Researching Irish health inequalities in England: a case study of first and second generation Irish men and women in Coventry

Abstract

Background. Despite consistent evidence that the Irish people living in Britain face a significant health disadvantage, when compared to white British people on a range of health indicators, the reasons and underlying generative mechanisms, need further uncovering. Design and Objectives. This research uses a mixed strategy design compatible with a critical realist perspective. The extensive/quantitative research component aims to evaluate the demi-regularity that Irish people in England have poorer health than the British general population. It engages in a secondary analysis of data from the Census 2001 Individual Licensed SARs, using self-reported Irish ethnicity and self-reported general health. The intensive/qualitative research component explores the generative mechanisms shaping Irish health experiences and inequalities in England, and Coventry in particular, including the contribution of, and interaction between, generative mechanisms of structural and identity/cultural aspects of ethnicity. It carries out an in-depth primary analysis of thirty-two semi-structured interview accounts from two generations of Irish men and women in Coventry, using a framework analytical approach. This is elaborated within a model of ethnicity as structure and identity developed in accordance with a critical realist and sociohistorical perspective. The research is realized through a collaborative community based participatory approach. Results and Conclusions. The extensive findings provide further evidence for an Irish health disadvantage in England, with some differences by country of birth, and provide clues to generative mechanisms for the demi-regularity found. The intensive findings concur with the extensive analysis and show that generative mechanisms from structural and identity dimensions of ethnicity 1) contribute to the health inequalities and/or experiences of first and second generation Irish people in England, 2) interact in complex ways, 3) are impacted by the socio-political context, i.e., British colonialism and a world capitalist economy, and 4) are shaped by interweaving forces of structure and agency