Reducing coronary heart disease in England: targets and implications

Abstract

IN a previous paper we reported on the extent of district health authority (DHA) variability in mortal ity from coronary heart disease in England. In this paper we discuss two issues: possible methods for setting target levels of mortality for individual DHAs, and the implications of the variations for action by those involved in health education and health pro motion. We are not suggesting that targets should be 'top down', but that districts should be able to assess an appropriate contribution to a national target, tak ing account of local circumstances. In addition, local targets should not be an excuse for inaction at national level. A commitment is required, not least from central government, in pursuing progressive public health measures, including issues of food pol icy and strict price and advertising control of smok ing.