Ethnic-minority groups in England and Wales-factors associated with the size and timing of elevated COVID-19 mortality: a retrospective cohort study linking census and death records
Ethnic-minority groups in England and Wales-factors associated with the size and timing of elevated COVID-19 mortality: a retrospective cohort study linking census and death records
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DOI：
10.1093/ije/dyaa208
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发表时间：
2020-12-01
影响因子：
7.7
通讯作者：
Diamond, Ian
中科院分区：
文献类型：
--
作者：
Ayoubkhani, Daniel;Nafilyan, Vahe;Diamond, Ian
背景资料：我们估计了种族与冠状病毒疾病之间的人口水平关联2019使用新关联的基于人口普查的数据集对2019冠状病毒病（COVID-19）死亡率进行了分析，并调查了种族特异性死亡率风险在大流行期间的演变情况。我们对2011年英格兰和威尔士人口普查的私人家庭受访者进行了一项回顾性队列研究，与死亡登记相关，并根据移民调整（n = 47 872 412）。关注结果为二零二零年三月二日至二零二零年五月十五日期间涉及COVID-19的死亡。我们估计的风险比（HR）的少数民族群体相比，白色人口，控制个人，家庭和地区的特点。结果：在年龄调整模型中，所有少数民族群体的COVID-19死亡风险均升高;黑人男性和女性的HR分别为3.13（95%置信区间：2.93至3.34）和2.40（2.20至2.61）。然而，在完全调整的女性模型中，除黑人外，所有种族的HR接近于1 [1.29（1.18至1.42）]。对于男性，黑人[1.76（1.63至1.90）]、孟加拉国/巴基斯坦[1.35（1.21至1.49）]和印度[1.30（1.19至1.43）]组的死亡风险仍然较高。所有种族群体的HR在封锁后都有所下降，特别是黑人和孟加拉国/巴基斯坦女性。结论：种族群体之间COVID-19死亡率的差异在很大程度上受到地理和社会人口因素的影响，尽管仍然存在一些残余差异。封锁与少数民族人口超额死亡风险的降低有关，这对第二波感染有影响。
Background: We estimated population-level associations between ethnicity and coronavirus disease 2019 (COVID-19) mortality using a newly linked census-based data set and investigated how ethnicity-specific mortality risk evolved during the pandemic.Methods: We conducted a retrospective cohort study of respondents to the 2011 Census of England and Wales in private households, linked to death registrations and adjusted for emigration (n = 47 872 412). The outcome of interest was death involving COVID-19 between 2 March 2020 and 15 May 2020. We estimated hazard ratios (HRs) for ethnic-minority groups compared with the White population, controlling for individual, household and area characteristics. HRs were estimated on the full outcome period and separately for pre- and post-lockdown periods.Results: In age-adjusted models, people from all ethnic-minority groups were at elevated risk of COVID-19 mortality; the HRs for Black males and females were 3.13 (95% confidence interval: 2.93 to 3.34) and 2.40 (2.20 to 2.61), respectively. However, in fully adjusted models for females, the HRs were close to unity for all ethnic groups except Black [1.29 (1.18 to 1.42)]. For males, the mortality risk remained elevated for the Black [1.76 (1.63 to 1.90)], Bangladeshi/Pakistani [1.35 (1.21 to 1.49)] and Indian [1.30 (1.19 to 1.43)] groups. The HRs decreased after lockdown for all ethnic groups, particularly Black and Bangladeshi/Pakistani females.Conclusion: Differences in COVID-19 mortality between ethnic groups were largely attenuated by geographical and socio-demographic factors, though some residual differences remained. Lockdown was associated with reductions in excess mortality risk in ethnic-minority populations, which has implications for a second wave of infection.