Ethnic inequalities in child development and health: an examination and comparison across the United Kingdom, the United States, and New Zealand
Lead Research Organisation:
University of Manchester
Department Name: Social Sciences
Abstract
Ethnic minority groups in the United Kingdom (UK), the United States (US) and New Zealand (NZ) have much poorer health and die younger than the white majority. The causes behind these inequalities in health are largely unexplained, although ethnic minority groups tend to be financially and materially poorer than white people, and this contributes to their worse health. Experiences of racism and discrimination have been found to also contribute to health differences between white people and ethnic minorities. Although broad similarities exist in the US, UK and NZ in terms of worse health among non-white ethnic groups relative to white people, health inequalities vary across ethnic minority groups both between and within countries and throughout the life course. Variations in ethnic inequalities in child health and development may arise due to differences in the countries of origin of the predominant minority groups, in reasons for migration, in cultural, economic and demographic profiles of the ethnic groups represented, and in civic and political cultures. The three countries that will be examined in this project are similar in terms of their documented ethnic inequalities, commitment to reducing said inequalities, and availability of health and social surveys, but also have stark differences, including in their healthcare and welfare systems, and very different ethnic minority populations, which vary, among other things, in terms of histories and reasons for migration and colonisation. Comparing the health of ethnic groups in these national settings will help us to better understand which factors lead to these different and avoidable health profiles, and will help inform policy makers about what are the key features that can be reduced, or promoted, in other to tackle preventable ethnic inequalities in health.
In the proposed project I will explore which factors influence the health and development of ethnic minority and white majority children during the early years of childhood, and lead to inequities in health as they grow up. I will analyse four datasets (one in the UK, one in the US and two in NZ), which provide detailed information on ethnic minority and white majority children's mental and physical health and development, as well as information about their families, schools, neighbourhoods and national context.
Key goals of this proposed project are to:
1. Examine the risk factors that contribute to generating ethnic health inequalities at the individual and family level, by assessing the contribution of a range of biological, psychosocial, economic and behavioural factors.
2. Examine factors that might explain ethnic inequalities in health at the neighbourhood level, including area deprivation, income inequality, social capital, and ethnic density.
3. Analyse structural differences between the UK, US and NZ as possible explanations for ethnic inequalities in child health and development, including migratory factors, socio-economic characteristics of the country of origin, social and public policies, structures for the delivery of healthcare, and historical and contemporary ethnic relations.
In the proposed project I will explore which factors influence the health and development of ethnic minority and white majority children during the early years of childhood, and lead to inequities in health as they grow up. I will analyse four datasets (one in the UK, one in the US and two in NZ), which provide detailed information on ethnic minority and white majority children's mental and physical health and development, as well as information about their families, schools, neighbourhoods and national context.
Key goals of this proposed project are to:
1. Examine the risk factors that contribute to generating ethnic health inequalities at the individual and family level, by assessing the contribution of a range of biological, psychosocial, economic and behavioural factors.
2. Examine factors that might explain ethnic inequalities in health at the neighbourhood level, including area deprivation, income inequality, social capital, and ethnic density.
3. Analyse structural differences between the UK, US and NZ as possible explanations for ethnic inequalities in child health and development, including migratory factors, socio-economic characteristics of the country of origin, social and public policies, structures for the delivery of healthcare, and historical and contemporary ethnic relations.
Planned Impact
Findings of this study will be of benefit to several individuals, groups and organisations, and will provide a sound evidence base to inform decisions in public health to promote disease prevention approaches, including policies to tackle national and global ethnic inequalities in health. Study results will be directly relevant to policy development and practice, and will have a tangible impact on health by identifying modifiable risk factors that can prevent avoidable health inequities, aid in building healthy communities, and promote protective social factors for ethnic minority populations.
Beneficiaries of this project include: 1) Researchers in several disciplines and different national settings, since the pathways explored, and the methodology employed provide an expansion of the field of ethnic health inequalities specifically, and wider structural inequalities more broadly; 2) Policy makers in the UK, US and NZ, who can benefit from the results of the proposed project by expanding their understanding of the risk factors that lead to preventable ethnic health inequalities; and 3) Bodies such as the Equality and Human Rights Commission (EHRC) and the Department for Communities and Local Government (CLG), since results disseminated in this proposed project can provide further information for current debates on the impact of immigration and increase our understanding about the importance that the context of reception in which migrants arrive can have on the development of health inequalities.
