Centre for Health Services Studies

 

profile image for  Peter Aspinall

Peter Aspinall

Emeritus Reader in Population Health

Centre for Health Services Studies

Peter is a social scientist who has worked over the last thirty years in a range of research areas

Peter is a social scientist who has worked over the last thirty years in a range of research areas, including urban and regional analysis, geriatric medicine, health services research, and, during the last decade, in public health, ethnicity terminology and classifications, and ethnicity and health. He has a broad breadth of experience of research within regional and district health authorities, London Boroughs and universities. He has been a member of the Health Services Advisory Group on the Census since 1994 and was the Office for National Statistics National Convenor for the working group on cultural background questions for the 2001 Census.

back to top

 

Also view these in the Kent Academic Repository
Articles

    Abstract

    The term ‘master status’, coined by Everett Hughes in 1945 with special reference to race, was conceptualised as one which, in most social situations, will dominate all others. Since then race and other collective social identities have become key features of people’s lives, shaping their ‘life scripts’. But is race still a ‘master’ or ‘dominant identity’ and, if not, what has replaced it? Analyses of recent social surveys show that race has lost its position to family, religion (in the South Asian and Black groups) and (amongst young mixed race people) also age/life-stage and study/work. However, many of these different identity attributes are consistently selected, suggesting the possibility – confirmed in in-depth interviews – that they may work through each other via intersectionality. In Britain race appears to have been undermined by the rise of ‘Muslim’ identity, the increasing importance of ‘mixed race’, and the fragmentation of identity now increasingly interwoven with other attributes like religion.

    Abstract

    During a period of unprecedented ethnicity data collection in Britain, an almost universal characteristic of this practice has been the mandated use of the decennial census ethnicity classifications. In Canada and the USA a greater plurality of methods has included open response, now recommended for the 2020 US Census. As the ethnic diversity of Britain has increased, driven by immigration dynamics and population mixing leading to ‘superdiversity’, the census is no longer able to capture the new populations. The validity and utility of unprompted open response is examined in several ‘mixed race’ datasets. It is argued that open response can be a modus operandi for large-scale ethnicity data collection and that the lack of consistency in recording of such responses need not necessarily be viewed as a drawback. Open response offers substantial insights into the country’s superdiversity in a way that ethnicity categorization alone cannot.

    Song, M. and Aspinall, P.J. (2012) Is racial mismatch a problem for young ‘mixed race’ people in Britain? The findings of qualitative research. Ethnicities, 12 (6). pp. 730-753. ISSN 1468-7968.

    Abstract

    Recent evidence concerning the racial identifications of ‘mixed race’ people suggests growing latitude in how they may identify. In this article, we examine whether mixed race young people believe that their chosen identifications are validated by others, and how they respond to others’ racial perceptions of them. While existing studies tend to assume that a disjuncture between self-identification and others’ perceptions of them is problematic, this was not necessarily the case among our respondents. While a racial mismatch between expressed and observed identifications was a common experience for these individuals, they varied considerably in terms of how they responded to such occurrences, so that they could feel: (1) misrecognized (and there were differential bases and experiences of misrecognition); (2) positive about the mismatch; or (3) indifferent to how others racially categorized them in their day-to-day interactions. Some differences in responses to such mismatch emerged among disparate types of mixed people. This study also found that we need to consider national identity, and other forms of belonging, in making sense of the diverse and often multilayered identifications and experiences of mixed race young people in Britain.

    Abstract

    Categories that capture the Indian subcontinent-origin population – ‘Indian’, ‘Pakistani’, ‘Bangladeshi’ – have been included on all the British census forms (1991, 2001, 2011) that have asked about ethnicity. Additionally, a free-text ‘Any other Asian background’ option was added in 2001 and repeated in 2011. These ethnicities are regarded as amongst the more stable in the British censuses, with greater reliability than those for the black groups. However, analysis of longitudinal datasets raises concerns about the quality of the data for the UK-born Indian origin population. Moreover, some of the groups concealed in residual census categories – such as Sri Lankans - have grown significantly. Other communities, such as ‘Kashmiris’, have unsuccessfully sought inclusion in the 2011 Census. While such concerns should not inhibit the use of the Indian subcontinent census data, monitoring of the utility and validity of these categories is required to ensure that they continue to meet data users’ needs.

