Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)

Introduction Evidence from previous pandemics, and the current COVID-19 pandemic, has found that risk of infection/severity of disease is disproportionately higher for ethnic minority groups, and those in lower socioeconomic positions. It is imperative that interventions to prevent the spread of COV...

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Main Authors: Rachael Wood, Aziz Sheikh, Alastair H Leyland, Duncan Buchanan, Chris Robertson, Colin R Simpson, Colin McCowan, Sarah Jane Stock, Utkarsh Agrawal, Lewis Ritchie, Annemarie Docherty, James Marple, Paul Henery, Kirsten J Hainey, Thomas Alexis, Steven Kerr
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/8/e048852.full
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author Rachael Wood
Aziz Sheikh
Alastair H Leyland
Duncan Buchanan
Chris Robertson
Colin R Simpson
Colin McCowan
Sarah Jane Stock
Utkarsh Agrawal
Lewis Ritchie
Annemarie Docherty
James Marple
Paul Henery
Kirsten J Hainey
Thomas Alexis
Steven Kerr
author_facet Rachael Wood
Aziz Sheikh
Alastair H Leyland
Duncan Buchanan
Chris Robertson
Colin R Simpson
Colin McCowan
Sarah Jane Stock
Utkarsh Agrawal
Lewis Ritchie
Annemarie Docherty
James Marple
Paul Henery
Kirsten J Hainey
Thomas Alexis
Steven Kerr
author_sort Rachael Wood
collection DOAJ
description Introduction Evidence from previous pandemics, and the current COVID-19 pandemic, has found that risk of infection/severity of disease is disproportionately higher for ethnic minority groups, and those in lower socioeconomic positions. It is imperative that interventions to prevent the spread of COVID-19 are targeted towards high-risk populations. We will investigate the associations between social characteristics (such as ethnicity, occupation and socioeconomic position) and COVID-19 outcomes and the extent to which characteristics/risk factors might explain observed relationships in Scotland.The primary objective of this study is to describe the epidemiology of COVID-19 by social factors. Secondary objectives are to (1) examine receipt of treatment and prevention of COVID-19 by social factors; (2) quantify ethnic/social differences in adverse COVID-19 outcomes; (3) explore potential mediators of relationships between social factors and SARS-CoV-2 infection/COVID-19 prognosis; (4) examine whether occupational COVID-19 differences differ by other social factors and (5) assess quality of ethnicity coding within National Health Service datasets.Methods and analysis We will use a national cohort comprising the adult population of Scotland who completed the 2011 Census and were living in Scotland on 31 March 2020 (~4.3 million people). Census data will be linked to the Early Assessment of Vaccine and Anti-Viral Effectiveness II cohort consisting of primary/secondary care, laboratory data and death records. Sensitivity/specificity and positive/negative predictive values will be used to assess coding quality of ethnicity. Descriptive statistics will be used to examine differences in treatment and prevention of COVID-19. Poisson/Cox regression analyses and mediation techniques will examine ethnic and social differences, and drivers of inequalities in COVID-19. Effect modification (on additive and multiplicative scales) between key variables (such as ethnicity and occupation) will be assessed.Ethics and dissemination Ethical approval was obtained from the National Research Ethics Committee, South East Scotland 02. We will present findings of this study at international conferences, in peer-reviewed journals and to policy-makers.
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spelling doaj-art-838d60134db9456e94b439f2547381bb2024-12-08T07:30:10ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2021-048852Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)Rachael Wood0Aziz Sheikh1Alastair H Leyland2Duncan Buchanan3Chris Robertson4Colin R Simpson5Colin McCowan6Sarah Jane Stock7Utkarsh Agrawal8Lewis Ritchie9Annemarie Docherty10James Marple11Paul Henery12Kirsten J Hainey13Thomas Alexis14Steven Kerr15Public Health Scotland, Edinburgh, UKUsher Institute, University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UKMRC/CSO Social and Public Health Sciences Unit, Glasgow, UKPublic Health Scotland, Edinburgh, UKPublic Health Scotland, Glasgow and Edinburgh, UKUsher Institute, The University of Edinburgh, Edinburgh, UKSchool of Medicine, University of St Andrews, St Andrews, Fife, UKCentre for Medical Informatics, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UKSchool of Medicine, University of St Andrews, St Andrews, Fife, UKGeneral Practice and Primary Care, Aberdeen University, Aberdeen, UKUsher Institute, The University of Edinburgh, Edinburgh, UKDepartment of Anaesthesia, Critical Care & Pain Medicine, NHS Lothian, Edinburgh, UKMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKScottish Government, Edinburgh, UKUsher Institute, The University of Edinburgh, Edinburgh, UKIntroduction Evidence from previous pandemics, and the current COVID-19 pandemic, has found that risk of infection/severity of disease is disproportionately higher for ethnic minority groups, and those in lower socioeconomic positions. It is imperative that interventions to prevent the spread of COVID-19 are targeted towards high-risk populations. We will investigate the associations between social characteristics (such as ethnicity, occupation and socioeconomic position) and COVID-19 outcomes and the extent to which characteristics/risk factors might explain observed relationships in Scotland.The primary objective of this study is to describe the epidemiology of COVID-19 by social factors. Secondary objectives are to (1) examine receipt of treatment and prevention of COVID-19 by social factors; (2) quantify ethnic/social differences in adverse COVID-19 outcomes; (3) explore potential mediators of relationships between social factors and SARS-CoV-2 infection/COVID-19 prognosis; (4) examine whether occupational COVID-19 differences differ by other social factors and (5) assess quality of ethnicity coding within National Health Service datasets.Methods and analysis We will use a national cohort comprising the adult population of Scotland who completed the 2011 Census and were living in Scotland on 31 March 2020 (~4.3 million people). Census data will be linked to the Early Assessment of Vaccine and Anti-Viral Effectiveness II cohort consisting of primary/secondary care, laboratory data and death records. Sensitivity/specificity and positive/negative predictive values will be used to assess coding quality of ethnicity. Descriptive statistics will be used to examine differences in treatment and prevention of COVID-19. Poisson/Cox regression analyses and mediation techniques will examine ethnic and social differences, and drivers of inequalities in COVID-19. Effect modification (on additive and multiplicative scales) between key variables (such as ethnicity and occupation) will be assessed.Ethics and dissemination Ethical approval was obtained from the National Research Ethics Committee, South East Scotland 02. We will present findings of this study at international conferences, in peer-reviewed journals and to policy-makers.https://bmjopen.bmj.com/content/11/8/e048852.full
spellingShingle Rachael Wood
Aziz Sheikh
Alastair H Leyland
Duncan Buchanan
Chris Robertson
Colin R Simpson
Colin McCowan
Sarah Jane Stock
Utkarsh Agrawal
Lewis Ritchie
Annemarie Docherty
James Marple
Paul Henery
Kirsten J Hainey
Thomas Alexis
Steven Kerr
Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)
BMJ Open
title Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)
title_full Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)
title_fullStr Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)
title_full_unstemmed Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)
title_short Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)
title_sort ethnic and social inequalities in covid 19 outcomes in scotland protocol for early pandemic evaluation and enhanced surveillance of covid 19 eave ii
url https://bmjopen.bmj.com/content/11/8/e048852.full
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