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Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review

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  • Aleesha Karia

    (Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 2LU, UK)

  • Reza Zamani

    (Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 2LU, UK)

  • Mohammad Akrami

    (Department of Engineering, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter EX4 4QF, UK)

Abstract

Socio-economic factors affecting health care can lead to delays in diagnosis of neurological conditions, consequentially affecting treatment and morbidity rates. This inequality in health care can leave patients from lower socio-economic backgrounds more vulnerable to a poorer quality of care from health care providers in the United Kingdom (U.K.). Aims: In this systematic review, we assess the impact of socio-economic status on the use of diagnostic neuroimaging in the U.K., measured by the timeliness, accessibility and appropriate use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, electroencephalography (EEG) and single-photon emission computed tomography (SPECT). We specifically evaluate the non-surgical use of neuroimaging techniques as this relies on the judgment of primary care-givers (e.g., doctors and radiologists), where health disparities are most common. This study includes the analysis of diagnostic imaging used for dementia, minor head injury, stroke, cancer, epilepsy, chronic inflammatory demyelinating polyneuropathy and Parkinson’s disease. With this study, we aim to assess the health inequalities at disease diagnosis. Methods: Using Medline (via Ovid), PubMed and Web of Science databases as sources of information, we critically appraise existing studies on neuroimaging use in the U.K. health care system, published between January 2010 and February 2021. Findings: A total of 18 studies were included in this research, revealing that there was an increase in patients of Black and Asian communities diagnosed with dementia and at an earlier age. There was little evidence to suggest that a lack of access to diagnostic imaging is associated with socio-economic status. However, there are data to suggest that people of a lower socio-economic background require more specialist services with diagnostic neuroimaging tools. In addition, there is evidence to suggest that diagnostic neuroimaging techniques could be utilised more effectively by health care workers to prevent unnecessary delays in diagnosis for patients in lower socio-economic areas.

Suggested Citation

  • Aleesha Karia & Reza Zamani & Mohammad Akrami, 2021. "Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review," IJERPH, MDPI, vol. 18(20), pages 1-27, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:20:p:10633-:d:653423
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    References listed on IDEAS

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    1. Tai Pong Lam & Kai Sing Sun & Hoi Yan Chan & Chak Sing Lau & Kwok Fai Lam & Robert Sanson-Fisher, 2019. "Perceptions of Chinese Towards Dementia in Hong Kong—Diagnosis, Symptoms and Impacts," IJERPH, MDPI, vol. 16(1), pages 1-9, January.
    2. Antonio Ivan Lazzarino & William Palmer & Alex Bottle & Paul Aylin, 2011. "Inequalities in Stroke Patients' Management in English Public Hospitals: A Survey on 200,000 Patients," PLOS ONE, Public Library of Science, vol. 6(3), pages 1-6, March.
    3. Shovanne Brown & Gill Livingston & Naaheed Mukadam, 2021. "A National Memory Clinic Survey to Assess Provision for People from Diverse Ethnic Backgrounds in England and Wales," IJERPH, MDPI, vol. 18(4), pages 1-11, February.
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