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CORONARY RISK FACTORS AND SOCIOECONOMIC STATUS
265
CORONARY RISK FACTORS AND SOCIOECONOMIC STATUS
SIR,-A minor point in the article by Holme et al.’ needs clarification. They note that serum cholesterol and triglyceride concentrations decrease with increasing socioeconomic status. Table1 confirms this. They go on to say that height divided by the cube root of weight, negatively correlated with lipids, increases with increasing status. Table t denies this. Height divided by the cube root of the weight decreases (from 42.2 to 410) as status increases from v to I. Some of the confusion might arise from "inversely" and numbering backwards and so forth. Is the text or the table (or both or neither) correct? Colorado Department of Health, Denver, Colorado 80220, U.S.A.
***This letter has been shown
RICHARD ROTHENBERG to
Mr
Holme, whose reply fol-
lows.—ED.L.
SIR,—Dr Rothenberg is quite right; there is a mistake in the
Height divided by the cube root of the weight decreases (from 42.2 to 41.0) with increasing status, thus making the negative gradients of serum cholesterol and triglycerides by increasing socioeconomic status still more interesting. I apologise text.
for this error. Life Insurance Companies’ Institute for Medical Statistics, Ullevaal Hospital,
Oslo, Norway
INGAR HOLME
1. Holme, I., and others, Lancet, 1976, ii, 1396.
Parliament One-parent Families IN a debate on one-parent families in the House of Lords
on
Jan. 19, speakers were particularly anxious to put forward ideas of a practical nature that would not involve large outlays of expenditure, but the Government were also taken to task for making no move to implement the main recommendations of the 1974 report of the Finer Committee. Introducing the debate, Lord SIMON OF GLAISDALE said that there were a quarter of a million fatherless families in Britain, and well over a million without an effective father-a number equivalent to the population of the City of Birmingham; 45 000 families had incomes below the supplementary-benefit level. Society had a duty to help these families-partly because, by means of the Divorce Reform Act, it was actively creating more and more fatherless families. The most important recommendation of the Finer Committee had been the introduction of the guaranteed maintenance allowance, which was designed to take the one-parent family out of the supplementary-benefit system altogether. This proposal had proved unacceptable to the Government, for reasons that appeared trifling; the alternative was continued reliance on supplementary benefit, which was precisely what the committee had said we should not have. Another of the committee’s important recommendations had been that a series of family courts should be established to deal with all cases concerning divorce and maintenance. At present a wife wanting a maintenance order had to apply to a police court and had to prove a matrimonial offence to get it; if she wanted relief in respect of the matrimonial home, she had to go to a county court; if she wanted a divorce she had to go to a divorce court. The family courts envisaged by the Finer Committee would exercise a judicial function and would also have a welfare function, where possible helping with reconciliation, trying to remove the stress and contention over children, and giving advice on such things as housing, supplementary benefit, taxation, and child benefit. The Government’s objections to the proposal did not stand up to examination. They said that there was a shortage of buildings, but there were public buildings, such as town halls, which could
be used. The second objection was about shortage of judicial manpower-but the proposals, if implemented, would have the effect of removing the great bulk of cases from the courts. Baroness YOUNG said that there were a number of practical ways in which better use could be made of resources to help one-parent families. The full child benefit could be introduced as quickly as possible; there could be a big increase in tax allowances and a reduction in tax rates so as to give one-parent families bigger take-home pay and thus encourage them to depend on themselves rather than the State (this could be financed by increasing indirect taxation); the rest of the taxcredit scheme could be introduced, thus giving single parents with taxable income below the tax threshold an extra cash income as of right; and all maintenance income-not just a part of it, as at present-could be treated as earned, rather than unearned, income. Another way to help single parents would be to redefine full-time work for the purposes of qualifying for family income supplement (at present defined as 30 hours a week), since school hours made it impossible for most mothers to work for this long. It might also be possible to come to some arrangements for schools to be used for day-care, so that children in single-parent families could stay longer at school until their mothers were free to collect them. And local-authority housing departments could be asked to review their points schemes in view of the need for flexibility in allotting council
