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Open Access Research article

Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community Health (SELCoH) study

Stephani L Hatch1*, Souci Frissa1, Maria Verdecchia1, Robert Stewart2, Nicola T Fear3, Abraham Reichenberg1, Craig Morgan4, Bwalya Kankulu1, Jennifer Clark1, Billy Gazard1, Robert Medcalf1, the SELCoH study team1 and Matthew Hotopf1

Author Affiliations

1 King's College London, Psychological Medicine, Institute of Psychiatry, 10 Cutcombe Road, London SE5 9RJ, UK

2 King's College London, Section of Epidemiology, Health Service and Population Research Department, Institute of Psychiatry, Box P060 De Crespigny Park London SE5 8AF, UK

3 King's College London, Academic Centre for Defence Mental Health, 10 Cutcombe Road, London SE5 9RJ, UK

4 King's College London, Section of Social Psychiatry, Health Service and Population Research Department, Institute of Psychiatry, Box P063 De Crespigny Park London SE5 8AF, UK

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BMC Public Health 2011, 11:861  doi:10.1186/1471-2458-11-861

Published: 11 November 2011

Abstract

Background

Responses to public health need require information on the distribution of mental and physical ill health by demographic and socioeconomic factors at the local community level.

Methods

The South East London Community Health (SELCoH) study is a community psychiatric and physical morbidity survey. Trained interviewers conducted face-to-face computer assisted interviews with 1698 adults aged 16 years and over, from 1076 randomly selected private households in two south London boroughs. We compared the prevalence of common mental disorders, hazardous alcohol use, long standing illness and general physical health by demographic and socioeconomic indicators. Unadjusted and models adjusted for demographic and socioeconomic indicators are presented for all logistic regression models.

Results

Of those in the sample, 24.2% reported common mental disorder and 44.9% reported having a long standing illness, with 15.7% reporting hazardous alcohol consumption and 19.2% rating their health as fair or poor. The pattern of indicators identifying health inequalities for common mental disorder, poor general health and having a long term illness is similar; individuals who are socioeconomically disadvantaged have poorer health and physical health worsens as age increases for all groups. The prevalence of poor health outcomes by ethnic group suggests that there are important differences between groups, particularly for common mental disorder and poor general health. Higher socioeconomic status was protective for common mental disorder, fair or poor health and long standing illness, but those with higher socioeconomic status reported higher levels of hazardous alcohol use. The proportion of participants who met the criteria for common mental disorder with co-occurring functional limitations was similar or greater to those with poor physical health.

Conclusions

Health service providers and policy makers should prioritise high risk, socially defined groups in combating inequalities in individual and co-occurring poor mental and physical problems. In population terms, poor mental health has a similar or greater burden on functional impairment than long term conditions and perceived health.