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In the past two decades, there has been a large increase in budget airline travel offerring either increased availability of sunshine holidays for more deprived groups, with narrowing of the deprivation gap, or a further increase in such holidays for the less deprived, resulting in a widened gap.
Survival increased for men and women in all deprivation groups to the end of the 1990s, but the increase was smaller in the more deprived groups in both sexes, and the deprivation gap in survival widened as a result (Table 2, Figure 2).
Survival up to 5 years remains 4 6% lower among men in the more deprived groups than among the more affluent, but the deprivation gap did not widen significantly during the 1990s.
Only for brain tumours in men was the deprivation gap in 3-year survival consistently positive (higher survival in more deprived groups) throughout the period 1996 2006.
For incentivised indicators in 2003, there was no difference in achievement of 3 out of 4 indicators by area deprivation, with the remaining one indicator showing significantly higher achievement in more deprived groups.
These may improve outcome in the more deprived groups.
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Attendance was lower among the more deprived group (most deprived third 47.5% v least deprived third 64.3%; P<0.001).
This may also explain the significant I to P paths and the very strong path between A and P for the more deprived group.
One possible explanation is that the patients from the more deprived group were less likely to be referred to specialist centres for surgery until the late 1990s.
As reported in detail elsewhere [ 37], biomarkers of chronic inflammation (CRP, IL-6) were higher in the more deprived group as were markers of endothelial activation (ICAM and vWF) (Table 1).
Two deprivation groups, using the median Carstairs and Morris Index rate as the cutpoint, were created resulting in one more affluent group (−4.51 to −0.86) and the other more deprived group (−0.77 to 12.44) and labelled as 'affluent group' and 'deprived group'.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com