Prevention and socioeconomic disadvantage.

BACKGROUND: Counselling in behavioural risk factors links chronic disease prevention and chronic disease care in the day-to-day work of general practice. This is particularly so in diabetes and cardiovascular disease. Each of these conditions is significantly more common in socioeconomically disadvantaged communities, suggesting that preventive activity may be particularly important for these groups; but what does that mean for general practitioners working with individual patients in their practice?
OBJECTIVE: This article sets out some broad approaches to making sure that preventive activity in general practice reaches effectively those living in adverse socioeconomic circumstances. DISCUSSION: Rather than different preventive care, we require extra and targeted effort and a modified approach. We need to ensure that preventive care reaches those most in need and is implemented in a way that is sensitive to patient context. Collecting data on patient socioeconomic status is an important step in applying an 'equity lens' to our preventive care. A practice team approach is required to develop clear goals and address any gaps identified in preventive care. At a one-to-one level we need to allocate extra time to patients as well as reflect on our own attitudes and assumptions about social disadvantage and health.