Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England
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, t...
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| Veröffentlicht in: | Journal of epidemiology and community health (1979) 2014-12, Vol.68 (12), p.1133-1144 |
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| creator | Mindell, J S Knott, C S Ng Fat, L S Roth, M A Manor, O Soskolne, V Daoud, N |
| description | 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. |
| doi_str_mv | 10.1136/jech-2014-203927 |
| format | Article |
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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.</description><identifier>ISSN: 0143-005X</identifier><identifier>EISSN: 1470-2738</identifier><identifier>DOI: 10.1136/jech-2014-203927</identifier><identifier>PMID: 25096809</identifier><identifier>CODEN: JECHDR</identifier><language>eng</language><publisher>London: BMJ Publishing Group</publisher><subject>Adult ; Aged ; Behavior modeling ; Biological and medical sciences ; Cigarette smoking ; Community health ; Demography ; England ; Ethnic Groups ; Female ; General aspects ; Health behavior ; Health Behavior - ethnology ; Health care inequality ; Health disparities ; Health Status Disparities ; Health Surveys ; Households ; Humans ; Interviews ; Interviews as Topic ; Male ; Medical sciences ; Men ; Middle Aged ; Miscellaneous ; Population ; Public health ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Qualitative research ; Sex Factors ; Social capital ; Social inequalities in health ; Social support ; Socioeconomic factors ; Socioeconomics ; Studies ; White people ; Young Adult</subject><ispartof>Journal of epidemiology and community health (1979), 2014-12, Vol.68 (12), p.1133-1144</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>2014 BMJ Publishing Group</rights><rights>2015 INIST-CNRS</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b560t-4a0522d4657d3c9227b9c9eceed37a8cfb0244b3c790ca7c0dd36cb78d390c7c3</citedby><cites>FETCH-LOGICAL-b560t-4a0522d4657d3c9227b9c9eceed37a8cfb0244b3c790ca7c0dd36cb78d390c7c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jech.bmj.com/content/68/12/1133.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jech.bmj.com/content/68/12/1133.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,803,3196,23571,27924,27925,58017,58250,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28911846$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25096809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mindell, J S</creatorcontrib><creatorcontrib>Knott, C S</creatorcontrib><creatorcontrib>Ng Fat, L S</creatorcontrib><creatorcontrib>Roth, M A</creatorcontrib><creatorcontrib>Manor, O</creatorcontrib><creatorcontrib>Soskolne, V</creatorcontrib><creatorcontrib>Daoud, N</creatorcontrib><title>Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England</title><title>Journal of epidemiology and community health (1979)</title><addtitle>J Epidemiol Community Health</addtitle><description>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.</description><subject>Adult</subject><subject>Aged</subject><subject>Behavior modeling</subject><subject>Biological and medical sciences</subject><subject>Cigarette smoking</subject><subject>Community health</subject><subject>Demography</subject><subject>England</subject><subject>Ethnic Groups</subject><subject>Female</subject><subject>General aspects</subject><subject>Health behavior</subject><subject>Health Behavior - ethnology</subject><subject>Health care inequality</subject><subject>Health disparities</subject><subject>Health Status Disparities</subject><subject>Health Surveys</subject><subject>Households</subject><subject>Humans</subject><subject>Interviews</subject><subject>Interviews as Topic</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Population</subject><subject>Public health</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Qualitative research</subject><subject>Sex Factors</subject><subject>Social capital</subject><subject>Social inequalities in health</subject><subject>Social support</subject><subject>Socioeconomic factors</subject><subject>Socioeconomics</subject><subject>Studies</subject><subject>White people</subject><subject>Young