Amele, S. et al. (2023) Quality of ethnicity data within Scottish health records and implications of misclassification for ethnic inequalities in severe COVID-19: a national linked data study. Journal of Public Health, (doi: 10.1093/pubmed/fdad196) (PMID:37861114) (Early Online Publication)
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Abstract
Background: We compared the quality of ethnicity coding within the Public Health Scotland Ethnicity Look-up (PHS-EL) dataset, and other National Health Service datasets, with the 2011 Scottish Census. Methods: Measures of quality included the level of missingness and misclassification. We examined the impact of misclassification using Cox proportional hazards to compare the risk of severe coronavirus disease (COVID-19) (hospitalization & death) by ethnic group. Results: Misclassification within PHS-EL was higher for all minority ethnic groups [12.5 to 69.1%] compared with the White Scottish majority [5.1%] and highest in the White Gypsy/Traveller group [69.1%]. Missingness in PHS-EL was highest among the White Other British group [39%] and lowest among the Pakistani group [17%]. PHS-EL data often underestimated severe COVID-19 risk compared with Census data. e.g. in the White Gypsy/Traveller group the Hazard Ratio (HR) was 1.68 [95% Confidence Intervals (CI): 1.03, 2.74] compared with the White Scottish majority using Census ethnicity data and 0.73 [95% CI: 0.10, 5.15] using PHS-EL data; and HR was 2.03 [95% CI: 1.20, 3.44] in the Census for the Bangladeshi group versus 1.45 [95% CI: 0.75, 2.78] in PHS-EL. Conclusions: Poor quality ethnicity coding in health records can bias estimates, thereby threatening monitoring and understanding ethnic inequalities in health.
| Item Type: | Articles |
|---|---|
| Status: | Early Online Publication |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal and Hainey, Dr Kirsten and Demou, Dr Evangelia and Kibuchi, Dr Eliud and McCabe, Dr Ronan and Pattaro, Dr Serena and Pearce, Dr Anna and Amele, Ms Sarah |
| Authors: | Amele, S., McCabe, R., Kibuchi, E., Pearce, A., Hainey, K., Demou, E., Irizar, P., Kapadia, D., Taylor, H., Nazroo, J., Bécares, L., Buchanan, D., Henery, P., Jayacodi, S., Woolford, L., Simpson, C. R., Sheikh, A., Jeffrey, K., Shi, T., Daines, L., Tibble, H., Almaghrabi, F., Fagbamigbe, A. F., Kurdie, A., Robertson, C., Pattaro, S., 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 Public Health |
| Publisher: | Oxford University Press |
| ISSN: | 1741-3842 |
| ISSN (Online): | 1741-3850 |
| Published Online: | 19 October 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Journal of Public Health 2023 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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