The BMJ goes to Borsetshire – a health check for The Archers

<em>Picture: alexkerhead</em>
Picture: alexkerhead
For a certain group of people – a community, if you will – this time last year was one of anxious anticipation. No, not Christmas, nor even Hogmanay: rather it was 2 January and it was to take place on the radio.

The Archers, the everyday tale of country folk, had been building to a climax. We thought there would be a death, but whose? Would it be Helen, about to give birth for the first time and facing a long, hazardous drive to hospital in the snow? Would it be (praise be!) Linda Snell, exhausted after the efforts of the Christmas show?

The excitement was so great that I, and others, accepted a party invitation for that night only on the proviso that there would be access to a radio.*

As it turned out, it was posh Nigel – husband of irritating Elizabeth – who plunged dramatically, and lengthily, to his death from the roof of Lower Loxley Hall; a lesson to us all (at least to those of us with manor houses) that you can’t be too careful when taking down the Christmas lights.

Nigel’s death may still be creating ripples in Ambridge – widow Elizabeth refuses to speak to her brother David Archer because she blames him for her husband’s demise. (David had taunted Nige about being afraid to go on the roof, then, stupidly, confessed as much to Elizabeth when (a) he must have known she’d go mad and (b) the only witness was deid.) But now it has reached the dizzy heights of medical research.

Yes, bmj.com reports today that the “risk of traumatic death” is far higher in fictional Ambridge than in the (real) rest of England and Wales.

Admittedly this is the Christmas BMJ, which tends to be on the lighter side of academia – other tales out today, incidentally, are that men aged 70 or older can “elude the Grim Reaper” by walking faster, because apparently that gentleman never makes it above three miles per hour, and that male orthopaedic surgeons have a better grip strength than male anaesthetists.

Nevertheless the Archers research is relatively rigorous – it uses big, technical words such as “epidemiological” and “confidence intervals”, so it must be meant to be taken seriously, sort of.

The author, a freelance medical and science writer named Rob Stepney, wanted to investigate whether The Archers was more true to life (and death) than TV soap operas. Previously, research has concluded that characters in EastEnders and Coronation Street have a higher risk of death than bomb disposal experts and racing drivers.

Stepney reviewed deaths, childbirth and episodes of serious illness over a period of two decades, from 1991 to September 2011. In this time there were 15 deaths, nine of male characters and six of female, equating to a mortality rate of 7.8 per thousand of population for men and 5.2 for women. This compares to an average of 8.5 per 1,000 in England and Wales for males and 5.8 for women.

Good news then, as overall death rates in Ambridge are actually lower than in the rest of England and Wales. Perhaps we should all move there.

Unfortunately, however, when it comes to accidental death or suicide, the risk is worryingly high, Stepney says. During the study period there was a road traffic accident, a death when a tractor overturned, a self-inflicted gunshot wound – and, of course, the Nigel death leap.

In scientific terms (yes, really), this translates to over a quarter – 27 per cent – of the total mortality in Ambridge. But in real life, accidents accounted for only 4 per cent of deaths in men in the year 2000, which was the midway point in the study.

Over the same period, there have been 13 children born to the 115 characters in the show, (one in a tepee at Glastonbury) making an annual birth rate of just 5.6 per 1,000, compared to 11.4 in England and Wales. But access to healthcare seems pretty good. Stepney points to the aforementioned Elizabeth, who was born with a heart defect, and who recently had a life-saving implant operation – she was lucky, Stepney says. “Nationally fewer than 100 such implants were carried out in 2009, so she may have had privileged access to expensive devices,” he adds.

He quotes Simon Dover, medical adviser to The Archers in 1989, shortly before the period under review, reporting that the programme’s production team had a particular liking for medical stories. And certainly there have been many over the years – sometimes even carrying out a useful public health function.

Greg Turner’s suicide, for example, illustrates the problem of depression among males in rural areas. Ruth’s breast cancer (although I’m assured by one medical listener that it was unrealistically portrayed) certainly raised awareness of the disease, while Jack Woolley’s descent into dementia has made painful – but compelling – listening. And any dairy maids will have been very careful about following environmental health regulations after the recent outbreak of e.coli from ice-cream tainted by Clarrie Grundy’s coming back to work too soon with a tummy bug.

“Although the confidence intervals around the relevant estimates are wide, The Archers seems to have a higher than expected number of traumatic deaths,” concludes the author. “In this respect it would be similar to soap operas set in urban environments and on television. However, in overall mortality, which in epidemiological terms is the most important outcome, The Archers ploughs its own furrow.”

In comparison to last year’s cliffhanger (roofhanger?), the current storylines are a bit tame. But perhaps they actually have another shocker up their sleeves for this 2 January. I’m still secretly hankering for a tragic accident involving Linda Snell, a llama and smug Tom’s organic sausages. Or how about something involving Brian? He could have an affair with a beautiful young woman; they could have a secret lovechild who will then have to be brought up by Brian’s wife, Jennifer, after the baby’s mother dies. Oh no, they’ve already done that.

* It was a great party, there was access to a radio and our lovely hostess was among those who sneaked away to listen.

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