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ORIGINALLY POSTED AT 11AM ON 18 MAY There are so many things wrong with this article it is hard to know where to start.
1. Comparing crude mortality between areas as a measure of health need or even demand is meaningless. No health service seeks to prevent death, only to postpone it, so the age at which people die is what is important, in any rational perspective.
2. Sheena Asthana states that deprived populations have lower crude rates of illness because they are younger, but then chooses one particular disease, cancer because this reflects her view. Cancer prevalence is lower in more deprived areas because we have a great preventative measure for Cancer in these areas, its called cardiovascular disease. Actually if you take all long term conditions together (accounting for 70% of NHS activity) crude prevalence is is about the same in the 20% most deprived PCT populations ( 22%) as in the 20% least deprived PCT population (23%). The difference is that in the deprived areas these people will be more likely to have multiple comorbidities ( see Barnett et al in the Lancet) and of course will be younger.

3. The argument is made that there is no good reason to prioritizing treating disease in people at younger ages. This is not due to a "fair innings" approach. Need is defined as the capacity to benefit. It is a simple fact that treating disease at a younger age has the potential to result is a greater benefit in terms of years of life gained.

4. It is not even true that health service utilization is higher in more affluent areas due to their older populations. The 20% most deprived PCT populations in 2010-11 experienced 1206 bed days in hospital per 1000 population, compared to 960 in the 20% least deprived PCT populations.

This insidious attempt to pit the needs of the elderly against the needs of the poor has to be challenged, both are important determinants of health care need and demand.