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11 Use of health services and prescribed medicines
Madhavi Bajekal
11.1.1 Background This chapter examines the use of GP services (11.2), dental services (11.3), and hospital services (11.4), followed by the use of prescribed medicines (11.5), contraceptive pills (11.6) and hormone replacement therapy (11.7). 11.1.2 The questions asked and measures used GP consultations Informants were asked whether they had talked to a doctor in person or by telephone, other than during a visit to a hospital, in the two weeks prior to interview. For each consultation (to a maximum of 9), informants were asked on whose behalf the consultation was made; whether it was on the NHS or paid for privately; whether the consultation was with a GP, a practice nurse, or a specialist physician; the site of consultation and whether the doctor had issued a prescription. Section 11.2 focuses on consultations on the informant's own behalf with a GP under the NHS in the two weeks prior to interview. These constitute 90% of all consultations recorded, the remainder being on behalf of others (1%), or on behalf of the informant but either paid for privately (2%) or with a doctor other than a GP (7%). Comparisons between sub-groups are based on two measures: the proportion who consulted a NHS GP in the past two weeks (the consultation rate) and the estimated mean number of consultations per year (the annual contact rate). Because some informants consulted more than once in the two-week reference period, the mean numbers of consultations per person have been annualised by multiplying by 26. This annual contact rate provides an estimate of GP workload which is known to be a slight overestimate when compared to actual annual contact rates recorded in the Morbidity Statistics from General Practice: fourth national study, 1991-92 (MSGP4).1 For the first time in the Health Survey for England series, informants were also asked if they had spoken to their GP in the last year about 'being anxious or depressed or about a mental, nervous or emotional problem'. Usual pattern of visits to a dentist Informants who had not lost all their natural teeth were asked whether they usually visited a dentist for a regular check-up, an occasional check up or only when they were having trouble with their teeth. As an indicator of overall dental health and healthcare need, informants were also asked if they had experienced toothache or severe discomfort with their teeth in the past six months. Hospital visits Informants were asked whether they had attended an outpatient or casualty department, or been admitted to hospital as a day patient or as an inpatient (overnight or longer), during the last year. Women aged 16 to 49 who had been admitted to hospital as a day patient or an inpatient were also asked if they had been admitted to hospital for stays other than those relating to childbirth. The difference between the responses to the two questions provides an estimate of the percentage of women admitted only for maternity care. Of the 498 women in the 16-49 age group who had been admitted to hospital as inpatients in the past year, 155 (31%) had been admitted only for childbirth. The equivalent percentage of maternity-only admissions for day patients was 9%. Prescribed medicines Following the practice of previous Health Surveys, information on prescribed medicines was collected as part of the nurse visit, and the name of each type of prescribed medication was recorded. Medicines were allocated a 6-digit code corresponding to the British National Formulary (BNF)2 listing, by the nurse. Any medicines that nurses were unable to code were checked by office coding staff. As the proportion of individuals taking medication was small, for analysis purposes medicines have been collapsed into 13 pharmacological groups, corresponding to BNF chapters. Contraceptives were not included as prescribed medicines. Because nurses did not visit informants in the general population sample in the 1999 Health Survey,3 data from the 1998 survey has been used to derive comparative statistics for the general population. Contraceptive pill use Women aged 16 and over were asked, on the self-completion questionnaire, whether they were taking a contraceptive pill or had had a contraceptive injection or implant. Those who were taking oral contraceptives or having a contraceptive injection or implant were asked to give the brand name of the contraceptive, and to indicate whether it was an injection, mini pill, combined pill or implant (Norplant). Pill brands were allocated a 6-digit BNF code. For consistency with earlier Health Surveys, the analysis is based on women aged 16-54, and type of pill used is derived from pill brand names. HRT use Women aged 16 and over were asked, on a self-completion questionnaire, whether they were currently, or had been, on hormone replacement therapy (HRT). All HRT users were asked at what age they had started on HRT medication and past users were asked at what age they stopped using HRT. All women were also asked whether they were menstruating or whether their periods had stopped. Women whose periods had stopped were then asked 'Did your periods stop as a result of an operation?' It has been assumed in the analysis that given the sequence of questions, most informants would have understood 'an operation' to mean a hysterectomy and have therefore categorised women who answered in the affirmative as having had a surgical menopause. 