Ethnicity, health and health services utilization in a British study
Smith, George Davey
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Despite the exponential growth in the number of studies addressing ethnicity and health, there is considerable debate about definitions of ethnicity, the appropriate use of ethnicity in health research and whether research focusing on ethnicity in the health field will ultimately result in reduced disadvantage or will simply contribute to the reification of ethnic origin as a cause of health problems. The authors present and discuss health outcomes among White (n = 227), African-Caribbean (n = 213) and Indian and Pakistani (n = 233) adults aged between 18 and 59 years living in Leeds as measured in a stratified population survey, with particular emphasis on the interaction between reports of health conditions and health status in relation to ethnicity and gender. The survey included both general and specific measures of health and impairment and was undertaken following extensive qualitative fieldwork. Overall the results of the study suggest that adults in both broad minority ethnic groups studied have a somewhat less favourable profile of physical and mental health and risk factors such as obesity and low birthweight. Despite an absence of ethnic differences in reporting of long-term conditions, minority groups had lower health status because those with long-term conditions were generally in worse health than their White counterparts. The study findings agree with previous research in suggesting that variation in health status was better explained by specific measures of actual limitations in daily activities than by general measures of limiting long-term illness. These data suggest that limiting long-term illness or disability questions may underestimate functional limitation relative to more specific measures and consequently their use in resource allocation may be problematic.