Education And Debate

Ethnicity as a variable in epidemiological research

BMJ 1994; 309 doi: (Published 30 July 1994) Cite this as: BMJ 1994;309:327
  1. P A Senior,
  2. R Bhopal
  1. Department of Epidemiology and Public Health, The Medical School, Newcastle upon Tyne NE2 4HH
  1. Correspondence to: Dr Senior c/o Professor Bhopal.
  • Accepted 20 June 1994

Ethnicity is used increasingly as a key variable to describe health data, and ethnic monitoring in the NHS will further stimulate this trend. We identify four fundamental problems with ethnicity in this type of research: the difficulties of measurement, the heterogeneity of the populations being studied, lack of clarity about the research purpose of the research, and ethnocentricity affecting the interpretation and use of data. Ethnicity needs to be used carefully to be a useful tool for health research. We make nine recommendations for future practice, one of which is that ethnicity and race should be recognised and treated as distinct concepts.

Epidemiology is the study of the distribution and determinants of disease. The main method of study, particularly for investigating the causes of disease, is to compare populations with different risks of disease. Ethnicity is a variable that is used increasingly to define populations for epidemiological studies. Differences by ethnicity in both the characteristics of populations and their experience of disease have been easy to describe, and the literature on ethnicity and health is large and growing.1 We consider here the nature of ethnicity, the attributes of sound epidemiological variables, the measurement and value of ethnicity as an epidemiological variable, and how ethnicity might best be used in future research. By reviewing critically ethnicity as a variable in epidemiology we hope to facilitate better research. This review is relevant to ethnic monitoring in the NHS.

What is ethnicity?

Ethnicity is derived from a Greek word meaning a people or tribe. The concept of ethnicity is neither simple nor precise,*RF 2-6* but it implies one or more of the following: shared origins or social background; shared culture and traditions that are distinctive, maintained between generations, and lead to a sense of identity and group; and a common language or religious tradition.*RF 3-6* …

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