Ethnic inequities in multimorbidity among people with psychosis: a retrospective cohort study

Fonseca de Freitas, D., Pritchard, M., Shetty, H., Khondoker, M. ORCID: https://orcid.org/0000-0002-1801-1635, Nazroo, J., Hayes, R. D. and Bhui, K. (2022) Ethnic inequities in multimorbidity among people with psychosis: a retrospective cohort study. Epidemiology and Psychiatric Sciences, 31. ISSN 2045-7960

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Abstract

Aims: Research shows persistent ethnic inequities in mental health experiences and outcomes, with a higher incidence of illnesses among minoritised ethnic groups. People with psychosis have an increased risk of multiple long-term conditions (MLTC; multimorbidity). However, there is limited research regarding ethnic inequities in multimorbidity in people with psychosis. This study investigates ethnic inequities in physical health multimorbidity in a cohort of people with psychosis. Methods: In this retrospective cohort study, using the Clinical Records Interactive Search (CRIS) system, we identified service-users of the South London and Maudsley NHS Trust with a schizophrenia spectrum disorder, and then additional diagnoses of diabetes, hypertension, low blood pressure, overweight or obesity and rheumatoid arthritis. Logistic and multinomial logistic regressions were used to investigate ethnic inequities in odds of multimorbidity (psychosis plus one physical health condition), and multimorbidity severity (having one or two physical health conditions, or three or more conditions), compared with no additional health conditions (no multimorbidity), respectively. The regression models adjusted for age and duration of care and investigated the influence of gender and area-level deprivation. Results: On a sample of 20 800 service-users with psychosis, aged 13–65, ethnic differences were observed in the odds for multimorbidity. Controlling for sociodemographic factors and duration of care, compared to White British people, higher odds of multimorbidity were found for people of Black African [adjusted Odds Ratio = 1.41, 95% Confidence Intervals (1.23–1.56)], Black Caribbean [aOR = 1.79, 95% CI (1.58–2.03)] and Black British [aOR = 1.64, 95% CI (1.49–1.81)] ethnicity. Reduced odds were observed among people of Chinese [aOR = 0.61, 95% CI (0.43–0.88)] and Other ethnic [aOR = 0.67, 95% CI (0.59–0.76)] backgrounds. Increased odds of severe multimorbidity (three or more physical health conditions) were also observed for people of any Black background. Conclusions: Ethnic inequities are observed for multimorbidity among people with psychosis. Further research is needed to understand the aetiology and impact of these inequities. These findings support the provision of integrated health care interventions and public health preventive policies and actions.

Item Type: Article
Additional Information: Data availability: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to the Information Governance framework and Research Ethics Committee approval in place concerning CRIS data use. Financial support This work utilised the Clinical Record Interactive Search (CRIS) platform, funded and developed by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. Additionally, this work was supported by the Lankelly Chase Foundation, which funded the work of the Synergi Collaborative Centre (a 5-year national initiative to build a knowledge hub on ethnic inequities and multiple disadvantages in severe mental illness in the UK). The funders of the study had no role in study design, data collection, data analysis, data interpretation, writing of the manuscript or in the decision to submit it for publication.
Uncontrolled Keywords: comorbidity,ethnic disparities,ethnic inequalities,ethnicity,multimorbidity,schizophrenia,epidemiology,public health, environmental and occupational health,psychiatry and mental health ,/dk/atira/pure/subjectarea/asjc/2700/2713
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 25 Jul 2022 09:30
Last Modified: 13 Aug 2022 02:26
URI: https://ueaeprints.uea.ac.uk/id/eprint/86839
DOI: 10.1017/S2045796022000385

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