Severe mental illness (SMI), which includes schizophrenia, bipolar disorder and major depression, affects roughly one in ten adults every year in the United Kingdom. People with SMI die 10-20 years earlier than people without SMI. This is mainly due to poorer physical health, in particular a higher risk of cardiovascular disease (CVD). The COVID-19 pandemic is thought to have worsened various pre-existing health inequalities, but the extent to which mental health inequalities have been exacerbated remains unclear.
Previous research, including analyses of the CVD-COVID-UK resource have shown that attendance at cardiology services and hospital admission for multiple CVD conditions, including heart disease, heart failure and stroke, decreased during the early period of the pandemic. Although admission rates for some conditions returned to normal during 2021, admission rates for certain conditions, including heart failure and stroke increased. Moreover, analyses of cardioprotective drug prescribing suggest a decrease in cardiovascular medication prescribing in the first year of the pandemic. These findings may reflect delays in accessing health care, with more major CVD events occurring due to interrupted or delayed primary or secondary prevention treatment. This may have disproportionately affected vulnerable sub-groups of the population, including those with mental illness.
This study will use English data from the CVD-COVID-UK resource to determine the impact of the COVID-19 pandemic on associations between mental illness and incidence of myocardial infarction, heart failure and stroke. This understanding will inform strategies to address these mental health inequalities and to mitigate the impact of future disruptions to health care provision.
Citation details to follow
- View the analysis code used in NHS England's SDE for England
- View the phenotyping algorithms and codelists used in NHS England's SDE for England
This is a sub-project of project CCU046 approved by the CVD-COVID-UK / COVID-IMPACT Approvals & Oversight Board (sub-project: CCU046_03).
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