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Introduction

The relationship between ethnicity and health status has been noted since quantitative health data were first recorded. In 1845 Engels recognised the poor health and mortality rates of Irish people living in England and drew attention to the poorer living conditions which they encountered. Today, Black and minority ethnic groups generally have worse health than the overall population, although some groups fare much worse than others, and patterns vary for different health conditions. This set of tables will explore these themes and investigate the extent to which the prevalence of limiting long term illness differs between ethnic groups over time, and whether these differences appear to be related to socioeconomic inequalities.

Most previous work on ethnic differences in health has been based on cross-sectional data and much of it has focussed on immigrants rather than members of minority ethnic groups including those born in the UK. This partly reflects data limitations. By contrast, the LS is noteworthy for the inclusion of large numbers in ethnic minorities who are born within the UK as well as immigrants, in addition to its ability to track individuals over time.

In 1971 and 1981 the only means of determining a respondent's ethnic group was to use the country of birth, supplemented by information on the country of birth of the LS member's parents which was gathered in 1971 only. More specific information on ethnicity was first collected in 1991 when respondents were able to self-report their ethnic identity from any of eight broad groups or, if preferred, to write in the name of their ethnic group. In 2001 the range of ethnic groups increased to 16, with respondents self-reporting more specific identities from within the broader categories of either: White, Mixed, Asian/Asian British, Black/Black British and Chinese/Other. Again there was the option for respondent to write in the name of their ethnic group. Contrary to most other data sources, the LS contains a large enough sample size to consider a range of ethnic minority groups and still have sufficient power for robust analysis.

However, how an individual reports their own ethnicity may vary according the context of the question and the options which are offered. Moreover, perception of ethnic identity may change over time following migration; second- or subsequent-generation migrants may no longer identify themselves as belonging to a minority ethnic group. Some report their ethnic identity differently from census to census, perhaps as a consequence of an increased number of categories on the form (Platt et al. 2005). Further information on using ethnicity in the LS is available in the Training module on Ethnicity.

A specific health question was first included at the 1991 Census. This asked whether a respondent experienced any long term illness which limited their daily activities. Ethnic minorities have been shown to under-report long term illness (without the 'limiting' qualification) by having a more restrictive notion than the White population of what is serious enough to class as a long standing illness (Nazroo 1997). However, validation studies from the 1991 Census suggest that limiting long term illness is a more valid reflection of health status (Thomas & Purdon 1994).

Lastly, all censuses contain a range of information on social circumstances at an individual and at a household level (more information is offered in the Training Module on Socio-Economic indicators). This includes data on individual educational attainment and social class, as well as broader markers of the standard of living such as housing tenure, car ownership, or household overcrowding. Therefore this example will use the LS to describe the relationships between ethnicity and health and explore whether socioeconomic position might explain patterns of ethnic inequalities in limiting long term illness.