    Aspinall, P.J. and Hashem, F. (2011) Responding to minority ethnic groups’ language support needs in Britain. Equality, Diversity and Inclusion: An International Journal, 30 (2). pp. 145-162. ISSN 2040-7149.

    Abstract

    Purpose – The purpose of this paper is to answer the question: in the British state's relationship with its diverse minority ethnic communities, how have politics framed administrative allocation of language support services? The dynamics of policy development are investigated, a tangible effect of the shift from unofficial pragmatic multiculturalism towards community cohesion/“Britishness” having been a government focus on English for speakers of other languages (ESOL) rather than translation/interpreting. This change has revealed a tension between the demands of identity and equality for minority ethnic people: respect for cultural identity requires provision of translation/interpreting while creating (political) equality between majority and minority communities entails the latter having access to the political language so placing an emphasis on ESOL. Design/methodology/approach – An evidence synthesis is undertaken of policy documents relating to the British state's provision of language support services and data on the skill levels in English from government surveys. Findings – The relative contribution of financial constraints and new policy/ideological positions to changes in the direction of policy and provision is assessed. With respect to the “new approach to ESOL”, this process of discretionary allocation that privileges policies of integration and community cohesion rather than language need itself is viewed against the inadequacies of the data currently available on levels of English language proficiency in providing the basis for making policy decisions and allocating resources. Originality/value – The level of English language skills amongst Britain's minority ethnic groups and of government policy to address skill deficits has been substantially neglected. The paper provides a policy focus ahead of the release of the 2011 Census findings on language questions.

    Aspinall, P.J. and Chinouya, M. (2011) Determining the identity of 'black Africans' in UK population and health policy contexts: ethical issues and challenges. Social Identities, 17 (2). pp. 255-270. ISSN 13504630.

    Abstract

    In everyday settings in the UK the self-determination of identity has been taken for granted. In the decennial census and the bureaucratic practices of modern governance, the ascription of ethnicity is in the hands of the subject who is the final arbiter, even if this sometimes breaks down by default. However, for some minority ethnic groups, notably 'black Africans', a group 'created' by the decennial census, observer-led approaches to determining identity have insinuated themselves into some policy contexts in the UK. The targeting by HIV/AIDS workers of 'black Africans' in mundane public settings based on such signalling devices as appearance and language or accent has been endorsed as a modus operandi in preventative care. For around a decade the UK Border Agency has made use of linguistic analysis and other forensic methods to establish the nationality of Somali-origin asylum seekers as against claims from other East Africans. Its latest Human Provenance Pilot Project - the use of isotope analysis and DNA ancestry testing to establish nationality - again places 'black Africans' on the front line. These external processes of identification raise important ethical challenges, given the potential for harm when assignment is incorrect.

    Aspinall, P.J. (2011) The health and healthcare of vulnerable migrant children. Poverty (138). pp. 13-14. ISSN 0032-5856.

    Abstract

    Many different groups of migrant children may be at particular risk of poor health and limited access to healthcare. These include unaccompanied asylum-seeking children (who have applied for asylum in their own right) and children who are dependants of asylum-seeking adults, for some of whom disadvantage may persist after they or their families have been granted refugee status or leave to remain.

    Aspinall, P.J. (2011) The utility and validity for public health of ethnicity categorisation in the 1991, 2001 and 2011 British censuses. Public Health, 125 (10). pp. 680-687. ISSN 0033-3506.

