ObjectivesElectronic health records (EHR) are increasingly used to investigate health inequalities across ethnic groups. Whilst there are some studies showing that the recording of ethnicity in EHR is imperfect, there is no robust evidence on the accuracy between the ethnicity information recorded in various real-world sources and census data. MethodsWe linked primary and secondary care NHS England data sources with Census 2021 data and compared individual-level agreement of ethnicity recording in General Practice Extraction Service (GPES) Data for Pandemic Planning and Research (GDPPR), Hospital Episode Statistics (HES), Ethnic Category Information Asset (ECIA) and Talking Therapies for anxiety and depression (TT) with ethnicity reported in the census. Census ethnicity is self-reported and, therefore, regarded as the most reliable population-level source of ethnicity recording. We further assessed the impact of multiple approaches to assigning a person an ethnic category. The number of people that could be linked to census from ECIA, GDPPR, HES and TT were 47.4m, 43.5m, 47.8m and 6.3m, respectively. ResultsAcross all four data sources, the White British category had the highest
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