Mackay Alex, Ashworth Mark, White Patrick
Academic Fellow, School of Population Health and Environmental Sciences, King's College London, Guy's Campus, London, UK.
Reader in Primary Care, School of Population Health and Environmental Sciences, King's College London, Guy's Campus, London, UK.
BJGP Open. 2017 Nov 29;1(4):bjgpopen17X101241. doi: 10.3399/bjgpopen17X101241. eCollection 2018 Jan.
Socioeconomic and ethnic factors are established determinants of cardiovascular health inequalities. The role of low proficiency in the majority language as a mediator of these inequalities is uncertain.
This study aimed to investigate the association between non-English language preference and cardiovascular health inequalities in a community in London.
DESIGN & SETTING: Retrospective, cross-sectional analysis of anonymised patient-level data collected from general practices in Lambeth, south London.
Cardiovascular disease prevalence, monitoring, and risk-identification data were compared between non-English and English language groups using multiple logistic regression.
Of the total number of patients registered at the 49 participating practices, 302 404 (83%) patients were aged ≥18 years. Preferred language was recorded by 69.4%: English 53.6%, Portuguese 3.2%, Spanish 2.6%, French 1.6%, Polish 1.4%, Somali 0.5%, and others 7.1%; 30.6% had no record of language preference. The non-English language preference group had a greater likelihood of coronary heart disease ([CHD], odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.03 to 1.34); diabetes mellitus ([DM], OR = 1.33, 95% CI = 1.23 to 1.43); obesity (OR = 1.08, 95% CI = 1.04 to 1.13); and smoking (OR = 1.18, 95% CI = 1.14 to 1.21), but no difference in the prevalence of hypertension or stroke. Cardiovascular monitoring was not less intense in this group. Portuguese-speakers (the largest non-English language preference group) had a greater likelihood of hypertension (OR = 1.43, 95% CI = 1.30 to 1.57); DM (OR = 1.74, 95% CI = 1.50 to 2.02); stroke (OR = 1.40, 95% CI = 1.08 to 1.81); obesity (OR = 1.53, 95% CI = 1.36 to 1.73); and smoking (OR = 1.13, 95% CI = 1.02 to 1.25).
The non-English language preference group was associated with a greater risk of some aspects of cardiovascular disease than the English language preference group, probably reflecting shared cultural and behavioural risk. Non-English language preference was not associated with lower rates of cardiovascular monitoring, providing some evidence of equitable primary care access in this group.
社会经济和种族因素是心血管健康不平等的既定决定因素。多数语言能力低下作为这些不平等的一个中介因素，其作用尚不确定。
本研究旨在调查伦敦一个社区中使用非英语语言偏好与心血管健康不平等之间的关联。
对从伦敦南部兰贝斯的全科医疗收集的匿名患者层面数据进行回顾性横断面分析。
使用多重逻辑回归比较非英语组和英语组之间的心血管疾病患病率、监测和风险识别数据。
在参与研究的49家医疗机构登记的患者总数中，302404名（83%）患者年龄≥18岁。69.4%的患者记录了偏好语言：英语53.6%、葡萄牙语3.2%、西班牙语2.6%、法语1.6%、波兰语1.4%、索马里语0.5%，其他7.1%；30.6%的患者没有语言偏好记录。非英语语言偏好组患冠心病（[CHD]，优势比[OR]1.18，95%置信区间[CI]=1.03至1.34）、糖尿病（[DM]，OR = 1.33，95% CI = 1.23至1.43）、肥胖（OR = 1.08，95% CI = 1.04至1.13）和吸烟（OR = 1.18，95% CI = 1.14至1.21）的可能性更大，但高血压或中风的患病率没有差异。该组的心血管监测强度并不低。说葡萄牙语的人（最大的非英语语言偏好组）患高血压（OR = 1.43，95% CI = 1.30至1.57）、糖尿病（OR = 1.74，95% CI = 1.50至2.02）、中风（OR = 1.40，95% CI = 1.08至1.81）、肥胖（OR = 1.53，95% CI = 1.36至1.73）和吸烟（OR = 1.13，95% CI = 1.02至1.25）的可能性更大。
与英语语言偏好组相比，非英语语言偏好组在心血管疾病某些方面的风险更高，这可能反映了共同的文化和行为风险。非英语语言偏好与较低的心血管监测率无关，这为该组公平获得初级医疗保健提供了一些证据。
