Inequalities in NHS Health Check participation in a multiethnic city

Jadhakhan, Ferozkhan and Safi, Ayazullah and Hossain, Muhammad (2026) Inequalities in NHS Health Check participation in a multiethnic city. Discover Public Health, 23 (1). ISSN 3005-0774

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Abstract

Introduction

The NHS Health Check programme targets adults aged 40–74 to reduce the risk of cardiovascular disease, diabetes, and stroke. Uptake is uneven, especially among minority ethnic and deprived communities. Birmingham, one of England’s most diverse and disadvantaged cities, provides a key setting to examine participation. This study explored ethnic and gender differences in NHS Health Check uptake.

Methods

A cross-sectional study design was used. Aggregated data were collected from ten ethnic groups: Arab, Bangladeshi, Black Caribbean, Chinese, Ghanaian, Indian, Nigerian, Pakistani, Somali, and White British. Variables included eligibility, actual uptake, and gender. Descriptive statistics, Pearson correlations, paired-samples t-tests, and a chi-square test of independence were conducted to explore patterns of uptake and the association between eligibility and attendance.

Results

Of 153 eligible participants, 45 completed the Health Check. Uptake varied widely across ethnic groups, from 6.7% (Arab) to 87.5% (Ghanaian). Eligibility was not significantly related to uptake ( r = 0.33, p = 0.345) and paired-samples t-tests confirmed large gaps between eligibility and attendance ( p < 0.001). Gender differences were minimal, with both males and females showing low uptake relative to eligibility. A significant association between ethnicity and uptake was found (χ² = 26.26, p = 0.002).

Conclusion

NHS Health Check uptake was low and varied sharply across ethnic groups. Eligibility did not predict attendance, and gender had limited influence. Cultural and structural factors strongly shaped engagement. Targeted, community-focused, and culturally tailored strategies are needed to improve awareness, trust, and accessibility, especially for groups with the lowest uptake.

Item Type:	Article
Identification Number:	10.1186/s12982-026-01931-0
Dates:	Date Event 9 April 2026 Accepted 22 April 2026 Published Online
Uncontrolled Keywords:	NHS health check, Ethnicity, Health check eligibility, Health check uptake
Subjects:	CAH02 - subjects allied to medicine > CAH02-06 - allied health > CAH02-06-04 - environmental and public health
Divisions:	Life and Health Sciences > Life and Sports Sciences
Depositing User:	Gemma Tonks
Date Deposited:	14 May 2026 13:34
Last Modified:	14 May 2026 13:34
URI:	https://www.open-access.bcu.ac.uk/id/eprint/17046

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