Ethnicity, class and health

Summary: In 1997 the initial analyses of the large-scale Fourth National Survey of Ethnic Minorities were presented in three volumes published by PSI: Ethnic Minorities in Britain: Diversity and Disadvantage, The Health of Britain’s Ethnic Minorities and Ethnicity and Mental Health. This new report brings together and updates the two publications on health, and draws on follow-up research. Using both the mental and physical health data from the survey, it critically examines various approaches to understanding ethnic differences in health, exploring further the complex relationship between ethnicity and health. Central to the report is a detailed examination of the contribution of socio-economic factors to differences in health, using data uniquely available in the Fourth National Survey. Ethnicity, Class and Health first examines the existing evidence on ethnic differences in health and the explanations for them. It looks at how rates of illness vary across and within ethnic groups and considers how far differences in health might be consistent across subgroups and generations. It then explores in detail the contribution of socio-economic factors to inequalities in health. The report concludes by considering the implications of its findings for our understanding of ethnic inequalities in health and raises a number of important theoretical issues for future research in this area. This report will be of interest to academics and students interested in epidemiology, public health medicine, medical sociology, anthropology and race relations; social researchers; health professionals; and policy maker

Where next for understanding race/ethnic inequalities in severe mental illness? Structural, interpersonal and institutional racism.

In this article we use the example of race/ethnic inequalities in severe mental illness to demonstrate the utility of a novel integrative approach to theorising the role of racism in generating inequality. Ethnic minority people in the UK are at much greater risk than White British people of being diagnosed with a severe - psychosis related - mental illness, and this is particularly the case for those with Black Caribbean or Black African origins. There is entrenched dispute about how we might understand the drivers of this inequality. To address this dispute we build on, and to a certain extent refine, established approaches to theorising structural and institutional racism, and integrate this within a theoretical framework that also incorporates racist/discriminatory interactions (interpersonal racism). We argue that this provides a conceptually robust and thorough analysis of the role of inter-related dimensions of racism in shaping risks of severe mental illness, access to care, and policy and practice responses. This analysis carries implications for a broader, but integrated, understanding of the fundamental drives of race/ethnic inequalities in health and for an anti-racism public health agenda

Ethnicity, class and health

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