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Ethnicity & Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ceth20
Ethnicity and health in context a
Thomas Astell-Burt a
Medical Research Council (MRC), Social and Public Health Sciences Unit Published online: 17 Dec 2013.
To cite this article: Thomas Astell-Burt (2013) Ethnicity and health in context, Ethnicity & Health, 18:6, 505-507, DOI: 10.1080/13557858.2013.866338 To link to this article: http://dx.doi.org/10.1080/13557858.2013.866338
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
Ethnicity & Health, 2013 Vol. 18, No. 6, 505–507, http://dx.doi.org/10.1080/13557858.2013.866338
EDITORIAL
Downloaded by [Universidad Autonoma de Barcelona] at 03:01 21 October 2014
Ethnicity and health in context
‘If your thinking is fixed on time,’ wrote Peter Gould, ‘to the exclusion of space and society, you will never illuminate anything of the slightest use’ (Gould 1993, 166). In the same year as he was awarded the prestigious Lauréat Prix International de Géographie Vautrin Lud, Gould published ‘The Slow Plague,’ an inspiring treatise on the role of geography in nurturing understandings of the HIV/AIDS pandemic. Gould was among many commentators around the late 1980s and early 1990s (e.g. Jones and Moon 1987; Wilson 1987; MacIntyre et al. 1993) calling for more research to explore the places in which people lived as potentially important determinants of their life-chances. Fast forward to the bustling metropolis of Beijing, China, in October 2013 and I was reminded of the aforementioned quote when listening to David McQueen and colleagues at the World Alliance in Risk Factor Surveillance (WARFS) Global Conference. McQueen re-emphasised the need to better incorporate understandings of space and society to enhance non-communicable disease and risk factor surveillance. Although the difficulties of measuring and identifying how people’s circumstances influence their health and other phenomena are well known (see Oakes 2004), interest in the role that context plays in determining what people are and are not able to do, how long they live and how much of that will be spent in good health, remains of substantive interest to a great range of people across many walks of life. This issue of the Journal speaks to the choir and also showcases the fascinating variety of questions and methodologies that reflect the diversity of Ethnicity and Health. The need to investigate the peculiarities of context and to push beyond simplistic understandings is an ever-present theme. Two US-based quantitative studies, for example, use samples of Peurto Ricans and other Latinos to report interesting findings. Todorova et al. (2013) use data from Boston (MA) to show that participants’ recognition of poor health status was dependent to some extent upon their level of acculturation. Around 1600 km west in Chicago, Viruell-Fuentes et al. (2013) investigated the patterning of social ties among Latino groups by nativity. Contra previous hypotheses, the authors of that paper found that US-born Latinos reported stronger social ties than their overseasborn counterparts. Meanwhile, in a qualitative study set north of the US-Canadian border in the city of Montreal, Tran, Charbonneau, and Valderrama-Benitez (2013) remind us of the importance of trust and local social ties for people who are willing to donate blood. Across the Atlantic, Bradby et al.’s (2013) qualitative study illuminates the scope for hospital chaplains to receive greater training and to promote awareness and more community engagement on the issue of organ donation. This article, like many of the papers featured in this edition of Ethnicity and Health, was set in the UK. Physical activity remains among many the ‘best buy’ in public health, yet as Horne et al.’s (2013) study shows, there are often misunderstandings of the benefits of exercise and the barriers to participation are not uniform across ethnic groups. In a second case of potential myth-busting this month, © 2013 Taylor & Francis
