Health Equalities Framework: the effect of moving from a care home to other settings on determinants of health inequalities

Abstract

The disparity in health between people with learning disabilities and the rest of the population is well established. Many of the health inequalities experienced by people with learning disabilities can be avoided through the provision of appropriate and timely assessment, diagnosis and treatment. Addressing health inequalities has become a focus for services in Scotland, and the Health Equalities Framework (HEF) is being used as a tool to record the effect of services in addressing these challenges.To explore how moving from a care home setting to other living arrangements affected the determinants of health inequalities for 19 people with learning disabilities. A total of 19 residents with learning disabilities at a care home in Scotland were required to find new accommodation as a result of their care home closing. The residents were moved into different types of accommodation. A HEF assessment was completed for all residents before the closure of the care home and a follow up HEF assessment was completed between 12 and 16 months after their move to new accommodation.Reductions in overall HEF scores were found following the move, along with significant reductions in the social and lifestyle determinants. To the authors’ knowledge, this is the first time that the HEF has been used in people with a learning disability to determine the effect of changing accommodation on exposure to determinants of health inequalities. After moving from a geographically isolated care home setting to other community-based care settings, the participants experienced a statistically significant reduction in the exposure to determinants of health inequalities in the social and lifestyle behaviour determinants of care.