@article{Amele_S-2023_143126,
title = {Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations, and deaths: analysis of two years of a record linked national cohort study in Scotland},
author = {Amele, S. and Kibuchi, E. and McCabe, R. and Pearce, A. and Henery, P. and Hainey, K. and Fagbamigbe, A. and Kurdi, A. and McCowan, C. and Simpson, C. and Dibben, C. and Buchanan, D. and Demou, E. and Almaghrabi, F. and Anghelescu, G. and Taylor, H. and Tibble, H. and Rudan, I. and Nazroo, J. and Bécares, L. and Daines, L. and Irizar, P. and Jayacodi, S. and Pattaro, S. and Sheikh, A. and Katikireddi, S.},
month = {jul},
year = {2023},
abstract = {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 March 1 ,2020, with follow-up to April 17, 2022. Self-reported ethnic group was taken from the Census and Cox proportion hazard models estimated hazard ratios (HRs) for COVID-19 infections, 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- 3.06)) and Pakistani 2.09(1.90-2.29) groups compared with White Scottish. The risk of COVID-19 hospitalisation or death following confirmed infection 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) relative to White Scottish. However, COVID-19 related deaths following hospitalisation did not differ. The risk of COVID-19 outcomes for ethnic minority groups was higher in the first three waves compared to fourth wave. Interpretation: Most ethnic minority groups were at increased risk of adverse COVID-19 outcomes in Scotland, especially White Gypsy/Traveller and Pakistani. Ethnic inequalities persisted following community infection but not following hospitalisation, suggesting differences in hospital treatment are not substantially contributing to ethnic inequalities.},
journal = {Journal of Epidemiology and Community Health},
publisher = {BMJ Publishing Group},
url = {http://dx.doi.org/10.1136/jech-2023-220501},
}
