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Showing results for tags 'Deprivation'.
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Content ArticleFrequent attendance at A&E—when a person goes to A&E five times or more in a year—is often because someone desperately needs help and care yet they have nowhere else to turn. Unmet social, emotional and practical needs can drive their physical and mental ill health to crisis point. A&E too often serves as a last resort when someone has not received, or cannot access, appropriate care and support earlier. Supporting people to get the help they need before this point improves their health and wellbeing, and reduces pressures on A&E and ambulance services. This research from the British Red Cross aims to deepen understanding of the needs of people who frequently attended A&E in Dorset. The findings and recommendations set out in this report reflect the importance of addressing health inequalities and highlight areas for national and local focus to better support people who frequently attend A&E. Key findings People who frequently attend A&E constitute a small and vulnerable minority of people in Dorset who struggled to get the support they needed for their clinical and non-clinical care needs. They made up a significant proportion of A&E attendances, 1.7 per cent of Dorset’s population account for 13.8 per cent of the county’s A&E attendances. There is a clear relationship between socio-economic deprivation and frequent A&E attendance. People who frequently attended A&E were 72 per cent more likely to live in Dorset’s most deprived areas. Hospital visits among people frequently attending in Dorset were more likely to be classed as urgent cases and have an emergency admission. Two groups made up around 70 per cent people frequently attending in the county: people over 70, most of who had multiple long-term conditions and people aged 20-49, particularly women aged 20-29 with high levels of mental ill health and a significant link with deprivation. More than a third (36 per cent) of frequent attendance periods by people in this second group required a new mental health referral. 70.2 per cent of these were closed within seven days. This does not include ‘did not attends’. There were increased rates of frequent A&E attendance, primary care use and mental health referrals among children and young people aged 19 and under following the height of Covid-19. Recommendations Continue to roll out and expand HIU services. Increase the breadth and availability of accessible, linked data, and harness it to identify people at risk of frequent attendance and opportunities for targeted support. Improve availability of, and access to, mental health support, with a particular focus on community services. Further develop multidisciplinary proactive care in primary care for people with long-term conditions, prioritising people most at risk of experiencing poor health outcomes due to other risk factors. Ensure that funding and performance measures support a preventative community-based approach which addresses nonclinical drivers of frequent attendance at A&E. Align targets and funding to support sustainable action on health inequalities.
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EventuntilThis virtual launch event celebrates the ARMA report Act Now: MSK Health inequalities and deprivation. • Hear about the findings of the report and what they mean for health services and healthcare professionals. • How does deprivation relate to MSK health? • What are the 5 steps to addressing health inequalities and what do they look like in practice? • What are the particular issues for children and young people? • What can you do to create change if you act now? Join the discussion with the panel: • Anthony Gilbert, Postdoctoral Clinical Research Physiotherapist, Royal National Orthopaedic Hospital NHS Trust • Shabir Aziz, Lived Experience Partner • Lesley Kay, National Clinical Director for MSK, NHS England • Jacqui Clinch, Consultant Paediatric Rheumatologist Register for the event
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Content ArticleThere are an estimated 363,000 adults experiencing multiple disadvantage in England—they may be experiencing a combination of homelessness, substance misuse, mental health issues, domestic abuse and contact with the criminal justice system. The Changing Futures programme works in partnership in local areas and across government to test innovative approaches and drive lasting change across the whole system, in order to provide better outcomes for adults experiencing multiple disadvantage. This prospectus provides information for partnerships interested in submitting an expressions of interest to be part of the Changing Futures programme.
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Content ArticleThe Health Equity Network (HEN) aims to build momentum for health equity across the UK. It provides an opportunity for organisations, community and voluntary groups and individuals to share their work on health equity and to engage across the country with others with the same interests. This is the report of HEN's first annual conference held on 5 October in Birmingham. The report includes links to videos of key speakers from the conference and bullet points detailing their input. It also includes brief summaries of the breakout sessions and a summary of feedback from attendees.
