RT Journal Article
SR Electronic
T1 Is it possible to identify populations experiencing material disadvantage in primary care? A feasibility study using the Clinical Practice Research Database
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP jech-2024-222396
DO 10.1136/jech-2024-222396
A1 Davies, Laurie E
A1 Sinclair, David R
A1 Kingston, Andrew
A1 Spiers, Gemma Frances
A1 Hanratty, Barbara
YR 2024
UL http://jech.bmj.com/content/early/2024/09/09/jech-2024-222396.abstract
AB Background Material disadvantage is associated with poor health, but commonly available area-based metrics provide a poor proxy for it. We investigate if a measure of material disadvantage could be constructed from UK primary care electronic health records.Methods Using data from Clinical Practice Research Datalink Aurum (May 2022) linked to the 2019 English Index of Multiple Deprivation (IMD), we sought to (1) identify codes that signified material disadvantage, (2) aggregate these codes into a binary measure of material disadvantage and (3) compare the proportion of people with this binary measure against IMD quintiles for validation purposes.Results We identified 491 codes related to benefits, employment, housing, income, environment, neglect, support services and transport. Participants with one or more of these codes were defined as being materially disadvantaged. Among 30,897,729 research-acceptable patients aged ≥18 with complete data, only 6.1% (n=1,894,225) were classified as disadvantaged using our binary measure, whereas 42.2% (n=13,038,085) belonged to the two most deprived IMD quintiles.Conclusion Data in a major primary care research database do not currently contain a useful measure of individual-level material disadvantage. This represents an omission of one of the most important health determinants. Consideration should be given to creating codes for use by primary care practitioners.