Cross-sectional study of ethnic differences in the utility of area deprivation measures to target socioeconomically deprived individuals

Baker, Jessica; Mitchell, Richard; Pell, Jill P.

doi:10.1016/j.socscimed.2013.02.025

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…29 Conversely, Parslow et al have reported that mortality risk for critically ill South Asian children admitted to PICU increased as deprivation decreased 30. Nevertheless, British non-White ethnic populations are more likely to be living in more socioeconomically deprived areas;31 using our data set, we confirmed that a higher proportion of infants affected by CHDs of Black, Asian and All Other ethnicity were living in the most deprived areas of England and Wales compared with affected white infants.…”

Section: Discussionsupporting

confidence: 73%

Ethnic and socioeconomic variation in incidence of congenital heart defects

Knowles¹,

Ridout

Crowe

et al. 2016

Arch Dis Child

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IntroductionEthnic differences in the birth prevalence of congenital heart defects (CHDs) have been reported; however, studies of the contemporary UK population are lacking. We investigated ethnic variations in incidence of serious CHDs requiring cardiac intervention before 1 year of age.MethodsAll infants who had a cardiac intervention in England and Wales between 1 January 2005 and 31 December 2010 were identified in the national congenital heart disease surgical audit and matched with paediatric intensive care admission records to create linked individual child records. Agreement in reporting of ethnic group by each audit was evaluated. For infants born 1 January 2006 to 31 December 2009, we calculated incidence rate ratios (IRRs) for CHDs by ethnicity and investigated age at intervention, antenatal diagnosis and area deprivation.ResultsWe identified 5350 infants (2940 (55.0%) boys). Overall CHD incidence was significantly higher in Asian and Black ethnic groups compared with the White reference population (incidence rate ratios (IRR) (95% CIs): Asian 1.5 (1.4 to 1.7); Black 1.4 (1.3 to 1.6)); incidence of specific CHDs varied by ethnicity. No significant differences in age at intervention or antenatal diagnosis rates were identified but affected children from non-White ethnic groups were more likely to be living in deprived areas than White children.ConclusionsSignificant ethnic variations exist in the incidence of CHDs, including for specific defects with high infant mortality. It is essential that healthcare provision mitigates ethnic disparity, including through timely identification of CHDs at screening, supporting parental choice and effective interventions. Future research should explore the factors underlying ethnic variation and impact on longer-term outcomes.

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Section: Discussionsupporting

confidence: 73%

Ethnic and socioeconomic variation in incidence of congenital heart defects

Knowles¹,

Ridout

Crowe

et al. 2016

Arch Dis Child

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“…Therefore, ethnic groups vary in lifestyle, such as alcohol consumption, smoking and diet, as well as their use of preventive and treatment services; including dental services. Furthermore, the innate characteristics of ethnic groups interact with environmental influences such as: differences in individual- and area-based socioeconomic status [ 19 ]; the impacts of migration, assimilation and discrimination [ 20 ]; and the ethnic mix of the communities in which people reside. Previous studies suggest that, whilst much of the ethnic differences in health and oral health can be explained by socioeconomic factors, cultural and behavioural factors and access to health, including dental, services may also play a role [ 3 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Ethnic differences in oral health and use of dental services: cross-sectional study using the 2009 Adult Dental Health Survey

et al. 2016

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BackgroundOral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services.MethodsWe used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators.ResultsThe study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and <20 teeth (Indian adjusted OR 0.31, 95 % CI 0.16-0.59; Pakistani/Bangladeshi adjusted OR 0.22, 95 % CI 0.08-0.57). They attended the dentist less frequently and were more likely to add sugar to hot drinks, but were significantly less likely to consume sweets and cakes. Adjustment for these attenuated the differences but they remained significant. Black participants had reduced risk of all outcomes but after adjustment for lifestyle the difference in fillings was attenuated, and extractions and tooth loss became non-significant.ConclusionsContrary to most health inequalities, oral health was better among non-White groups, in spite of lower use of dental services. The differences could be partially explained by reported differences in dietary sugar.

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“…Second, area deprivation measures, such as the IMD, are derived from a majority White population. This may mean that they do not perform as well in ethnic minority groups, although we have previously found that area deprivation measures are better at identifying individual deprivation in ethnic minority groups in England 40 41. Last, area may have an impact on health over and above individual circumstances 38.…”

Section: Discussionmentioning

confidence: 91%