Laurence Gruer - Academia.edu (original) (raw)

Papers by Laurence Gruer

European Journal of Public Health, 2021

Studies from several countries have shown that the COVID-19 pandemic has disproportionally affect... more Studies from several countries have shown that the COVID-19 pandemic has disproportionally affected migrants. Many have numerous risk factors making them vulnerable to infection and poor clinical outcome. Policies to mitigate this effect need to take into account public health principles of inclusion, universal health coverage and the right to health. In addition, the migrant health agenda has been compromised by the suspension of asylum processes and resettlement, border closures, increased deportations and lockdown of camps and excessively restrictive public health measures. International organizations including the World Health Organization and the World Bank have recommended measures to actively counter racism, xenophobia and discrimination by systemically including migrants in the COVID-19 pandemic response. Such recommendations include issuing additional support, targeted communication and reducing barriers to accessing health services and information. Some countries have had ...

Public Health in Practice, 2021

The inaugural conference of the Global Society on Migration, Ethnicity, Race and Health COVID-19 ... more The inaugural conference of the Global Society on Migration, Ethnicity, Race and Health COVID-19 examined the impact of the COVID-19 pandemic on migrants and ethnic minorities and the role of racism. Migrants everywhere have faced tightening immigration restrictions, more obstacles to healthcare, increased racism and worsening poverty. Higher COVID-19 mortality rates have been otbserved in ethnic/racial minorities in the United Kingdom and the United States. Structural racism has been implicated, operating, for example, through more crowded living conditions and higher-risk occupations. In Brazil, good data are lacking but a seroprevalence survey suggested higher rates of infection among ethnic minorities and slum dwellers. Considerable disruption of services for migrants at the border with Venezuela have occurred. National policy responses to protect vulnerable groups have been lacking. In Australia, with strict COVID-19 control metrtrun 0 asures and inclusive policies, there have been few cases and deaths reported in Indigenous communities so far. In most countries, the lack of COVID-19 data by ethnic/racial group or migrant status should be addressed. Otherwise, racism and consequent inequalities will go undetected.

Public Health, 2020

Objectives To investigate ethnic differences in falls and road traffic injuries in Scotland. Stud... more Objectives To investigate ethnic differences in falls and road traffic injuries in Scotland. Study design A retrospective cohort of 4.62 million people, linking the Scottish Census 2001, with selfreported ethnicity, to hospitalisation and death records for 2001-2013. Methods We selected cases with ICD-10 diagnostic codes for falls and road traffic injuries (RTIs). Using Poisson regression, age-adjusted rate ratios (RRs, multiplied by 100 as percentages) and 95% confidence intervals (CIs) were calculated by sex for 10 ethnic groups with the White Scottish as reference. We further adjusted for country of birth and socioeconomic status (SES). Results During about 49 million person-years, there were 275,995 hospitalisations or deaths from fallrelated injuries and 43,875 from RTIs. Compared to the White Scottish, RRs for falls were higher in most White and Mixed groups, e.g. White Irish males (RR 131; 95% CI 122-140) and Mixed females (126; 112-143), but lower in Pakistani males (72; 64-81) and females (72; 63-82) and African females (79; 63-99). For RTIs, RRs were higher in Other White British males (161; 147-176) and females (156; 138-176) and Other White males (119; 104-137) and females (143; 121-169) and lower in Pakistani females (74; 57-98). The ethnic variations differed by road user type, with few cases among non-White motorcyclists and non-White female cyclists. The RRs were minimally altered by adjustment for country of birth or SES. Conclusion We found important ethnic variations in injuries due to falls and RTIs, with generally lower rates in non-White groups. Culturally related differences in behaviour offer the most plausible explanation, including variations in alcohol use. The findings do not point to the need for new interventions in Scotland at present. However, as the ethnic mix of each country is unique, other countries could benefit from similar data linkage-based research. Highlights • Ethnic inequalities in injuries are demonstrated in Scotland based on a large sample size and a fine ethnic granularity including distinct White ethnic groups. • White minority ethnic groups had the highest rates of fall-related injuries in Scotland. • Fall-related injuries were the least likely in the Pakistani population. • Ethnic differences in road traffic injuries varied by the type of road user. • Ethnic differences in injuries were not explained by socioeconomic status or country of birth.

European Journal of Public Health, 2018

European Journal of Public Health, 2019

Background With growing numbers of migrants worldwide, accurate data are needed to assess the hea... more Background With growing numbers of migrants worldwide, accurate data are needed to assess the health of migrants and ethnic minorities, highlight inequalities and evaluate relevant policies and actions. To summarise and reveal the complexity of the findings, we developed data visualisation techniques based on epidemiological principles. Methods We used published results from the Scottish Health and Ethnicity Linkage Study (SHELS), a retrospective cohort of 4.62 million people linking census ethnicity data to health service and death records during 2001-2013. In tables mainly using rate ratios, we employed different colours to show health advantage, disadvantage or equivalence; different colour shades to represent degree of certainty, combining effect size and precision of estimate; and different font sizes for absolute rates, to highlight more common conditions. We ranked health conditions by age-adjusted rate within each ethnic group to show differences in burden of disease and dis...

