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Found 91 results
  1. Content Article
    The Children and Young People’s Health Equity Collaborative (CHEC) is a partnership between the UCL Institute of Health Equity (IHE), Barnardo’s and three Integrated Care Systems (ICSs), Birmingham and Solihull, Cheshire and Merseyside, and South Yorkshire. The CHEC sees action on the social determinants of health as essential in improving health outcomes among children and young people and reducing inequalities in health. The CHEC recognises that social determinants of health are generally not sufficiently addressed in policies, services and interventions that aim to support better health among children and young people. This framework has been developed by the CHEC with direct input from children and young people local to the three ICSs. The CHEC Board were also involved in its development. The framework’s main purpose is to underpin action for achieving greater equity in children and young people’s health and wellbeing and will be used to support the development of pilot interventions in the three partner ICS areas. There is an ambition for the framework also to be used more widely, encouraging other ICSs to take action on the social determinants of health among children and young people.
  2. Content Article
    The health action process approach (HAPA) is a social-cognitive model that specifies motivational and volitional determinants of health behaviour. This meta-analysis of studies applying the HAPA in health behaviour contexts estimates the size and variability of correlations among model constructs, test model predictions and test effects of past behaviour and moderators on model relations.
  3. Content Article
    Despite major gains in diagnosis and treatment, England continues to experience high disparities in cancer outcomes, with social and financial deprivation major drivers. This article from the thinktank Public Policy Projects looks at the underlying issues that lead to variation in both the likelihood of developing cancer, such as dietary differences, and in diagnosis, such as inaccessible screening programmes
  4. News Article
    Poorer people find it much harder to access NHS care than the well-off and have a worse experience when they do get it, research by the health service’s consumer watchdog has found. Those on the lowest incomes have much more difficulty getting a GP appointment, dental care or help with mental health problems, according to a survey by Healthwatch England. They are also more likely to feel they are not listened to by a health professional and not involved in key decisions about their care compared with those who are financially comfortable. The links between poverty and ill-health are well known, but the Healthwatch findings show that the worse-off also face the disadvantage what the watchdog called barriers to obtaining healthcare when they need it. The findings have prompted fears that the NHS is too often a “two-tier service” with access closely related to wealth, and calls for it to do more to make services more accessible to everyone. Healthwatch’s survey of 2,018 people aged 16 and over in England, which was a representative sample of the population, found that: 42% of those who described their financial situation as “really struggling” said they had trouble getting to see a GP, double the 21% of those who were “very comfortable”. 38% of the worst-off found it hard to get NHS dental care, compared with 20% of the better-off. 28% of the very poor had difficulty accessing mental health treatment, whereas only 9% of the very comfortable did so. Read full story Source: The Guardian, 4 March 2024
  5. Content Article
    Using experiences of care from over 10 million people collected over the past ten years, Healthwatch England presents a bold vision for the NHS in 2030. In a new report, Healthwatch outlines what they think the NHS should be in six years and how it can get there. The vision calls for a focus on three key themes: Making the NHS easier to access and navigate. Tackling health inequalities.  Building a patient-centred culture. 
  6. Content Article
    Although disparities in surgical outcomes are well-documented, understanding of how socioecological factors drive these disparities remains limited. This US study’s objective was to develop and assess the acceptability and feasibility of a comprehensive tool to evaluate socioecological determinants of health in patients requiring colorectal surgery. The authors developed an 88-item assessment tool measuring 31 socioecological determinants of health. It was assessed as having high acceptability and feasibility for patients who required colorectal surgery. The authors concluded that this work will help to identify what research is needed to understand and address surgical disparities.
  7. News Article
    People living in the most deprived parts of the country are more than twice as likely to be in poor health as those living in the most affluent, a new report has revealed. People in Liverpool are almost three times more likely to be in poor health than those in Oxfordshire, and twice as likely to be economically inactive, research by the cross-party IPPR Commission on Health and Prosperity found. The researchers found a “stark divide” in health and wealth throughout the UK was leaving many “bad health blackspots”, with people more likely to be out of work. Overall, people living in the most deprived parts of the country are more than twice as likely to be in poor health as those living in the most affluent – and are around 40% more likely to report economic inactivity. Read full story Source: The Independent, 18 January 2024
  8. Content Article
    MBRRACE have released their latest UK maternal mortality figures. The maternal death rate in 2020-22 was 13.41 per 100,000 maternities. This is significantly 53% higher than the rate of 8.79 deaths per 100,000 maternities in the previous three year period (2017-19).
