Close window to return

Issue 6, July 2000, pp.6.

Reports from the Programme conference:
Ethnicity, socio-economic position and health
George Davey Smith

Health status differs between ethnic groups and also varies by socio-economic position. The relationship between ethnicity, socio-economic position and health is complex, however, and has changed over time and can differ between countries.

In the USA there is a long tradition of treating ethnic group membership simply as a socio-economic measure, and differentials in health status between African-Americans and groups of initially European origin have been considered purely socio-economic. A contrary position sees the differences as either 'cultural' or due to some inherent 'racial' differences.

While conventionally measured socio-economic indicators statistically explain much of the African-American/European origin health differences, it is not the full story. Ways of indexing socio-economic position clearly contribute to this - for example, at a given level of income, African-Americans have less wealth and poorer socio-economic backgrounds than the European origin population, and these factors are known to influence health independently of current income. Additional factors, such as the extent of racism, are also likely to be of importance.

Similar complexity exists when analysing ethnicity, social position and health in Britain and this was briefly illustrated with quantitative and qualitative data. It was concluded that studies which inadequately account for socio-economic circumstances when examining ethnic group differences in health can reify ethnicity (and its supposed correlates); however, the simple reduction of all ethnic differences in health to socio-economic factors is untenable. The only productive way forward is through studies which recognise the complexity of the relationships between socio-economic position, ethnicity and health which exist within particular populations at particular times.