Ethnicity and socioeconomic status: missing in research means missing in clinical guidance

Beard, Eleanor; Dixon, Sharon; Rai, Tanvi; Hayward, Gail

doi:10.3399/bjgpo.2021.0034

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…With as many as four in ten people identifying to be from a CALD background, the lack of inclusion of people from non‐English speaking backgrounds in research related to PR indicates the possibility of missing a sizeable proportion of the patient population when evaluating the effects of PR. More importantly, the findings highlight the importance of identification of CALD and the need to include ethnicity as a variable when collecting data related to prevalence of disease for both research and government reports, which remains to be rarely reported in studies globally (Beard et al., 2021; Flanagin et al., 2021). Using the recent Australian Institute of Health and Wellbeing report on COPD as an example (Australian Institute of Health and Welfare, 2020), increased prevalence of COPD among people from Aboriginal and Torres Strait Islander background and lower socioeconomic areas was reported, but differences in prevalence of COPD among ethnic groups were not reported.…”

Section: Discussionmentioning

confidence: 96%

“…With as many as four in ten people identifying to be from a CALD background, the lack of inclusion of people from non-English speaking backgrounds in research related to PR indicates the possibility of missing a sizeable proportion of the patient population when evaluating the effects of PR. More importantly, the findings highlight the importance of identification of CALD and the need to include ethnicity as a variable when collecting data related to prevalence of disease for both reand government reports, which remains to be rarely reported in studies globally (Beard et al, 2021;Flanagin et al, 2021)…”

Section: Discussionmentioning

confidence: 97%

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Access to pulmonary rehabilitation for people from culturally and linguistically diverse communities: A cohort study

Tang

Lavercombe

Southcott

et al. 2022

Health Social Care Comm

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Little is known about the extent of cultural and linguistic diversity among people with chronic obstructive pulmonary disease (COPD) in Australia and if ethno‐cultural factors influence engagement in pulmonary rehabilitation (PR). We conducted a prospective cohort study to evaluate the extent of cultural and linguistic diversity among people with COPD and identify variables that influence engagement in PR. Patients with COPD attending the respiratory outpatient clinic at a metropolitan health service completed a study‐specific questionnaire with results descriptively analysed. Access issues of awareness, referrals, attendance and completion of PR were examined. A multiple regression analysis was conducted to identify variables that influenced engagement in PR. Ninety‐seven participants were recruited, of whom 36 (37%) self‐identified a culturally and linguistically diverse (CALD) community. While participants from CALD communities had less awareness of PR as compared with the English Australian group (χ2(df) = 5.3 (1), p = 0.02), there were no significant between‐group differences in number of observed referrals (p = 0.30), attendance (p = 0.50) and completions of PR (p = 0.90). Only 11 (11%) out of 97 participants completed PR. Age (p = 0.006) and being from a CALD community (p = 0.03) were independent factors impacting on the awareness of PR while English proficiency (p = 0.04) was an independent factor impacting on referrals to PR. While older age and being from a CALD community were associated with having less awareness in PR, referrals to, attendance and completion rates of PR were similar regardless of ethnicity.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Access to pulmonary rehabilitation for people from culturally and linguistically diverse communities: A cohort study

Tang

Lavercombe

Southcott

et al. 2022

Health Social Care Comm

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“…First, it risks those at the lower end of the socioeconomic scale continuing to be underrepresented and underserved. 40 Second, it suggests a conflation of ethnicity with disadvantage and deprivation, an oversimplified analysis of the position of ethnic minorities in society. In the UK, certain ethnic minorities (Chinese, Indian) outperform white populations on a number of parameters including educational attainment, and within-group variation is wide though most ethnic minorities are however over-represented compared with white populations in the most deprived decile.…”

Section: Reviewmentioning

confidence: 99%

Boosting and broadening recruitment to UK cancer trials: towards a blueprint for action

Nanton,

Bryan,

Pope

et al. 2023

bmjonc

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Recruitment and retention in cancer trials are long-standing issues, exacerbated by the COVID-19 pandemic. The UK National Institute of Health Research and leading clinicians have emphasised the urgency to achieve and surpass prepandemic levels of participation.Data from a recent UK trial demonstrated the impact of COVID-19 and highlighted factors that limited recruitment. In response to this worldwide problem, studies have identified strategies for remediation at the levels of funding, the research environment, study design and trial team-related aspects, yet evidence of progress is lacking.Equality, diversity and inclusivity have become central to UK health and social policy during the 2000s. The need for greater inclusivity in trials has become a particular concern for cancer researchers and funders in the UK and in the USA, in recognition of potential bias in results. In the UK trials, the lack of standardised recording of ethnicity data renders interpretation difficult and caution is required in comparisons with the USA.Recently, the focus of concern has shifted away from the impact of deprivation and low socioeconomic status on trial participation. Barriers created by these factors and their frequent intersection with ethnicity should not be overlooked.The UK has adopted an advisory approach to broadening recruitment, publishing policy documents, guidance and toolkits. In the USA, by contrast, action on inclusion is increasingly mandated. Within the UK paradigm, the cancer research community is strongly encouraged to adopt a coordinated approach towards standardised digital data collection and embed and evaluate innovative, cocreated, locally relevant strategies.

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“…The implications of language-based exclusion in research are that essential data could be missed; including how different groups of people present clinically in relation to disease, or differences in responsivity to treatments 6–9. Exclusion based on language ability has the potential to lead to greater disparities in health outcomes, as well as limiting the generalisability of the study outcomes 9.…”

Section: Introductionmentioning

confidence: 99%

Addressing the language barriers to inclusion in paediatric emergency medicine research

Walsh,

Dliso,

Messahel

2023

Arch Dis Child Educ Pract Ed

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Ethnicity and socioeconomic status: missing in research means missing in clinical guidance

Cited by 6 publications

References 9 publications

Access to pulmonary rehabilitation for people from culturally and linguistically diverse communities: A cohort study

Access to pulmonary rehabilitation for people from culturally and linguistically diverse communities: A cohort study

Boosting and broadening recruitment to UK cancer trials: towards a blueprint for action

Addressing the language barriers to inclusion in paediatric emergency medicine research

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