Latest news with #healthcareinequality
Medscape
6 days ago
- Health
- Medscape
Care Seeking for Concussion Varies by Material Deprivation
Children with the least material deprivation visit the emergency department (ED) for concussion more frequently than children with the most material deprivation, according to a Canadian study. The results suggest inequality in access to care, the study authors wrote. 'Underserved youth are about 1.5 to 1.8 times less likely to seek care than those in the highest socioeconomic bracket,' study author Alison Macpherson, PhD, professor of kinesiology and health science at York University in Toronto, told Medscape Medical News . The study was published online on July 11 in Injury Prevention . A Wide Gap ED visits for concussion have increased substantially over the past decade among patients younger than 20 years in Toronto. In the current study, researchers analyzed data for all Ontario ED visits for children and adolescents (ages 0-19 years) diagnosed with concussion between 2010 and 2020. The study population included 140,031 patients. Data were obtained from ICES (formerly known as the Institute for Clinical Evaluative Sciences), a health services research organization funded by the Ontario Ministry of Health. Socioeconomic status was assessed using factors of household material deprivation, which included low income, unemployment, single-parent families, parents without a high school diploma, and living in residences in need of major repair. Data were compared by age and sex. All age groups saw a rise in rates of concussion-related visits from 2010 to 2019, but the 10- to 14-year-olds and 15- to 19-year-olds saw the largest increases. For the former group, concussion-related visits per 100,000 increased from 350 in 2010 to 737 in 2019. For the latter group, visits increased from 382 in 2010 to 872 in 2019. Sex-related differences in concussion have been decreasing, and by 2019-2020, there were no significant differences between males and females, the researchers found. The gap in visits due to material deprivation was wide. The rates of concussion-related ED visits per 100,000 children were 36.7 in 2010 and 43.3 in 2020 among children with the greatest material deprivation. The corresponding rates in children with the lowest material deprivation were 62.6 and 61.8. Part of the reason for the difference could be inequitable participation in organized sports, Macpherson said, 'but the socioeconomic association persisted in 2020' amid the COVID-19 pandemic, a time when most organized sports were canceled. The study 'suggests that something else is going on,' she added. Concussions are 'an invisible injury,' and while the decision to seek care is clear-cut with a broken bone, for example, the decision is less automatic for a concussion, Macpherson said. Some of the barriers to seeking care may include a lack of awareness about concussions and parents' decreased ability to take time off to present their child for care. Rowan's Law in Ontario, which mandates concussion education in all high schools, and Parachute Canada, Canada's injury prevention organization, provide many of the education tools, Macpherson said. However, some parents might be unable to read the materials in English and might need them in another language. Special education may be needed in low-income areas with parent meetings, for example. Also, awareness could better expand to playgrounds and other areas outside of organized team sports settings, Macpherson said. A limitation of the study is that it was not able to determine whether care for concussion was sought in healthcare facilities outside EDs, the study authors acknowledged. Education Through Sports Commenting on the study for Medscape Medical News, Shannon Scratch, PhD, a clinician scientist and director of the Neurorehab Outcomes via Education and Learning Laboratory at Holland Bloorview Kids Rehabilitation Hospital in Toronto, said that she was heartened to see that sex differences in concussion care seeking in the ED are fading away. 'This is a really promising trend,' she said. 'It is also clear that there is a concussion care access divide based on socioeconomic status. We now need to focus on closing this gap,' Scratch added. 'Education initiatives in equitable settings may be one factor. But it is important to know that there are many reasons why some families do not feel comfortable or are unable to present to emergency services in Ontario.' So far, many adults have received concussion education only through their child's sports setting, Scratch said. Families from lower socioeconomic backgrounds do not have the same access to organized sports in the community and outside of school settings. 'There are also high barriers to entry in sports like hockey — for example, registration and equipment costs and ability to travel — where we have seen the greatest focus on concussion education and protocol development,' Scratch continued. 'Therefore, a more balanced and equitable approach to concussion education is needed. Young people and their parents should be provided with concussion education, including how to recognize symptoms and access care, within schools and their local communities. Focusing education on adults who support young people, including teachers and coaches, should also continue,' she said. The study was initially supported by a Canadian Institutes of Health Research Chair in Child and Youth Health Services and Policy Research. Macpherson and Scratch reported having no relevant financial relationships.