11.2.1 Introduction A number of studies which have compared the utilisation of services across minority ethnic groups have shown that rates of GP consultations are higher in minority ethnic groups, particularly among South Asian groups.4, 5, 6 The notable exceptions are Chinese people, who have low rates of utilisation for all health services, including inpatient and outpatient services.7 However, utilisation data by itself tells us little about whether there is effective access to appropriate care. It remains unclear to what extent higher GP consultations among minority ethnic groups reflect greater ill health and social disadvantage or are related to other factors such as health beliefs and knowledge, problems with communication, acceptability of services provided, or a combination of these. In this section, the 'consultation rate' refers to the proportion of informants who had consulted a NHS GP in the past two weeks, while the 'annual contact rate' refers to the estimated annual number of consultations with a GP (see Section 11.1.2 above). The number of people who consult a GP at all during the year, and the number of consultations made by each person who consults a GP at all, are both reflected in the annual contact rate, which is a proxy measure of GP workload. 11.2.2 GP consultations, by minority ethnic group GP consultations by men 12% of men in the general population had consulted a GP in the past two weeks, with 2% having consulted two or more times. Among minority ethnic groups, the consultation rate (the percentage who consulted a GP in the past two weeks) was highest for Bangladeshi men (22%), followed by Indian, Pakistani and Black Caribbean men (ranging from 15% to 17%). The proportions of Irish men (10%) and Chinese men (8%) consulting were lower than that for the general population (12%). South Asian and Black Caribbean men were more likely to have consulted a GP more than once during the reference period. Men in the general population had an annual contact rate of 3.7. Table 11.1
shows the annual contact rates for each minority ethnic group. It also
shows, on an age-standardised basis, the ratios of these contact rates
to the contact rate for men in the general population. After taking
into account age differences between groups, South Asian and Black Caribbean
men were shown to make more contacts annually than men in the general
population, the standardised ratios ranging from 1.46 (Black Caribbean
men) to 2.64 (Bangladeshi men). Age-adjusted contact ratios for Chinese
and Irish men were not significantly different from that of the general
population. GP consultations by women As in the case of men, consultation rates were higher among Black Caribbean and South Asian women (21% to 24%) than among women in the general population (18%), while consultation rates for Chinese women (16%) and Irish women (20%) were closer to those for women in the general population. Across all groups, consultation rates were higher for women than men, except for Bangladeshi women who had similar rates to Bangladeshi men. The annual contact rate for women in the general population was 5.6.
Pakistani women had a significantly higher annual contact rate (8.6).
The pattern of variation in annual contact rates between minority ethnic
groups for women was similar to that found for men, but the differences
between groups were smaller. Table 11.1 also shows the age-standardised
ratios of minority ethnic group annual contact rates to those of women
in the general population. These ratios were significantly higher for
Pakistani (1.84), Bangladeshi (1.46), Indian (1.30) and Irish (1.25)
women, with Black Caribbean and Chinese women having rates similar to
that of the general population. GP consultation by age In most of the groups shown in Table 11.2, there was an increase in both consultation rates and annual contact rates with increasing age. The Irish were an exception, displaying no age trend, but the age trend was stronger in the other minority ethnic groups than in the general population. The age trend was particularly marked for Pakistani, Bangladeshi and Chinese men, and for Chinese women. For these groups, consultation rates were about five times as high at age 55 and over as at age 16-34, whereas among men in the general population they were only twice as high (and among women in the general population only about 1.1 times as high). The steeper age gradients in minority ethnic groups, relative to the general population, were due more to greater numbers consulting among older people than to lower consultation rates among younger people. Age gradients were generally steeper for men than women. This is because
consultation rates for women in the younger age groups are increased
by consultations linked to pregnancy and birth control, in addition
to those relating to illness. 11.2.3 Socio-economic variations in GP consultation Social class of head of household Observed consultation rates and annual contact rates were generally higher for men in manual than non-manual social classes. Age standardisation reduced some of these differences, which were not significant for individual groups, though the general tendency was still for rates to be higher among men in manual social classes. Women's observed consultation and contact rates were also generally higher in manual than non-manual households. In this case, however, age standardisation did not reduce the differences, and although these differences were not significant within any one minority ethnic group, the tendency for women in manual social classes to consult GPs more than women in non-manual social classes was clearer than among men. Irish men and women were an exception to the overall pattern, age-standardised
