Ethnic differences in multimorbidity after accounting for social-economic factors, findings from The Health Survey for England.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 9204966 Publication Model: Print Cited Medium: Internet ISSN: 1464-360X (Electronic) Linking ISSN: 11011262 NLM ISO Abbreviation: Eur J Public Health Subsets: MEDLINE
    • Publication Information:
      Publication: Oxford : Oxford University Press
      Original Publication: Stockholm, Sweden : Almqvist & Wiksell International, c1991-
    • Subject Terms:
      Ethnicity* ; Cardiovascular Diseases*/epidemiology; Adult ; Humans ; Cross-Sectional Studies ; Multimorbidity ; Minority Groups ; England/epidemiology ; Economic Factors ; Health Surveys ; Biomarkers
    • Abstract:
      Background: Social-economic factors and health behaviours may be driving variation in ethnic health inequalities in multimorbidity including among distinct ethnic groups.
      Methods: Using the cross-sectional nationally representative Health Surveys for England 2011-18 (N = 54 438, aged 16+), we performed multivariable logistic regression on the odds of having general multimorbidity (≥2 longstanding conditions) by ethnicity [British White (reference group), White Irish, Other White, Indian, Pakistani, Bangladeshi, Chinese, African, Caribbean, White mixed, Other Mixed], adjusting for age, sex, education, area deprivation, obesity, smoking status and survey year. This was repeated for cardiovascular multimorbidity (N = 37 148, aged 40+: having ≥2 of the following: self-reported diabetes, hypertension, heart attack or stroke) and multiple cardiometabolic risk biomarkers (HbA1c ≥6.5%, raised blood pressure, total cholesterol ≥5mmol/L).
      Results: Twenty percent of adults had general multimorbidity. In fully adjusted models, compared with the White British majority, Other White [odds ratio (OR) = 0.63; 95% confidence interval (CI) 0.53-0.74], Chinese (OR = 0.58, 95% CI 0.36-0.93) and African adults (OR = 0.54, 95% CI 0.42-0.69), had lower odds of general multimorbidity. Among adults aged 40+, Pakistani (OR = 1.27, 95% CI 0.97-1.66; P = 0.080) and Bangladeshi (OR = 1.75, 95% CI 1.16-2.65) had increased odds, and African adults had decreased odds (OR = 0.63, 95% CI 0.47-0.83) of general multimorbidity. Risk of cardiovascular multimorbidity was higher among Indian (OR = 3.31, 95% CI 2.56-4.28), Pakistani (OR = 3.48, 95% CI 2.52-4.80), Bangladeshi (OR = 3.67, 95% CI 1.98-6.78), African (OR = 1.61, 95% CI 1.05-2.47), Caribbean (OR = 2.18, 95% CI 1.59-2.99) and White mixed (OR = 1.98, 95% CI 1.14-3.44) adults. Indian adults were also at risk of having multiple cardiometabolic risk biomarkers.
      Conclusion: Ethnic inequalities in multimorbidity are independent of social-economic factors. Ethnic minority groups are particularly at risk of cardiovascular multimorbidity, which may be exacerbated by poorer management of cardiometabolic risk requiring further investigation.
      (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.)
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    • Grant Information:
      NHS England; NHS
    • Accession Number:
      0 (Biomarkers)
    • Publication Date:
      Date Created: 20230827 Date Completed: 20231216 Latest Revision: 20240104
    • Publication Date:
      20240104
    • Accession Number:
      PMC10710338
    • Accession Number:
      10.1093/eurpub/ckad146
    • Accession Number:
      37634091