Downloaded by [Universidad Autonoma de Barcelona] at 03:01 21 October 2014
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Editorial
Becares and Nazroo (2013) report that the association between ‘ethnic density’ and mental health was not explained by measures of social capital. This study adds to fairly similar findings reported by previous studies in the UK (Das-Munshi et al. 2010), the USA (Vogt Yuan 2007) and Australia (Feng, Astell-Burt, and Kolt 2013). It is to the latter context that the final paper in this edition is set and where this author will soon return. Of the 22.6 million inhabitants of the so-called ‘lucky country,’ over one-quarter were born outside Australia (Australian Bureau of Statistics 2006) and 50% of whom originate from countries where English is not the predominantly spoken language (Anikeeva et al. 2010). Australia’s largest cities are ethnically heterogeneous and this yields a rich tapestry of contexts that are likely to play a role in determining lifechances (Astell-Burt et al. 2013). Fryer and colleagues’ qualitative study of 13 persons from 7 different groups report that some language proficiency is sufficient to get by, but key information articulated by health professionals may not be fully appreciated by patients who mainly speak in a different language (Fryer et al. 2013). Having only a basic grasp of Chinese-Mandarin and having spent the last week travelling around Beijing working with colleagues at Chinese Center for Disease Control and Prevention (China CDC), this author can fully attest to the significance of language proficiency within a given space and time. Gould was surely right; understandings of what and how people do need to be framed within the particular sets of circumstances that they have occurred. Context still matters and, I for one, look forward to seeing more articles which address these people-in-place type of issues in future editions of Ethnicity and Health. Thomas Astell-Burt Medical Research Council (MRC) Social and Public Health Sciences Unit References Anikeeva, O., P. Bi, J. E. Hiller, P. Ryan, D. Roder, and G. S. Han. 2010. “The Health Status of Migrants in Australia: A Review.” Asia-Pacific Journal of Public Health 22 (2): 159–193. doi:10.1177/1010539509358193. Astell-Burt, T., X. Feng, K. Croteau, and G. S. Kolt. 2013. “Influence of Neighbourhood Ethnic Density, Diet and Physical Activity on Ethnic Differences in Weight Status: A Study of 214,807 Adults in Australia.” Social Science & Medicine 93: 70–77. doi:10.1016/j.socscimed.2013. 06.006. Australian Bureau of Statistics. 2006. A Picture of the Nation: The Statistician’s Report on the 2006 Census. Canberra: Australian Government. Becares, L., and J. Nazroo. 2013. “Social Capital, Ethnic Density and Mental Health among Ethnic Minority People in England: A Mixed-methods Study.” Ethnicity and Health. doi:10.1080/ 13557858.2013.828831. Bradby, H., C. Kenten, S. Deedat, and M. Morgan. 2013. “‘Having a Different Conversation around Death’: Diverse Hospital Chaplains’ Views on End-of-life Care.” Ethnicity and Health. doi:10.1080/13557858.2013.828832. Das-Munshi, J., L. Becares, M. E. Dewey, S. A. Stansfeld, and M. J. Prince. 2010. “Understanding the Effect of Ethnic Density on Mental Health: Multi-level Investigation of Survey Data from England.” British Medical Journal 341: c5367. doi:10.1136/bmj.c5367. Feng, X., T. Astell-Burt, and G. S. Kolt. 2013. “Do Social Interactions Explain Ethnic Differences in Psychological Distress and the Protective Effect of Local Ethnic Density? A Cross-sectional Study of 226 487 Adults in Australia.” BMJ Open 3: e002713. doi:10.1136/bmjopen-2013002713. Fryer, C. E., S. F. Mackintosh, M. J. Stanley, and J. Crichton. 2013. “‘I Understand All the Major Things’: How Older People with Limited English Proficiency Decide Their Need for a
Downloaded by [Universidad Autonoma de Barcelona] at 03:01 21 October 2014
Ethnicity & Health
507
