Tackling the inverse care law: Analysis of policies to improve general practice in deprived areas since 1990

Fisher, Rebecca; Allen, Lucinda; Malhotra, Akanksha; Alderwick, Hugh

doi:10.37829/hf-2022-p09

Cited by 24 publications

(17 citation statements)

References 53 publications

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“…101 Health Foundation research points to the need for an independent review of general practice funding allocations and better central supervision of GP distribution in England to avoid perpetuating existing inequities in access to general practice. 102 The supply of staff other than GPs…”

Section: Implications 81mentioning

confidence: 99%

NHS workforce projections 2022

Shembavnekar¹,

Buchan²,

Bazeer³

et al. 2022

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Section: Implications 81mentioning

confidence: 99%

NHS workforce projections 2022

Shembavnekar¹,

Buchan²,

Bazeer³

et al. 2022

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“…There has been inequitable funding for GP practices across England [ 60 , 61 ], with practices serving deprived communities and transient populations being relatively underfunded in comparison with practices serving more affluent communities [ 62 ]. This negatively impacted MMR uptake in these deprived communities [ 22 , 61 ].…”

Section: Resultsmentioning

confidence: 99%

Mitigating Vaccine Hesitancy and Building Trust to Prevent Future Measles Outbreaks in England

et al. 2023

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Measles, a highly infectious respiratory viral infection associated with severe morbidity and mortality, is preventable when coverage with the highly effective measles, mumps and rubella vaccine (MMR) is ≥95%. Vaccine hesitancy is responsible for measles outbreaks in countries where measles had previously been eliminated, including in England, and is one of the ten threats to global public health identified by the World Health Organization (WHO). Official administrative 2012–2021 data on measles incidence and MMR coverage in England were reviewed alongside a scoping literature review on factors associated with MMR uptake in England. Whilst measles incidence has reduced significantly since 2012, sporadic measles outbreaks in England have occurred with geographic disparities and variations in MMR coverage. Over the last decade, MMR uptake has fallen across all regions with no area currently reaching the WHO target of 95% coverage of both doses of MMR necessary for herd immunity. Factors associated with MMR coverage overlap with the 3C (convenience, complacency and confidence) model of vaccine hesitancy. The COVID-19 pandemic has reinforced pre-existing vaccine hesitancy. Increasing MMR uptake by reducing vaccine hesitancy requires allocated funding for area-based and targeted domiciliary and community-specific immunisation services and interventions, public health catch-up campaigns and web-based decision aid tools.

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“…People with co-occurring MHPs and HD are also more likely to experience physical multimorbidity, yet in practice services are not as integrated as they could be [ 58 ] highlighting the mismatch between healthcare needs and utilisation [ 59 ]. Addiction and mental health services are not currently equipped to screen for and identify chronic physical NCDs and therefore, refer individuals to other services but this can mean that people only get the support when symptoms and chronicity are more serious.…”

Section: Discussionmentioning

confidence: 99%

The clustering of physical health conditions and associations with co-occurring mental health problems and problematic alcohol use: a cross-sectional study

et al. 2023

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Background There is strong evidence for the co-occurrence of mental health conditions and alcohol problems, yet physical health outcomes among this group are not well characterised. This study aimed to identify clusters of physical health conditions and their associations with mental health and problematic alcohol use in England’s general population. Methods Cross-sectional analysis of the 2014 Adult Psychiatric Morbidity Survey (N = 7546) was conducted. The survey used standardised measures of problematic alcohol use and mental health conditions, including the Alcohol Use Disorders Identification Test (AUDIT) and the Clinical Interview Schedule-Revised. Participants self-reported any lifetime physical health conditions. Latent class analysis considered 12 common physical illnesses to identify clusters of multimorbidity. Multinomial logistic regression (adjusting for age, gender, ethnicity, education, and occupational grade) was used to explore associations between mental health, hazardous drinking (AUDIT 8 +), and co-occurring physical illnesses. Results Five clusters were identified with statistically distinct and clinically meaningful disease patterns: ‘Physically Healthy’ (76.62%), ‘Emerging Multimorbidity’ (3.12%), ‘Hypertension & Arthritis’ (14.28%), ‘Digestive & Bowel Problems’’ (3.17%), and ‘Complex Multimorbidity’ (2.8%). Having a mental health problem was associated with increased odds of ‘Digestive & Bowel Problems’ (adjusted multinomial odds ratio (AMOR) = 1.58; 95% CI [1.15–2.17]) and ‘Complex Multimorbidity’ (AMOR = 2.02; 95% CI [1.49–2.74]). Individuals with co-occurring mental health conditions and problematic alcohol use also had higher odds of ‘Digestive & Bowel Problems’ (AMOR = 2.64; 95% CI [1.68–4.15]) and ‘Complex Multimorbidity’ (AMOR = 2.62; 95% CI [1.61–4.23]). Conclusions Individuals with a mental health condition concurrent with problematic alcohol use experience a greater burden of physical illnesses, highlighting the need for timely treatment which is likely to include better integration of alcohol and mental health services.

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Tackling the inverse care law: Analysis of policies to improve general practice in deprived areas since 1990

Cited by 24 publications

References 53 publications

NHS workforce projections 2022

NHS workforce projections 2022

Mitigating Vaccine Hesitancy and Building Trust to Prevent Future Measles Outbreaks in England

The clustering of physical health conditions and associations with co-occurring mental health problems and problematic alcohol use: a cross-sectional study

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