Using Electronic Health Records to Understand Health in Emerging Communities

Background: Ethnic inequalities in health and care are well-established. However, the lack of fine-grained data and small group sizes mean that the health and care needs of some ethnic groups are not well-quantified. Methods: The North West London (NWL) Whole Systems Integrated Care (WSIC) database contains linked, deidentified records from General Practices (GPs), hospitals, and social care in NWL. Using this data, we examined health outcomes and healthcare utilisation of the Romanian and Somali communities in Brent. Results: After age- and sex-standardisation, Somalis had higher prevalence of long-term conditions (LTCs), while Romanians had lower prevalence. Even after adjusting for prevalence of LTCs, the odds of having had an emergency department attendance, or hospital admission was higher for Somali adults, while Romanian adults had higher odds of having hospital admissions or avoidable emergency department attendances. Conclusion: This work is the first to quantify health outcomes and utilisation of these communities in the UK, and demonstrate that routine healthcare data can be used to understand and quantify ethnic inequalities in health and care.