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Karlsen, S. & Nazroo, J.Y. (2002) Agency and structure: the impact of ethnic identity and racism on the health of ethnic minority people. Sociology of Health & Illness, 24: 1–20.
Quote p. 8: "The analysis presented here showed independent relationships between perceptions of racial discrimination, experience of racial harassment, class indicators and health, with all three
independent variables having a considerable impact on health."
Nazroo, J.Y. (1998). Genetic, cultural or socioeconomic vulnerability? Explaining ethnic inequalities in health. Sociology of Health and Illness, 20:714–734.
David
Is there good evidence that in the UK there are important health
inequalities (disregarding the genetic stuff) which relate to ethnicity
and are not explained by poverty? If so I would be grateful for references.
Martin Rathfelder
Director
Socialist Health Association
22 Blair Road
Manchester
M16 8NS
0161 286 1926
www.sochealth.co.uk
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On 02/07/10 09:27, Ingleby, J.D. (David) wrote:
> This is an interesting report, but it contains a striking omission. It
> acknowledges in several places that ethnicity-related factors are an
> important cause of health inequalities, e.g.: "Our analysis of data
> from Lambeth indicates that in areas with large ethnic populations,
> ethnicity is as important in control of diabetes and blood pressure as
> deprivation" (p. 40). However, in its review of measures to tackle
> health inequalities, the report ignores the previous government's
> initiatives to promote racial and ethnic equality in health.
> The same rift between the discourses of "health inequality" and
> "ethnic differences" can be seen in the Marmot review, "Fair Society,
> Healthy Lives". The neglect of ethnicity in this document was rightly
> castigated by Salway /et al./ in the BMJ
> (http://171.66.124.147/cgi/eletters/340/feb09_1/c684#234369).
> This dichotomy in the work of researchers and policy-makers on health
> inequality has puzzled me for some time. It's a purely European
> phenomenon, not found in the USA. Is it because deep down, Europeans
> don't want to accept that ethnicity is an important determinant of
> social stratification in their societies?
> Whatever the reason, Salway et al. are in my view right to conclude
> that "sustained attention to ethnic diversity and inequality must be
> part-and-parcel of the mainstream health inequalities agenda". It
> would be nice to have some discussion of the issue on this list, given
> its transatlantic membership.
> Best wishes,
> David Ingleby
> www.ercomer.eu/ingleby <http://www.ercomer.eu/ingleby>
> P.S. Readers of the report who want to consult the research in Lambeth
> mentioned on p. 40 will be disappointed. The study mentioned in
> footnote 33, /Inequalities in health due to ethnicity and social
> deprivation – an analysis of primary care data from one inner-city
> area over a three year period/, is said to be available on the website
> http://www.nao.org.uk , but it doesn't seem to be.
>
> ------------------------------------------------------------------------
> *Van:* The Health Equity Network (HEN) namens David McDaid
> *Verzonden:* vr 2-7-2010 08:04
> *Aan:* [log in to unmask]
> *Onderwerp:* England: Tackling inequalities in life expectancy in
> areas with the worst health and deprivation
>
> FYI – new report from National Audit Office in England on previous
> govt efforts to tackle health inequalities
>
> Press release and link to report below
>
> Best wishes
>
> David McDaid
>
> LSE Health and Social Care
>
> **http://www.nao.org.uk/publications/1011/health_inequalities.aspx**
>
> **"The Department of Health has made a concerted effort to tackle a
> very difficult and long-standing problem. However, it was slow to take
> action and health inequalities were not a top priority for the NHS
> until 2006. We recognize that this is a very complicated issue and
> that it took time to develop an evidence base. However, the best,
> cost-effective interventions have been identified and now must be
> employed on a larger scale in order to have a greater impact and
> improve value for money.**
>
> **"The Department should target its efforts on the most deprived areas
> of the country and develop costed proposals to maintain or increase
> investment in preventative interventions to tackle the conditions
> which lead to health inequalities."**
>
> **Amyas Morse, head of the National Audit Office, 2 July 2010**
>
> The Department of Health has made a serious attempt to tackle health
> inequalities across England. But, according to a National Audit Office
> report published today, having set a target in 2000 to reduce health
> inequalities, it took time to embed the issue in the policy and
> planning framework of the NHS and to develop an evidence base of the
> most cost-effective interventions.
>
> Given the slowness in applying cost-effective interventions on the
> scale required in the early and mid-2000s, the NAO was unable to
> conclude that the Department’s approach provided value for money up to
> this time. More recently the improved take-up of these interventions
> is likely to have improved value for money.
>
> The NAO report found that, although life expectancy overall has
> increased, the gap in life expectancy between the national average and
> the Government’s dedicated “spearhead” areas has continued to widen.
> The Department will not meet its target to reduce the health
> inequalities gap by 10 per cent by 2010, as measured by life
> expectancy at birth, if current trends continue.
>
> The Department’s strategy, published in 2003, lacked effective
> mechanisms to achieve the target because the evidence base was still
> being developed. It was not until 2006-07 that the strategy was
> matched by focused action to tackle health inequalities, leaving
> little time for these actions to have an impact before the 2010 target
> date.
>
> Three key, cost-effective interventions to reduce the gap in life
> expectancy were identified by the Department’s 2007 Health
> Inequalities Intervention Tool: increase the prescribing, first, of
> drugs to control blood pressure and, secondly, of drugs to reduce
> cholesterol, by 40 per cent; and double the capacity of smoking
> cessation services. But these interventions have not yet been used on
> the scale required to close the gap and progress in improving the
> take-up of these interventions is not monitored.
>
> Primary care trusts are required to address health inequalities from
> within their general budgets and, therefore, it is not possible to
> identify how much money has been spent. PCTs in spearhead areas had
> £230 more per head to spend than the PCTs in non-spearheads, but there
> is evidence that some of the extra money is absorbed by higher
> hospital costs in deprived areas.
>
> David McDaid
>
> Senior Research Fellow, LSE Health and Social Care and European
> Observatory on Health Systems and Policies,
>
> London School of Economics and Political Science
>
> Houghton Street
>
> London
>
> WC2A 2AE
>
> e-mail: [log in to unmask]
>
>
> Please access the attached hyperlink for an important electronic
> communications disclaimer:
> http://www.lse.ac.uk/collections/planningAndCorporatePolicy/legalandComplianceTeam/legal/disclaimer.htm