Time period trends in ethnic inequalities in limiting long term illness in England and Wales

Purpose – This paper's aim is to analyse ethnic group differences in self reported limiting long term illness (LLTI) among middle-aged men and women in England and Wales and compare patterns of variation in 1991 and 2001. Design/methodology/approach – The methodology is a cross-sectional analysis of two nationally representative cohorts aged 40-59 in 1991 and 2001, respectively. Seven ethnic minority groups were selected from the Office for National Statistics Longitudinal Study of England and Wales (White Irish, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African and Chinese). Logistic regression estimated the odds ratio for having a LLTI in each ethnic minority group compared to White British. The odds of having a LLTI in 2001 compared to 1991, by sex, were adjusted stepwise for differences in age, social class, car ownership, household overcrowding and tenure and length of residence. Findings – All ethnic groups reported a higher prevalence of LLTI in 2001 than in 1991. The rise in LLTI was largest in White Irish, Bangladeshi and Pakistani and smallest in Black African and Chinese groups. Controlling for socioeconomic factors had a weak influence on the risk of limiting long term illness in men and women. Controlling for length of residence attenuated the risk of LLTI in 2001 in White Irish and Pakistani men, and Indian men and women. Practical implications – Emerging ethnic differences highlight a growing need for differential health services to manage the increase in LLTI and demands for illness management. Originality/value – The paper illustrates that ethnic differences in LLTI changed during the 1990s with some groups becoming more disadvantaged relative to the White British population and others less so