Preventing alcohol-related harms, including those causing liver disease, is a public health priority in the UK, especially in Scotland, but the effects of ethnicity are not known. Researchers assessed liver- and alcohol-related events (hospitalisations and deaths) in Scotland using self-reported measures of ethnicity.
The study linked Scottish NHS hospital admissions and mortality to the Scottish Census 2001, and recorded ethnic differences in hospitalisations and mortality (2001–2010) of all liver diseases, alcoholic liver disease (ALD) and specific alcohol-related diseases (ARD). Risk ratios (RR) were calculated using Poisson regression with robust variance, by sex, adjusted for age, country of birth and the Scottish Index of Multiple Deprivation (SIMD). The White Scottish population was the standard reference population with 95% confidence intervals (CI) calculated to enable comparison (multiplied by 100 for results).
For all liver diseases, Chinese men and women had higher risk (RR 162; 95% CI 127–207 and 141; 109– 184, respectively), as did Other South Asian men (144; 104–201) and Pakistani women (140; 116–168). Lower risks for all liver diseases occurred in African origin men (42; 24–74), other White British men (72; 63–82) and women (80; 70–90) and other White women (80; 67–94).
For ALD, White Irish had a 75% higher risk for men (175; 107–287). Other White British men had about a third lower risk of ALD (63; 50–78), as did Pakistani men (65; 42–99). For ARD, almost 2-fold higher risks existed for White Irish men (182; 161–206) and Any Mixed Background women (199; 152–261). Lower risks of ARD existed in Pakistani men (67; 55–80) and women (48; 33–70), and Chinese men (55; 41–73) and women (54; 32–90).
Dr Neeraj Bhala, who conducted the study at University of Edinburgh’s Centre for Population Health Sciences, said: “The ethnic variation in the alcohol and liver-related hospitalisations and deaths in Scotland found in this large-scale study is a cause for concern”. “We have important lessons to learn about preventing these alcohol- and liver-related deaths, and we should look to communities with typically low levels of alcohol consumption to help develop policies that benefit the whole population of Scotland.”
Source: Ethnic Variations in Liver- and Alcohol-Related Disease Hospitalisations and Mortality: The Scottish Health and Ethnicity Linkage Study. Neeraj Bhala, Genevieve Cézard, Hester JT Ward, Narinder Bansal, Raj Bhopal. DOI: . Alcohol and Alcoholism, first published online: 6 May 2016.