About the research
Previous research strongly suggests that ethnic minorities are more likely to suffer a poorer health profile compared to the overall population. Trends have emerged to suggest that certain social factors such as socioeconomic status and health behaviours are not fixed across generations and have a role to play in these health inequalities.
This study draws on the Health Survey for England to investigate the differences in health between the first and second generation immigrants, and determines the extent to which intergenerational changes in socioeconomic status and health behavioural factors might explain variations.
The research findings suggest that strong upward intergenerational socioeconomic mobility did not improve health profiles among ethnic minorities. Health behaviours worsened across generations, although the degree of change was highly specific to each ethnic group studied. Findings showed that both the social and economic contexts and the cultural identities and behaviours of ethnic minorities differ across generations, but ultimately their opposing influences on health result in stable overall patterns of health inequality.
In short, this study illustrates that ethnic minorities in England report consistent rates of fair to poor health across generations, despite the health benefits resulting from upward social mobility. These health inequalities are unaffected by changes in health behaviours. Understanding these intergenerational pathways will have important public health policy implications as immigrant populations not only mature, but also have children of their own.
Methodology
The analysis is based on ethnicallyâboosted data from 28,628 respondents to the combined 1999 and 2004 Health Survey for England. Cross-sectional analysis investigated generational differences in self-rated general health, limiting illness, obesity, hypertension, depression, psychological distress and a range of biomarkers of cardiovascular disease across several ethnic minority groups in the UK (Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, Irish, Chinese and other). Responses from 18,407 members of the UK’s white population were used as reference.
Multivariate logistic and linear regression was used to assess the risk of having poor health in the second generation compared to the first. Additionally the risks within each generation compared to the general population were described. Generational movement relative to the white baseline was assessed for all ethnic groups adjusted for age and gender.
Publications
This research was featured in the following academic journals:
Smith, N.R., Kelly, Y.J., and Nazroo, J.Y. (2009) ‘Intergenerational continuities of ethnic inequalities in general health in England’, Journal of Epidemiology and Community Health 63(3), pp. 253-258. doi:10.1136/jech.2008.077495
Smith, N.R., Kelly, Y.J., and Nazroo, J.Y. (2012) ‘The effects of acculturation on obesity rates in ethnic minorities in England: Evidence from the Health Survey for England’, The European Journal of Public Health, 22(4), pp. 508-513. doi: 10.1093/eurpub/ckr070