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Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers

Winifred Ekezie, Christopher A. Martin, Rebecca F. Baggaley, Lucy Teece, Joshua Nazareth, Daniel Pan, Shirley Sze, Luke Bryant, Katherine Woolf, Laura J. Gray, Kamlesh Khunti, Manish Pareek Orcid Logo, Laura Nellums, Anna L. Guyatt, Catherine John, I Chris McManus, Ibrahim Abubakar, Amit Gupta, Keith R. Abrams, Martin D. Tobin, Louise Wain, Sue Carr, Edward Dove, David Ford Orcid Logo, Robert Free, (on behalf of the UK-REACH study collaborative group)

BMC Medicine, Volume: 21, Issue: 1

Swansea University Author: David Ford Orcid Logo

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DOI (Published version): 10.1186/s12916-023-03109-w

Abstract

BackgroundHealthcare workers’ (HCW) well-being has a direct effect on patient care. However, little is known about the prevalence and patterns of long-term medical conditions in HCWs, especially those from ethnic minorities. This study evaluated the burden of multiple long-term conditions (MLTCs), i...

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Published in: BMC Medicine
ISSN: 1741-7015
Published: Springer Science and Business Media LLC 2023
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>66409</id><entry>2024-05-14</entry><title>Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers</title><swanseaauthors><author><sid>52fc0c473b0da1b7218d87f9fc68a3e6</sid><ORCID>0000-0001-6551-721X</ORCID><firstname>David</firstname><surname>Ford</surname><name>David Ford</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-05-14</date><deptcode>MEDS</deptcode><abstract>BackgroundHealthcare workers’ (HCW) well-being has a direct effect on patient care. However, little is known about the prevalence and patterns of long-term medical conditions in HCWs, especially those from ethnic minorities. This study evaluated the burden of multiple long-term conditions (MLTCs), i.e. the presence of two or more single long-term conditions (LTCs), among HCWs in the United Kingdom (UK) and variation by ethnicity and migration status.MethodsWe used baseline data from the UK-REACH cohort study collected December 2020–March 2021. We used multivariable logistic regression, adjusting for demographic, occupational and lifestyle factors to examine the relationship between self-reported LTCs/MLTCs and ethnicity, migration status and time since migration to the UK.ResultsOf 12,100 included HCWs, with a median age of 45 years (IQR: 34–54), 27% were overseas-born, and 30% were from non-White ethnic groups (19% Asian, 4% Black, 4% Mixed, 2% Other). The most common self-reported LTCs were anxiety (14.9%), asthma (12.2%), depression (10.7%), hypertension (8.7%) and diabetes (4.0%). Mental health conditions were more prevalent among UK-born than overseas-born HCWs for all ethnic groups (adjusted odds ratio (aOR) using White UK-born as the reference group each time: White overseas-born 0.77, 95%CI 0.66–0.95 for anxiety). Diabetes and hypertension were more common among Asian (e.g. Asian overseas, diabetes aOR 2.97, 95%CI 2.30–3.83) and Black (e.g. Black UK-born, hypertension aOR 1.77, 95%CI 1.05–2.99) groups than White UK-born. After adjustment for age, sex and deprivation, the odds of reporting MLTCs were lower in most ethnic minority groups and lowest for those born overseas, compared to White UK-born (e.g. White overseas-born, aOR 0.68, 95%CI 0.55–0.83; Asian overseas-born aOR 0.75, 95%CI 0.62–0.90; Black overseas-born aOR 0.52, 95%CI 0.36–0.74). The odds of MLTCs in overseas-born HCWs were equivalent to the UK-born population in those who had settled in the UK for ≥ 20 years (aOR 1.14, 95%CI 0.94–1.37).ConclusionsAmong UK HCWs, the prevalence of common LTCs and odds of reporting MLTCs varied by ethnicity and migrant status. The lower odds of MLTCs in migrant HCWs reverted to the odds of MLTCs in UK-born HCWs over time. Further research on this population should include longitudinal studies with linkage to healthcare records. Interventions should be co-developed with HCWs from different ethnic and migrant groups focussed upon patterns of conditions prevalent in specific HCW subgroups to reduce the overall burden of LTCs/MLTCs.