BBC News
7 days ago
- Health
- BBC News
'Unfair NHS waiting lists' revealed in official report
More than half of the overall NHS waiting list for non urgent treatment in England is made up of people of working age (19 to 64), the first official deep dive into inequalities in waiting lists has found. The data shows, for those aged 18 to 64, waiting lists for gynaecology are the biggest. And women make up a higher proportion of those waiting (57%), compared to men, in all cases where sex is recorded. NHS England officials say the figures should help hospitals address "unfair waits" for planned care among the communities who wait the longest. NHS trusts are being asked to use the data to understand and reduce inequalities faced by patients. Patients in the poorest communities and those from Asian or Asian British backgrounds are more likely to wait longer than 18 weeks than any other group, the report says. Some 3.1% of patients living in the most deprived areas were waiting more than 12 months to begin treatment at the end of June compared to 2.7% in the least deprived. Figures show:56% of the overall waiting list is made up of people aged 19 to 64a third of those waiting are aged 65 and overamong over 65s, ophthalmology has the greatest backlogwomen are more likely to be waiting over 18 weeks for treatment than menwomen are also more likely than men to wait for more than 52 weeksHealth and Social Care Secretary, Wes Streeting, said: "Sunlight is the best disinfectant. Only by being upfront and shining a light on inequalities can we begin to tackle the problem."He added that the recently announced 10 year health plan would tackle health inequalities by diverting billions of pounds to working class communities, and provide targeted care to all patients where they live, via a neighbourhood health centres will be rolled out first in places where healthy life expectancy is lowest, including deindustrialised cities and coastal towns. Gynaecology has had one of the worst waiting lists across the UK for a number of Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists, said: "At the moment, women in the most deprived areas face some of the longest waits, threatening to entrench existing health inequalities."Delays can lead to a need for more complex treatment and significantly impact women's health, wellbeing, and daily lives."She added that it has been encouraging to see wait lists begin to fall in recent months, with NHS staff "working tirelessly" to deliver more appointments.
Malay Mail
15-07-2025
- Health
- Malay Mail
Rakan KKM: No friend to those in need
JULY 15 — Public hospitals were never meant to resemble private hospitals. They exist precisely because profit-driven care leaves people behind. Yet with Rakan KKM, we are asked to accept the idea that the same tax-funded wards can be quietly turned into pay-per-use zones, where money determines how quickly you see a doctor. This is not some academic worry. Private hospitals exist to make money; no one disputes it. But public hospitals are built on a simple promise: when you are sick, you are equal to everyone else. That is not a sentimental slogan. It is the only reason taxpayers agree to fund a system meant to serve all, not just the fortunate. So why is the government so determined to blur that line? Why, just as subsidies are being clawed back and new taxes are piled onto families already stretched thin, must Malaysians be told they should pay extra for the privilege of timely care in hospitals they already own? And what of the resources this will quietly consume? Specialists and nurses are not idling in abundance. They are already stretched so thin that entire wards function on life support. In the Klang Valley hospitals, nurse-to-patient ratios sit at 1 to 10, far below safe standards, while over 20 per cent of specialist positions remain vacant. Yet we are told this scheme will have no impact. As if time and skill can be conjured out of nothing and from nowhere. As if rationing what little manpower exists to serve paying patients is somehow not a form of abandonment. Proponents call this pragmatism. A necessary compromise to stop the talent exodus. But when did it become acceptable policy to imitate everything we once criticised? If public hospitals now run on 'pay more, get more,' what sets them apart from private hospitals except the logo over the door? Is it only a question of which government-linked company gets to collect the fees? Imagine if a government school declared that to keep the best teachers, it would sell 'premium education plans' to the wealthy for faster grading, smaller classes, better facilities. In Klang Valley hospitals, nurse-to-patient ratios sit at 1 to 10, far below safe standards, while over 20 per cent of specialist positions remain vacant. — Picture by Raymond Manuel Would we call that modernisation? Or would we recognise it as the thin end of the wedge? Or picture the fire department offering 'express response packages,' promising to save homes that have signed up and paid first. Would we nod approvingly and call that innovation? Should the police auction off faster investigations to crime victims who can afford a premium plan? Rakan KKM is not simply a new revenue stream. It is a confession that the government no longer believes public goods can survive without a market price tag attached. That citizens must pay twice, once in taxes, again at the counter, to claim the care they have already funded. If public hospitals and private hospitals become indistinguishable in practice, why pretend there is still any difference in principle? What becomes of the promise that no Malaysian would be left behind just because they cannot pay? We are told this is not privatisation. Perhaps on paper it isn't. But in spirit, it is something worse: a slow surrender. A cynical rebranding of inequality as reform. Next time the ministry calls healthcare a right, they should add the footnote: terms and conditions, and your wallet, apply.