Adult</subject><issn>0143-005X</issn><issn>1470-2738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkc2r1DAUxYMovvHp3o0SEEGQaj7aJnEnj_EDHrhRcFduk9uZljaZl7TiLPzfzdjxCW7eJjfk_O7JTQ4hTzl7w7ms3w5o94VgvMyLNELdIxteKlYIJfV9ssmCLBirvl-QRykNLG-VMA_JhaiYqTUzG_Jr-_Mwgoc5xCPtwOaaaBci3SOM8572Hm8WGPu5x0TBxpASdX3XYUQ_U5z3vrcUvKM79A4j3cWwHNI76mAG2sUwUaDZvQ8eRpqW-AOP2ZNu_S7f6h6TBx2MCZ-c6yX59mH79epTcf3l4-er99dFW9VsLkpglRCurCvlpDVCqNZYgxbRSQXadi0TZdlKqwyzoCxzTta2VdrJfKCsvCSvVt9DDDcLprmZ-mRxzDNgWFLDNdO1qLmSd6M1N5Iro1lGX_yHDmGJ-aGZUsoIXWphMsVW6s_nReyaQ-wniMeGs-aUYnNKsTml2Kwp5pbnZ-OlndDdNvyNLQMvzwAkC2MXwds-_eO04VyXdeaerdyQcrC3eimFFqzSWX-96u003D3Wb47YvZE</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Mindell, J S</creator><creator>Knott, C S</creator><creator>Ng Fat, L S</creator><creator>Roth, M A</creator><creator>Manor, O</creator><creator>Soskolne, V</creator><creator>Daoud, N</creator><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>20141201</creationdate><title>Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England</title><author>Mindell, J S ; Knott, C S ; Ng Fat, L S ; Roth, M A ; Manor, O ; Soskolne, V ; Daoud, N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b560t-4a0522d4657d3c9227b9c9eceed37a8cfb0244b3c790ca7c0dd36cb78d390c7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Behavior modeling</topic><topic>Biological and medical sciences</topic><topic>Cigarette smoking</topic><topic>Community health</topic><topic>Demography</topic><topic>England</topic><topic>Ethnic Groups</topic><topic>Female</topic><topic>General aspects</topic><topic>Health behavior</topic><topic>Health Behavior - ethnology</topic><topic>Health care inequality</topic><topic>Health disparities</topic><topic>Health Status Disparities</topic><topic>Health Surveys</topic><topic>Households</topic><topic>Humans</topic><topic>Interviews</topic><topic>Interviews as Topic</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Men</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Population</topic><topic>Public health</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Qualitative research</topic><topic>Sex Factors</topic><topic>Social capital</topic><topic>Social inequalities in health</topic><topic>Social support</topic><topic>Socioeconomic factors</topic><topic>Socioeconomics</topic><topic>Studies</topic><topic>White people</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mindell, J S</creatorcontrib><creatorcontrib>Knott, C S</creatorcontrib><creatorcontrib>Ng Fat, L S</creatorcontrib><creatorcontrib>Roth, M A</creatorcontrib><creatorcontrib>Manor, O</creatorcontrib><creatorcontrib>Soskolne, V</creatorcontrib><creatorcontrib>Daoud, N</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Journal of epidemiology and community health (1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mindell, J S</au><au>Knott, C S</au><au>Ng Fat, L S</au><au>Roth, M A</au><au>Manor, O</au><au>Soskolne, V</au><au>Daoud, N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England</atitle><jtitle>Journal of epidemiology and community health (1979)</jtitle><addtitle>J Epidemiol Community Health</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>68</volume><issue>12</issue><spage>1133</spage><epage>1144</epage><pages>1133-1144</pages><issn>0143-005X</issn><eissn>1470-2738</eissn><coden>JECHDR</coden><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.</abstract><cop>London</cop><pub>BMJ Publishing Group</pub><pmid>25096809</pmid><doi>10.1136/jech-2014-203927</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of epidemiology and community health (1979), 2014-12, Vol.68 (12), p.1133-1144 |
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| subjects | Adult Aged Behavior modeling Biological and medical sciences Cigarette smoking Community health Demography England Ethnic Groups Female General aspects Health behavior Health Behavior - ethnology Health care inequality Health disparities Health Status Disparities Health Surveys Households Humans Interviews Interviews as Topic Male Medical sciences Men Middle Aged Miscellaneous Population Public health Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative research Sex Factors Social capital Social inequalities in health Social support Socioeconomic factors Socioeconomics Studies White people Young Adult |
| title | Explanatory factors for health inequalities across different ethnic and gender groups: data from a national survey in England |
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