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

Lee, Sze Chim, DelPozo-Banos, Marcos, Lloyd, Keith, Jones, Ian ORCID: https://orcid.org/0000-0001-5821-5889, Walters, James ORCID: https://orcid.org/0000-0002-6980-4053 and John, Ann 2023. 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. Schizophrenia Research 260 , pp. 113-122. 10.1016/j.schres.2023.08.014 Item availability restricted.

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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 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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher:	Elsevier
ISSN:	0920-9964
Date of First Compliant Deposit:	15 August 2023
Date of Acceptance:	14 August 2023
Last Modified:	09 Nov 2023 20:18
URI:	https://orca.cardiff.ac.uk/id/eprint/161774

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