Abstract
Purpose
Equity profiles are an established public health tool used to systematically identify and address inequity within health and health services. Our aim was to conduct an equity profile to identify inequity in eye health across Leeds and Bradford. This paper presents results of findings for diabetic retinopathy in Bradford and Airedale.
Methods
A variety of routine health data were included and sub-analysed by measures of equity, including age, sex, ethnicity, and deprivation to identify inequity in eye health and healthcare. The Spearman Rank Correlation Coefficient was used to determine the association between variables.
Results
The prevalence of diagnosed diabetes in Bradford and Airedale district is 6.6% compared to 4.3% in nearby Leeds and 5.1% nationally. The age-standardised prevalence of diagnosed diabetic retinopathy within Bradford and Airedale is 2.21% (95% CI 1.54–2.26%), with a disproportionately high prevalence of disease in the Pakistani population and the most deprived parts of the population. There was a poorer uptake of diabetic retinopathy screening in more deprived parts of the district and the proportions with a higher rate of referral to ophthalmology following the screening in Black and Minority Ethnic populations compared with the white population (13.2% vs6.9%). Uptake of secondary care outpatient appointments is much lower in more deprived populations.
Conclusion
Inequalities are inherent in diabetic retinopathy prevalence, diagnosis, and treatment. The reasons for these inequities are multi-factorial and further investigation of reasons for poor uptake of services is required. Addressing the inequalities in eye health and healthcare requires cross-organisational collaboration.
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Acknowledgements
We thank Bernadette Murphy, Public Health Programme Manager, NHS Leeds; Helen Lee, Public Health Development Manager, RNIB; Adam Greatwood, Health and Social Care Manager, Action for Blind People; David Judson, Public Health Data Analyst, NHS Bradford and Airedale; Frank Wood, Public Health Data Analyst, NHS Leeds; Richard Dixon, Information Manager (GIS and Public Health), NHS Leeds; Ravi Naru, Clinical Advisor–Optometry, NHS Bradford and Airedale; Edwin Bonner, Clinical Advisor–Optometry, NHS Bradford and Airedale; Suzanne Beshara, Diabetic Retinopathy Screening Programme Manager, NHS Bradford and Airedale; Kate Horsfall, Screening Coordinator and Senior Public Health Manager, NHS Bradford and Airedale; Faruque Ghanchi, Consultant Ophthalmologist, Bradford Teaching Hospital Trust; Roopa Setty, Locum Consultant in Ophthalmology, Leeds Teaching Hospitals NHS Trust; Darren Shickle, Academic Department of Public Health, University of Leeds; Simon Grant, Deputy Director of Medicines Management, NHS Bradford and Airedale; Simon Labbett, Rehabilitation Officer, Visual Impairment, Bradford Adult and Community Services; David Allen, Head of Prevention of Sight Loss, RNIB; Cherelle Matthews, Data Quality Team Manager, NHS Bradford and Airedale; and Medisoft Limited, Leeds Innovation Centre, 103 Clarendon Road, Leeds, LS2 9DF.
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Additional information
Equity profile commissioned by RNIB. Presented at Royal College of Ophthalmology Annual Congress 2011, Vision 2020 Annual Conference 2011 and Faculty of Public Health Conference 2011.
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Kliner, M., Fell, G., Gibbons, C. et al. Diabetic retinopathy equity profile in a multi-ethnic, deprived population in Northern England. Eye 26, 671–677 (2012). https://doi.org/10.1038/eye.2012.3
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DOI: https://doi.org/10.1038/eye.2012.3
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