Assessment of health care, hospital admissions, and mortality by ethnicity: population-based cohort study of health-system performance in Scotland

Katikireddi, Srinivasa Vittal; Cézard, Geneviève; Bhopal, Raj; Williams, Linda; Douglas, Anne; Millard, Andrew; Steiner, Markus; Buchanan, D; Sheikh, Aziz; Gruer, Laurence

doi:10.1016/s2468-2667(18)30068-9

Cited by 41 publications

(65 citation statements)

References 40 publications

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“…As previous research (Bhopal et al 2012d;Gruer et al 2016;Bhopal et al 2018;Katikireddi et al 2018), we find that White Scottish experience poorer health compared to many minority populations, including White British, White Irish, White Polish and other White groups. Similarly to other previous work (Bhopal et al 2012a;Millard et al 2012;Bhopal et al 2015;Cezard et al 2016;Katikireddi et al 2018), we also find that the Pakistani population also has high rates of poor ill health, especially for ages 45 and above. Overall, while we have used self-rated health measures, our results are similar to the cited studies that have used objective measures of health, such as hospitalizations and mortality.…”

Section: Discussionsupporting

confidence: 82%

“…The research on health and ethnicity in Scotland has broadly come to either of two main conclusions: (1) the majority White Scottish population suffers poorer health than most other ethnicities, or (2) the South Asian population has a higher risk of ill health and mortality from specific diseases. Recent work has found that White Scottish men and women experience higher rates of cancer (Bhopal et al 2012d), higher mortality (Bhopal et al 2018), including preventable and amenable mortality (Katikireddi et al 2018), lower life expectancy (Gruer et al 2016), and worse selfrated health (The Scottish Government 2015) compared to most other larger ethnic groups. For example, both men and women of Asian and other White origin (except White Irish) can expect to live 2-6 years longer than White Scottish (Gruer et al 2016).…”

Section: Health and Ethnicity In Scotland And Elsewherementioning

confidence: 99%

“…For example, Pakistani have high rates of heart failure (Bhopal et al 2012a) and coronary heart disease (Millard et al 2012). The risk of avoidable hospital admissions is higher for Pakistani, Indian and Bangladeshi men compared to White Scottish men (Katikireddi et al 2018). The relative risks for first all-respiratory disease hospitalization or death are higher for Indian, Pakistani and other South Asian men and Pakistani and other South Asian women compared to White Scottish (Bhopal et al 2015).…”

Section: Health and Ethnicity In Scotland And Elsewherementioning

confidence: 99%

“…Scotland and the UK are no exception to these trends and considerable strides have been made in understanding health outcomes for minority groups. The Scottish Health and Ethnicity Linkage Study (SHELS) linked the 2001 census to health data (Bhopal et al 2011) and has since looked at a number of health outcomes, including mortality (Katikireddi et al 2018), cancer (Bhopal et al 2012d), stroke (Bhopal et al 2012b), respiratory diseases (Bhopal et al 2015), chest pain and angina (Bhopal et al 2012c). In addition, the Information Services Division (ISD), the analytical arm of the NHS National Services Scotland, and the Scottish Government have published analysis of health outcomes and use of health services by ethnicity (The Scottish Government 2015; ISD Scotland 2017b).…”

Section: Introductionmentioning

confidence: 99%

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Differences in ill health and in socioeconomic inequalities in health by ethnic groups: a cross-sectional study using 2011 Scottish census

et al. 2019

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Objectives: We compare rates of ill health and socioeconomic inequalities in health by ethnic groups in Scotland by age. We focus on ethnic differences in socioeconomic inequalities in health. There is little evidence of how socioeconomic inequalities in health vary by ethnicity, especially in Scotland, where health inequalities are high compared to other European countries. Design: A cross-sectional study using the 2011 Scottish Census (population 5.3 million) was conducted. Directly standardized rates were calculated for two self-rated health outcomes (poor general health and limiting long-term illness) separately by ethnicity, age and small-area deprivation. Slope and relative indices of inequality were calculated to measure socioeconomic inequalities in health. Results: The results show that the White Scottish population tend to have worse health and higher socioeconomic inequalities in health than many other ethnic groups, while White Polish and Chinese people tend to have better health and low socioeconomic inequalities in health. These results are more salient for ages 30-44. The Pakistani population has high rates of poor health similar to the White Scottish for ages 15-44, but at ages 45 and above Pakistani people have the highest rates of poor self-rated health. Compared to other ethnicities, Pakistani people are also more likely to experience poor health in the least deprived areas, particularly at ages 45 and above. Conclusions: There are statistically significant and substantial differences in poor self-rated health and in socioeconomic inequalities in health between ethnicities. Rates of ill health vary between ethnic groups at any age. The better health of the younger minority population should not be taken as evidence of better health outcomes in later life. Since socioeconomic gradients in health vary by ethnicity, policy interventions for health improvement in Scotland that focus only on deprived areas may inadvertently exclude minority populations.

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Section: Discussionsupporting

confidence: 82%

Section: Health and Ethnicity In Scotland And Elsewherementioning

confidence: 99%

Section: Health and Ethnicity In Scotland And Elsewherementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differences in ill health and in socioeconomic inequalities in health by ethnic groups: a cross-sectional study using 2011 Scottish census

et al. 2019

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“…a patient factor such as frailty) led to patients in that group experiencing negative implications for their patient safety thereby leading authors to conclude that the characteristic itself was a contributing/associated factor to the patient safety issue of interest. Four studies reported no discernible/neutral effect [36,59,84,92], two indicated a positive effect on patient safety [55,88] and one mixed effects as two outcomes were measured and had different directions [93]. This study defined culturally unsafe practice as any actions that diminish, demean, or disempower the cultural identity and well-being of an individual and applied this concept to health care.…”

Section: Description Of Contributory/associated Factorsmentioning

confidence: 99%

Patient safety in marginalised groups: a narrative scoping review

Cheraghi-Sohi

Panagioti

Daker‐White

et al. 2020

Int J Equity Health

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Background: Marginalised groups ('populations outside of mainstream society') experience severe health inequities, as well as increased risk of experiencing patient safety incidents. To date however no review exists to identify, map and analyse the literature in this area in order to understand 1) which marginalised groups have been studied in terms of patient safety research, 2) what the particular patient safety issues are for such groups and 3) what contributes to or is associated with these safety issues arising.Methods: Scoping review. Systematic searches were performed across six electronic databases in September 2019. The time frame for searches of the respective databases was from the year 2000 until present day.Results: The searches yielded 3346 articles, and 67 articles were included. Patient safety issues were identified for fourteen different marginalised patient groups across all studies, with 69% (n = 46) of the studies focused on four patient groups: ethnic minority groups, frail elderly populations, care home residents and low socio-economic status. Twelve separate patient safety issues were classified. Just over half of the studies focused on three issues represented in the patient safety literature, and in order of frequency were: medication safety, adverse outcomes and near misses. In total, 157 individual contributing or associated factors were identified and mapped to one of seven different factor types from the Framework of Contributory Factors Influencing Clinical Practice within the London Protocol. Patient safety issues were mostly multifactorial in origin including patient factors, health provider factors and health care system factors.Conclusions: This review highlights that marginalised patient groups are vulnerable to experiencing a variety patient safety issues and points to a number of gaps. The findings indicate the need for further research to understand the intersectional nature of marginalisation and the multi-dimensional nature of patient safety issues, for groups that have been under-researched, including those with mental health problems, communication and cognitive impairments. Such understanding provides a basis for working collaboratively to co-design training, services and/or interventions designed to remove or at the very least minimise these increased risks.Trial registration: Not applicable for a scoping review.

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