Premature mortality twice as high in most deprived areas compared to most affluent

A major new paper in the Lancet highlights rates of premature mortality that are two times higher in the most deprived areas of England (Blackpool) compared to most affluent (Wokingham).

Dr Harry Rutter, Clinical Research Fellow at the London School of Hygiene and Tropical Medicine was among the prominent experts in the field who authored the paper.

Dr Harry Rutter

Dr Rutter, a public health physician, was Principal Investigator of the CLAHRC’s evaluation of the Greater London Authority’s Healthy Schools London programme. 

All-cause age-standardised years of life lost due to premature mortality (YLL) and years lost due to disability (YLD) per 100 000 population by UK country and English Upper Tier Local Authorities, 2016

The work presents findings from a new Global Burden of Disease (GBD) Study funded by the Bill & Melinda Gates Foundation and Public Health England. 

The Global Burden of Disease includes evidence collected and analyzed by a consortium of more than 3,000 researchers in more than 130 countries and provides a tool for goverments and policy makers to measure health loss from hundreds of diseases, injuries, and risk factors, so that health systems can be improved and inequalties tackled

The authors of the Lancet paper used the data to estimate years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and attributable risks from 1990 to 2016 for England, Scotland, Wales, Northern Ireland, the UK, and 150 English Upper-Tier Local Authorities. They estimated the burden of disease by cause of death, condition, year, and sex.

You can view via an interactive ‘Lost Years’ map – which reveals the extent of health inequality across the UK.

Changes in health in the countries of the UK and 150 English
Local Authority areas 1990–2016: a systematic analysis for
the Global Burden of Disease Study 2016
Nicholas Steel, John A Ford, John N Newton, Adrian C J Davis, Theo Vos, Mohsen Naghavi, Scott Glenn, Andrew Hughes, Alice M Dalton, Diane Stockton, Ciaran Humphreys, Mary Dallat, Jürgen Schmidt, Julian Flowers, Sebastian Fox, Ibrahim Abubakar, Robert W Aldridge,Allan Baker, Carol Brayne, Traolach Brugha, Simon Capewell, Josip Car, Cyrus Cooper, Majid Ezzati, Justine Fitzpatrick, Felix Greaves, Roderick Hay, Simon Hay, Frank Kee, Heidi J Larson, Ronan A Lyons, Azeem Majeed, Martin McKee, Salman Rawaf, Harry Rutter, Sonia Saxena, Aziz Sheikh, Liam Smeeth, Russell M Viner, Stein Emil Vollset, Hywel C Williams, Charles Wolfe,  Anthony Woolf, Christopher J L Murray

How can we improve dementia care in UK black elders?

Black elders dismiss the warning signs of dementia until the condition becomes too severe to ignore or a crisis strikes. They are also less likely to receive a diagnosis of their condition, resulting in delayed treatment and
less time to plan for the future.

Our latest BITE – a summary of published CLAHRC research provides an overview of our work with black elders, their families and carers to;

  1. identify barriers and facilitators to seeking help for dementia.
  2. based on what we found, work with dementia patients and their          carers, volunteers from the public, clinicians and experts in the treatment and research of dementia to develop an intervention – a leaflet entitled Getting help for forgetfulness (below)
  3. trial the intervention with GP registered patients, who were asked to rate it and evaluate its effect on their intention to seek help from their doctor.

What are the challenges of knowledge co-production in embedded research?

The concept of knowledge co-production is used in health services research to describe partnerships (which can involve researchers, practitioners, managers, commissioners or service users) with the purpose of creating, sharing and negotiating different knowledge types used to
make improvements in health services.

The CLAHRC has researchers “embedded” in a number of our partner organisations in the NHS and local government. The “researcher in residence” model has the advantage of allowing academics to be close to the ground and gain insight into how an organisation really operates. It also presents challenges in creating and maintaining key relationships and professional independence.

In a newly published BITE-sized summary of our research we present the results of our examination of three case studies and the wider implications for this model of working.

One to one specialling and sitters in acute care hospitals; reviewing the evidence

One to one nursing, or specialling is a way of caring for patients by providing continuous observation (by “sitters”) for an individual for a period of time during acute physical or mental illness.

Some patients need more than a general level of observation on a ward, often with the primary aim of reducing risk and protecting the patient.

Our review, published in a BITE, examined published evidence on the topic of specialling and sitters, aiming to identify the challenges and concerns relating to the cost effectiveness and quality of care.

Medication adherence in asthma: can pharmacists help?

Preventer inhalers (inhaled corticosteroids) are a common medication for asthma, and people get the full benefit of the medication by taking their prescribed doses correctly. We know many patients struggle to take enough doses effectvely, which impacts their ability to manage the condition.

Could pharmacists hold the key to helping patients take medicines effectively and in the right doses?

Our latest BITE – a postcard “need to know” summary of our research – presents the findings of our review of the evidence on whether pharmacists involved in asthma care could help people take their preventer inhaler as prescribed, therefore giving them the full benefit of their medication.