NHS health checks: a cross- sectional observational study on equity of uptake and outcomes
Background The National Health Checks programme aims to reduce the incidence of cardiovascular diseases and health inequalities in England. We assessed equity of uptake and outcomes from NHS Health Checks in general practices in Bristol, UK. Methods A cross-sectional study using patient-lev...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BioMed Central
2018
|
| Subjects: | |
| Online Access: | https://eprints.nottingham.ac.uk/51040/ |
| _version_ | 1848798398775296000 |
|---|---|
| author | Coghill, Nikki Garside, L Montgomery, Alan A. Feder, Gene Horwood, Jeremy |
| author_facet | Coghill, Nikki Garside, L Montgomery, Alan A. Feder, Gene Horwood, Jeremy |
| author_sort | Coghill, Nikki |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
The National Health Checks programme aims to reduce the incidence of cardiovascular diseases and health inequalities in England. We assessed equity of uptake and outcomes from NHS Health Checks in general practices in Bristol, UK.
Methods
A cross-sectional study using patient-level data, from 38 general practices. We descriptively analysed the socioeconomic status (SES) of patients invited and the SES and ethnicity of those attending. Logistic regression was used to test associations between invitation and attendance, with population characteristics.
Results
Between June 2010 to October 2014, 31,881 patients were invited, and 13,733 NHS Health Checks completed. 47% of patients invited from the three least and 39% from the two most-deprived index of multiple deprivation quintiles, completed a Check. Proportions of invited patients, by ethnicity were 64% non-black and Asian and 31% black and Asian. Men were less likely to attend than women (OR 0.73, 95% confidence interval 0.67 to 0.80), as were patients ≤ 49 compared to ≥ 70 years (OR 0.40, 95% confidence interval 0.65 to 0.83).
After controlling for SES and population characteristics, compared to patients with low CVD risk, high risk patients were more likely to be prescribed cardiovascular drugs (OR 6.2, 95% confidence interval 4.51 to 8.40). Compared to men, women (OR 01.18, 95% confidence interval 1.03 to 1.35) were more likely to be prescribed cardiovascular drugs, as were those ≤ 49 years (50–59 years, OR 1.42, 95% confidence intervals 1.13–1.79, 60–69 years, OR 1.60, 95% confidence intervals, 1.22–2.10, ≥ 70 years, OR 1.64, 95% confidence intervals, 1.14 to 2.35).
Controlling for population characteristics, the following groups were most likely to be referred to lifestyle services: younger women (OR 2.22, 95% CI 1.69 to 2.94), those in the most deprived IMD quintile (OR 3.22, 95% CI 1.63 to 6.36) and those at highest risk of CVD (OR, 2.77, 95% CI 1.91 to 4.02).
Conclusions
We found no statistically significant evidence of inequity in attendance for an NHS Health Check by SES. Being older or a woman were associated with better attendance. Targeting men, younger patients and ethnic minority groups may improve equity in uptake for NHS Health Checks. |
| first_indexed | 2025-11-14T20:19:09Z |
| format | Article |
| id | nottingham-51040 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T20:19:09Z |
| publishDate | 2018 |
| publisher | BioMed Central |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-510402018-04-10T09:44:26Z https://eprints.nottingham.ac.uk/51040/ NHS health checks: a cross- sectional observational study on equity of uptake and outcomes Coghill, Nikki Garside, L Montgomery, Alan A. Feder, Gene Horwood, Jeremy Background The National Health Checks programme aims to reduce the incidence of cardiovascular diseases and health inequalities in England. We assessed equity of uptake and outcomes from NHS Health Checks in general practices in Bristol, UK. Methods A cross-sectional study using patient-level data, from 38 general practices. We descriptively analysed the socioeconomic status (SES) of patients invited and the SES and ethnicity of those attending. Logistic regression was used to test associations between invitation and attendance, with population characteristics. Results Between June 2010 to October 2014, 31,881 patients were invited, and 13,733 NHS Health Checks completed. 47% of patients invited from the three least and 39% from the two most-deprived index of multiple deprivation quintiles, completed a Check. Proportions of invited patients, by ethnicity were 64% non-black and Asian and 31% black and Asian. Men were less likely to attend than women (OR 0.73, 95% confidence interval 0.67 to 0.80), as were patients ≤ 49 compared to ≥ 70 years (OR 0.40, 95% confidence interval 0.65 to 0.83). After controlling for SES and population characteristics, compared to patients with low CVD risk, high risk patients were more likely to be prescribed cardiovascular drugs (OR 6.2, 95% confidence interval 4.51 to 8.40). Compared to men, women (OR 01.18, 95% confidence interval 1.03 to 1.35) were more likely to be prescribed cardiovascular drugs, as were those ≤ 49 years (50–59 years, OR 1.42, 95% confidence intervals 1.13–1.79, 60–69 years, OR 1.60, 95% confidence intervals, 1.22–2.10, ≥ 70 years, OR 1.64, 95% confidence intervals, 1.14 to 2.35). Controlling for population characteristics, the following groups were most likely to be referred to lifestyle services: younger women (OR 2.22, 95% CI 1.69 to 2.94), those in the most deprived IMD quintile (OR 3.22, 95% CI 1.63 to 6.36) and those at highest risk of CVD (OR, 2.77, 95% CI 1.91 to 4.02). Conclusions We found no statistically significant evidence of inequity in attendance for an NHS Health Check by SES. Being older or a woman were associated with better attendance. Targeting men, younger patients and ethnic minority groups may improve equity in uptake for NHS Health Checks. BioMed Central 2018-04-03 Article PeerReviewed application/pdf en cc_by https://eprints.nottingham.ac.uk/51040/1/NHS%20Health%20Checks%202018.pdf Coghill, Nikki, Garside, L, Montgomery, Alan A., Feder, Gene and Horwood, Jeremy (2018) NHS health checks: a cross- sectional observational study on equity of uptake and outcomes. BMC Health Services Research, 18 . 238/1-238/11. ISSN 1472-6963 NHS health checks – Primary care – Inequalities – Public health – Gender – Ethnicity https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3027-8 doi:10.1186/s12913-018-3027-8 doi:10.1186/s12913-018-3027-8 |
| spellingShingle | NHS health checks – Primary care – Inequalities – Public health – Gender – Ethnicity Coghill, Nikki Garside, L Montgomery, Alan A. Feder, Gene Horwood, Jeremy NHS health checks: a cross- sectional observational study on equity of uptake and outcomes |
| title | NHS health checks: a cross- sectional observational study on equity of uptake and outcomes |
| title_full | NHS health checks: a cross- sectional observational study on equity of uptake and outcomes |
| title_fullStr | NHS health checks: a cross- sectional observational study on equity of uptake and outcomes |
| title_full_unstemmed | NHS health checks: a cross- sectional observational study on equity of uptake and outcomes |
| title_short | NHS health checks: a cross- sectional observational study on equity of uptake and outcomes |
| title_sort | nhs health checks: a cross- sectional observational study on equity of uptake and outcomes |
| topic | NHS health checks – Primary care – Inequalities – Public health – Gender – Ethnicity |
| url | https://eprints.nottingham.ac.uk/51040/ https://eprints.nottingham.ac.uk/51040/ https://eprints.nottingham.ac.uk/51040/ |