New research published in BMJ Open has found that increased local authority spending is associated with reduced hospital admissions for nutritional anaemia, whereas reduced spending from austerity measures caused increased admissions, the impact of which was greater in more deprived areas. Authors recommend reinvesting in local authority services to help prevent admissions associated with nutritional anaemias.
Anaemia is caused by a reduction in red blood cell number or the haemoglobin content of red blood cells. Nutritional anaemias related to poor diet are caused by low nutritional intake of micronutrients such as iron, vitamin B12 and folate. Nutritional anaemias are associated with a range of adverse health outcomes and the deficiencies which cause them are risk factors for many other diseases.
There has been an increase in hospital admissions for nutritional anaemias since 2005, from 173 per 100,000 to 632 per 100,000. Alongside this, in 2010 the UK government introduced austerity policies leading to reductions in local authority funding. This affected a range of services including social care, housing and transport. On average, local authority spending increased by 9% between 2005 and 2009, but then decreased by 20% between 2010 to 2018. These cuts varied between regions with more deprived local authorities experiencing greater cuts.
The relationship between changes in local government spending and risk of nutritional anaemia is unclear. In this study, researchers investigated the relationship between changes to local authority spending and nutritional anaemia hospital admissions.
Researchers analysed national data from 2005-2018. This included NHS hospitals for 312 local authorities. They examined changes in total local authority spending from the SPHR-funded Place Based Longitudinal Resource and how these related to changes in hospital admissions, both where nutritional anaemia was the main reason for admission, and where it was a contributory factor.
On average, a £100 higher local authority service spending was associated with a 1.9% decrease in nutritional anaemia hospital admissions. In the most deprived areas, a £100 higher spending was associated with a 2.6% lower admission rate, suggesting a greater impact of increased spending in more deprived areas.
Researchers examined hospitalisations only, which does not necessarily give a full picture of the burden of disease, for example, many more people may visit the GP than end up being admitted to hospital.
Dr Anthony Laverty, author on the study says: “these findings highlight the range of consequences of changing public spending. Greater spending was linked to fewer people being admitted to hospital with nutritional anaemia, and cutting money with more admissions. They serve as a reminder of the importance of public spending, especially now the UK faces an ongoing cost of living crisis”
This study adds more evidence to support the need for reinvestment in local authority services as a means to improve population health outcomes and reduce health inequalities. Authors emphasise the importance of this, particularly in the context of possible further reductions in local authority budgets in the current cost-of-living crisis.
Read the publication: Local area public sector spending and nutritional anaemia hospital admissions in England: a longitudinal ecological study.