scholarly journals Ethnicity, Household Composition and COVID-19 Mortality: A National Linked Data Study

2020 ◽  
Author(s):  
Vahé Nafilyan ◽  
Nazrul Islam ◽  
Daniel Ayoubkhani ◽  
Clare Gilles ◽  
Srinivasa Vittal Katikireddi ◽  
...  
Keyword(s):  
Older Adults ◽  
Ethnic Minority ◽  
South Asian ◽  
Minority Groups ◽  
Household Composition ◽  
Ethnic Minority Groups ◽  
Dependent Children ◽  
Registration Data ◽  
Increased Risk ◽  
Older Males

AbstractBackgroundEthnic minorities have experienced disproportionate COVID-19 mortality rates. We estimated associations between household composition and COVID-19 mortality in older adults (≥ 65 years) using a newly linked census-based dataset, and investigated whether living in a multi-generational household explained some of the elevated COVID-19 mortality amongst ethnic minority groups.MethodsUsing retrospective data from the 2011 Census linked to Hospital Episode Statistics (2017-2019) and death registration data (up to 27th July 2020), we followed adults aged 65 years or over living in private households in England from 2 March 2020 until 27 July 2020 (n=10,078,568). We estimated hazard ratios (HRs) for COVID-19 death for people living in a multi-generational household compared with people living with another older adult, adjusting for geographical factors, socio-economic characteristics and pre-pandemic health. We conducted a causal mediation analysis to estimate the proportion of ethnic inequalities explained by living in a multi-generational household.ResultsLiving in a multi-generational household was associated with an increased risk of COVID-19 death. After adjusting for confounding factors, the HRs for living in a multi-generational household with dependent children were 1.13 [95% confidence interval 1.01-1.27] and 1.17 [1.01-1.35] for older males and females. The HRs for living in a multi-generational household without dependent children were 1.03 [0.97 - 1.09] for older males and 1.22 [1.12 - 1.32] for older females. Living in a multi-generational household explained between 10% and 15% of the elevated risk of COVID-19 death among older females from South Asian background, but very little for South Asian males or people in other ethnic minority groups.ConclusionOlder adults living with younger people are at increased risk of COVID-19 mortality, and this is a notable contributing factor to the excess risk experienced by older South Asian females compared to White females. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.FundingThis research was funded by the Office for National Statistics.

scholarly journals Ethnicity, household composition and COVID-19 mortality: a national linked data study

2021 ◽  
pp. 014107682199997
Author(s):  
Vahé Nafilyan ◽  
Nazrul Islam ◽  
Daniel Ayoubkhani ◽  
Clare Gilles ◽  
Srinivasa Vittal Katikireddi ◽  
...  
Keyword(s):  
South Asian ◽  
White Women ◽  
Minority Groups ◽  
Elderly Women ◽  
Household Composition ◽  
Elderly Men ◽  
Dependent Children ◽  
Registration Data ◽  
Hazard Ratios ◽  
Increased Risk

Objective To estimate the proportion of ethnic inequalities explained by living in a multi-generational household. Design Causal mediation analysis. Setting Retrospective data from the 2011 Census linked to Hospital Episode Statistics (2017-2019) and death registration data (up to 30 November 2020). Participants Adults aged 65 years or over living in private households in England from 2 March 2020 until 30 November 2020 (n=10,078,568). Main outcome measures Hazard ratios were estimated for COVID-19 death for people living in a multi-generational household compared with people living with another older adult, adjusting for geographic factors, socioeconomic characteristics and pre-pandemic health. Results Living in a multi-generational household was associated with an increased risk of COVID-19 death. After adjusting for confounding factors, the hazard ratios for living in a multi-generational household with dependent children were 1.17 (95% confidence interval [CI] 1.06–1.30) and 1.21 (95% CI 1.06–1.38) for elderly men and women. The hazard ratios for living in a multi-generational household without dependent children were 1.07 (95% CI 1.01–1.13) for elderly men and 1.17 (95% CI 1.07–1.25) for elderly women. Living in a multi-generational household explained about 11% of the elevated risk of COVID-19 death among elderly women from South Asian background, but very little for South Asian men or people in other ethnic minority groups. Conclusion Elderly adults living with younger people are at increased risk of COVID-19 mortality, and this is a contributing factor to the excess risk experienced by older South Asian women compared to White women. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.

