title: Ethnic Variations in Liver- and Alcohol-Related Disease Hospitalisations and Mortality: The Scottish Health and Ethnicity Linkage Study.
abstract: OBJECTIVE
  Preventing alcohol-related harms, including those causing liver disease, is a public health priority in the UK, especially in Scotland, but the effects of ethnicity are not known. We assessed liver- and alcohol-related events (hospitalisations and deaths) in Scotland using self-reported measures of ethnicity.
  
  
  METHODS
  Linking Scottish NHS hospital admissions and mortality to the Scottish Census 2001, we explored ethnic differences in hospitalisations and mortality (2001-2010) of all liver diseases, alcoholic liver disease (ALD) and specific alcohol-related diseases (ARD). Risk ratios (RR) were calculated using Poisson regression with robust variance, by sex, adjusted for age, country of birth and the Scottish Index of Multiple Deprivation (SIMD) presented below. The White Scottish population was the standard reference population with 95% confidence intervals (CI) calculated to enable comparison (multiplied by 100 for results).
  
  
  RESULTS
  For all liver diseases, Chinese had around 50% higher risks for men (RR 162; 95% CI 127-207) and women (141; 109-184), as did Other South Asian men (144; 104-201) and Pakistani women (140; 116-168). Lower risks for all liver diseases occurred in African origin men (42; 24-74), other White British men (72; 63-82) and women (80; 70-90) and other White women (80; 67-94). For ALD, White Irish had a 75% higher risk for men (175; 107-287). Other White British men had about a third lower risk of ALD (63; 50-78), as did Pakistani men (65; 42-99). For ARD, almost 2-fold higher risks existed for White Irish men (182; 161-206) and Any Mixed Background women (199; 152-261). Lower risks of ARD existed in Pakistani men (67; 55-80) and women (48; 33-70), and Chinese men (55; 41-73) and women (54; 32-90).
  
  
  CONCLUSIONS
  Substantial variations by ethnicity exist for both alcohol-related and liver disease hospitalisations and deaths in Scotland: these exist in subgroups of both White and non-White populations and practical actions are required to ameliorate these differences.
authors.affiliation: Gastroenterology and Liver Units, Queen Elizabeth Hospital Birmingham, University of Birmingham, Edgbaston, Birmingham, B15 2TH, UK Department of Gastroenterology, Wellington Regional Hospital, Capital and Coast District Health Board, Newtown, Wellington 6011, New Zealand nijbhala@gmail.com.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Bhala
authors.affiliation: Edinburgh Migration, Ethnicity and Health Research Group (EMEHRG), Centre for Population Health Sciences, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH89AG, UK.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Cézard
authors.affiliation: Edinburgh Migration, Ethnicity and Health Research Group (EMEHRG), Centre for Population Health Sciences, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH89AG, UK Public Health & Intelligence, NHS National Services Scotland, Gyle Crescent, Edinburgh, EH12 9EB, UK.
authors.forename: Hester J T
authors.initials: HJ
authors.lastname: Ward
authors.affiliation: Edinburgh Migration, Ethnicity and Health Research Group (EMEHRG), Centre for Population Health Sciences, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH89AG, UK Cardiovascular Epidemiology Unit, Strangeways Research Laboratory, Department of Public Health and Primary Care, University of Cambridge, Worts Causeway, CB1 8RN, UK.
authors.forename: Narinder
authors.initials: N
authors.lastname: Bansal
authors.forename: Raj
authors.initials: R
authors.lastname: Bhopal
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000208:ethnology* / Q000401:mortality; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008107:Liver Diseases / Q000208:ethnology / Q000401:mortality; D008108:Liver Diseases, Alcoholic / Q000208:ethnology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D044469:Racial Groups / Q000706:statistics & numerical data*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult