TY - JOUR
T1 - Ethnic variations in falls and road traffic injuries resulting in hospitalisation or death in Scotland
T2 - the Scottish Health and Ethnicity Linkage Study
AU - Cézard, G.
AU - Gruer, L.
AU - Steiner, M.
AU - Douglas, A.
AU - Davis, C.
AU - Buchanan, D.
AU - Katikireddi, S.V.
AU - Millard, A.
AU - Sheikh, A.
AU - Bhopal, R.
N1 - The authors thank the Chief Scientist Office for a grant (CZH/4/878), NHS Health Scotland for a supplementary grant (no number), and Information Services Division (ISD) of NHS National Services Scotland and National Records of Scotland for in-house technical support. S.V.K. acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15) and Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). A.S. is supported by the Farr Institute and Health Data Research UK.
PY - 2020/5
Y1 - 2020/5
N2 - ObjectivesTo investigate ethnic differences in falls and road traffic injuries (RTIs) in Scotland.Study designA
retrospective cohort of 4.62 million people, linking the Scottish
Census 2001, with self-reported ethnicity, to hospitalisation and death
records for 2001–2013.MethodsWe
selected cases with International Classification of Diseases–10
diagnostic codes for falls and RTIs. Using Poisson regression,
age-adjusted risk ratios (RRs, multiplied by 100 as percentages) and 95%
confidence intervals (CIs) were calculated by sex for 10 ethnic groups
with the White Scottish as reference. We further adjusted for country of
birth and socio-economic status (SES).ResultsDuring
about 49 million person-years, there were 275,995 hospitalisations or
deaths from fall-related injuries and 43,875 from RTIs. Compared with
the White Scottish, RRs for falls were higher in most White and Mixed
groups, e.g., White Irish males (RR: 131; 95% CI: 122–140) and Mixed
females (126; 112–143), but lower in Pakistani males (72; 64–81) and
females (72; 63–82) and African females (79; 63–99). For RTIs, RRs were
higher in other White British males (161; 147–176) and females (156;
138–176) and other White males (119; 104–137) and females (143; 121–169)
and lower in Pakistani females (74; 57–98). The ethnic variations
differed by road user type, with few cases among non-White motorcyclists
and non-White female cyclists. The RRs were minimally altered by
adjustment for country of birth or SES.ConclusionWe
found important ethnic variations in injuries owing to falls and RTIs,
with generally lower risks in non-White groups. Culturally related
differences in behaviour offer the most plausible explanation, including
variations in alcohol use. The findings do not point to the need for
new interventions in Scotland at present. However, as the ethnic mix of
each country is unique, other countries could benefit from similar data
linkage-based research.
AB - ObjectivesTo investigate ethnic differences in falls and road traffic injuries (RTIs) in Scotland.Study designA
retrospective cohort of 4.62 million people, linking the Scottish
Census 2001, with self-reported ethnicity, to hospitalisation and death
records for 2001–2013.MethodsWe
selected cases with International Classification of Diseases–10
diagnostic codes for falls and RTIs. Using Poisson regression,
age-adjusted risk ratios (RRs, multiplied by 100 as percentages) and 95%
confidence intervals (CIs) were calculated by sex for 10 ethnic groups
with the White Scottish as reference. We further adjusted for country of
birth and socio-economic status (SES).ResultsDuring
about 49 million person-years, there were 275,995 hospitalisations or
deaths from fall-related injuries and 43,875 from RTIs. Compared with
the White Scottish, RRs for falls were higher in most White and Mixed
groups, e.g., White Irish males (RR: 131; 95% CI: 122–140) and Mixed
females (126; 112–143), but lower in Pakistani males (72; 64–81) and
females (72; 63–82) and African females (79; 63–99). For RTIs, RRs were
higher in other White British males (161; 147–176) and females (156;
138–176) and other White males (119; 104–137) and females (143; 121–169)
and lower in Pakistani females (74; 57–98). The ethnic variations
differed by road user type, with few cases among non-White motorcyclists
and non-White female cyclists. The RRs were minimally altered by
adjustment for country of birth or SES.ConclusionWe
found important ethnic variations in injuries owing to falls and RTIs,
with generally lower risks in non-White groups. Culturally related
differences in behaviour offer the most plausible explanation, including
variations in alcohol use. The findings do not point to the need for
new interventions in Scotland at present. However, as the ethnic mix of
each country is unique, other countries could benefit from similar data
linkage-based research.
KW - Ethnicity
KW - Accidents
KW - Falls
KW - Road traffic injuries
KW - Scotland
U2 - 10.1016/j.puhe.2020.01.013
DO - 10.1016/j.puhe.2020.01.013
M3 - Article
SN - 0033-3506
VL - 182
SP - 32
EP - 38
JO - Public Health
JF - Public Health
ER -
