These data can be used to compare socioeconomic inequalities for several conditions, providing insight into a healthcare system with no direct financial barriers to treatment (the National Health
Service in England). We aimed to selleck product assess socioeconomic inequalities in the burden of illness (estimated by validated scales, biomarker and reported symptoms) of angina, cataract, depression, diabetes and osteoarthritis, and compare them with inequalities in self-reported medical diagnosis and treatment, in order to determine whether key components of healthcare were received equitably. Methods We obtained data from the ELSA cohort, an interview survey of a sample of the population aged 50 years or older in England. The sample was selected from households that had previously responded to the Health Survey for England, and drawn from selected postcode sectors stratified by health authority and deprivation to be representative of adults aged 50 or more living in private households in England.15 Participants are interviewed in their homes or care homes every 2 years about a wide range of health, economic and social topics. We used data collected from core participants
who had been interviewed in any of four waves of ELSA from wave 2 in 2004–2005 until wave 5 in 2010–2011. Wave 2 was the first wave to include questions on receipt of quality-indicated healthcare, and information was not collected on every variable in every wave. We studied five common and important long-term conditions: angina, diabetes, depression, osteoarthritis and cataract.
Effective treatment is freely available for all five conditions from the National Health Service. Variables We collected data on illness burden, self-reported medical diagnosis and treatment of angina, cataract, depression, diabetes and osteoarthritis. The illness burden for angina was defined as grade 2 on the Rose Angina scale (pain or discomfort in chest when walking at an ordinary pace on the level on most occasions or more often, which makes participant stop or slow down if occurs while walking, and which then goes away within 10 min, and which includes either sternum (any level), or left arm and left anterior Dacomitinib chest). Illness burden for diabetes was defined as a fasting glycosylated haemoglobin level of >7.5%.16 Illness burden for depression was defined as a score of 3 or more on the eight-item Centre for Epidemiologic Studies Depression Scale (CES-D). The application of these standardised scales in ELSA has been described previously.1 Illness burden for osteoarthritis was defined as self-reported pain in the hip or knee of 5 or more on a scale of 0–10.17 Illness burden for cataract was defined broadly as reporting poor vision or blindness.