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  • An analogy between socioeconomic deprivation level and loss of health from adverse effects of medical treatment in England

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Original article
An analogy between socioeconomic deprivation level and loss of health from adverse effects of medical treatment in England
  1. Raimundas Lunevicius1,2,
  2. Juanita A Haagsma3,4
  1. 1 Emergency General Surgery and Major Trauma Centre, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
  2. 2 School of Medicine, University of Liverpool, UK
  3. 3 Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  4. 4 Erasmus University Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Dr Raimundas Lunevicius, Aintree University Hospital NHS Foundation Trust, Emergency General Surgery and Major Trauma Centre, Lower Lane, Liverpool, L9 7AL. School of Medicine, University of Liverpool, UK; raimundas.lunevicius{at}aintree.nhs.uk

Abstract

Background The purpose of this study was to show whether and how levels, trends and patterns obtained from estimates of premature deaths from adverse effects (AEs) of medical treatment depended on the deprivation level in England over the 24-year period, 1990–2013. We provide a report to inform decision-making strategies to reduce the burden of disease arising from AEs of medical treatment in the most deprived areas of the country.

Methods Comparative analysis was driven by a single cause-of-injury category—AEs of medical treatment—from the Global Burden of Disease 2013 study. We report the mean values with 95% uncertainty intervals (UIs) for five socioeconomic deprivation areas of England.

Results In the most deprived areas of England, the death rate declined from 2.27 (95% UI 1.65 to 2.57) to 1.54 (1.28 to 2.08) deaths (32.16% change). The death rate in the least deprived areas was 1.22 (0.88 to 1.38) in 1990; it was 1.17 (0.97 to 1.59) in 2013 (4.1% change). Regarding disability-adjusted life year (DALY) rates, the same trend is observed. Although the gap between the most deprived and least deprived populations of England narrowed with regards to number of deaths, and rates of deaths and DALYs from AEs of medical treatment, inequalities between marginal levels of deprivation remain.

Conclusions The study suggests that a relationship between deprivation level and health loss from the AEs of medical treatment across England is possible. This could then be used when devising and prioritising health policies and strategies.

  • adverse effects
  • mortality
  • DALY
  • population health
  • England

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/injuryprev-2016-042274

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    Footnotes

    • Contributor RL was responsible for the study concept, design, data analysis, interpretation of data and drafting the manuscript. RL takes responsibility for the integrity of the data and the accuracy of the data analysis. JAH contributed providing guidance, revised draft critically and substantially for important intellectual content. Authors had full access to all of the data (including statistical reports and tables) in the study. RL is the guarantor for the study.

    • Funding This study had no specific funding. Bill & Melinda Gates Foundation is sponsor of overall GBD project. It had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The researchers are independent from the funder of GBD 2013 study.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Primary data available athttp://vizhub.healthdata.org/gbd-compare/england.