Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study
Objectives Explore inequalities in risk factors, mental and physical health morbidity in non-pregnant women of reproductive age in contact with mental health services and how these vary per ethnicity.Design Retrospective cohort study.Setting Data from Lambeth DataNet, anonymised primary care records...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e059257.full |
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| author | Amelia Jewell Matthew Broadbent Stephani Hatch Mark Ashworth Megan Pritchard Sarah Dorrington Louise Howard Raquel Catalao |
| author_facet | Amelia Jewell Matthew Broadbent Stephani Hatch Mark Ashworth Megan Pritchard Sarah Dorrington Louise Howard Raquel Catalao |
| author_sort | Amelia Jewell |
| collection | DOAJ |
| description | Objectives Explore inequalities in risk factors, mental and physical health morbidity in non-pregnant women of reproductive age in contact with mental health services and how these vary per ethnicity.Design Retrospective cohort study.Setting Data from Lambeth DataNet, anonymised primary care records of this ethnically diverse London borough, linked to anonymised electronic mental health records (‘CRIS secondary care database’).Participants Women aged 15–40 years with an episode of secondary mental health care between January 2008 and December 2018 and no antenatal or postnatal Read codes (n=3817) and a 4:1 age-matched comparison cohort (n=14 532).Main outcome measures Preconception risk factors including low/high body mass index, smoking, alcohol, substance misuse, micronutrient deficiencies and physical diagnoses.Results Women in contact with mental health services (whether with or without severe mental illness (SMI)) had a higher prevalence of all risk factors and physical health diagnoses studied. Women from minority ethnic groups were less likely to be diagnosed with depression in primary care compared with white British women (adjusted OR 0.66 (0.55–0.79) p<0.001), and black women were more likely to have a SMI (adjusted OR 2.79 (2.13–3.64) p<0.001). Black and Asian women were less likely to smoke or misuse substances and more likely to be vitamin D deficient. Black women were significantly more likely to be overweight (adjusted OR 3.47 (3.00–4.01) p<0.001), be diagnosed with hypertension (adjusted OR 3.95 (2.67–5.85) p<0.00) and have two or more physical health conditions (adj OR 1.94 (1.41–2.68) p<0.001) than white British women.Conclusions Our results challenge the perspective that regular monitoring of physical health in primary care should be exclusively encouraged in people with a l diagnosis. The striking differences in multimorbidity for women in contact with mental health services and those of ethnic minority groups emphasise a need of integrative models of care. |
| format | Article |
| id | doaj-art-ef6ef7dec0b04499bad64bed33308e99 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-ef6ef7dec0b04499bad64bed33308e992025-02-02T14:30:18ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-059257Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort studyAmelia Jewell0Matthew Broadbent1Stephani Hatch2Mark Ashworth3Megan Pritchard4Sarah Dorrington5Louise Howard6Raquel Catalao7South London and Maudsley NHS Foundation Trust, London, UKNIHR Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UKDepartment of Psychological Medicine, King’s College London, London, UKKing`s College London School of Life Course and Population Sciences, London, UKNIHR Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UKDepartment of Psychological Medicine, King’s College London, London, UKSection of Women`s Mental Health, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UKDepartment of Psychological Medicine, King’s College London, London, UKObjectives Explore inequalities in risk factors, mental and physical health morbidity in non-pregnant women of reproductive age in contact with mental health services and how these vary per ethnicity.Design Retrospective cohort study.Setting Data from Lambeth DataNet, anonymised primary care records of this ethnically diverse London borough, linked to anonymised electronic mental health records (‘CRIS secondary care database’).Participants Women aged 15–40 years with an episode of secondary mental health care between January 2008 and December 2018 and no antenatal or postnatal Read codes (n=3817) and a 4:1 age-matched comparison cohort (n=14 532).Main outcome measures Preconception risk factors including low/high body mass index, smoking, alcohol, substance misuse, micronutrient deficiencies and physical diagnoses.Results Women in contact with mental health services (whether with or without severe mental illness (SMI)) had a higher prevalence of all risk factors and physical health diagnoses studied. Women from minority ethnic groups were less likely to be diagnosed with depression in primary care compared with white British women (adjusted OR 0.66 (0.55–0.79) p<0.001), and black women were more likely to have a SMI (adjusted OR 2.79 (2.13–3.64) p<0.001). Black and Asian women were less likely to smoke or misuse substances and more likely to be vitamin D deficient. Black women were significantly more likely to be overweight (adjusted OR 3.47 (3.00–4.01) p<0.001), be diagnosed with hypertension (adjusted OR 3.95 (2.67–5.85) p<0.00) and have two or more physical health conditions (adj OR 1.94 (1.41–2.68) p<0.001) than white British women.Conclusions Our results challenge the perspective that regular monitoring of physical health in primary care should be exclusively encouraged in people with a l diagnosis. The striking differences in multimorbidity for women in contact with mental health services and those of ethnic minority groups emphasise a need of integrative models of care.https://bmjopen.bmj.com/content/12/7/e059257.full |
| spellingShingle | Amelia Jewell Matthew Broadbent Stephani Hatch Mark Ashworth Megan Pritchard Sarah Dorrington Louise Howard Raquel Catalao Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study BMJ Open |
| title | Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study |
| title_full | Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study |
| title_fullStr | Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study |
| title_full_unstemmed | Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study |
| title_short | Ethnic inequalities in mental and physical multimorbidity in women of reproductive age: a data linkage cohort study |
| title_sort | ethnic inequalities in mental and physical multimorbidity in women of reproductive age a data linkage cohort study |
| url | https://bmjopen.bmj.com/content/12/7/e059257.full |
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