Race/Ethnicity and health – Some concluding remarks Finn Diderichsen University of Copenhagen

The routine use in epidemiology: Together with social position often used as rather crude confounders, implying a lot of residual confounding and biased results on riskfactors effect. A major source of ecological bias in area based studies – unhealthy Norwegians in Oslo may live in immigrant dense areas and generate high mortality rates The very heterogenous patterns of health related selection into migration

Scientific relevance of the concept Does the etiological role of the concept actually dissolve into Nazroo’s 6 mediating factors: SES, culture, migration, genes, access to service and discrimination ? Or are the health effects of the 6 factors actually aggrevated/mediated through the existence and use of the concept ? The concept ”lives its own life” and reproduces the inequities through the belief of a common anciestry and fate

A parallel: Social position We find the concept useful even when we know that the health effect is mediated by several welldefined pathways and causes Because it reflects upstream mechanisms distributing power and wealth in society And because health differencies across social position reflects inequities But the concept of social positon may not ”live its own life”

Policy relevance of the race/ethnicity concept It represent an important category of inequity But is it a relevant category for collective action for health equity – similary to what unions have been historically ?

Policy relevance of the concept Welfare states are important contributing, but not sufficent determinant of population health Welfare states demand a shared sense of collective values and fate – is categorizations then more part of the problem or part of the solution? Welfare states demand that everybody are treated equally and with respect – we still have far to go !