rates being lower (though not significantly) in manual households. Equivalised household income In the general population, a significantly lower percentage of both men and women consulted in the highest income tertile than in the lowest income tertile. Expressed in terms of GP workload, men in the lowest income tertile had an annual contact rate of 5.7, while men in the highest income group had an annual contact rate of 3.0. The equivalent figures for women were 7.6 and 5.0, respectively. However, there was no consistent pattern of variation by income across
ethnic groups. In the highest income tertile, contact rate ratios were
significantly higher for Indian men (1.53) than for the general population
(0.86). Chinese men in the highest household income tertile had the
lowest standardised contact rate ratio of all men (0.29), but rates
for Chinese men in the other income tertiles were not significantly
different from the corresponding general population rates. Among women,
apart from a lower standardised contact rate ratio for Pakistani women
in the highest income tertile (0.35), there were no significant patterns
of variation for women across minority ethnic groups within any income
category. 11.2.4 GP consultation rates for depression and anxiety, by minority ethnic group More women (20%) than men (14%) in the general population had consulted a GP in the past year about a mental, nervous or emotional problem or about being anxious or depressed. Patient consultation rates recorded in the MSGP4, under mental disorders (Chapter V, ICD9), are much lower at 12% for women and 7% for men aged 16 and over.1 This difference may be due to several reasons. First, the different modes under which data were collected in the two studies, namely, self-report in the Health Survey and doctor-coded reason for consultation in the MSGP4, would influence case definition. Second, the MSGP4 study was limited to 60 self-selected, predominantly large practices in non-metropolitan areas and the differences in the population profile of the two studies may account for the lower rates in the MSGP4. Lastly, there may have been an increase in consultation rates for depression and anxiety, the two most commonly diagnosed conditions in Chapter V, over the nine years between the two studies. Comparing minority ethnic groups to the general population, standardised ratios
for consulting a GP for psychological distress were significantly higher
for Irish men (1.51), and significantly lower for Chinese men (0.59)
and women (0.41) and Bangladeshi women (0.64). Consultation rates for psychological distress were highest among those
aged 35-44 for both men and women for the general population and for
the Irish and Black Caribbean groups. For the South Asian groups, consultation
rates rose steadily with age. Rates for Bangladeshi women under 55 were
lower than for most other groups, but among those aged 55 and over,
rates were similar to those for other South Asian women. Chinese men
and women had the lowest rates in each age and sex group. 11.3 Pattern of use of dental service 11.3.1 Introduction Previous community surveys have shown that dentist services are considerably under-used by minority ethnic groups.8, 9 However, as these surveys did not ask informants the reason for visiting the dentist, it is difficult to ascertain whether higher rates of service use among the white population are because of relatively poor dental health, or due to cultural differences in attitudes towards preventative health, or indeed, whether the cost of dental care is a barrier to attendance. The Health Survey provides information on the usual pattern of dental attendance by informants, rather than a measure of actual service use. 11.3.2 Dental attendance pattern, by minority ethnic group Questions about the usual pattern of dentist visits were asked of informants who had all or some natural teeth. In the analysis and associated tables, persons with no natural teeth are included in the base where prevalence figures are quoted. 10% of men and 13% of women in the general population had no natural teeth. After standardisation for differences in age between minority ethnic groups, Black Caribbean men and women were at significantly higher risk of having lost all their teeth (risk ratios 1.58 and 1.25 respectively, compared to 1.00 for the general population). Total teeth loss among the other minority ethnic groups was significantly lower for Chinese men (0.53) and for Bangladeshi women (0.57), but did not differ significantly from the age-standardised rates for the general population for any of the other groups. For all minority ethnic groups, the percentage of women who visited a dentist
regularly was higher than for men. About half of all men and three in
five women in the general population visited the dentist regularly.
If those with no natural teeth are excluded, these percentages rise
to 54% of men and 70% of women.
