1. Inequalities in health 2: Ethnicity
G672

2. Recap: Whiteboards What do we mean by ‘ethnicity’?
How does this differ from race and nationality?

3. Race, Ethnicity & Nationality
Concept
Meaning
Race
Biological differences, linked to phenotypes (physical characteristics) and genotypes (underlying genetic differences).
Ethnicity
Groups within society that share things like culture, traditions, language, religion, race, ancestry etc.
Nationality
A sense of ‘belonging’ to a particular nation through origin, birth or naturalisation.
Q: Which Sociologist described the different features of ethnicity?

4. (Modood; 2005)
Ethnicity
Culture
Geographical
Descent &
Origin
Sense of Identity
Language
Clothes,
tradition
values,
religious
food,

5. Definitions Check: Whiteboards (define min. 3)
MULTICULTURALISM
SUPERDIVERSITY
CULTURAL DIVERSITY
HYBRIDITY
ETHNIC MINORITY
CODE SWITCHING

6. Whiteboards: Which are the main ethnic groups in Britain?
Race or Ethnicity?
Race is often regarded as an outdated concept and sociologists prefer the broader concept of ethnicity...
However, some argue that race is a better term for explaining the position of ethnicities at the bottom of the social stratification system – because sociologists like Miles (1989) have identified racism as the main cause...
Whiteboards: Which are the main ethnic groups in Britain?

7. Ethnic Groups: England & Wales
Q: Which groups are not represented above?
Q: Why does this differ from the usual ‘official’ figure of 9% ethnic minority groups in the UK?

8. Difficulties in studying Ethnicity/Health
In Pairs:
What extraneous factors might complicate these studies? Identify at least three factors.
Look at Modood’s definition of ethnicity: Why might it be difficult to use the concept of ‘ethnicity’ in studying health?

9. Difficulties in studying Ethnicity/Health
Extraneous Factors:
Does ethnicity matter more than income, occupation, gender, age, class, birthplace etc. in measuring health?

10. Difficulties in studying Ethnicity/Health
Operationalising Ethnicity:
Researchers wanting to measure ethnicity will need to operationalise (make measurable) the concept.
Different researchers may operationalise the concept differently, making results and studies difficult to compare.

11. Difficulties in studying Ethnicity/Health
Extraneous Factors: What does this table show – and what does it suggest about difficulties in studying ethnicity/health?
Group
Under 15 (%)
16-44 (%)
45-64 (%)
65-74 (%)
75+ (%)
White 19 42 22 9 7
Black, Caribbean 48 25 4 1
Black, African 29 59 10
Pakistani 43 12
Bangladeshi 47 38 14
Chinese 23 2

12. Ethnic differences in Health
Most minority groups have higher mortality rates.
Most ethnic groups have higher rates of still-birth and infant mortality
Africans and Afro-Caribbeans are 50% more likely to die of stroke
Asians 50% more likely to die of heart disease
Most ethnic groups have lower rates of cancer
Afro Caribbeans are 7 times more likely to be diagnosed as psychotic

13. Age-standardised “not good” health rates (2001) – based on self-reporting.

14. In Pairs
Consider the different types of explanation. For each, decide on at least two explanations as to why some ethnic minorities experience lower life expectancy and higher rates of illness: ARTEFACT BIOLOGICAL CULTURAL/BEHAVIOURAL STRUCTURAL/MATERIAL MIGRATION/RACISM

15. Genetic/Biological Factors

16. Genetic/Biological Factors
Some disorders have clear genetic causes e.g. Tay Sachs disease among the Jewish population; sickle- cell anaemia among Afro-Caribbeans.
disease/Pages/Introduction.aspx
anaemia/Pages/Introduction.aspx

17. Genetic/Biological Factors
However, this explanation only works for a few such disorders.
Zubin & Spring (1977) pointed out that some people are genetically vulnerable to schizophrenia but it is mainly down to lifestyle that decides if or how symptoms ever appear.

18. Individual/Behavioural Factors

19. Individual Behaviour
As individuals, we make choices about how to behave...
...Therefore, it is up to us whether we make the right or wrong decisions regarding our health.
“The real cause of poor health among Northerners is their choice of diet. People should look after themselves better.” – Edwina Currie, 1986

20. Individual Behaviour (Things YOU do/avoid): Copy & Complete
Activity
High or low risk to health?
Why a risk?
Short-term or long-term risk?
Why do you do/avoid the activity?

21. Individual Behaviour: Table
Are your choices/decisions similar to those of others?
How closely are your choices/decisions linked to your ideas about health risks (e.g. Do you always avoid things with long-term risks?)
Identify at least five healthy activities.

22. Individual Behaviour
There is some argument that certain ethnic groups are more likely to make healthy lifestyle choices than others (e.g. Choice of diet).
However, this view is debatable: Many of these ‘choices’ might be more closely linked to cultural beliefs (e.g. Particular foods might be eaten/avoided for religious reasons, not as a lifestyle choice).

23. What does the graph suggest about individual behaviour and ethnicity
What does the graph suggest about individual behaviour and ethnicity? What problems might there be with this data?

