Recording of wider determinants of health in UK primary care using the Clinical Practice Research Datalink (CPRD) databases, a descriptive cross-sectional study.

Introduction: To explore the recording of wider determinants of health in the Clinical Practice Research Datalink (CPRD) Gold and CPRD Aurum primary care databases (jointly CPRD Combined), and, presented these for description in relation to the UK Census 2011 and UK Census 2021. Wider determinants explored include country of birth, language, religion, sexual orientation, gender identity, care home residence, unpaid carer responsibilities, and relationship status. Methods: All acceptable, currently registered patients from the CPRD databases on the relevant UK Census dates were included. The proportion of patients with a record pertaining to each wider determinant of health was assessed. The distribution of each characteristic in the CPRD populations was descriptively presented against the distribution of that characteristic in the UK Census populations. Results: There were 17,232,402 and 16,935,144 acceptable, currently registered patients in CPRD Combined at the time of the 2011 and 2021-2 UK Censuses, respectively. The proportion of CPRD Combined patients in 2021-2 with any codes related to country of birth was 3.65%, to language was 42.92%, to religion was 7.05%, to sexual orientation was 1.46%, to gender identity was 0.11%, to care home residence was 0.43%, to unpaid carer responsibilities was 1.35%, and to legal partnership status was 25.39%. Recording increased between the Censuses. Recording was lower in CPRD Gold compared to CPRD Aurum. Conclusions: Recording of the wider determinants of health examined in this study was low in primary care across the board. Despite limitations, researchers still use CPRD data to investigate questions on the wider determinants of health because of the sparsity of alternative real world data sources that include the richness of health-related data available in CPRD.