The Article in Brief

The Inverse Care Law: Clinical Primary Care Encounters in Deprived and Affluent Areas of Scotland

Stewart W. Mercer, MBChB, PhD , and colleagues

Background The inverse care law states that good medical care is least available where it is most needed. This study aims to learn more about the inverse care law by examining primary care doctor visits in the most and least deprived areas of Scotland.

What This Study Found Patients in most deprived areas had more serious psychological problems, more long-term illness, and a greater number of medical conditions than patients in least deprived areas. Although patients in deprived areas had more problems to discuss, their doctor visits were usually shorter than in less deprived areas. General practitioners working in deprived areas were more stressed than those in the least deprived areas.

Implications

• The increased burden of ill health and multiple medical conditions in poor communities results in high demands on primary care doctor visits.
• If the inverse care law is to be reversed, health care policies must address inequalities in public health by focusing on the primary care setting.