scholarly journals Do sex differences in the prevalence of ECG abnormalities vary across ethnic groups living in the Netherlands? A cross-sectional analysis of the population-based HELIUS study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039091
Author(s):  
Renee Bolijn ◽  
C Cato ter Haar ◽  
Ralf E Harskamp ◽  
Hanno L Tan ◽  
Jan A Kors ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Ethnic Minority ◽  
Ethnic Groups ◽  
South Asian ◽  
Minority Groups ◽  
Population Based ◽  
Secondary Outcome ◽  
Ethnic Minority Groups ◽  
Ecg Abnormalities

ObjectivesMajor ECG abnormalities have been associated with increased risk of cardiovascular disease (CVD) burden in asymptomatic populations. However, sex differences in occurrence of major ECG abnormalities have been poorly studied, particularly across ethnic groups. The objectives were to investigate (1) sex differences in the prevalence of major and, as a secondary outcome, minor ECG abnormalities, (2) whether patterns of sex differences varied across ethnic groups, by age and (3) to what extent conventional cardiovascular risk factors contributed to observed sex differences.DesignCross-sectional analysis of population-based study.SettingMulti-ethnic, population-based Healthy Life in an Urban Setting cohort, Amsterdam, the Netherlands.Participants8089 men and 11 369 women of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged 18–70 years without CVD.Outcome measuresAge-adjusted and multivariable logistic regression analyses were performed to study sex differences in prevalence of major and, as secondary outcome, minor ECG abnormalities in the overall population, across ethnic groups and by age-groups (18–35, 36–50 and >50 years).ResultsMajor and minor ECG abnormalities were less prevalent in women than men (4.6% vs 6.6% and 23.8% vs 39.8%, respectively). After adjustment for conventional risk factors, sex differences in major abnormalities were smaller in ethnic minority groups (OR ranged from 0.61 in Moroccans to 1.32 in South-Asian Surinamese) than in the Dutch (OR 0.49; 95% CI 0.36 to 0.65). Only in South-Asian Surinamese, women did not have a lower odds than men (OR 1.32; 95% CI 0.96 to 1.84). The pattern of smaller sex differences in ethnic minority groups was more pronounced in older than in younger age-groups.ConclusionsThe prevalence of major ECG abnormalities was lower in women than men. However, sex differences were less apparent in ethnic minority groups. Conventional risk factors did not contribute substantially to observed sex differences.

scholarly journals END-OF-LIFE INFORMATION PREFERENCES OF ASIAN OLDER ADULTS: A SYSTEMATIC REVIEW OF THE LITERATURE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S412-S412
Author(s):  
Kristina Shiroma ◽  
Nathan Davis ◽  
Bo Xie
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Ethnic Minority ◽  
End Of Life ◽  
Minority Groups ◽  
Future Research ◽  
Ethnic Minority Groups ◽  
Information Preferences ◽  
Cultural Aspects ◽  
Mesh Terms

Abstract Older adults of Asian ethnic minority groups are often underrepresented in the literature on cultural aspects of end-of-life (EOL) decision making. This literature review aimed to systematically investigate the cultural aspects of EOL decision making for aging adults of Asian ethnic minority groups. In February 2019, systematic searches were conducted in PubMed using MeSH terms “end-of-life”, “decision-making”, and “culture OR cultural”. Articles with human subjects, full text in English, published in the past 10 years, with original, empirical findings were included. After multiple rounds of screening, the final sample included 22 results, with sample sizes ranging from 11 to over 9 millions representing South Asian, Chinese, Korean, Taiwanese, Singaporean, Asian and Asian/Pacific adults. The findings suggest the literature on older Asian adults is present, but limited. Future research is needed to explore cultural aspects of Asian ethnic minority groups in respect to older adult’s information preferences in EOL decision-making.

scholarly journals SARS-CoV-2 vaccine uptake in a multi-ethnic UK healthcare workforce: A cross-sectional study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (11) ◽  
pp. e1003823
Author(s):  
Christopher A. Martin ◽  
Colette Marshall ◽  
Prashanth Patel ◽  
Charles Goss ◽  
David R. Jenkins ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
South Asian ◽  
Minority Groups ◽  
Data Extraction ◽  
Adverse Outcomes ◽  
Vaccine Uptake ◽  
University Hospitals ◽  
Cross Sectional ◽  
Hospital System ◽  
Increased Risk

