title: Ethnicity and cardiovascular health inequalities in people with severe mental illnesses: protocol for the E-CHASM study.
abstract: OBJECTIVE
  People with severe mental illnesses (SMI) experience a 17- to 20-year reduction in life expectancy. One-third of deaths are due to cardiovascular disease. This study will establish the relationship of SMI with cardiovascular disease in ethnic minority groups (Indian, Pakistani, Bangladeshi, black Caribbean, black African and Irish), in the UK.
  
  
  METHODS
  E-CHASM is a mixed methods study utilising data from 1.25 million electronic patient records. Secondary analysis of routine patient records will establish if differences in cause-specific mortality, cardiovascular disease prevalence and disparities in accessing healthcare for ethnic minority people living with SMI exist. A nested qualitative study will be used to assess barriers to accessing healthcare, both from the perspectives of service users and providers.
  
  
  RESULTS
  In primary care, 993,116 individuals, aged 18+, provided data from 186/189 (98 %) practices in four inner-city boroughs (local government areas) in London. Prevalence of SMI according to primary care records, ranged from 1.3-1.7 %, across boroughs. The primary care sample included Bangladeshi [n = 94,643 (10 %)], Indian [n = 6086 (6 %)], Pakistani [n = 35,596 (4 %)], black Caribbean [n = 45,013 (5 %)], black African [n = 75,454 (8 %)] and Irish people [n = 13,745 (1 %)]. In the secondary care database, 12,432 individuals with SMI over 2007-2013 contributed information; prevalent diagnoses were schizophrenia [n = 6805 (55 %)], schizoaffective disorders [n = 1438 (12 %)] and bipolar affective disorder [n = 4112 (33 %)]. Largest ethnic minority groups in this sample were black Caribbean [1432 (12 %)] and black African (1393 (11 %)).
  
  
  CONCLUSIONS
  There is a dearth of research examining cardiovascular disease in minority ethnic groups with severe mental illnesses. The E-CHASM study will address this knowledge gap.
authors: Department of Health Service and Population Research, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, PO 33, London, SE5 8AF, UK. jayati.das-munshi@kcl.ac.uk.
authors: J
authors: J
authors: Das-Munshi
authors: Division of Health and Social Care Research, Department of Primary Care and Public Health Sciences, King's College London, 3rd Floor, Addison House, Guy's Campus, London, SE1 1UL, UK.
authors: M
authors: M
authors: Ashworth
authors: South London and Maudsley Trust and King's College London, London, UK.
authors: F
authors: F
authors: Gaughran
authors: Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
authors: S
authors: S
authors: Hull
authors: Department of Health Service and Population Research, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, PO 33, London, SE5 8AF, UK.
authors: C
authors: C
authors: Morgan
authors: University of Manchester, Manchester, England.
authors: J
authors: J
authors: Nazroo
authors: Natural Language Processing Group, Department of Computer Science, University of Sheffield, Sheffield, England.
authors: A
authors: A
authors: Roberts
authors: Department of Health Service and Population Research, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, PO 33, London, SE5 8AF, UK.
authors: D
authors: D
authors: Rose
authors: Division of Health and Social Care Research, Department of Primary Care and Public Health Sciences, King's College London, 3rd Floor, Addison House, Guy's Campus, London, SE1 1UL, UK.
authors: P
authors: P
authors: Schofield
authors: Institute of Psychiatry, Psychology and Neuroscience, King's College London, Room M1.06, De Crespigny Park, London, SE5 8AF, UK.
authors: R
authors: R
authors: Stewart
authors: Department of Health Service and Population Research, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, PO 33, London, SE5 8AF, UK.
authors: G
authors: G
authors: Thornicroft
authors: Department of Health Service and Population Research, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, PO 33, London, SE5 8AF, UK.
authors: M J
authors: MJ
authors: Prince
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data; D001714:Bipolar Disorder / Q000208:ethnology*; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000208:ethnology*; D017691:Caribbean Region / Q000208:ethnology; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D011618:Psychotic Disorders / Q000208:ethnology*; D036301:Qualitative Research; D012559:Schizophrenia / Q000208:ethnology*; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
keywords: Bipolar affective disorder; Cardiovascular disease; Ethnicity; Schizophrenia; Severe mental illness