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For Wales, 88%95%5% CI 69%too 118%) of the mortality gap for CHD was closed, and 88%95%5% CI 70%too 111%) of the mortality gap for CHD in Northern Ireland was closed.
This accounts for 40%95%5% CI 33% to 51%) of the mortality gap for CHD, stroke and diet-related cancers between Scotland and England.
Table 2 shows the mortality gap for CHD, stroke and diet-related cancers in Wales, Scotland and Northern Ireland in comparison with England.
This is one factor underpinning the scandalous 20-year mortality gap for men and 15-year gap for women between people living with and without mental illness in high income countries [ 48].
We found that delayed diagnosis of MI, decreased use of reperfusion and increased time to reperfusion after a STEMI, decreased use of angiography after a non-STEMI and decreased use of secondary prevention medicines might all explain some of the mortality gap for people with COPD after an MI.
For Wales, the mortality gap for CHD, stroke and diet-related cancer was reduced by 81%95%5% CI 62% to 108%) in the counterfactual scenario, and for Northern Ireland the mortality gap was reduced by 81%95%5% CI 67%to99%9%). Figure 1 shows the percentage of the mortality gap closed under the counterfactual scenario for each country for CHD, stroke and diet-related cancers separately.
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Studies have shown that the mortality gap narrows for some populations, in incarceration settings demonstrating the importance of routinized healthcare provision.
In Scotland, the largest reduction in the mortality gap was for CHD (58% reduction; 95% CI 47%to72%2%).
The estimated number of deaths delayed or averted for each country was used as a numerator to calculate the percentage of the mortality gap closed for each country under the hypothetical counterfactual scenario of achieving a diet equivalent to that in England.
Compared with the mortality rate for the general population, the mortality gap remained fairly stable for adults aged under 65; for those aged 65-84, however, the mortality gap widened during the study period.
This study has also shown that these differences in treatment are possible explanations for some of the mortality gap at the population level for both STEMIs and non-STEMIs.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com