Ethnicity and Health

Question 1

Define ethnicity, including cultural characteristics (giving examples).

Answer 1

The construct of ethnicity or ethnic is generally utilised to denote some form of distinctive set of cultural characteristics, such as common geographical and ancestral origins, language and traditions.

Often though, other shared characteristics are used such as nationality, migrant status, religion, and ‘race’.

Question 2

Define culture.

Answer 2

An array of shared implicit mental precepts regulating understanding and behaviour.
A construct - those sets of beliefs and ideas that a defined social group draws upon in order to identify and manage the practical problems of their everyday lives.

Question 3

What is institutional racism?

Answer 3

Professional cultures and institutional practices play an important role in reinforcing and constructing norms of ‘compliant’ patient behaviour. Patients from ethnic minorities are often identified as those falling outside of these constructed norms of patient behaviour.

OR
‘The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people’

Question 4

Describe the tension between reification (making something real/concrete) of ethnicity and the need to provide a socially accountable healthcare service.

Answer 4

Ethnicity is used as an exposure variable in epidemiology, so is therefore one of several variables that are used to subdivide the population for purposes of health research and for planning service provision. It is also monitored to achieve an equitable provision of services.

However, this is problematic because we are deriving measurable categories from what are essentially ‘social constructions’. It can lead to artefactual data, which is problematic for the subsequent use of this data in generating research findings and planning for health needs and policy development.

Question 5

Describe the principles of culturally competent healthcare practice.

Answer 5

Health professionals need to be sensitive to cultural differences, as well as to the complexities and dynamics of ethnicity. This can provide them with essential information about a patients beliefs and practices as they pertain to health and health care.

It can also challenge stereotypes.

Question 6

Define social capital.

Answer 6

“Social capital is the quantity and quality of social interactions in a community. Those features of social organisations – such as networks of secondary associations, high levels of interpersonal trust and norms of mutual aid and reciprocity – which act as resources for individuals and facilitate collective action”.

Question 7

What is epidemiology?

What research strategy does it employ?

Answer 7

The study of patterns of disease and the factors that influence the emergence, propagation and frequency of disease in a population.

Measuring differential exposure variables of populations.

Question 8

Give some examples of exposure variables. (6)

Answer 8

Gender
Age
Occupation
Socio-economic class
Health behaviour
Ethnicity

Question 9

What is a social construct?

Answer 9

The understanding that everyday knowledge is creatively produced by individuals and is directed towards practical problems. Our concepts and categories/ideas and beliefs are the realities of the world.

Question 10

In epidemiological research the construct of ethnicity generally incorporates two methodologically distinct concepts. What are they?

Answer 10

a) Ethnic group - based on an individual conception of social group membership and personal identity.
b) Ethnic origin - an allocated definition based on common ancestry or place of origin.

Question 11

What does the NHS Ethnic Category coding assume?

What are the problems with this? (4)

Answer 11

That ethnic boundaries are fixed and clear, when in practice they are fluid and imprecise.

• The label of ethnic difference is often imposed by the majority groups, who construct minorities as the ‘outsiders’.
• Separates people into advantaged and disadvantaged.
• Plays down the commonalities of life for minority groups
• Leads to an ignoring of the common experiences of racism and of material deprivation, and their impact upon health outcomes.