Respiratory illness in children: Do deprived children have worse coughs?

Parents of a stratified random sample of 234 children from 21 general practices in North East England were interviewed at home. All these children had been reported in a postal questionnaire as having had a cough between six and ten weeks before the interview. Interviews covered social characteristics of the family, the severity of the child's cough and the reactions of the parents to hypothetical sets of symptoms. The parents of children in materially deprived circumstances appeared to report worse coughs than other parents. We confirmed this finding by constructing a scale of perceived cough severity. However, we found no evidence that the inequality was due to exaggeration of the severity of the cough by materially deprived parents. Our conclusion that materially deprived children suffer worse respiratory illness is the more important because previous evidence suggets that the after-effects persist into adulthood

Primary Health Care for People with a Learning Disability

The delivery of health care to people with a learning disability living in the community has come under increasing scrutiny. Concerns have been raised over both the current quality of this care and its future organisation. In this article we review the evidence on current practice focusing on epidemiology, health status and policy directives affecting primary health care. Four specific areas for service developments are identified: an individual focus within an epidemiological framework, the evaluation of the effectiveness of current therapies, practice organisation and the awareness of health within social care. It is proposed that an effective model of primary health care is possible, supported by research, training, inter-service collaboration and purchasing guidelines