An urgent need for primary care to engage with social and structural determinants of health

Mariam Molokhia and Seeromanie Harding

Open AccessPublished:January 28, 2021DOI:  https://doi.org/10.1016/S2468-2667(21)00004-9

In The Lancet Public Health, Ruth Watkinson and colleagues  report on ethnic inequalities in health among older adults (ie, those aged >55 years) by use of the large, nationally representative, English cross-sectional General Practice Patient Survey (GPPS). They estimated the association between ethnicity and health-related quality of life (HRQoL) in 18 ethnic groups (including Gypsy or Irish Travellers), adjusting for age and stratifying by sex. The study showed marked ethnic and sex inequalities in health-related quality of life (HRQoL) and its domains, and in key proximal determinants of health, namely the presence of long-term conditions or multimorbidity, experience of primary care, degree of local service support provision, and patient self-confidence in management of own health. Adjustments for area-level social deprivation did not generally alter the observed ethnic and sex inequalities in HRQoL.