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Black and Minority Ethnic Health Inequalities and the 'Mixed-Race' Population
Ayo Bakare
Ayo Bakare

In 2006 I carried out research focusing on the recognition of inequalities in health for Black and Minority Ethnic (BME) groups. It specifically focused on if, and how these inequalities will effect the growing mixed race population and the implications this may have on existing health policy. It also explored issues of identity as a critique on existing outdated research, in an effort to gain insight into how mixed race people feel they are perceived ('racially') by society and how they want to be perceived.

I used qualitative methods in undertaking this study. The qualitative research consisted of five semi-structured interviews which explored how a sample of mixed race people identify with their 'racial' group and how they feel they are 'racially' perceived by the NHS and if this has had any influence on their health care experience. The study allowed for depth and understanding of the issue through analysing experiences and opinions of the participants which could only be gained by the methodology which was chosen.

Findings
As the study progressed, the issue of mixed-race contemporary identity and experience of racism, acceptance, and cultural balance, became the prevalent themes and although they were not directly related to health care experience, they had a direct bearing on future policy and provision for all public sector services.

The mixed-race individuals interviewed raised various issues in regard to objective beliefs and prejudices which are often inflicted on them, as well as inappropriate categorisation or assumptions based on ignorance as to how they should be classified and where they should belong ethnically.

Treatment by the NHS
The study showed that with the exception of two occurrences, the majority of participants were happy with access and provision in the health service and didn't feel subject to worse treatment because of their ethnicity. However, all participants were aware of racism and believed that they were likely to be subject to it in other contexts.
Education

A particularly insightful finding was the amount of racism and prejudice that had been experienced by participants in all levels of education from Primary school through to University. This moulding of children's and young adults' futures based on teachers low expectations of them is an area that needs much more attention and transparency as it will have major implications for future generations.

Unpacking terminology
Implications of these findings include the government's need to 'unpack' the loaded terminology used to describe all non-white groups. BME is simply not appropriate as it serves to marginalise groups which are not yet largely politically established such as mixed race, as well as a host of other communities which are new to Britain. Much emphasis has been placed on serving certain minority communities' needs. Mixed race people however have often been considered to have the same needs as the black community. My research identified that this is not necessarily the case and there are many differences which have gone unidentified and must be met.

Policy implications
Policy implications are clear in that public sector services need to develop increased awareness of mixed race and make additions to their race relations schemes and policies which provide emphasis on the issues that have been highlighted. Moreover, as the mixed race population grows, organisations specifically designed for single parents and mixed race children which provide support on issues of culture, tradition and identity will be required. The mixed race population seem to have a valuable advantage of cross cultural awareness and the ability to cross ethnic boundaries as a result of their backgrounds and experiences and this should be supported and celebrated.

My findings provided useful insights into the identity issues that affect mixed race individuals and how these will translate into policy initiatives. However, it must be emphasised that due to the small sample, the findings cannot be generalised to represent all mixed-race individuals' opinions. In future research of this area, a larger sample across a more varied age range should be considered to increase the scope and understanding of the issues.

My research is a contribution to the growing body of contemporary literature on mixed race studies and paves the way for the development of further study into the experience of mixed race people using public services. It hoped to dismantle existing pathologies about mixed race individuals and give a platform to a politically marginal group. In undertaking the research, I hope that other mixed-race people will challenge institutions to ensure service provision is specific to their individual needs.

Recommendations
The following recommendations have emerged though undertaking this study:

Education policy

* Teachers should be made more aware of the identity issues that may face ...mixed-race children in order to resolve any issues with sensitivity and ...understanding.
* More should be done to tackle some teachers low expectations of black and ...minority ethnic groups.
* Regulate career advice to ensure people are aware of their rights and their ...ability to pursue their chosen career path.

Health Policy

* Undertake research into health issues that may be specific to mixed-race ...people.
* Implement compulsory training on the specific needs of different communities to ...ensure that individual needs are met in health care provision.
* Plan for the provision of community based services which are sensitive to ...issues around identity.
* Take steps to promote awareness and training about the issues that are likely ...to accompany being mixed-race to encourage general understanding by health ...professionals.

General

* Provide funding for projects and initiatives which will help single parents and ...mixed-race children at every stage of their development.
* Re-assess race relations policy to be more specific in regards to needs of ...different ethnic groups.
* Put employment initiatives into place which specifically target mixed race people ...to ensure that they are supported and are able to achieve promotion.
* Target the provision of vulnerable children in care.



This paper was first submitted as part of the e-conference mixedness and mixing 4-6 September 2007.

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