</abstract><type>Journal Article</type><journal>BMC Medicine</journal><volume>21</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1741-7015</issnElectronic><keywords>Ethnic minorities, Migrants, Morbidity, Multiple chronic conditions, Multimorbidity, Comorbidity,Healthcare workers, United Kingdom</keywords><publishedDay>30</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-11-30</publishedDate><doi>10.1186/s12916-023-03109-w</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>UK-REACH is supported by a grant from the MRC-UK Research and Innovation (MR/V027549/1) and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. WE, RFB, KK, LJG and MP were supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and Leicester NIHR Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.</funders><projectreference/><lastEdited>2024-06-19T13:16:36.0755894</lastEdited><Created>2024-05-14T10:35:31.7679156</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Winifred</firstname><surname>Ekezie</surname><order>1</order></author><author><firstname>Christopher A.</firstname><surname>Martin</surname><order>2</order></author><author><firstname>Rebecca F.</firstname><surname>Baggaley</surname><order>3</order></author><author><firstname>Lucy</firstname><surname>Teece</surname><order>4</order></author><author><firstname>Joshua</firstname><surname>Nazareth</surname><order>5</order></author><author><firstname>Daniel</firstname><surname>Pan</surname><order>6</order></author><author><firstname>Shirley</firstname><surname>Sze</surname><order>7</order></author><author><firstname>Luke</firstname><surname>Bryant</surname><order>8</order></author><author><firstname>Katherine</firstname><surname>Woolf</surname><order>9</order></author><author><firstname>Laura J.</firstname><surname>Gray</surname><order>10</order></author><author><firstname>Kamlesh</firstname><surname>Khunti</surname><order>11</order></author><author><firstname>Manish</firstname><surname>Pareek</surname><orcid>0000-0003-1521-9964</orcid><order>12</order></author><author><firstname>Laura</firstname><surname>Nellums</surname><order>13</order></author><author><firstname>Anna L.</firstname><surname>Guyatt</surname><order>14</order></author><author><firstname>Catherine</firstname><surname>John</surname><order>15</order></author><author><firstname>I Chris</firstname><surname>McManus</surname><order>16</order></author><author><firstname>Ibrahim</firstname><surname>Abubakar</surname><order>17</order></author><author><firstname>Amit</firstname><surname>Gupta</surname><order>18</order></author><author><firstname>Keith R.</firstname><surname>Abrams</surname><order>19</order></author><author><firstname>Martin D.</firstname><surname>Tobin</surname><order>20</order></author><author><firstname>Louise</firstname><surname>Wain</surname><order>21</order></author><author><firstname>Sue</firstname><surname>Carr</surname><order>22</order></author><author><firstname>Edward</firstname><surname>Dove</surname><order>23</order></author><author><firstname>David</firstname><surname>Ford</surname><orcid>0000-0001-6551-721X</orcid><order>24</order></author><author><firstname>Robert</firstname><surname>Free</surname><order>25</order></author><author><firstname>(on behalf of the UK-REACH study collaborative</firstname><surname>group)</surname><order>26</order></author></authors><documents><document><filename>66409__30349__aab6e72b3e5045e0a1e915e49da7ff8f.pdf</filename><originalFilename>66409.pdf</originalFilename><uploaded>2024-05-14T10:37:51.1585829</uploaded><type>Output</type><contentLength>1401576</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is licensed under a Creative Commons Attribution 4.0 International License.