Ethnicity, race, and health in multicultural societies : foundations for better epidemiology, public health, and health care

Most of the industrialized world now comprises multi-ethnic societies, with people from widely varying ancestry, cultures, languages, and beliefs. With the globalization of trade, increasing international travel, and migration, the whole world is destined to become multi-ethnic within the next 20 or 30 years. This change poses huge challenges for doctors, nurses, public health practitioners, health-care managers, and policy makers who have to meet legal and policy obligations to deliver health outcomes, and provide health-care of equal quality and effectiveness. To achieve this, they need a solid understanding of the underlying concepts of race and ethnicity, and how these are applied to achieve better health for ethnic-minority populations. They also need to have an awareness of the misuses of these concepts, particularly taking into account the history of racism that permeates many societies to this day. Written in non-technical language, with all terminology explained and defined, this book provides an accessible introduction to these complex issues. The key concepts of race and ethnicity are explained, including their uses and misuses. The strengths and weaknesses of these concepts in terms of epidemiology, policy-making, health service planning, research, health-care, and health promotion are illustrated. The book emphasizes theory, ideas, and principles, and counters the study of ethnicity and race in a theoretical way. Practical application of the theory is demonstrated through the use of extensive examples. The conceptual frameworks of ethnicity and race required by practitioners and researchers are slightly different, including the nature of research questions, the relative value of various methods of classification, and the approach to data analysis, presentation, and interpretation, and these differences are made explicit. Overall, the interdependence of theory and practice is demonstrated, making this an ideal foundation text or refresher for those involved in race and ethnicity from a health care perspective. acprof-9780198568179-miscMatter-1 Title Pages Raj S. Bhopal Title Pages (p.i) Ethnicity, Race, and Health in Multicultural Societies (p.ii) (p.iii) Ethnicity, Race, and Health in Multicultural Societies Title Pages Title Pages acprof-9780198568179-miscMatter-4 (p.v) Dedication Raj S. Bhopal (p.v) Dedication acprof-9780198568179-miscMatter-6 (p.ix) Foreword Raj S. Bhopal (p.ix) Foreword (p.ix) Foreword (p.ix) Foreword acprof-9780198568179-miscMatter-7 (p.xi) Preface Raj S. Bhopal (p.xi) Preface (p.xi) Preface (p.xi) Preface (p.xi) Preface (p.xi) Preface acprof-9780198568179-miscMatter-8 (p.xv) Acknowledgements Raj S. Bhopal (p.xv) Acknowledgements (p.xv) Acknowledgements acprof-9780198568179-miscMatter-9 (p.xvii) Sources and permissions Raj S. Bhopal (p.xvii) Sources and permissions (p.xvii) Sources and permissions acprof-9780198568179-miscMatter-10 (p.308) A brief glossary Raj S. Bhopal (p.308) A brief glossary (p.308) A brief glossary (p.308) A brief glossary (p.308) A brief glossary (p.308) A brief glossary (p.308) A brief glossary (p.308) A brief glossary (p.308) A brief glossary (p.308) A brief glossary acprof-9780198568179-miscMatter-12 (p.345) Ethnicity and health web sites: a selection Raj S. Bhopal (p.345) Ethnicity and health web sites: a selection Organizations’ web sites (p.345) Ethnicity and health web sites: a selection (p.345) Ethnicity and health web sites: a selection (p.345) Ethnicity and health web sites: a selection Journals specializing in ethnicity and health (p.345) Ethnicity and health web sites: a selection (p.348) Reports and general information on specific topics (p.345) Ethnicity and health web sites: a selection (p.345) Ethnicity and health web sites: a selection (p.345) Ethnicity and health web sites: a selection Networks Statistics and census (these and other websites were used in chapter 2) (p.345) Ethnicity and health web sites: a selection acprof-9780198568179-chapter-1 Introduction: The concepts of ethnicity and race in health Raj S. Bhopal Introduction: The concepts of ethnicity and race in health Bhopal Raj S. Abstract and Keywords Introduction: The concepts of ethnicity and race in health Chapter contents Objectives 1.1 Introduction Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health (p.5) 1.2 Epidemiology—the author's professional perspective Introduction: The concepts of ethnicity and race in health 1.3 Ethnicity and race as exposure variables Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health 1.4 Ethnicity and race: self and others’ perception of biological and cultural characteristics 1.4.1 Race Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health 1.4.2 Ethnicity Introduction: The concepts of ethnicity and race in health 1.5 Problems in using the race and ethnicity concepts in epidemiology and other quantitative health sciences Introduction: The concepts of ethnicity and race in health 1.5.1 The problem of heterogeneous populations 1.5.2 Ambiguity about the research purpose Introduction: The concepts of ethnicity and race in health 1.5.3 The problem of ethnocentricity Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health 1.6 Race ethnicity and social harm Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health 1.7 Race and ethnicity in relation to ancestry, nationality, country of birth and religion Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health 1.8 Analyse your own background and identity using the concepts of race and ethnicity RSB on ethnicity Introduction: The concepts of ethnicity and race in health RSB on race Joan