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Healthcare inequalities among patients with diabetes

In the UK, nearly five million people are living with diabetes and a further five million are at increased risk of developing type 2 diabetes.

A review of studies on inequalities in healthcare among patients with type 2 diabetes by individual socioeconomic status and reginal deprivation has been carried out. Their results reveal the existence of clear inequalities for the quality of good care, regional deprivation, and individual Social Economic Status (SES).

Health inequalities are defined by NHS England and Public Health England as ‘the preventable, unfair and unjust differences in health status between groups, populations or individuals that arise from the unequal distribution of social, environmental and economic condition with societies which determine the risk of people getting ill, their ability to prevent sickness, or opportunities to take action and access to treatment when ill health occurs.’

Socioeconomic inequality of access to healthcare is seen across the entire spectrum of healthcare, not just in diabetes. Data from the NHS suggests longer waiting times of up to 35% within public hospitals between those in the most and least deprived population quintile groups.

Specifically focusing on diabetes, individual research has been carried out and trends are clear towards worse healthcare for patients with low SES in terms of both process of care and intermediate outcome indicators. Patients living in deprived areas less often achieved glycaemic control targets and tended to have high blood pressure and worse lipid profile control. 

The authors concluded that low individual SES and residential area deprivation were associated with higher risks of microvascular and macrovascular complications and existed across different healthcare systems. The situation of health inequality was exacerbated in the last decade due to the world recession of 2008 in which it was reported that more health issues, such as diabetes, were starting to be seen in the younger population with low socioeconomic background.

The NHS has tried to hammer down on the issue of health inequalities in the north west and applied for further funding to be granted to help tackle the issues in January 2021. 

The North West Coast Clinical Networks discussed that despite the investment in diabetes treatment and care since 2017, they recognised that not everyone was accessing health services equally, therefore wanted to introduce a collaborative sharing programme that encourages improvement in care for groups that face the greatest inequalities. 

The application highlighted that those in the health inequalities groups were the BAME population, people with learning difficulties, homelessness, travelling communities, sensory impaired diabetes, the LGBT+ community, people in care homes and in prison.

The health disparities have been worsened by the COVID-19 pandemic which has had a disproportionate impact on outcomes and care for those from ethnic minority groups and those living in deprived areas. In the North West Coast Clinical Networks application for further funding, the application noted that in a study of 61 million residents in the UK, a third of who died of the virus had a diagnosis of diabetes.

The report published by Diabetes UK on 10 May 2023 explains the backlog in preventable and avoidable deaths of people living with diabetes. The charity has now presented a campaign to Parliament named ‘Diabetes Is Serious’ to shed light on the social inequalities that continue to be faced meaning that essential care to monitor their blood sugar and blood pressure levels to reduce the risk of complications is not going ahead. Their research found that 1.9 million people living with diabetes did not receive vital care they needed in 2021/22.

Our team of medical negligence experts are hosting a webinar, focusing on missed checks and disrupted care resulting in people missing out on vital diabetes care. In it, we'll be joined by Dr Mark Vanderpump, a consultant endocrinologist who specialises in diabetes and endocrinology to discuss the impact of diabetes on healthcare outcomes for patients.

The webinar will be held on 19 July from 1-2pm.

Find out more about Irwin Mitchell's expertise in supporting people affected by diabetes care issues at our dedicated section on the website.