Background Healthcare workers (HCWs) and ethnic minority groups are at increased risk of COVID-19 infection and adverse outcomes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is now available for frontline UK HCWs; however, demographic/occupational associations with vaccine uptake in this cohort are unknown. We sought to establish these associations in a large UK hospital workforce. Methods and findings We conducted cross-sectional surveillance examining vaccine uptake amongst all staff at University Hospitals of Leicester NHS Trust. We examined proportions of vaccinated staff stratified by demographic factors, occupation, and previous COVID-19 test results (serology/PCR) and used logistic regression to identify predictors of vaccination status after adjustment for confounders. We included 19,044 HCWs; 12,278 (64.5%) had received SARS-CoV-2 vaccination. Compared to White HCWs (70.9% vaccinated), a significantly smaller proportion of ethnic minority HCWs were vaccinated (South Asian, 58.5%; Black, 36.8%; p < 0.001 for both). After adjustment for age, sex, ethnicity, deprivation, occupation, SARS-CoV-2 serology/PCR results, and COVID-19-related work absences, factors found to be negatively associated with vaccine uptake were younger age, female sex, increased deprivation, pregnancy, and belonging to any non-White ethnic group (Black: adjusted odds ratio [aOR] 0.30, 95% CI 0.26–0.34, p < 0.001; South Asian: aOR 0.67, 95% CI 0.62–0.72, p < 0.001). Those who had previously had confirmed COVID-19 (by PCR) were less likely to be vaccinated than those who had tested negative. Limitations include data being from a single centre, lack of data on staff vaccinated outside the hospital system, and that staff may have taken up vaccination following data extraction. Conclusions Ethnic minority HCWs and those from more deprived areas as well as younger staff and female staff are less likely to take up SARS-CoV-2 vaccination. These findings have major implications for the delivery of SARS-CoV-2 vaccination programmes, in HCWs and the wider population, and should inform the national vaccination programme to prevent the disparities of the pandemic from widening.

scholarly journals Ethnic differences in COVID-19 infection, hospitalisation, and mortality: an OpenSAFELY analysis of 17 million adults in England

2020 ◽  
Author(s):  
Rohini Mathur ◽  
Christopher T. Rentsch ◽  
Caroline Morton ◽  
William J Hulme ◽  
Anna Schultze ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
South Asian ◽  
Ethnic Differences ◽  
Minority Groups ◽  
Household Size ◽  
Ethnic Minority Groups ◽  
Icu Admission ◽  
Explanatory Factors ◽  
Clinical Records ◽  
White Adults

Background: COVID-19 has had a disproportionate impact on ethnic minority populations, both in the UK and internationally. To date, much of the evidence has been derived from studies within single healthcare settings, mainly those hospitalised with COVID-19. Working on behalf of NHS England, the aim of this study was to identify ethnic differences in the risk of COVID-19 infection, hospitalisation and mortality using a large general population cohort in England. Methods: We conducted an observational cohort study using linked primary care records of 17.5 million adults between 1 February 2020 and 3 August 2020. Exposure was self-reported ethnicity collapsed into the 5 and 16 ethnicity categories of the English Census. Multivariable Cox proportional hazards regression was used to identify ethnic differences in the risk of being tested and testing positive for SARS-CoV-2 infection, COVID-19 related intensive care unit (ICU) admission, and COVID-19 mortality, adjusted for socio-demographic factors, clinical co-morbidities, geographic region, care home residency, and household size. Results: A total of 17,510,002 adults were included in the study; 63% white (n=11,030,673), 6% south Asian (n=1,034,337), 2% black (n=344,889), 2% other (n=324,730), 1% mixed (n=172,551), and 26% unknown (n=4,602,822). After adjusting for measured explanatory factors, south Asian, black, and mixed groups were marginally more likely to be tested (south Asian HR 1.08, 95%CI 1.07-1.09; black HR 1.08; 95%CI 1.06-1.09, mixed HR 1.03, 95%CI 1.01-1.05), and substantially more likely to test positive for SARS-CoV-2 compared with white adults (south Asian HR 2.02. 95% CI 1.97-2.07; black HR 1.68, 95%CI 1.61-1.76; mixed HR 1.46, 95%CI 1.36-1.56). The risk of being admitted to ICU for COVID-19 was substantially increased in all ethnic minority groups compared with white adults (south Asian HR 2.22, 95%CI 1.96-2.52; black HR 3.07, 95%CI 2.61-3.61; mixed HR 2.86, 95%CI 2.19-3.75, other HR 2.86, 95%CI 2.31-3.63). Risk of COVID-19 mortality was increased by 25-56% in ethnic minority groups compared with white adults (south Asian HR 1.27, 95%CI 1.17-1.38; black HR 1.55, 95%CI 1.38-1.75; mixed HR 1.40, 95%CI 1.12-1.76; other HR 1.25, 95%CI 1.05-1.49). We observed heterogeneity of associations after disaggregation into detailed ethnic groupings; Indian and African groups were at higher risk of all outcomes; Pakistani, Bangladeshi and Caribbean groups were less or equally likely to be tested for SARS-CoV-2, but at higher risk of all other outcomes, Chinese groups were less likely to be tested for and test positive for SARS-CoV-2, more likely to be admitted to ICU, and equally likely to die from COVID-19. Conclusions: We found evidence of substantial ethnic inequalities in the risk of testing positive for SARS-CoV-2, ICU admission, and mortality, which persisted after accounting for explanatory factors, including household size. It is likely that some of this excess risk is related to factors not captured in clinical records such as occupation, experiences of structural discrimination, or inequitable access to health and social services. Prioritizing linkage between health, social care, and employment data and engaging with ethnic minority communities to better understand their lived experiences is essential for generating evidence to prevent further widening of inequalities in a timely and actionable manner.

