Social and spatial inequalities in healthcare use among people living with dementia in England (2002-2016)

Watson, James, Green, Mark A., Giebel, Clarissa ORCID logo ORCID: , Darlington-Pollock, Frances and Akpan, Asangaedem (2023) Social and spatial inequalities in healthcare use among people living with dementia in England (2002-2016). Aging and Mental Health, 27 (8). pp. 1476-1487.

[thumbnail of Akpan_SocialAndSpatial.pdf]
PDF - Published Version
Available under License CC BY

Download (1MB) | Preview
Official URL:


Objectives: Healthcare services for people living with dementia (PLWD) are stretched, and government promises of increased funding remain undelivered. With the UK dementia population to surpass 1 million by 2024, and dementia care costs predicted to almost treble by 2040, it is essential we understand differences in healthcare use among PLWD. This study aimed to explore social and spatial variations in healthcare use among people diagnosed with dementia (2002–2016).

Methods: Data were derived from Electronic Health Records of Clinical Practice Research Datalink GP patients in England (n = 142,302). To standardise healthcare contacts, rates of healthcare contacts per year were calculated for three primary (GP observations and medications) and three secondary healthcare types [Accident & Emergency (A&E) attendances and, emergency and elective hospital admissions]. Fully-adjusted generalised linear regression models were used to identify healthcare use variation by social and spatial groups. Twelve models were generated, one for each healthcare type in early- and late-onset populations separately.

Results: This study highlights numerous social and spatial variations in healthcare use among PLWD. Among PLWD, several groups tended to have healthcare service use more closely associated with negative outcomes, including a greater likelihood of A&E attendances and emergency and elective hospital admissions. These groups include: men, people from White ethnicity groups and people from more deprived and rural areas.

Conclusions: Systemic and social measures are needed to reduce variations in healthcare use inequalities in PWLD. These include greater healthcare continuity, health checks and medicines reviews, culturally appropriate services, better and more accessible treatment and improved infrastructure.

Item Type: Article
Journal / Publication Title: Aging and Mental Health
Publisher: Taylor and Francis Group
ISSN: 1364-6915
Departments: Institute of Health > Rehabilitation and Sport Science
Additional Information: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Depositing User: Insight Administrator
SWORD Depositor: Insight Administrator
Date Deposited: 22 Aug 2022 09:59
Last Modified: 13 Jan 2024 15:17


Downloads per month over past year

Downloads each year

Edit Item