Markers of deprivation, bias and ethnicity: are individual and area level markers of deprivation heterogeneously associated with outcomes between ethnic groups?
Why the research is needed
To greater understand health inequalities related to ethnicity, it is important to identify potential risk factors that may explain some of the increased risk between ethnic groups. Deprivation is one of the greatest known risk factors for poor health and is a universally underpinning determinant of health inequalities within and between populations. Factors linked to deprivation have been suggested to be important in explaining the excess risk of COVID-19 observed in minority ethnic communities. Interestingly however, most of the current literature around deprivation and health inequalities assume that IMD, the official measure of deprivation used in the UK, is an equally accurate measurement of deprivation across all ethnic groups. If this is not the case, new, more accurate measures of deprivation will need to be identified for minority ethnic groups given the importance of deprivation and its graded association with health outcomes. Current public health measures that use IMD as a measure may not act as an accurate or useful measurement of deprivation in minority ethnic groups and therefore distort its associations with health and other outcomes (e.g. employment). Further, most public health policies are geared towards improving components of IMD, however, if this is not as accurate a measurement in minority ethnic individuals, or if certain components of IMD are more relevant to ethnic minorities than white individuals, ethnic health inequalities may persist as we are not focusing on the right markers to improve or measure.
What is already known about the subject
There is strong evidence that deprivation is a universally underpinning factor associated with poor health. Further, there is evidence to suggest ethnic minority groups may have poorer outcomes for certain health conditions.
Who we will be working with
We are working with Office for National Statistics.
How patients and the public are involved
After we have generated our results, the Centre for Ethnic Health Research and Leicester BRC will run dedicated programme of community engagement with our local communities (e.g. minority ethnic) to disseminate the research results and understand perceptions and attitudes towards the results and explore future work. We will further engagement with relevant health charities, such as the South Asian Health Foundation.
What we will do
Across ethnic groups, we will conduct secondary analysis assessing if measures of area level deprivation (i.e. IMD) and individual level deprivation (i.e. household deprivation, being economically inactive) are heterogeneously associated with outcomes (e.g. all-cause mortality).
What the benefits will be
Likely benefits may include the identification of deprivation measures that are unique to minority ethnic individuals. Greater precision and accuracy of measuring deprivation will likely lead to more personalised and efficient policies aimed at reducing inequalities. In addition, it may lead to more accurate measurement of deprivation in minority ethnic groups in ONS databases.
When the findings will be available
The findings will be available from March 2024 and beyond (dependent upon publication timeline for academic paper).
How we are planning for implementation
PPIE members and groups regularly contribute to the portfolio of ethnic health inequality research that is undertaken at UoL and across NIHR infrastructure, and this proposal will utilise these links. Sessions will be arranged with the PPIE groups via the Centre for Ethnic Health Research to explore individuals’ perceptions about the drivers of inequality/deprivation and if it is believed any drivers differ by ethnic group (i.e., language skills, structural racism). These discussions will help identify potential markers of deprivation to include in current and future analyses. Further, PPIE groups will inform the dissemination of findings through identification of key messages for dissemination and co-production of culturally/language specific summary reports, infographics/materials and disseminated through the most culturally appropriate communication channels.
Dr Francesco Zaccardi, Fz43@le.ac.uk.