in major field research studies in collaboration with national medical institutions. CINI's work has gained international recognition, but its expansions have never impinged upon its primary concern: the welfare of the poor and sick. *** DIRECT SUPPORT *** A08BC105 00004 [ABSTRACT FROM AUTHOR]

Presents correspondence related to medicine to the editors of the journal 'British Medical Journal'. Functions of the Clinical Standards Advisory Group; Concernment on the health risk of drinking water; Dilemma associated with industrial and environmental health.