ArticleAnnals of family medicine
The inverse care law: clinical primary care encounters in deprived and affluent areas of Scotland.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 198 papers, 3 of them syntheses that pooled it.
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Who cites it
198 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Do people perceive benefits in the use of social prescribing to address loneliness and/or social isolation? A qualitative meta-synthesis of the literature.BMC health services research · 2022Pooled it
- International variations in primary care physician consultation time: a systematic review of 67 countries.BMJ open · 2017Pooled it
- Multimorbidity in primary care: a systematic review of prospective cohort studies.The British journal of general practice : the journal of the Royal College of General Practitioners · 2012Pooled it
- From a research trial to routine practice: stakeholders' perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales.BMC health services research · 2021Trial
- Patterning in Patient Referral to and Uptake of a National Exercise Referral Scheme (NERS) in Wales From 2008 to 2017: A Data Linkage Study.International journal of environmental research and public health · 2020Trial
- Effectiveness of Community-Links Practitioners in Areas of High Socioeconomic Deprivation.Annals of family medicine · 2019Trial
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- A multidisciplinary primary care team consultation in a socio-economically deprived community: an exploratory randomised controlled trial.BMC health services research · 2011Trial
- Sociodemographic and Clinical Correlates of Missed Opportunities for Evidence-Based Alcohol Counseling Among Adults Who Report Binge Drinking.American journal of preventive medicine · 2026Article
- Online mindfulness-based cognitive therapy as an adjuvant-treatment for Chinese patients with psoriasis: A randomized controlled trial.JAAD international · 2026Article
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- Disparities in emergency department outcomes by race during the 2022-2023 COVID-influenza twindemic.BMC emergency medicine · 2026Observational
- Identifying children at risk in Swedish Child Health Services.Scandinavian journal of public health · 2025Article
- Has the new GP contract in Scotland reduced health inequalities? Qualitative evaluation of the views of general practitioners working in deprived areas.International journal for equity in health · 2025Article
- Addressing the inverse care law in Scottish general practice: systematic scoping review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Laryngeal Cancer in the West of Scotland 2014-2020: Trends and Survival in a Cohort of 867 Patients.The Laryngoscope · 2025Article
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- Inequality in the accumulation of diseases and medications among older adults: a longitudinal cohort study 2016-2021.BMJ public health · 2025Article
138 more citing papers are in PubMed but not listed here.
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe inverse care law states that the availability of good medical care tends to vary inversely with the need for it in the population served, but there is little research on how the inverse care law actually operates.
methodsA questionnaire study was carried out on 3,044 National Health Service (NHS) patients attending 26 general practitioners (GPs); 16 in poor areas (most deprived) and 10 in affluent areas (least deprived) in the west of Scotland. Data were collected on demographic and socioeconomic factors, health variables, and a range of factors relating to quality of care.
resultsCompared with patients in least deprived areas, patients in the most deprived areas had a greater number of psychological problems, more long-term illness, more multimorbidity, and more chronic health problems. Access to care generally took longer, and satisfaction with access was significantly lower in the most deprived areas. Patients in the most deprived areas had more problems to discuss (especially psychosocial), yet clinical encounter length was generally shorter. GP stress was higher and patient enablement was lower in encounters dealing with psychosocial problems in the most deprived areas. Variation in patient enablement between GPs was related to both GP empathy and severity of deprivation.
conclusionsThe increased burden of ill health and multimorbidity in poor communities results in high demands on clinical encounters in primary care. Poorer access, less time, higher GP stress, and lower patient enablement are some of the ways that the inverse care law continues to operate within the NHS and confounds attempts to narrow health inequalities.
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