Abstract

Scotland’s population has become increasingly ethnically diverse. The aim of this study was to better understand future changes to the ethnic profile of the population and the implications for population health. The literature regarding ethnicity and health, particularly in the Scottish context, was reviewed alongside analyses of past trends and new future projections (2011–2031) of the size of the non-White ethnic minority population in Scotland and Glasgow (Scotland’s largest and most ethnically diverse city). The literature emphasises that the relationships between ethnicity, socioeconomic position (SEP) and health are extremely complex. In Scotland this complexity is arguably enhanced, given the different, less disadvantaged, SEP profile of many ethnic minority groups compared with those in other countries. Although indicators of overall health status have been shown to be better among many non-White ethnic minority groups compared with the White Scottish population, such analyses mask varying risks of particular diseases among different groups. This complexity extends to understanding the underlying causes of these differences, including the ‘healthy migrant’ effect, ‘acculturation’, and the impact of different types and measures of SEP. The proportion of the population belonging to a non-White ethnic group increased four-fold in both Scotland and Glasgow between 1991 and 2011. New projections suggest that by 2031, around 20% of Glasgow’s total population (and 25% of children) will belong to a non-White minority group. Given this, there is a clear need for policy-makers and service-planners to seek to understand the implications of these changes to the Scottish population.

Highlights

  • Different ethnic population groups can often experience very different health outcomes, representing stark inequalities

  • The concept of ethnicity is one that is contested, and which encompasses a broad range of factors including race, culture and context-specific factors such as discrimination and stigma against minority populations

  • For alcoholic liver disease (ALD) and the broader category of alcohol-related diseases (ARD), Indian men were observed to be at considerably greater risk than White Scots

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Summary

Introduction

Different ethnic population groups can often experience very different health outcomes, representing stark inequalities. The evidence for, and implications of, this are important to understand for the formulation of public health policy in all societies with ethnically diverse populations, and/or where the ethnic composition of the population is changing rapidly. Across the country as a whole, but in its largest city, Glasgow, there have been notable increases in the number of people identifying as belonging to an ethnic minority in recent years. The overall aim of this work, was to gain a better understanding of the changing ethnic profiles of Scotland and Glasgow, and their related population health implications. What is known about the links between ethnicity and health (including their interactions with socioeconomic position, a key health determinant) (a) in high income countries; (b) in Scotland in particular? The specific research questions were: 1. What is known about the links between ethnicity and health (including their interactions with socioeconomic position, a key health determinant) (a) in high income countries; (b) in Scotland in particular?

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