Ethnic minorities: introduction

Ethnicity refers to a common group identity based on language, culture, religion or other social characteristics. This means that people define their own ethnicity, that everyone (and not just those in minorities) has ethnicity and that a person's ethnic identity may change over time. More information on defining ethnicity and race is available.

In the 2001 Census minority ethnic groups accounted for 9.1% of the population of England (source: Office for National Statistics, 2001 Census(21Kb)) but only 2.01% (89,000) of the Scottish population (source: GROS Census 2001 - reference volume, see Table Standard 201). In Scotland the largest minority ethnic groups are of Pakistani and of white Irish origin, but there may be local concentrations of specific groups such as asylum seekers or migrant workers. More details on the ethnic composition of the Scottish population are available.

Country of birth has been used as a guide to ethnic group, though it gives only an approximate indication. For example, Gill et al analysed mortality by country of birth in England and Wales around the 1991 Census and found that men and women born in Pakistan had lower overall mortality than the general population. The most common cause of death among those born in Pakistan was circulatory disease, and compared to the general population, people born in Pakistan had substantially raised risk of both ischaemic heart disease and stroke (see Table 1). Death rates from diabetes were also substantially increased in men and women. People born in Pakistan had a much lower risk of lung and colon cancer than the general population, but despite this, cancer was the second most common cause of death overall. The death rates for tuberculosis were much higher than the general population, but average number of deaths was much smaller than other causes. These figures emphasise that minority ethnic groups should not be assumed to have worse health across the board. They also emphasise that, in general, the health needs of ethnic minorities should be assessed using absolute measures, such as numbers of deaths rather than relative ones, such as Standardised Mortality Ratio (SMR).

Table 1: Average number of deaths per year and Standardised Mortality Ratio (SMR), including 95% confidence interval, for Pakistan-born residents of England and Wales, 1989-92

	Men		Women
	Deaths	SMR	Deaths	SMR
Ischaemic heart disease	229	148 (135,158)	38	111 (93,130)
Stroke	42	149 (127,174)	24	159 (129,194)
Diabetes	23	418 (336,514)	12	425 (313,563)
Tuberculosis	3	466 (248,796)	6	2219 (1407,3329)

Source: Gill PS, Kai J, Bhopal RS, Wild SH. Health care needs assessment: black and minority ethnic groups (book chapter, in press). Oxford, Radcliffe Medical Press.

Similar, but unpublished, analyses have been carried out for mortality by country of birth in Scotland. In the absence of specific Scottish data, mortality estimates from England and Wales have been used as an approximate guide to likely causes and patterns of mortality in Scotland.