Understanding and tackling ethnic inequalities in health

1. Understanding and tackling ethnic inequalities in health An ESRC Research Seminar Series Organisers: Sarah Salway and Kiran Nanchahal

2. Background • Interest in links between race, ethnicity & health is not new. • Huge increase in available data, and significant shift in policy, in last 10-15 years. • Evidence of large and persistent inequality (and diversity) in many aspects of social, economic and health-related well-being between ethnic groups. • Growing number of ‘ethnic health researchers’. • Increased programme activity at local level.

3. Background (2) • Improving health of minority ethnic groups central component of government’s agenda to reduce social exclusion and inequalities in health • Significant action at policy level across many government departments: new research programmes, new focused interventions, and new targets for achieving reduction in ethnic minority disadvantage. • Increased recognition of ways in which different dimensions of disadvantage inter-relate.

4. Background (3) • Wide range of factors contribute to health outcomes in ethnic minority groups: • Differential access & quality of health services • Socio-cultural influences • Socio-economic disadvantage • Racial discrimination • Migration and life events • Genetic or biological variation • Need cross-disciplinary methods of enquiry and multi-sector intervention

5. ESRC Research Seminar SeriesAims and objectives • Promote discussion networks between academic researchers and strengthen their contribution to long term health of the social sciences • Value to research • Setting or enhancing personal research agendas • Increasing range of personal research contacts • Increasing degree of collaborative research • Value to policy makers • Impact on knowledge and perceptions of the research field • Political impact on area of operation or policy

6. Aims of this seminar series • To bring together academics from wide range of institutional settings, practitioners, policy-makers, and other users of research. • To share current knowledge regarding patterns and determinants of health among different ethnic groups, as well as ‘best practice’ in researching ethnicity and health. • To engage in debate surrounding current issues and challenges regarding the generation and application of knowledge to effective practice.

7. Some issues and challenges • What is ‘ethnicity’? – fluid and complex • Health-focused research often not based on theoretical framework. • How can inequality be understood, monitored and addressed if categories keep shifting? • How can greater understanding of lived experiences: ‘What I am’, and ‘What it means to be me’, be put to practical use to bring about positive change? • Potential pitfalls of attention to ethnicity • Reification of ethnic ‘groups’ and contribution to boundaries of exclusion. • Lack of representation of powerless groups, racism, victim-blaming, stereotyping. • Overlooking of other axes of inequality (and their inter-relationships).

8. Issues and challenges (2) • Ever-increasing diversity (countries of origin, life-stage, generation, class) • Is detailed understanding of particular situations useful? • Can we expect to tailor services to meet diverse needs? • Or, should generic cultural competencies be the objective? • Can investigations move beyond the descriptive to the predictive? • Problems of generalisability of findings over time, e.g. current studies on older groups.

9. Issues and challenges (3) • Translating knowledge into policy and practice • Gap between academia and world of service provision • Need for more “researcher-practitioners” and multi-experience teams. • Danger of nuanced interpretations being translated into stereotypical responses. • What should be the boundaries of the health sector? • Who should be concerned about ethnic minority health? • What other issues should concern health practitioners? • How can local knowledge be built upon? • What models of participation & empowerment work well? • How can local initiatives be scaled up effectively?

10. Participation in the series • Sectors • Academics • Policy makers • Service providers • Hierarchy • Senior/ Junior staff • Suggestions for • Speakers & discussants • Publicity • Feedback • New collaborations? • New initiatives? • New ways of looking at things?

11. Understanding the links between socioeconomic deprivation & health among ethnic minority groups Using assessments of biological and genetic risk to inform policy priorities Gender, generation and identity: socio-cultural constructions and their influences on health 1. February 2005, LondonJames Nazroo & Sarah Salway 2. June 2005, LeedsKarl Atkin & Elizabeth Anionwu 3. October 2005, LondonSeeromanie Harding & Kiran Nanchahal Seminars & convenors (2005)

12. Migration, trans-national links and life-course influences on health Cultural competence in health and social research Evidence into practice: increasing appropriateness and cultural competence of health and social care provision 4.January 2006, WarwickDavid Owen & Hannah Bradby 5. April 2006, LeicesterMark Johnson & Raj Bhopal 6. July 2006, SheffieldKate Gerrish & Sarah Salway Seminars & convenors (2006)

13. Up-to-date information URL : www.shef.ac.uk/ethnichealthinequalities

14. Many thanks to.. • ESRC for providing funding • The Brady Centre • Our speakers and discussants • Linda Belk for administration • All participants

15. A reminder • Seminar 2 • June 2005, Leeds • Convenors: Karl Atkin & Elizabeth Anionwu • Using assessments of biological and genetic risk to inform policy priorities www.shef.ac.uk/ethnichealthinequalities