Ethnicity as a Social Determinant of Health
Social factors of human life have their ultimate effects on the quality of life and, consequently, on health status. According to Crear-Perry et al. (2021), the integration of social determinants of health into national health care systems allows for bridging the gap between different groups of population and eliminating inequalities and health disparities. While some aspects of life refer to human choices that ultimately result in health outcomes, others, such as ethnicity, gender, socio-economic status, sexuality, and others, are beyond one’s choice (Palmer et al., 2019). However, they have their impact on health and should be reviewed for proper analysis. One of the important determinants of the heath is ethnicity or racial belonging, which causes significant disparities in access to health care and the overall health status of the representatives of minorities (Gordon, Banegas and Tucker-Seeley, 2020). This discussion paper is aimed at defining ethnicity as a social determinant of health, exploring its manifestations, causes, and theoretical premises contributing to its understanding. It is claimed that systematic racism on individual, institutional, and cultural levels disproportionately exposes ethnic minorities to inequalities in health.
Ethnicity as a social determinant of health is regarded to have a significant influence on the health-related outcomes of minorities. Ethnicity is defined as a set of cultural beliefs, heritage, behaviors, language, and religion that is common to the representatives of the same group (Byrne et al., 2020). Thus, belonging to a particular ethnic group that is regarded as a minority in a society where a different ethnicity is dominant, serves as a factor influencing people’s health outcomes.
Ethnic and racial particularities have a significant influence on human health. The ways in which it is manifested are numerous and include the prevalence of particular diseases, access to health care, obtaining preventative care, and affording safe living conditions to facilitate health. Individuals representing ethnic minorities are more frequently exposed to malnutrition (Duggan et al., 2020). Moreover, the morbidity of Diabetes Mellitus, Covid 19, and cardiovascular diseases are found to be of higher rate in the representatives of minority groups (Barinas‐Mitchell et al., 2020; Duggan et al., 2020; Goff, 2019). Due to institutional racism, people representing ethnic minority groups are exposed to inequality in care and treatment. According to Byrne et al. (2020), there is a significant difference in the reported experience of GP care quality between the representatives of different ethnic groups. British White group reported an overall 84% rate of positive GP care experience, while the Indian group reported 78%, Bangladeshi 77%, and Chinese 72% (Byrne et al., 2020, p. 85). These statistical data demonstrate the ways in which ethnicity affects health.
The reasons why ethnicity predetermines health outcomes are associated with the stereotypes and the social conditions that contextualize the ethnic and racial characteristics of people. Ethnic minorities suffer from health disparities because of the systematic exposure to biases across the spheres of life in a diverse society (Riley, 2020). According to Cobbinah and Lewis (2018), racism in the health care system and outside it causes a significant impact on the health quality of the representatives of minority groups. Indeed, this assertion is supported by other researchers who agree that individual and institutional stereotypical attitudes diminish opportunities for proper economic and personal development of minority representatives due to the superiority of the dominant ethnicity (Devakumar et al., 2020; Hackett et al., 2020). Thus, ethnicity is the reason for health disparities due to social inequality.
When explaining the scope, particularities, and manifestations of ethnicity as an influential social determinant of health, one might refer to the psychosocial theory. This theoretical framework allows for setting the innate characteristics of ethnicity in the context of social perception. According to Oversveen et al. (2017), the psychosocial theory holds that the reactions of people to their life experiences have an ultimate impact on their health. For example, an elevated level of stress and anxiety due to discrimination based on ethnic belonging might cause long-term disruptions in health systems (Vargas, Huey Jr. and Miranda, 2020). This theory demonstrates that the quality of life under the pressures of racism and the lack of the feeling of belonging diminishes the opportunities for minorities to live as healthily as the dominating ethnic groups.
Another theory that might clarify the relationship between ethnicity and health is the behavioral theory. It holds that people’s behaviors individually and as elements of health care institutions are cultivated by their perception and attitudes toward minority representatives (Neblett Jr, 2019). In this regard, individual, institutional, and cultural racism is manifested through “beliefs in the superiority of one’s race and is characterized by “behavioral enactments” between individuals that maintain a power differential between racial groups” (Neblett Jr, 2019, p. 12). Thus, such stereotypical beliefs predetermine human behavior in relation to minorities, which is why there exists diminished access to health within ethnic minority communities.
In summation, among the many social determinants of health, ethnicity has become one of the most evident and decisive in contemporary society in the United Kingdom. In the globalized and diverse world of today, ethnic and racial minorities inhabit every corner of the state. However, the instances of racism, discrimination, and biased attitudes throughout the social, economic, and political systems limit the opportunities of ethnic minorities to access health care, afford preventative and timely care, as well as ensure proper housing, employment, and other socio-economic essentials that have an ultimate impact on health. As a result, health disparities on the ethnic ground are evident throughout the health care system. Due to the behavioral patterns and psychosocial experiences influenced by racism and discrimination across systems, ethnic minority groups are disproportionately exposed to health disparities. They are manifested via a higher rate of morbidity and having chronic illnesses, as well as suffering from the lack of preventative care. The overviewed statistics show high rates of diabetes, Covid 19, cardiovascular diseases, and other disabilities in ethnic minority groups. Thus, ethnicity plays a pivotal role in determining human health outcomes.
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