Alex Mackay1, Mark Ashworth2, Patrick White2. 1. Academic Fellow, School of Population Health and Environmental Sciences, King's College London, Guy's Campus, London, UK. 2. Reader in Primary Care, School of Population Health and Environmental Sciences, King's College London, Guy's Campus, London, UK.
Abstract
BACKGROUND: Socioeconomic and ethnic factors are established determinants of cardiovascular health inequalities. The role of low proficiency in the majority language as a mediator of these inequalities is uncertain. AIM: This study aimed to investigate the association between non-English language preference and cardiovascular health inequalities in a community in London. DESIGN & SETTING: Retrospective, cross-sectional analysis of anonymised patient-level data collected from general practices in Lambeth, south London. METHOD: Cardiovascular disease prevalence, monitoring, and risk-identification data were compared between non-English and English language groups using multiple logistic regression. RESULTS: Of the total number of patients registered at the 49 participating practices, 302 404 (83%) patients were aged ≥18 years. Preferred language was recorded by 69.4%: English 53.6%, Portuguese 3.2%, Spanish 2.6%, French 1.6%, Polish 1.4%, Somali 0.5%, and others 7.1%; 30.6% had no record of language preference. The non-English language preference group had a greater likelihood of coronary heart disease ([CHD], odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.03 to 1.34); diabetes mellitus ([DM], OR = 1.33, 95% CI = 1.23 to 1.43); obesity (OR = 1.08, 95% CI = 1.04 to 1.13); and smoking (OR = 1.18, 95% CI = 1.14 to 1.21), but no difference in the prevalence of hypertension or stroke. Cardiovascular monitoring was not less intense in this group. Portuguese-speakers (the largest non-English language preference group) had a greater likelihood of hypertension (OR = 1.43, 95% CI = 1.30 to 1.57); DM (OR = 1.74, 95% CI = 1.50 to 2.02); stroke (OR = 1.40, 95% CI = 1.08 to 1.81); obesity (OR = 1.53, 95% CI = 1.36 to 1.73); and smoking (OR = 1.13, 95% CI = 1.02 to 1.25). CONCLUSION: The non-English language preference group was associated with a greater risk of some aspects of cardiovascular disease than the English language preference group, probably reflecting shared cultural and behavioural risk. Non-English language preference was not associated with lower rates of cardiovascular monitoring, providing some evidence of equitable primary care access in this group.
BACKGROUND: Socioeconomic and ethnic factors are established determinants of cardiovascular health inequalities. The role of low proficiency in the majority language as a mediator of these inequalities is uncertain. AIM: This study aimed to investigate the association between non-English language preference and cardiovascular health inequalities in a community in London. DESIGN & SETTING: Retrospective, cross-sectional analysis of anonymised patient-level data collected from general practices in Lambeth, south London. METHOD: Cardiovascular disease prevalence, monitoring, and risk-identification data were compared between non-English and English language groups using multiple logistic regression. RESULTS: Of the total number of patients registered at the 49 participating practices, 302 404 (83%) patients were aged ≥18 years. Preferred language was recorded by 69.4%: English 53.6%, Portuguese 3.2%, Spanish 2.6%, French 1.6%, Polish 1.4%, Somali 0.5%, and others 7.1%; 30.6% had no record of language preference. The non-English language preference group had a greater likelihood of coronary heart disease ([CHD], odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.03 to 1.34); diabetes mellitus ([DM], OR = 1.33, 95% CI = 1.23 to 1.43); obesity (OR = 1.08, 95% CI = 1.04 to 1.13); and smoking (OR = 1.18, 95% CI = 1.14 to 1.21), but no difference in the prevalence of hypertension or stroke. Cardiovascular monitoring was not less intense in this group. Portuguese-speakers (the largest non-English language preference group) had a greater likelihood of hypertension (OR = 1.43, 95% CI = 1.30 to 1.57); DM (OR = 1.74, 95% CI = 1.50 to 2.02); stroke (OR = 1.40, 95% CI = 1.08 to 1.81); obesity (OR = 1.53, 95% CI = 1.36 to 1.73); and smoking (OR = 1.13, 95% CI = 1.02 to 1.25). CONCLUSION: The non-English language preference group was associated with a greater risk of some aspects of cardiovascular disease than the English language preference group, probably reflecting shared cultural and behavioural risk. Non-English language preference was not associated with lower rates of cardiovascular monitoring, providing some evidence of equitable primary care access in this group.
Entities:
Keywords:
cardiovascular health inequalities; ethnicity; language preference
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