    Abstract

    Objectives To evaluate the utility and validity of the ethnicity categorizations across the 1991, 2001 and 2011 British Censuses for public health purposes. Study design Narrative review. Methods A review of journal literature and census and other policy reports was undertaken to assess specified criteria for the utility and validity of the 1991, 2001 and 2011 Censuses for public health. Results The census ethnicity categorization satisfactorily captures the ethnic diversity of the population, and adheres to the principle of self-identification in the labels used and underlying conceptual base. The stability of some of the categories (especially ‘Black’ groups and ‘Mixed’) continues to be problematic for public health. Concealed heterogeneity has been partially addressed in the ‘White’ group but remains in the ‘Black African’ group. Colour categories (‘White’ and ‘Black’) have been retained in the 2011 Census, with only limited objection amongst the communities they describe. Conclusions The complexity of the classifications and range of data on the dimensions of ethnicity have increased over the three decades. The breakdown of the ‘Black African’ group, the shortcomings of ‘Mixed’ categorization, and the way in which the ‘White’ category is subdivided require further investigation.

    Abstract

    Debates about how the sub-Saharan African origin population should be categorised in censuses and official data collection in Britain lie at the interface between 'blackness' and 'Africanness'. The continued use of 'Black African', the official label chosen by the Great Britain census agency for inclusion in the 1991 Census ethnic group question, has been questioned in development programmes for the 2011 Census. While the referent 'black' is acceptable to most Black African community members, some constituencies find the term offensive, notably, academic stakeholders and some African community organisations. Others argue, however, that the language of colour is needed to set while privilege against black disadvantage. The term has been further challenged on the grounds of the 'fallacy of homogeneity', as it conceals substantial diversity with respect to countries of origin, language, religion, and migration histories. An inclusive 'Africanness', that is, one that accommodates those who consider themselves African irrespective of ethnic origin, on the other hand, has rarely been used in data collection. At a time when the 'Black African' population has grown by almost 50% in just six years, based on population estimates undertaken by the Office for National Statistics, a number of solutions to address the shortcomings of this category are discussed and a plea is made for more research on how 'Black Africans' describe themselves in their own words, unprompted by the census term.

    Aspinall, P.J. and Hashem, F. (2010) Are our data on teenage pregnancy across ethnic groups in England fit for the purpose of policy formulation, implementation and monitoring? Critical Public Health, 20 (1). pp. 47-70. ISSN 0958-1596.

    Abstract

    The Teenage Pregnancy Strategy for England has a Public Service Agreement target to substantially reduce the level of teenage pregnancies by 2010. It argues that all the main risk factors need to be incorporated into risk assessments undertaken by agencies and professionals. These include deprivation, poor educational attainment and disengagement from school, and ethnicity, the last's association with high teenage pregnancy rates being independent of deprivation. The strategy adds, too, that local areas should target delivery of their local strategy more intensively on these groups most at risk. An attempt and quality of ethnicity data on maternities and abortions, based on extensive structured searches of a wide range of abstracted and full-text literature and statistical sources published 1997-2008. This reveals that, in practice, local teenage pregnancy strategies have little, if any, ethnically coded data to draw upon and it is not surprising that they have had difficulties in targeting these groups. The experience of other countries demonstrates that data of quality can be collected on teenage pregnancy if this is prioritised. The Race Relations (Amendment) Act 2000 should be used to catalyse statutory agencies to set up the necessary systems to ensure that collection of teenage pregnancy data by ethnic group is routine and robust.

    Aspinall, P.J. (2010) Concepts, terminology and classifications for the “mixed” ethnic or racial group in the United Kingdom. Journal of Epidemiology and Community Health, 64 (6). pp. 557-560. ISSN 0143-005X.

    Abstract

    Background The way to categorise people born of inter-ethnic and racial unions — the “mixed” group — remains unclear and requires new insights, given the increasing size and complexity of the group and its emerging health profile. Methods A mixed methods research study focusing on ethnic options of young “mixed race” people (n=326) recruited in colleges and universities investigated respondents' preferences with respect to concepts, terminology and classifications. Results The overwhelming generic term of choice was mixed race, widely interpreted by respondents to include mixed minority groups. Respondents were able to assign themselves in a valid way to a 12-category extended 2001 England and Wales Census classification for “mixed”, which collapses into five main groupings and also maps back to the census categories. Among options tested for census purposes, multi-ticking performed poorly and is not recommended. Conclusions A more finely granulated classification for “mixed” is feasible where needed, but this requires more extensive testing before it can be judged preferable to a “tick one or more” option that has been shown to have poor reproducibility in validation surveys.

