TY - JOUR
T1 - Quality of ethnicity data within Scottish health records and implications of misclassification for ethnic inequalities in severe COVID-19
T2 - a national linked data study
AU - Amele, Sarah
AU - McCabe, Ronan
AU - Kibuchi, Eliud
AU - Pearce, Anna
AU - Hainey, Kirsten
AU - Demou, Evangelia
AU - Irizar, Patricia
AU - Kapadia, Dharmi
AU - Taylor, Harry
AU - Nazroo, James
AU - Bécares, Laia
AU - Buchanan, Duncan
AU - Henery, Paul
AU - Jayacodi, Sandra
AU - Woolford, Lana
AU - Simpson, Colin R
AU - Sheikh, Aziz
AU - Jeffrey, Karen
AU - Shi, Ting
AU - Daines, Luke
AU - Tibble, Holly
AU - Almaghrabi, Fatima
AU - Fagbamigbe, Adeniyi Francis
AU - Kurdi, Amanj
AU - Robertson, Chris
AU - Pattaro, Serena
AU - Katikireddi, Srinivasa Vittal
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of Faculty of Public Health.
Funding Information:
SA, RM, EK, AP, KH, ED & SVK acknowledge funding from the Medical Research Council (MC_UU_00022/2 & MC_ST_00022) and the Scottish Government Chief Scientist Office (SPHSU17). SVK also acknowledges funding from a National Records of Scotland Senior Clinical Fellowship (SCAF/15/02).
Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of Faculty of Public Health.
PY - 2024/2/23
Y1 - 2024/2/23
N2 - BACKGROUND: We compared the quality of ethnicity coding within the Public Health Scotland Ethnicity Look-up (PHS-EL) dataset, and other National Health Service datasets, with the 2011 Scottish Census.METHODS: Measures of quality included the level of missingness and misclassification. We examined the impact of misclassification using Cox proportional hazards to compare the risk of severe coronavirus disease (COVID-19) (hospitalization & death) by ethnic group.RESULTS: Misclassification within PHS-EL was higher for all minority ethnic groups [12.5 to 69.1%] compared with the White Scottish majority [5.1%] and highest in the White Gypsy/Traveller group [69.1%]. Missingness in PHS-EL was highest among the White Other British group [39%] and lowest among the Pakistani group [17%]. PHS-EL data often underestimated severe COVID-19 risk compared with Census data. e.g. in the White Gypsy/Traveller group the Hazard Ratio (HR) was 1.68 [95% Confidence Intervals (CI): 1.03, 2.74] compared with the White Scottish majority using Census ethnicity data and 0.73 [95% CI: 0.10, 5.15] using PHS-EL data; and HR was 2.03 [95% CI: 1.20, 3.44] in the Census for the Bangladeshi group versus 1.45 [95% CI: 0.75, 2.78] in PHS-EL.CONCLUSIONS: Poor quality ethnicity coding in health records can bias estimates, thereby threatening monitoring and understanding ethnic inequalities in health.
AB - BACKGROUND: We compared the quality of ethnicity coding within the Public Health Scotland Ethnicity Look-up (PHS-EL) dataset, and other National Health Service datasets, with the 2011 Scottish Census.METHODS: Measures of quality included the level of missingness and misclassification. We examined the impact of misclassification using Cox proportional hazards to compare the risk of severe coronavirus disease (COVID-19) (hospitalization & death) by ethnic group.RESULTS: Misclassification within PHS-EL was higher for all minority ethnic groups [12.5 to 69.1%] compared with the White Scottish majority [5.1%] and highest in the White Gypsy/Traveller group [69.1%]. Missingness in PHS-EL was highest among the White Other British group [39%] and lowest among the Pakistani group [17%]. PHS-EL data often underestimated severe COVID-19 risk compared with Census data. e.g. in the White Gypsy/Traveller group the Hazard Ratio (HR) was 1.68 [95% Confidence Intervals (CI): 1.03, 2.74] compared with the White Scottish majority using Census ethnicity data and 0.73 [95% CI: 0.10, 5.15] using PHS-EL data; and HR was 2.03 [95% CI: 1.20, 3.44] in the Census for the Bangladeshi group versus 1.45 [95% CI: 0.75, 2.78] in PHS-EL.CONCLUSIONS: Poor quality ethnicity coding in health records can bias estimates, thereby threatening monitoring and understanding ethnic inequalities in health.
KW - Humans
KW - Ethnicity
KW - State Medicine
KW - Semantic Web
KW - COVID-19
KW - Scotland/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85186480194&partnerID=8YFLogxK
U2 - 10.1093/pubmed/fdad196
DO - 10.1093/pubmed/fdad196
M3 - Article
C2 - 37861114
SN - 1741-3842
VL - 46
SP - 116
EP - 122
JO - Journal of public health
JF - Journal of public health
IS - 1
ER -