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Content ArticleThe ICS Delivery Forum is a series of regional conferences hosted by Public Policy Projects. Each event convenes local ICS leadership, key health and care experts and other stakeholders including industry leaders. A series of panel discussions and case study presentations are given throughout the day. This document summarises key insights from the Manchester ICS Delivery Forum event held on 25 May 2023. The document places these discussions into the broader context of health and care transformation, both at a local and national level, so wider sources and research are used to expand upon the key points. It looks at the following aspects of integration in Manchester: Community engagement Working with VCSE organisations Governance
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Content ArticleThis article summarises the findings of research by Healthwatch into the impact of the cost of living crisis on people's decisions about accessing health and care. The research, which surveyed 2000 adults in England, was conducted four times between October 2022 and March 2023. It suggests that people are increasingly avoiding vital health and care services due to the fear of extra costs. Examples include avoiding: going to a dentist because of the cost of checks ups or treatment booking an NHS appointment because they couldn’t afford the associated costs, such as accessing the Internet or the cost of a phone call buying over the counter medication they normally rely on taking up one or more NHS prescriptions because of the cost. Healthwatch sets out a series of recommendations, including ensuring that the support available to help with healthcare costs is communicated to those that need it.
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Content ArticleEngland is the only country in the UK to still charge patients for prescriptions, with charges having been abolished in Wales and Scotland in 2007 and 2011, respectively. However, for patients in England, the cost is rising; in March 2023, the government announced an inflationary increase of 3.21%, bringing the prescription charge up to £9.65. And the number of people eligible to pay could increase, following government proposals to raise the upper age exemption for free prescriptions from 60 to 65 years. This article looks at the impact of prescription charges on health inequalities, particularly focusing on the impact of the cost of living crisis. The reporter speaks to pharmacists who regularly see patients making difficult choices about which prescriptions to collect, as well as highlighting research that suggests many patients with long term conditions are forgoing their medications as they cannot afford them.
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Content ArticleThis BMJ article by journalist Andrew Kersley reports on a meeting of 157 medical experts and academics held at the Royal Society of Medicine on poverty and the cost-of-living crisis, which took place in May 2023. One academic at the event warned that the long term effect of ongoing economic inequality on life expectancy was worse than six unmitigated covid pandemics. The three solutions proposed at the meeting that received the most support were: a national strategy to tackle poverty the nationwide delivery of “more affordable, quality, secure social and rental housing” urgently increasing the rate of Universal Credit as well as removing the restrictions related to total benefits and multiple children.
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Content ArticleThis report by The King's Fund is part of new research project that explores how NHS providers and integrated care systems (ICSs) are approaching inclusive recovery. It highlights that in 2022, people in the most deprived areas were twice as likely to be waiting more than a year for elective care compared to people in the least deprived areas. The report explores three big questions health and care leaders should be asking themselves and their teams about inequalities in their elective backlog:How are we measuring inequalities and whyDo we know why inequalities existHow will we know if things are improving?
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Content ArticleIn the UK today, nearly 40% of the population are living in poverty because of low income. This means that nurses and midwives are likely to meet people experiencing poverty and deprivation as part of their everyday work and should be ready and able to help them access the assistance they need to overcome the associated challenges. This article in the British Journal of Nursing examines the link between financial status and people's health and wellbeing. The article includes a case study and suggestions as to how nurses and midwives can promote financial wellbeing. Related reading The Dahlgren-Whitehead rainbow (1991) The Dahlgren-Whitehead model of health determinants: 30 years on and still chasing rainbows (14 September 2021)
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Content ArticleThis blog by the Centre for Mental Health looks at data about young people's mental health in 2022 from NHS Digital, highlighting the urgent need for effective mental health services and support for young people. It looks at what needs to change to improve the picture for young people's mental health including addressing child poverty, implementing whole school and college approaches and investing in early intervention support. Key findings One in four teenagers aged 17-19 have a mental health difficulty, an increase from one in six in 2021. Poverty continues to have a strong link to young people’s poor mental health. Reversed patterns of probable mental health difficulty for boys/young men and girls/young women highlights the need for specific gender-specific approaches. Young people with a mental health difficulty are more likely to have negative experience of social media. Young people with a mental health difficulty are more likely to miss school and feel unsafe while at school.
