Influence of deprivation and rurality on patient-reported outcomes of men living with and beyond prostate cancer diagnosis in the UK: A population-based study

Smith, Graham; Downing, Amy; Norman, Paul; Wright, Penny; Hounsome, Luke; Watson, Eila; Wagland, Richard; Selby, Peter J.; Kind, Paul; Donnelly, David; Butcher, Hugh; Huws, Dyfed Wyn; McNair, Emma; Gavin, Anna; Glaser, Adam

doi:10.1016/j.canep.2020.101830

Cited by 6 publications

(3 citation statements)

References 34 publications

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“…We also classified areas as urban or rural using the Office for National Statistics' mid-2018 estimates of population density for local authorities in the UK [41], and applying a binary classification of rurality using thresholds based on the Rural-Urban Classification [42], where the threshold for maximum population density in rural areas was 288 people per square kilometre. While population density is not strictly an urban-rural measure, it is a good proxy for which comparable data is available across Great Britain [43]. We present a map of rural and urban areas defined by population density in appendix 4.…”

Section: Data and Measuresmentioning

confidence: 99%

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Inequalities in local government spending on cultural, environmental and planning services: a time-trend analysis in England, Scotland, and Wales

et al. 2023

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Background Local government provides Cultural, Environmental, and Planning (CEP) services, such as parks, libraries, and waste collection, that are vital for promoting health and wellbeing. There have been significant changes to the funding of these services over the past decade, most notably due to the UK government’s austerity programme. These changes have not affected all places equally. To understand potential impacts on health inequalities, we investigated geographical patterning of recent CEP spending trends. Methods We conducted a time trend analysis using routinely available data on local government expenditure. We used generalised estimating equations to determine how expenditure trends varied across 378 local authorities (LAs) in Great Britain between 2009/10 and 2018/19 on the basis of country, deprivation, rurality, and local government structure. We investigated the gross expenditure per capita on CEP services, and the CEP expenditure as a proportion of total local authority budgets. We present the estimated annual percentage change in these spend measures. Results Expenditure per capita for CEP services reduced by 36% between 2009/10 and 2018/19. In England, the reduction in per capita spending was steepest in the most deprived quintile of areas, falling by 7.5% [95% CI: 6.0, 8.9] per year, compared to 4.5% [95% CI: 3.3, 5.6] per year in the least deprived quintile. Budget cuts in Scotland and Wales have been more equitable, with similar trends in the most and least deprived areas. Welsh LAs have reduced the proportion of total LA budget spent on CEP services the most (-4.0% per year, 95% CI: -5.0 to -2.9), followed by Scotland (-3.0% per year, 95% CI: -4.2 to -1.7) then England (-1.4% per year, 95% CI: -2.2 to -0.6). In England, rural and unitary LAs reduced their share of spending allocated to CEP more than urban and two-tier structured LAs, respectively. Conclusion Funding for cultural, environmental and planning services provided by local government in the UK has been cut dramatically over the last decade, with clear geographical inequalities. Local areas worst affected have been those with a higher baseline level of deprivation, those with a single-tier local government structure, and English rural local authorities. The inequalities in cuts to these services risk widening geographical inequalities in health and wellbeing.

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Section: Data and Measuresmentioning

confidence: 99%

“…More complex measures might consider population size, how built up or sparse an area is, or proximity to urban areas. However, population density is the most consistently reported measure across Great Britain and is considered a good proxy for rurality [43].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Inequalities in local government spending on cultural, environmental and planning services: a time-trend analysis in England, Scotland, and Wales

et al. 2023

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“…The RUC is a measure of urbanisation, based on resident population only, and does not reflect the land use, policy or financial characteristics of an area. [18][19][20][21] The RUC is produced for England and Wales combined, but separate data sources and methodologies are used for Scotland and Northern Ireland making these non-comparable across nations.…”

Section: Methodsmentioning

confidence: 99%

Completeness and representativeness of small area socioeconomic data linked with the UK Clinical Practice Research Datalink (CPRD)

Mahadevan¹,

Harley²,

Fordyce³

et al. 2022

J Epidemiol Community Health

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BackgroundThe Clinical Practice Research Datalink (CPRD) holds primary care electronic healthcare records for 25% of the UK population. CPRD data can be linked via practice postcode in the UK, and additionally via patient postcode in England, to area-level socioeconomic status (SES) data including the Index of Multiple Deprivation (IMD), the Carstairs Index and the Townsend Deprivation Index; as well as rural–urban classification (RUC). This study aims to describe the completeness and representativeness of CPRD-linked SES and RUC data.MethodsPatients currently registered at general practices contributing data to the May 2021 snapshots of CPRD GOLD (n=445 587) and CPRD Aurum (n=13 278 825) were used to assess the completeness and representativeness of CPRD-linked SES and RUC data against the UK general population.ResultsAll currently registered patients had complete SES and RUC data at practice level across the UK. Most English patients in CPRD GOLD (78%), CPRD Aurum (94%) and combined (93%) had SES and RUC data at patient level. Patient-level SES data in CPRD for England were comparable to England’s general population (average IMD decile in CPRD 5.52±0.00 vs 5.50±0.02). CPRD UK practices were on average in more deprived areas than the UK general population (6.06±0.07 vs 5.50±0.02). A slightly higher proportion of CPRD patients and practices were from urban areas (85%) as compared with the UK general population (82%).ConclusionCompleteness of CPRD-linked SES and RUC data is high. The CPRD populations were broadly representative of the general populations in the UK in terms of SES and RUC.

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(Un-) healthy ageing: Geographic inequalities in disability-free life expectancy in England and Wales

et al. 2022

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Influence of deprivation and rurality on patient-reported outcomes of men living with and beyond prostate cancer diagnosis in the UK: A population-based study

Cited by 6 publications

References 34 publications

Inequalities in local government spending on cultural, environmental and planning services: a time-trend analysis in England, Scotland, and Wales

Inequalities in local government spending on cultural, environmental and planning services: a time-trend analysis in England, Scotland, and Wales

Completeness and representativeness of small area socioeconomic data linked with the UK Clinical Practice Research Datalink (CPRD)

(Un-) healthy ageing: Geographic inequalities in disability-free life expectancy in England and Wales

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