Ethnicity can influence susceptibility to infection, as covid-19 has shown. Few countries have systematically investigated ethnic variations in infection.
We linked the Scotland 2001 Census, including ethnic group, to national databases of hospitalisations/deaths and serological diagnoses of bloodborne viruses for 2001-2013. We calculated age-adjusted rate-ratios (RRs) in 12 ethnic groups for all infections combined, 15 infection categories, and HIV, hepatitis B (HBV) and hepatitis C (HCV) viruses.
We analysed over 1.65 million infection-related hosptilsations/deaths. Compared with White Scottish, RRs for all infections combined were 0.8 or lower for Other White British, Other White and Chinese males and females, and 1.2-1.4 for Pakistani and African males and for socioeconomic status or birthplace had little effect. RRs for specific infection categories followed similar patterns with striking exceptions. For HIV, RRs were 136 in and 14 in males; for HBV, 125 in and 59 in males, 55 in and 24 in males; and for HCV, 2.3-3.1 in Pakistanis and Africans.
Ethnic differences were found in overall rates and many infection categories, suggesting multiple causative pathways. We recommend census linkage as a powerful method for studying the disproportionate impact of covid-19.


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Gruer, L., Cézard, G., Wallace, L., Hutchinson, S., Douglas, A., Buchanan, D., Katikireddi, S., Millard, A., Goldberg, D., Sheikh, A. & Bhopal, R. 2021, 'Complex differences in infection rates between ethnic groups in Scotland: a retrospective, national census-linked cohort study of 1.65 million cases', Journal of Public Health, article no: fdaa267. https://doi.org/10.1093/pubmed/fdaa267

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Last updated: 29 June 2022
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