  9. Content Article
    This 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.
  10. Content Article
    Cancers are the leading cause of death in England. This study from Rashid et al. published in Lancet Oncology aimed to estimate trends in mortality from leading cancers from 2002 to 2019 for the 314 districts in England. The study found that declines in overall cancer mortality have been unequal both geographically and among different groups of cancers. The greatest geographical inequality was observed for cancers with modifiable risk factors and potential for screening for precancerous lesions. Addressing risk factors such as smoking and alcohol use, expanding access to and utilisation of screening for prevention and early detection, and improving the quality of care should be used to reduce deaths in areas where they remain highest. High-resolution spatiotemporal data can help identify where intervention is required and track progress.
  11. Content Article
    Sepsis, characterised by significant morbidity and mortality, is intricately linked to socioeconomic disparities and pre-admission clinical histories. This study in eClinical Medicine looked at the association between non-COVID-19 related sepsis and health inequality risk factors amidst the pandemic in England, with a secondary focus on their association with 30-day sepsis mortality. It found that socioeconomic deprivation, comorbidity and learning disabilities were associated with an increased odds of developing non-COVID-19 related sepsis and 30-day mortality in England. This study highlights the need to improve the prevention of sepsis, including more precise targeting of antimicrobials to higher-risk patients. It also revealed that people with learning disabilities were almost four times as likely to develop the life-threatening illness. People with chronic liver disease were just over three times as likely, and chronic kidney disease stage 5 over 6 times more likely to develop non-COVID-19 sepsis. Cancer, neurological disease, immunosuppressive conditions, and having multiple prior courses of antibiotics were also associated with developing non-COVID-19 sepsis.
  12. News Article
    Poor people and those with existing health problems are much more likely to die from sepsis, one of the UK’s biggest killers, a study has found. Sepsis, or blood poisoning, is a potentially fatal condition triggered when the body reacts to an infection by attacking its own tissues and vital organs. It leads to an estimated 48,000 deaths a year in Britain. Research from the University of Manchester has disclosed for the first time how some groups are at much higher risk of dying from the condition than the general population. An analysis of 248,767 cases of non-Covid sepsis in England between January 2019 and June 2022 has found that the most deprived people are twice as likely to die from it within 30 days. The findings, published in the journal eClinicalMedicine, also show that: People with learning disabilities are almost four times more likely to get sepsis. People with liver disease have about three times greater risk. Patients with chronic kidney disease that is at stage 5 are more than six times as likely to develop it. “This study shows socioeconomic deprivation, comorbidity and learning disabilities are associated with an increased risk of developing non-Covid related sepsis and 30-day mortality in England.” Read full story Source: The Guardian, 23 November 2023
  13. Content Article
    Aortic valve replacement (AVR) is a life-saving procedure for symptomatic severe aortic stenosis (AS), which relieves symptoms, increases life expectancy and improves quality of life. Little is known about the rate of AVR provision by gender, race or social deprivation level in the NHS across England. However, a large analysis examining AVR on the health service in England – the first of its kind – reveals striking inequalities in its provision. Women, black and Asian people, and those living in the poorest parts of the country are much less likely to receive the life-saving procedure, the study shows. “In this large, national dataset, female gender, black or south Asian ethnicities and high deprivation were associated with significantly reduced odds of receiving AVR in England,” the authors wrote. Dr Clare Appleby, a consultant cardiologist at the Liverpool Heart and Chest hospital NHS foundation trust and an author of the study, said public health initiatives to understand and tackle these inequalities should be prioritised. “Severe symptomatic aortic stenosis is a serious disease that causes mortality and reduces quality of life for patients,” she said. “Left untreated it has a worse prognosis than many common metastatic cancers, with average survival being 50% at two years, and around 20% at five years.” Further research and public health initiatives to understand and address inequalities in the timely provision of AVR are important and should be prioritised in England.
  14. Content Article
    Mental health in the UK is getting worse. Sickness absence due to mental illness is soaring, rates of mental health difficulties are increasing at an alarming rate, and already overstretched services are struggling to meet rising demands. Along with over 30 organisations with an interest in mental health, the Centre for Mental Health has developed a plan to address this and build a mentally healthier nation.
