Education And Debate Theories in health care and research

Theories of race, ethnicity and culture

BMJ 1998; 317 doi: (Published 14 November 1998) Cite this as: BMJ 1998;317:1381
  1. Naomi Pfeffer, senior lecturer. (
  1. School of Community Health, Psychology and Social Work, Faculty of Environmental and Social Studies, University of North London, London N5 2AD

    Series editor: Priscilla Alderson

    This is the fourth in a series of six articles on the importance of theories and values in health research

    Advice on which of the many possible definitions of race, ethnicity, and culture is most appropriate has been published in some medical journals.1Sensitivity to what these words may mean to an individual and, in a collective context, their explosive potential, has been encouraged partly by the latest phase in what has been called the “race policy environment.” Its history can be summarised briefly. The “race neutrality” of British public policy that emerged in the postwar period, which contributed to the entrenchment of inequality, was supplanted in the mid-1960s by assimiliationist policies informed by a belief that disadvantage in “racial” minorities might be eradicated if they adopted indigenous cultural behaviours such as the English diet. These policies were replaced in the 1980s by others promoting “racial harmony,” a blending of identities as a means of defusing racial tension. In the current phase, there is a recognition of the importance that people attach to having their distinctive identity acknowledged and respected, and moreover, recognition that the structure of British society and institutional racism both contribute to the disadvantages experienced by minorities.2

    Summary points

    Race, ethnicity, and culture should not be perceived as problematic “facts” or “things”

    The category “white” is too broad —and often meaningless

    Research into the relevance of race, ethnicity, and culture should address everyone's health, not just that of the victims of inequality

    Globalisation, displacement, and social movements are undermining the capacity of one nation to fix people's identity

    The old terminology

    The current phase of this race policy environment is stimulating research into whether, how, and when racism and race, ethnicity, or culture influence susceptibility to disease and access to or use of health services. Investigators, …

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