Ethnic variations in falls and road traffic injuries resulting in hospitalisation or death in Scotland: the Scottish Health and Ethnicity Linkage Study

Cezard, G., Gruer, L., Steiner, M., Douglas, A., Davis, C., Buchanan, D., Katikireddi, V. , Millard, A., Sheikh, A. and Bhopal, R. (2020) Ethnic variations in falls and road traffic injuries resulting in hospitalisation or death in Scotland: the Scottish Health and Ethnicity Linkage Study. Public Health, 182, pp. 32-38. (doi: 10.1016/j.puhe.2020.01.013) (PMID:32151824) (PMCID:PMC7294220)

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Abstract

Objectives: To investigate ethnic differences in falls and road traffic injuries (RTIs) in Scotland. Study design: A retrospective cohort of 4.62 million people, linking the Scottish Census 2001, with self-reported ethnicity, to hospitalisation and death records for 2001–2013. Methods: We selected cases with International Classification of Diseases–10 diagnostic codes for falls and RTIs. Using Poisson regression, age-adjusted risk ratios (RRs, multiplied by 100 as percentages) and 95% confidence intervals (CIs) were calculated by sex for 10 ethnic groups with the White Scottish as reference. We further adjusted for country of birth and socio-economic status (SES). Results: During about 49 million person-years, there were 275,995 hospitalisations or deaths from fall-related injuries and 43,875 from RTIs. Compared with the White Scottish, RRs for falls were higher in most White and Mixed groups, e.g., White Irish males (RR: 131; 95% CI: 122–140) and Mixed females (126; 112–143), but lower in Pakistani males (72; 64–81) and females (72; 63–82) and African females (79; 63–99). For RTIs, RRs were higher in other White British males (161; 147–176) and females (156; 138–176) and other White males (119; 104–137) and females (143; 121–169) and lower in Pakistani females (74; 57–98). The ethnic variations differed by road user type, with few cases among non-White motorcyclists and non-White female cyclists. The RRs were minimally altered by adjustment for country of birth or SES. Conclusion: We found important ethnic variations in injuries owing to falls and RTIs, with generally lower risks in non-White groups. Culturally related differences in behaviour offer the most plausible explanation, including variations in alcohol use. The findings do not point to the need for new interventions in Scotland at present. However, as the ethnic mix of each country is unique, other countries could benefit from similar data linkage-based research.

Item Type:Articles
Additional Information:Funding: The authors thank the Chief Scientist Office for a grant (CZH/4/ 878), NHS Health Scotland for a supplementary grant (no number), and Information Services Division (ISD) of NHS National Services Scotland and National Records of Scotland for in-house technical support. S.V.K. acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15) and Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). A.S. is supported by the Farr Institute and Health Data Research UK.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal and Millard, Dr Andrew
Authors: Cezard, G., Gruer, L., Steiner, M., Douglas, A., Davis, C., Buchanan, D., Katikireddi, V., Millard, A., Sheikh, A., and Bhopal, R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Public Health
Publisher:Elsevier
ISSN:0033-3506
ISSN (Online):1476-5616
Published Online:06 March 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Public Health 182:32-38
Publisher Policy:Reproduced under a Creative Commons license

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiChief Scientist Office (CSO)SCAF/15/02HW - Public Health
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
727671SPHSU Core Renewal: Informing Healthy Public Policy Research ProgrammePeter CraigMedical Research Council (MRC)MC_UU_12017/15IHW - MRC/CSO SPHU
Chief Scientist Office (CSO)SPHSU13
Chief Scientist Office (CSO)SPHSU15