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Published on: April 15, 2009
Ethnic Representation, Deprivation and Seizure Outcomes in a UK Tertiary Epilepsy Clinic
Natasha S Carmichael1, Lana Yh Lai2, Md Shadab Mashuk3
1Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
Background:
Ethnic disparities in healthcare access are well-documented, but their impact on epilepsy outcomes in the UK remains unclear. We examined ethnic representation and seizure outcomes in a tertiary epilepsy clinic.
Methods:
Retrospective analysis of 1,609 adults attending Manchester Centre for Clinical Neurosciences (2020-2024). Ethnic distribution was compared with census data. Logistic regression assessed associations between ethnicity and seizure freedom, adjusting for age, sex, and deprivation.
Results:
Asian (6.4 %), Black (1.4 %), and Mixed (1.7 %) patients were underrepresented compared to Greater Manchester demographics (13.6 %, 4.0 %, 3.0 % respectively; all p < 0.001), and ethnic minorities were disproportionately from deprived areas. Overall, 24.4 % achieved seizure freedom. Descriptive rates varied (Black 17.4 %, Asian 17.5 %, White 24.2 %, Mixed 36.4 %), but ethnicity was not independently associated with seizure freedom (Others vs White: OR 1.17, 95 % CI 0.84-1.62, p = 0.36).
Conclusions:
Ethnic minorities are underrepresented in this tertiary epilepsy clinic yet achieve comparable outcomes once engaged in care, indicating disparities in access rather than treatment quality. Culturally competent care delivery, community outreach, and systematic review of referral pathways are needed to ensure equitable access to specialist services.
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