24. Cultural Factors

25. Cultural Explanations
To what extent does the way of life of different ethnic groups affect their chances of getting ill? In terms of smoking rates, you cannot make generalisations about ethnicity. It is vital to take into account social class, regional or religious variations.

26. Cultural Explanations
To what extent does the way of life of different ethnic groups affect their chances of getting ill? ‘Asians’ (statistically) experience high levels of heart disease. This has been linked to their use of fats like ghee in cooking But many ‘Asians’ (e.g. Those from South India) traditionally eat very healthy, vegetarian diets So statistics that describe ‘Asians’ as a single group are flawed – as are such assumptions about ethnic groups.

27. Cultural Explanations
To what extent does the way of life of different ethnic groups affect their chances of getting ill? Many cultural factors actually favour the health of ethnic minorities. For example, as we’ve seen, Bangladeshi women have the lowest smoking rates of any group. Mortality rates from lung cancer and chronic bronchitis are extremely low in people from the Indian sub-continent.

28. Cultural Explanations
Complete the evaluation of cultural explanations by filling in the missing words on your worksheets. Beneath this, in a couple of sentences, summarise the meaning in your own words.

29. Material/Structural Factors

30. Material/Structural Explanations
Key Question: To what extent do people’s material surroundings/living conditions and position in the social structure explain their ill-health? Are some ethnic groups materially better off than others?

31. Labour Force Survey (1998-2000)
41% of white men in the highest two social class groups, compared to:
47% of Indian men
44% of Chinese men
33% of black men
31% of Pakistani men
23% of Bagladeshi men and…

32. Labour Force Survey (1998-2000)
41% of Chinese women
34% of white women
34% of black women
33% of Indian women
29% of Pakistani/Bangladeshi women

33. Material/Structural Explanation #1: Unemployment
Unemployment: Place in order of likelihood of being jobless:

34. Material/Structural Explanation #2: Type of Work
Amin (1992) claimed that some ethnic minorities are concentrated in more hazardous work – therefore suffer more accidents/work related illnesses.

35. Material/Structural Explanation #3: Housing & Homelessness
A survey of homeless households (placed in B&B accommodation) found that:
The majority were of ethnic minority background
The majority of the adults were between 16-34
Only 56% spoke English as a first language

36. Material/Structural Explanation #3: Housing & Homelessness
Lissauer et al (1994) examined complaints made by this group, many of which have potential risks to health and wellbeing:
Nature of complaint
How many complained
Lack of space
70%
Nowhere for children to play
68%
Isolation
58%
Noise
38%
Lack of privacy
32%

37. Material/Structural Explanation #3: Housing & Homelessness
People in this situation experience:
Having to relocate regularly...
...Therefore difficulty registering with a GP
Increased likelihood of using hospital emergency services
Higher rates of depression
Higher rates of mild childhood illnesses

38. Evaluation: Whiteboards
For the following statements, you need to decide which is a strength and which is a weakness of material/structural explanations.
Write S or W on your whiteboards...

39. Strength or Weakness?
The material explanation is supporting by a variety of evidence that shows ethnic groups suffer higher rates of unemployment and deprivation.

40. Strength or Weakness?
The material explanation often treats ethnic minorities as one homogenous group rather than exploring differences between them

41. Strength or Weakness?
The material explanation does not consider the relationship between lifestyle and material circumstances

42. Strength or Weakness?
The material explanation doesn’t consider the relationship between gender, age and region with material circumstances

43. The material explanation does not ‘blame’ victims for their illnesses
Strength or Weakness?
The material explanation does not ‘blame’ victims for their illnesses

44. Strength or Weakness?
Material factors are useful in explaining some illnesses (e.g. Depression) but not all illnesses

45. Migration & Racism

46. Migration & Racism
Brown (1994) states that racial discrimination and harassment may have an adverse effect on health (e.g. for stress, personal injury).
Asians are 50 x more likely than white people to suffer racial victimisation...
Black people are 36 x more likely...

47. Artefact Explanations

48. Artefact Explanations
‘Evidence’ linking ethnicity to illness and death can be misleading.
Material/structural factors like unemployment are probably more significant overall...
...Plus there are many additional variables to be taken into account e.g. Gender, age, region...

49. Homework
Outline and evaluate the view that genetic/biological factors cause some ethnic minorities to experience more ill health than others [33]
Due: Next Lesson

50. Ethnicity & Mental Illness

51. Ethnicity & Mental Illness
Nazroo (1997)
African-Caribbean people are more likely to suffer depression but less likely to suffer anxiety. They are also over-represented in treatment for psychotic disorders.
People of South Asian origin have the lowest rates of depression.

52. Ethnicity & Mental Illness
Black adolescents (especially those born outside of the UK)are over-represented in mental health services (Tolmac & Holmes; 2005).
People of African-Caribbean origin are most likely to be referred to mental health services via the police, courts or prisons (Rogers & Pilgrim; 2005).

53. Explanations
If you get a question on ethnicity and mental health in the exam, you should use the same CULTURAL AND MATERIAL EXPLANATIONS as those that explain general ethnic health inequalities.