scholarly journals Racial and Ethnic Digital Divides in Posting COVID-19 Content on Social Media Among US Adults: Secondary Survey Analysis (Preprint)

2020 ◽  
Author(s):  
Celeste Campos-Castillo ◽  
Linnea I. Laestadius
Keyword(s):  
Older Adults ◽  
Social Media ◽  
Ethnic Minority ◽  
Race And Ethnicity ◽  
Minority Groups ◽  
The United States ◽  
Ethnic Minority Groups ◽  
Digital Divides ◽  
Gender And Age ◽  
Racial And Ethnic Minority

BACKGROUND Public health surveillance experts are leveraging user-generated content on social media to track the spread and effects of COVID-19. However, racial and ethnic digital divides, which are disparities among people who have internet access and post on social media, can bias inferences. This bias is particularly problematic in the context of the COVID-19 pandemic because due to structural inequalities, members of racial and ethnic minority groups are disproportionately vulnerable to contracting the virus and to the deleterious economic and social effects from mitigation efforts. Further, important demographic intersections with race and ethnicity, such as gender and age, are rarely investigated in work characterizing social media users; however, they reflect additional axes of inequality shaping differential exposure to COVID-19 and its effects. OBJECTIVE The aim of this study was to characterize how the race and ethnicity of US adults are associated with their odds of posting COVID-19 content on social media and how gender and age modify these odds. METHODS We performed a secondary analysis of a survey conducted by the Pew Research Center from March 19 to 24, 2020, using a national probability sample (N=10,510). Respondents were recruited from an online panel, where panelists without an internet-enabled device were given one to keep at no cost. The binary dependent variable was responses to an item asking whether respondents “used social media to share or post information about the coronavirus.” We used survey-weighted logistic regressions to estimate the odds of responding in the affirmative based on the race and ethnicity of respondents (white, black, Latino, other race/ethnicity), adjusted for covariates measuring sociodemographic background and COVID-19 experiences. We examined how gender (female, male) and age (18 to 30 years, 31 to 50 years, 51 to 64 years, and 65 years and older) intersected with race and ethnicity by estimating interactions. RESULTS Respondents who identified as black (odds ratio [OR] 1.29, 95% CI 1.02-1.64; <i>P</i>=.03), Latino (OR 1.66, 95% CI 1.36-2.04; <i>P</i>&lt;.001), or other races/ethnicities (OR 1.33, 95% CI 1.02-1.72; <i>P</i>=.03) had higher odds than respondents who identified as white of reporting that they posted COVID-19 content on social media. Women had higher odds of posting than men regardless of race and ethnicity (OR 1.58, 95% CI 1.39-1.80; <i>P</i>&lt;.001). Among men, respondents who identified as black, Latino, or members of other races/ethnicities were significantly more likely to post than respondents who identified as white. Older adults (65 years or older) had significantly lower odds (OR 0.73, 95% CI 0.57-0.94; <i>P</i>=.01) of posting compared to younger adults (18-29 years), particularly among those identifying as other races/ethnicities. Latino respondents were the most likely to report posting across all age groups. CONCLUSIONS In the United States, members of racial and ethnic minority groups are most likely to contribute to COVID-19 content on social media, particularly among groups traditionally less likely to use social media (older adults and men). The next step is to ensure that data collection procedures capture this diversity by encompassing a breadth of search criteria and social media platforms.

scholarly journals Pain amongst ethnic minority groups of South Asian origin in the United Kingdom: a review

