Socioeconomic Differences in Mortality Amenable to Health Care among Finnish Adults

1. I am puzzled by the definition of amenable deaths used in the paper. In the title it seems like the main focus is mortality amenable to health care. However, premature death of COPD was classified as amenable to health care. This I find very strange. I would believe that smoking would be the main factor associated with COPD and not the health care? A reference was given to work from Australia and New Zealand, published in a report (see ref 29). However, I cannot see that COPD is classified as «Amenable to health care» in ref 29: http://www.publichealth.gov.au/pdf/atlases/avoid_mortality_aust_2006/avoid_mortality_full.pdf. In the Appendix 1.1, table A1. It COPD is listed as avoidable mortality, but not as “Amenable to health care”. Their definition is this: “Amenable causes were defined as those causes whose case fatality could be substantively reduced by currently available health care technologies. For example, for cancers this was operationalised as a five year relative survival rate greater than 60% (given existing age and stage distribution at diagnosis). All other causes on the list were classified as ‘preventable’, in that their associated mortality could be substantially reduced by preventing the condition from occurring in the first place, ie incidence reduction”.