Bulletin of the World Health Organization

Ethnicity, race and health in a multicultural environment: foundations for better epidemiology, public health and health care

Helen Therese Allan a

This book is a thoughtful and useful addition to my reading list as a teacher of nursing, health care and research. It provides researchers and health-care practitioners with a strong foundation upon which to begin to think about race, ethnicity, multiculturalism and health care. This will be a useful textbook for health-care and research students at the postgraduate level; although undergraduates would find it a useful starting point to exploring the topic in greater depth. The intended audience for this book is wide, however: medical scientists, social scientists, health-care practitioners and researchers. The scholarly, but at the same time personal and inviting, style in which the book is written immediately engages the reader and encourages active and consolidated learning. Each chapter has a clearly stated objective, summary and conclusion, which provide the reader with a readily assimilable overview of the material being presented.

Raj Bhopal, a well known researcher in the area of race, ethnicity and health care, has a great deal to say about how health-care providers must begin to start thinking about research on, and the provision of, health care in a multicultural society. He acknowledges that multiculturalism and multicultural living are challenges for health-care providers but insists that they need to be addressed if we are to “meet social, ethical, legal and policy obligations to deliver evidence-based health care.” For it is our failure to attend to multiculturalism in a balanced way that has led to unfair and inequitable health-care provision. There is a need for this book because there is poor understanding of how ethnicity and race influence health care in a multicultural society and hence little is being done to address the problem at the practical level. As Bhopal says, the “quality of the research leaves much to be desired” and the service fails to adapt to meet the needs of ethnic minority users.

In this book, the author provides readers with the knowledge and skills to deconstruct ethnicity, race and multiculturalism in health care, i.e., he provides historical and sociological explanation of these concepts, which unpick layers of historical and social and cultural meanings. He explores the context in which they emerged and how this context influences their accepted dominant meanings in today’s health-care practice. Much of this may be uncomfortable reading for those of us who are white and have failed to see how such meaning has often shaped poor delivery of health care and poor research. It is through this process of deconstruction that readers are encouraged to reflect on taken-for-granted assumptions and hence to begin the process of thinking about and hopefully changing their practice as researchers or health-care practitioners. The book’s clear presentation of methods of enquiry grounded in examples of health-care policy and planning is designed to encourage changes in actual practice. As Bhopal states “it is the intention that the reader will acquire the depth of knowledge to use the concepts and not merely be aware of them.” ■


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