Timing and incidence of health conditions recorded during childhood in White British and Pakistani British children: evidence from the Born in Bradford cohort

OBJECTIVE: To examine ethnic differences in the incidence and timing of recorded health conditions from birth to adolescence between White British and Pakistani British children. DESIGN: Longitudinal population-based birth cohort linked to primary care electronic health records. SETTING: Born in Bradford (BiB), a multiethnic UK birth cohort. PARTICIPANTS: 13 282 children born between 2007 and 2011 with linked primary care records and ≥1-year follow-up, including 4818 White British and 5878 Pakistani British children in the primary comparison. MAIN OUTCOME MEASURES: Recorded diagnoses of atopic conditions, overweight/obesity, common mental health disorders and neurodevelopmental disorders. Incidence rates, Kaplan-Meier cumulative incidence and sex-adjusted Cox regression HRs were estimated. RESULTS: Atopic conditions emerged early and were more common among Pakistani British children, with higher hazards of eczema (HR 2.29, 95% CI 2.01 to 2.61), allergic rhinoconjunctivitis (HR 2.27, 2.00 to 2.58) and asthma (HR 1.35, 1.22 to 1.50). Overweight/obesity was recorded later and was also more frequent in Pakistani British children (HR 1.25, 1.16 to 1.35). In contrast, common mental health and neurodevelopmental diagnoses were more frequently recorded among White British children; Pakistani British children had lower hazards of neurodevelopmental diagnoses (HR 0.28, 0.23 to 0.35) and mental health disorders (HR 0.53, 0.41 to 0.70). CONCLUSIONS: Ethnic differences in recorded health conditions between White British and Pakistani British children were condition-specific and varied by age. These findings identify when recorded diagnoses diverge in Bradford and highlight the need to distinguish differences in morbidity from differences in recognition, access, assessment, and recording.