Genevieve Cezard , University of St Andrews
Nissa Finney, University of St Andrews
Hill Kulu, University of St Andrews
Alan D. Marshall, University of Edinburgh
Background: In Scotland, studies using indicators of general health, such as self-assessed health and mortality have shown diverging ethnic patterns. In particular, poorer reported health was found along with lower mortality in the Pakistani population. We analyse ethnic differences in hospitalisation-based multimorbidity, thus offering an objective measure of morbidity in order to improve our understanding of ethnic inequalities in health in Scotland and the Pakistani morbidity-mortality paradox. Methods: We use the Scottish Health and Ethnicity Linkage Study, linking the 2001 Scottish Census data for 4.6 million people to their hospitalisation records. The census includes self-declared ethnicity and a range of socio-demographic information. A multimorbidity indicator (two comorbidities or more) is created based on hospitalisation records and the 17 comorbidities of the Charlson index. Ethnic differences in multimorbidity are assessed using Poisson regression models to calculate age-adjusted relative risks by ethnicity. Results: The analysis shows lower risks of multimorbidity in Other White British, Other White and Chinese populations and higher risks in the Pakistani population compared to the White Scottish majority population. These differences persist when accounting for socio-economic status and migrant generations. Further analyses reveal that the Pakistani population had higher risks of hospitalisations due to cardiovascular disease, stroke, diabetes, renal disease, and respiratory disease, but lower risks due to cancer and dementia. Conclusion: The analysis of multimorbidity confirms a morbidity disadvantage in the Pakistani population of Scotland, supporting a morbidity-mortality paradox. Further research is warranted to understand why the Pakistani population seems to survive longer with higher morbidity.
Presented in Session P2. Poster Session Ageing, Health and Mortality