Ethnic differences in multimorbidity after accounting for social-economic factors, findings from The Health Survey for England.

Background Social-economic factors and health behaviours may be driving variation in ethnic health inequalities in multimorbidity including among distinct ethnic groups. Methods Using the cross-sectional nationally representative Health Surveys for England 2011–18 (N  = 54 438, aged 16+), we performed multivariable logistic regression on the odds of having general multimorbidity (≥2 longstanding conditions) by ethnicity [British White (reference group), White Irish, Other White, Indian, Pakistani, Bangladeshi, Chinese, African, Caribbean, White mixed, Other Mixed], adjusting for age, sex, education, area deprivation, obesity, smoking status and survey year. This was repeated for cardiovascular multimorbidity (N  = 37 148, aged 40+: having ≥2 of the following: self-reported diabetes, hypertension, heart attack or stroke) and multiple cardiometabolic risk biomarkers (HbA 1c ≥6.5%, raised blood pressure, total cholesterol ≥5mmol/L). Results Twenty percent of adults had general multimorbidity. In fully adjusted models, compared with the White British majority, Other White [odds ratio (OR) = 0.63; 95% confidence interval (CI) 0.53–0.74], Chinese (OR = 0.58, 95% CI 0.36–0.93) and African adults (OR = 0.54, 95% CI 0.42–0.69), had lower odds of general multimorbidity. Among adults aged 40+, Pakistani (OR = 1.27, 95% CI 0.97–1.66; P  = 0.080) and Bangladeshi (OR = 1.75, 95% CI 1.16–2.65) had increased odds, and African adults had decreased odds (OR = 0.63, 95% CI 0.47–0.83) of general multimorbidity. Risk of cardiovascular multimorbidity was higher among Indian (OR = 3.31, 95% CI 2.56–4.28), Pakistani (OR = 3.48, 95% CI 2.52–4.80), Bangladeshi (OR = 3.67, 95% CI 1.98–6.78), African (OR = 1.61, 95% CI 1.05–2.47), Caribbean (OR = 2.18, 95% CI 1.59–2.99) and White mixed (OR = 1.98, 95% CI 1.14–3.44) adults. Indian adults were also at risk of having multiple cardiometabolic risk biomarkers. Conclusion Ethnic inequalities in multimorbidity are independent of social-economic factors. Ethnic minority groups are particularly at risk of cardiovascular multimorbidity, which may be exacerbated by poorer management of cardiometabolic risk requiring further investigation. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Public Health is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)