Inequality, infections and chronic disease in England: the interaction of risk factors and the dynamics of transmission

在英国，不同的人感染病毒的可能性不同。当人们被感染时，他们的病情也有差异。同样的人群更有可能被感染，也更有可能感到非常不适。这些群体是少数族裔背景的人，也是那些经历社会经济贫困的群体。一些群体更容易感染的原因有很多，例如，因为他们的工作或行为而有更多的社会接触，或者他们可能有不同类型的接触，例如，如果他们在医院工作，或者必须经常去那里接受治疗。其他因素包括人们居住的家庭规模，或者与他们一起生活的不同年龄的人。这一点很重要，因为许多传染病传播都发生在家庭中。如果人们被感染，他们更有可能感到非常不适的原因主要是因为他们的年龄和如果他们有现有的健康状况，例如心脏病。其中一些情况在生活在社会经济贫困中的人和少数族裔群体中更为常见。不同人群之间的健康差异被称为健康差异，存在这些差异的原因很多，解决这些差异有多么困难。这项研究的目的是更好地了解健康差距以及传染病在造成和维持这些差距方面所起的作用。归根结底，目标是制定更好的干预措施，努力减少生活在社会经济贫困或少数民族群体中的人所经历的健康差距。我将通过分析英国2000多万人的电子健康记录数据来研究这些问题。健康记录被安全地保存在一个名为OpenSAFELY的分析平台上，单个患者的健康数据永远不会有被暴露的风险。为了增加健康记录，我将使用一款名为AirMid的智能手机应用程序来询问人们一天有多少社交联系人，以及他们的联系人的年龄和职业。我还将使用这款应用程序来询问人们他们感染了多少次，他们的病情有多严重，以及他们是去全科医生还是去医院。收集这些数据将有助于理解不同群体之间的差异。在项目期间，我将分析感染在人口中不同群体中的分布情况，以及哪些因素与感染更多有关。我将研究感染如何与不同的死因相关联，以及这些关联对于少数民族群体或那些经历贫困的人是否有所不同。在该项目的后期，我将使用计算机模型来尝试了解是否有可以缩小健康差距的干预措施，如接种疫苗或更好的治疗。该项目将有患者顾问参与，分享他们的经验并参与研究。

In England, there are differences between people in how likely they are to catch infections. There are also differences in how ill people get when they are infected. The same groups of people are more likely to get infected and more likely to get very unwell. Those groups are people of ethnic minority backgrounds, and those groups who experience socioeconomic deprivation. There are lots of reasons why some groups are more likely to catch infections, for example because they have more social contacts because of their job, or their behaviour, or they may have different types of contact, for example if they work in a hospital or have to go there frequently for treatment. Other factors include the size of households that people live in, or the different ages of people they live with. This is important because a lot of infectious disease transmission happens in households. The reasons why people are more likely to get very unwell if they are infected are mostly because of their age and if they have an existing health condition, for example, heart disease. Some of these conditions are more common amongst people who live with socioeconomic deprivation, and amongst ethnic minority groups. Differences in health between groups of people are called health disparities, and there are lots of reasons why these differences exist, and how difficult they are to solve. What this study aims to do is understand better the health disparities and the role that infectious diseases play in creating and sustaining them. Ultimately the aim is to develop better interventions to try to decrease the health disparities that people who live with socioeconomic deprivation or ethnic minority groups experience. I will study these problems by analysing electronic health records data for over 20 million people in England. The health records are held securely on an analysis platform called OpenSAFELY, and individual patient health data is never at risk of being exposed. To add to the health records, I will use a smartphone app called Airmid to ask people about how many social contacts they have in a day and the age and occupation of their contacts. I will also use the app to ask people about how many infections they get, how severe they are, and whether they go to the GP or hospital for that infection. Collecting these data will help understand the differences seen between groups. During the project, I will analyse how infections are distributed among different groups in the population and what factors are associated with having more infections. I will look at how infections are associated with different causes of death, and if those associations are different for ethnic minority groups or those experiencing deprivation. Later in the project I will use computer models to try to understand if there are interventions that could decrease the health disparities, such as vaccination or better treatment. The project will have patient advisors involved to share their experiences and participate in the research.