1

Komkrich Silathong (Jack) M00393087 (Resubmit: 21-3-14)

SSC4041 Applied Research Methods

Module Lecturer: Dr Alessio D’Angelo

Word count: 1,669

Topic: Analysis of the Statistical Relationship between

Ethnicity and Health Problems in the UK

Rationale for the Study

Health can also be affected by socioeconomic status,

living standards and racial and ethnic background. Therefore,

research conducted in poorer neighbourhoods highlighted the

relationship between health and ethnicity is interesting to

study (Ortiz & Zimmerman, 2013; Farmer & Ferraro, 2005; p.

191). There are several variable relating to this topic.

Firstly, Office of National Statistics (ONS) defined ethnicity

as a “collective identity, “a social construct specific to a

social and historical context” and is based on the assumption

that a collectivity has its roots in common ancestry,

heritage, religion, culture, nationality, language and a

territory” (Afkhami, 2012; p. 6). From Table 1, the ethnicity

was divided into 17 categories based on Census classification

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(ONS, 2014). According to Nazroo (1997), he argued that the

levels of health problems differ substantially across South

Asian populations and there is a need to focus on the specific

segments of the ethnic minority population”. Furthermore, Li

(2004; p. 24) explains that the individual census records can

illustrate inequalities in relation to ethnicity, e.g. impact

of ethnicity on health.

Further important variable is health problems mean

general health which is defined as a self-assessment of an

individual’s general state of health. People were asked to

access whether their health was very good, fair, bad or very

bad that leading to unjust and preventable inequalities in

health (ONS, 2014; Becares, 2013). This assessment is not

based on a person’s health over any specified period of time

(Census, 2011).

Research Questions

There is a research question that the researchers need to

explore “What is the kind of relationship between Ethnicity

and Health Problems.

Methodology

The report will focus on the ethnic populations living in

the UK that are hypothesized relating to their health

problems. This report will carry out quantitative research

through a crosstab analysis, because ethnicity nominal

variable and general health is ordinal are the measurement

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levels. In case of nominal variables which is defined as a

set of categories for grouping objects, events or population,

with no presumption about the order (i.e. ethincity and health

problems) (Blaikie, N. (2003). The categories must be

similar, mutually absolute and complete that can be allocated

to one category, but the ordinal variable can also order the

group such as general health (Ibid). Therefore, the 2011

Census designed two measures of health (i.e. limiting long-

term illness, and general self-assessed health (Becares, 2013;

ONS, 2014). ONS (Ibid) identified to measure by asking the

question about the day-to-day activities how they were limited

by their health problems or age. Moreover, General self-

assessed health was measured by asking about their health

status in general with the alternative answer concerning with

the level of health level (i.e. ‘Very good’, ‘Good’, ‘Fair’

‘Bad’, or ‘Very Bad’) (Blaiskie, 2003; ONS, 2014).

This research will use the 2011 Census of the UK Office,

anonymised and protected for 100 years, for National

Statistics (ONS) which is most accurate estimate possible for

the population and the largest maker of official statistics in

the UK relating several topics, such as population, demography

and migration, the labor market (e.g. employment, unemployment

and earnings), and other social statistics (D’ Angelo, 2013;

ONS, 2014).

Research Methods

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The datasets will focus on populations based on the 2011

Census for the UK. This source of information was the Office

of Population Censuses and Survey and the General Register

Office (Chapman & Wykes, 1996; p. 27).

ONS survey a large number of the Census information e.g.

employment; unemployment; economic inactivity; Ethnicity;

accommodation and health problems. (UK Data Archive, 2013;

Fairlie & Meyer, 1996).

ONS social surveys ask questions concerning with people’s

ethnicity and health problems (ONS, 2014). This information is

used to see if different types of people have different

experiences in life (for instance, in employment and health)

(Ibid). The questionnaire items relate to descriptions of

ancestry and ethnic affiliation, lifestyle, experience of

racism, and social and community involvement (Nazroo &

Karlsen, 2001). Ethnic minority groups in the UK may

generally be deemed both disadvantaged and powerless (Gidden,

1993).

Population

The main population base for outputs from the 2011 Census

is the normal resident population as at census day 27 March

2011. Albeit, the population will include non-UK short-period

resident, this population can be analyzed separately and is

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not included in the main outputs from the 2011 Census. All of

them, unless specified, are created utilizing normal resident

of the UK only (ONS, 2014).

