Researchers say that the health of ethnic minorities in Scotland can now be better assessed and improved as census information can be linked to records of illness and death. The findings of their study may lead to health databases being 'seeded' with codes, to discover the true picture of health amongst ethnic minorities.
The demonstration project, funded by the Scottish Executive, was prompted by previous research in the UK which shows more health problems, including higher than average death rates from heart disease, are found amongst men and women born in the Indian sub continent. Reasons for this are believed to include generally poorer socio-economic status, environmental factors, barriers to accessing health services, genetic factors and the effects of racism.
Raj Bhopal, leader of the project and Professor of Public Health at the University, explained: "Scotland has high quality databases about hospital admissions, but they do not include information about the patient's ethnic group because this information is not routinely collected. As a result, we have had no reliable information about how health and the use of health services vary between different ethnic groups. The research team, which included staff from the Information and Statistics Division (ISD) and the General Register Office for Scotland (GROS), ran this pilot project to test different methods of making better use of existing databases.
"Our approach was to combine information from a variety of sources including hospital and census records using new computerised linkage methods. The project included strict controls to ensure the confidentiality of individual personal information, and to test the methods, the team focused on the example of heart disease. Previous research in England has shown that heart disease is more common in some ethnic groups than others. For example, in England death rates from heart disease are 51% higher in men born in Bangladesh than among those born in England. We have found that there are similar differences in Scotland, with the incidence of heart attack being 60-70% higher compared with non-South Asians."
The report also showed many other important variations. For example, South Asians had four to five times more diabetes than non-South Asians, but quality of care for diabetics was very similar.
Andy Kerr, Minister for Health said:
"I welcome this novel piece of research which illustrates what many in the health profession have suspected for years - that some ethnic minority communities suffer disproportionately from health problems, particularly around heart disease.
"Building up a comprehensive picture of the relationship between ethnicity and health is crucial if we are to most effectively address some of the ingrained inequalities that clearly exist across society. As a result of this work, Scotland is leading the way in providing information about the health of ethnic groups. The success of the project owes much to the advanced level of technical expertise in Scotland, a highly cooperative research team and leadership, resource and moral support from the partner organisations.
"I look forward to working with Professor Bhopal through our National Resource Centre for Ethnic Minority Health to make full use of the results of this pioneering work. We have already taken steps to build this work into the way we work so that in the future NHS Scotland will have the information and support it needs to ensure that Scotland's ethnic minority communities benefit fully from the Executive's commitment to address inequality and close the health gap."
Ethnic variations in health, and the need for data in Scotland