Researchers have long questioned the theoretical integrity of ethnic categories in health research (Bradby 2003), yet evidence of enduring inequalities in contexts of growing diversity means that enquiry into the causes remains of primary importance. Though research on ethnicity and health now generally includes measures of socio-economic circumstances (SEC), individual, group and contextual variables moderate this relationship, disavowing views of ethnicity as simply a proxy for disadvantage. The papers in this issue grapple with this complex intersection of ethnicity with other vectors of differentiation including migration history, age and gender, revealing differences in the ways in which these operate across diverse contexts. De Grande et al. in Belgium and Sevillano et al. in Spain, for example, explore variations in self-reported health within and between ethnic groups based on gender or migration history which was not consistently attenuated by SEC. These findings suggest limitations in overarching theories such as the 'healthy migrant effect' or 'acculturation'. As in these studies, migration history is increasingly recognised as vital for a more nuanced understanding of the relationship between ethnicity and health. However, limiting this to distinguishing between 'first' and 'second generation' obscures how histories of empire and religion, as well as global and local economic and political changes, play out in dynamic patterns of migration with far-reaching consequences for those who migrate and their descendants. As evidenced in Meschke et al.'s study with Hmong in the USA, the disadvantages and trauma faced by refugees and other forced migrants represent very different categories of experience from those who migrate in search of opportunities for employment or education.
展开▼
