Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)

Henery, P. et al. (2021) Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II). BMJ Open, 11(8), e048852. (doi: 10.1136/bmjopen-2021-048852) (PMID:34376451) (PMCID:PMC8359861)

Abstract

Introduction: Evidence from previous pandemics, and the current COVID-19 pandemic, has found that risk of infection/severity of disease is disproportionately higher for ethnic minority groups, and those in lower socioeconomic positions. It is imperative that interventions to prevent the spread of COVID-19 are targeted towards high-risk populations. We will investigate the associations between social characteristics (such as ethnicity, occupation and socioeconomic position) and COVID-19 outcomes and the extent to which characteristics/risk factors might explain observed relationships in Scotland. The primary objective of this study is to describe the epidemiology of COVID-19 by social factors. Secondary objectives are to (1) examine receipt of treatment and prevention of COVID-19 by social factors; (2) quantify ethnic/social differences in adverse COVID-19 outcomes; (3) explore potential mediators of relationships between social factors and SARS-CoV-2 infection/COVID-19 prognosis; (4) examine whether occupational COVID-19 differences differ by other social factors and (5) assess quality of ethnicity coding within National Health Service datasets. Methods and analysis: We will use a national cohort comprising the adult population of Scotland who completed the 2011 Census and were living in Scotland on 31 March 2020 (~4.3 million people). Census data will be linked to the Early Assessment of Vaccine and Anti-Viral Effectiveness II cohort consisting of primary/secondary care, laboratory data and death records. Sensitivity/specificity and positive/negative predictive values will be used to assess coding quality of ethnicity. Descriptive statistics will be used to examine differences in treatment and prevention of COVID-19. Poisson/Cox regression analyses and mediation techniques will examine ethnic and social differences, and drivers of inequalities in COVID-19. Effect modification (on additive and multiplicative scales) between key variables (such as ethnicity and occupation) will be assessed. Ethics and dissemination: Ethical approval was obtained from the National Research Ethics Committee, South East Scotland 02. We will present findings of this study at international conferences, in peer-reviewed journals and to policy-makers.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Katikireddi, Professor Vittal and Hainey, Dr Kirsten and Henery, Mr Paul and Leyland, Professor Alastair
• Authors: Henery, P., Vasileiou, E., Hainey, K. J., Buchanan, D., Harrison, E., Leyland, A. H., Alexis, T., Robertson, C., Agrawal, U., Ritchie, L., Stock, S. J., McCowan, C., Docherty, A., Kerr, S., Marple, J., Wood, R., Moore, E., Simpson, C. R., Sheikh, A., and Katikireddi, S. V.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 10 August 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in BMJ Open 11(8): e048852
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
		Inequalities in health		Medical Research Council (MRC)	MC_UU_00022/2	HW - MRC/CSO Social and Public Health Sciences Unit
				Office of the Chief Scientific Adviser (CSO)	SPHSU17
172690		Understanding the impacts of welfare policy on health: A novel data linkage study	Srinivasa Katikireddi	Office of the Chief Scientific Adviser (CSO)	SCAF/15/02	HW - Public Health