Ethnic variations in five lower gastrointestinal diseases: Scottish Health and Ethnicity Linkage Study

Abstract

ObjectivesOur objective was to augment the limited evidence mainly from local, clinical studies of ethnic differences in gastrointestinal disorders. Our question was: are there ethnic variations in hospitalisation/death for lower gastrointestinal disorders in Scotland?SettingScotland.PopulationThis retrospective-cohort linked 4.65 (of 4.9) million people in the 2001 census of Scotland (providing data on ethnicity, country of birth and indicators of socioeconomic deprivation) to 9 years of National Health Service hospitalisation and death records.Primary and secondary outcome measures and analysisFor appendicitis, we studied all ages; for irritable bowel syndrome, ulcerative colitis, Crohn's disease and diverticular disease, we included those ≥20 years. Using Poisson regression (robust variance) we calculated, by ethnic group and sex, first-hospitalisation/death age-adjusted rates per 100 000 person-years, and relative risks (RRs) with 95% CIs multiplied by 100, so the White Scottish reference population had an RR=100.ResultsThere were ethnic variations; for example, for irritable bowel syndrome, RRs (95% CIs) were comparatively high in Other White British women (128.4 (111.0 to 148.6)), and low in Pakistani women (75.1 (60.6 to 93.1)). For appendicitis, RRs were high in men in Other White British (145.2 (127.8 to 164.9)), and low in most non-White groups, for example, Pakistanis (73.8 (56.9 to 95.6)). For ulcerative colitis, RRs were high in Indian (169.8 (109.7 to 262.7)) and Pakistani (160.8 (104.2 to 248.2)) men. For Crohn's disease, the RR was high in Pakistani men (209.2 (149.6 to 292.6)). For diverticular disease, RRs were high in Irish men (176.0 (156.9 to 197.5)), and any Mixed background women (144.6 (107.4 to 194.8)), and low in most non-White groups, for example, Chinese men (47.1 (31.0 to 71.6) and women (46.0 (30.4 to 69.8)).ConclusionsAppendicitis and diverticular disease were comparatively low in most non-White groups, while ulcerative colitis and Crohn's disease were mostly higher in South Asians. Describing and understanding such patterns may help clinical practice and research internationally.

Life expectancy of different ethnic groups using death records linked to population census data for 4.62 million people in Scotland

“…We know from other analyses that the socioeconomic profiles of the Asian ethnic minorities in Scotland vary according to the specific ethnic group and the socioeconomic measures used (see online supplementary table). In a paper on gastrointestinal disease in this cohort, ‘ethnic variations were mostly not much altered by socioeconomic or country of birth adjustment’ 18. We think that if we had been able to adjust for socioeconomic status, it would have been unlikely to alter greatly the differences in life expectancy between the ethnic groups.…”

Seasonal and climatic variation in the incidence of adult acute appendicitis: a seven year longitudinal analysis

“…4 Displays cumulative incidence of acute appendicitis admissions from 2012 to 2019 against the average monthly temperature for the same period and geographic area demographic at HDFT, has an uncertain influence on the results of this study. Previous work has shown significant variation in appendicitis across different ethnicities, but no absolute preponderance has been established [1,18]. Further research is required to control for this.…”

Aging and health among migrants in a European perspective

“…As is the case in the general population, and in particularly among aging people, multimorbidity is common among migrant groups in Europe [ 27 , 52 ]. Some migrant groups have comparably higher rates of gastrointestinal diseases (including esophagitis, gallstone disease, pancreatitis and Crohn’s disease) and higher risks of respiratory disease compared to native populations [ 53 ].…”