Socioeconomic Disparities in Leg Amputation Rates Due to Arterial Disease

A recent study conducted by researchers at the University of Sheffield reveals alarming disparities in leg amputation rates due to peripheral arterial disease (PAD) across socioeconomic strata in England. The findings indicate that individuals residing in the most disadvantaged areas are four times more likely to undergo major leg amputations compared to those in affluent regions. Furthermore, the study highlights a concerning trend: patients from these disadvantaged backgrounds exhibit higher mortality rates following amputation procedures.

The research, published in the journal BJS Open on June 12, 2025, analyzed hospital admissions and census data spanning a 12-year period from 2006 to 2018. In total, the study reported 47,249 major lower limb amputations attributed to PAD, a condition characterized by the buildup of fatty deposits in the arteries, which restricts blood flow to the legs. According to the study, above-knee amputations were approximately four times more prevalent in the most socioeconomically disadvantaged areas, while below-knee amputations were three times more common.

Professor Ravi Maheswaran, Emeritus Professor of Epidemiology and Public Health at the University of Sheffield, emphasized the gravity of the situation, stating, "Being told you need to have a leg amputated can be a devastating and frightening experience for patients. Greater efforts are needed in socioeconomically disadvantaged areas in order to prevent and manage peripheral arterial disease, reduce amputation rates, and improve survival following amputation."

The study also pointed out that, while amputation rates have decreased among individuals aged 65 and older from 2006 to 2018, little progress has been made for those under 65, suggesting persistent health inequalities linked to socioeconomic status. These findings align with previous research indicating that socioeconomic disadvantages contribute significantly to adverse health outcomes.

The implications of these disparities extend beyond individual health, affecting broader societal structures. Patients from lower socioeconomic backgrounds often face barriers to accessing adequate healthcare services, leading to delayed diagnoses and treatment for conditions like PAD. Furthermore, a lack of resources for preventive care exacerbates the risk of complications, including infections and gangrene, which can necessitate amputation.

This study's findings resonate with the World Health Organization's ongoing efforts to address health inequities globally. According to a 2023 report by the WHO, social determinants of health—including income, education, and neighborhood conditions—play a crucial role in shaping health outcomes. The WHO has called for targeted interventions to reduce these disparities, advocating for increased funding and policy changes to improve healthcare access in disadvantaged areas.

In response to the study, healthcare professionals and policymakers are urged to take immediate action to address the underlying social determinants contributing to these alarming disparities. This may include enhancing community health initiatives, improving access to screening and treatment for PAD, and implementing educational programs aimed at promoting healthier lifestyle choices in at-risk populations.

As the UK continues to grapple with health inequalities, it remains imperative for stakeholders to prioritize the health needs of socioeconomically disadvantaged groups. Addressing these disparities will not only improve individual health outcomes but also foster a more equitable healthcare system overall. The call to action is clear: comprehensive strategies must be developed and implemented to mitigate the risk of PAD and its devastating consequences in the most vulnerable populations.