{
  "abstract": "Background This study investigates the influence of ethnicity and deprivation on multimorbidity, aiming to support fair and effective healthcare planning.Methods We conducted a retrospective longitudinal study using data from 1,413,074 adults (9,874,694 person-years) aged 18 and over, sampled from linked records in the Clinical Practice Research Datalink and Hospital Episode Statistics, covering the period from 2008 to 2019. These data encompass administrative patient records from primary and secondary care. Ethnicity was classified into nine groups, and area-level deprivation was measured using deciles of the 2015 English Index of Multiple Deprivation. Multimorbidity was defined as a Cambridge Multimorbidity Score — a weighted score of long-term conditions predicting mortality and healthcare utilisation — exceeding 1.5. Logistic regression analyses evaluated the risks of multimorbidity and individual conditions, adjusting for age, sex, area deprivation, region, and year. Akaike’s Information Criterion was used to test whether the effect of ethnicity varied by area deprivation.Results We identified 264,412 participants with multimorbidity, representing 18.7% of the sample. Preliminary findings indicate that, compared to White individuals, Pakistani and Bangladeshi individuals had higher odds of multimorbidity (Adjusted Odds Ratio (AOR):1.33, 95% confidence interval: [1.30, 1.35]; and AOR:1.39 [1.35, 1.44], respectively). Chinese, Black African, Other Asian, and Other ethnic groups exhibited lower odds (AOR:0.35 [0.34, 0.37]; AOR:0.73 [0.72, 0.75]; AOR:0.82 [0.80, 0.84]; and AOR:0.75 [0.74, 0.76], respectively). A higher prevalence of cardiometabolic diseases explained most of the additional burden of multimorbidity among Pakistani and Bangladeshi populations, despite their comparatively lower prevalence of chronic obstructive pulmonary disease and alcohol-related problems. No evidence was found of synergistic or antagonistic interactions between ethnicity and area deprivation.Conclusion In this large English cohort, Pakistani and Bangladeshi groups exhibited higher rates of multimorbidity, predominantly due to cardiometabolic disease. This highlights the importance of targeted cardiometabolic prevention and equitable healthcare planning that go beyond considerations of area deprivation.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Joshua Edefo"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Anna Head"
    },
    {
      "affiliations": [
        "The Health Foundation, London, UK"
      ],
      "name": "Watt Toby"
    },
    {
      "affiliations": [
        "The Health Foundation, London, UK"
      ],
      "name": "Ann Raymond"
    },
    {
      "affiliations": [
        "The Health Foundation, London, UK"
      ],
      "name": "Laurie Rachet-Jacquet"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Martin O’Flaherty"
    },
    {
      "affiliations": [
        "Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK"
      ],
      "name": "Christodoulos Kypridemos"
    }
  ],
  "title": "P15-4 Does area deprivation modify ethnic inequalities in multimorbidity: evidence from a retrospective cohort study of 1.4 million adults in England (2008-2019)",
  "uid": "aadf9845-e22a-5acd-8704-50602bde06a6"
}