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Lookup NU author(s): Dr Charlotte Parbery-Clark, Dr Lorraine McSweeneyORCiD, Dr Joanne LallyORCiD, Dr Sarah SowdenORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s) 2024.Background: Addressing socioeconomic inequalities in health and healthcare, and reducing avoidable hospital admissions requires integrated strategy and complex intervention across health systems. However, the understanding of how to create effective systems to reduce socio-economic inequalities in health and healthcare is limited. The aim was to explore and develop a system’s level understanding of how local areas address health inequalities with a focus on avoidable emergency admissions. Methods: In-depth case study using qualitative investigation (documentary analysis and key informant interviews) in an urban UK local authority. Interviewees were identified using snowball sampling. Documents were retrieved via key informants and web searches of relevant organisations. Interviews and documents were analysed independently based on a thematic analysis approach. Results: Interviews (n = 14) with wide representation from local authority (n = 8), NHS (n = 5) and voluntary, community and social enterprise (VCSE) sector (n = 1) with 75 documents (including from NHS, local authority, VCSE) were included. Cross-referenced themes were understanding the local context, facilitators of how to tackle health inequalities: the assets, and emerging risks and concerns. Addressing health inequalities in avoidable admissions per se was not often explicitly linked by either the interviews or documents and is not yet embedded into practice. However, a strong coherent strategic integrated population health management plan with a system’s approach to reducing health inequalities was evident as was collective action and involving people, with links to a “strong third sector”. Challenges reported include structural barriers and threats, the analysis and accessibility of data as well as ongoing pressures on the health and care system. Conclusion: We provide an in-depth exploration of how a local area is working to address health and care inequalities. Key elements of this system’s working include fostering strategic coherence, cross-agency working, and community-asset based approaches. Areas requiring action included data sharing challenges across organisations and analytical capacity to assist endeavours to reduce health and care inequalities. Other areas were around the resilience of the system including the recruitment and retention of the workforce. More action is required to embed reducing health inequalities in avoidable admissions explicitly in local areas with inaction risking widening the health gap.
Author(s): Parbery-Clark C, McSweeney L, Lally J, Sowden S
Publication type: Article
Publication status: Published
Journal: BMC Public Health
Year: 2024
Volume: 24
Issue: 1
Online publication date: 10/08/2024
Acceptance date: 18/07/2024
Date deposited: 04/10/2024
ISSN (electronic): 1471-2458
Publisher: BioMed Central Ltd
URL: https://doi.org/10.1186/s12889-024-19531-5
DOI: 10.1186/s12889-024-19531-5
Data Access Statement: Individual participants’ data that underlie the results reported in this article and a data dictionary defining each field in the set are available to investigators whose proposed use of the data has been approved by an independent review committee for work. Proposals should be directed to weima@sdu.edu.cn to gain access, data requestors will need to sign a data access agreement. Such requests are decided on a case by case basis.
PubMed id: 39127652
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