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Showing results for tags 'Social determinants of health'.
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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. -
Content ArticleReducing social inequalities in health and health determinants, including physical activity (PA), is a major challenge for public health. PA-promoting interventions are increasingly implemented. Little is known, however, about the impact of these interventions on social inequalities. For prioritising interventions most likely to be effective in reducing inequalities, studies of PA interventions need to conduct equity impact assessments. The aim of this article is to describe the development of a logic model framework for equity impact assessments of interventions to promote PA. The framework was developed within the prevention research network AEQUIPA—Physical activity and health equity: primary prevention for healthy ageing, informed by an equity-focused systematic review, expert interviews, exploratory literature searches, and joint discussions within the network. The framework comprises a general equity-focused logic model to be adapted to specific interventions. The intervention-specific equity-focused logic models illustrate the key elements relevant for assessing social inequalities in study participation, compliance with and acceptance of interventions, as well as the efficacy of interventions. Equity impact assessments are beneficial for prioritising interventions most likely to be effective in reducing health inequalities.
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Content ArticleAccording to the United Nations Convention on the Rights of the Child, all children have the right to the highest attainable standard of health “without discrimination of any kind”. The UK has committed to upholding this right—but not all children in the UK are equally protected. Racism is a known risk factor for health in children, ranging from preterm birth and low birthweight, to major depression and asthma, and childhood is a vital period that can shape health throughout the life course. The authors of this Lancet article report on a roundtable discussion convened by Race & Health and the Race Equality Foundation in October 2023. The discussion focused on racism in the UK health system, with the aims of identifying key areas of exposure to racism in the UK health system for children, and the main barriers to uprooting racist structures and practices in the health system. The roundtable recommended the following immediate actions: Adopt a human rights-based approach that upholds children's rights to the highest attainable standard of health without discrimination and abolish policies that undermine these rights for minoritised children. Incorporate anti-racist health and research practice into the health system's functioning and commissioning, including by increasing engagement during decision making, and co-creation of processes, policies, and procedures with minoritised communities to foster greater trust. Integrate anti-racist training within health-care curricula to ensure that the next generation of health workers have the information and skills to recognise and combat racism in the health system. Embed professional accountability to uphold anti-racist principles and practice into the health system, including by embedding anti-racism within the annual appraisal process as a professional requirement. Ensure that data and evidence collected and valued by the health system incorporate the voices and inputs of communities, delivering epistemic justice. End structural discrimination in institutions and systems that shape children's interactions with the health system, including social care systems, and separate policing and prison systems from health care. Uphold equality, diversity, and inclusion commitments and funding and allocate funding to dismantle racism and white supremacy in the UK health system. Co-create anti-racist and anti-oppressive services with minoritised communities, providing a viable alternative to oppressive systems and structures.
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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.
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Content ArticleIn Birmingham, eight out of 10 Somali children live in ‘poor’ households with low levels of economic activity and high rates of mental health issues, such as PTSD. In the UK, six in 10 (59%) people in the Somali community live in overcrowded accommodation, compared to fewer than one in 10 (8%) of the overall population. Meanwhile, studies show that many Somali people find it difficult to access health and social care services, due to language and socio-economic barriers. Suad Duale is a community activist, clinician, mother and researcher who grew up as a Somali refugee in Birmingham. In this blog for The King's Fund, she describes how unfair treatment of the Somali community leads to a collective lack of trust in professionals, particularly in the health system. She describes the issues contributing to the disparities faced by the community, including a lack of people from the Somali community in leadership roles who are able to advocate for the needs of the community. She describes the work of Dream Chaser Youth Club in Birmingham, where she volunteers by acting as a link to help people from the Somali community connect with health and care services.
