ObjectivesThe aim of this systematic review was to evaluate studies which employed routine and cohort data sets to understand inequalities in dementia care pathways.MethodsWe identified 27 research papers using routine data sets to investigate inequalities in dementia care pathways through electronic and grey literature searches. Papers were independently assessed by two reviewers for inclusion based on defined criteria. Included papers were quality rated using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Data was extracted based on stage(s) in dementia care pathway and socio‐economic factors investigated.ResultsInequalities were noted across dementia care pathways. Socio‐economic and protected characteristics were shown to impact the likelihood of people with dementia moving into institutional nursing care, the quality and consistency of their treatment, need for emergency and urgent healthcare, the rate of illness progression and their long‐term survival. Research was often disparate ignoring the multiple parts of the dementia care pathway, or the impact of specific factors across multiple stages.ConclusionsOur study highlights issues in dementia care pathways based on socio‐economic or protected characteristics. Equitable service provision, more culturally appropriate services, improved health literacy and increased provision for both early diagnosis and care at home can help narrow the gap in dementia care inequalities. There is greater need for research investigating dementia care pathways as something greater than the sum of its parts; exploring the influence of socio‐economic factors from a person's entrance into the system and throughout.

Background: Little is known about how people with dementia and/or their family carers access health and social care services after a diagnosis. The aim of this study was to explore potential inequalities in care pathways for people with young-onset and late on-set dementia (YOD/LOD), including their family carers, with coronavirus disease 2019 (COVID-19) occurring throughout the course of the study and enabling a comparison between pre-pandemic and COVID-19 times. Methods: People with YOD and LOD with their family carers were recruited via local support groups in the North West Coast region of England. Semi-structured interviews explored the experiences of people with YOD and LOD and family carers on their access to both health and social care services and community-based services. Transcripts were coded by two researchers and analysed using thematic analysis. Fifteen interviews were conducted with seven people with YOD or LOD and 14 family carers between January and March 2020. Some interviews were conducted only with the person with dementia, because they did not have a family carer, and others were conducted only with the family carer, because the person with dementia was in the severe stages of the condition. Results: Four themes emerged from the interviews: (1) Getting the ball rolling: the process of diagnosis; (2) Balancing the support needs of people with dementia and carers; (3) Barriers to accessing support; and (4) Facilitators to accessing support. Inequities existed for both YOD and LOD, with emerging evidence of unequal experiences in accessing care at the beginning of the COVID-19 pandemic. Discussion: People with YOD and LOD and their carers require better support in accessing services after a diagnosis. Greater understanding of the pathways through which inequalities materialise are needed, especially those that might have been disrupted or exacerbated by the COVID-19 pandemic.

3Residential mobility can have negative impacts on health, with some studies finding that residential 4 mobility can contribute to widening health gradients in the population. However, ethnically 5 differentiated experiences of residential mobility and the relationship with health are neglected in the 6 literature. To examine the relationship between residential mobility, risk of cardiovascular disease 7 (CVD) and ethnicity, we constructed a cohort of 2,077,470 participants aged 30+ resident in New 8Zealand using encrypted National Health Index (eNHI) numbers linked to individual level routinely 9 recorded data. Using binary logistic regression, we model the risk of CVD for the population stratified 10 by ethnic group according to mover status, baseline deprivation and transitions between deprivation 11 statuses. We show that the relationship between residential mobility and CVD varies between ethnic 12 groups and is strongly influenced by the inter-relationship between residential mobility and deprivation 13 mobility. Whilst residential mobility is an important determinant of CVD, much of the variation 14 between ethnic groups is explained by contrasting deprivation experiences. To reduce inequalities in 15 CVD within New Zealand, policies must focus on residentially mobile M ori, Pacific and South Asian 16 populations who already have a heightened risk of CVD living in more deprived areas. 17 Key words 18New Zealand; CVD; Ethnicity; Inequalities; Mobility; Migration; Deprivation; Record Linkage 19 Introduction 20Cardiovascular disease (CVD) and associated morbidities are among the leading causes of global deaths 21 (World Health Organisation, 2014). In New Zealand (NZ) there are marked variations between ethnic 22 groups in the prevalence of CVD (Blakely et al., 2004;Riddell et al., 2007;Jatrana and Blakely, 2008; 23 Kerr et al., 2008; Grey et al., 2010; Mehta et al., 2011; Perumal et al., 2012; Ker et al., 2015; Mehta et 24 al., 2014;Exeter et al., 2015;Wells et al., 2015). Between 1980 and 1999, while all ethnic groups 25 experienced reductions in CVD mortality, M ori and Pacific populations saw markedly smaller 26 2 reductions than non-M ori non-Pacific (nMnP) groups (Blakely et al., 2005). By 2007, these disparities 27 had not disappeared: M ori males and females almost invariably had the highest age-specific prevalence 28 of CVD across all age groups, as well as the highest age-standardised prevalence of CVD (7.41 29 compared to NZ's total population at 4.77, and 5.68 for the Pacific group) (Cheuk Chan et al., 2008). 30Stark differences in risk of CVD and CVD mortality between ethnic groups are not restricted to NZ. 31For example, rates of ischaemic heart disease amongst South Asian males are 30 to 40% higher than 32 rates amongst the UK's general population (Department of Health, 2001). In the US in 2013, Black 33 groups had 30% higher mortality from CVD than Whites, increasing to 113% higher CVD mortality 34 than Asians and Pacific Islanders (Singh et al., 2015). 35Exploring why ethnic in...