For 2011 Census objectives, a normal resident of the UK

is anyone who, on census day, was in the country and had

stayed or intended to live in the UK for a term of 12 months

or more, or had a permanent UK address and was outside country

and intended to be outside the country for less than 12 months

(Ibid).

The population derives from the ethnic group living in

the UK, totalling 60,938,955 persons (ONS, 2014).

Findings

The numbers of the population in each ethnic group in the

UK, as recorded in the 2011 Census, are illustrated in Table

1. General, White British at 45.1 million (80.5 per cent)

population was the majority groups in 2011, followed by the

Other White with 2.5 million population (4.4 per cent) (Figure

1; ONS, 2014). On the other hand, Other ethnic group was the

lowest group (1 per cent) (Table 1). The most ethnic

population in 2011 has increased from the population in 2001

(Table 1). On the other hand, White British and White Irish

population reduced between 2001 and 2011.

Table 1: Ethnic groups 2001 and 2011, England and Wales,

England and Wales1

6United Kingdom

 

Percentages

2001 2011

White

Irish 1.2 0.9Gypsy or

Irish

travelle

r2 0 0.1Other

White 2.6 4.4

Mixed/multiple ethnic

groups

White

and

Black

Caribbea

n 0.5 0.8White

and

Asian 0.4 0.6White

and

Black

African 0.2 0.3Other

Mixed 0.3 0.5

Asian/Asian British

Indian 2.0 2.5Pakistan

i 1.4 2.0Banglade

shi 0.5 0.8Chinese1 0.4 0.7Other

Asian1

0.5 1.5

United Kingdom (Cont.)

 

Percentages

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Note:

1. Comparability issues exist between these ethnic groups for

the 2001 and 2011 Census (this excludes White British about

80.5 per cent).

2. No comparable data exists for these ethnic groups in the

2001 Census.

Source: Census, Office for National Statistics

According to table 1 and figure 1 also shows all ethnic

minority groups in this figure that also includes the White

British (80.5 per cent).

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Figure 1: Ethnic minority groups, England and Wales, 20111

Note: 1. This chart includes White British (80.5 per cent)

Source: Census 2011, Office for National Statistics

This research applies data 2011 Census on limiting long-

term illness to clarify broad differences in health between

seventeen ethnic groups in England and Wales (Table 1;

Becares, 2013). Improvements in ethnic minority groups’ social

status and their living conditions of disadvantaged groups can

possibly be decreased the Ethnic health inequalities.

While, Figure 2 illustrates men from the White Gypsy or

Irish Traveler, Mixed, White-Black Caribbean, White Irish and

Black Caribbean groups had better levels of limiting long-term

illness than White British men. Unfortunately, the White Gysy

or Irish Traveler have health problems twice the White British

men’s level. On the other hand, the rates of the ethnic group

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of Bangladeshi, Arab and Pakistani have poorer health’s rates

than the White British men.

Figure 2: Ethnic inequalities in health for men in 2011 Age-

standardised ratios of Limiting Long-Term Illness for ethnic

minority groups, compared to the White Britist group, males

2011

Note: Adapted from Table 2 (Annex A)

Source: Census 2011, Office for National Statistics; Becares,

2013

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From Figure 2 and 3, inequalities are obviously

illustrated in the health of the White Gypsy or Irish Traveler

groups which both of men and women have nearly twice the

levels of limiting long-term illness of the White British. On

the other hand, both of Chinese men and women group have the

best health among all groups, approximately lower than half

the White illness levels. White British men had better health

levels than White British women (Figure 2, 3).

Figure 3: Ethnic inequalities in health for women in 2011 Age-

standardised ratios of Limiting Long-Term Illness for ethnic

minority groups, compared to the White Britist group, females

2011

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Note: Adapted from Table 2 (Annex A)

Source: Census 2011, Office for National Statistics; Becares,

2013

Discussion

According to the first question “what is the kind of

relationship between Ethnicity and Health Problems?”, the

tables and figures can show that there are the relationships

between them. The poor health may be caused by several

factors, including biological determinants (age, sex,

hereditary factors), and broader social determinants such as

education, social position, income, occupations, working

conditions, housing tenure, local environment, and experiences

of ethnic discrimination (Jones, 1993, Becares, 2013).

Accordance with Nazroo (2001), ethnic minorities were

contributed an higher rate of disease (e.g. limiting

longstanding illness, heart disease, diabetes, and

hypertension) than White citizens. Furthermore, Becares

(2013) argues that the social variables of health are

unequally delivered across minority ethnic groups. Social

differences between populations have recognized implications

for self-assessed health, which are reflected in these results

(Browning et al. ,2003).