Economic and societal impact of this research will be maximised by accessing a wide range of outlets to disseminate findings to study users. Non-academic beneficiaries will be engaged with the study via activities including a 1-day conference targeted at local and national policy makers, and third sector organisations; briefing notes submitted to community agencies and local organisations; and collaborations with the Ahmed Iqbal Ullah Education Trust.
Beneficiaries in the academic world will be directly reached through at least 5 publications in peer-reviewed academic journals in the fields of epidemiology and public health, medical sociology, and health geography. Papers will include a focus on methodological aspects of the study, as well as theoretical pieces and a focus on substantive empirical findings and implications for policy and practice. Findings will also be disseminated at national and international academic conferences such as the American Public Health Association, the BSA Medical Sociology conference, the World Congress of Epidemiology, the Annual Scientific Meeting of the Society for Longitudinal and Life Course Studies, and the Annual Scientific Meeting of the Society for Epidemiological Research.
Beneficiaries of this project include: 1) Researchers in several disciplines and different national settings, since the pathways explored, and the methodology employed provide an expansion of the field of ethnic health inequalities specifically, and wider structural inequalities more broadly; 2) Policy makers in the UK, US and NZ, who can benefit from the results of the proposed project by expanding their understanding of the risk factors that lead to preventable ethnic health inequalities; and 3) Bodies such as the Equality and Human Rights Commission (EHRC) and the Department for Communities and Local Government (CLG), since results disseminated in this proposed project can provide further information for current debates on the impact of immigration and increase our understanding about the importance that the context of reception in which migrants arrive can have on the development of health inequalities.
Economic and societal impact of this research will be maximised by accessing a wide range of outlets to disseminate findings to study users. Non-academic beneficiaries will be engaged with the study via activities including a 1-day conference targeted at local and national policy makers, and third sector organisations; briefing notes submitted to community agencies and local organisations; and collaborations with the Ahmed Iqbal Ullah Education Trust.
Beneficiaries in the academic world will be directly reached through at least 5 publications in peer-reviewed academic journals in the fields of epidemiology and public health, medical sociology, and health geography. Papers will include a focus on methodological aspects of the study, as well as theoretical pieces and a focus on substantive empirical findings and implications for policy and practice. Findings will also be disseminated at national and international academic conferences such as the American Public Health Association, the BSA Medical Sociology conference, the World Congress of Epidemiology, the Annual Scientific Meeting of the Society for Longitudinal and Life Course Studies, and the Annual Scientific Meeting of the Society for Epidemiological Research.
People |
ORCID iD |
Laia Becares (Principal Investigator) |
Publications
Zhang N
(2015)
Does the timing of parental migration matter for child growth? A life course study on left-behind children in rural China.
in BMC public health
Zhang N
(2016)
A multilevel analysis of the relationship between parental migration and left-behind children's macronutrient intakes in rural China.
in Public health nutrition
Zhang N
(2016)
Patterns and Determinants of Double-Burden of Malnutrition among Rural Children: Evidence from China.
in PloS one
Zhang N
(2017)
Neighbourhood Ethnic Density Effects on Behavioural and Cognitive Problems Among Young Racial/Ethnic Minority Children in the US and England: A Cross-National Comparison.
in Population research and policy review
Webb E
(2017)
The Inter-relationship of Adolescent Unhappiness and Parental Mental Distress.
in The Journal of adolescent health : official publication of the Society for Adolescent Medicine
Wallace S
(2016)
Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom.
in American journal of public health
Schofield P
(2016)
Minority status and mental distress: a comparison of group density effects.
in Psychological medicine
Schofield P
(2018)
Neighbourhood ethnic density and psychosis - Is there a difference according to generation?
in Schizophrenia Research
Sanchez-Vaznaugh EV
(2016)
Active school transport and fast food intake: Are there racial and ethnic differences?
