Dataset Information

Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.

ABSTRACT:

Purpose

Socioeconomic deprivation is associated with increased rates of self-harm but its association with levels of clinical care has not previously been explored. The aim of the current study was to investigate socioeconomic differences in the clinical management of people who self-harm.

Methods

Cross-sectional analysis of 3607 people presenting to a large inner-city hospital following self-harm.

Results

People living in the least deprived quintile were more likely to receive a psychosocial assessment (most vs. least deprived: 63.51 vs. 70.14%). This effect persisted in our fully adjusted model (OR 1.45, CI 1.15-1.82, p = 0.002). Mediation analysis suggested this association was in large part explained by higher rates of self-discharge in people presenting from areas of higher deprivation.

Conclusions

Compared to those from more deprived areas, people from less deprived areas are more likely to receive a psychosocial assessment when presenting to hospital following self-harm. The occurrence of higher rates of self-discharge from emergency departments among those from more deprived areas may explain the association.

SUBMITTER: Carroll R

PROVIDER: S-EPMC5702367 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Publications

Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.

Carroll Robert R Knipe Duleeka D Moran Paul P Gunnell David D

Social psychiatry and psychiatric epidemiology 20171004 12

<h4>Purpose</h4>Socioeconomic deprivation is associated with increased rates of self-harm but its association with levels of clinical care has not previously been explored. The aim of the current study was to investigate socioeconomic differences in the clinical management of people who self-harm.<h4>Methods</h4>Cross-sectional analysis of 3607 people presenting to a large inner-city hospital following self-harm.<h4>Results</h4>People living in the least deprived quintile were more likely to rec ...[more]

PMID: 28980024

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Project description:BackgroundSocioeconomic conditions affect the dynamics of the Covid-19 pandemic. We analysed the association between area-level socioeconomic deprivation, proportion of non-nationals, and incidence of Covid-19 infections in Germany.MethodsUsing linked nationally representative data at the level of 401 German districts from three waves of infection (January-2020 to May-2021), we fitted Bayesian spatiotemporal models to assess the association between socioeconomic deprivation, and proportion of non-nationals with Covid-19 incidence, controlling for age, sex, vaccination coverage, settlement structure, and spatial and temporal effects. We estimated risk ratios (RR) and corresponding 95% credible intervals (95% CrI). We further examined the deprivation domains (education, income, occupation), interactions between deprivation, sex and the proportion of non-nationals, and explored potential pathways from deprivation to Covid-19 incidence.FindingsCovid-19 incidence risk was 15% higher (RR=1·15, 95%-CrI=1·06-1·24) in areas classified with the highest deprivation quintile (Q5) compared to the least deprived areas (Q1). Medium-low (Q2), medium (Q3), and medium-high (Q4) deprived districts showed 6% (1·06, 1·00-1·12), 8% (1·08, 1·01-1·15), and 5% (1·05, 0·98-1·13) higher risk, respectively, compared to the least deprived. Districts with higher proportion of non-nationals showed higher incidence risk compared to districts with lowest proportion, but the association weakened across the three waves. During the first wave, an inverse association was observed with highest incidence risk in least deprived areas (Q1). Deprivation interacted with sex, but not with the proportion of non-nationals.InterpretationSocioeconomic deprivation, and proportion of non-nationals are independently associated with the incidence of Covid-19. Regional planning of non-pharmaceutical interventions and vaccination strategies would benefit from consideration of area-level deprivation and non-national residency.FundingThe study was funded by the German Ministry of Health (ZMV I 1 - 25 20 COR 410).

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Dataset Information

Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.

Purpose

Methods

Results

Conclusions

Publications

Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.

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