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Public Policy|Southampton

Rethinking Care: A Population Health Approach to Managing Multimorbidity

Lucy Kaluvu BDS, MSc; NIHR Applied Research Collaboration North West Coast (ARC NWC) Doctoral Fellow/ PhD candidate Edge Hill University Visiting researcher, Department of Primary Care and Population Health Sciences, University of Southampton 

The burden of multimorbidity, comprising both physical and mental health conditions, is escalating swiftly among people with lower income levels in England. The frequency of physical mental health comorbidity is elevated due to the contributing burden of mental health conditions like anxiety, depression, and enduring mental illnesses such as dementia. Habits such as tobacco smoking and alcohol consumption have also added to the multimorbidity burden. By the year 2035, individuals presenting with complex multimorbidity are projected to double in number from 4% in the year 2015. More than 30% of the individuals will present with a mental health condition within multimorbidity.

In England, health outcomes for long-term conditions have been found to differ between the North and South regions. The North regions (North East, North West, Yorkshire and the Humber) have shown higher mortality rates, lower life expectancy, more deprivation and a history of suffering from long-term economic and social decline compared to the South regions (East, South West, London and South East). Subsequently, these long-standing regional inequalities have been further reflected in the rising disease burden, poorer health outcomes, and overall declining health status of individuals residing in the North regions when compared to those in the South regions. Currently, more than two-thirds of people aged 65 and older have multimorbidity. The interplay of socioeconomic factors, limited access to health and social care resources, and the burden of managing multiple physical and mental health conditions highlight a nuanced policy approach to addressing these challenges within multimorbidity care. Current mental health initiatives such as the Children and Young People’s Mental Health initiative have played a pivotal role in enhancing awareness and providing support. This initiative offers NHS-funded mental health services, as well as mental health support embedded within schools or colleges which have significantly contributed to raising awareness of a spectrum of mental health conditions, spanning from psychosis to anxiety. Local and national policies can serve as a conduit for advocating a holistic approach to patient-centred care. This approach could ensure access to mental health programs within the long-term care planning for younger individuals with multimorbidity.

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