    Chinouya, M. and Aspinall, P.J. (2010) Ethical Issues in Targeted HIV Prevention Work among ‘Black African’ Migrants in London. International Journal of Migration, Health and Social Care, 6 (4). pp. 20-33. ISSN 1747-9894.

    Abstract

    ‘Black Africans’ in England are disproportionately and highly affected by the heterosexually contracted HIV epidemic. Policy and practice frameworks have advocated ethnic matching in HIV prevention. We explore how self-identifying ‘black African’ workers in London were co-producers of ‘black African’ identities to target in preventative HIV interventions. Drawing on a focused literature review and 12 in-depth interviews with workers, the paper identifies themes associated with co-production of an African identify by workers. The historical inclusion of the category ‘black African’ in the 1991 census coincided with the emergence of Africans as at higher HIV ‘risk’. In co-producing an African public, the workers projected their heterosexual and Christian affiliations on to the targeted population, perceiving themselves as ‘insiders’ knowledgeable about rumours that had historically co-produced African identities. Fear of those in authority galvanised the formation of African-led agencies, offering entry points for HIV prevention to Africans. By projecting aspects of their complex ‘selves’ on to the ‘other’, encounters in public spaces were deemed ‘opportunities’ for outreach interventions. The ethics of ‘cold calling’, confidentiality and informed consent were taken as ‘given’ in these socially produced ‘private’ spaces located in ‘public’ venues. In following HIV prevention frameworks as advocated by Pulle et al (2004), the workers endorsed yet problematised the notion of ethnic matching.

    Aspinall, P.J. (2010) Concepts, terminology, and classifications for the 'mixed' ethnic or racial group. Journal of Epidemiology & Community Health, 64. pp. 557-560. ISSN 0143-005X.

    Abstract

    Background: The way to categorise people born of inter-ethnic and racial unions - the ‘mixed’ group - remains unclear and requires new insights, given the increasing size and complexity of the group and its emerging health profile. Methods: A mixed methods research study focussing on ethnic options of young ‘mixed race’ people (n=326) recruited in colleges and universities investigated respondents’ preferences with respect to concepts, terminology, and classifications. Results: The overwhelming generic term of choice was ‘mixed race’, widely interpreted by respondents to include mixed minority groups. Respondents were able to assign themselves in a valid way to a 12-category extended 2001 England and Wales Census classification for ‘mixed’, which collapses into five main groupings and also maps back to the census categories. Amongst options tested for census purposes, multi-ticking performed poorly and is not recommended. Conclusions: A more finely granulated classification for ‘mixed’ is feasible where needed but this requires more extensive testing before it can be judged preferable to a ‘tick one or more’ option that has been shown to have poor reproducibility in validation surveys.

    Aspinall, P.J. (2010) Does the British state’s categorisation of 'mixed race' meet public policy needs? Social Policy and Society, 9 (1). pp. 55-69. ISSN 1474-7464.

    Abstract

    The England and Wales 2001 Census was the first to include ‘Mixed’ categories which have now been adopted across government. The four ‘cultural background’ options were highly prescriptive, specifying combinations of groups. This paper assesses how satisfactorily these analytical categories captured self-ascribed cultural affiliation based on the criteria of validity, reliability and utility of the data for public services. Finally, the paper asks whether we now need a census question on ethnic origin/ancestry in addition to – or instead of – ethnic group or whether multi-ticking or a focus on family origins might give more useful public policy data and better measure the population's ethnic diversity.

