Ethnicity and health

Black and minority ethnic (BME) groups generally have worse health than the overall population, although some BME groups fare much worse than others, and patterns vary from one health condition to the next. Evidence suggests that the poorer socio-economic position of BME groups is the main factor driving ethnic health inequalities. Several policies have aimed to tackle health inequalities in recent years, although to date, ethnicity has not been a consistent focus. This POSTnote reviews the evidence on ethnic health inequalities, the causes and policy options.

Ethnicity

Ethnicity results from many aspects of difference which  are socially and politically important in the UK.  These include race, culture, religion and nationality, which impact on a person’s identity and how they are seen by others. People identify with ethnic groups at many different levels. They may see themselves as British, Asian, Indian, Punjabi and Glaswegian at different times and in different circumstances. However, to allow data to be collected and analysed on a large scale, ethnicity is often treated as a fixed characteristic. BME groups are usually classified by the methods used in the UK census, which asks people to indicate to which of 16 ethnic groups they feel they belong.

Health inequalities

Health inequalities are differences in health status that are driven by inequalities in society. Health is shaped by many different factors, such as lifestyle, material wealth, educational attainment, job security, housing conditions, psycho-social stress, discrimination and the health services. Health inequalities represent the cumulative effect of these factors over the life-course; they can be passed on from one generation to the next through maternal influences on baby and child development. 

Ethnic health inequalities Large-scale surveys like the Health Survey for England show that BME groups as a whole are more likely to report ill-health, and that ill-health among BME people starts at a younger age than in the White British. There is more variation in the rates of some diseases by ethnicity than by other socio-economic factors. However, patterns of ethnic variation in health are extremely diverse, and inter-link with many overlapping factors: 

• Some BME groups experience worse health than others. For example, surveys commonly show that Pakistani, Bangladeshi and Black-Caribbean people report the poorest health, with Indian, East African Asian and Black African people reporting the same health as White British, and Chinese people reporting better health. 

• Patterns of ethnic inequalities in health vary from one health condition to the next. For example, BME groups tend to have higher rates of cardio-vascular disease than White British people, but lower rates of many cancers.

• Ethnic differences in health vary across age groups, so that the greatest variation by ethnicity is seen among the elderly.

• Ethnic differences in health vary between men and women, as well as between geographic areas. 

• Ethnic differences in health may vary between generations. For example, in some BME groups, rates of ill-health are worse among those born in the UK than in first generation migrants.