Ethnic minorities experience multiple inequalities across different domains including health and tenure. Notwithstanding extensive research demonstrating a clear connection between tenure and health, the relationship between health, tenure and ethnicity is under-explored. In this paper, we examine ethnic inequalities in health and tenure in England using cross-sectional census microdata for 1991, 2001 and 2011. We find that ethnic inequalities in health persist over time while the relationship between health and tenure varies between ethnic groups. These results suggest that traditional explanations linking health and tenure are not sufficient to adequately capture the myriad experiences of different ethnic groups.

Internal migration is one of the main drivers of local population change and therefore an important factor to consider in the provision of services across key domains such as housing, health and education. In recent years, the population of England and Wales has become increasingly ethnically diverse, with groups varying in age structure and time spent in the UK (whether at the group or individual level). However, relatively little is known about the internal migration patterns of these diverse groups, with research into internal migration propensity not accounting for the possible interplay between ethnicity, country of birth and age. Using micro‐data from the 2011 Census for England and Wales, this paper addresses this gap in knowledge, exploring whether widely reported determinants of internal migration operate differently for different ethnic groups, stratified by age and country of birth. This paper also explores whether for ethnic minority groups born overseas, time spent in the UK matters for migration propensity. When stratifying ethnic groups by age and country of birth, differences in migration propensity do not appear to be explained by socio‐economic differences, as previous research in the field suggests. However, for those born overseas, some of the differences are explained by time spent in the UK. From a policy perspective, it is evident that a more nuanced understanding of the way in which propensity to migrate may vary between ethnic groups differing in age and country of birth is needed to ensure sustained provision and equitable access across key service domains. Further research must examine the extent to which differences in migration propensity shapes the nature of migration events, whether in terms of distance or frequency of move.

There exists a large body of research focused on migration distance, where migration is either the outcome of interest or used as an input variable to model something else. However, there is little consistency in the distance thresholds used: these are often arbitrary, based on administrative boundaries or constrained by definitions available in the dataset. This causes problems with comparison across studies, and in some cases where migration distance is poorly defined could lead to issues with interpretation of results. Using Binary Logistic Regression and drawing on data from the 2011 Census Sample of Anonymised Records for England and Wales, we demonstrate that the odds of migrating vary when considering a range of population characteristics across 16 distance thresholds. We argue that the choice of distance cut-offs needs to be population and context specific and that decisions about these cut-offs should be made carefully as part of the study design.

We used longitudinal information on area deprivation status to explore the relationship between residential-deprivation mobility and Cardiovascular Disease (CVD). Data from 2,418,397 individuals who were: enrolled in any Primary Health Organisation within New Zealand (NZ) during at least 1 of 34 calendar quarters between 1st January 2006 and 30th June 2014; aged between 30 and 84 years (inclusive) at the start of the study period; had no prior history of CVD; and had recorded address information were analysed. Including a novel trajectory analysis, our findings suggest that movers are healthier than stayers. The deprivation characteristics of the move have a larger impact on the relative risk of CVD for younger movers than for older movers. For older movers any kind of move is associated with a decreased risk of CVD.

COVID-19 is unique in that it is the first global pandemic occurring amidst a crowded information environment that has facilitated the proliferation of misinformation on social media. Dangerous misleading narratives have the potential to disrupt ‘official’ information sharing at major government announcements. Using an interrupted time-series design, we test the impact of the announcement of the first UK lockdown (8–8.30 p.m. 23 March 2020) on short-term trends of misinformation on Twitter. We utilise a novel dataset of all COVID-19-related social media posts on Twitter from the UK 48 hours before and 48 hours after the announcement (n = 2,531,888). We find that while the number of tweets increased immediately post announcement, there was no evidence of an increase in misinformation-related tweets. We found an increase in COVID-19-related bot activity post-announcement. Topic modelling of misinformation tweets revealed four distinct clusters: ‘government and policy’, ‘symptoms’, ‘pushing back against misinformation’ and ‘cures and treatments’.