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Content ArticleThis cohort study in JAMA Network Open aimed find out whether medical insurance type is associated with time to withdrawal of life-sustaining therapy in adult trauma patients in the US. The findings suggest that being uninsured is associated with a shift in decision-making toward earlier withdrawal of life-sustaining therapy, which could indicate that socioeconomic status informs end-of-life care for patients with critical injuries.
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Content Article
Welsh Health Equity Solutions Platform
Patient-Safety-Learning posted an article in Health inequalities
The Welsh Health Equity Solutions Platform is part of the Welsh Health Equity Status Report initiative (WHESRi), which supports a healthier, more equal and prosperous Wales. The platform is a gateway to data, evidence, health economics and modelling, policies, good practice, innovative tools and practical solutions to help improve population wellbeing and reduce the health equity gap in Wales and beyond. It is structured around an innovative WHO framework of ‘Five Essential Conditions’ for healthy prosperous lives for all. The platform will link with and feed into a WHO health equity gateway, providing an example and inspiration for countries to learn and follow, as well as to contribute and share. The platform includes: Data Explorer: Select and display indicators filtered by essential condition, with the option to download for use in presentations Health economics and modelling: Explore the interactive ‘Cost of health inequalities in Wales’ database and view health economics resources Policy: Explore Welsh policies and legislation that help to reduce inequity and create a more sustainable and fairer society in Wales UK and international: View resources from the UK and around the world, presenting knowledge and insights on health equity Vulnerability and unmet needs: View resources exploring health equity, vulnerability and unmet needs in Wales Solutions: View resources on potential solutions to help address health equity Generate report: Generate and download customised reports presenting selected information from across the Solutions Platform filtered by information type (e.g. data, UK and international, solutions) and essential condition -
Content ArticleThis US cross-sectional study in JAMA Network Open aimed to find out whether there is a difference in reported inappropriate antipsychotic medication use between severely and less severely deprived neighbourhoods, and whether this difference is modified by greater total nurse staffing hours. The study included 10,966 nursing homes and found that nursing homes that fell below critical levels of staffing (less than three hours of nurse staffing per resident-day), were associated with higher inappropriate antipsychotic medication use among nursing homes in severely deprived neighbourhoods (19.2%) compared with nursing homes in less deprived neighbourhoods (17.1%). These findings suggest that addressing staffing deficiencies in nursing homes, particularly those located in severely deprived neighbourhoods, is crucial in mitigating inappropriate antipsychotic medication use.
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Content ArticleHome dying is a policy indicator of ‘quality dying’ in many high-income countries, but there is evidence that people living in areas of higher deprivation have a reduced likelihood of dying at home. However, there is limited research which centres the views and experiences of people living with both socioeconomic deprivation and serious advanced illness. This study used visual methods to address this gap in knowledge, focusing on barriers to and experiences of home dying for people experiencing poverty and deprivation in the UK. The authors used photovoice and professional documentary photography between April 2021 and March 2023 with eight participants with serious advanced illness, six of whom had died by the end of the study. They also worked with four bereaved family members to create digital stories. Key findings There are high costs associated with dying at home, the nature and impact of which were conveyed by images such as a heating thermostat set to low. Images also expressed how for some participants, the environment inside and outside the home was experienced as oppressive and alienating because of cramped, materially poor social housing, as well as urban noise, crime, mould and damp and a lack of access to outside space. Nevertheless, the home environment was important to all participants, particularly as a site to support the continuation of their identity and autonomy and some were explicit about wanting to remain at home for as long as possible. This study provides unique insights regarding the significant policy shift needed to improve the extent and experience of home dying for the growing number of people dying in the context of financial hardship and deprivation both in the UK, and elsewhere.
