Most people prefer to avoid being admitted to hospital at the end of their life, yet hospitalisation and death in hospital is common. There is consistent evidence of a social gradient in place of death: people who live in more deprived areas are more likely to die in hospital. The reasons underlying this social inequality are not well understood.
In this project, ARC palliative and end of life care researchers will investigate housing quality, social support and health, as potential mediators of the relationship between socioeconomic position and death in hospital. They will also evaluate the relationship to age and ethnicity.
Dr Joanna Davies, postdoctoral researcher at King’s College London, who is leading the research, says: “We want to understand more about how social factors like the quality of housing and informal caregiver support influence end of life care for different groups. Generating evidence on the causes of inequality in end of life care can help us to identify ways to address and reduce inequality.”
This project is an observational study using secondary analysis of data from the Office for National Statistics Longitudinal Study (ONS LS) for England and Wales. The ONS Longitudinal Study has rarely been used to study end of life, yet it contains rich social data collected in the national Census linked to vital events data, including death registration for a 1% nationally representative sample of the population in England and Wales.
Participants are deceased ONS Longitudinal Study cohort members aged 18 and above who completed the Census in England or Wales in 2011 and died within 12 months (approximately 5,000 cohort members).
This study has been designed in consultation with a patient and public involvement (PPI) member. A workshop with 10 to 12 PPI members will be held to discuss the findings and identify priorities for future work. We will recruit PPI members from diverse communities to ensure representation from marginalised groups, including people from ethnic minorities, people with disabilities and people on a low income.
This project is funded by Marie Curie (MC-21-816) and is expected to compete in October 2023.