in Preventive medicine
Title | Racism and child health videos |
Description | The product are three videos that emerged from a collaboration with the spoken artist Yusra Warsama, and the audiovisual artist Mauro Camal. The text and images in the videos are inspired by the research conducted in the ESRC Future Research Leaders grant. |
Type Of Art | Film/Video/Animation |
Year Produced | 2015 |
Impact | Three videos: https://www.youtube.com/watch?v=iAk8ibz8b9E https://www.youtube.com/watch?v=zeFC9Nyzoks https://www.youtube.com/watch?v=DktUgxVTt5I |
URL | https://www.youtube.com/watch?v=DktUgxVTt5I |
Description | Several important findings have emerged from this grant. Across the different national contexts, this study has documented ethnic inequalities in different health outcomes among children, and the multiple driving mechanisms of these inequalities. Findings from the UK have documented the detrimental association between maternal experiences and child health, and have provided support for the role of maternal mental health as the main pathway by which mother's experiences of racial discrimination impact on child health. Using the Millennium Cohort Study we document that experiences of racial discrimination that mothers and families experience when the children are aged 5 have important implications for children's socioemotional development six years later, when they are 11. Work in the US has shown the structural disadvantages faced by ethnic minority school boys and girls, and how these lead to lower academic outcomes, but not to poorer self-perceived academic potential. Additional US-based work has also shown that the benefits of walking home from school - a health behaviour that is usually encouraged as it promotes physical activity - are different depending on children's ethnicity. For example, walking home from school is highly beneficial for white children, but this is not the case for Latino and African American children. For them, walking home from school is associated with increased consumption of fast food and sugary drinks. This is because fast food outlets are more common in the neighbourhoods where they live, as compared to neighbourhoods where white children live, on average, so a health behaviour that is theorised as protective for their health, becomes detrimental because of the wider structural factors that pattern ethnic inequalities among children. Work in New Zealand has documented the harm of racial discrimination experienced by the mother and her partner on the mother's mental health during and after pregnancy, which have important implications for child health and development. These finding support the thesis that ethnic inequalities in health emerge prior to birth, and are transmitted across generations. The project has been extended to include Australia. Research from this new collaboration shows that in Australia, ethnic minority and indigenous children are less likely to report bullying than white children, but more likely to report experiences of racial discrimination. In other words, children differentiate between bullying and racism. This has important implications for how we ask children about their experiences of victimisation in school, and documents that experiences of racial discrimination - and their related harm on health and development - start early in life. |
Exploitation Route | Findings of this project highlight the harm of racial discrimination - both at the interpersonal and at the institutional level - in patterning and reproducing ethnic inequalities in health in the UK, the US, and NZ. Finding can be taken forward by governmental and third sector organisations that aim to reduce ethnic inequalities in health. I also developed, in collaboration with a spoken word artist and an audiovisual artist, three videos based on the work on racism and child health. These videos can be used to disseminate the message on the harm of racial discrimination to non-academic audiences. |
Sectors | Agriculture, Food and Drink,Communities and Social Services/Policy,Education,Healthcare,Government, Democracy and Justice,Other |
Description | Findings from this study were used by an audiovisual artist and a spoken word artist to develop three videos around the harm of racism on child health. These videos were uploaded onto youtube channels and have been used to engage in international conversations regarding policy implications and societal harms of racism. These videos can be found here: - Warsama, Y., Bécares, L., & Camal, M. (2015). You Keep Digging from your Throne. Video on racism and child health. Available at: https://www.youtube.com/watch?v=iAk8ibz8b9E - Warsama, Y., Bécares, L., & Camal, M. (2015). Screaming Targets. Video on racism and child health. Available at: https://www.youtube.com/watch?v=DktUgxVTt5I - Warsama, Y., Bécares, L., & Camal, M. (2015). Callous Tongue. Video on racism and child health. Available at: https://www.youtube.com/watch?v=zeFC9Nyzoks In addition to the videos, impact of this study was achieved via blogs in several outlets, including policy outlets, blogs of third sector agencies, and the ESRC. These are specified below: - Bécares, L. (2015). Addressing mother's experiences of racial discrimination. http://blog.policy.manchester.ac.uk/featured/2015/11/addressing-mothers-experiences-of-racial-discrimination/ - Bécares, L. (2015). The link between racism and children's poor health. RaceCard Runnymede Trust blog. Available at: http://www.racecard.org.uk/racism-2/the-link-between-racism-and-childrens-poor-health/ - Bécares, L. (2015). A collaboration between art and research to show how racism hurts child health. ESRC blog. Available at: http://blog.esrc.ac.uk/2015/07/28/a-collaboration-between-art-and-research-to-show-how-racism-hurts-child-health/ - Bécares, L. (2015). How Racism Harms Health. CoDE blog. Available at: http://blog.policy.manchester.ac.uk/featured/2015/01/how-racism-harms-health/ In the last month of the project we organised a policy workshop titled "Ethnic inequalities in health: policy implications" which had academic and non-academic speakers, and aimed to disseminate the findings of the project, and of similar studies, and discuss possible policy implications of this work. The workshop included a presentation by Jabeer Butt, Deputy Chief Officer of the Race Equality Foundation, and was attended by a mix of undergraduate and postgraduate students, and non-academic audiences. |
