Unfair distribution

The recently revised NICE guidelines on COPD provide some grim reading. Currently, NICE says that COPD affects between 2% and 4% of the population, but the burden of the disease falls heavily on areas of deprivation: "men aged 20-64 employed in unskilled manual occupations being 14 times more likely to die from chronic obstructive pulmonary disease than those in professional occupations ." At the moment, COPD is the UK's 5th leading cause of death but this is expected to rise, with the condition becoming the 3rd leading cause of mortality worldwide. And it doesn't stop there: NICE's review suggests that this is a substantially under-diagnosed condition, under-represented in death certificates and in primary care prevalence assessments.