housing to one-parent families. Lord HYLTON also spoke about housing, saying that reforms were needed on such things as co-ownership of the matrimonial home, joint tenancies of local-authority housing, and easier transferral of tenancies from husband to wife. Lord GARDINER asked that the Government should as a matter of urgency consider the case for reform of the machinery of Supplementary Benefits Commission tribunals and the procedures for appealing against their decisions. Replying to the debate, Lord WELLS-PESTELL said that he did not believe that the Government had done too badly when it came to one-parent families. What people tended to forget was that the recommendations of the Finer Committee included a drastic restructuring of financial support for one-parent families, wholesale reform of the matrimonial law in magistrates’ courts, which the Government agreed was long overdue, and a completely new system of courts for family matters, which they also supported. It was completely wrong, however, to say that there was no problem about buildings; people waited for months in custody and on bail to come to trial because there were not enough facilities to deal with them. Moreover, there had to be a special kind of environment if one was to have a family court; it was not a question of setting up a few tables and chairs. The Government did not feel able to accept the Finer Committee’s proposal for the guaranteed maintenance allowance for three main reasons: it would cost something like jC250 million to introduce, and there was not the money available for such a benefit; it would require the establishment of several thousand extra civil servants to administer the allowance and the related system of administrative orders for the recovery of maintenance from liable relatives; and all the allowance would do for about 300 000 one-parent families would be to transfer them from one form of means-tested benefit (supplementary benefit) to another. There was not really anything to be gained by it. Likewise, the introduction of the tax-credit scheme, at an estimated cost of about £5000 million, was quite unrealistic at the present time. To certain other administrative points-such as the redefinition of full-time work for the purposes of paying family income supplement-the Government had not altogether shut their minds. But any answers that the Government had to give to questions raised during the debate (the subject of which was vast, and could not be dealt with properly in the time available) were bound to be unsatisfactory. The unpleasant fact had to be faced that the Government were up against the lack of money and the inability to have the manpower to do all the things they wanted to do.
CORONARY RISK FACTORS AND SOCIOECONOMIC STATUS
SIR,-A minor point in the article by Holme et al.’ needs clarification. They note that serum cholesterol and triglyceride concentrations decrease with increasing socioeconomic status. Table1 confirms this. They go on to say that height divided by the cube root of weight, negatively correlated with lipids, increases with increasing status. Table t denies this. Height divided by the cube root of the weight decreases (from 42.2 to 410) as status increases from v to I. Some of the confusion might arise from "inversely" and numbering backwards and so forth. Is the text or the table (or both or neither) correct? Colorado Department of Health, Denver, Colorado 80220, U.S.A.
***This letter has been shown
RICHARD ROTHENBERG to
Mr
Holme, whose reply fol-
lows.—ED.L.
SIR,—Dr Rothenberg is quite right; there is a mistake in the
Height divided by the cube root of the weight decreases (from 42.2 to 41.0) with increasing status, thus making the negative gradients of serum cholesterol and triglycerides by increasing socioeconomic status still more interesting. I apologise text.
for this error. Life Insurance Companies’ Institute for Medical Statistics, Ullevaal Hospital,
