Ethnicity, socioeconomic status and health inequality among children

Background:

Why are some groups healthier than others, or are less affected by certain diseases? This research aims to delve into these health inequalities, covering both physical and mental health, comparing different ethnic groups. Importantly, we want to find out whether any differences we might observe between different ethnic groups is explained by differences in things like their income or educational background, rather than ethnicity directly. This is important because, whilst government makes the reduction of health inequalities a very high priority, designing policies to achieve this requires us to understand the reasons for any differences.

We have done some work on this issue in adults already.  The new work extends the analysis. We're looking at how the area they live in, and their family's situation, play a role. For immigrant groups, we want to know how factors like language and how long they’ve lived in Britain affect their health.

Aims and Objectives:

• Measure health differences among children and adults based on ethnicity and socioeconomic status.

• Examine how ethnicity is influenced by factors like language and time since immigration.

• Differentiate the impact of deprivation at the family and neighbourhood levels.

Methods:

Importantly, the proposed study will also extend the analysis to consider children. We’ll examine whether their ethnicity and their parents’ income, education, etc affect their health. We’ll measure children’s health in different ways including both mental and physical health, and also health behaviour (e.g. attitudes to smoking, drinking, drug abuse). We want to predict what the lifelong consequences may be of these health inequalities in early life. To do this, we're using a large research survey (called “Understanding Society") that follows the same individuals and families over many years, asking questions about different parts of their lives like health, jobs, income, education and housing. Because it collects information from the same people over time, it helps researchers like us see how things change. The study involves a lot of people from different backgrounds, so we can understand what life is like for many different types of individuals and families.

A significant limitation is that there is no link between the data in the Understanding Society survey and official records of deaths. Because of this, the survey misses some cases of ill-health leading to death. We’ll try to understand how the results of our research might be affected by this.

Policy relevance & dissemination:

DHSC and related bodies, particularly the Office for Health Inequalities and Disparities, make policy where the reduction of health inequalities is either a key aim or must, at least, be considered. This work will provide information to help shape those policies. 

What was the study about?

This research looked at how ethnicity and socioeconomic status (SES) shape health inequalities. It focused on people living in the UK, from children to adults, and aimed to find out which factor – ethnicity or SES – plays a bigger role in health inequalities and to identify the most affected groups in the population. The goal was to help design better health policies and guide targeted health interventions.

How was the study done?

We used data from a large UK survey called the UK Household Longitudinal Survey. Our study covers 13 years (from 2009 to 2022) and includes health information from people of all ages. We used statistical models (random effects models) to explore how SES and ethnicity are linked to people’s health and health inequalities.

What did we find?

1. Socioeconomic Disadvantage is the Strongest Predictor of Poor Health

●     People from lower SES backgrounds tend to have worse health at every age and are more likely to have long-term illnesses, mental health problems and unhealthy habits/behaviours.

●     Health inequalities due to SES continue into adulthood, even after adjusting for early-life health conditions.

2. Ethnicity Has a Mixed Impact on Health

● Some ethnic minority groups have better health in certain areas. For example, they are less likely to have mental health issues or cardiovascular problems.

●        However, some health disadvantages are evident, particularly:

○ Adolescent girls from ethnic minorities exercise less, which may cause health issues later on.

○ South Asian adults are more likely to have diabetes.

●     Overall, ethnicity alone is less predictive of poor health than SES, except for some specific conditions.

3. Health Inequalities in Children and Adolescents

● Mental health is generally better among ethnic minority children than among White children.

● Exercise levels are significantly lower for South Asian girls.

●     Ethnic minority adolescents are less likely to engage in behaviours such as smoking and drinking alcohol than White adolescents.

What does this mean for policy?

●     Interventions focused on SES - for example, targeting poverty and neighbourhood deprivation - could reduce health inequalities across ethnic groups.

●     Health policies should be tailored - considering specific disease risks, age and sex.

● Addressing barriers like language difficulties could help people from ethnic minority communities get better care.

Conclusion

Although ethnicity can affect health, socioeconomic disadvantage is the dominant factor driving health inequalities in the UK. Effective policies should focus on reducing SES-related inequalities while also considering targeted interventions to address health challenges faced by specific ethnic groups.