Professional Interpreter during Health Care after Stroke.” Ethnicity and Health. doi:10.1080/ 13557858.2013.828830. Gould, P., 1993. The Slow Plague: A Geography of the Aids Pandemic. London: Wiley-Blackwell. Horne, M., D. A. Skelton, S. Speed, and C. Todd. 2013. “Perceived Barriers to Initiating and Maintaining Physical Activity among South Asian and White British Adults in Their 60s Living in the United Kingdom: A Qualitative Study.” Ethnicity and Health. doi:10.1080/ 13557858.2013.814762. Jones, K., and G. Moon. 1987. Health, Disease and Society: An Introduction to Medical Geography. London: Routledge. Macintyre, S., S. Maciver, and A. Sooman. 1993. “Area, Class and Health: Should We Be Focusing on Places or People?” Journal of Social Policy 22 (2): 213–234. doi:10.1017/S00472794000 19310. Oakes, J. M. 2004. “The (Mis) Estimation of Neighborhood Effects: Causal Inference for a Practicable Social Epidemiology.” Social Science & Medicine 58 (10): 1929–1952. doi:10.1016/j. socscimed.2003.08.004. Todorova, I. L. G., K. L. Tucker, M. P. Jimenez, A. K. Lincoln, S. Arevalo, and L. M. Falcon. 2013. “Determinants of Self-rated Health and the Role of Acculturation: Implications for Health Inequalities.” Ethnicity and Health. doi:10.1080/13557858.2013.771147. Tran, N. Y. L., J. Charbonneau, and V. Valderrama-Benitez. 2013. “Blood Donation Practices, Motivations and Beliefs in Montreal’s Black Communities: The Modern Gift under a New Light.” Ethnicity and Health. doi:10.1080/13557858.2012.734279. Viruell-Fuentes, E. A., J. D. Morenoff, D. R. Williams, and J. S. House. 2013. “Contextualizing Nativity Status, Latino Social Ties, and Ethnic Enclaves: An Examination of the ‘Immigrant Social Ties Hypothesis’.” Ethnicity and Health. doi:10.1080/13557858.2013.814763. Vogt Yuan, A. S. 2007. “Racial Composition of Neighborhood and Emotional well-being.” Sociological Spectrum 28 (1), 105–129. doi:10.1080/02732170701675284. Wilson, W. J. 1987. The Truly Disadvantaged: The Inner City, the Underclass, and Public Policy. Chicago: University of Chicago Press.
Ethnicity & Health Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ceth20
Ethnicity and health in context a
Thomas Astell-Burt a
Medical Research Council (MRC), Social and Public Health Sciences Unit Published online: 17 Dec 2013.
To cite this article: Thomas Astell-Burt (2013) Ethnicity and health in context, Ethnicity & Health, 18:6, 505-507, DOI: 10.1080/13557858.2013.866338 To link to this article: http://dx.doi.org/10.1080/13557858.2013.866338
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
Ethnicity & Health, 2013 Vol. 18, No. 6, 505–507, http://dx.doi.org/10.1080/13557858.2013.866338
EDITORIAL
Downloaded by [Universidad Autonoma de Barcelona] at 03:01 21 October 2014
Ethnicity and health in context
‘If your thinking is fixed on time,’ wrote Peter Gould, ‘to the exclusion of space and society, you will never illuminate anything of the slightest use’ (Gould 1993, 166). In the same year as he was awarded the prestigious Lauréat Prix International de Géographie Vautrin Lud, Gould published ‘The Slow Plague,’ an inspiring treatise on the role of geography in nurturing understandings of the HIV/AIDS pandemic. Gould was among many commentators around the late 1980s and early 1990s (e.g. Jones and Moon 1987; Wilson 1987; MacIntyre et al. 1993) calling for more research to explore the places in which people lived as potentially important determinants of their life-chances. Fast forward to the bustling metropolis of Beijing, China, in October 2013 and I was reminded of the aforementioned quote when listening to David McQueen and colleagues at the World Alliance in Risk Factor Surveillance (WARFS) Global Conference. McQueen re-emphasised the need to better incorporate understandings of space and society to enhance non-communicable disease and risk factor surveillance. Although the difficulties of measuring and identifying how people’s circumstances influence their health and other phenomena are well known (see Oakes 