From Table 1 including figure 1 and 2, ethnic minority

groups have very various levels of illness health. The

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biological determinants in forming health across various

categories in society are obviously documented, including,

among educates comparing health of all ethnic groups (Acheson,

1998; Nazroo, 2003).

From Figure 1 and 2, the most of ethnic minority

populations, both genders, noticeably have poorer health

problems than the White British population.

There are also important variations in the socioeconomic

situations of population from various ethnic minority groups

such as the poorer people more like to live in poor quality

housing (i.e. Without central heating, being overcrowded, and

having lower access to consumer durables) (Evandrou, 2000).

This leads to their quality of life and health problems.

Conclusion

The social determinants of health and biological

determinants are possibly brought about unfair and preventable

health inequalities. The accessible approach to solve this

problem is to start with the social determinants of health by

enhancing the health of the people of the UK, and decreasing

minority ethnic health inequalities (Becares, 2013). According

to Evandrou (2000; p. 27), ‘policies which deal with

deprivation and poverty may also administer to decrease of

health inequalities, as well as developing services which are

culturally competent and acceptable to different ethnic groups

remains a key priority’.

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From above reasons, there are the relationships between

the ethnicity and health problems because the social

determinant (i.e. ethnicity) was related to the ethnic heatlh

inqualities that have to address this factor. Nevertheless,

there is another factor (i.e. biological determinant) relating

to this problem, but it is so difficult to solve this problem.

However, the UK governments and policy-makers have to

consider such factors in designing appropriate public health

policies (Edmondson et al., 2011; Nicholson et al., 2008; Adda

et al, 2003, Harris et al., 2006).

References

Acheson, D. (1998). Independent Inquiry into Inequalities in Health (the

Acheson Report). London: HMSO.

Adda, J., Chandola, T. & Marmot, M. (2003). ‘Socioeconomic

Status and Health: Causality and Pathways’. Journal of Econometrics,

112 (1); pp. 57-63.

Afkhami, R. (2012). Ethnicity: Introductory User Guide.

Economic and Social Data Service (ESDS), the UK Data Service.

Becares, L. (October, 2013). ‘Which Ethnic Groups have the

Poorest Health? Ethnic Health Inequalities 1991 to 2011’.

Joseph Rowntree Foundation, Dynamics of Diversity Evidence from the

2011 Census: ESRC Centre on Dynamics of Ethnicity (CoDE), pp.

1-4. Available from www.ethnicity.ac.uk Accessed 21 March

2014.

14

Blaikie, N. (2003). Analyzing Quantitative Data: From Description to

Explanation. London: Sage.

Bouma, G. D. & Ling, R. (2004). The Research Process. 5th Edn.

Oxford: Oxford University Press.

Browing, C. R., Cagney, K. A. & Wen, M. (2003). ‘Explaining

Variation in Health Status across Space and Time: Implications

for Racial and Ethnic Disparities in Self-Rated Health. Social

Science and Medicine, 57, pp. 1221-1235.

Chapman, M. & Wykes, C. (1996). Plain Figures. Second Edition, Civil

Service College Management in Government, London; Crown.

Chaturvedi, N., Mckeigue, P. & Marmot, M. (1994).

‘Relationship of Glucose Tolerance to Cororary Risk in Afro-

Caribbeans Compared with Europeans, Diabetologia, 37; pp. 65-

72.

Cruickshank, J. & Alleyne, S. (1987). ‘Black West Indian and

Matched White Diabetics in Britain Compared with Diabetics in

Jamaica, Diabetics Care, 10; pp. 170-179.

D’ Angelo, A. (2013). Secondary Data. SSC4041: Applied

Research Methods Document, MA Global Governance, London:

Middlesex University. Available from

http://www.ons.gov.uk/ons/index.html. Accessed 16 March 2014.

Edmondson, N. E., Bent III, J. P. & Chan, C. (2011).

‘Laryngomalacia: The Role of Gender and Ethnicity’. International

Journal of Pediatric Otorhinolaryngology, 75; pp. 1562-1564.

15

Evandrou, M. (Winter, 2000). ‘Ethnic Inequalities in Health in

Later Life’. Health Statistics Quarterly, 8; pp. 20-28.

Fairlie, R. W. & Meyer, B. D. (1996). Ethnic and Racial Self-

Employment Differences and Possible Explanations’. The Journal of

Human Resources, 31 (4); pp. 757-793.

