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New atlas reveals huge differences in liver disease deaths in England

Public Health England’s (PHE) new liver disease atlas reveals a patient’s chances of survival depends on a postcode lottery

Public Health England’s (PHE) new liver disease atlas reveals a patient’s chances of survival depends on a postcode lottery. The new data exposes the chance of premature death to be roughly 8 times higher in some areas compared to others.

Julia Verna, head of Clinical Epidemiology at PHE, hopes that ‘health professionals will make the most of this rich data source to inform how they reduce the burden of liver disease in their areas’.

Liver disease now accounts for nearly 12% of deaths in men aged 40-49 years old in the UK and has become the fourth most common cause of premature deaths in under 75s, behind heart disease and lung cancer.

Ninety per cent of liver disease cases are caused by major risk factors such as alcohol, obesity and Hepatitis B & C and are thus easily preventable through changes to lifestyle. PHE hope that their new atlas will enable health care professionals to distribute resources more efficiently and improve patient outcomes.

Professor Verna argues that ‘Chronic liver disease is a silent killer of young adults, creeping up and showing itself when it’s often too late. However, around 90% of liver disease is preventable.’

There are significant geographical variations in the distribution of premature deaths caused by liver disease. In South Norfolk premature mortality rates are at a low of 3.9 per 100,000, while in Blackpool the number is almost 8 times higher at 30.1. The geographical difference further illustrates how in more deprived area, one’s chance of premature death from liver disease is greater than in more affluent areas.

Levels of inequality, then, play a big role in the risk factors associated with liver disease. Huge variations exist between the rate of alcohol-specific hospital admissions nationally, with most cases being clustered in more deprived areas (there is a 7.4 fold difference between some areas). Furthermore, in the poorest 5th of the country, people with liver disease live 9 years less than those in the richest 5th.

The UK’s performance compared to the rest of Europe is also worrying. The UK’s standardised death rate per 100,000 of the population has risen from 5 in 1994 to 10 at present. This is at the same time as most of Europe has experienced a steady decline in its rates – France has fallen from 13 in 1994 to 8 today and the EU-27 average has followed a similar track, suggesting much more could be done to prevent these premature deaths in the UK.