What would it take to eradicate health inequalities? A cross-sectional study using routine administrative data

Scott, Sonya; Curnock, Esther; Mitchell, Rory; Robinson, Mark; Tod, Elaine; McCartney, Gerry

doi:10.1016/s0140-6736(13)62513-1

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…health behaviours), and derived effect sizes from observational studies which did not examine a change in the exposure. These models are vulnerable to overestimation of impact on inequalities because we assume that a change in exposure at that distal point in the causal chain will improve outcomes despite there being several other causal pathways through which more ‘upstream’ exposures such as poverty will continue to generate mortality [ 2 ] [ 44 – 47 ] [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Informing Investment to Reduce Inequalities: A Modelling Approach

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundReducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions.ObjectivesTo provide estimates of the impact of a range of interventions on health and health inequalities.Materials and MethodsLiterature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a ‘living wage’; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII).ResultsIntroduction of a ‘living wage’ generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted.ConclusionsInterventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities.

show abstract

Section: Discussionmentioning

confidence: 99%

Informing Investment to Reduce Inequalities: A Modelling Approach

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Health inequalities – defined as the ‘systematic differences in the health of people occupying unequal positions in society’ 1 – are wider in Scotland than in any other country in Western Europe. 2 The fundamental causes of health inequalities are due to societal inequalities in income, wealth and power, 3,4 and much attention has rightly been paid to the social determinants of health. 5 However, healthcare can mitigate inequalities, by reducing severity and delaying progression of conditions, 6 and therefore healthcare is itself a social determinants of health.…”

Section: Introductionmentioning

confidence: 99%

Half a century of the inverse care law: A comparison of general practitioner job satisfaction and patient satisfaction in deprived and affluent areas of Scotland

Mercer

Lunan²,

MacRae

et al. 2022

Scott Med J

View full text Add to dashboard Cite

Background and Aims The ‘inverse care law’, first described in 1971, results from a mismatch of healthcare need and healthcare supply in deprived areas. GPs in such areas struggle to cope with the high levels of demand resulting in shorter consultations and poorer patient outcomes. We compare recent national GP and patient satisfaction data to investigate the ongoing existence of this disparity in Scotland. Methods and Results Secondary analysis of cross-sectional national surveys (2017/2018) on upper and lower deprivation quintiles. GP measures; job satisfaction, job stressors, positive and negative job attributes. Patient measures; percentage positive responses per practice on survey questions on access and consultation quality. GPs in high deprivation areas reported lower job satisfaction and positive job attributes, and higher job stressors and negative job attributes compared with GPs in low deprivation areas. Patients living in high deprivation areas reported lower satisfaction with access and consultation quality than patients in low deprivation areas. These differences in GP and patient satisfaction persisted after adjusting for confounding variables. Conclusions Lower GP work satisfaction in deprived areas was mirrored by lower patient satisfaction. These findings add to the evidence that the inverse care law persists in Scotland, over 50 years after it was first described.

show abstract

“…Despite improvements in overall health in the United Kingdom in recent years (Murray et al 2013), health disparities still exist across different socioeconomic, cultural, religious and sexual orientation groups (Scott et al 2013;Westwood et al 2015). Inequalities are visible in both religious (Laird et al 2007;Hussain andChoudhury 2007, Rassool 2014) and sexual minority groups (Clarke et al 2010;Elliott et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Intersectional identities and dilemmas in interactions with healthcare professionals: an interpretative phenomenological analysis of British Muslim gay men

Semlyen

Ali

Flowers

2017

Culture, Health & Sexuality

View full text Add to dashboard Cite

Individual interviews were conducted with six self-identified Muslim gay men living in London focusing on their experience of health service use. Transcripts were analysed using interpretative phenomenological analysis. Analysis identified two major themes: the close(d) community and self-management with healthcare professionals, detailing participants' concerns regarding the risks of disclosing sexuality; and the authentic identity - 'you're either a Muslim or you're gay, you can't be both' - which delineated notions of incommensurate identity. Analysis highlights the need for health practitioners to have insight into the complexity of intersectional identities, identity disclosure dynamics and the negative consequences of assumptions made, be these heteronormative or faith-related.

show abstract

What would it take to eradicate health inequalities? A cross-sectional study using routine administrative data

Cited by 3 publications

References 0 publications

Informing Investment to Reduce Inequalities: A Modelling Approach

Informing Investment to Reduce Inequalities: A Modelling Approach

Half a century of the inverse care law: A comparison of general practitioner job satisfaction and patient satisfaction in deprived and affluent areas of Scotland

Intersectional identities and dilemmas in interactions with healthcare professionals: an interpretative phenomenological analysis of British Muslim gay men

Contact Info

Product

Resources

About