International Journal of STD & AIDS, 1994

The first HIV-positive diagnosis among injecting drug users (IDU) in Glasgow was made in 1985. By... more The first HIV-positive diagnosis among injecting drug users (IDU) in Glasgow was made in 1985. By the end of 1987 prevalence among IDU receiving voluntary attributable tests was 4.8%. Since 1990, an annual cross-sectional survey of HIV prevalence and risk behaviours among 500 current Glasgow IDU has provided a more representative sample. Anonymously-tested saliva samples obtained from respondents revealed prevalence rates of 1.8%, 1.2% and 1.0% in 1990, 1991 and 1992 respectively. Since 1987 a wide range of measures aimed at reducing HIV-related risk behaviour among IDU has been introduced and maintained in Glasgow. Against this background, there is evidence that IDU in the city have reduced their risk behaviours. The findings reported here suggest that implementing harm-reduction measures when prevalence is low may inhibit the rapid dissemination of HIV.

Journal of Epidemiology & Community Health, 2011

BMJ, 1993

of conduct in relation to genetic research of this type should not only help to avoid specific pr... more of conduct in relation to genetic research of this type should not only help to avoid specific problems of the type described but also help to maintain trust between families and research workers. That trust has been the basis of much of the successful research so far and must be maintained in the future ifgenetic advances are to be continued and used to help families with serious inherited disorders. 1 Committee on the Ethics ofGene Therapy. Report. London: HMSO, 1992. 2 Review of the guidance on the research use of fetuses and fetal materiaL Report.

Addiction, 1995

... BI in Kristenson et al. (1983) and Persson &amp; Magnusson (1989) consists of several... more ... BI in Kristenson et al. (1983) and Persson &amp; Magnusson (1989) consists of several sessions over a long period of time (monthly check-ins during 1 year). ... That is about the same as BI in the studies mentioned by Kristenson et al. (1983) and Persson &amp; Magnusson (1989). ...

Addiction, 1997

This study aims to identify the physical harm associated with injecting drug use and examine the ... more This study aims to identify the physical harm associated with injecting drug use and examine the treatment-seeking behaviour of injecting drug users (IDUs). Specific attention is given to the factors associated with presentation and non-presentation of injecting-related problems. Participants were interviewed by research staff using a semi-structured questionnaire, then physically examined by a medical team. Needles exchanges in Glasgow. One hundred and twelve injecting drug users. Respondents' accounts of their current injecting-related problems were found to be consistent with the clinician's findings, suggesting that IDUs are able to self-diagnose injecting-related harm. However, almost three-quarters had not sought help for these problems. Qualitative data suggest the main reasons for non-presentation, or delayed presentation, of injecting-related problems are normalization of injecting-related harm and a reluctance to attend available services. Almost half of those seeking treatment for injecting-related problems did so during an emergency or crisis. Low threshold services, such as needle exchanges, may have to take a more proactive stance to encourage injectors to present with injecting-related problems. This may help reduce injecting-related harms, especially the resulting medical complications, which would in turn relieve the pressure on other services such as hospital Accident and Emergency Departments.

A long-term cohort study of working men in Israel found that smokers who reduced their cigarette ... more A long-term cohort study of working men in Israel found that smokers who reduced their cigarette consumption had lower subsequent mortality rates than those who did not. We conducted comparable analyses in 2 populations of smokers in Scotland. The Collaborative Study included 1,524 men and women aged 40–65 years in a working population who were screened twice, in 1970–1973 and 1977. The Renfrew/Paisley Study included 3,730 men and women aged 45–64 years in a general population who were screened twice, in 1972–1976 and 1977– 1979. Both groups were followed up through 2010. Subjects were categorized by smoking intensity at each screening as smoking 0, 1–10, 11–20, or ≥21 cigarettes per day. At the second screening, subjects were catego-rized as having increased, maintained, or reduced their smoking intensity or as having quit smoking between the first and second screenings. There was no evidence of lower mortality in all reducers compared with maintainers. Multivariate adjusted hazard...

BMJ, 2021

We disagree with Razai and colleagues on the comparative lack of data on ethnicity in the United ... more We disagree with Razai and colleagues on the comparative lack of data on ethnicity in the United Kingdom.1 Few countries have produced more data than the UK, in part through inclusion of ethnicity and country of birth in its national censuses since 1991.2 The Scottish Health and Ethnicity Linkage Study linked the 2001 Scotland census to death records and NHS databases. It has published 28 papers onmanyoutcomes for up to 15 ethnic groups.3 This includes an analysis of infection relatedhospital admission or death and bloodborne viral infections.4 Showingcomplexethnicdifferences across 18 specific infection categories, the study contextualises the disproportionate effects of covid-19 on ethnic minorities.