    Abstract

    A broad range of terms have been proposed and debated for the 'mixed race' population. Dissatisfaction with 'mixed race', the term most widely used but contested on the grounds that it references the now discredited concept of 'race', has led to the search for an alternative. In 1994 the Royal Anthropological Institute advocated 'mixed origins'; despite subsequent further efforts, this alternative has gained little momentum. 'Mixed race' now competes with terms such as 'mixed heritage', 'dual heritage', and 'mixed parentage' amongst data users. However, research indicates that the term of choice of most respondents in general population and student samples of this population group is 'mixed race', other terms - including 'mixed origins' - attracting little support. Given its dominance, it is premature to argue that the term 'mixed race' should be replaced by candidates that are not self-descriptors.

    Aspinall, P.J. (2009) Suicide rates in people of South Asian origin in England and Wales. British Journal of Psychiatry, 194 (6). pp. 566-567. ISSN 0007-1250.

    Abstract

    A notable finding in McKenzie et al's study1 of suicide rates in people of South Asian origin is that the high relative rates in younger Asian women reported in previous research studies are found in the 1993–98 data-set but not that for 1999–2003, which shows high relative rates for Asian women over 65. In discussing their results, the investigators acknowledge potential problems with the study's methodology, including the numerator (how well the SANGRA name recognition algorithm ascertains individuals of South Asian origin in more recent samples) and denominator (the validity of a linear interpolation of numbers over their period). However, perhaps cautions are required with respect to the overall robustness of the SANGRA algorithm and the issue of numerator/denominator compatibility: the numerator uses an operational definition of ethnicity (derived from name information) and the denominator is based on self-assignment by individuals to census categories.

    Aspinall, P.J. (2009) The future of ethnicity classification. Journal of Ethnic & Migration Studies, 35 (9). pp. 1417-1435. ISSN 1469-9451.

    Abstract

    In the first decade of the twenty-first century, 'diversity' has emerged as a key value in its own right, celebrated through human rights and similar policies promoting identity and providing an additional focus to that of the more traditional equalities agenda and its concern with 'statistical proportionality'. It has been conjectured that classifications rooted in diversity policy will either propel data collection practices into the use of finer-grained distinctions or that these measurement systems will collapse under their own weight. In Britain pressure to increase the number of categories in ethnicity classifications highlights the tension between the validity of granular categories and their utility (in terms of practicality of data collection). Similarly, the interest in identity evokes a trade-off between the selective attribution of such measures and the greater stability of operationally defined ethnicity. In meeting the challenge of the diversity agenda, a number of approaches—innovative for Britain—are now being debated to accommodate greater numbers of categories in census collections. These include multi-ticking across categories (thereby capturing multiplicity) and the shift from classifications framed by colour to those privileging ethnic background (but attended by category proliferation). Conceptually, the measurement of the multiple dimensions of ethnicity has found favour but not so far encompassing ethnic origin/ancestry collected in US and Canadian Censuses. While some have argued that ethnicity classifications are already unwieldy and that retrenchment is needed, validity—increasingly insisted upon by the collectivities themselves and other non-state organisations—is seen as winning out. The demands of inclusiveness and identity visibility indicate that classifications are headed in the direction of greater complexity.

    Aspinall, P.J. and Chinouya, M. (2008) Is the standardised term 'Black African' useful in demographic and health research in the United Kingdom? Ethnicity & Health, 13 (3). pp. 183-202. ISSN 1355-7858.

    Abstract

    Objective. The main objective of this paper is to review the literature on the term 'Black African' with respect to a number of themes: its use in the census and official data collections; the acceptability of a colour-based term; the heterogeneity concealed within the 'Black African' collectivity; the invisibility of distinct populations; the concealment of disparities in health, health care, and determinants; the capture of 'Black Africans' in other countries; and a set of possible alternatives for classifying this population. Design. Structured searches were undertaken on a wide range of government and other grey literature sources and on two biomedical databases (Medline and EMBASE), using combinations of search terms for the collectivity and specific national origin groups. Results. Analyses of the data show that the term 'Black African' conceals substantial heterogeneity with respect to national origins, religion, and language. It includes many who have come to the UK since the 1960s from former colonies but also sizeable groups arriving as refugees and asylum seekers from a wide range of African countries. Moreover, its boundaries are fuzzy, especially with regard to those originating in Horn of Africa countries. Marked variations are found in the (albeit limited) available disaggregated data on health and the determinants of inequalities. Conclusions. Given the substantial increase in the size of the group, the extent to which such heterogeneity can continue to be tolerated in a single term must be questioned. The 'Black African' collectivity merits categorisation that addresses this issue and the proposed regional subdivisions in the Scotland 2006 Census Test currently offer the best solution.