Mackintosh on race and ethnicity Nigel Unwin on race and ethnicity Introduction: The concepts of ethnicity and race in health Naseer Ahmad on race and ethnicity Introduction: The concepts of ethnicity and race in health Introduction: The concepts of ethnicity and race in health 1.9 The potential benefits of the race and ethnicity concepts in the health context Introduction: The concepts of ethnicity and race in health (p.27) 1.10 Conclusions Introduction: The concepts of ethnicity and race in health Summary Introduction: The concepts of ethnicity and race in health acprof-9780198568179-chapter-2 Terminology and classifications for ethnic and racial groups Raj S. Bhopal Terminology and classifications for ethnic and racial groups Bhopal Raj S. Abstract and Keywords Terminology and classifications for ethnic and racial groups Chapter contents Objectives Terminology and classifications for ethnic and racial groups 2.1 Introduction: turning the concept of ethnicity and race into classifications Terminology and classifications for ethnic and racial groups 2.2 Reflection on the word Asian and similar labels Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups A note on terminology relating to ethnicity Terminology and classifications for ethnic and racial groups 2.3 Facets of ethnicity and race in classifications Terminology and classifications for ethnic and racial groups 2.4 From concept, to category, to classification Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups The United States of America Terminology and classifications for ethnic and racial groups United Kingdom Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups New Zealand 2.5 Census categories are not necessarily a good match for identity Terminology and classifications for ethnic and racial groups Terminology and classifications for ethnic and racial groups 2.6 Towards a common international terminology 2.7 Conclusions Terminology and classifications for ethnic and racial groups Ethnicity, race, and culture: guidelines for research, audit, and publication Terminology and classifications for ethnic and racial groups Summary Terminology and classifications for ethnic and racial groups Appendix Canada Terminology and classifications for ethnic and racial groups Brazil India Terminology and classifications for ethnic and racial groups Australia Fiji (p.59) Mauritius Terminology and classifications for ethnic and racial groups South Africa Singapore acprof-9780198568179-chapter-3 Challenges of collecting and interpreting data using the concepts of ethnicity and race Raj S. Bhopal Challenges of collecting and interpreting data using the concepts of ethnicity and race Bhopal Raj S. Abstract and Keywords Challenges of collecting and interpreting data using the concepts of ethnicity and race (p.61) Contents Challenges of collecting and interpreting data using the concepts of ethnicity and race Objectives 3.1 Introduction Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.2 Data as an agent for health improvement—making choices Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.3 Collecting data by ethnic monitoring: difficulties, choices and concepts Challenges of collecting and interpreting data using the concepts of ethnicity and race (p.67) 3.4 Context, purpose and measures of ethnicity and race 3.4.1 Political Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.4.2 Health policy 3.4.3 Health care planning Challenges of collecting and interpreting data using the concepts of ethnicity and race (p.71) 3.4.4 Clinical care Challenges of collecting and interpreting data using the concepts of ethnicity and race (p.72) 3.4.5 Research Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.5 Collecting ethnicity and health data 3.5.1 Self assessment of ethnic group Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.5.2 Country of birth of self, parents and grandparents Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.5.3 Assessment by an observer using relevant data 3.5.3.1 Name search Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.5.4 Assessment on the basis of visual inspection Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.5.5 Combining self-reported data and observation Challenges of collecting and interpreting data using the concepts of ethnicity and race (p.79) 3.6 Practicalities of assigning ethnicity in health settings 3.6.1 Primary care Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.6.2 Secondary care Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.6.3 Mortality data Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.6.4 Linking data Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.6.5 Modelling data Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.6.6 Retrospective addition of ethnic codes Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.7 Interpreting data Challenges of collecting and interpreting data using the concepts of ethnicity and race Challenges of collecting and interpreting data using the concepts of ethnicity and race 3.8 Making use of data 3.9 Conclusion Summary Challenges of collecting and interpreting data using the concepts of ethnicity and race acprof-9780198568179-chapter-4 Historical analysis of the development of health and health care services for ethnic minorities Raj S. Bhopal Historical analysis of the development of health and health care services for ethnic minorities Bhopal Raj S. Abstract and Keywords Historical analysis of the development of health and health care services for ethnic minorities Contents Objectives 4.1 Introduction: migration and ethnicity Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities 4.2 Characterizing society's response to the health aspects of