Who uses NHS health checks? Investigating the impact of ethnicity and gender and method of invitation on uptake of NHS health checks.

Erica J Cook,Raj Gangotra,Gurch Randhawa,Jonathon Cox,Andy Guppy,Chloe Sharp

doi:10.1186/s12939-016-0303-2

Abstract

BackgroundNHS Health Checks is a national risk assessment prevention programme for all individuals aged 40-74 that reside in England. Through the systematic assessment of an individual’s ten year disease risk, this programme aims to provide early identification and subsequent management of this risk. However, there is limited evidence on how socio-demographic factors impact on uptake and what influence the invitation method has on uptake to this programme.MethodsNHS Health Check data from April 2013 to March 2014 was analysed (N = 50,485) for all 30 GP Practices in Luton, a culturally diverse town in England, UK. Data was collected for age, ethnicity, uptake (attendance and non attendance) and invitation method (letter written, verbal face-to-face, telephone). Actual usage of NHS Health Checks was determined for each ethnic group of the population and compared using Chi-square analysis.ResultsThe overall uptake rate for Luton was 44 %, markedly lower that the set target of 50–75 %. The findings revealed a variation of uptake in relation to age, gender, level of deprivation. Ethnicity and gender variations were also found, with ‘White British’ ‘Black Caribbean’ and ‘Indian’ patients most likely to take up a NHS Health Check.However, patients from ‘Any Other White Background’ and ‘Black African’ were significantly less likely to uptake an NHS Health Check compared to all other ethnic groups. Ethnicity and gender differences were also noted in relation to invitation method.ConclusionsThe findings revealed that different invitation methods were effective for different ethnic and gender groups. Therefore, it is suggested that established protocols of invitation are specifically designed for maximizing the response rate for each population group. Future research should now focus on uncovering the barriers to uptake in particular culturally diverse population groups to determine how public health teams can better engage with these communities.

Highlights

NHS Health Checks is a national risk assessment prevention programme for all individuals aged 40-74 that reside in England
The findings suggested that the significantly lowest uptake of the NHS Health Check was found from patients who resided from the most deprived wards for both males and females with an uptake rate of 0.31 and 0.38 respectively (p < .001)
NHS Health Checks is a national prevention programme, which aims to assess the risk of all 40–74 year olds in England of heart disease, stroke, diabetes, kidney disease and certain types of dementia

Summary

Introduction

NHS Health Checks is a national risk assessment prevention programme for all individuals aged 40-74 that reside in England. The NHS Health Check programme was formally launched in April 2009 as a population-wide disease prevention programme in England which aimed to improve life expectancy through the reduction of morbidity and mortality [1] This programme is essentially a risk assessment which uses specific tests and measurements to systematically assess an individual’s ten year risk of developing heart disease, stroke, diabetes and kidney disease alongside raising a patients awareness of dementia [2, 3]. This provides an early identification of risk, which can be used as a basis to inform a discussion with the patient surrounding lifestyle, and medical approaches that would be best suited to managing this risk. This is supported by more recent research which suggested increasing age, female status and living in an area with low levels of deprivation were all predictive of (positive) NHS Health Check uptake [7]

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