Which population groups are at risk and why?
This section will focus on core epidemiological issues that take account of fixed risk factors (such as age, gender, ethnicity, family history) and modifiable risk factors (such as behaviour). The wider determinants of health (such as housing, transport and environment) are also considered.
Age
Older adults, aged 65 and over, have higher rates of emergency admissions due to factors such as new technologies, rising expectations and changes in care pathways as well as demographics3. Particularly, the 75 and over age group account for the highest rates of emergency conditions, where elderly age and female gender are significant predictors of hospital admission risk4.
Gender
Women have slightly higher rates of emergency hospital admissions than men, particularly in older age groups4, likely due to longer life expectancy and higher prevalence of chronic conditions.
Men are more likely to be admitted for certain acute and high-risk conditions. Particularly those under age 50 due to risk-taking behaviours and lower engagement with preventative healthcare4.
Socioeconomic status
People in more deprived socioeconomic groups are significantly more at risk of emergency hospital admissions. A ONS 2023 report states individuals in the most deprived 10% of areas in England were 1.7 times more likely to attend A&E departments than those in the least deprived 10%5, 6.
Qualifications
Public health evidence strongly links lower educational attainment with higher risk of emergency admissions largely due to the influence of education on health literacy, access to care and long-term health behaviours7.
Mental health
Individuals experiencing mental health issues and conditions are at higher risk for emergency hospital admissions. Individuals experiencing mental health crises are frequently admitted to hospital as an emergency8.
Ethnicity
Ethnic minority groups are at increased risk of emergency hospital admissions. Black and Asian ethnic groups had higher admission rates relative to their population size4, due to structural barriers9, higher prevalence of chronic conditions, delayed diagnosis and treatment and socioeconomic disadvantage.
Prisoners
Prisoners are at increased risk as they often experience poorer physical and mental health than the general population, conditions which if left unmanaged or exacerbated by prison environment can lead to acute health episodes requiring emergency care10.
Sexual Orientation
LGBTQ+ people experience disproportionately worse health outcomes and poorer experiences of healthcare compared to the general population11. This is linked to higher rates of mental health conditions, increased substance misuse and barriers to accessing healthcare.
Vulnerable Children
Vulnerable children are at increased risk of emergency hospital admissions due to poorer physical and mental health12. Those in care, those with disabilities, or those exposed to domestic violence require enhanced monitoring and support further increasing emergency hospital admissions risk12.