For all minority ethnic groups, and for both men and women, regular dental attendance (age-standardised) was significantly lower than for the general population. Compared to the general population, standardised ratios for Black Caribbeans averaged about 0.65, for Indians, Pakistanis and Chinese about 0.53 to 0.58 and for Bangladeshis about 0.25 (see inset table and Figure 11B). Except for Irish women, informants in all the minority ethnic groups were significantly more likely to visit a dentist only when having trouble with their teeth. Besides going to the dentist infrequently or only when having problems with their teeth, South Asian men and women, and particularly Bangladeshi women, were also about two to three times less likely than the general population ever to visit a dentist. Table 11.7, Figure 11B
The proportion attending regularly was higher in those aged 35-44
than among either younger or older informants. This pattern was consistent
across all groups and for both sexes. Lower rates among those aged 55
and over are partly due to the substantial proportions with no natural
teeth. If the analysis is limited to people with at least some natural
teeth (table not shown), the proportion of the general population attending
regularly in the older age group was similar to that for those aged
35-54, but was a little lower in most minority ethnic groups. Part of
the increase in regular attendance in the middle age group is due to
the shift in pattern of attendance from occasional to regular use. The
proportions visiting a dentist only when having trouble with their teeth
or never visiting a dentist remained markedly stable across age groups
for all minority ethnic groups. The low overall rates of regular attendance
noted earlier for minority ethnic groups compared to the general population
were found in all age groups. 11.4 Hospital attendance rates 11.4.1 Introduction This section examines the proportion of people attending hospital, either as an outpatient or, after excluding visits related solely to maternity, as a day or inpatient. Informants in the 1999 Health Survey were not asked how often they had used each type of hospital service in the past year, or for inpatient stays, the number of nights spent in hospital on each occasion. It is not therefore possible to calculate hospital utilisation rates. Comparisons between sub-groups in this section are based on hospital 'attendance' rates, a measure similar to the GP consultation rate defined above. 11.4.2 Hospital attendance rates, by minority ethnic group Outpatient attendance A third of men (33%) and women (31%) in the general population had visited
an outpatient or casualty department in the previous year. Comparing
overall age-standardised attendance ratios between minority ethnic groups,
levels of outpatient attendance for most minority ethnic groups were
similar to those for the general population. The exceptions were Chinese
men and women, both with age-standardised ratios of 0.62 relative to
the general population, and Bangladeshi men (0.86) and Pakistani women
(0.86). Among those aged 16-34, Irish men and women and Black Caribbean women had levels of attendance similar to that of the general population in that age group, at about 30%. Levels of attendance for both young men and young women in all other minority ethnic groups, on the other hand, were significantly lower and, in the case of the Chinese and Bangladeshis, as low as half the general population level. This pattern of lower levels of outpatient attendance in younger members of
minority ethnic groups relative to the general population is reversed
in the older age groups. In those aged 35-54, outpatient attendance
by Pakistani men and Bangladeshi men and women was higher by about 7
percentage points than in the corresponding age group in the general
population. For these minority ethnic groups, outpatient attendance
levels in the oldest age group were as high or higher than those in
the general population. Indian, Black Caribbean and Irish men, on the
other hand, showed higher than average rates only among those aged 55
and over. This pattern of low attendance rates in the youngest age group,
followed by higher than average rates from age 35 onwards, resulted
in the overall rate for minority ethnic groups not differing significantly
from that of the general population (cf. Table 11.9). The exceptions
to this general pattern were the Chinese, who had consistently low attendance
rates for all three age groups. Day patient admissions In the general population, the percentage of men and women who were admitted to hospital as day patients was 8%, after excluding maternity admissions. Admission rates did not vary significantly by minority ethnic group, or by sex. For men in minority ethnic groups as well as for the general population there
was an upward trend with increasing age in the percentage admitted to
hospital as day patients. The rising trend with age was not consistent
across all minority ethnic groups for women, with Black Caribbean women
having higher rates among those aged 35-54 (10%) than among those aged
55 and over (5%). Inpatient admissions After excluding admissions relating to maternity, the percentage of men and
women in the general population who had been admitted to hospital as
inpatients in the previous year was identical for both sexes at 9%.
After age standardisation, Chinese men and women were significantly
less likely (0.62 and 0.55, respectively) and Pakistani men more likely
(1.43), relative to the general population, to have been admitted as
inpatients. In general, the pattern that emerges is for inpatient admissions
to rise after age 55, but this pattern is not consistent across minority
ethnic groups, partly because the small numbers of those aged 55 and
over among the minority ethnic groups make estimates unstable. 11.4.3 Socio-economic variation in hospital utilisation, by minority ethnic group Outpatient attendance There were no consistent differences in outpatient attendance between social
classes within minority ethnic group. There was a decline in outpatient attendance by men in the general population
as household income rose. This pattern was less clear in the case of
women. There was no clear pattern of variation in outpatient attendance
by household income within minority ethnic groups, and no evidence among
men in these groups of the inverse relation to household income that
was seen in men in the general population. Inpatient attendance As with outpatient attendance, there were no consistent differences in inpatient attendance between social classes within minority ethnic group. In the general population, inpatient attendance was inversely associated with household income, for both men and women. As with social class, there was no clear pattern of variation with income within minority ethnic groups, and no evidence that their inpatient attendance shared the inverse relationship with income seen in the general population. 11.5.1 Introduction The Health Survey provides unique national data on the number and types of medication actually taken by informants, as opposed to items dispensed, statistics for which are available routinely from the Prescription Prescribing Authority data. For chronic health conditions where medication is an integral part of effective disease management, the Health Survey data provide a proxy measure of population morbidity. However, variations in prescribing are related to patient and non-patient related factors, such as differences between practices in treatment protocols. 11.5.2 Use of prescribed medication, by minority ethnic group Overall, men in the general population were taking on average 1.0 prescribed
medicines, and women 1.3. The higher average number of medicines taken
by women was because a larger proportion of them were on prescribed
medication (1 in 2) than of men (2 in 5), rather than because more drugs
were prescribed to each person on medication. The mean number of medicines
taken per taker (defined as a patient taking one or more prescribed
medications) was 2.6 for both men and women.
