Which Ethnic Group Have the Poorest Health
For a person to enjoy a good quality of life, remaining strong and healthy is essential. However the ability to retain good health is often affected by a range of diverse factors including ethnicity, living standards, age, occupation and access to medical facilities. The purpose of this research is to investigate whether of people of working age within the Bangladeshi Community are more prone to illness that their counterparts within the White British population.
Aims of the Study
Research Question: Does the Bangladeshi worker community experience ill health more than their White British counterparts?
In order to explore the question of whether Bangladeshi people of working age are more prone to illness when compared to their White British counterparts, I have chosen to address and collect information on the following:
- The attitudes that Bangladeshi and White British workers have towards ill health
- The knowledge and awareness that Bangladeshi workers have towards accessing NHS services
- The ways in which Bangladeshi workers can become more aware of the means of reducing ill health
- How Bangladeshi workers can be encouraged to make lifestyle changes in order to nurture their health
The Literature review I conducted has revealed evidence which suggest that Bangladeshi workers are more prone to illness than their White British counterparts. For instance- research conducted by the Joseph Rowntree Foundation in 2007, revealed a significant difference between levels of long- term illness within the White British and Bangladeshi working age communities (Salway et al, 2007). According to the research, 16% of the White British sample suffered from long term illness, compared to 64% of the Bangladeshi sample. There was also a marked difference in the age of onset, with the White British workers within the sample experiencing illness between the ages of 50 and 59, whereas the Bangladeshi sample experienced onset between 34 and 39.
The relationship between health and ethnicity has been an area of much debate and exploration amongst academics over the years, and has often been linked to the concept of, “social exclusion”, an aspect of which relates to the difficulties that some ethnic minorities have in accessing adequate housing, employment, opportunities and public services. ( Purdy and Banks, 2001). Concerns regarding the inequalities that ethnic minorities encounter when accessing welfare service systems created vital legislation in the early 1980s in the form of the “Black Report”, and addresses inequalities that continue to exist today, “The Black Report placed emphasis on material explanations for class inequalities in health, which given the class locations of ethnic minority people might also be relevant to ethnic inequalities in health.” ( Nazroo in Bury and Gabe, 2002:145). More recently, research conducted as part of the Fourth National Survey of Ethnic Minorities in 1993 suggested that some Asian groups such as Bangladeshis and Pakistanis are more at risk of experiencing acute heart disease than other ethnicities, an assertion that has been controversial amongst academics, “ While this approach was useful in uncovering the extent to which convenient assumptions of similarity within obviously heterogeneous groups were false, it could be suggested that these findings mean we can use the term, “ Pakistani and Bangladeshi” heart disease, rather than, “ South Asian” heart disease to describe the situation” ( Nazroo in Bury and Gabe, 2004: 147). These insights and others very much informed my opinion as I embarked on this research project.
Social Classification, Age, Sample Size, Location and Research Timings:
In order to explore a wide range of attitudes towards health, I recruited respondents using a random sampling approach, in order to ensure that a range of attitudes and perspectives were explored. As a result, the sample comprised a wide range of occupation and educational backgrounds and abilities, reflecting all of the categories of present social and market research social classification ( Robson, 2002 ) This form of classification consists of the following:
- AUpper Middle ClassSenior Management or Professional
- BMiddle ClassAssociate Management or Professional
- C1Lower Middle ClassClerical, admin and support staff
- C2Skilled Working ClassSkilled manual workers with a formal training or qualifications
- DUn skilled Working ClassUn skilled manual workers without formal qualifications or training
- EPeople who exist on low incomes and benefitsCan be anything from casual workers to pensioners
In order to construct a sample which reflected the categories in the above table, I recruited respondents at locations regularly frequented by people of all backgrounds, including the Croydon Whitgift Shopping Centre, Croydon High Street and the Croydon Bangladeshi Welfare Association. I recruited 40 respondents in total- which included working people within the Bangladeshi and White British populations, between the ages of 25 and 60. Both male and female respondents are included and research commenced at the beginning of March and concluded at the beginning of May.
Ethics and Data Protection
Before conducting the research, I gained the approval and permission of both the London Borough of Croydon and the University’s Ethical Review Committee. Prior to questioning the respondents, I explained to them the purpose of the research, how their opinions would inform the findings, and how the findings would be used. I also assured them that their views would remain completely confidential, and that they had the opportunity to opt out of the project at any time they wished to. The questions were also carefully constructed in a manner that would not cause distress or offence, and I made a concerted effort to make them feel comfortable and valued (Bryman, 2012).
