Using existing data to conduct international comparisons of ethnic inequalities in health: A developmental project comparing the UK and the Netherlands

Charles Agyemang, Raj Bhopal, M. Nicolaou, A. Kunst, Paola C. Zaninotto, Nigel Unwin, James D. Nazroo, Karien Stronks

Research output: Chapter in Book/Report/Conference proceedingChapter


Background: Cardiovascular disease (CVD) is a major public health burden and the rates differ between ethnic minority groups. The causes of the differences are
incompletely understood and pose a high level scientific challenge for public health, epidemiology and clinical care. Comparing data on ethnic minority populations from similar geographical origin who have migrated under very different circumstances to different industrialised countries provide the opportunity to carry out comparative analyses that will assist greater understanding on ethnic inequalities in health. This paper describes: (1) migration histories of African and South Asian origin populations living in the Netherlands and the UK and differences in the residing countries’ national context in terms of economic, socio-political, health access and policies that may influence their
health; and (2) design and methods of a study aimed to evaluate how existing databases on CVD risk factors in both countries can be utilised for international comparative
studies to advance our knowledge on ethnic inequalities in CVD.

Methods/design: Through a systematic literature search, existing studies that
collected standardised data on CVD and risk factors in South Asian and African descent populations in the UK (Health Surveys for England and Newcastle Heart Project) and the Netherlands (the SUNSET study) conducted between 1990 and 2006 were identified. Each collaborator provided anonymised individual participants’ data. Two workshops were held in Amsterdam to discuss methodological issues relating to the datasets and cross-standardisation protocols were subsequently developed.

Results: There were important differences in migration histories among English and Dutch South Asian and African origin populations and the national context in which they currently live. We also found striking differences in CVD risk factors between English and Dutch South Asian and African groups living in England and the Netherlands. Hypertension, diabetes, metabolic syndrome and smoking were generally higher among Dutch South Asian and Africans than among their England equivalent groups. Health care factors played a role.

Conclusion: These findings seem to suggest that the national contextual factors may influence the prevalence of CVD risk factors in different ways among ethnic minority groups living in different countries. Cross-standardisation exercise of the existing CVD datasets indicates that with careful standardisation procedures, the existing international datasets on ethnic minority groups can be utilised for international comparative studies. These datasets provide promising possibilities in advancing our understanding and thereby addressing ethnic inequalities in health.
Original languageEnglish
Title of host publicationEthnicity
Subtitle of host publicationTheories, International Perspectives and Challenges
PublisherNova Publishers
ISBN (Print)978-1-62808-161-9
Publication statusPublished - 2013

Publication series

NameSocial Issues, Justice and Status: Immigration in the 21st Century: Political, Social and Economic Issues


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