Black women most likely to experience multiple, chronic health conditions

Black women can face the worst health inequalities, a study of women living in south London has concluded.

The research by the Faculty of Life Sciences & Medicine at King’s College London (KCL) found that, when compared to other ethnic groups experiencing multi-morbidities, Black women had the highest disadvantage.

The study looked at a cohort of south London patients, and was supported by the non-profit organisation Impact on Urban Health and Dr Hiten Dodhia, consultant in public health at the London Borough of Lambeth and a member of the KCL faculty.

Multi-morbidities are defined as two or more long-term health conditions, such as depression, anxiety, asthma, and chronic pain.

As part of a wider study of multi-morbidity conditions affecting patients in Lambeth and Southwark, researchers examined 826,000 patients’ data for the prevalence of long-term conditions.

They found that almost half of Black Caribbean patients had multi-morbidity conditions compared to a third of Black African patients and 31% of White British patients. The most common conditions experienced were anxiety, chronic pain, depression, asthma and hypertension.

The study found that, when compared to other patient groups, Black women had twice and in some cases three times the rate of long-term conditions, including chronic pain, anxiety, hypertension, osteoarthritis, diabetes and morbid obesity.

“Our findings suggest that the very communities most hard hit by Covid-19 are the same ones that have experienced years of long-term health problems because of long-term conditions (LTCs). Many of these conditions are preventable or can be alleviated and controlled using the expertise of local primary care,” said Dr Mark Ashworth, professor of primary care from the School of Life Course & Population Sciences within the faculty.

The researchers also found that multi-morbidity patients used primary care services three times as often as patients without these conditions.

However, when a patient becomes depressed, the rate of using healthcare services doubled, meaning that when depressed, multimorbidity patients used primary care services six times as often as patients without those conditions.

Dr Marina Soley-Bori, lecturer in health economics from the School of Life Course & Population Sciences, said: “A mental health diagnosis is often a significant driver of primary care use. We found individuals with anxiety and depression accounted for 31% of total primary care consultation costs within the multimorbid population.

“Most notably, we found the trio of anxiety, depression and chronic pain to be the costliest long-term condition combination. ‘High-cost’ individuals tend to have more complex and diverse needs with a higher risk of poorly coordinated care. More individualised, patient-centric, care is required to prevent poorer health outcomes for this group,” Dr Soley-Bori added.