Does the British state’s categorisation of 'mixed race' meet public policy needs?

The England and Wales 2001 Census was the first to include ‘Mixed’ categories which have now been adopted across government. The four ‘cultural background’ options were highly prescriptive, specifying combinations of groups. This paper assesses how satisfactorily these analytical categories captured self-ascribed cultural affiliation based on the criteria of validity, reliability and utility of the data for public services. Finally, the paper asks whether we now need a census question on ethnic origin/ancestry in addition to – or instead of – ethnic group or whether multi-ticking or a focus on family origins might give more useful public policy data and better measure the population's ethnic diversity

Main findings and Recommendations

This study aimed to enhance the evidence base on health promotion issues related to minority ethnic groups, refugees/asylum seekers and Gypsy Travellers in Wales. The study objectives were to: identify gaps in the existing evidence base of health needs and health promotion issues for the study groups identify existing good practice of health services and promotion for the study groups explore ways of delivering health promotion policy/programmes targeting these groups in a culturally and socially sensitive manner, and to identify issues for further research

The development of social class sensitive proxies for infant mortality at the PCT level: An appraisal of candiate indicators for the commission for health improvement

The main aim of the work is to identify social class-sensitive proxies for infant mortality at Primary Care Trust level that could be used in the CHI performance ratings process for PCTs in 2003/4

Operationalising the collection of ethnicity data in studies of the sociology of health and illness

In response to the burgeoning interest in ethnic health issues and related published research, a number of recent contributors have attempted to clarify or systematize the usage of overarching terminology like 'ethnicity', 'race', 'culture', and 'racism', including the development of guidelines. However, the operational problems of how to collect ethnicity data in studies of the sociology of health and illness have not been satisfactorily addressed. This paper explores conceptual issues, notably, the meanings of ethnic identity and ethnic origin/ancestry; methodological approaches, including which dimensions to collect, multidimensional versus global measures, and exclusive groups versus optional ethnicity; and also practical issues such as method of assignment. The approach calls for a stronger development of the theoretical understandings of ethnicity and work on how best ethnicity should be conceptualised and measured in the different approaches to explaining ethnic inequalities in health

The Sri Lankan community of descent in the UK: a neglected population in demographic and health research

The Sri Lankan diaspora population is substantially neglected in UK demographic and health research and not captured in census and survey ethnic group questions, though 127,242 Sri Lankan-born migrants were enumerated in England and Wales in 2011. Important intersections are reported between the period of arrival of these migrants, the purpose behind their movement, and related population characteristics, with 47% having arrived during 2001–2011. Between 1984 and 2004 around 50,000 asylum applications were made by Sri Lankan Tamils. Sri Lankan migrants generally display more favourable circumstances on key socio- economic variables than do other diaspora populations from South Asia. These include generic health status and mortality. This may be attributable to the‘healthy migrant’effect, given the community’s recent migration, though the application of its effect to this population requires caution as a significant proportion came to Britain as asylum-seekers (forced migration) rather than as self-selecting migrants. A more advantageous socio-economic profile may also have contributed

Measuring the health patterns of the ‘mixed/multiple’ ethnic group in Britain: data quality problems, reporting issues, and implications for policy

The ‘mixed’ group, officially recognised in the 2001 Census, is one of the most rapidly growing ethnic groups in Britain. Although ‘mixed’ categorisation was added to ethnic coding in NHS datasets, our knowledge of health patterns for this population is meagre. Data quality problems remain a key obstacle, including poor reproducibility of the data and constraints on reporting due to sparse data bias. The consequent minimal and indicative evidence base has focused mainly on risky health behaviours, mental health and generic measures of self-rated health, as it has in the U.S.A. and Canada. There is negligible information on the main underlying causes of death, such as neoplasms, heart disease and stroke. Consideration should be given to pooling data across multiple years of health and general purpose surveys to enable reporting for the four ‘mixed’ categories and adjustment for mediating factors and relevant confounders, such as measures of socio-economic status

Evidence of continued injecting drug use after attaining sustained treatment-induced clearance of the hepatitis C virus: implications for reinfection

Background: People who inject drugs (PWID) are at the greatest risk of hepatitis C virus (HCV) infection, yet are often denied immediate treatment due to fears of on-going risk behaviour. Our principal objective was to examine evidence of continued injecting drug use among PWID following successful treatment for HCV and attainment of a sustained viral response (SVR). Methods: PWID who attained SVR between 1992 and June 2012 were selected from the National Scottish Hepatitis C Clinical Database. Hospitalisation and mortality records were sourced for these patients using record linkage techniques. Our primary outcome variable was any hospitalisation or death, which was indicative of injecting drugs post-SVR. Results: The cohort comprised 1170 PWID (mean age at SVR 39.6y; 76% male). The Kaplan Meier estimate of incurring the primary outcome after three years of SVR was 10.59% (95% CI, 8.75–12.79) After adjusting for confounding, the risk of an injection related hospital episode or death post-SVR was significantly increased with advancing year of SVR: AHR:1.07 per year (95% CI, 1.01–1.14), having a pre-SVR acute alcohol intoxication-related hospital episode: AHR:1.83 (95% CI, 1.29–2.60), and having a pre-SVR opiate or injection-related hospital episode: AHR:2.59 (95% CI, 1.84–3.64). Conclusion: Despite attaining the optimal treatment outcome, these data indicate that an increasing significant minority of PWID continue to inject post-SVR at an intensity which leads to either hospitalisation or death and increased risk of reinfection