    Aspinall, P.J. and Mitton, L. (2008) 'Kinds of people' and equality monitoring in the UK. Policy and Politics, 36 (1). pp. 55-74. ISSN 0305-5736.

    Abstract

    Over the last few decades social identities have grown in importance, 'sexual orientation' and 'national identity' being the latest to join the fold. While all jostle for official recognition, which of these identity groups is monitored - and in what settings - is of practical importance. Respondent burden, concerns about confidentiality and disclosure, and the lack in some cases of benchmark data raise issues around the feasibility of monitoring multiple 'equality strands'. As most organisations have limited capacity to undertake such analysis, a broader repertoire of approaches needs to be considered if this process is to be more than a meaningless bureaucratic exercise.

    Aspinall, P.J. and Mitton, L. (2008) Operationalising 'sexual orientation' in routine data collection and equality monitoring in the UK. Culture Health and Sexuality, 10 (1). pp. 57-72. ISSN 1369-1058.

    Abstract

    New legal provisions and regulatory practices in the UK have afforded protection against discrimination for sexual orientation minorities and conferred rights similar to those of heterosexually partnered couples. In addition, sexual orientation has been recognised as one of the main equality strands in new equality legislation and equality governance. Government departments and statutory and other organisations now face the need to collect equal opportunities and other data on these groups to monitor compliance. However, there has been little track record in the UK of collecting data on this dimension, resulting in issues of definition, categorisation, sample size and potential measurement error having to be addressed from a negligible evidence base. Limited survey data indicate significant problems relating to item non-response and misreporting, reflecting wider concerns about the sensitivity of the data and disclosure. Given that sexual orientation is on track to be mainstreamed in the context of workforce recruitment and service delivery, a strategy across government and other sectors is needed to pool expertise and establish a shared evidence base and stock of good practice.

    Aspinall, P.J. (2008) Non-white: a candidate for the lexical room 101. Journal of Epidemiology & Community Health, 62 (10). pp. 875. ISSN 0143-005X.

    Abstract

    In the USA, the 1977 and 1997 Race and Ethnic Standards for Administrative Reporting deemed the term “non-white” unacceptable for use in the presentation of federal government data.1 Yet, in the UK, the term continues to enjoy widespread saliency in the reports of government and its agencies (such as the Office for National Statistics (ONS)), and in scholarly writing (over 170 instances in the BMJ during the years 1994–2007). While it provides a convenient shorthand for describing those in ethnic groups who are not categorised as “white”, the changing ethnic diversity of the country and a more robust race relations governance—including the introduction of positive duties—make the use of “non-white” seem somewhat anachronistic.

    Aspinall, P.J. and Song, A.M. and Hashem, F. (2008) The ethnic options of ‘mixed race’ people in Britain: Full Research Report. ESRC Society Today.

    Abstract

    The ‘mixed race’ population has increased significantly in size over the last ten to fifteen years, due mainly to the growing number of inter-ethnic unions but also the acceptability of declaring mixed race identities. Over 670,000 people chose to identify with the newly included ‘Mixed’ categories in the 2001 UK Censuses and the group is now one of the fastest growing. The census enumeration of the group has led to substantial research interest in its demography and how its membership identifies in ethnic/racial terms. However, at the time of the application, relatively little research had focused on how ‘mixed race’ people perceived their range of identity options and how they made decisions about these options. Even less was known about how the experiences of disparate kinds of ‘mixed’ people might vary, especially in relation to these identity choices they perceive and make.

