The Sri Lankan diaspora population is substantially neglected in UK demographic and health research and not captured in census and survey ethnic group questions, though 127,242 Sri Lankan-born migrants were enumerated in England and Wales in 2011. Important intersections are reported between the period of arrival of these migrants, the purpose behind their movement, and related population characteristics, with 47% having arrived during 2001–2011. Between 1984 and 2004 around 50,000 asylum applications were made by Sri Lankan Tamils. Sri Lankan migrants generally display more favourable circumstances on key socio- economic variables than do other diaspora populations from South Asia. These include generic health status and mortality. This may be attributable to the'healthy migrant'effect, given the community's recent migration, though the application of its effect to this population requires caution as a significant proportion came to Britain as asylum-seekers (forced migration) rather than as self-selecting migrants. A more advantageous socio-economic profile may also have contributed.

In western countries the mixed race/ethnicity population is experiencing a rapid increase in numbers and growing diversity, raising challenges for its capture in censuses and surveys. Methods include exact combinations of interest, multi-ticking, and open response, as exemplified by the censuses of England and Wales, the USA and Canada, and Scotland and Northern Ireland, respectively. However, investigations of question face validity, reproducibility of findings, and efficacy of capture reveal quality problems with all three approaches. The low reporting reliability of this population urgently requires research and testing to identify optimal strategies. While there is clearly no one gold standard method of capture and current approaches have developed within national contexts, it is timely to review these methods across the three countries and to make recommendations for the upcoming 2020/21 censuses.

The 'mixed' group, officially recognised in the 2001 Census, is one of the most rapidly growing ethnic groups in Britain. Although 'mixed' categorisation was added to ethnic coding in NHS datasets, our knowledge of health patterns for this population is meagre. Data quality problems remain a key obstacle, including poor reproducibility of the data and constraints on reporting due to sparse data bias. The consequent minimal and indicative evidence base has focused mainly on risky health behaviours, mental health and generic measures of self-rated health, as it has in the U.S.A. and Canada. There is negligible information on the main underlying causes of death, such as neoplasms, heart disease and stroke. Consideration should be given to pooling data across multiple years of health and general purpose surveys to enable reporting for the four 'mixed' categories and adjustment for mediating factors and relevant confounders, such as measures of socio-economic status.

Background : The 'health observatory' model has successfully proliferated across several world regions, this study being conducted to define the geographical and physical bases and main functions of health observatories serving largely urbanized populations and the support needed for set-up and sustainability. Methods : A scoping study of literature and observatory websites was undertaken to identify health observatories, main functions, year established and publications, followed by a self-completion survey to further investigate these characteristics, define the help observatories would have liked at set-up and later on, and how such help might effectively be accessed. Results: Of 69 health observatories contacted, 27 (39%) mainly established since 2000 completed the survey. Most responding observatories had a sub-national/regional or sub-regional/local geographical base and no one type of physical or organizational base predominated. Nearly all observatories undertook preparation of population-based health reports and intelligence, data analysis and interpretation services, and a primary commitment to working with local/regional partners to support evidence-based decision-making. Most prioritized help with deciding and defining the scope of the observatory, estimating the core resources required for establishing/developing it, addressing sustainability issues, identifying knowledge, skills and skill-mix required to undertake the health intelligence/analytic functions, accessing data/IT expertise and developing training and capacity-building programmes. The preferred means of accessing this support was a virtual network(s) of experts on particular topics to support mutual learning and toolboxes developed for specific observatory functions. Conclusions: Although the health observatory as an organizational model is maturing, the learning derived from sharing structured guidance and support is regarded as invaluable.

Objectives Smoking is the leading risk factor for disability-adjusted life-years, yet evidence with which to establish the smoking rates of people with different ethnic backgrounds and how they are changing in relation to recent migration is lacking. The objective is to provide current information on the changing risk profiles of the UK population. Study design Observational study using cross-sectional surveys. Methods Data from the Integrated Household Survey (pooled for the years 2009/10–2011/12), obtained under Special Licence, and the GP Patient Survey (2012) have been used to establish smoking prevalence in a wider range of ethnic groups in England and Wales, including the 'mixed' groups and amongst East European migrants, and how such prevalence differs across socio-economic classes. Results Smoking prevalence is substantially higher amongst migrants from East European countries (that for males exceeding 50% from three such countries and for females over 33% from four countries) and from Turkey and Greece, compared with most other non-UK born groups, and amongst ethnic groups is elevated in the 'mixed' groups. Rates are highest in the Gypsy or Irish Traveller group, 49% (of 162) and 46% (of 155) for males and females respectively. Across ethnic groups, rates are almost always higher in the UK born than non-UK born population with the notable exception of the 'White Other' group, with Prevalence Ratios (PRs) indicating a larger migrant-non-migrant differential amongst females (e.g. Indians 2.95 (2.33–3.73); Black Caribbeans 3.28 (2.73–3.94). Age-adjusted rates show the persistence of these differentials in females across age groups, though young males (18–29) in seven minority ethnic groups show lower rates in the UK-born groups. The 'White' and 'Chinese' groups show a strong socio-economic gradient in smoking which is absent in the South Asian groups and diminished in the 'mixed' and black groups. Conclusions Given the evidence that smoking behaviour is significantly different in some of the new groups, notably East European migrants, stop smoking services are failing to optimize the acceptability and, consequently, favourable outcomes for these programmes. These services need to be adapted to the particular patterns of smoking behaviour and language skills within different communities of descent.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

'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.

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.

In recent years, Britain has witnessed a significant growth in the 'mixed race' population. However, we still know remarkably little about this diverse population. How do young mixed race people think about and experience their multiracial status? What kinds of ethnic options do mixed race people possess, and how may these options vary across different types of 'mixes'? How important are their ethnic and racial identities, in relation to other bases of identification and belonging? This book investigates the ethnic and racial options exercised by young mixed race people in higher education in Britain, and it is the first to explore the identifications and experiences of various types of mixed race individuals. It reveals the diverse ways in which these young people identify and experience their mixed status, the complex and contingent nature of such identities, and the rise of other identity strands, such as religion, which are now challenging race and ethnicity as a dominant identity.

This book focuses on the migration history, demography, and socio-economic position of the Somali community in Britain, the largest of the Somali diaspora communities outside the African subcontinent. It addresses a number of specific themes, including the statistical invisibility of ethnic Somalis in official data collection and the decennial census; the rapidly growing size of the Somali migrant community in Britain, experiencing a growth rate of over 160 per cent in a decade; and, its complex migration history, including significant flows of asylum-seekers and refugees and onward migration from European Union countries.

To date there have been few efforts to investigate the impact of the current recession on the health of the population through the exploitation of routine official sources of information. One reason for this may be the fact that official statistics on population health and health care utilisation take a significant amount of time to validate, this making them less sensitive as timely indicators of change. Yet there are some sources whose release is timely and which offer potential data to systematically assess the effects of the recession on the health of the population. This report is exploratory in attempting to identify such candidate indicators. Further work is required through consultation and peer review processes to establish more precisely whether these indicators can be populated with routine health data.