Associations between multiple long-term conditions and mortality in diverse ethnic groups

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Multiple health conditions disproportionately affect ethnic minority groups, leading to higher mortality rates.
• Existing research on differential mortality is primarily US-based, necessitating studies in other regions like England.

Purpose of the Study:

• To investigate if the association between multiple health conditions and mortality differs across ethnic groups in England.
• To address the gap in understanding ethnic variations in mortality risk once conditions are established.

Main Methods:

• A cohort of 532,059 primary care patients in England was followed from 2015 to 2019.
• Mortality was analyzed using Cox regression models, examining the interaction between the number of long-term conditions (from a list of 32) and ethnicity, adjusted for age and sex.
• Ethnicity data was sourced from primary care or hospital records.

Main Results:

• An increased number of long-term conditions was associated with higher mortality.
• The association between multiple conditions and mortality was significantly greater in Pakistani, Black African, Black Caribbean, and Other Black ethnic groups compared to White ethnicity.
• For individuals aged 50, the mortality rate per additional condition was substantially higher in Black Caribbean (1.43) and Other Black (1.78) groups than in the White ethnicity group (1.33).

Conclusions:

• The mortality risk associated with multiple chronic conditions is elevated in ethnic minority groups compared to White populations in England.
• Further research is required to identify the underlying factors contributing to these health inequalities.
• Targeted clinical and self-management support for individuals with multiple conditions from ethnic minority backgrounds may help reduce disparities.