Ethnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in England
<p><strong>Background:</strong><br /> Ethnic minorities have experienced disproportionate COVID-19 mortality rates in the UK and many other countries. We compared the differences in the risk of COVID-19 related death between ethnic groups in the first and second waves the of...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Working paper |
| Language: | English |
| Published: |
Cold Spring Harbor Laboratory
2021
|
| _version_ | 1826286319763980288 |
|---|---|
| author | Nafilyan, V Islam, N Mathur, R Ayoubkhani, D Banerjee, A Glickman, M Humberstone, B Diamond, I Khunti, K |
| author_facet | Nafilyan, V Islam, N Mathur, R Ayoubkhani, D Banerjee, A Glickman, M Humberstone, B Diamond, I Khunti, K |
| author_sort | Nafilyan, V |
| collection | OXFORD |
| description | <p><strong>Background:</strong><br />
Ethnic minorities have experienced disproportionate COVID-19 mortality rates in the UK and many other countries. We compared the differences in the risk of COVID-19 related death between ethnic groups in the first and second waves the of COVID-19 pandemic in England. We also investigated whether the factors explaining differences in COVID-19 death between ethnic groups changed between the two waves.</p><br />
<p><strong>Methods:</strong><br />
Using data from the Office for National Statistics Public Health Data Asset on individuals aged 30-100 years living in private households, we conducted an observational cohort study to examine differences in the risk of death involving COVID-19 between ethnic groups in the first wave (from 24th January 2020 until 31st August 2020) and second wave (from 1st September to 28th December 2020). We estimated age-standardised mortality rates (ASMR) in the two waves stratified by ethnic groups and sex. We also estimated hazard ratios (HRs) for ethnic-minority groups compared with the White British population, adjusted for geographical factors, socio-demographic characteristics, and pre-pandemic health conditions.</p><br />
<p><strong>Results:</strong><br />
The study population included over 28.9 million individuals aged 30-100 years living in private households. In the first wave, all ethnic minority groups had a higher risk of COVID-19 related death compared to the White British population. In the second wave, the risk of COVID-19 death remained elevated for people from Pakistani (ASMR: 339.9 [95% CI: 303.7 – 376.2] and 166.8 [141.7 – 191.9] deaths per 100,000 population in men and women) and Bangladeshi (318.7 [247.4 – 390.1] and 127.1 [91.1 – 171.3] in men and women)background but not for people from Black ethnic groups. Adjustment for geographical factors explained a large proportion of the differences in COVID-19 mortality in the first wave but not in the second wave. Despite an attenuation of the elevated risk of COVID-19 mortality after adjusting for sociodemographic characteristics and health status, the risk was substantially higher in people from Bangladeshi and Pakistani background in both the first and the second waves.</p><br />
<p><strong>Conclusion:</strong><br />
Between the first and second waves of the pandemic, the reduction in the difference in COVID-19 mortality between people from Black ethnic background and people from the White British group shows that ethnic inequalities in COVID-19 mortality can be addressed. The continued higher rate of mortality in people from Bangladeshi and Pakistani background is alarming and requires focused public health campaign and policy changes.</p> |
| first_indexed | 2024-03-07T01:42:00Z |
| format | Working paper |
| id | oxford-uuid:973206df-7edb-42e2-a2be-151172db769a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:42:00Z |
| publishDate | 2021 |
| publisher | Cold Spring Harbor Laboratory |
| record_format | dspace |
| spelling | oxford-uuid:973206df-7edb-42e2-a2be-151172db769a2022-03-26T23:57:49ZEthnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in EnglandWorking paperhttp://purl.org/coar/resource_type/c_8042uuid:973206df-7edb-42e2-a2be-151172db769aEnglishSymplectic ElementsCold Spring Harbor Laboratory2021Nafilyan, VIslam, NMathur, RAyoubkhani, DBanerjee, AGlickman, MHumberstone, BDiamond, IKhunti, K<p><strong>Background:</strong><br /> Ethnic minorities have experienced disproportionate COVID-19 mortality rates in the UK and many other countries. We compared the differences in the risk of COVID-19 related death between ethnic groups in the first and second waves the of COVID-19 pandemic in England. We also investigated whether the factors explaining differences in COVID-19 death between ethnic groups changed between the two waves.</p><br /> <p><strong>Methods:</strong><br /> Using data from the Office for National Statistics Public Health Data Asset on individuals aged 30-100 years living in private households, we conducted an observational cohort study to examine differences in the risk of death involving COVID-19 between ethnic groups in the first wave (from 24th January 2020 until 31st August 2020) and second wave (from 1st September to 28th December 2020). We estimated age-standardised mortality rates (ASMR) in the two waves stratified by ethnic groups and sex. We also estimated hazard ratios (HRs) for ethnic-minority groups compared with the White British population, adjusted for geographical factors, socio-demographic characteristics, and pre-pandemic health conditions.</p><br /> <p><strong>Results:</strong><br /> The study population included over 28.9 million individuals aged 30-100 years living in private households. In the first wave, all ethnic minority groups had a higher risk of COVID-19 related death compared to the White British population. In the second wave, the risk of COVID-19 death remained elevated for people from Pakistani (ASMR: 339.9 [95% CI: 303.7 – 376.2] and 166.8 [141.7 – 191.9] deaths per 100,000 population in men and women) and Bangladeshi (318.7 [247.4 – 390.1] and 127.1 [91.1 – 171.3] in men and women)background but not for people from Black ethnic groups. Adjustment for geographical factors explained a large proportion of the differences in COVID-19 mortality in the first wave but not in the second wave. Despite an attenuation of the elevated risk of COVID-19 mortality after adjusting for sociodemographic characteristics and health status, the risk was substantially higher in people from Bangladeshi and Pakistani background in both the first and the second waves.</p><br /> <p><strong>Conclusion:</strong><br /> Between the first and second waves of the pandemic, the reduction in the difference in COVID-19 mortality between people from Black ethnic background and people from the White British group shows that ethnic inequalities in COVID-19 mortality can be addressed. The continued higher rate of mortality in people from Bangladeshi and Pakistani background is alarming and requires focused public health campaign and policy changes.</p> |
| spellingShingle | Nafilyan, V Islam, N Mathur, R Ayoubkhani, D Banerjee, A Glickman, M Humberstone, B Diamond, I Khunti, K Ethnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in England |
| title | Ethnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in England |
| title_full | Ethnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in England |
| title_fullStr | Ethnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in England |
| title_full_unstemmed | Ethnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in England |
| title_short | Ethnic differences in COVID-19 mortality during the first two waves of the coronavirus pandemic: A nationwide cohort study of 29 million adults in England |
| title_sort | ethnic differences in covid 19 mortality during the first two waves of the coronavirus pandemic a nationwide cohort study of 29 million adults in england |
| work_keys_str_mv | AT nafilyanv ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT islamn ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT mathurr ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT ayoubkhanid ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT banerjeea ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT glickmanm ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT humberstoneb ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT diamondi ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland AT khuntik ethnicdifferencesincovid19mortalityduringthefirsttwowavesofthecoronaviruspandemicanationwidecohortstudyof29millionadultsinengland |