Farmer, M. M. & Ferraro, K.F. (2005). ‘Are Racial Disparities

in Health Conditional on Socioeconomic Status?’. Social Science &

Medicine, 60 (1); pp. 191-204.

Giddens, A. (1993). Sociology. 2nd Edn., Cambridge: Polity.

Jones, T. (1993). Britain’s Ethnic Minorities. London: Policy Studies

Institute.

Li, Y. (2004). ‘Samples of Anonymised Records (SARs) from the

UK Censuses. Sociology, 38 (3); pp. 553-572.

Nazroo, J. (1997). ‘Health and Health Services’, in Modood, T.

& Berthoud, R. (Eds.). Ethnic Minorities in Britain, London, PSI.

Nazroo, J. Y. (2001). Ethnicity, Class and Health. London: Policy

Studies Institute.

Nazroo, J. Y. (2003). ‘The Structuring of Ethnic Inequalities

in Health: Economic Position, Racial Discrimination and

Racism’. American Journal of Public Health, 93 (2); pp. 277-284.

Nazroo, J. Y. & Karlsen, S. (September, 2001). Ethnic Inequalities in

Health: Social Class, Racism and Identity’ Research Findings: 10: from the

Health Variation Program. Economic & Social Research

16

Council.Available from http://www.lancaster.ac.uk/ fass/

projects/ hvp/ pdf/ fd10.pdf. Accessed 15 March 2014.

Nicholson, A., Pikhart, H., Pajack, A., Malyutina, S.,

Kubinova, R., Peasey, A., Topor-Madrid, R., Nikitin, Y.,

Capkova, N., Marmot, M. & Bobak, M. (2008). ‘Socioeconomic

Status over the life-course and Depressive Symptoms in Men and

Women in Eastern Europe’. Journal of Affective Disorders, 105 (1-3); p.

125-136.

Office of National Statistics (ONS) (2011). 2011 Census, Key

Statistics for Local Authorities in England and Wales. Available from

http://www.ons.gov.uk/ons/rel/ census/2011-census/key-

statistics-for-local-authorities-in-england-and-wales/

index.html Accessed 21 March 2104.

Office of National Statistics (February, 2014). Labour Force

Survey User Guide - Volume 3: Details of LFS Variables 2013, Version 4.

Office of National Statistics (ONS).

Office of National Statistics (2013). 2011 Census: General Health,

Local Authorities in England and Wales. Available from

http://www.neighbourhood.statistics.gov.uk. Accessed 20 March

2014.

Ortiz, S. E. & Zimmerman, F. j. (February, 2013).

‘Race/Ethnicity and the Relationship between Homeownership and

Health’ American Journal of Public Health, Published online, pp. e1-

e8 doi:10.2105/AJPH.2012.300944.

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Simpson, L. & Akinwale, R. (2006). Quantifying Stability and

Change in Ethnic Group. CCSR Working Paper 2006-05.

The UK Data Archive. (2013). The Quarterly LFS, October - December 2006.

Available from www.data-archive.ac.uk. Accessed 19 December

2013.

Whincup, P. H., Nightingale, C. M., Owen, C. G., Rudnicka, A.

R., Gibb, I., McKay, C. M., Donin, A. S., Sattar, N., Alberti,

K. G. M. M. & Cook, D. G. (2010). ‘Early Emergence of Ethnic

Differences in Type 2 Diabetes Precursors in The UK: The Child

Heart and Health Study in England (CHASE Study)’. PLoS Medicine,

7 (4); pp. 1-10.

Zetter, R., Griffiths, D., Sigona, N., Flynn, D., Pasha, T., &

Beynon, R. (2006). Immigration, Social Cohesion and Social Capital. Joseph

Rowntree Foundation.

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Annex

Annes A: Table 2: Ethnic inequalities in health for men and females in 2011 Age-standardised ratios of

Limiting Long-Term Illness for ethnic minority groups, compared to the White Britist group, males and

females 2011.Total  

Age-specific rate

Expected illness from E&W rates expected Age standardised Excess

Crude rate 0-15

15-64 65+ 0-15 15-64 65+ illness

illnessratio

Rel toWB ill

arab 12% 3% 14% 66% 919

8,286

1,784

10,989

1.07 1.05 739

bangladeshi 14% 3% 16% 76% 2,229

17,720

4,367

24,317

1.23 1.20 5,537

black african 8% 2% 9% 54% 4,308

46,791

7,506

58,605

0.70 0.69 -17,535

black caribbean 19% 4% 14% 60% 1,483

29,834

25,167

56,485

1.07 1.04 3,711

black other 12% 3% 14% 59% 1,530

10,941

2,775

15,246

1.05 1.03 747

chinese 7% 2% 5% 47% 730

23,020

5,962

29,712

0.45 0.44 -16,247

indian 15% 2% 12% 68% 3,841

67,253

33,861

104,955

0.98 0.97 -1,639

mixed other 10% 3% 12% 56% 1,705

11,374

3,067

16,145

0.93 0.91 -1,100

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mixed white and asian 8% 3% 11% 51% 2,293

