Ethnic inequities in 6-8 week baby check coverage in England 2006- 2021: a cohort study using the Clinical Practice Research Datalink

Br J Gen Pract. 2024 Aug 29;74(746):e595-e603. doi: 10.3399/BJGP.2023.0593. Print 2024 Sep.

Abstract

Background: Inequities in the coverage of 6-8-week maternal checks, health visitor reviews, and infant vaccinations have been reported in England. Ethnic inequities in 6-8-week baby checks have not been studied nationally.

Aim: To examine the effect of maternal ethnicity on 6-8 week baby check coverage in England 2006-2021.

Design and setting: This cohort study used electronic health records from primary care in England.

Method: Baby check coverage was calculated in 16 ethnic groups, by year and region. Risk ratios were estimated using modified Poisson regression. Coverage and timing of baby checks in relation to maternal checks and infant vaccinations by ethnic group were calculated.

Results: Ethnic inequities in 6-8 week baby check coverage in England varied by year and region. Coverage increased 2006-2007 to 2015-2016, then stabilised to 80-90% for most groups. Coverage was lowest for Bangladeshi and Pakistani groups 2006-2007 to 2011-2012. In the West Midlands, coverage was lowest at approximately 60% for four groups: Bangladeshi, Caribbean, African, and Any other Black, African or Caribbean background. In the North West, coverage was lowest for Bangladeshi (65.3%) and Pakistani (69.2%) groups. These patterns remained after adjusting for other factors and persisted over time. Coverage was highest in those whose mothers received a maternal check and those who received at least one dose of 8-week infant vaccinations.

Conclusion: Coordinated action at the level of integrated commissioning boards, primary care networks, and GP practices is required to better understand the reasons behind these inequities and redress the persistent disparities in 6-8 week baby check coverage.

Keywords: 6–8 week baby check; 6–8 week maternal postpartum check; ethnicity; preventive medicine; primary health care; vaccination.

MeSH terms

  • Adult
  • Cohort Studies
  • England
  • Ethnicity* / statistics & numerical data
  • Female
  • Healthcare Disparities* / ethnology
  • Humans
  • Infant
  • Infant, Newborn
  • Primary Health Care
  • Vaccination / statistics & numerical data

Grants and funding

This study was funded by Doctor of Philosophy scholarships awarded to Claire X Zhang by the University of Oxford Clarendon Fund, St Cross College, and Nuffield Department of Population Health. It was also part-funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted through the Policy Research Unit in Maternal and Neonatal Health and Care, PR-PRU-1217-21202. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no involvement in the study.