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Winter excess morbidity: is it a summer phenomenon?
S J Watkins1, D Byrne, M McDevitt
1Stockport Health Authority, Hazel Grove. stephen.watkins@stockport-ha.nwest.nhs.uk
Journal of Public Health Medicine
|October 5, 2001
Summary
Winter excess morbidity was not observed as hypothesized. Instead, affluent groups experienced winter excess morbidity, while less affluent groups showed summer excess morbidity, suggesting potential summer health benefits for the wealthy.
Area of Science:
- Public Health
- Epidemiology
- Environmental Health
Background:
- Hypothesized that winter excess mortality from cold exposure correlates with winter excess morbidity.
- Predicted a social gradient in winter morbidity, with higher rates in less affluent groups due to inadequate housing and increased cold exposure.
Purpose of the Study:
- To investigate winter and summer hospital admission rates for ischaemic heart disease.
- To determine if a social class gradient exists in winter morbidity, with greater excess in less affluent populations.
Main Methods:
- Utilized routine hospital admissions data from Stockport.
- Analyzed age- and sex-standardized admission rates for ischaemic heart disease, stratified by ACORN (A Classification of Residential Neighbourhoods) social groups.
- Compared winter and summer admission rates and ratios.
Main Results:
- The social class gradient in ischaemic heart disease admissions was more pronounced in summer than in winter.
- Affluent groups exhibited winter excess morbidity.
- Less affluent groups displayed summer excess morbidity.
Conclusions:
- The findings suggest an alternative hypothesis: winter excess morbidity may be linked to summer health benefits, such as leisure opportunities, disproportionately available to affluent individuals.
- This alternative hypothesis warrants further investigation in a dedicated study.
- The current data present an unexpected pattern that challenges the initial hypothesis regarding cold exposure and winter morbidity.