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Objectives: Healthcare services for people living with dementia (PLWD) are stretched, and government promises of increased funding remain undelivered. With the UK dementia population to surpass 1 million by 2024, and dementia care costs predicted to almost treble by 2040, it is essential we understand differences in healthcare use among PLWD. This study aimed to explore social and spatial variations in healthcare use among people diagnosed with dementia (2002-2016)., Methods: Data were derived from Electronic Health Records of Clinical Practice Research Datalink GP patients in England ( n  = 142,302). To standardise healthcare contacts, rates of healthcare contacts per year were calculated for three primary (GP observations and medications) and three secondary healthcare types [Accident & Emergency (A&E) attendances and, emergency and elective hospital admissions]. Fully-adjusted generalised linear regression models were used to identify healthcare use variation by social and spatial groups. Twelve models were generated, one for each healthcare type in early- and late-onset populations separately., Results: This study highlights numerous social and spatial variations in healthcare use among PLWD. Among PLWD, several groups tended to have healthcare service use more closely associated with negative outcomes, including a greater likelihood of A&E attendances and emergency and elective hospital admissions. These groups include: men, people from White ethnicity groups and people from more deprived and rural areas., Conclusions: Systemic and social measures are needed to reduce variations in healthcare use inequalities in PWLD. These include greater healthcare continuity, health checks and medicines reviews, culturally appropriate services, better and more accessible treatment and improved infrastructure.

Population ageing is one of the most significant demographic changes underway in many countries. Far from being a homogenous group, older people and their experiences of ageing are diverse. A better understanding of the characteristics and geography of the older population, including the older workforce, is important. It allows policymakers and stakeholders to better adapt to the opportunities and challenges that the ageing population brings. This paper describes the implementation of the Ageing in Place Classification (AiPC) in England. AiPC is a multidimensional geodemographic classification, and it employs a wide range of spatially representative attributes of older people's sociodemographic characteristics and their living environment at the small area level. The openly available product provides valuable insights that can be implemented in both local and national contexts, in particular to improve service delivery and inform targeted policy interventions. AiPC is readily updateable with the arrival of new Census data; the concept and framework are also transferable to other countries., Competing Interests: Conflicts of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2022.)

Improvements in life expectancy at birth in the UK had stalled prior to 2020 and have fallen during the COVID-19 pandemic. The stagnation took place at a time of relatively high net migration, yet we know that migrants to Australia, the USA and some Nordic countries have positively impacted national life expectancy trends, outperforming native-born populations in terms of life expectancy. It is important to ascertain whether migrants have contributed positively to life expectancy in the UK, concealing worsening trends in the UK-born population, or whether relying on national life expectancy calculations alone may have masked excess mortality in migrant populations. We need a better understanding of the role and contribution of migrant populations to national life expectancy trends in the UK., (© The Author(s) 2022. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Policy responses to the Global Financial Crisis emphasized wide-ranging fiscal austerity measures, many of which have been found to negatively impact health outcomes. This paper investigates change in patterns of mortality at local authority level in England (2010-11 to 2017-18) and the relation with fiscal austerity measures., Methods: Data from official local authority administrative records are used to quantify the gap between observed deaths and what was anticipated in the 2010-based subnational population projections. Regression analyses are used to explore the relation between excess deaths, austerity and wider process of population change at local authority level., Results: We estimate 231 707 total excess deaths, the majority of which occurred since 2014-15 (89%) across the majority of local authorities (91%). Austerity is positively associated with excess deaths. For working age adults, there is a clear gradient to the impact of austerity, whereas for older adults, the impact is more uniform., Conclusions: Fiscal austerity policies contributed to an excess of deaths for older people and widened social inequalities for younger populations. These results call for an end to all austerity measures and require further research into areas with the highest total excess deaths as a priority following the COVID-19 pandemic., (© The Author(s) 2021. Published by Oxford University Press.)