Linking census data to health records clarifies ethnic inequalities in health and care

Scobie emphasises outcome heterogeneity and the need for higher quality data, including missing and inaccurate ethnicity data in health records and uncertainty of population denominators.1 We recommend linking census data to health records as a solution.Extracting ethnicity from census data reduces both missing data and misclassification, especially of non-white ethnic minorities. It also provides a near complete population denominator including those not engaging with healthcare. These advantages are important for improving data quality on ethnic variations in healthcare. This has already been achieved in Scotland.Linkage of the census to NHS health data, including mortality;2 hospital admissions,3 including mental health and compulsory admission to psychiatric hospitals;4 cancer registration;5 breast and bowel screening;67 and primary care8 was done in Scotland by the Scottish Health and Ethnicity Linkage Study (SHELS).9SHELS produced high quality data on more than 29 different health outcomes by ethnicity.10 Like Scobie, we have also produced a graphic illustrating the…
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