Ethnic minorities more likely to underreport health problems, research finds
Asian and Black people with long-term health conditions are more likely to underreport anxiety, depression and daily activity difficulties than white populations, new research shows.
The findings, based on data from 2.6 million people in England, raise concerns about how health outcomes are measured and how services are designed for diverse communities.
Researchers found that people from different ethnic groups with similar health conditions rated their quality of life differently.
The study, by health economists at the University of Manchester and funded by the National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, explored these differences.
Dr Juan Marcelo Virdis from the University of Manchester said: “Our study found that certain Black and Asian ethnic groups could be more likely to downplay different aspects of how health affects their lives.
“This is important because differences between perceived and actual health can affect how people seek healthcare and could, for example, delay a clinical consultation.
“But understanding these differences is crucial for designing equitable health services and improving outcomes across diverse populations.”
Data from the General Practice Patient Survey included 2.3 million white respondents, 160,000 Asian, 70,000 Black, 20,000 of mixed or multiple background, and 60,000 from other ethnic groups.
Participants reported which of 15 long-term health conditions they had.
The researchers used the EQ-5D-5L, a standardised tool developed by the EuroQol Group to measure health-related quality of life across five areas: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression.
Each area has five levels of severity, from no problems to extreme problems or inability.
In some cases, such as mobility among Black and other ethnic groups or self-care among Asian groups, respondents were more likely to choose extreme rather than moderate categories.
The study also found variation within these broader ethnic groupings.
The reasons why some ethnic groups report differently remain unclear.
The researchers suggest that people’s cultural background and expectations may shape how they interpret health questions and what they consider “normal”.
Although the survey relies on self-reported data, this measure is considered more objective than those used in earlier studies in England.
It is also the largest analysis to date examining differences in self-rated health across ethnic groups.
The findings have implications for how healthcare providers interpret patient-reported symptoms.
If some groups consistently understate problems such as anxiety or difficulty with daily activities, they may not receive the care or support they need.
Dr Virdis said: “Our research provides a foundation for further studies using objectively measured health conditions, such as biological risk factors or physical health measures like grip strength.
“We were not able to investigate the mechanisms involved, so this could be a focus for future qualitative research.”
