Act now

Serious spinal pathology can have devastating and life-changing or life-limiting consequences and must be diagnosed early to optimise treatment outcomes. 

However, the incidence of serious pathology and the ability to diagnose early can be adversely affected by health inequalities. 

Health inequalities can be experienced by people grouped around a range of factors including socio-economic factors, the environment in which people live, protected characteristics such as ethnicity, and socially excluded groups such as those who are homeless. 

Physiotherapists can make an important difference for the health of all people by embracing substantial roles in influencing public health challenges of the 21st century.

These factors can affect people’s exposure to health risks and their opportunities to lead healthy lives. 

A person’s behaviour is a key determinant of their health status. ‘Risky’ health behaviours include smoking, poor diet, harmful alcohol consumption and lack of exercise, and are more common in these groups. 

Importantly, socio-economic factors combined with health behaviours influence the health inequalities a person may experience. 

The most significant social and economic factors influencing poor musculoskeletal (MSK) health are poverty, education, employment, environment, and food ethos. These determinants of health not only predispose people living in deprivation to having benign MSK conditions at a younger age and with worse outcomes; they are also risk factors of more serious MSK pathologies such as spinal infection, malignancy, or fracture. 

Hence, although health inequalities are described as avoidable and unfair, they directly impact the incidence of serious pathology which can present in a musculoskeletal setting.

Thus, it is imperative for clinicians to gain an understanding of health inequalities in their local population and give due consideration to how health inequalities could be contributing to a patient risk of serious pathology. 

Furthermore, physiotherapists can make an important difference for the health of all people by embracing substantial roles in influencing public health challenges of the 21st century and consider new ways of working which could lessen the health inequalities gap. 

Act now – serious pathology of the spine is affected by health inequalities.