2004), interest in the role that context plays in determining what people are and are not able to do, how long they live and how much of that will be spent in good health, remains of substantive interest to a great range of people across many walks of life. This issue of the Journal speaks to the choir and also showcases the fascinating variety of questions and methodologies that reflect the diversity of Ethnicity and Health. The need to investigate the peculiarities of context and to push beyond simplistic understandings is an ever-present theme. Two US-based quantitative studies, for example, use samples of Peurto Ricans and other Latinos to report interesting findings. Todorova et al. (2013) use data from Boston (MA) to show that participants’ recognition of poor health status was dependent to some extent upon their level of acculturation. Around 1600 km west in Chicago, Viruell-Fuentes et al. (2013) investigated the patterning of social ties among Latino groups by nativity. Contra previous hypotheses, the authors of that paper found that US-born Latinos reported stronger social ties than their overseasborn counterparts. Meanwhile, in a qualitative study set north of the US-Canadian border in the city of Montreal, Tran, Charbonneau, and Valderrama-Benitez (2013) remind us of the importance of trust and local social ties for people who are willing to donate blood. Across the Atlantic, Bradby et al.’s (2013) qualitative study illuminates the scope for hospital chaplains to receive greater training and to promote awareness and more community engagement on the issue of organ donation. This article, like many of the papers featured in this edition of Ethnicity and Health, was set in the UK. Physical activity remains among many the ‘best buy’ in public health, yet as Horne et al.’s (2013) study shows, there are often misunderstandings of the benefits of exercise and the barriers to participation are not uniform across ethnic groups. In a second case of potential myth-busting this month, © 2013 Taylor & Francis
Downloaded by [Universidad Autonoma de Barcelona] at 03:01 21 October 2014
506
Editorial
Becares and Nazroo (2013) report that the association between ‘ethnic density’ and mental health was not explained by measures of social capital. This study adds to fairly similar findings reported by previous studies in the UK (Das-Munshi et al. 2010), the USA (Vogt Yuan 2007) and Australia (Feng, Astell-Burt, and Kolt 2013). It is to the latter context that the final paper in this edition is set and where this author will soon return. Of the 22.6 million inhabitants of the so-called ‘lucky country,’ over one-quarter were born outside Australia (Australian Bureau of Statistics 2006) and 50% of whom originate from countries where English is not the predominantly spoken language (Anikeeva et al. 2010). Australia’s largest cities are ethnically heterogeneous and this yields a rich tapestry of contexts that are likely to play a role in determining lifechances (Astell-Burt et al. 2013). Fryer and colleagues’ qualitative study of 13 persons from 7 different groups report that some language proficiency is sufficient to get by, but key information articulated by health professionals may not be fully appreciated by patients who mainly speak in a different language (Fryer et al. 2013). Having only a basic grasp of Chinese-Mandarin and having spent the last week travelling around Beijing working with colleagues at Chinese Center for Disease Control and Prevention (China CDC), this author can fully attest to the significance of language proficiency within a given space and time. Gould was surely right; understandings of what and how people do need to be framed within the particular sets of circumstances that they have occurred. Context still matters and, I for one, look forward to seeing more articles which address these people-in-place type of issues in future editions of Ethnicity and Health. Thomas Astell-Burt Medical Research Council (MRC) Social and Public Health Sciences Unit References Anikeeva, O., P. Bi, J. E. Hiller, P. Ryan, D. Roder, and G. S. Han. 2010. “The Health Status of Migrants in Australia: A Review.” Asia-Pacific Journal of Public Health 22 (2): 159–193. doi:10.1177/1010539509358193. Astell-Burt, T., X. Feng, K. Croteau, and G. S. Kolt. 2013. “Influence of Neighbourhood Ethnic Density, Diet and Physical Activity on Ethnic Differences in Weight Status: A Study of 214,807 Adults in Australia.” Social Science & Medicine 93: 70–77. doi:10.1016/j.socscimed.2013. 