Smith, N.R.; (2010) Intergenerational continuities in ethnic inequalities in health in the UK. Doctoral thesis , UCL (University College London).

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Abstract

Previous research strongly suggests that ethnic minorities are more likely to suffer a poorer health profile compared to the overall population. Trends have emerged to suggest that social factors such as socioeconomic status and health behaviours are not fixed across generations and have a role to play in these inequalities in health. This thesis investigated the differences in ethnic inequalities in health between the first and second generations, and determined the extent to which intergenerational changes in socioeconomic status and health behavioural factors might explain any variation that exists. The study used ethnically‐boosted data from the third sweep of the Millennium Cohort Study (n=14,860) and the combined 1999 and 2004 Health Survey for England (n=28,628). Crosssectional analysis investigated generational differences in self rated general health, limiting illness, obesity, hypertension, depression, psychological distress and a range of biomarkers of cardiovascular disease, across the major ethnic minority groups in the UK (Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, Irish, Chinese and Other). Children were additionally assessed for levels of cognitive development using the British Abilities Scales II. The generational change in socioeconomic circumstances (social class, highest educational qualification and household income) and the extent of acculturation (current smoking and drinking status, dietary behaviours and patterns of breastfeeding, immunisations and physical exercise) was examined. Strong upward intergenerational socioeconomic mobility in ethnic minority groups did not lead to improving health profiles. The second generation required greater levels of social advantage than the first generation to achieve the same level of health. Acculturative shifts led to a worsening in health behaviours, although the degree of change was highly ethnic group specific. Findings showed that the social and economic contexts, and the cultural identities and behaviours of ethnic minorities, differ across generations, but ultimately their opposing influences on health result in stable overall patterns of health inequality across generations.

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