University of Leicester
Browse
Ethnicity, household composition and COVID-19.pdf (1.38 MB)

Ethnicity, household composition and COVID-19 mortality: a national linked data study

Download (1.38 MB)
journal contribution
posted on 2021-07-06, 21:51 authored by V Nafilyan, N Islam, D Ayoubkhani, C Gilles, SV Katikireddi, R Mathur, A Summerfield, K Tingay, M Asaria, A John, P Goldblatt, A Banerjee, M Glickman, K Khunti
Objective: To estimate the proportion of ethnic inequalities explained by living in a multi-generational household. Design: Causal mediation analysis. Setting: Retrospective data from the 2011 Census linked to Hospital Episode Statistics (2017-2019) and death registration data (up to 30 November 2020). Participants: Adults aged 65 years or over living in private households in England from 2 March 2020 until 30 November 2020 (n=10,078,568). Main outcome measures: Hazard ratios were estimated for COVID-19 death for people living in a multi-generational household compared with people living with another older adult, adjusting for geographic factors, socioeconomic characteristics and pre-pandemic health. Results: Living in a multi-generational household was associated with an increased risk of COVID-19 death. After adjusting for confounding factors, the hazard ratios for living in a multi-generational household with dependent children were 1.17 (95% confidence interval [CI] 1.06–1.30) and 1.21 (95% CI 1.06–1.38) for elderly men and women. The hazard ratios for living in a multi-generational household without dependent children were 1.07 (95% CI 1.01–1.13) for elderly men and 1.17 (95% CI 1.07–1.25) for elderly women. Living in a multi-generational household explained about 11% of the elevated risk of COVID-19 death among elderly women from South Asian background, but very little for South Asian men or people in other ethnic minority groups. Conclusion: Elderly adults living with younger people are at increased risk of COVID-19 mortality, and this is a contributing factor to the excess risk experienced by older South Asian women compared to White women. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.

Funding

This research was funded by the Office for National Statistics. VN is also funded by Health Data Research UK (HDRUK). HDR-UK is an initiative funded by the UK Research and Innovation, Department of Health and Social Care (England) and the devolved administrations, and leading medical research charities. SVK acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13) and the Scottish Government Chief Scientist Office (SPHSU13)

History

Citation

Journal of the Royal Society of Medicine; 2021, Vol. 114(4) 182–211

Author affiliation

Diabetes Research Centre

Version

  • VoR (Version of Record)

Published in

Journal of the Royal Society of Medicine

Volume

114

Issue

4

Pagination

182–211

Publisher

SAGE Publications

issn

0141-0768

eissn

1758-1095

Acceptance date

2021-02-15

Copyright date

2021

Available date

2021-07-06

Spatial coverage

England

Language

eng

Usage metrics

    University of Leicester Publications

    Categories

    Licence

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC