Our four-year study has looked at the experience of people living in the local community and found high rates of illness attributable to Long Term Conditions (LTCs), but these rates are not spread evenly. Our findings suggest that the very communities most hard hit by Covid-19 are the same ones that have experienced years of long-term health problems because of LTCs. Many of these conditions are preventable or can be alleviated and controlled using the expertise of local primary care.
Dr Mark Ashworth, Professor of Primary Care from the School of Life Course & Population Sciences
23 March 2023
Black women face the worst health inequalities in South London
Researchers have found that Black women have the most long-term health conditions of any ethnic group, in a study of South London patients.
A new study from researchers from the Faculty of Life Sciences & Medicine, supported by Impact on Urban Health, and Dr Hiten Dodhia, Consultant in Public Health, Lambeth, found that when compared to other ethnic groups experiencing multimorbidities, Black women have the highest disadvantage.
Multimorbidities are defined as two or more long-term health conditions, like depression, anxiety, asthma, chronic pain and more.
As part of a wider study of multimorbidity conditions affecting patients in Lambeth and Southwark, researchers examined 826,000 patients’ data for the prevalence of long-term conditions. The researchers found that almost half of Black Caribbean patients had multimorbidity conditions compared to a third of Black African patients and 31% of White British patients. The most common conditions experienced were anxiety, chronic pain, depression, asthma and hypertension.
The study found that when compared to other patient groups, Black women have twice and in some cases three times the rate of long-term conditions including chronic pain, anxiety, hypertension, osteoarthritis, diabetes and morbid obesity.
He added: “Our team often said that without data, health inequalities are invisible, and that could not be more true when it comes to understanding local multimorbidity patterns. Our findings show the value of using locally based community data, derived from anonymised primary care records, which has helped construct a snapshot of the public health of Londoners in Southwark and Lambeth.”
The researchers also found that multimorbidity patients used primary care services three times as often as patients without these conditions. However, when a patient becomes depressed, the rate of using healthcare services doubled, meaning that when depressed, multimorbidity patients used primary care services six times as often as patients without those conditions.
Dr Marina Soley-Bori, Lecturer in Health Economics from School of Life Course & Population Sciences, said: “A mental health diagnosis is often a significant driver of primary care use. We found individuals with anxiety and depression accounted for 31% of total primary care consultation costs within the multimorbid population. Most notably, we found the trio of anxiety, depression and chronic pain to be the costliest long-term condition combination. ‘High-cost’ individuals tend to have more complex and diverse needs with a higher risk of poorly coordinated care. More individualised, patient-centric, care is required to prevent poorer health outcomes for this group.”
This research was funded by the GSTT Charity/Impact on Urban Health. The data was taken from the electronic primary care health records of 826,166 patients registered at GP practices in an ethnically diverse, urban setting in London between 2005 and 2020.
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Lecturer in Health Economics