Ethnic minorities: routine NHS data
Overall the completeness of ethnicity information in Scottish hospital records has been increasing. The level of completeness currently varies by Health Board (figure 1). The usefulness of increasing completeness of ethnicity information in hospital records has been demonstrated by a ScotPHO pilot project report looking at first admissions for Coronary Heart Disease (CHD) (51Kb). The pilot showed that in comparison with census linked data, routinely collected data have validity in some NHS Board areas. These data raise some interesting questions about variations in admissions rates. NHS Boards may wish to use such information to further investigate health needs among their local ethnic groups, and to prioritise health improvement work. Knox et al (2016) have demonstrated an innovative method for increasing the completeness of routinely collected ethnicity data by using a look-back method.
A 2017 report by Emma McNair reviews the equality data that is available in Scottish administrative health datasets. This data can be used to help us to better understand health inequalities across the population that effect people of different genders, age, sexual orientation, and ethnicity. Routinely collected ethnicity data has a varying degree of quality and completeness across administrative data sets. For example, the completeness of ethnicity data varies by NHS Health Board and ranges from 31.4% in the Western Isles to 98.7% in Ayrshire and Arran (October-December 2022). This data is therefore of limited use. In contrast to this, ethnicity was recorded on 97% of the death registrations in Scotland in 2021 (NRS Vital Statistics 2021, Table 5.04). One complexity of ethnicity data is that ethnicity refers to a range of factors including nationality, skin colour, culture, and heritage. As a result of this, an individual’s ethnicity can be inconsistently defined and recorded.
The Scottish Health Ethnicity Linkage Study (SHELS) has linked the 2001 census ethnic identifiers to routinely available NHS hospital admissions and mortality data.
Exploration of the relationship between socio-economic status, health and ethnicity has used the SHELS data to show that measures of socio-economic position and CHD are not consistently associated in different ethnic groups, see Fischbacher et al 2013.
A separate study using data from the 1991 Scottish census linked to mortality records has found no evidence of a linear relationship between ethnicity and deprivation or social class for mortality risk, see Millard et al 2015.