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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 Article
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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. -
News ArticleBlack 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
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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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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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EventDecades of research has shown that the health of the population in England is unequal, with people who live in more deprived areas experiencing illness earlier in life and dying younger. Previous Health Foundation analysis has projected that 9.3 million people could be living with major illness by 2040, which is 2.6 million, or 39%, more people than in 2019. In April, the Health Foundation’s REAL Centre published its second report in their ‘Health in 2040’ series, this time exploring how current patterns of ill health vary with deprivation across England, and to what extent this is projected to change by 2040. The findings have important implications for health inequality among the working age population and how it poses a challenge to labour supply and economic growth. This webinar will convene experts to explore what the findings mean for how we might need to change as a society, and what can we do to better prepare for the future. Register
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News Article
Record 3.7m workers in England will have major illness by 2040, study finds
Patient Safety Learning posted a news article in News
A record 3.7 million workers in England will have a major illness by 2040, according to research. On current trends, 700,000 more working-age adults will be living with high healthcare needs or substantial risk of mortality by 2040 – up nearly 25% from 2019 levels, according to a report by the Health Foundation charity. But the authors predicted no improvement in health inequalities for working-age adults by 2040, with 80% of the increase in major illness in more deprived areas. Researchers at the Health Foundation’s research arm and the University of Liverpool examined 1.7m GP and hospital records, alongside mortality data, which was then linked to geographical data to estimate the difference in diagnosed illness by level of deprivation in England in 2019, the last year of health data before the pandemic. They then projected how levels of ill health are predicted to change in England between 2019 and 2040 based on trends in risk factors such as smoking, alcohol use, obesity, diet and physical activity, as well as rates of illness, life expectancy and population changes. Without action, the authors warn, people in the most deprived areas of England are likely to develop a major illness 10 years earlier than those in the least deprived areas and are also three times more likely to die by the age of 70. Read full story Source: The Guardian, 17 April 2024 -
Content ArticleThis Health Foundation report explores how patterns of diagnosed ill health vary by socioeconomic deprivation in England. This report is the second output from the REAL Centre’s programme of research with the University of Liverpool. Building on the projections in Health in 2040, this report is one of the first studies to unpack patterns of inequalities in diagnosed illness by socioeconomic deprivation across England and project them into the future. Stark inequalities are projected to stubbornly persist up to 2040, with profound implications not only for people’s quality of life, but also their ability to work and the wider economy. The report also finds that health inequality is largely due to a small group of long-term conditions, with chronic pain, type 2 diabetes and anxiety and depression projected to increase at a faster rate in the most deprived areas.
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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 Lancet article highlights three challenges to measuring and analysing social determinants of health (SDoH) for which data science—a cross-disciplinary set of skills to make judgements and decisions with data by using it responsibly and effectively—can be harnessed. The three challenges the authors examine are: Data necessary for capturing the exposure of interest at multiple levels appropriately are not always available nor easy to measure. SDoH are distal to individual health outcomes compared to biomedical determinants such as comorbidities. The distal placement of SDoH in relation to health outcomes results in requires long periods of time to observe their effect.
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Content ArticleThis report was put together by two charities, Pathway and Crisis, and reveals how the national crisis facing both our health and housing systems leads to worsening health for people in inclusion health groups. Drawing on 85 pieces of published literature from the past two years, and a survey of frontline medical and healthcare professionals, the findings reveal how those who are most excluded in our society struggle to access health services due to inflexibility, discrimination and stigma. It calls on the Government, along with NHS England, to lead reform of mainstream health services and to increase the availability of specialist care. It further calls for a commitment to deliver the social housing needed to ensure that everyone has a safe and healthy home.
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Content ArticleWomen and people born biologically female have unique health needs across the life span, and their health outcomes often differ from those of men. Although women make up greater than half of the world’s population, these unique needs remain both insufficiently understood, due to decades of exclusion from scientific and medical research, and inadequately addressed, due to systems and cultures that often dismiss or devalue their experiences. This article discusses highlights from the National Academy of Medicine's Annual Meeting Scientific Symposium in October 2023 on the subject of women’s health. It looks at improving representation in research, bridging the gap in terms of social determinants of health and the need to reassess and research the female chromosomal makeup.
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Content ArticleCurrently, it is estimated that more than one in five people in the UK are living in poverty. This King's Fund analysis reveals that people living in poverty find it harder to live a healthy life, live with greater illness, face barriers to accessing timely treatment, and die earlier than the rest of the population. The analysis looks at the link between poverty and each of the following: prevalence of ill health difficulties accessing health care late or delayed treatment poorer health outcomes. The long read argues that while the NHS can, and should, do more to make timely care accessible to deprived communities, wider government and societal action is needed to address the root causes of poverty.
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Content ArticleThe 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.
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Content ArticleThe 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.
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Content Article
Unpacking cancer disparities in England (7 March 2024)
Patient-Safety-Learning posted an article in Cancers
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 -
News Article
Worst-off find it harder than well-off to access NHS care, survey finds
Patient Safety Learning posted a news article in News
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 -
Content ArticleUsing 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.
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Content ArticleAlthough 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.
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News Article
Stark UK divide in health and wealth with sickness ‘clearly linked to poverty’
Patient Safety Learning posted a news article in News
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
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