06.006. Australian Bureau of Statistics. 2006. A Picture of the Nation: The Statistician’s Report on the 2006 Census. Canberra: Australian Government. Becares, L., and J. Nazroo. 2013. “Social Capital, Ethnic Density and Mental Health among Ethnic Minority People in England: A Mixed-methods Study.” Ethnicity and Health. doi:10.1080/ 13557858.2013.828831. Bradby, H., C. Kenten, S. Deedat, and M. Morgan. 2013. “‘Having a Different Conversation around Death’: Diverse Hospital Chaplains’ Views on End-of-life Care.” Ethnicity and Health. doi:10.1080/13557858.2013.828832. Das-Munshi, J., L. Becares, M. E. Dewey, S. A. Stansfeld, and M. J. Prince. 2010. “Understanding the Effect of Ethnic Density on Mental Health: Multi-level Investigation of Survey Data from England.” British Medical Journal 341: c5367. doi:10.1136/bmj.c5367. Feng, X., T. Astell-Burt, and G. S. Kolt. 2013. “Do Social Interactions Explain Ethnic Differences in Psychological Distress and the Protective Effect of Local Ethnic Density? A Cross-sectional Study of 226 487 Adults in Australia.” BMJ Open 3: e002713. doi:10.1136/bmjopen-2013002713. Fryer, C. E., S. F. Mackintosh, M. J. Stanley, and J. Crichton. 2013. “‘I Understand All the Major Things’: How Older People with Limited English Proficiency Decide Their Need for a
Downloaded by [Universidad Autonoma de Barcelona] at 03:01 21 October 2014
Ethnicity & Health
507
Professional Interpreter during Health Care after Stroke.” Ethnicity and Health. doi:10.1080/ 13557858.2013.828830. Gould, P., 1993. The Slow Plague: A Geography of the Aids Pandemic. London: Wiley-Blackwell. Horne, M., D. A. Skelton, S. Speed, and C. Todd. 2013. “Perceived Barriers to Initiating and Maintaining Physical Activity among South Asian and White British Adults in Their 60s Living in the United Kingdom: A Qualitative Study.” Ethnicity and Health. doi:10.1080/ 13557858.2013.814762. Jones, K., and G. Moon. 1987. Health, Disease and Society: An Introduction to Medical Geography. London: Routledge. Macintyre, S., S. Maciver, and A. Sooman. 1993. “Area, Class and Health: Should We Be Focusing on Places or People?” Journal of Social Policy 22 (2): 213–234. doi:10.1017/S00472794000 19310. Oakes, J. M. 2004. “The (Mis) Estimation of Neighborhood Effects: Causal Inference for a Practicable Social Epidemiology.” Social Science & Medicine 58 (10): 1929–1952. doi:10.1016/j. socscimed.2003.08.004. Todorova, I. L. G., K. L. Tucker, M. P. Jimenez, A. K. Lincoln, S. Arevalo, and L. M. Falcon. 2013. “Determinants of Self-rated Health and the Role of Acculturation: Implications for Health Inequalities.” Ethnicity and Health. doi:10.1080/13557858.2013.771147. Tran, N. Y. L., J. Charbonneau, and V. Valderrama-Benitez. 2013. “Blood Donation Practices, Motivations and Beliefs in Montreal’s Black Communities: The Modern Gift under a New Light.” Ethnicity and Health. doi:10.1080/13557858.2012.734279. Viruell-Fuentes, E. A., J. D. Morenoff, D. R. Williams, and J. S. House. 2013. “Contextualizing Nativity Status, Latino Social Ties, and Ethnic Enclaves: An Examination of the ‘Immigrant Social Ties Hypothesis’.” Ethnicity and Health. doi:10.1080/13557858.2013.814763. Vogt Yuan, A. S. 2007. “Racial Composition of Neighborhood and Emotional well-being.” Sociological Spectrum 28 (1), 105–129. doi:10.1080/02732170701675284. Wilson, W. J. 1987. The Truly Disadvantaged: The Inner City, the Underclass, and Public Policy. Chicago: University of Chicago Press.
