Amele, S. et al. (2023) Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations, and deaths: Analysis of two years of a record linked national cohort study in Scotland. Journal of Epidemiology and Community Health, 77, pp. 641-648. (doi: 10.1136/jech-2023-220501) (PMID:37524538) (PMCID:PMC10511958)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
303241.pdf - Published Version Available under License Creative Commons Attribution. 4MB |
Abstract
Background: This study aims to estimate ethnic inequalities in risk for positive SARS-CoV-2 tests, COVID-19 hospitalisations and deaths over time in Scotland. Methods: We conducted a population-based cohort study where the 2011 Scottish Census was linked to health records. We included all individuals≥16 years living in Scotland on 1 March 2020. The study period was from 1 March 2020 to 17 April 2022. Self-reported ethnic group was taken from the census and Cox proportional hazard models estimated HRs for positive SARS-CoV-2 tests, hospitalisations and deaths, adjusted for age, sex and health board. We also conducted separate analyses for each of the four waves of COVID-19 to assess changes in risk over time. Findings: Of the 4 358 339 individuals analysed, 1 093 234 positive SARS-CoV-2 tests, 37 437 hospitalisations and 14 158 deaths occurred. The risk of COVID-19 hospitalisation or death among ethnic minority groups was often higher for White Gypsy/Traveller (HR 2.21, 95% CI (1.61 to 3.06)) and Pakistani 2.09 (1.90 to 2.29) groups compared with the white Scottish group. The risk of COVID-19 hospitalisation or death following confirmed positive SARS-CoV-2 test was particularly higher for White Gypsy/Traveller 2.55 (1.81–3.58), Pakistani 1.75 (1.59–1.73) and African 1.61 (1.28–2.03) individuals relative to white Scottish individuals. However, the risk of COVID-19-related death following hospitalisation did not differ. The risk of COVID-19 outcomes for ethnic minority groups was higher in the first three waves compared with the fourth wave. Interpretation: Most ethnic minority groups were at increased risk of adverse COVID-19 outcomes in Scotland, especially White Gypsy/Traveller and Pakistani groups. Ethnic inequalities persisted following community infection but not following hospitalisation, suggesting differences in hospital treatment did not substantially contribute to ethnic inequalities.
| Item Type: | Articles |
|---|---|
| Additional Information: | This work was supported by the ESRC (grant number ES/W000849/1). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. SA, EK, RM, AP, KH, ED and SVK are supported by Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17). SVK acknowledges funding from a National Records of Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17). AP acknowledges funding from Wellcome Trust (205412/Z/16/Z). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal and Hainey, Dr Kirsten and Anghelescu, Dr Gina and Demou, Dr Evangelia and McCabe, Dr Ronan and Kibuchi, Dr Eliud and Pattaro, Dr Serena and Henery, Mr Paul and Pearce, Dr Anna and Amele, Ms Sarah |
| Authors: | Amele, S., Kibuchi, E., McCabe, R., Pearce, A., Henery, P., Hainey, K., Fagbamigbe, A. F., Kurdi, A., McCowan, C., Simpson, C. R., Dibben, C., Buchanan, D., Demou, E., Almaghrabi, F., Anghelescu, G., Taylor, H., Tibble, H., Rudan, I., Nazroo, J., Bécares, L., Daines, L., Irizar, P., Jayacodi, S., Pattaro, S., Sheikh, A., and Katikireddi, S. V. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU College of Social Sciences > School of Social and Political Sciences > Urban Studies |
| Journal Name: | Journal of Epidemiology and Community Health |
| Publisher: | BMJ Publishing Group |
| ISSN: | 0143-005X |
| ISSN (Online): | 1470-2738 |
| Published Online: | 31 July 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Journal of Epidemiology and Community Health 77:641-648 |
| Publisher Policy: | Reproduced under a Creative Commons License |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information