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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 4/2016

Open Access 01-04-2016 | Study Protocols and Samples

Ethnicity and cardiovascular health inequalities in people with severe mental illnesses: protocol for the E-CHASM study

Authors: J. Das-Munshi, M. Ashworth, F. Gaughran, S. Hull, C. Morgan, J. Nazroo, A. Roberts, D. Rose, P. Schofield, R. Stewart, G. Thornicroft, M. J. Prince

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 4/2016

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Abstract

Purpose

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.
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Metadata
Title
Ethnicity and cardiovascular health inequalities in people with severe mental illnesses: protocol for the E-CHASM study
Authors
J. Das-Munshi
M. Ashworth
F. Gaughran
S. Hull
C. Morgan
J. Nazroo
A. Roberts
D. Rose
P. Schofield
R. Stewart
G. Thornicroft
M. J. Prince
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 4/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-016-1185-8

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