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 66409 2024-05-14 Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers 52fc0c473b0da1b7218d87f9fc68a3e6 0000-0001-6551-721X David Ford David Ford true false 2024-05-14 MEDS BackgroundHealthcare workers’ (HCW) well-being has a direct effect on patient care. However, little is known about the prevalence and patterns of long-term medical conditions in HCWs, especially those from ethnic minorities. This study evaluated the burden of multiple long-term conditions (MLTCs), i.e. the presence of two or more single long-term conditions (LTCs), among HCWs in the United Kingdom (UK) and variation by ethnicity and migration status.MethodsWe used baseline data from the UK-REACH cohort study collected December 2020–March 2021. We used multivariable logistic regression, adjusting for demographic, occupational and lifestyle factors to examine the relationship between self-reported LTCs/MLTCs and ethnicity, migration status and time since migration to the UK.ResultsOf 12,100 included HCWs, with a median age of 45 years (IQR: 34–54), 27% were overseas-born, and 30% were from non-White ethnic groups (19% Asian, 4% Black, 4% Mixed, 2% Other). The most common self-reported LTCs were anxiety (14.9%), asthma (12.2%), depression (10.7%), hypertension (8.7%) and diabetes (4.0%). Mental health conditions were more prevalent among UK-born than overseas-born HCWs for all ethnic groups (adjusted odds ratio (aOR) using White UK-born as the reference group each time: White overseas-born 0.77, 95%CI 0.66–0.95 for anxiety). Diabetes and hypertension were more common among Asian (e.g. Asian overseas, diabetes aOR 2.97, 95%CI 2.30–3.83) and Black (e.g. Black UK-born, hypertension aOR 1.77, 95%CI 1.05–2.99) groups than White UK-born. After adjustment for age, sex and deprivation, the odds of reporting MLTCs were lower in most ethnic minority groups and lowest for those born overseas, compared to White UK-born (e.g. White overseas-born, aOR 0.68, 95%CI 0.55–0.83; Asian overseas-born aOR 0.75, 95%CI 0.62–0.90; Black overseas-born aOR 0.52, 95%CI 0.36–0.74). The odds of MLTCs in overseas-born HCWs were equivalent to the UK-born population in those who had settled in the UK for ≥ 20 years (aOR 1.14, 95%CI 0.94–1.37).ConclusionsAmong UK HCWs, the prevalence of common LTCs and odds of reporting MLTCs varied by ethnicity and migrant status. The lower odds of MLTCs in migrant HCWs reverted to the odds of MLTCs in UK-born HCWs over time. Further research on this population should include longitudinal studies with linkage to healthcare records. Interventions should be co-developed with HCWs from different ethnic and migrant groups focussed upon patterns of conditions prevalent in specific HCW subgroups to reduce the overall burden of LTCs/MLTCs. Journal Article BMC Medicine 21 1 Springer Science and Business Media LLC 1741-7015 Ethnic minorities, Migrants, Morbidity, Multiple chronic conditions, Multimorbidity, Comorbidity,Healthcare workers, United Kingdom 30 11 2023 2023-11-30 10.1186/s12916-023-03109-w COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee UK-REACH is supported by a grant from the MRC-UK Research and Innovation (MR/V027549/1) and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19. WE, RFB, KK, LJG and MP were supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and Leicester NIHR Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. 2024-06-19T13:16:36.0755894 2024-05-14T10:35:31.7679156 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Winifred Ekezie 1 Christopher A. Martin 2 Rebecca F. Baggaley 3 Lucy Teece 4 Joshua Nazareth 5 Daniel Pan 6 Shirley Sze 7 Luke Bryant 8 Katherine Woolf 9 Laura J. Gray 10 Kamlesh Khunti 11 Manish Pareek 0000-0003-1521-9964 12 Laura Nellums 13 Anna L. Guyatt 14 Catherine John 15 I Chris McManus 16 Ibrahim Abubakar 17 Amit Gupta 18 Keith R. Abrams 19 Martin D. Tobin 20 Louise Wain 21 Sue Carr 22 Edward Dove 23 David Ford 0000-0001-6551-721X 24 Robert Free 25 (on behalf of the UK-REACH study collaborative group) 26 66409__30349__aab6e72b3e5045e0a1e915e49da7ff8f.pdf 66409.pdf 2024-05-14T10:37:51.1585829 Output 1401576 application/pdf Version of Record true This article is licensed under a Creative Commons Attribution 4.0 International License. true eng https://creativecommons.org/licenses/by/4.0/
title Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers
spellingShingle Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers
David Ford
title_short Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers
title_full Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers
title_fullStr Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers
title_full_unstemmed Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers
title_sort Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers
author_id_str_mv 52fc0c473b0da1b7218d87f9fc68a3e6
author_id_fullname_str_mv 52fc0c473b0da1b7218d87f9fc68a3e6_***_David Ford
author David Ford
author2 Winifred Ekezie
Christopher A. Martin
Rebecca F. Baggaley
Lucy Teece
Joshua Nazareth
Daniel Pan
Shirley Sze
Luke Bryant
Katherine Woolf
Laura J. Gray
Kamlesh Khunti
Manish Pareek
Laura Nellums
Anna L. Guyatt
Catherine John
I Chris McManus
Ibrahim Abubakar
Amit Gupta
Keith R. Abrams
Martin D. Tobin
Louise Wain
Sue Carr
Edward Dove
David Ford
Robert Free
(on behalf of the UK-REACH study collaborative group)
format Journal article
container_title BMC Medicine
container_volume 21
container_issue 1
publishDate 2023
institution Swansea University
issn 1741-7015
doi_str_mv 10.1186/s12916-023-03109-w
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description BackgroundHealthcare workers’ (HCW) well-being has a direct effect on patient care. However, little is known about the prevalence and patterns of long-term medical conditions in HCWs, especially those from ethnic minorities. This study evaluated the burden of multiple long-term conditions (MLTCs), i.e. the presence of two or more single long-term conditions (LTCs), among HCWs in the United Kingdom (UK) and variation by ethnicity and migration status.MethodsWe used baseline data from the UK-REACH cohort study collected December 2020–March 2021. We used multivariable logistic regression, adjusting for demographic, occupational and lifestyle factors to examine the relationship between self-reported LTCs/MLTCs and ethnicity, migration status and time since migration to the UK.ResultsOf 12,100 included HCWs, with a median age of 45 years (IQR: 34–54), 27% were overseas-born, and 30% were from non-White ethnic groups (19% Asian, 4% Black, 4% Mixed, 2% Other). The most common self-reported LTCs were anxiety (14.9%), asthma (12.2%), depression (10.7%), hypertension (8.7%) and diabetes (4.0%). Mental health conditions were more prevalent among UK-born than overseas-born HCWs for all ethnic groups (adjusted odds ratio (aOR) using White UK-born as the reference group each time: White overseas-born 0.77, 95%CI 0.66–0.95 for anxiety). Diabetes and hypertension were more common among Asian (e.g. Asian overseas, diabetes aOR 2.97, 95%CI 2.30–3.83) and Black (e.g. Black UK-born, hypertension aOR 1.77, 95%CI 1.05–2.99) groups than White UK-born. After adjustment for age, sex and deprivation, the odds of reporting MLTCs were lower in most ethnic minority groups and lowest for those born overseas, compared to White UK-born (e.g. White overseas-born, aOR 0.68, 95%CI 0.55–0.83; Asian overseas-born aOR 0.75, 95%CI 0.62–0.90; Black overseas-born aOR 0.52, 95%CI 0.36–0.74). The odds of MLTCs in overseas-born HCWs were equivalent to the UK-born population in those who had settled in the UK for ≥ 20 years (aOR 1.14, 95%CI 0.94–1.37).ConclusionsAmong UK HCWs, the prevalence of common LTCs and odds of reporting MLTCs varied by ethnicity and migrant status. The lower odds of MLTCs in migrant HCWs reverted to the odds of MLTCs in UK-born HCWs over time. Further research on this population should include longitudinal studies with linkage to healthcare records. Interventions should be co-developed with HCWs from different ethnic and migrant groups focussed upon patterns of conditions prevalent in specific HCW subgroups to reduce the overall burden of LTCs/MLTCs.
published_date 2023-11-30T13:16:35Z
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