The effect of ethnic density on health

1
The effect of ethnic density on health

• Laia Bécares, James Nazroo Mai Stafford
• UPTAP/BURISA Workshop
• 26th September 2008

2
Odds of reporting fair or poor health compared
with White English
Controlled for age and gender

Source Health Survey for England 2004
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Health Inequalities

• Socio-economic inequalities
• Migration effects
• Culture lifestyle
• Genetic differences
• Access to and quality of healthcare
• Racial harassment and discrimination

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Racial Discrimination in the UK

• Interpersonal or institutional
• 25 of ethnic minority people fearful of racial
  harassment
• 20 of ethnic minority people report being
  refused a job for racial reasons
• 3/4 of them say it has happened more than once
• 20 of ethnic minority people believe that most
  employers would refuse somebody a job for racial
  reasons

Fourth National Survey on Ethnic Minorities,
Moodod et al., 1997
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Area deprivation and Health

• Segregation - social manifestation of individual
  prejudices and institutional discrimination3
• Caribbean, Pakistani, Bangladeshi, and to some
  extent Indian people, more likely to reside in
  disadvantaged wards
• Neighbourhood effects associated with risk of
  all-cause mortality, infant and child health,
  chronic disease among adults, and health
  behaviour4

3. Williams et al., 2000 4. Pickett Pearl, 2001
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Sample Characteristics Area Deprivation
Area Deprivation 1999 2004 HSE
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Ethnic Density Effect

• As the proportion of an ethnic minority group
  increases, their health complications will
  decrease5
• Associated with better mental health, better
  pregnancy outcomes, reduced mortality and
  morbidity
• Results not consistent methodological and
  measurement limitations

5. Faris Dunham, 1939 Halpern Nazroo, 2000
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Pathways between Ethnic Density Health

• UPTAP project hypothesises that ethnic density
  impacts on health through
• Social norms
• Buffering effect against racism
• Increased political mobility

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1. Social Norms Model
Decreased likelihood that an ethnic minority
person will experience racial harassment
through Informal social
control Low tolerance against
discrimination
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2. Buffering Effect Model

• Social support protects from potentially
  pathogenic influence of stressful events such as
  discrimination
• Hypothesised to act through 2 ways
• change in appraisal process of stressful event
• recognition and discussion of event with others

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3. Increased Political Mobility Model
Stronger sense of community and belongingness
produces and is fuelled by increased political
mobility Better services for the community
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Data

• 1999 2004 Health Survey for England
• Fourth National Survey of Ethnic Minorities
  (1993-1994)
• 2005 2007 Home Office Citizenship Survey
  (forthcoming)

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Ethnic Density

• From UK Census
• At ward MSOA level
• Individual ethnic group density
• Overall ethnic minority density
• Continuous
• Categorical

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Ethnic Density and Racism
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Experiences of racism by a 10 increase in own
ethnic density



Odds Ratio






Source FNS data plt.05, plt.01, plt.001
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Experiences of racism by a 10 increase in
overall ethnic minority density
Odds Ratio




Source FNS data plt.05, plt.01, plt.001
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Ethnic Density and Mental Health
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Reports of psychotic symptomatology by a 10
increase in own ethnic density




Odds Ratio








Source FNS data plt.05, plt.01, plt.001
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Reports of psychotic symptomatology by a 10
increase in overall ethnic minority density
Odds Ratio








Source FNS data plt.05, plt.01, plt.001
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Ethnic Density and Physical Health
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Reports of fair, poor or very poor health by a
10 increase in own ethnic density

Odds Ratio
Source FNS data plt.05, plt.01, plt.001
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Reports of fair, poor or very poor health by a
10 increase in overall ethnic minority density





Odds Ratio
Source FNS data plt.05, plt.01, plt.001
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Ethnic Density and Alcohol Use
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Odds of reporting current drinking by a 10
increase in own ethnic density


plt.05, plt.01, plt.001
Adjusted for age, gender, SES, area deprivation,
and generation
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Odds of reporting current drinking by a 10
increase in overall ethnic density


plt.05, plt.01, plt.001
Adjusted for age, gender, SES, area deprivation,
and generation
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Conclusions

• Ethnic minorities who live in areas of greater
  ethnic density experience less racism
• Ethnic density protective of mental health and
  current alcohol consumption
• Ethnic density performs differently across ethnic
  groups and health outcomes
• Still to come political participation, social
  networks and sense of community

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Implications

• Protective benefits of ethnic density found but
  picture still inconclusive further research
• Understanding pathways behind ethnic density can
  help us better understand healthy communities
• Additional evidence for the detrimental impact of
  racism on health

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The effect of ethnic density on health

• Laia Bécares, James Nazroo Mai Stafford
• UPTAP/BURISA Workshop
• 26th September 2008