Education And Debate

HIV and AIDS, other sexually transmitted diseases, and tuberculosis in ethnic minorities in United Kingdom: Is surveillance serving its purpose?

BMJ 1997; 314 doi: (Published 14 June 1997) Cite this as: BMJ 1997;314:1747
  1. Kevin M De Cock, professor of medicine and international healtha,
  2. Nicola Low, lecturer in genitourinary medicineb
  1. a London School of Hygiene and Tropical Medicine, London WC1E 7HT
  2. b Department of Genitourinary Medicine, King's College School of Medicine and Dentistry, London
  1. Correspondence to: Professor De Cock
  • Accepted 27 February 1997

Experience of disease differs across ethnic groups, and ethnicity is a relevant personal characteristic for descriptive epidemiology. Information about ethnicity and country of birth is omitted from the routine notification of many diseases. HIV infection and AIDS, other sexually transmitted diseases, and tuberculosis have different incidence rates in different ethnic groups in the United Kingdom. Omission of ethnic data from surveillance activities allows such differences in incidence to go undetected and unaddressed. Surveillance data that included ethnic details could guide interventions to reduce inequalities in health between different subpopulations.


Disease surveillance–the routine collection, analysis, and dissemination of data about the distribution of diseases–is essential for the planning and provision of services for preventing, treating, and controlling diseases.1 2 Surveillance data describe the occurrence of diseases in time, place, and person. In addition to age and sex, relevant personal characteristics may include ethnic group and country of birth, although these are omitted from many surveillance activities.

Three public health problems with wide variation in incidence and prevalence across subpopulations in the United Kingdom are HIV infection and AIDS, other sexually transmitted diseases, and tuberculosis. We discuss the need for epidemiological surveillance to incorporate data on ethnicity for more effective interventions for these unequally distributed diseases.

Ethnic minority groups in United Kingdom

The 1991 census was the first to document the ethnic distribution of the population of the United Kingdom. About 5.5% of the population belongs to self defined ethnic minority groups (table 1),3 although this may be an underestimate because of incomplete registration.4 The distribution of people from minority groups throughout the country is uneven, with most living in large urban centres.

View this table:
Table 1

Ethnic groups in the United Kingdom (data from 1991 census3)

In the following discussion we adhere whenever possible to the names for ethnic groups defined by the Office of …

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