migration Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities 4.2.1 UK Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities 4.2.2 United State of America Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities 4.2.3 Australia and the indigenous population—aborigines Historical analysis of the development of health and health care services for ethnic minorities 4.2.4 South Africa (under apartheid) Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities 4.2.5 Netherlands Historical analysis of the development of health and health care services for ethnic minorities 4.3 A pattern of response—derivation of principles Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities Historical analysis of the development of health and health care services for ethnic minorities 4.4 Conclusion Historical analysis of the development of health and health care services for ethnic minorities Summary Historical analysis of the development of health and health care services for ethnic minorities acprof-9780198568179-chapter-5 Defining health and health care needs using quantitative and qualitative data Raj S. Bhopal Defining health and health care needs using quantitative and qualitative data Bhopal Raj S. Abstract and Keywords Defining health and health care needs using quantitative and qualitative data Contents (p.113) Objectives 5.1 Health needs assessment: an overview Defining health and health care needs using quantitative and qualitative data Basic principles (extracted from a longer list) (p.114) 5.1.1 The concepts of health and health needs in a nutshell Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.1.2 Health needs assessment Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.2 The questions driving data collection in health needs assessment 5.2.1 What are the demographic and social characteristics of the minority ethnic groups in the local area and how are these changing? Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data (p.122) 5.2.2 What are the cultures and lifestyles of the ethnic minority populations and how are they changing? Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.2.3 Which illnesses and diseases affect the ethnic minority populations and in what quantity? Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.2.4 Epidemiological approaches to presentation and interpretation of data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data (p.132) 5.2.5 Epidemiological approaches for health needs assessment: making choices and understanding limitations Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.2.6 Patterns of disease in ethnic minority groups Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.2.7 How do we explain differences? Defining health and health care needs using quantitative and qualitative data 5.2.8 What services are available and adapted for ethnic minority populations? Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.3 What do the public and health professionals think of the service? The role of qualitative data in health needs assessment Defining health and health care needs using quantitative and qualitative data 5.3.1 Gauging the experiences of members of ethnic minority communities as users of health services using interviewing Defining health and health care needs using quantitative and qualitative data 5.4 Focus groups 5.5 How many people from ethnic minority populations use the available services? What is the quality of their interaction with staff? Are the services meeting the need? Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data 5.6 How can services for minority ethnic groups be evaluated? Defining health and health care needs using quantitative and qualitative data 5.7 Conclusions Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Defining health and health care needs using quantitative and qualitative data Summary Defining health and health care needs using quantitative and qualitative data acprof-9780198568179-chapter-6 Ethnic inequalities in health and health care Raj S. Bhopal Ethnic inequalities in health and health care Bhopal Raj S. Abstract and Keywords Contents Ethnic inequalities in health and health care Objectives (p.151) 6.1 What are health inequalities and why are they inevitable by race and ethnicity? Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.2 What is the scale of ethnic health inequalities? Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care (p.158) 6.3 Perpetuation and augmentation of ethnic health inequalities: the role of racism 6.3.1 Defining racism and assessing its importance Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.3.2 Historical racism Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.3.3 Differences between Black and White patients in the management of disease in the USA Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.3.4 Inequalities, stigma and the social standing of ethnic minority groups Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.3.5 Racism: some lessons from Hitler Ethnic inequalities in health and health care Ethnic inequalities in health and health care (p.167) 6.3.6 Hitler on racial admixture 6.3.7 Hitler on the superiority of the Aryan race, and the exploitation of inferior groups Ethnic inequalities in health and health care 6.3.8 Drawing lessons from Hitler‘s legacy 6.4 Racism in service delivery, ethnocentrism and equity 6.4.1 Types of racism in health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.4.2 Personal experiences of racism Ethnic inequalities in health and health care 6.4.3 Using race and ethnicity to combat racism and achieve equity Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.5 Exploration of the measurement of the relationship of socio-economic position and health: an example of ethnic