    Abstract

    This review attempts to evaluate a proposed lexicon for African-descent populations from the viewpoint of saliency amongst those described and wider official and scientific usage, focusing on Britain and the USA. It is argued that it is unsatisfactory to privilege the term ‘African American’ over ‘Black’ for Africandescent populations in the USA as the evidence base shows that both labels compete as self-designations on co-equal terms, while ‘Black’ is the prevalent term in scientific writing. Moreover, ‘African American’ is not an inclusive term for the African-descent population and it is not known how prevalent and enduring the term will prove to be. With respect to Britain, the census terms of ‘Black African’ and ‘Black Caribbean’ are well established, the increasing popularity of ‘Black British’ also being recognized in census labels. Given the increasing interest in the relationship between ethnic identity and health, there are arguments for documenting the diversity of terminology amongst different user constituencies in country-specific settings. The approach of synthetic glossaries of consensual terms may, through the need for economy and parsimony in the use of terminology, contribute to an unsatisfactory paring of that diversity.

    Aspinall, P.J. and Jacobson, B. (2007) Why poor quality of ethnicity data should not preclude its use for identifying disparities in health and healthcare. Quality & Safety in Health Care, 16 (3). pp. 176-180. ISSN 1475-3898.

    Abstract

    Background: Data of quality are needed to identify ethnic disparities in health and healthcare and to meet the challenges in governance of race relations. Yet concerns over completeness, accuracy and timeliness have been long-standing and inhibitive with respect to the analytical use of the data. Aims: To identify incompleteness of ethnicity data across routine health and healthcare datasets and to investigate the utility of analytical strategies for using data that is of suboptimal quality. Methods: An analysis by government office regions of ethnicity data incompleteness in routine datasets and a comprehensive review and evaluation of the literature on appropriate analytical strategies to address the use of such data. Results: There is only limited availability of ethnically coded routine datasets on health and healthcare, with substantial variability in valid ethnic coding: although a few have high levels of completeness, the majority are poor (notably hospital episode statistics, drug treatment data and non-medical workforce). In addition, there is also a more than twofold regional difference in quality. Organisational factors seem to be the main contributor to the differentials, and these are amenable-yet, in practice, difficult-to change. This article discusses the strengths and limitations of a variety of analytical strategies for using data of suboptimal quality and explores how they may answer important unresolved questions in relation to ethnic inequalities. Conclusions: Only by using the data, even when of suboptimal quality, and remaining close to it can healthcare organisations drive up quality.

    Aspinall, P.J. (2007) Approaches to developing an improved cross-national understanding of concepts and terms relating to ethnicity and race. International Sociology, 22 (1). pp. 41-70. ISSN 0268-5809.

    Abstract

    Investigators from the fields of comparative social and epiden-dological research have identified the need for an improved cross-national understanding of the concepts and terms relating to ethnicity and race. Suggestions have included the harmonization in surveys of variables like ethnicity and religion in a comparative European context and an internationally applicable and agreed glossary of terms relating to ethnicity and race. Pleas have been entered for work towards such goals, involving statistical offices and institutions in the European Union and bodies like the World Health Organization and International Epidemiological Association. This article examines how the conceptual bases of this terminology, issues of geographical specificity and the problem of which terms merit recognition impact on these goals. Different approaches to improving our understanding of this terminology in a cross-national context are explored. Given that the meanings of concepts and terms in the field of ethnicity and race invariably can only be understood in their national context of use - which is frequently layered, manifold, subtle and complex - an approach that explores the connotative reach of the different concepts and terms within this context is needed. Functional equivalence is more likely to be achieved by harmonization than the systematization of such knowledge through the economical form of a glossary of synthetic analytical terminology. However, given the socially and psychologically driven nature of ethnicity as a 'global' concept, harmonization may only be successful when limited to its multiple dimensions.

Total publications in KAR: 114 [See all in KAR]
back to top

 

Centre for Health Services Studies, University of Kent, Canterbury, Kent, CT2 7NF

Enquiries: +44 (0)1227 824057 or email the Centre for Health Services Studies

Last Updated: 14/12/2012