Rheumatology ◽  
1999 ◽  
Vol 38 (12) ◽  
pp. 1184-1187 ◽  
Author(s):  
P. Njobvu ◽  
I. Hunt ◽  
D. Pope ◽  
G. Macfarlane
Keyword(s):  
United Kingdom ◽  
Ethnic Minority ◽  
South Asian ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Asian Origin ◽  
South Asian Origin ◽  
The United Kingdom

Perceived ethnic discrimination as a risk factor for psychotic symptoms: a systematic review and meta-analysis

2020 ◽  
Vol 50 (7) ◽  
pp. 1077-1089 ◽  
Author(s):  
Olivier Bardol ◽  
Stéphanie Grot ◽  
Hans Oh ◽  
Emmanuel Poulet ◽  
Halima Zeroug-Vial ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ethnic Minority ◽  
Ethnic Minorities ◽  
Minority Groups ◽  
Meta Analysis ◽  
Ethnic Discrimination ◽  
Psychotic Symptoms ◽  
Ethnic Minority Groups ◽  
Increased Risk ◽  
Perceived Ethnic Discrimination

AbstractBackgroundPrevious studies have shown an elevated risk of psychotic symptoms (PS) and experiences (PEs) among ethnic minority groups, with significant variation between groups. This pattern may be partially attributable to the unfavorable socio-environmental conditions that surround ethnic minority groups. Perceived ethnic discrimination (PED) in particular has been a salient putative risk factor to explain the increased risk.MethodsWe conducted a systematic literature review and meta-analysis to assess the impact of PED on reporting PS/PEs in ethnic minorities. This review abides by the guidelines set forth by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The included studies were obtained from the databases: Medline, PsycINFO, and Web Of Science. Sub-group analyses were performed assessing the effect of PED in different subtypes of PS, the influence of ethnicity and moderating/mediating factors.ResultsSeventeen studies met the inclusion criteria, and nine were used to conduct the meta-analysis. We found a positive association between PED and the occurrence of PS/PEs among ethnic minorities. The combined odds ratio were 1.77 (95% CI 1.26–2.49) for PS and 1.94 (95% CI 1.42–2.67) for PEs. We found that the association was similar across ethnic groups and did not depend on the ethnic origin of individuals. Weak evidence supported the buffering effects of ethnic identity, collective self-esteem and social support; and no evidence supported the moderating effect of ethnic density. Sensitivity to race-based rejection significantly but only slightly mediated the association.ConclusionThese findings suggest that PED is involved in the increased risk of PS/PEs in ethnic minority populations.

scholarly journals Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study

2006 ◽  
Vol 36 (11) ◽  
pp. 1541-1550 ◽  
Author(s):  
PAUL FEARON ◽  
JAMES B. KIRKBRIDE ◽  
CRAIG MORGAN ◽  
PAOLA DAZZAN ◽  
KEVIN MORGAN ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Psychotic Disorders ◽  
Minority Groups ◽  
Age Groups ◽  
Incidence Rates ◽  
Psychotic Symptoms ◽  
Ethnic Minority Groups ◽  
Black Africans ◽  
Increased Risk ◽  
Rate Ratios

Background. The incidence of schizophrenia in the African-Caribbean population in England is reported to be raised. We sought to clarify whether (a) the rates of other psychotic disorders are increased, (b) whether psychosis is increased in other ethnic minority groups, and (c) whether particular age or gender groups are especially at risk.Method. We identified all people (n=568) aged 16–64 years presenting to secondary services with their first psychotic symptoms in three well-defined English areas (over a 2-year period in Southeast London and Nottingham and a 9-month period in Bristol). Standardized incidence rates and incidence rate ratios (IRR) for all major psychosis syndromes for all main ethnic groups were calculated.Results. We found remarkably high IRRs for both schizophrenia and manic psychosis in both African-Caribbeans (schizophrenia 9·1, manic psychosis 8·0) and Black Africans (schizophrenia 5·8, manic psychosis 6·2) in men and women. IRRs in other ethnic minority groups were modestly increased as were rates for depressive psychosis and other psychoses in all minority groups. These raised rates were evident in all age groups in our study.Conclusions. Ethnic minority groups are at increased risk for all psychotic illnesses but African-Caribbeans and Black Africans appear to be at especially high risk for both schizophrenia and mania. These findings suggest that (a) either additional risk factors are operating in African-Caribbeans and Black Africans or that these factors are particularly prevalent in these groups, and that (b) such factors increase risk for schizophrenia and mania in these groups.

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