  15. Content Article
    The latest data from the Office for National Statistics (ONS) provides the most comprehensive and up to date national profile of ethnic inequalities in mortality overall and from common physical conditions. It shows a complex picture of ethnic inequalities in mortality in England, with differences between people from ethnic minority and the White British groups, between different ethnic minority groups, and across different health conditions. This King's Fund blog looks at the complex interplay of factors drives ethnic differences in health.
  16. Content Article
    A global shortage of an estimated 18 million health workers is anticipated by 2030, a record 130 million people are in need of humanitarian assistance, and there is the global threat of pandemics such as COVID-19. At least 400 million people worldwide lack access to the most essential health services, and every year 100 million people are plunged into poverty because they have to pay for healthcare out of their own pockets. There is, therefore, an urgent need to find innovative strategies that go beyond the conventional health-sector response. WHO recommends self-care interventions for every country and economic setting as critical components on the path to reaching universal health coverage (UHC), promoting health, keeping the world safe and serving the vulnerable.
  17. Content Article
    The early use of automated external defibrillators (AEDs) improves outcomes in out-of-hospital cardiac arrest (OHCA). This study in the journal Heart investigated AED access across Great Britain according to socioeconomic deprivation. The authors found that in England and Scotland, there are differences in distances to the nearest 24/7 accessible AED between the most and least deprived communities. They concluded that equitable access to ‘out-of-hours’ accessible AEDs may improve outcomes for people with OHCA.
  18. News Article
    The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas. The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend. The research findings include: ‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments; “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”; Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.” Read full story (paywalled) Source: HSJ, 25 August 2023
  19. Content Article
    People living in deprived areas experience the most significant health inequalities in terms of access, experience and outcomes. There are large reductions in life expectancy for those living in the most deprived areas compared to people living in the least deprived areas. NHS England commissioned a research project into access, experience and outcomes related to health services in socio-economically deprived communities. This communications and engagement toolkit is an output of the research. The toolkit is designed to be used by communications and engagement professionals and others across the NHS with a responsibility for communicating to and engaging with people in the most deprived areas. 
  20. News Article
    A 60-year-old woman in England’s poorest areas typically has the same level of illness as a woman 16 years older in the richest areas, a study into health inequalities has found. The Health Foundation found a similarly stark, though less wide, gap in men’s health. At 60 a man living in the most deprived 10% of the country typically has the burden of ill-health experienced by a counterpart in the wealthiest 10% at the age of 70. The thinktank’s analysis of NHS data also shows that women in England’s poorest places are diagnosed with a long-term illness at the age of 40 on average, whereas that does not happen to those in the most prosperous places until 48. The findings underline Britain’s wide and entrenched socio-economic inequalities in health, which the Covid-19 pandemic highlighted. Ministers have promised to make tackling them a priority as part of the commitment to levelling up, but a promised white paper on that has been delayed. Researchers led by Toby Watt said their findings were likely to be the most accurate published so far because they were based on data detailing patients’ interactions with primary care and hospital services, and unlike previous studies did not rely on people’s self-reported health. “In human terms, these stark disparities show that at the age of 40, the average woman living in the poorest areas in England is already being treated for her first long-term illness. This condition means discomfort, a worse quality of life and additional visits to the GP, medication or hospital, depending on what it is. At the other end of the spectrum, the average 40-year-old woman will live a further eight years – about 10% of her life – without diminished quality of life through illness,” Watt said. Read full story Source: The Guardian, 17 August 2022
  21. News Article
    Rises in the cost of living are already having a negative impact of people's health, health professionals warn. BBC News has been told of people skipping meals or cutting back on medication, because of money worries. The Royal College of Nursing says people are having to make heart-wrenching choices that compromise their health and wellbeing. Along with GPs and hospital doctors, they warn health inequalities between rich and poor risk becoming worse. Laura Brant, 28, has already had to make some tough choices about a treatment keeping her alive. Having lived with kidney disease since the age of seven, she has already had two kidney transplants - and now needs another. Laura is dependent on a dialysis machine to carry out the filtering process usually performed by the kidneys. Without it, she could be dead in a week. Laura was having dialysis at home - but the machine used so much electricity and water the bills started to mount rapidly. "I'd say that it's the straw that broke the camel's back, really, with the cost of running the dialysis machine, the water it uses, the electric," she says. "And it was adding to my anxiety, like, 'How am I going to pay to do this treatment every month?'" Royal College of Physicians president Dr Andrew Goddard says some of his respiratory-medicine colleagues are hearing of patients choosing to turn off oxygen supplies to save money. "Respiratory disease disproportionately affects those least able to afford to improve their social circumstances," he says. "It seems likely the cost of living crisis will widen this disparity further." Read full story Source: BBC News, 9 June 2022
