Kieron Boyle, Chief Executive, Guy's and St Thomas' Charity
Jul 09, 2018
At some point in our lives most of us will develop a long-term health condition. Many of us will develop more than one. But how we each get to that point varies hugely – both in when we develop our first condition, and how quickly we progress from one to many.
This variation does not look to be random. Rather, it seems to track issues of deprivation, culture, lifestyle and place.
As a foundation we focus on big health challenges that affect inner-city areas. Multiple long-term conditions are key amongst these. As a result, we’re in the early stages of a ten-year programme to address the issue with our local communities.
This research, the first of its kind, looks in detail at the progression to complexity for people with long-term health conditions. It combines analysis of local health data alongside people’s experiences of the issue. We hope it contributes a helpful perspective to an important national debate, as well as act as an invitation to partners looking to tackle the same challenges.
The research’s findings suggest three key insights, and many more questions, all of which require further exploration.
The first insight is that this is not just a problem of old age. For example, in our boroughs over a third of people with multiple long-term conditions are middle aged or younger. The average age of diagnosis for some mental health conditions is when people are in their thirties.
The findings from our research suggest three key insights, and many more questions, all of which require further exploration.
The second is that a single disease focus may miss the combined impact on the person. On the one hand it can mask prevalence. For example, while just over 5% of our local population have diabetes, over 60% of people with multiple long-term conditions do. On the other, it can underplay the cumulative impact of multiple conditions on people’s quality of life, their family, relationships, finances and ability to work.
The third is that background and social context play an important role. For example, although black communities make up 18% of our local adult population they account for 27% of people with multiple long-term conditions.
Our belief is that it’s in all this variation that opportunity exists. If we can better understand what sits behind it, then we can each do more to address it.
Those living in the most deprived areas are developing conditions on average 10 years earlier than those living in the least.
Our belief is that it’s in all this variation that opportunity exists. If we can better understand what sits behind it, then we can each do more to address it. And it’s urgent that we do. The burden of multiple long-term conditions carries great cost, both for individuals and for the state. It also requires quite profound shifts for how we both think about and coordinate services around health.
In short, if our goal is to delay the progression from one condition to many, there’s no time to lose.
06 August, 2019
Erica Levine from the Arnold Institute for Global Health writes about our learning partnership, comparing efforts in improving health in New York and London.
14 May, 2019
Our Director of Funding, Jon Siddall, shares lessons we've learned from taking a place-based approach to improving urban health.
26 February, 2019
Ahead of the Nuffield Trust Health Policy Summit, our Chief Executive, Kieron Boyle, discusses the five things we've learned about multiple long-term conditions.