Education And Debate

Caring for Older People: Ethnic elders

BMJ 1996; 313 doi: (Published 07 September 1996) Cite this as: BMJ 1996;313:610
  1. Shah Ebrahim, professor of clinical epidemiologya
  1. a Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London NW3 2PF

    The numbers of elderly people from ethnic groups within Britain is rising rapidly as postwar immigrants age. Ethnic elders face problems owing to age-associated increased risks of common chronic diseases, racial discrimination, and poor access to many health services and social services. This disadvantage will be alleviated through increased understanding of health beliefs held by ethnic elders and ensuring better access to services through mechanisms such as employment of more staff from ethnic minority groups in senior positions, better training of staff, and more appropriate and sensitive environments. The myths that family care is sufficient, that no use of services implies no need, and that assimilation into the majority population will occur must be discounted.

    Since the 1870s Britain has received large numbers of immigrants from different countries and cultures (fig 1). Migration is due to “push” and “pull” factors. After the second world war, Britain actively recruited labour from Commonwealth countries to aid the reconstruction effort—a major “pull”; many came thinking they would earn enough money to return home and retire in comfort. “Push” factors are poverty, political instability, and oppression.

    Fig 1

    Trends in world migration to Britain

    Immigration policy became much less flexible during the 1980s and led to reductions in the numbers of new arrivals. New migrants arrive daily from some countries (such as Somalia) where political oppression endangers life but not from others (former Yugoslavia). British immigration policies are not consistent.

    It is still possible for older people from some countries to resettle in Britain by joining their children. The distribution of ethnic minorities in Britain is strongly biased towards inner city areas of major industrial towns. Bradford, Leeds, Manchester, Nottingham, Wolverhampton, Leicester, Birmingham, Coventry, and London have high numbers of elderly people of different ethnic origins.

    View this table:

    OPCS classification of ethnicity for 1991 census


    Ethnicity is a …

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