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Trends in socioeconomic inequalities in incidence of severe mental illness – A population-based linkage study using primary and secondary care routinely collected data between 2000 and 2017
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Keith Lloyd ,
Ian Jones,
James T.R. Walters,
Ann John
Schizophrenia Research, Volume: 260, Pages: 113 - 122
Swansea University Authors:
Sze Chim Lee, Marcos del Pozo Banos , Keith Lloyd , Ann John
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DOI (Published version): 10.1016/j.schres.2023.08.014
Abstract
Objective: In 2008, the UK entered a period of economic recession followed by sustained austerity measures. We investigate changes in inequalities by area deprivation and urbanicity in incidence of severe mental illness (SMI, including schizophrenia-related disorders and bipolar disorder) between 20...
| Published in: | Schizophrenia Research |
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| ISSN: | 0920-9964 |
| Published: |
Elsevier BV
2023
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa64074 |
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| Abstract: |
Objective: In 2008, the UK entered a period of economic recession followed by sustained austerity measures. We investigate changes in inequalities by area deprivation and urbanicity in incidence of severe mental illness (SMI, including schizophrenia-related disorders and bipolar disorder) between 2000 and 2017.Methods: We analysed 4.4 million individuals from primary and secondary care routinely collected datasets (2000-2017) in Wales and estimated the incidence of SMI by deprivation and urbanicity measured by the Welsh Index of Multiple Deprivation (WIMD) and urban/rural indicator respectively. Using linear modelling and joinpoint regression approaches, we examined time trends of the incidence and incidence rate ratios (IRR) of SMI by the WIMD and urban/rural indicator adjusted for available confounders.Results: We observed a turning point of time trends of incidence of SMI at 2008/2009 where slope changes of time trends were significantly increasing. IRRs by deprivation/urbanicity remained stable or significantly decreased over the study period except for those with bipolar disorder sourced from secondary care settings, with increasing trend of IRRs (increase in IRR by deprivation after 2010: 1.6% per year, 95% CI: 1.0%-2.2%; increase in IRR by urbanicity 1.0% per year, 95% CI: 0.6%-1.3%).Conclusions: There was an association between recession/austerity and an increase in the incidence of SMI over time. There were variations in the effects of deprivation/urbanicity on incidence of SMI associated with short- and long-term socioeconomic change. These findings may support targeted interventions and social protection systems to reduce incidence of SMI. |
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| Keywords: |
Austerity, deprivation, inequality, recession, severe mental illness, urbanicity |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
Welsh Government through Health and Care Research Wales (grant awarded to The National Centre for Mental Health’ with Grant No.: CA04); Health Data Research UK which receives its funding from HDR UK Ltd (NIWA1) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. |
| Start Page: |
113 |
| End Page: |
122 |