Abstract
BackgroundPopulation health status scores are routinely used to inform economic evaluation and evaluate the impact of disease and/or treatment on health. It is unclear whether the health status in black and minority ethnic groups are comparable to these population health status data. The aim of this study was to evaluate health-status in South Asian and African-Caribbean populations.MethodsCross-sectional study recruiting participants aged ≥ 45 years (September 2006 to July 2009) from 20 primary care centres in Birmingham, United Kingdom.10,902 eligible subjects were invited, 5,408 participated (49.6%). 5,354 participants had complete data (49.1%) (3442 South Asian and 1912 African-Caribbean). Health status was assessed by interview using the EuroQoL EQ-5D.ResultsThe mean EQ-5D score in South Asian participants was 0.91 (standard deviation (SD) 0.18), median score 1 (interquartile range (IQR) 0.848 to 1) and in African-Caribbean participants the mean score was 0.92 (SD 0.18), median 1 (IQR 1 to 1). Compared with normative data from the UK general population, substantially fewer African-Caribbean and South Asian participants reported problems with mobility, usual activities, pain and anxiety when stratified by age resulting in higher average health status estimates than those from the UK population. Multivariable modelling showed that decreased health-related quality of life (HRQL) was associated with increased age, female gender and increased body mass index. A medical history of depression, stroke/transient ischemic attack, heart failure and arthritis were associated with substantial reductions in HRQL.ConclusionsThe reported HRQL of these minority ethnic groups was substantially higher than anticipated compared to UK normative data. Participants with chronic disease experienced significant reductions in HRQL and should be a target for health intervention.
Highlights
Population health status scores are routinely used to inform economic evaluation and evaluate the impact of disease and/or treatment on health
Black and minority ethnic groups (BMEGs) comprise 4.6 million (7.9%) of the UK population, the majority residing in deprived large metropolitan areas, as measured by the Index of Multiple Deprivation 2007 (IMD 2007) with greater Birmingham having the largest proportion of BMEGs outside London [1,2]
The baseline characteristics of patients enrolled in the E-ECHOES study are shown in Table 1. 13,097 subjects were screened, 10,902 were eligible and invited to participate and 420 (3.2%) did not meet the study inclusion criteria. 6,506 booked an appointment of which 5,408 (49.6%) completed the screening process and 5,354 (49.1%) had complete health status data (3442 South Asian and 1912 African-Caribbean participants)
Summary
Population health status scores are routinely used to inform economic evaluation and evaluate the impact of disease and/or treatment on health. Such measures usefully allow the generation of a utility score (where 0 is a health state defined as equivalent to the state of death and 1 is full health, with negative scores indicating a health state worse than death) These scores can be used in combination with the time spent in a health state to generate Quality Adjusted Life Years and used as a measure of effectiveness in economic evaluation. Utility measures such as the EQ-5D, SF-6D, Health Utilities Index and Quality of Well-Being Scale may be used to evaluate health status in both the general population and in clinical trials to evaluate the effect of disease and response to treatment [5,6,7,8]
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