Ethnic density effects on physical health

Lead Research Organisation: University of York
Department Name: Health Science

Abstract

Some research studies of health among ethnic minority groups have shown that people may have better health if they live in areas with high concentrations of people from the same ethnic group. This has been called a group density effect. It has been suggested that this effect may be linked to the stress and social stigma of belonging to a low status group and the ways in which discrimination and prejudice worsen or ease this stress. One reason why this is such an important area to study is that it allows us to distinguish between the effects of better material conditions usually enjoyed by ethnic minority groups who live outside minority areas, and the effects of psychological or social factors.

This research project is from a team of social epidemiologists, medical sociologists and demographers, and will examine ethnic group density effects on physical health. Most previous studies have been of mental health and so this project aims to look at the effect in relation to several different health outcomes, in several different ethnic groups, in two countries.

The results of this research will need to be communicated to non-academic and public users with care and sensitivity, given the possibility as they might be misinterpreted as favouring residential segregation rather than illustrating the effects of social stigma and the benefits that would come from reducing discrimination and prejudice in society. Results will be communicated as non-technical reports to relevant non-academic institutions that have an interest in social policy related to ethnic minorities. In the UK, these include the Commission for Racial Equality, the Social Exclusion Unit and the Neighbourhood Renewal Unit. In the USA, non-academic users at the federal level include the Office of Minority Health at the Department of Health and Human Services Administration and the Office of Minority Health at the Centers for Disease Control and Dissemination.

Health professionals and health service organizations with an interest or remit in cultural competence within health care will also be interested in findings generated by this research programme. Such organizations include: the National Center for Cultural Competence and the Cross-Cultural Health Care Program in the USA, and in the UK: the Black Practitoners and Learners Network of the National Institute of Adult Continuing Education and the Transcultural Nursing and HealthCare Association supported by the Foundation of Nursing Studies.

Technical Summary

There is some evidence that the health of members of low status ethnic minorities is less good if they live in areas where they are in more of a minority. If this reflects the stress of exposure to the stigmatisation associated with minority status, then it may serve as a model for, and opportunity to explore, wider processes of social comparison which may be important in social inequalities in health. This is a proposal to conduct a systematic programme of secondary data analysis on the effects of ethnic density on physical health. Members of minorities living within their own communities seem to be partly protected from the effects of stigmatisation. First observed for mental health and now reported in a few studies of physical health, this phenomenon is potentially important not only because it may be a testament to the experience of all stigmatized minorities, including the poor, but also because it enables us to distinguish between the effects of better material conditions usually enjoyed by people living in majority areas, and the psychosocial effects of discrimination. The proposed series of secondary data analyses involving quantitative, multilevel methods aims to: establish the saliency of ethnic density effects for physical health; identify the ?tipping point? at which ethnic density becomes protective for health; and establish the size of areas in which any effect is clearest. The use of extant publicly-available datasets offers a timely and cost-effective opportunity to address an important dimension of the social determinants of health.

Publications

10 25 50

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Pickett KE (2009) Ethnic density effects on maternal and infant health in the Millennium Cohort Study. in Social science & medicine (1982)

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Pickett KE (2008) People like us: ethnic group density effects on health. in Ethnicity & health

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Power M (2018) Hidden hunger? Experiences of food insecurity amongst Pakistani and white British women. in British food journal (Croydon, England)

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POWER M (2017) All in it Together? Community Food Aid in a Multi-Ethnic Context in Journal of Social Policy

 
Description MRC Research Grant
Amount £3,576,156 (GBP)
Funding ID MR/N024397/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 09/2016 
End 08/2021
 
Description NIHR CLAHRC for Leeds, York & Bradford
Amount £10,000,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR CLAHRC Yorkshire and Humber
Sector Charity/Non Profit
Country United Kingdom
Start 06/2008 
End 05/2013
 
Description NIHR Career Scientist Award CSA/03/07/014 Deprivation, difference and early development: Healthy societies for healthy families
Amount £319,000 (GBP)
Funding ID CSA/03/07/014 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 10/2007 
End 09/2012
 
Description University of York Teaching Scholarship
Amount £50,000 (GBP)
Organisation University of York 
Sector Academic/University
Country United Kingdom
Start 10/2007 
End 02/2011
 
Description Group density research network 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution We meet regularly as a research network to collaborate on systematic reviews, to discuss research in progress and plan future work.
Collaborator Contribution Collaborated on systematic review, internal review of our research papers, collaboration on planning and financing a conferenceCollaborated on systematic review, internal review of our research papers, collaboration on planning and financing a conference
Impact We have worked together on two systematic reviews, one submitted, one in preparation, and we collectively organized and financed a conference for policy-makers in April 2010
Start Year 2006
 
Description Group density research network 
Organisation University of Manchester
Country United Kingdom 
Sector Academic/University 
PI Contribution We meet regularly as a research network to collaborate on systematic reviews, to discuss research in progress and plan future work.
Collaborator Contribution Collaborated on systematic review, internal review of our research papers, collaboration on planning and financing a conferenceCollaborated on systematic review, internal review of our research papers, collaboration on planning and financing a conference
Impact We have worked together on two systematic reviews, one submitted, one in preparation, and we collectively organized and financed a conference for policy-makers in April 2010
Start Year 2006
 
Description People Like Us conference, Manchester 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact More than 100 people, about two-thirds academic and one third policy makers and health professionals attended a 1-day conference (http://www.ccsr.ac.uk/events/peoplelikeus/) to examine and discuss the origins and implications of ethnic concentration

This has led to new research collaborations and projects
Year(s) Of Engagement Activity 2010