Asian and Black patients are more likely to underreport health problems than White populations, according to research involving 2.6 million people.
The study by University of Manchester found that people from different ethnic groups with health conditions rated their quality of life differently, even when they reported similar prevalence of actual illness.
Asian and Black ethnic groups with long-term health conditions could be more likely to downplay anxiety and depression, and under-report their ability to carry out daily activities than White populations.
Lead author Dr Juan Marcelo Virdis said: ‘This is important because differences between perceived and actual health can affect how you seek healthcare and could, for example, delay a clinical consultation.’
He added that understanding these differences was ‘crucial for designing equitable health services and improving outcomes across diverse populations’.
The study was based on data from the General Practice Patient Survey in England, including 2.3 million White respondents, 160,000 Asian, 70,000 Black, 20,000 mixed or multiple backgrounds, and 60,000 from other ethnic groups.
The research from Manchester is the largest study to tackle differences in self-rating.
The researchers based their analysis on EQ-5D-5L, a standardised measurement tool to measure health-related quality of life.
There are five self-reported dimensions of health in 5D: mobility, self-care, usual activities, pain/discomfort, anxiety/depression.
The 5L refers to five levels of self-reported severity for each dimension: no problems, slight problems, moderate problems, severe problems, extreme problems/unable.
The researchers analysed five ethnic groups of patients who reported having one or more of 15 long-term health conditions.
The reason why some ethnic groups report differently remains unclear, though researchers speculate that responses to health questions are subjective and influenced by background and expectations.
Dr Virdis said more evidence was needed.
‘Our research provides a scenario for further studies using objectively measured health conditions, such as biological risk factors, or objective measures of physical health such as grip strength.
‘In addition, we were not able to investigate the mechanisms at play, so this could be a focus for future qualitative research,’ he said.
The research was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester (ARC-GM) and was published last week in the journal Quality of Life Research.
