Increasingly Diverse: the Changing Ethnic Profiles of Scotland and Glasgow and the Implications for Population Health

Abstract

Scotland's population has become increasingly ethnically diverse. The aim of this study was to better understand future changes to the ethnic profile of the population and the implications for population health. The literature regarding ethnicity and health, particularly in the Scottish context, was reviewed alongside analyses of past trends and new future projections (2011-2031) of the size of the non-White ethnic minority population in Scotland and Glasgow (Scotland's largest and most ethnically diverse city). The literature emphasises that the relationships between ethnicity, socioeconomic position (SEP) and health are extremely complex. In Scotland this complexity is arguably enhanced, given the different, less disadvantaged, SEP profile of many ethnic minority groups compared with those in other countries. Although indicators of overall health status have been shown to be better among many non-White ethnic minority groups compared with the White Scottish population, such analyses mask varying risks of particular diseases among different groups. This complexity extends to understanding the underlying causes of these differences, including the 'healthy migrant' effect, 'acculturation', and the impact of different types and measures of SEP. The proportion of the population belonging to a non-White ethnic group increased four-fold in both Scotland and Glasgow between 1991 and 2011. New projections suggest that by 2031, around 20% of Glasgow's total population (and 25% of children) will belong to a non-White minority group. Given this, there is a clear need for policy-makers and serviceplanners to seek to understand the implications of these changes to the Scottish population.

Geospatial mapping and data linkage uncovers variability in outcomes of foot disease according to multiple deprivation: a population cohort study of people with diabetes

“…We are unable to account for this with current geospatial mapping approaches. However, this is not straightforward because in Glasgow proportionately much higher key ethnic minority groups, including Chinese, Indian and Pakistani, live in much less socioeconomically disadvantaged circumstances [30]. previous data zone if a person moved.…”

“…However, Glasgow's unique SIMD patterning also provides an ideal test bed to assess the outcomes of foot disease in a region with high levels of deprivation, encompassing almost one-fifth of the Scottish population [19]. Ethnicity overlaps with poverty, deprivation and restricted access to healthcare [30]. Since key ethnic minority groups live in socioeconomically disadvantaged circumstances in the UK, this may have contributed to the geospatial patterns observed.…”

Does ethnic diversity explain intra-UK variation in mortality? A longitudinal cohort study

“…A recent large programme of research into ethnicity and health in Scotland27 further emphasised the importance of the choice of measure of SEP in a Scottish context 28. The same research provided evidence of varying levels of risk of particular diseases across different non-White ethnic groups: the impact of adjusting for SEP in the analyses was often minimal, but varied depending on the disease category studied 14 29…”

“…In most developed countries, ethnic inequalities in health are to a large extent an extension of socioeconomic inequalities, given the more disadvantaged socioeconomic profile of most ethnic minority groups 12 13. However, in Scotland, the socioeconomic profile of many non-White minority groups is much less disadvantaged, and quite different to that in England 14. The complexity also extends to understanding other important underlying reasons for differences in health status between ethnic groups.…”

Adult education and migration in Scotland: Policies and practices for inclusion

“…The area has historically attracted migrants from all over the world including 'from the Highlands of Scotland; from Ireland; Jewish people fleeing persecution in Eastern Europe; people from the Punjab and other parts of the Indian sub-continent; and, most recently, Roma from Slovakia, the Czech Republic, Romania and Bulgaria settling in the area' (COSLA 2015 p. 12). The population of this community rose by almost 15% between 2001 and 2010 through immigration, and has become increasingly ethnically diverse since the last Census in 2011 (Walsh, 2017). Approximately a third of this community's population is from an ethnic minority.…”