Ethnic minorities: key data sources
Information about the health of minority ethnic groups in Scotland is limited, particularly from routine health service sources. The following indicate some potential sources of information.
Hospital discharge and outpatient data
Information on hospital inpatient and daycase discharges in Scotland is collected in the SMR01 database; the corresponding database for outpatient attendances is the SMR00 database. For Scotland as a whole, the recording of ethnicity is improving: a valid ethnic group code was recorded in 82% of inpatient and daycase records (SMR01) and 72% of new outpatient appointment records (SMR00) in the quarter ending 31st March 2016. Recent information on data completeness is available from ISD.
The 2001 Census provides information on self-assessed health among minority ethnic groups in Scotland. Further details from the Census are available in two reports produced by the Scottish Executive: Analysis of ethnicity in the 2001 Census and Analysis of religion in the 2001 Census. In July 2008 the Scottish Government announced a new ethnicity classification which was used for Scotland's 2011 Census and is recommended for use in all relevant Scottish Official Statistics.
The 2011 census can provide a range of tabulations by ethnicity and there is a report on equality results as well. See the population composition page in our ethnicity data section. There is a summary of 2011 census resultsrelating to ethnicity and allied topics, an Analysis of Equality results from the 2011 Census produced by the Scottish Government and an Overview of Equality Results from the 2011 Census Release 2, giving a useful comparison to England for ethnic distribution by deprivation.
In 2015 a report comparing the health of ethnic groups in Scotland using census 2011 data was published using age standardised data. It showed Gypsy travellers and Pakistani people had the worst self-assessed health. Older females (age 65+ years) had worse health than older males in almost all ethnic groups. except for 'Caribbean or Black', 'White: Polish', 'Other Asian' and 'White: Gypsy/Traveller'. The largest differences were for 'Indian', 'Bangladeshi' 'Pakistani' and 'Other Ethnic Group', where older women's health was much worse than older men's.
A number of periodic or ongoing surveys with national coverage have the potential to provide information about the health of minority ethnic groups. However, in many cases the numbers of people from minority ethnic groups included in the survey are too small to produce reliable information.
The retrospective coding project, Ethnicity and health in Scotland: can we fill the information gap?(468Kb), has linked Census data to routine hospital discharge data, providing information about coronary heart disease among minority ethnic groups in Scotland. A second phase is now extending the work to cover cancer, mental health and the health of women and children.
Ethnic group is recorded in some specialised databases, but not all use standardised definitions of ethnic group.
Classifications of ethnic group based on the 2001 Census are included in the Scottish Health and social care data dictionary. Note that this has been superseded by the new ethnicity classification (211Kb) introduced for official statistics in Scotland.
As described in our Policy page on ethnic minorities the Scottish Migrant and Ethnic Health Research Strategy group (SMEHRS) provides an overview of Scottish research and a set of research priorities in this area.
The Centre for Population Health Science at the University of Edinburgh plays a leading role in Scottish research on ethnicity and health, and publications, including those produced through the Scottish Health and Ethnicity Linkage Study (SHELS) can be found through Edinburgh University's Migration, Ethnicity and Health pages (EMEHRG) . Further phases of work have extended the topics covered to cancer, mental health, the health of women and children, primary care consultations, infectious diseases, respiratory infections, cancer screening, Work on all-cause hospitalisations and mortality is progressing. Information on the Prevention of type 2 Diabetes and Obesity in South Asians (PODOSA) trial can also be found through the EMEHRG site.
At the University of Glasgow, the Social and Public Health Sciences unit also has a leading research programme on ethnicity and health especially relating to children and adolescents and mental wellbeing. The Glasgow Refugee Asylum and Migration Network (GRAMNet) has developed a range of ongoing research projects.
The former National Resource Centre for Ethnic Minority Health (NRCEMH) and the Scottish Diabetes Group produced a report on diabetes in minorities ethnic groups which was also published by Baradaran and colleagues (key references). It includes data from a survey of diabetes service users in Glasgow and describes the pattern of services in Scotland. It makes recommendations about improving the quality of care for people with diabetes from minority ethnic groups in Scotland.
By registering (for free) on the Diabetes UK website: access to a number of useful papers can be gained, for example Shahid S (2013) The excess risk of cardiovascular disease in people with type 2 diabetes of South Asian ethnicity. Diabetes & Primary Care 15: 20–8. This suggests that clinicians should use a clinical CVD risk calculator which incorporates ethnicity and diabetes as variables.
Comparative data for England and Wales
Data sources on the health of minority ethnic groups in England and Wales are much more extensive and may be useful as a general guide to the likely issues in Scotland. A comprehensive review of data from England and Wales has been published by Gill et al (see key references).
Mental health among ethnic minorities in England was covered in the EMPIRIC report (2002) see the ScotPHO website on vulnerable groups’ mental health.