[ ] warns of sample base less than 50. Medication taken by men Comparing the observed mean values across minority ethnic groups,
Pakistani and Chinese men had significantly less prescribed drug use
than the general population (0.7 and 0.4 medicines per person, respectively),
and Bangladeshi men had significantly more (1.5). However, after standardising
for age, all South Asian men had a significantly higher mean number
of drugs per person than the general population (see ratios in inset
table, and Figure 11C). Indian and Bangladeshi men currently on medication
were also likely to be prescribed more drugs per taker. Medication taken by women As with men, the pattern that emerged after data were age-standardised
showed higher levels of medication per person (relative to the general
population) for Pakistani (1.42) and Bangladeshi women (1.37) and, for
Pakistani women only, a significantly higher number of medicines taken
per taker (see ratios in inset table). Chinese women, on the other hand,
were significantly low users of prescribed medication, with a standardised
ratio of 0.59 per person, relative to women in the general population. Variations by age in the taking of medication For all minority ethnic groups and both sexes, there was an increase with advancing age in the proportion of people on prescribed medication and a corresponding rise in the number who were on more than one prescribed medicine. The combined effect of the parallel increase in users and number of medicines per user is that the mean number of drugs per person for men in the general population doubled from 0.3 for men aged 16-34 to 0.6 among those aged 35 to 54, and then more than doubled again to 2.0 among those aged 55 and over. The equivalent figures for women were 0.5, 0.9 and 2.3, showing a similar magnitude of increase with age, but from a higher base value in the youngest age band. The Irish pattern of medication usage by age was the most similar
to that of the general population. The mean number of medicines per
person was significantly higher for younger (16-34) and older (55 and
over) Bangladeshi men, Indian men aged 35 and over and Bangladeshi and
Pakistani women aged 35 to 54. Some of these differences were particularly
large: for example, more than half of Bangladeshi men aged 55 and over
were on four or more drugs, compared to one in five men aged 55 and
over in the general population. Chinese men and women in each age group,
on the other hand, had significantly lower rates of usage than the general
population. 11.5.3 Category of prescribed medicine taken, by minority ethnic group The most frequently taken types of medicine for both sexes in the general population, as defined by 13 therapeutic groups, were those for cardiovascular disease and central nervous system (CNS). This pattern shows some variation across minority ethnic groups, although medication for cardiovascular diseases and CNS remained ranked within the top four most used groups of prescribed drugs. Notable exceptions were higher proportions of Bangladeshi men and women taking gastrointestinal medicines (17% and 13%, respectively, compared to the general population average of about 8%) and two to three times more South Asian women on medicines relating to nutrition and blood. The latter is likely to be symptomatic of the higher rates of iron deficiency anaemia in South Asian women (cf. Chapter 10 Blood Analytes, haemoglobin). Comparisons of age-standardised usage ratios for four major groups of medicines - cardiovascular, CNS, endocrine and musculoskeletal - highlighted some interesting findings. The age-standardised ratios for endocrine related drug usage for Black Caribbean, Indian, Pakistani and Bangladeshi men relative to men in the general population ranged from 2.47 to 3.93. More than a third of all drugs prescribed in the endocrine group relate to drugs used in diabetes control (BNF chapter 6.1). High age-standardised rates for this category of drugs amongst Black Caribbean and South Asian men is consistent with evidence which shows a higher prevalence of diabetes in these groups.9 However, contrary to a similar pattern of high diabetes prevalence and mortality among women in black and minority ethnic groups, the age-standardised relative risks of drug usage for medication related to the endocrine system were very similar across all groups. This discrepancy could partly be related to differences between minority ethnic groups in the proportion of women receiving hormone replacement therapy (HRT, also see below), which are also classified under the endocrine group of drugs. Indian men (ratio 1.47) and Black Caribbean women (1.87) were the
only ethnic minority groups to have significantly higher cardiovascular-related
prescriptions than the general population. Bangladeshi men had more
