Reducing social inequality in palliative and end of life care

South LondonGeneric Health Relevance
Start Date: 1 Oct 2016 End Date: 30 Sep 2019

The challenges posed by the UK’s rapidly ageing population are well known. After decades of falling death rates, the number of people dying each year is expected to rise 17% between 2012 and 2030.

For policy makers and health professionals, there is an urgent need to plan around these demographic changes. However, currently, there is very little evidence about the needs of socially disadvantaged older people, an important subgroup of the UK’s ageing population.

A PhD training fellow at CLAHRC South London, Joanna Davies, is leading a project which aims to address this gap in the evidence - advancing our understanding of the relationship between old age, social disadvantage and health outcomes at the end of life.

‘The aim’, says Joanna, ‘is to inform effective health policies targeted at reducing social inequality in palliative and end of life care, for which there is both a moral and financial imperative.’

Joanna will conduct a systematic literature review of current evidence that will analyse the relative importance of different socio-economic factors on outcomes for older people at the end of life, including their income, education, where they live, housing, living situation and family life.

She will then combine this with analysis of UK population cohort data, including the English Longitudinal Study of Ageing (ELSA), to create new knowledge about the social determinants of place of death for older people.

Finally, Joanna, will be using new routine clinical data being collected from specialist palliative care teams as part of the CLAHRC’s OACC and C-CHANGE projects, to carry out the first analysis of social patterning in relation to patient-centred outcome measures for older adults at the end of life. This work will seek to understand how the clinical complexity of patients is associated with age and level of deprivation.

The project, entitled ‘Understanding the social determinants of outcomes important to older people at the end of life: reducing social inequality in palliative care’, was adopted by the CLAHRC in May 2017 and is expected to finish in September 2019. It is funded by the Dunhill Medical Trust.

Ms Joanna Davies