Long-term conditions in minoritised urban populations: Latin American community of London

Background Minoritised populations in the United Kingdom frequently identify in multiple ethnic groupings and therefore little is known of their health needs. There were 136,062 Latin American people recorded in the 2021 UK Census across six different ethnic groups. Aim Characterise the incidence of long-term conditions (LTCs) and multiple LTCs (mLTCs) amongst the Latin American community of London. Design and setting Retrospective cohort study using pseudonymised primary care data from 890,922 individuals in an urban, superdiverse area of London from 2005-2022. Method Latin American individuals were identified using country of birth, language and ethnicity codes, and validated against Census findings. Multivariable competing risks regression models estimated the effect of being Latin American, compared to the White British ethnic group, on incidence of 32 LTCs and risk factors relevant to urban populations. Results 28,617 Latin American people were identified in this cohort, 3.2% of total. In multivariable analysis, compared to the White British ethnic group, being Latin American was associated with twice the rate of HIV/AIDS (hazard ratio (HR) 2.00; 95% confidence interval (CI) 1.65–2.43), 60% increased rate of diabetes (HR 1.61; 95%CI 1.47–1.77) and almost twice the rate of systemic lupus erythematosus and rheumatoid arthritis (HRs 2.28; 95% CI 1.18–4.38 and 1.69; 95% CI 1.32–2.17 respectively). Conclusion Using commonly-recorded primary care codes accurately and reliably identifies markedly higher risks of HIV/AIDS, diabetes and joint disease among London’s Latin American population. These data can be used to target inclusive and equitable health interventions. How it fits in Little is known of the health of the United Kingdom’s (UK) Latin American population, who usually identify in multiple ethnic groups and are therefore hidden from ethnicity statistics. This study identified 28,617 Latin Americans using country of birth, ethnicity and language codes in a large primary care record dataset in London (n=890,438). Compared to the White ethnic group, the Latin American population are at higher risk of HIV/AIDS, diabetes, systemic lupus erythematosus and rheumatoid arthritis. These data reveal health inequalities in a frequently hidden and locally important population of the UK. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement JS is funded by an NIHR In-Practice Fellowship (NIHR303520). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: All data were extracted under the terms of a signed data sharing agreement with each practice and with project-specific approval following submission of a data privacy impact assessment, approved by Lambeth Clinical Commissioning Group on 2 November 2017. Information governance approval required low number suppression. In this case we have suppressed numbers of fewer than 20 patients for ethnic group, and fewer than 100 patients for country of birth tabulations. Separate ethical committee approval was not required (Health Research Authority, 29 September 2017) since all data were fully anonymised for the purposes of research access, and all patient identifiable data had been removed. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data are not publicly available to share, but the research group can provide descriptive aggregate data. Requests should be made to Mark Ashworth (mark.ashworth{at}kcl.ac.uk).