First Year Of Impact | 2015 |
Sector | Education,Culture, Heritage, Museums and Collections,Other |
Impact Types | Cultural,Societal |
Description | Humanities Strategic Investment Fund |
Amount | £13,236 (GBP) |
Organisation | University of Manchester |
Sector | Academic/University |
Country | United Kingdom |
Start | 09/2015 |
End | 07/2016 |
Description | Understanding the influence of the wider context: family and neighbourhood effects on health |
Amount | £7,900 (GBP) |
Organisation | University of Manchester |
Sector | Academic/University |
Country | United Kingdom |
Start | 05/2012 |
End | 09/2013 |
Description | ESRC/NIH Workshop on "How the Social Environment Gets Under the Skin" |
Organisation | Emory University |
Country | United States |
Sector | Academic/University |
PI Contribution | On June 17-18 2015, the NIH and the ESRC organised a workshop on "How the Social Environment Gets Under the Skin." One of the outputs of the workshop is a special issue in the journal 'Population Research and Policy Review.' I will contribute two papers to that special issue, one that examines cross-national differences in ethnic inequalities in child socioemotional and cognitive profiles, and the other which examines cross-national differences in neighbourhood effects on child outcomes. |
Collaborator Contribution | I have analysed and written up the UK-section of the two papers, whereas my partners have analysed and written up the US sections. |
Impact | Multi-disciplinary partnership (epidemiology, public health, sociology, human development). Outputs still in progress. |
Start Year | 2015 |
Description | ESRC/NIH Workshop on "How the Social Environment Gets Under the Skin" |
Organisation | University College London |
Department | Research Department of Epidemiology and Public Health |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | On June 17-18 2015, the NIH and the ESRC organised a workshop on "How the Social Environment Gets Under the Skin." One of the outputs of the workshop is a special issue in the journal 'Population Research and Policy Review.' I will contribute two papers to that special issue, one that examines cross-national differences in ethnic inequalities in child socioemotional and cognitive profiles, and the other which examines cross-national differences in neighbourhood effects on child outcomes. |
Collaborator Contribution | I have analysed and written up the UK-section of the two papers, whereas my partners have analysed and written up the US sections. |
Impact | Multi-disciplinary partnership (epidemiology, public health, sociology, human development). Outputs still in progress. |
Start Year | 2015 |
Description | ESRC/NIH Workshop on "How the Social Environment Gets Under the Skin" |
Organisation | University of Texas at Austin |
Country | United States |
Sector | Academic/University |
PI Contribution | On June 17-18 2015, the NIH and the ESRC organised a workshop on "How the Social Environment Gets Under the Skin." One of the outputs of the workshop is a special issue in the journal 'Population Research and Policy Review.' I will contribute two papers to that special issue, one that examines cross-national differences in ethnic inequalities in child socioemotional and cognitive profiles, and the other which examines cross-national differences in neighbourhood effects on child outcomes. |
Collaborator Contribution | I have analysed and written up the UK-section of the two papers, whereas my partners have analysed and written up the US sections. |
Impact | Multi-disciplinary partnership (epidemiology, public health, sociology, human development). Outputs still in progress. |
Start Year | 2015 |
Description | A longitudinal examination of experienced racial discrimination on maternal mental health, parenting practices and child socioemotional development |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | The association between experienced racism and poor health is well documented, and experiences of racism and discrimination have been identified as a crucial distal determinant of ethnic health inequalities. However, this literature is mainly based on cross-sectional examinations focused on adult health. Longitudinal examinations of the association between racism and health, as well as studies examining the relationship between racism and child health, are limited. In addition, evidence on how mothers' experiences of racism and discrimination impact on child health and development, and the mechanisms by which this occurs, is scarce. In this study we employ a life course approach to examine: 1) the longitudinal association between maternal reports of experienced discrimination and maternal mental health; 2) the impact of maternal experiences of racism and discrimination on the child's socioemotional development, and 3) the mechanisms by which maternal experiences of racism and discrimination impact on children's health and development, with a focus on the possible mediating role of parenting practices. We use data the Millennium Cohort Study (MCS3 and MCS4), which include measures on individual- and area-level experiences of racism and discrimination, indicators of maternal mental health (Kessler 6), children's socioemotional development (SDQ), and information on parental practices and socioeconomic circumstances. Unknown |
Year(s) Of Engagement Activity | 2014 |
Description | Workshop on "Ethnic inequalities in health: policy implications" |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Undergraduate students |
Results and Impact | The workshop consisted in engaging students and third sector organisations with policy responses to ethnic inequalities in child health. The event was organised around brief presentations (20 mins) by academics and members of third sector organisations, and guided discussion on policy responses to ethnic inequalities. |
Year(s) Of Engagement Activity | 2015 |