Socioeconomic Inequalities in the Consequences of Gastrointestinal Infections
Tanith completed her PhD in 2018, with her thesis ‘Socioeconomic Inequalities in the Consequences of Gastrointestinal Infections’ under the supervision of David Taylor-Robinson, Margaret Whitehead, Ben Barr and Sarah O’Brien at the University of Liverpool, Jeremy Hawker at Public Health England and Mara Violato at the University of Oxford.
In addition to her PhD, Tanith has a BSc (Hons) in Prosthetics and Orthotics, and an MSc in Public Health. She now works as a Research Associate in Health Data Analysis at the University of Liverpool’s Department of Public Health and Policy.
Gastrointestinal (GI) infections are very common and are associated with numerous adverse consequences for the individual, healthcare sector and economy as a whole. Relatively little is known about whether the consequences of having a GI infection are experienced by all members of society equally, or whether certain groups are disproportionately affected. Some evidence suggests those of lower socioeconomic status (SES) are more likely to present to healthcare services with GI infections. This may reflect greater need amongst more disadvantaged groups, either due to increased risk of infection or disease severity. This project aimed to enhance the evidence base by examining socioeconomic inequalities in the risk of infection, and by exploring the extent of inequalities in disease severity, sickness absence and hospitalisation outcomes due to GI infections.
Three studies were conducted. Firstly, a systematic review of literature from high income countries revealed that children of lower SES, but not adults, had a greater risk of infection compared to their more affluent counterparts. Secondly, analysis of a UK-based survey called the IID2 study showed that GI infection cases of all ages, of lower SES, were more likely to experience severe symptoms and be absent from work or school. Thirdly, using English Hospital Episode Statistics data, increasing neighbourhood deprivation was associated with increasing emergency hospital admission rates and admission duration for GI infections, for both adults and children.
Evidence from this project suggests that in the UK important consequences of GI infections, such as sickness absence, disease severity and emergency hospitalisation, disproportionately affect socioeconomically disadvantaged groups. With this in mind, it is recommended that due consideration should be afforded to policies that address inequalities in the consequences of being ill with a GI infection, as well as current UK policies designed to reduce the risk of acquiring an infection.
- Margaret Whitehead – Dept. Public Health & Policy & NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool
- Jeremy Hawker - NIHR Health Protection Research Unit in Gastrointestinal Infections, Public Health England
- David Taylor-Robinson - Dept. Public Health & Policy, University of Liverpool
- Sarah O’Brien – Dept. Public Health & Policy & NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool
- Ben Barr - Dept. Public Health & Policy, University of Liverpool
- Mara Violato - NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Oxford
Adams, N*., Rose, T.C*., Taylor-Robinson, D., Barr, B., Hawker, J., O'Brien S.J., Violato, M. & Whitehead, M. Relationship between socioeconomic status and gastrointestinal infections in developed countries: a systematic review and meta-analysis. PLoS ONE. 2018, 13:1.
Adams, NL., Rose, T.C., Hawker, J., Violato, M., O'Brien S.J., Whitehead, M., Barr, B. & Taylor-Robinson, D. Socioeconomic status and infectious intestinal disease in the community: a longitudinal study (IID2 study). European Journal of Public Health. 2018, 28:1: 134-138.
Rose, T.C., Adams, NL., Barr, B., Hawker, J., O'Brien, S.J., Violato, M., Whitehead, M. & Taylor-Robinson, D. Socioeconomic status is associated with symptom severity and sickness absence in people with infectious intestinal disease in the UK. BMC Infectious Diseases. 2017, 17: 447.
Rose T.C, Adams NL, Taylor-Robinson DC, Barr B, Hawker J, O’Brien S.J, Violato M, Whitehead M. Relationship between socioeconomic status and measures of infectious intestinal disease severity. European Journal of Public Health. 2016, 26(suppl 1): ckw166.060.
Adams, N*., Rose, T.C*., Taylor-Robinson, D., Barr, B., Hawker, J., O'Brien S.J., Violato, M. & Whitehead, M. Relationship between socioeconomic status and gastrointestinal infections in developed countries: a systematic review. PROSPERO International prospective register of systematic reviews. 2016, 5:13.
Adams, N., Byrne, L., Smith, G.A., Elson, R., Harris, J.P., Salmon, R., Smith, R., O'Brien, S.J., Adak, G.K., Jenkins, C. Shiga Toxin-Producing Escherichia coli O157, England and Wales, 1983-2012. Emerging Infectious Diseases. 2016, 22:4.
* Joint first authors