11,065

2,718

16,076

0.82 0.81 -2,837

mixed white and black african 8% 3% 12% 54%

1,169

5,517

960

7,647

0.90 0.88 -797

mixed white and black caribbean 11% 4% 13% 60%

2,705

15,499

3,787

21,991

1.04 1.02 787

other 14% 3% 14% 64% 976

14,970

5,429

21,376

1.04 1.02 865

other asian 10% 3% 9% 56% 2,669

42,433

11,743

56,845

0.75 0.73 -14,387

pakistani 15% 4% 17% 78% 5,283

46,030

13,487

64,800

1.30 1.27 19,312

white british 21% 3% 14% 56% 112,275

1,932,011

2,655,566

4,699,853

1.02 1.00 93,500

White Gypsy or Irish Traveller 25% 5% 30% 73%

263

2,460

982

3,704

1.97 1.93 3,596

white irish 27% 3% 15% 53% 429

22,623

52,568

75,620

1.01 0.99 409

white other 9% 2% 7% 52% 5,416

137,820

52,516

195,752

0.62 0.61 -74,663

All groups   3% 13% 56%    

arab 12% 4% 12% 51% 1,573

11,921

2,352

15,846

0.98 0.95 -353

bangladeshi 11% 4% 12% 69% 3,626

17,918

4,436

25,980

0.99 0.96 -134

black african 7% 4% 7% 43% 0.59 -20,225

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6,904 39,923 5,344 52,171 0.61

black caribbean 17% 6% 13% 53% 2,423

23,298

19,150

44,870

1.05 1.02 2,419

black other 11% 5% 13% 52% 2,497

10,430

1,913

14,840

1.02 0.99 362

chinese 6% 2% 4% 39% 1,169

18,945

4,643

24,756

0.44 0.42 -13,938

indian 11% 3% 9% 53% 6,409

65,786

27,591

99,786

0.78 0.75 -22,056

mixed other 10% 5% 12% 49% 2,808

9,492

2,171

14,470

0.96 0.93 -644

mixed white and asian 8% 4% 10% 45% 3,797

11,080

2,286

17,163

0.83 0.80 -2,934

mixed white and black african 8% 4% 11% 49%

1,900

5,041

692

7,633

0.91 0.88 -717

mixed white and black caribbean 12% 6% 14% 55%

4,373

13,773

3,223

21,370

1.14 1.10 3,000

other 12% 4% 12% 52% 1,610

16,897

4,227

22,734

0.97 0.94 -763

other asian 9% 3% 9% 47% 4,498

36,535

8,726

49,760

0.74 0.72 -12,973

pakistani 12% 5% 12% 64% 8,676

45,297

12,844

66,817

1.03 1.00 1,845

white british 18% 5% 13% 50% 186,608

1,795,351

1,891,996

3,873,955

1.03 1.00 124,573

White Gypsy or Irish 25% 8% 30% 70% 1.99 3,644

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Traveller 430 2,197 846 3,473 2.05

white irish 25% 5% 16% 52% 714

21,165

35,077

56,957

1.11 1.08 6,315

white other 7% 3% 6% 46% 8,966

115,507

31,272

155,744

0.57 0.55 -67,421

All groups   5% 13% 50%

Note: 1) This table adapted from some the 2011 Census data on limiting long-term illness

Available from http:// www. ons. gov. uk/ ons/rel/ census/2011-census-analysis/ethnic-

variations-in-general-health-and-unpaid-care-provision/index.html Accessed 21 March 2014.

2) The table calculates crude illness rates, standardized illness rates and excess ill in

2011

3) Each ethnic minority group, males and females separately

4) On stadnardisation, it is always against the England and Wales age-specific rates.

5) On Excess ill, it is the excess of observed ill, over the expected ill – distributed

England and Wales age-specific rates

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6) The excess ill is displayed only when it is positive and the group’s SIR is more than

the White British group.

Source: Census 2011, Office for National Statistics; Becares, 2013

………………………………….

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