Ethnicity as an epidemiological determinant—crudely racist or crucially important?

Open Access
Publisher Website
Google Scholar
Abstract
The study of disease variation between populations is a central tenet of epidemiological enquiry, which has both generated and tested aetiological hypotheses.1 Yet such inter-ethnic group comparisons have attracted considerable criticism even within the epidemiological community, due in part to suspicions of a covert racist agenda.2– 4 Recent developments in genetic research may, to some minds, have broadened the value of ethnic group comparisons, whereas to others, they are an unhappy reminder of eugenics. In addition, such research has often emphasized high rates of disease in minority ethnic groups, for example diabetes, sexually transmitted diseases and certain cancers, with implications that such disease rates (and therefore these ethnic groups) are a problem. It then follows that these differences are best addressed by the imposition of changes in practices, which may not be appropriate, and implicitly encourages assimilation of minority ethnic groups to the Western norm. This issue of the International Journal of Epidemiology is timely in its focus on the epidemiological examination of ethnicity and its association with health and disease. But before discussing the implications of this work, we should first reconsider what we mean by ethnicity.