Cardiovascular Disease Inequalities in the East of England and Equity-focussed Quality Improvement

In collaboration with the Eastern Academic Health Sciences Network (AHSN), Dr John Ford and Abe Tolley looked at inequalities in cardiovascular disease (CVD) in the East of England.

Dr Ford is Clinical Lecturer in Public Health at the Primary Care Unit and leads the Inequalities pillar at the Cambridge Institute of Public Health, while Abe Tolley is a University of Cambridge medical student.

They analysed data from 2021 to gain an insight into how the Covid-19 pandemic has compounded both the burden of CVD as well as health inequalities. They recommend equity-focussed quality improvement in primary care to address these inequalities.

For the first time in history, we have the data to show that the pandemic has led to a rapid compounding of health inequalities. These inequalities manifest as higher cases and deaths in socio-economically disadvantaged groups and minority ethnic groups. Cardiovascular disease is a primary driver of these stark inequalities in life expectancy.”

– Dr John Ford and Abe Tolley, University of Cambridge

The team examined CVD inequalities in CVD in the East of England through general practice level data on risk factors, cardiovascular disease (CVD) prevalence, quality-of-care, lipid treatment, deprivation (based on Index of Multiple Deprivation (IMD) and practice demographics (including age, sex and ethnicity).

They found stark socioeconomic inequalities in the risk factors for CVD, especially smoking and obesity. Increased deprivation was also associated with increased prevalence of all CVDs examined, with the exception of atrial fibrillation (suggesting possible under diagnosis). The most deprived areas showed the lowest patient satisfaction rates while the most affluent areas showed the highest. Full conclusions and figures can be found in the reports below.

Equity focussed quality improvement (EF-QI) will be key to reducing these inequalities, through ensuring initiatives focus on disadvantaged groups or conditions intrinsically associated with disadvantage. A how-to guide for EF-QI can be found below.

 

Reports

Cardiovascular Disease Inequalities in the East of England (2 pages)

How-to-guide: Equity-focussed Quality Improvement (3 pages)

 

Contact

Dr John Ford, Clinical Lecturer in Public Health: jf653@medschl.cam.ac.uk

Abe Tolley, Medical Student: alt60@cam.ac.uk

For Eastern AHSN queries, contact Nick Pringle, Senior Advisor & CVD Programme Lead: nick.pringle@eahsn.org