Oslo, Norway
INGAR HOLME
1. Holme, I., and others, Lancet, 1976, ii, 1396.
Parliament One-parent Families IN a debate on one-parent families in the House of Lords
on
Jan. 19, speakers were particularly anxious to put forward ideas of a practical nature that would not involve large outlays of expenditure, but the Government were also taken to task for making no move to implement the main recommendations of the 1974 report of the Finer Committee. Introducing the debate, Lord SIMON OF GLAISDALE said that there were a quarter of a million fatherless families in Britain, and well over a million without an effective father-a number equivalent to the population of the City of Birmingham; 45 000 families had incomes below the supplementary-benefit level. Society had a duty to help these families-partly because, by means of the Divorce Reform Act, it was actively creating more and more fatherless families. The most important recommendation of the Finer Committee had been the introduction of the guaranteed maintenance allowance, which was designed to take the one-parent family out of the supplementary-benefit system altogether. This proposal had proved unacceptable to the Government, for reasons that appeared trifling; the alternative was continued reliance on supplementary benefit, which was precisely what the committee had said we should not have. Another of the committee’s important recommendations had been that a series of family courts should be established to deal with all cases concerning divorce and maintenance. At present a wife wanting a maintenance order had to apply to a police court and had to prove a matrimonial offence to get it; if she wanted relief in respect of the matrimonial home, she had to go to a county court; if she wanted a divorce she had to go to a divorce court. The family courts envisaged by the Finer Committee would exercise a judicial function and would also have a welfare function, where possible helping with reconciliation, trying to remove the stress and contention over children, and giving advice on such things as housing, supplementary benefit, taxation, and child benefit. The Government’s objections to the proposal did not stand up to examination. They said that there was a shortage of buildings, but there were public buildings, such as town halls, which could
be used. The second objection was about shortage of judicial manpower-but the proposals, if implemented, would have the effect of removing the great bulk of cases from the courts. Baroness YOUNG said that there were a number of practical ways in which better use could be made of resources to help one-parent families. The full child benefit could be introduced as quickly as possible; there could be a big increase in tax allowances and a reduction in tax rates so as to give one-parent families bigger take-home pay and thus encourage them to depend on themselves rather than the State (this could be financed by increasing indirect taxation); the rest of the taxcredit scheme could be introduced, thus giving single parents with taxable income below the tax threshold an extra cash income as of right; and all maintenance income-not just a part of it, as at present-could be treated as earned, rather than unearned, income. Another way to help single parents would be to redefine full-time work for the purposes of qualifying for family income supplement (at present defined as 30 hours a week), since school hours made it impossible for most mothers to work for this long. It might also be possible to come to some arrangements for schools to be used for day-care, so that children in single-parent families could stay longer at school until their mothers were free to collect them. And local-authority housing departments could be asked to review their points schemes in view of the need for flexibility in allotting council
housing to one-parent families. Lord HYLTON also spoke about housing, saying that reforms were needed on such things as co-ownership of the matrimonial home, joint tenancies of local-authority housing, and easier transferral of tenancies from husband to wife. Lord GARDINER asked that the Government should as a matter of urgency consider the case for reform of the machinery of Supplementary Benefits Commission tribunals and the procedures for appealing against their decisions. Replying to the debate, Lord WELLS-PESTELL said that he did not believe that the Government had done too badly when it came to one-parent families. What people tended to forget was that the recommendations of the Finer Committee included a drastic restructuring of financial support for one-parent families, wholesale reform of the matrimonial law in magistrates’ courts, which the Government agreed was long overdue, and a completely new system of courts for family matters, which they also supported. It was completely wrong, however, to say that there was no problem about buildings; people waited for months in custody and on bail to come to trial because there were not enough facilities to deal with them. Moreover, there had to be a special kind of environment if one was to have a family court; it was not a question of setting up a few tables and chairs. The Government did not feel able to accept the Finer Committee’s proposal for the guaranteed maintenance allowance for three main reasons: it would cost something like jC250 million to introduce, and there was not the money available for such a benefit; it would require the establishment of several thousand extra civil servants to administer the allowance and the related system of administrative orders for the recovery of maintenance from liable relatives; and all the allowance would do for about 300 000 one-parent families would be to transfer them from one form of means-tested benefit (supplementary benefit) to another. There was not really anything to be gained by it. Likewise, the introduction of the tax-credit scheme, at an estimated cost of about £5000 million, was quite unrealistic at the present time. To certain other administrative points-such as the redefinition of full-time work for the purposes of paying family income supplement-the Government had not altogether shut their minds. But any answers that the Government had to give to questions raised during the debate (the subject of which was vast, and could not be dealt with properly in the time available) were bound to be unsatisfactory. The unpleasant fact had to be faced that the Government were up against the lack of money and the inability to have the manpower to do all the things they wanted to do.