Limitations and Researcher Bias
As with all research projects, this investigation had certain imperfections and limitations in its design and execution. Above all, the study would most likely have been very different if it had been conducted within a, “real world research” context without the researcher having to juggle the research work with other priorities such as course work. Also, as the data was collected in one area, it may be regionally biased. However, it should be pointed out that the majority of people within communities experience many similar conditions and socialising factors, which can make, “snap- shot” studies representative of the larger population valid, and on the whole and much social, commercial and market research is carried out in this manner. Another factor than can affect the reliability of data is the possibility of respondents expressing what they feel researchers want them to hear- therefore modifying or embellishing responses. Whilst this remains an issue in all research projects, it should be pointed out that the rapid answering that quantitative closed questionnaires tends to produce, will most likely make respondents answer bluntly and accurately- without the after-thoughts that inform much qualitative work (Robson, 2002).
Data Collection Methods
The project used a variety of methodologies including an initial pilot study, primary and secondary methods. Secondary and desk research, including the Literature Review was undertaken in order to create a detailed knowledge of the subject which was to be explored in the research, as well as key hypotheses to be addressed. Additionally, a pilot study was conducted prior to undertaking the fieldwork in order to test the relevance and clarity of the questions and subjects posed to respondents, as a means of making the fieldwork as effective and seamless as possible.
During the primary, fieldwork stage of research, I chose to use a mostly quantitative questionnaire with close ended questions, in order to specifically focus on the topics that needed to be explored to satisfy the research objectives. This created a situation in which respondent’s answers were consistently relevant. However in order to ensure that the respondents had the opportunity to express additional issues relating to the topics, I also included several open ended questions- inspired by a more qualitative approach.
Data Analysis Methods
Once the fieldwork had been completed I chose to use the Statistical Package for Social Sciences or SPSS as a means of analysing the data I had collected. This approach provides several benefits, including the ability to record and log data quickly and to organize it across a range of analytical formats including statistical and multivariative approaches. For presentation purposes, the results were ordered into graphs, charts and tables ( Blaxter, et al, 2011) which aimed to reduce misunderstandings and comprehension issues.
Dissemination of Findings and Results
The research findings were presented using a short reform format and have been made available to the University for future reference. During the life of the project, I also kept the sponsor up-to-date with the findings as they developed, both in the shape of preliminary insights and the conclusive more detailed final report. I have also passed the findings onto the respondents via email, and have thanked them enormously for their crucial participation in the project.
Crucially, the research revealed that minority ethnic respondents experienced aspects of social exclusion, both in terms of accessing mainstream health services and society in general. This is mainly attributed to the lack of English language skills that some of the sample had, as well as cultural issues which result in the secrecy and concealment of health issues, problems and ailments. Within the Bangladeshi sample there was also a tendency for health issues to be internalised within the social and family networks of the community itself- which also resulted in a resistance to seeking mainstream NHS support and services.
The Bangldeshi worker community have a tendency to experience the onset of serious illnesses earlier than their White British counterparts, through a range of behavioural and cultural factors that prevent them from accessing NHS service in a systematic manner that would improve their health.
Considerations for Future Research
The aim of the research was to provide information and insights relating to why Bangladeshis are prone to ill health, and how public awareness can be raised in order to address their problems. However, during the fieldwork and analysis stage, I was very surprised to the extent that people within the Bangladeshi community conceal their ill health and delay accessing help as a result of strong societal and cultural pressures. Therefore, I have emphasised the need for additional research in the final report, in order to obtain more information on this subject, as a means of devising solutions that can help eradicate such problems. Based on the research that has been conducted so far, I am confident that my data collection and data analysis approaches offer effective means of generating crucial findings- but would also recommend using different methodologies for future research such as qualitative focus groups and face to face interviews. This approach will enable the researcher to get a greater understanding of key issues, and can involve the use of enabling and projective techniques that can enable respondents to express themselves in a clearer manner. ( Robson, 2002). Focus groups and face to face interviews can also provide vital insights on behaviour and practice which is not always possible when using a quantitative approach. (Bryman, 2012). This is often expressed through the recall of certain situations and experiences- which can also serve to create a greater understanding of the contexts of certain situation- for instance, the specific ways in which Bangladeshi people interact with NHS services.
Details of Funding
The research was budgeted at ?500 and was funded by Research Councils UK ( RCUK). The organisation regularly commissions research within a range of academic disciplines including medical, biological, social, economic and environmental sciences, in order to investigate ways of increasing wellbeing within society. The research I conducted was funded with the intention of finding ways to address the impact of poor health within the Bangladeshi working age community.
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