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Ethnic inequalities in health: should we talk about implicit white supremacism?
  1. John Launer
  1. Postgraduate Medical Journal, London WC1H 9JP, UK
  1. Correspondence to Dr John Launer, Postgraduate Medical Journal, London WC1H 9JP, UK; johnlauner{at}

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If you live in the United States or the United Kingdom and have black or brown skin, your health is likely to be poorer on average than if you have white skin. You are also likely to receive healthcare of a lower standard. The statistics are dismal.1 Between 1991 and 2011, for example, Pakistani and Bangladeshi women in the UK had mortality rates 10% higher than white women. Long-term illness in men over 65 was reported by 69% of Pakistani men and 64% of Bangladeshi men, compared with 50% of white men. Women of the same ethnic groups reported even higher rates of long-term illness compared with white women. Black Caribbean men also had higher rates of long-term illness than white men. Similarly, a report from Public Health England in 2017 showed that children in black ethnic groups have higher than average levels of infant mortality. The black Caribbean group also had significantly worse levels of low birth weight and readiness for school.2

There are of course some variations and exceptions within ethnic disparities. People from certain minorities may do better than others in different respects, while specific individuals may manage to buck the trend. Some of the evidence is also complicated by the effects of social and educational deprivation, as well as poverty, which all intersect with ethnicity as determinants of health inequality, and spread beyond these groups. Having said that, ethnicity generally acts as an independent variable, augmenting other disadvantages. Racism and racial prejudice appear to be contributing factors here.3 These operate …

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