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Content ArticleThis BMJ long-read article argues that health is going in the wrong direction in the UK, and reversing the trend requires political and societal commitment to deal with the underlying causes. It proposes evidence-based solutions to the worsening health and widening inequalities in the UK through action on the social determinants of health.
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Content ArticleLocal authorities fund many of the services—such as housing, education and social care—which either support or tackle the drivers of health inequalities. The Institute of Health Equity (IHE) has looked at every local authority in England and plotted levels of health, inequalities in health and cuts in their spending power. This report provides information from 17 local authorities with statistically significant increases in inequalities in life expectancy. The report shows, since 2010, central government spending cuts to local authorities were highest in areas with lower life expectancy and more health inequalities, further harming health in these places. It also confirms widening inequalities in life expectancy between regions in England and within local authorities since 2010.
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A large number of people live with long-term breathlessness that has a significant impact on their daily lives. For some, breathlessness is not directly linked to an underlying, diagnosable illness, and these people can struggle to access effective treatment and support. In this interview, respiratory doctor Anna Moore explains some of the causes of breathlessness including its links to a wide range of socioeconomic factors. She outlines the person-centred, multi-disciplinary approach her team at Barts Health is taking to help people overcome breathlessness and highlights the need for more research in this area. -
Content Article
Throughout 2023, the Arthritis and Musculoskeletal Alliance (ARMA) carried out the first ever national inquiry into musculoskeletal (MSK) health inequalities. The inquiry found that the prevalence and impact of musculoskeletal conditions are not experienced equally across the population. Musculoskeletal conditions are linked to deprivation and age, are more prevalent in women and disproportionately affect some ethnic groups. Deprivation is a significant driver of inequalities in MSK health. People in deprived areas experience more chronic pain, are more likely to have a long term MSK condition and experience worse clinical outcomes and quality of life. These inequalities are avoidable through changes in the design and delivery of MSK services, and actions to address wider determinants of health and prevention. The report makes recommendations to reduce health inequalities in MSK care, treatment and outcomes. -
Content ArticleThis report by the Institute of Health Equity (IHE) highlights that a million people in 90% of areas in England lived shorter lives than they should have between 2011 and the start of the pandemic. Using several published ONS data sources, calculations were made from the number of excess deaths in the decade from 2011 in England. The report's findings add to evidence about the cumulative impact of regressive funding cuts associated with austerity on the population's health. As a result of austerity, life expectancy failed to increase, and actually fell for women in the 10% of poorest areas, and health inequalities widened. Key findings The period from 2011 to 2019 saw 890,000 people dying earlier than they otherwise would have done had they experienced the death rates seen in the least deprived quintile (20 percent) of areas. Around 102,000 of these deaths were additional to what might have been expected based on levels in the two years prior to 2011. In 2020, the level of excess deaths rose by over a further 24,000 compared to that over the previous five years. Based on weekly monitoring figures published by the Office for Health Improvement and Disparities (OHID), there were nearly 11,000 more excess deaths in the most deprived 80 percent of areas during the Covid-19 pandemic in 2020 than in the least deprived 20 percent. This suggests that over 13,000 deaths in 2020 (the difference between 24,000 and 11,000 deaths) were associated with the pre-existing trend in mortality due to inequality. If the above comparisons are made with a less deprived group, the least deprived decile (10 percent) of areas, these figures reduce, but only slightly: Over a million people dying earlier than they otherwise would have done in 2011-19. Around 148,000 of these were additional to what might have been expected based on levels in the two years prior to 2011. About a further 28,000 deaths in 2020 in excess of the level in the previous five years.
