2023-08-02 エディンバラ大学
◆調査結果は、民族間の不平等がいつどの段階で発生するかを理解し、今後の対策に活用できると研究者は述べている。研究チームはスコットランドの症例を分析し、白人ジプシー/トラベラーやパキスタン人が重症のCovid-19リスクが高いことを確認した。ただし、入院後の死亡リスクには民族間の違いは見られなかったとの結果も示された。研究には多くの国内外の大学や機関が参加している。
<関連情報>
- https://www.ed.ac.uk/news/2023/covid-risk-study-pinpoints-ethnic-inequalities
- https://jech.bmj.com/content/early/2023/07/26/jech-2023-220501
SARS-CoV-2陽性、感染予後、COVID-19入院、死亡における民族的不平等:スコットランドにおける2年間の記録連動全国コホート研究の分析 Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations and deaths: analysis of 2 years of a record linked national cohort study in Scotland
Sarah Amele,Eliud Kibuchi,Ronan McCabe,Anna Pearce,Paul Henery,Kirsten Hainey,Adeniyi Francis Fagbamigbe,Amanj Kurdi,Colin McCowan,Colin R Simpson,Chris Dibben,Duncan Buchanan,Evangelia Demou,Fatima Almaghrabi,Gina Anghelescu,Harry Taylor,Holly Tibble,Igor Rudan,James Nazroo,Laia Bécares,Luke Daines,Patricia Irizar,Sandra Jayacodi,Serena Pattaro,Aziz Sheikh,Srinivasa Vittal Katikireddi
Journal of Epidemiology & Community Health Published July 31, 2023
DOI:10.1136/jech-2023-220501
Abstract
Background This study aims to estimate ethnic inequalities in risk for positive SARS-CoV-2 tests, COVID-19 hospitalisations and deaths over time in Scotland.
Methods We conducted a population-based cohort study where the 2011 Scottish Census was linked to health records. We included all individuals≥16 years living in Scotland on 1 March 2020. The study period was from 1 March 2020 to 17 April 2022. Self-reported ethnic group was taken from the census and Cox proportional hazard models estimated HRs for positive SARS-CoV-2 tests, hospitalisations and deaths, adjusted for age, sex and health board. We also conducted separate analyses for each of the four waves of COVID-19 to assess changes in risk over time.
Findings Of the 4 358 339 individuals analysed, 1 093 234 positive SARS-CoV-2 tests, 37 437 hospitalisations and 14 158 deaths occurred. The risk of COVID-19 hospitalisation or death among ethnic minority groups was often higher for White Gypsy/Traveller (HR 2.21, 95% CI (1.61 to 3.06)) and Pakistani 2.09 (1.90 to 2.29) groups compared with the white Scottish group. The risk of COVID-19 hospitalisation or death following confirmed positive SARS-CoV-2 test was particularly higher for White Gypsy/Traveller 2.55 (1.81–3.58), Pakistani 1.75 (1.59–1.73) and African 1.61 (1.28–2.03) individuals relative to white Scottish individuals. However, the risk of COVID-19-related death following hospitalisation did not differ. The risk of COVID-19 outcomes for ethnic minority groups was higher in the first three waves compared with the fourth wave.
Interpretation Most ethnic minority groups were at increased risk of adverse COVID-19 outcomes in Scotland, especially White Gypsy/Traveller and Pakistani groups. Ethnic inequalities persisted following community infection but not following hospitalisation, suggesting differences in hospital treatment did not substantially contribute to ethnic inequalities.
