In the previous chapter, a number of differences in healthcare outcomes by ethnicity were examined and attention was drawn to some of the existing ethnic health inequalities in the UK and why they occur. However, it has been widely acknowledged in both health research and applied healthcare practice that ethnic health data is hampered by poor quality data. Thus, it is argued in this chapter that improvements need to be made to improve the visibility of ethnic minority groups in research and public health reports and in the methods utilised to research them (Bhopal, 1997, 2007). It is argued that by improving the equality and cultural competency practices of health researchers, we can improve visibility of diverse BME groups in health research data and practice.

As discussed in Chapter 1, there are common issues that occur in the recording of ethnic health data due to misunderstanding of the meaning of ethnicity and/or race (Williams, 1994; Mollersen and Holte, 2009), there are variations and inaccuracies in the recording of ethnicity (Aspinall, 2003, 2011, Comstock et al, 2004; Saunders et al, 2013) and there is a failure to record ethnicity (Public Health England, 2020a, 2020b, 2020c). This is actually complicated further by limited understanding of appropriate equality and cultural competency practices that are required to improve visibility of ethnic minority groups in research and health monitoring (Benoit et al, 2005; Mateos et al, 2009). But what are the implication of this for understanding of ethnic health inequalities and the drivers – and what more can we do to address these issues?

Problems with existing data: misunderstanding the meaning of ethnicity and race and the distinction between these concepts

As discussed in Chapter 1, the concepts of ethnicity and race are contentious terms that are often misunderstood and used interchangeably in health research and applied practice (Craig et al, 2012). The more common general conceptions recognise that ethnicity refers to one's cultural and social identity and difference, and race is a biological referent that refers to one's skin colour (Malik, 1996; Mason, 2000; Mulholland and Dyson, 2001; Johnson et al, 2019).

Despite these general conceptions, race classifications are combined with ethnic identity in health research and practice to label various ethnic minority groups (Bhopal and Donaldson, 1998; Comstock and Castillo, 2004; Bhopal, 2007, 2013).