Across the planet, many people are living better and longer, as humans continue to experience a substantial overall decrease in mortality. Unfortunately, that happy trend is not evenly distributed across communities.
Despite the progress in healthcare over the last century, resulting in longer life expectancy and better disease survival outcomes, significant disparities between various population groups remain a major global health issue.
A new study by Georgia Institute of Technology researchers in the open-access journal PLOS Global Health probes ethnic health disparities and mortality risk factors in the United Kingdom. Their work points to mortality risk factors that are group-specific, but modifiable, supporting the notion of targeted interventions that could lead to greater health equity.
“Different ethnic groups show very different levels of disease-specific mortality along with distinct mortality risk factors,” said I. King Jordan, professor in the School of Biological Sciences, and principal investigator on the study. “Unfortunately, when it comes to health, ethnicity still matters.”
Both environmental and genetic factors, and the interaction between them over time, have been cited as main contributors of health disparities. Closing the gap will require a long-term, complex series of solutions.
“Taking a one-size fits all approach to healthcare will only exacerbate the very health disparities that already disproportionately burden ethnic minorities,” said Jordan, whose collaborators on the study were lead author Kara Keun Lee, as well as Emily Norris, Lavanya Rishishwar, Andrew Conley, and John McDonald, emeritus professor in the School of Biological Sciences and founding director of Georgia Tech’s Integrated Cancer Research Center.
The work was done in collaboration with, and with support from, the NIH’s National Institute on Minority Health and Health Disparities (NIMHD) and Leonardo Mariño-Ramírez, a researcher working on epidemiology and genetics research at NIMHD’s Division of Intramural Research (DIR).
The UK Example
The research team analyzed data on 490,610 Asian, Black, and White participants from the UK Biobank, a study that enrolled 500,000 people in the UK aged 40 to 69 between 2006 and 2010. The UK Biobank includes data spanning physical measures, lifestyle, blood and urine biomarkers, imaging, genetic, and linked medical and death registry records.
Certain causes of mortality were more common among the different ethnic groups: Asian individuals had the highest mortality from ischemic heart disease, while individuals in the Black community had the highest mortality from COVID-19, and White individuals had the highest mortality from cancers of respiratory/intrathoracic organs.
In addition, some preexisting medical conditions and biomarkers showed specific associations with ethnicity and mortality. Mental health diagnoses, for instance, were a major risk factor for mortality in the Asian group, whereas parasitic diseases and C-reactive protein (CRP) serum levels were associated with higher mortality in the Black group.
“These results underscore the importance of population-specific studies that can help decompose health disparities and inform targeted interventions towards, shrinking the health disparity gap,” said Jordan, who praised Lee’s approach to the study, “which highlights the importance of considering individuals’ self-reported identity as it relates to their health outcomes, disease risks, and exposures.”
For future work, the team plans to look at racial and ethnic health disparities in the US, in collaboration with the NIMHD.
CITATION: Kara Keun Lee, Emily T. Norris, Lavanya Rishishwar, Andrew B. Conley, Leonardo Mariño-Ramírez, John F. McDonald, and I. King Jordan. “Ethnic disparities in mortality and group-specific risk factors in the UK Biobank.” doi.org/10.1371/journal.pgph.0001560
Writer: Jerry Grillo