Background: Little is known about how people with dementia and/or their family carers access health and social care services after a diagnosis. The aim of this study was to explore potential inequalities in care pathways for people with young-onset and late on-set dementia (YOD/LOD), including their family carers, with coronavirus disease 2019 (COVID-19) occurring throughout the course of the study and enabling a comparison between pre-pandemic and COVID-19 times. Methods: People with YOD and LOD with their family carers were recruited via local support groups in the North West Coast region of England. Semi-structured interviews explored the experiences of people with YOD and LOD and family carers on their access to both health and social care services and community-based services. Transcripts were coded by two researchers and analysed using thematic analysis. Fifteen interviews were conducted with seven people with YOD or LOD and 14 family carers between January and March 2020. Some interviews were conducted only with the person with dementia, because they did not have a family carer, and others were conducted only with the family carer, because the person with dementia was in the severe stages of the condition. Results: Four themes emerged from the interviews: (1) Getting the ball rolling: the process of diagnosis; (2) Balancing the support needs of people with dementia and carers; (3) Barriers to accessing support; and (4) Facilitators to accessing support. Inequities existed for both YOD and LOD, with emerging evidence of unequal experiences in accessing care at the beginning of the COVID-19 pandemic. Discussion: People with YOD and LOD and their carers require better support in accessing services after a diagnosis. Greater understanding of the pathways through which inequalities materialise are needed, especially those that might have been disrupted or exacerbated by the COVID-19 pandemic.

There exists a large body of research focused on migration distance, where migration is either the outcome of interest or used as an input variable to model something else. However, there is little consistency in the distance thresholds used: these are often arbitrary, based on administrative boundaries or constrained by definitions available in the dataset. This causes problems with comparison across studies, and in some cases where migration distance is poorly defined could lead to issues with interpretation of results. Using Binary Logistic Regression and drawing on data from the 2011 Census Sample of Anonymised Records for England and Wales, we demonstrate that the odds of migrating vary when considering a range of population characteristics across 16 distance thresholds. We argue that the choice of distance cut‐offs needs to be population and context specific and that decisions about these cut‐offs should be made carefully as part of the study design.

COVID-19 is unique in that it is the first global pandemic occurring amidst a crowded information environment that has facilitated the proliferation of misinformation on social media. Dangerous misleading narratives have the potential to disrupt ‘official’ information sharing at major government announcements. Using an interrupted time-series design, we test the impact of the announcement of the first UK lockdown (8–8.30 p.m. 23 March 2020) on short-term trends of misinformation on Twitter. We utilise a novel dataset of all COVID-19-related social media posts on Twitter from the UK 48 hours before and 48 hours after the announcement (n = 2,531,888). We find that while the number of tweets increased immediately post announcement, there was no evidence of an increase in misinformation-related tweets. We found an increase in COVID-19-related bot activity post-announcement. Topic modelling of misinformation tweets revealed four distinct clusters: ‘government and policy’, ‘symptoms’, ‘pushing back against misinformation’ and ‘cures and treatments’.

Ethnic minorities experience multiple inequalities across different domains including health and tenure. Notwithstanding extensive research demonstrating a clear connection between tenure and health, the relationship between health, tenure and ethnicity is under-explored. In this paper, we examine ethnic inequalities in health and tenure in England using cross-sectional census microdata for 1991, 2001 and 2011. We find that ethnic inequalities in health persist over time while the relationship between health and tenure varies between ethnic groups. These results suggest that traditional explanations linking health and tenure are not sufficient to adequately capture the myriad experiences of different ethnic groups.

The 'healthy immigrant effect' and 'migrant mortality advantage' describe the better health and lower mortality of international immigrants as compared with the native‐born populations of high‐income countries. However, a growing body of evidence suggests that it is much more common to observe low mortality among immigrants than it is good health, pointing to the existence of a potential paradox that mirrors the well‐known gender paradox in health and mortality. To investigate this, we used the Office for National Statistics Longitudinal Study, a large‐scale representative 1% sample of the England and Wales resident population comprising linked individual‐level health, mortality, and socio‐demographic data. We compared health and mortality within and across major immigrant groups over 20 years using logistic regression for health and discrete‐time survival analysis for mortality, both before and after adjusting for socio‐demographic factors. Of the eight origin subgroups studied, we found persistent evidence of a health‐mortality paradox within three: men and women from India, Pakistan and Bangladesh, and the Caribbean. We discuss potential explanations and implications of this paradox and suggest that decision makers need to react to help these subgroups preserve their health in order to delay the onset of limiting illnesses and emergence of this paradox.

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.