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- Page navigation anchor for Interpretation of ethnicity-specific data: Increased risk vs. increased utilizationInterpretation of ethnicity-specific data: Increased risk vs. increased utilization
It was with great pleasure we read the article by Robson et al. titled “NHS Health Checks: Equity and outcomes 2009-17: An observational study”. We would like to offer additional contributions regarding explanations for the findings and differences between ethnic groups. It is difficult to ascertain whether ethnic disparities in incidence of disease between attendees and non-attendees are due to underlying higher risk of disease in these groups or the result of the NHS Health Check. It is well established that Black and South Asian patients have increased risk of hypertension and diabetes compared to White patients and that ethnicity-specific BMI cutoffs should be utilized. It would be important to understand the risk of incident disease in attendees vs. non-attendees within each ethnic group. Interestingly, in a recent 2021 Lancet article, study authors found that adjusted incidence of type 2 diabetes occurred at far lower BMI in South Asians (BMI of 23.9) and Black Caribbeans (BMI of 26.0) compared to White patients with BMI of 30.1 Additionally, at comparable BMIs, Bangladeshis had the highest risk of Type II diabetes, followed by Pakistanis and Indians. This is in line with the ethnic differences in NHS Health Check attendance rates, potentially offering an explanation for South Asians’ high attendance rates. Lastly, Eastwood et al., in a June 2021 article assessing UK ethnic differences in statin initiation, found that t...
Competing Interests: None declared. - Page navigation anchor for Engagement, effectiveness and improved equity of NHS Health ChecksEngagement, effectiveness and improved equity of NHS Health Checks
The manuscript is interesting and based on personal experiences and discussion with scientists, the following measures can be instituted to increase the uptake of NHS Health Checks.1 The public could be made aware of the life-threatening, yet preventable nature of stroke and heart attacks through banners in pubs, sports centres, gyms, public events. At every opportunity, health education and getting the Health Checks demands promotion. The waiting times for appointment at the clinic should be minimal. The participants need to be given detailed information as to what specific measurements and tests will be carried out and the detailed numeric results. It should be spelt out that a blood glucose test is not done at the check but recommended only if their body-mass-index and blood-pressure cross a certain threshold. If results are all satisfactory than the follow up should be ensured.
The outcomes of the health screening i.e., detection of more people with increased risk for cardiovascular diseases and type 2 diabetes (DM) can be improved by additional non- invasive simple measures. Based on research on primary care participants, we have found that ankle blood-pressures are associated more with DM and cardiovascular diseases compared to brachial blood-pressures.2 We propose ankle blood-pressure to be part of NHS Health Checks.
The NHS Health Checks requires customizing for different populations. The significance of...
Show MoreCompeting Interests: None declared.