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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

Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Keith Lloyd Orcid Logo, Ian Jones, James T.R. Walters, Ann John Orcid Logo

Schizophrenia Research, Volume: 260, Pages: 113 - 122

Swansea University Authors: Sze Chim Lee, Marcos del Pozo Banos Orcid Logo, Keith Lloyd Orcid Logo, Ann John Orcid Logo

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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...

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Published in: Schizophrenia Research
ISSN: 0920-9964
Published: Elsevier BV 2023
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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.</abstract><type>Journal Article</type><journal>Schizophrenia Research</journal><volume>260</volume><journalNumber/><paginationStart>113</paginationStart><paginationEnd>122</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0920-9964</issnPrint><issnElectronic/><keywords>Austerity, deprivation, inequality, recession, severe mental illness, urbanicity</keywords><publishedDay>31</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-10-31</publishedDate><doi>10.1016/j.schres.2023.08.014</doi><url>http://dx.doi.org/10.1016/j.schres.2023.08.014</url><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><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.</funders><projectreference>CA04, NIWA1</projectreference><lastEdited>2023-10-03T12:10:41.2745876</lastEdited><Created>2023-08-14T16:10:53.8584070</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Sze Chim</firstname><surname>Lee</surname><order>1</order></author><author><firstname>Marcos</firstname><surname>del Pozo Banos</surname><orcid>0000-0003-1502-389X</orcid><order>2</order></author><author><firstname>Keith</firstname><surname>Lloyd</surname><orcid>0000-0002-1440-4124</orcid><order>3</order></author><author><firstname>Ian</firstname><surname>Jones</surname><order>4</order></author><author><firstname>James T.R.</firstname><surname>Walters</surname><order>5</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>6</order></author></authors><documents><document><filename>64074__28483__c37a0fec4e4945e092601decf2e2f82c.pdf</filename><originalFilename>64074.AAM.pdf</originalFilename><uploaded>2023-09-08T09:52:47.7535863</uploaded><type>Output</type><contentLength>310627</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><documentNotes>Accepted manuscript version distributed under the terms of a Creative Commons CC-BY-NC-ND licence.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.en</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 64074 2023-08-14 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 10628af4988d624b49c4de7bd78b4694 Sze Chim Lee Sze Chim Lee true false f141785b1c0ab9efe45665d35c081b84 0000-0003-1502-389X Marcos del Pozo Banos Marcos del Pozo Banos true false a13aaa0df9045c205e82ed3b95d18c10 0000-0002-1440-4124 Keith Lloyd Keith Lloyd true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2023-08-14 FGMHL 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. Journal Article Schizophrenia Research 260 113 122 Elsevier BV 0920-9964 Austerity, deprivation, inequality, recession, severe mental illness, urbanicity 31 10 2023 2023-10-31 10.1016/j.schres.2023.08.014 http://dx.doi.org/10.1016/j.schres.2023.08.014 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 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. CA04, NIWA1 2023-10-03T12:10:41.2745876 2023-08-14T16:10:53.8584070 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Sze Chim Lee 1 Marcos del Pozo Banos 0000-0003-1502-389X 2 Keith Lloyd 0000-0002-1440-4124 3 Ian Jones 4 James T.R. Walters 5 Ann John 0000-0002-5657-6995 6 64074__28483__c37a0fec4e4945e092601decf2e2f82c.pdf 64074.AAM.pdf 2023-09-08T09:52:47.7535863 Output 310627 application/pdf Accepted Manuscript true Accepted manuscript version distributed under the terms of a Creative Commons CC-BY-NC-ND licence. true eng https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.en
title 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
spellingShingle 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
Sze Chim Lee
Marcos del Pozo Banos
Keith Lloyd
Ann John
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
author_id_str_mv 10628af4988d624b49c4de7bd78b4694
f141785b1c0ab9efe45665d35c081b84
a13aaa0df9045c205e82ed3b95d18c10
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv 10628af4988d624b49c4de7bd78b4694_***_Sze Chim Lee
f141785b1c0ab9efe45665d35c081b84_***_Marcos del Pozo Banos
a13aaa0df9045c205e82ed3b95d18c10_***_Keith Lloyd
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Sze Chim Lee
Marcos del Pozo Banos
Keith Lloyd
Ann John
author2 Sze Chim Lee
Marcos del Pozo Banos
Keith Lloyd
Ian Jones
James T.R. Walters
Ann John
format Journal article
container_title Schizophrenia Research
container_volume 260
container_start_page 113
publishDate 2023
institution Swansea University
issn 0920-9964
doi_str_mv 10.1016/j.schres.2023.08.014
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1016/j.schres.2023.08.014
document_store_str 1
active_str 0
description 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.
published_date 2023-10-31T12:10:42Z
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