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News ArticleFemale survivors of breast cancer living in the most deprived areas have a 35% higher risk of developing second, unrelated cancers, compared with those from the most affluent areas, research shows. Breast cancer is the most commonly diagnosed cancer in the UK, with about 56,000 people being told they have it each year. Improved diagnosis and treatments mean that five-year survival rates are now 86% in England. People who survive breast cancer have a greater likelihood of second primary (unrelated) cancer, but until now the exact risk has not been clear. A team of researchers led by the University of Cambridge analysed NHS data from almost 600,000 patients in England and found, compared with the general female population, women who had survived breast cancer had an increased risk of developing 12 other primary cancers. Compared with the most affluent, the least well-off female survivors of breast cancer had a 166% greater chance of developing lung cancer, a 78% higher risk of stomach cancer, more than 50% increased risk of bladder and oesophagus cancers, 48% higher risk of head and neck cancer and 43% increased risk of kidney cancer. Read full story Source: Guardian, 24 April 2024
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Content ArticleA joint paper by Public Health Wales and Cardiff University has identified a worrying trend of depreciating health inequalities between Wales’ most and least deprived areas. This blog outlines the key findings of the paper, including how the gap in life expectancy increased amongst both men and women between 2002 and 2020. This was primarily caused by large drops in life expectancy in Wales’ most deprived areas, including a sharp decline for women between 2018 and 2020.
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Content ArticleThis report by NHS Digital presents findings from the third in a series of follow up reports to the 2017 Mental Health of Children and Young People (MHCYP) survey, conducted in 2022. The sample includes 2,866 of the children and young people who took part in the MHCYP 2017 survey. It looks at the mental health of children and young people aged 7 to 24 years living in England in 2022, as well as examining their household circumstances, and their experiences of education, employment and services and of life in their families and communities. Key findings In 2022, 18.0% of children aged 7 to 16 years and 22.0% of young people aged 17 to 24 years had a probable mental disorder. In children aged 7 to 16 years, rates rose from 1 in 9 (12.1%) in 2017 to 1 in 6 (16.7%) in 2020. Rates of probable mental disorder then remained stable between 2020, 2021 and 2022. In young people aged 17 to 19 years, rates of a probable mental disorder rose from 1 in 10 (10.1%) in 2017 to 1 in 6 (17.7%) in 2020. Rates were stable between 2020 and 2021, but then increased from 1 in 6 (17.4%) in 2021 to 1 in 4 (25.7%) in 2022. 11 to 16 year olds with a probable mental disorder were less likely to feel safe at school (61.2%) than those unlikely to have a mental disorder (89.2%). They were also less likely to report enjoyment of learning or having a friend they could turn to for support. 1 in 8 (12.6%) 11 to 16 year old social media users reported that they had been bullied online. This was more than 1 in 4 (29.4%) among those with a probable mental disorder. 11 to 16 year old social media users with a probable mental disorder were less likely to report feeling safe online (48.4%) than those unlikely to have a disorder (66.5%). 1 in 5 (19.9%) 7 to 16 year olds lived in households that experienced a reduction in household income in the past year. This was more than 1 in 4 (28.6%) among children with a probable mental disorder. Among 17 to 22 year olds with a probable mental disorder, 14.8% reported living in a household that had experienced not being able to buy enough food or using a food bank in the past year, compared with 2.1% of young people unlikely to have a mental disorder.
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Content ArticleThis report by LCP Health Analytics, looks at how inequalities across the medicine life cycle impact patients and populations. It paints a vision of what success could look like, and proposes specific, feasible calls to action across industry, health technology assessment (HTA) bodies and players that could transform the role of the life science sector in reducing inequalities and fostering healthy populations. The report identifies two key challenges in addressing health inequalities that are tractable, and where the life science sector is most likely to make commitments and contributions: Multimorbidity is increasing and embedding inequalities in health Financial incentives across health systems are not aligned with patient and population health
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Content ArticleThis report by NHS Wales summarises the ways in which the cost of living crisis can impact on health and well-being. It takes a public health lens to identify actions for policy makers and decision-makers to protect and promote the health and well-being of people in Wales in their response to the cost of living crisis, outlining what a public health approach to the crisis could look like in the short and longer-term.
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