Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers.
Association between ethnicity and migration status with the prevalence of single and multiple long-term conditions in UK healthcare workers.
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DOI：
10.1186/s12916-023-03109-w
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发表时间：
2023-11-30
期刊：
影响因子：
9.3
通讯作者：
Pareek, Manish
中科院分区：
文献类型：
--
作者：
Ekezie, Winifred;Martin, Christopher A.;Baggaley, Rebecca F.;Teece, Lucy;Nazareth, Joshua;Pan, Daniel;Sze, Shirley;Bryant, Luke;Woolf, Katherine;Gray, Laura J.;Khunti, Kamlesh;Pareek, Manish
关键词：
医护人员（HCW）的健康状况对患者护理有直接影响。然而，对卫生保健工作者，特别是少数民族卫生保健工作者长期医疗状况的流行程度和模式知之甚少。本研究评估了多重长期疾病（MLTCs）的负担，即存在两种或多种单一长期疾病（LTCs），在英国（UK）的卫生保健工作者中，以及种族和移民身份的差异。我们使用了2020年12月至2021年3月收集的英国- reach队列研究的基线数据。我们使用多变量逻辑回归，调整人口统计学、职业和生活方式因素来检验自述LTCs/MLTCs与种族、移民身份和移民到英国后的时间之间的关系。在纳入的12,100名HCWs中，年龄中位数为45岁（IQR: 34-54岁），27%为海外出生，30%为非白人族群（19%为亚洲人，4%为黑人，4%为混血儿，2%为其他）。最常见的自述LTCs是焦虑（14.9%）、哮喘（12.2%）、抑郁（10.7%）、高血压（8.7%）和糖尿病（4.0%）。在所有种族中，英国出生的卫生保健员的心理健康状况比海外出生的卫生保健员更普遍（每次使用英国出生的白人作为参照组的调整优势比（aOR）：海外出生的白人为0.77，焦虑的95%CI为0.66-0.95）。糖尿病和高血压在亚洲人群（如海外亚洲人，糖尿病aOR为2.97,95%CI为2.30-3.83）和黑人人群（如英国出生的黑人，高血压aOR为1.77,95%CI为1.05-2.99）中比英国出生的白人人群更为常见。在调整了年龄、性别和贫困因素后，与英国出生的白人相比，大多数少数民族报告MLTCs的几率较低，海外出生的人报告MLTCs的几率最低（例如，白人海外出生，aOR 0.68, 95%CI 0.55-0.83；亚洲海外出生，aOR 0.75, 95%CI 0.62-0.90；黑人海外出生，aOR 0.52, 95%CI 0.36-0.74）。在海外出生的HCWs中，MLTCs的发生率与在英国定居≥20年的英国出生的HCWs相当（aOR 1.14, 95%CI 0.94-1.37）。在英国医护人员中，常见LTCs的患病率和报告MLTCs的几率因种族和移民身份而异。随着时间的推移，移民HCWs发生多胞胎的几率较低，而在英国出生的HCWs发生多胞胎的几率也较低。对这一人群的进一步研究应包括与医疗记录相关的纵向研究。应与来自不同种族和移民群体的卫生保健工作者共同制定干预措施，重点关注特定卫生保健工作者亚群体中普遍存在的疾病模式，以减轻长期卫生保健工作者/多长期卫生工作者的总体负担。在线版本包含补充材料，可在10.1186/s12916-023-03109-w获得。
Healthcare 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. We 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. Of 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). Among 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. The online version contains supplementary material available at 10.1186/s12916-023-03109-w.
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影响因子：
2.9
作者：
Kyle RG;Wills J;Mahoney C;Hoyle L;Kelly M;Atherton IM
通讯作者：
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DOI：
10.1136/bmjmed-2022-000247
发表时间：
2022
期刊：
BMJ medicine
影响因子：
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影响因子：
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