The Independent
01-07-2025
- Health
- The Independent
The hidden inequalities children on transplant waiting lists face
Academics at the University of Bristol identified significant inequalities in kidney transplant care for children in the UK, analyzing data from 1996 to 2020. The research found that Black children, those from more deprived backgrounds, and girls were less likely to be placed on the kidney transplant waiting list. Black children were 19 per cent less likely and children from the poorest backgrounds were 33 per cent less likely to be wait-listed compared to their white and wealthiest peers, respectively, while girls were 12 per cent less likely than boys. Although gender and income disparities reduced once children were on the waiting list, disadvantages for Black children persisted, including fewer living donor opportunities and lower odds of receiving a transplant. Experts from Kidney Care UK and NHS Blood and Transplant described the findings as shocking, highlighting the need to address systemic barriers and encourage more organ donations, especially from Black and Asian communities.
Yahoo
30-06-2025
- Health
- Yahoo
Girls and black children face inequalities in transplant treatment, study shows
Sick girls are less likely to be put on the kidney transplant waiting list compared to boys, according to analysis. Academics found that some children in need of a kidney transplant are facing inequalities in their care. Black children are less likely to be put on the transplant waiting list, as are those from more deprived backgrounds, researchers from the University of Bristol found. There are currently 137 children aged 17 and under on the kidney transplant waiting list in the UK. Researchers set out to examine whether inequalities exist in access to kidney transplantation among children in the UK by analysing the UK Renal Registry and NHS Blood and Transplant data between 1996 and 2020. They found that girls were 12% less likely to be put on a transplant waiting list compared to boys. Children from the poorest backgrounds were 33% less likely to be put on the waiting list compared to those from the wealthiest. And black children were 19% less likely to be put on the waiting list compared to their white peers. Once children are on the waiting list, the disparities related to gender and income appeared to reduce, but disadvantages for black children persisted. 'We were particularly struck by how early these disparities appear in the transplant process,' said Dr Alice James, lead author of the study. 'It's not just about who gets a transplant, but who even gets considered in the first place. 'Those from black ethnic backgrounds face systemic disadvantages even after being placed on the waitlist, including fewer living donor opportunities.' When looking at kidney transplants given by a living donor within two years of being on the waiting list, the odds of getting a transplant are lower among those from poorer backgrounds and children of black or Asian ethnicity, according to the study, which has been presented to the ESOT (European Society for Organ Transplantation) Congress 2025. Dr James added: 'It is notable – and particularly disquieting – that such disparities are evident even in a paediatric population within a universal healthcare system like the NHS. 'The persistent disadvantage faced by children from black ethnic backgrounds even after wait-listing is especially striking, suggesting systemic or cultural barriers that extend beyond access alone.' On gender inequalities seen in the study, she added: 'The gender disparity in wait-listing, with girls being less likely to be wait-listed, may reflect implicit gender biases in clinical decision-making, differences in parental advocacy, or variation in disease presentation and severity between sexes. 'There may also be social factors influencing clinicians' assumptions about transplant suitability or family engagement in the transplantation process. 'While evidence is limited in paediatric populations, adult studies suggest that women are often perceived as less suitable candidates due to comorbidities or psychosocial factors— perceptions that may inadvertently extend to female children.' Fiona Loud, policy director at Kidney Care UK, said: 'This research is shocking and it's not good enough to see such heartbreaking inequalities so early in life. 'There are around 1,000 children receiving kidney replacement therapy via either dialysis or transplant in the UK. 'This is a relatively small number which should mean we have a real opportunity to change this and make sure we improve things for the future for children and young people. 'But right now it is very hard for families whose children have kidney failure. 'More work needs to be done to explore local barriers and raise awareness of the value and importance of living kidney donation through personalised and community education programmes.' Professor Derek Manas, medical director for organ and tissue donation at NHS Blood and Transplant, which is responsible for allocating organs to people on the list, said: 'These results will help hospital clinical teams across the UK to further understand and mitigate this issue. 'NHS Blood and Transplant does not decide which individual patients are added to the transplant waiting list, but we do manage how organs are allocated to patients and the research found that once patients are on the waiting list, they had equitable access to donations, irrespective of ethnicity or deprivation. 'The transplant community has come a long way in ensuring equity once listed but this study confirms we all have more to do. 'Kidneys also need to be matched and people from the same ethnicity are more likely to be a match. 'There are currently not enough donors from black and Asian backgrounds and we urge people to show their support for donation on the NHS Organ Donor Register and to tell their families they want to donate.' An NHS England spokesperson said: 'The decision to place somebody on the transplant list should never be affected by their gender, ethnicity or family income and this analysis is a stark reminder that, whilst we have made progress on tackling health inequalities, much remains to be done – and this will be at the heart of the 10 Year Health Plan. 'More widely, we know kidney failure disproportionately impacts people from Black African and Black Caribbean heritage so we would always encourage more donors from these backgrounds to come forward, and we have recently launched a new simple genetic blood test for these groups to help reduce the risk of kidney failure.'
