Ethnic disparities in mortality and group-specific risk factors in the UK Biobank.

Autor:	Lee KK; School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America.; Integrated Cancer Research Center, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America., Norris ET; IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America., Rishishwar L; IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America., Conley AB; IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America., Mariño-Ramírez L; National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States of America., McDonald JF; School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America.; Integrated Cancer Research Center, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America., Jordan IK; School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America.; Integrated Cancer Research Center, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America.; IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Feb 23; Vol. 3 (2), pp. e0001560. Date of Electronic Publication: 2023 Feb 23 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0001560
Abstrakt:	Despite a substantial overall decrease in mortality, disparities among ethnic minorities in developed countries persist. This study investigated mortality disparities and their associated risk factors for the three largest ethnic groups in the United Kingdom: Asian, Black, and White. Study participants were sampled from the UK Biobank (UKB), a prospective cohort enrolled between 2006 and 2010. Genetics, biological samples, and health information and outcomes data of UKB participants were downloaded and data-fields were prioritized based on participants with death registry records. Kaplan-Meier method was used to evaluate survival differences among ethnic groups; survival random forest feature selection followed by Cox proportional-hazard modeling was used to identify and estimate the effects of shared and ethnic group-specific mortality risk factors. The White ethnic group showed significantly worse survival probability than the Asian and Black groups. In all three ethnic groups, endoscopy and colonoscopy procedures showed significant protective effects on overall mortality. Asian and Black women show lower relative risk of mortality than men, whereas no significant effect of sex was seen for the White group. The strongest ethnic group-specific mortality associations were ischemic heart disease for Asians, COVID-19 for Blacks, and cancers of respiratory/intrathoracic organs for Whites. Mental health-related diagnoses, including substance abuse, anxiety, and depression, were a major risk factor for overall mortality in the Asian group. The effect of mental health on Asian mortality, particularly for digestive cancers, was exacerbated by an observed hesitance to answer mental health questions, possibly related to cultural stigma. C-reactive protein (CRP) serum levels were associated with both overall and cause-specific mortality due to COVID-19 and digestive cancers in the Black group, where elevated CRP has previously been linked to psychosocial stress due to discrimination. Our results point to mortality risk factors that are group-specific and modifiable, supporting targeted interventions towards greater health equity. Competing Interests: The authors have declared that no competing interests exist. (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Databáze:	MEDLINE
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