RT Journal Article
SR Electronic
T1 Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations and deaths: analysis of 2 years of a record linked national cohort study in Scotland
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 641
OP 648
DO 10.1136/jech-2023-220501
VO 77
IS 10
A1 Amele, Sarah
A1 Kibuchi, Eliud
A1 McCabe, Ronan
A1 Pearce, Anna
A1 Henery, Paul
A1 Hainey, Kirsten
A1 Fagbamigbe, Adeniyi Francis
A1 Kurdi, Amanj
A1 McCowan, Colin
A1 Simpson, Colin R
A1 Dibben, Chris
A1 Buchanan, Duncan
A1 Demou, Evangelia
A1 Almaghrabi, Fatima
A1 Anghelescu, Gina
A1 Taylor, Harry
A1 Tibble, Holly
A1 Rudan, Igor
A1 Nazroo, James
A1 Bécares, Laia
A1 Daines, Luke
A1 Irizar, Patricia
A1 Jayacodi, Sandra
A1 Pattaro, Serena
A1 Sheikh, Aziz
A1 Katikireddi, Srinivasa Vittal
YR 2023
UL http://jech.bmj.com/content/77/10/641.abstract
AB 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.Data may be obtained from a third party and are not publicly available. Under the provisions of the Statistics and Registration Service Act 2007, the linked 2011 census data used in this study are not permitted to be shared.