CNS (2.38) and musculoskeletal-related (1.86) prescriptions than the
general population. Chinese men had significantly lower usage of CNS
(0.32) and musculoskeletal (0.43) drug groups and Chinese women of CNS
drugs (0.34). Questions on this topic were confined to women aged 16-54. In the
general population, almost 3 in 4 (73%) women aged 16-54 did not use
the contraceptive pill. About 4 in 5 of women who did use some form
of hormonal contraception (pill, injection or implant) used the combined
pill. Comparisons of age-standardised ratios of hormonal contraceptive
usage across minority ethnic groups show that Indian (0.65) and Pakistani
(0.60) women had a significantly lower pill usage than that in the general
population. The other minority ethnic groups did not show any significant
variation from the levels of use found in the general population. 11.7 Hormone replacement therapy (HRT) use In the general population, 11% of women aged 16 and over were currently
on HRT and 7% had used HRT in the past. A third of those who had ever
used HRT had been prescribed HRT as a result of a hysterectomy. Except
for Irish women, whose pattern of HRT usage was similar to that in the
general population, the observed proportions who had ever been on HRT
therapy were much lower in minority ethnic groups, ranging from 5% to
8% compared to 18% in the general population. Given the relatively younger
age profile of some of the minority ethnic groups, these differences
in uptake become narrower after age standardisation, but persist. After
controlling for age, the standardised ratios of HRT usage ranged between
0.40 (Chinese) and 0.51 (Black Caribbean), compared to women in the
general population.
References and notes 1 McCormick A, Fleming D, Charlton J. Morbidity Statistics from General Practice. Fourth National Study 1991-1992. HMSO, London, 1995. 2 British National Formulary British Medical Association and Royal Pharmaceutical Society of Great Britain, London, September 1997. 3 Other than those who happened to be members of the specified minority ethnic groups, or formed part of a small sub-sample set up for special purposes (see 'The nurse visit' in Chapter 1: Introduction, Section 1.5.6). 4 Balarajan R, Yuen P, Soni Raleigh V. Ethnic differences in general practitioner consultations. BMJ 1989 299: 958-60. 5 Gillam S J, Jarman B, White P, Law R. Ethnic differences in consultation rates in urban general practice. BMJ 1989, 299:953-7 6 Smaje C. Health, 'Race' and Ethnicity: Making Sense of the Evidence. King's Fund Institute, London, 1995. 7 Sproston K, Pitson L, Whitfield G, Walker E. Health and lifestyles of the Chinese population in England. Health Education Authority, London, 1999. 8 Rudat K. Black and Minority Ethnic Groups in England: Health and Lifestyles. Health Education Authority, London, 1994. 9 Nazroo J. The Health of Britain's Ethnic Minorities. Policy Studies Institute, London, 1997. 11.1 (NHS) GP consultations in the two weeks before interview and annual contact rate per person, by minority ethnic group 11.2 (NHS) GP consultations in the two weeks before interview and annual contact rate per person, by age within minority ethnic group 11.3 (NHS) GP consultations in the two weeks before interview and annual contact rate per person, by social class of head of household within minority ethnic group 11.4 (NHS) GP consultations in the two weeks before interview and annual contact rate per person, by equivalised household income tertile within minority ethnic group 11.5 GP consultations in the past year about being anxious or depressed or about a mental, nervous or emotional problem, by minority ethnic group 11.6 GP consultations in the past year about being anxious or depressed or about a mental, nervous or emotional problem, by age within minority ethnic group 11.7 Dental attendance pattern, by minority ethnic group 11.8 Dental attendance pattern, by age within minority ethnic group 11.9 Hospital attendance (excluding maternity) in the past year, by minority ethnic group 11.10 Hospital attendance (excluding maternity) in the past year, by age within minority ethnic group 11.11 Hospital attendance (excluding maternity) in the past year, by social class of head of household within minority ethnic group 11.12 Hospital attendance (excluding maternity) in the past year, by equivalised household income tertile within minority ethnic group 11.13 Number of prescribed medicines taken, by minority ethnic group 11.14 Number of prescribed medicines taken, by age within minority ethnic group 11.15 Category of prescribed medicine taken, by minority ethnic group 11.16 Contraceptive pill use, derived from brand name, by minority ethnic group 11.17 HRT usage, by minority ethnic group
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