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Geospatial mapping and data linkage uncovers variability in outcomes of foot disease according to multiple deprivation: a population cohort study of people with diabetes – published online 17/12/2019

Figure from Hurst paper

Joanne E. Hurst, Ruth Barn, Lesley Gibson, Hamish Innes, Sicco A. Bus, Brian Kennon, David Wylie, James Woodburn

Social deprivation is a reported risk factor for foot ulceration, lower extremity amputation and subsequent mortality in people with diabetes. However, it is unclear if the prevalence of these outcomes is random or forms patterns according to the geographical distribution of social deprivation. In this issue, Hurst et al (https://doi.org/10.1007/s00125-019-05056-9) report the use of routinely collected health data, its linkage, and visualisation of foot outcomes by deprivation status over the large health administrative area of National Health Service (NHS) Greater Glasgow and Clyde. The authors report that foot ulceration, amputation and subsequent mortality are highly prevalent in areas with the worst social deprivation, with distinct geographical near-neighbour clustering of areas with similar characteristics. Conversely, low prevalence is associated with areas of relatively low deprivation, confirming stark inequalities across the health board. They suggest that this technique of geospatial mapping can inform health service redesign by targeting resources at identified hot spot regions, potentially improving outcomes and reducing inequalities.

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