Healthy ageing in a multi-ethnic population: a descriptive analysis from the HELIUS study

Abstract Background Ethnic health disparities have rarely been explored from a multidimensional ageing perspective. The objective of this study was to investigate these disparities in the Healthy Life in an Urban Setting (HELIUS) cohort using the Healthy Ageing Score (HAS). Methods We computed the HAS using seven biopsychosocial domains from HELIUS baseline data (2011-2015), discerning between healthy, moderate, and poor ageing. We explored HAS differences by ethnicity, sex, and age group using Kruskal Wallis, Pearson Chi-squared, and multinomial logistic regression, adjusting for sociodemographic factors. Results We included 17,091 participants (54.8% women, age (mean (SD)=44.5(12.8) years)) from South-Asian (14.8%) and African (20.5%) Surinamese, Dutch (24.3%), Moroccan (15.5%), Turkish (14.9%), and Ghanaian (10.1%) origins. The HAS (overall: poor (69.0%), moderate (24.8%), and healthy (6.2%)) differed between ethnicities (poorest in South-Asian Surinamese) and was poorer in women and post midlife (cut-off 45 years) across all ethnicities (all p≤0.0001). In the fully-adjusted models in men and women, poor ageing (vs. healthy ageing) was highest in the South-Asian Surinamese (aOR(95%CI)) (2.96(2.24-3.90) and 6.88(3.29-14.40), respectively) and the Turkish (2.80(2.11-3.73) and 7.10(3.31-15.24), respectively) groups compared to the Dutch, in the oldest age group (5.89(3.62-9.60) and 13.17(1.77-98.01), respectively) vs. the youngest, and in the divorced (1.48(1.10-2.01) and 2.83(1.39-5.77), respectively) vs. the married. Poor ageing was inversely associated with educational and occupational levels, mainly in men. C onclusion Ethnic minorities displayed less healthy ageing than theDutch. This disparity appeared to be more pronounced in women, persisted before and after midlife, and was associated with sociodemographic factors that warrant further investigation.