Social inequalities between patients with chronic illness widens

Social inequalities between patients with chronic illness widens
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The lives of chronic disease patients who have a lower socio-economic status are increasingly more negatively impacted by the illness than those who are better off, according to a Belgian study.

The unequal distribution of the loss of "healthy life years" as a result of chronic illnesses such as diabetes and heart diseases increased, researchers from the Sciensano National Health Institute and Ghent University (UGent) found in a study carried out between 2013 and 2018. This means that, systematically, patients with a "lower social position" more often lose more healthy life years than people with a "higher social position."

"Chronic diseases are more common in people with a lower social position and the diseases also have a greater impact on their quality of life," said Lisa Van Wilder, health scientist at UGent. "Various factors play a role in this, such as a less healthy living and working environment, poorer health literacy and more limited access to health care."

More and more years lost

One study in 2013 showed that people with lower incomes lost a total of 50,000 healthy years of life through chronic diseases per 100,000 people. In the group with the "highest social position," this was just under 20,000 – a difference of 30,000.

"In 2018, the difference between the two groups rose to 40,000 lost healthy life years. More healthy life years were lost due to chronic diseases compared to 2013 in all groups, but much more in the groups with the lowest social position," explained Brecht Devleesschauwer, an epidemiologist at Sciensano.

This shows that social inequalities play a big role in the health status of Belgians, despite the country having a relatively strong healthcare system.

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Researchers concluded that, if everyone had the health status of the well-off group, the loss of healthy life years through chronic diseases would be 40% lower in 2018.

Some conditions have a greater health gap than others. For example, as much as 74% of the impact of strokes could be avoided if social inequalities did not exist, the scientists said. The impact on the quality of life of patients is expected to further increase as the population ages and chronic diseases are less likely to result in mortality.

"The prevention and control of chronic diseases are becoming an increasingly important policy priority, both at the Belgian and European levels. Special attention to the socially vulnerable is crucial in this regard in order not to further increase health inequalities," said Devleesschauwer.

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