Mindell, JS;
Knott, CS;
Ng Fat, LS;
Roth, MA;
Manor, O;
Soskolne, V;
Daoud, N;
(2014)
Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England.
Journal of Epidemiology and Community Health
, 68
(12)
pp. 1133-1144.
10.1136/jech-2014-203927.
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Abstract
BACKGROUND: The objective of this study was to examine the relative contribution of factors explaining ethnic health inequalities (EHI) in poor self-reported health (pSRH) and limiting long-standing illness (LLI) between Health Survey for England (HSE) participants. METHOD: Using HSE 2003-2006 data, the odds of reporting pSRH or of LLI in 8573 Bangladeshi, Black African, Black Caribbean, Chinese, Indian, Irish and Pakistani participants was compared with 28,470 White British participants. The effects of demographics, socioeconomic position (SEP), psychosocial variables, community characteristics and health behaviours were assessed using separate regression models. RESULTS: Compared with White British men, age-adjusted odds (OR, 95% CI) of pSRH were higher among Bangladeshi (2.05, 1.34 to 3.14), Pakistani (1.77, 1.34 to 2.33) and Black Caribbean (1.60, 1.18 to 2.18) men, but these became non-significant following adjustment for SEP and health behaviours. Unlike Black Caribbean men, Black African men exhibited a lower risk of age-adjusted pSRH (0.66, 0.43 to 1.00 (p=0.048)) and LLI (0.45, 0.28 to 0.72), which were significant in every model. Likewise, Chinese men had a lower risk of age-adjusted pSRH (0.51, 0.26 to 1.00 (p=0.048)) and LLI (0.22, 0.10 to 0.48). Except in Black Caribbean women, adjustment for SEP rendered raised age-adjusted associations for pSRH among Pakistani (2.51, 1.99 to 3.17), Bangladeshi (1.85, 1.08 to 3.16), Black Caribbean (1.78, 1.44 to 2.21) and Indian women (1.37, 1.13 to 1.66) insignificant. Adjustment for health behaviours had the largest effect for South Asian women. By contrast, Irish women reported better age-adjusted SRH (0.70, 1.51 to 0.96). CONCLUSIONS: SEP and health behaviours were major contributors explaining EHI. Policies to improve health equity need to monitor these pathways and be informed by them.
| Type: | Article |
|---|---|
| Title: | Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/jech-2014-203927 |
| Publisher version: | http://dx.doi.org/10.1136/jech-2014-203927 |
| Language: | English |
| Additional information: | This article has been accepted for publication in the Journal of Epidemiology and Public Health following peer review. The definitive copyedited, typeset version, Mindell, JS; Knott, CS; Ng Fat, LS; Roth, MA; Manor, O; Soskolne, V; Daoud, N; (2014) Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England. Journal of Epidemiology and Community Health, 68 (12) pp. 1133-1144, is available online at: http://dx.doi.org/10.1136/jech-2014-203927. |
| Keywords: | Ethnicity, Health Behaviour, Self-rated Health, Social Class, Social Inequalities, Adult, Aged, Demography, England, Ethnic Groups, Female, Health Behavior, Health Status Disparities, Health Surveys, Humans, Interviews as Topic, Male, Middle Aged, Sex Factors, Young Adult |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1437771 |
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