Background Having multiple long-term conditions has been associated a higher treatment burden, reduced quality of life and a higher risk of mortality. Epidemiological evidence suggests that people from minoritised ethnic groups have a higher prevalence of multiple long-term conditions (MLTCS) but questions remain regarding the patterning of MLTCs by age and how this varies for different ethnic group populations. The aim of this study is to describe age-related patterns of MLTCs, and combinations of physical and mental health conditions across different ethnic groups in England.
Methods We analysed data from Clinical Practice Research Datalink (CPRD) 2016, and the English GP Patient Survey (GPPS) 2015–2017, to give us insight into both primary care recorded and self-reported long-term conditions. We described the association between total number of LTCs, and age using a multilevel regression model adjusting for sex and deprivation with patients nested within GP practices. Similar analyses were repeated for two or more physical LTCs and two or more LTCs including a mental health condition.
Results For both primary care recorded and self-reported LTCs, people from minoritised ethnic groups had a lower prevalence of MLTCs at younger ages compared to their white counterparts. We observed ethnic inequalities from middle we age onwards with steeper age-related increases in MLTCs among Bangladeshi, Pakistani, Indian, Black Caribbean and Gypsy or Irish Travellers. These trends were also seen after adjusting for area-level deprivation. These patterns were similar when physical LTCs were considered. Compared to minoritised ethnic group people. people from the white ethnic group were more likely to report 2 or more LTCs that included a mental health condition.
Conclusion This study finds ethnic inequalities in the prevalence of MLTCs from midlife onwards and identifies ethnic group populations that are at a particular risk of MLTCs. The findings raise several questions concerning the underlying processes that lead to these differential health outcomes. Further research is required to identify these processes and inform efforts to address age-related inequalities experienced by people from minoritised ethnic groups compared with their white counterparts.
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