  22. News Article
    Women, low earners and ethnic minorities are faring worse on NHS waiting lists, according to research. Healthwatch, a patient watchdog, warned there was a risk that those with “more demands on their lives” such as long hours or caring responsibilities could end up at the back of the queue. It urged hospitals to be proactive in managing waiting lists and communicate with patients who might otherwise be left in limbo. The Healthwatch survey found 54% of women had waited more than four months for treatment, compared with 42% of men. They were also more likely to have had treatment delayed or cancelled, and to feel that a delay to treatment had made an impact on their ability to work. Some 54% of people on lower incomes had been waiting more than four months for hospital care, compared with 34% of higher wealth individuals. They reported a greater impact on their mental health and their ability to work. And 57% of respondents from ethnic minorities had faced a delay to or cancellation of hospital treatment, compared with 42 per cent of white British people. Louise Ansari, Healthwatch England’s national director, said the factors could have a “layering effect” that meant people had a much poorer experience, calling for “an additional specific focus on those groups” so that they do not end up “in worse and worse health”. Read full story (paywalled) Source: The Times, 8 June 2022
  23. News Article
    New research shared with HSJ has ‘laid bare’ the inequalities experienced by medical trainees, with black doctors more likely to perform worse in exams than any other ethnic group. The report published by the General Medical Council (GMC) highlights that UK medical graduates of black or black British heritage have the lowest specialty exam pass rate of all ethnic groups at 62%, which is almost 20 percentage points lower than that of white doctors (79%). It is the first time the medical regulator has split this data by ethnicity, it said. The GMC has pledged to “eliminate discrimination, disadvantage and unfairness” in undergraduate and postgraduate medical education by 2031 and the disproportionate number of fitness to practise complaints received about ethnic minority doctors and doctors who gained their medical qualification outside of the UK by 2026. Read full story (paywalled) Source: HSJ, 2 March 2023
  24. News Article
    Black people have the highest rate of sexually transmitted infections in Britain and officials are not doing enough to address the issue, sexual health experts have warned. Black Britons have “disproportionally high rates” of various STI diagnoses compared to white Britons, with those of Black Caribbean heritage specifically having the highest rates for chlamydia, gonorrhoea, herpes and trichomoniasis. Experts have told The Independent that healthcare providers are failing to address these disparities in STIs. They have called for more research to fully understand the complicated reasons why STIs are higher among people of Black ethnicity. Research conducted through the Health Protection Research Unit (HPRU) found that there were no clinical or behavioural factors explaining the disproportionately high rates of STI diagnoses among Black people. But higher rates of poverty and poor health literacy among marginalised communities are all linked with higher STI rates, according to a 2016 study, which found that behavioural and contextual factors are likely to be contributing. Moreover, experiences of racism among Black people can fuel a reluctance to engage with sexual health services and test frequently, according to HIV activist Susan Cole-Haley. She told The Independent: “I very much believe that it is linked to socioeconomic disadvantage and racism, often in healthcare settings, which can be a significant barrier for people accessing testing, for instance, and feeling comfortable engaging with care.” Read full story Source: The Independent, 19 February 2023
  25. News Article
    While some people avoided seeking medical care during the worst of the pandemic, worried about the risk of infection or unable to get an appointment because hospitals and doctors were overwhelmed, now many in the USA are finding that inflation and the uncertain economy have thrown up another barrier. “We are starting to see some individuals who are putting off some care, especially preventive care, due to the costs,” said Dr. Tochi Iroku-Malize, the president of the American Academy of Family Physicians and the chair of family medicine for Northwell Health in New York. Choosing between going to the doctor or paying for rent and food, “the health issue is no longer the priority,” she said. With the prices of prescription drugs, hospital stays and other treatments expected to increase significantly this year and next, some doctors expect families to have an even harder time affording medical care. When Margaret Bell, 71, found that her cancer had returned four years ago, she hesitated to resume her chemotherapy because she could not afford it, and higher prices have made it even harder. She would regularly skip appointments. About one-fourth of respondents in a recent Gallup poll said they put off care last year for what they considered a “serious” condition. Read full story (paywalled) Source: New York Times, 16 February 2023
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