New study urges change of heart in discussions on heart failure

A shiny red plastic heart and a stethoscope

When it comes to Parliamentary debates, heart failure is lower on the agenda than pot-holes in pavements and roads.

In fact, heart failure (HF) has a lower public profile compared with other serious health conditions such as cancer and dementia, new research by Lancaster University has shown.

An article ‘Language Matters - Representations of the term heart failure in English discourse: a large-scale linguistic study’ published in the world-leading medical journal ‘BMJ Open Heart’ today, by Professor Elena Semino and Dr Jane Demmen, of Lancaster University, highlights that HF is underdiscussed in contemporary English compared with cancer and dementia.

And it is also underdiscussed in UK parliamentary debates, even compared with the less-obviously life-threatening topic of pot-holes in roads and pavements.

In 2018, for example, ‘pot-holes’ were mentioned more than 10 times per million words, 37 times more often than ‘HF’, mentioned 0.28 times per million words.

Using the Oxford English Corpus (OEC) of 21st century English-language texts, totalling over two billion words, and the UK Hansard Reports of parliamentary debates from 1945 to early 2021, the study investigated the extent to which HF is discussed in general contemporary English, UK parliamentary debates and the ways in which HF is framed in discussions, when compared with two other serious health conditions, cancer and dementia.

The Lancaster research team worked with cardiologist Rajiv Sankaranarayanan, from Liverpool University Hospitals NHS Foundation Trust, and the Chief Executive and founder of the heart failure charity ‘Pumping Marvellous’, Nick Hartshorne-Evans.

In the OEC, the term ‘heart failure’ occurs 4.26 times per million words (per million words), ‘dementia’ occurs 3.68 times per million words and ‘cancer’ occurs 81.96 times per million words.

Cancer is talked about 19 times more often than HF and 22 times more often than dementia.

These, say the study, are disproportionately high in relation to actual incidence: annual cancer incidence is 1.8 times that of the other conditions; annual cancer mortality is two times that caused by coronary heart disease (including HF) or dementia.

‘Heart failure’ is used much less than ‘cancer’ in UK parliamentary debates (House of Commons and House of Lords) between 1945 and early 2021, and less than ‘dementia’ from 1990 onwards.

“Discussions of heart failure are comparatively technical and formulaic, lacking the survivor narratives that occur in discussions of cancer,” says lead author Professor Elena Semino.

“Results of this study should motivate all stakeholders involved in HF to redouble their efforts to spread awareness regarding the seriousness of the condition in general discourse as well as to engage parliamentarians better and thereby exert influence on commissioners to significantly improve investment in prevention, early diagnosis and better management of heart failure.”

The study was commissioned by the Pumping Marvellous Foundation, a UK heart failure patient charity funded by donations and fundraising by individuals, with support from the NHS and charitable organisations plus corporate sponsorship.

Pumping Marvellous Chief Executive Nick Hartshorne-Evans said: “Anecdotally we guessed that heart failure was underrepresented in Parliamentary discussions compared to other significant health conditions. This analysis, working in partnership with the University of Lancaster underlines the need for M.P’s to discuss heart failure more frequently. Elevating the condition that impacts over 920,000 people in the UK onto the policy agenda.”

The study was conducted by linguists at the ESRC Centre for Corpus Approaches to Social Science, a research centre at Lancaster University, which specialises in applying computer-assisted frequency-based statistical methods to the study of language in social life using large bodies of text.

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