variations in CHD Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.6 Strategies for tackling ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care Ethnic inequalities in health and health care 6.7 Conclusion Ethnic inequalities in health and health care Ethnic inequalities in health and health care Summary Ethnic inequalities in health and health care Notes A definition of ‘Aryan’ acprof-9780198568179-chapter-7 Principles for setting priorities for ethnic minority populations Raj S. Bhopal Principles for setting priorities for ethnic minority populations Bhopal Raj S. Abstract and Keywords Principles for setting priorities for ethnic minority populations Chapter contents Objectives 7.1 Introduction Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations 7.2 The epidemiological underpinnings of priority-setting Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations 7.3 Analysis of past approaches Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations 7.4 Towards a set of principles and standards Principles for setting priorities for ethnic minority populations 7.5 Setting priorities using epidemiological data; the example of cancer Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations 7.5.1 South Asian and Caribbean origin populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations 7.5.2 Interpreting patterns Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations 7.6 Impact of priority decisions on inequalities Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations Principles for setting priorities for ethnic minority populations 7.7 Evidence base for interventions in the field of minority ethnic health Principles for setting priorities for ethnic minority populations 7.8 Conclusions Principles for setting priorities for ethnic minority populations Summary Principles for setting priorities for ethnic minority populations acprof-9780198568179-chapter-8 Strategic approaches to health and health care services for ethnic minority groups Raj S. Bhopal Strategic approaches to health and health care services for ethnic minority groups Bhopal Raj S. Abstract and Keywords Strategic approaches to health and health care services for ethnic minority groups Contents Objectives Strategic approaches to health and health care services for ethnic minority groups 8.1 Introduction to policy, strategy and models of service delivery Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups 8.2 Examples of policy and strategy 8.2.1 General—the UK and the USA Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups 8.2.2 Scotland—a late starter, making rapid progress in the context of social justice 8.2.2.1 Health inequalities are a priority for the health service in Scotland 8.2.2.2 The Race Relations Amendment Act and race equality schemes Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups 8.2.2.3 Health Department letter (HDL) and stock-take: Fair for All The need for a strategic approach Managerial responsibility Strategic approaches to health and health care services for ethnic minority groups Assessment of health needs and translating knowledge into action Recruitment/development and retention of ethnic minority staff Dialogue with ethnic minority communities Summary Background Strategic approaches to health and health care services for ethnic minority groups Action Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to health and health care services for ethnic minority groups Strategic approaches to he Most of the industrialized world now comprises of multi-ethnic societies, with_x000D_ people from widely varying ancestry, cultures, languages, and beliefs. With_x000D_ globalization of trade, increasing international travel, and migration, the whole_x000D_ world is destined to become multi-ethnic within the next 20 or 30 years. This poses_x000D_ huge challenges for doctors, nurses, public health practitioners, health care_x000D_ managers, and policy makers who have to meet legal and policy obligations to_x000D_ deliverhealth outcomes, and provide health care of equal quality and effectiveness._x000D_ To achieve this, they need a solid understanding of the underlying concepts of race_x000D_ and ethnicity, and how these are applied to achieve better health for ethnic_x000D_ minority populations. They also need to have an awareness of themisuses of these_x000D_ concepts, particularly taking into account the history of racism that permeates many_x000D_ societies to this day.Written in non-technical language, with all terminology_x000D_ explained and defined, this book provides an accessible introduction to these_x000D_ complex issues. The key concepts of race and ethnicity are explained, including_x000D_ their uses and misuses. The strengths and weaknesses of these concepts in terms of_x000D_ epidemiology, policy making, health service planning, research, health care, and_x000D_ health promotion are illustrated. The book emphasises theory, ideas, and principles,_x000D_ and and its aims are to helpcounteract the unethical and atheoretical methods often_x000D_ used to study ethnicity. Practical application of the theory is demonstrated through_x000D_ the use of extensive examples. The conceptual frameworks of ethnicity and race_x000D_ required by practitioners and researchers are slightly different, including the_x000D_ natureof research questions, the relative value of various methods of_x000D_ classification, and the approach to data analysis, presentation, and interpretation,_x000D_ and these differences are made explicit. Overall, the interdependence of theory and_x000D_ practice is demonstrated, making this and ideal foundation text or refresher for_x000D_ those involved in race and ethnicity from a health care perspective.