Bernadett Varga By: Bernadett Varga
Public Health Policy Adviser - Ethnic Minorities & Migrants
View profile and Diary

21 May 2020 : Our cultural determinants of health

"So, we have our unhealthy lifestyles, we eat unhealthy dishes, we smoke, we don’t do sport and we don’t attend screening programs either."

There are thousands of excellent public health experts on ethnic minority and migrant health, however, there is something crucial most of them lack. It is the personal experience.

Being a public health professional from an ethnic minority background I also have a skills-set that cannot be learnt at school. It is my ethnic and cultural heritage, which might not seem to be relevant first when talking about public health but in fact it is, as besides the social and environmental determinants of health these variables also influence and determine health behaviors and are responsible for health inequities.  

In order to understand the characteristics of the health attitudes of ethnic minorities, let me give you the example of the Roma through my lens. The health literacy of ethnic minority groups is low in general, which for us, the Roma means that we do not understand either the importance of health screening programs or the dangers of bad eating habits.

Most of us smoke, women, men, teenagers and when we eat the aspect of eating healthy is not a priority as opposed to the size and quality of the servings. Quality food to us is measured by the level of satisfaction and not by nutritional scores. The way we serve food is set by an unspoken obligation to be generous towards anyone and everyone, and we often feed our neighbours, too. Doing otherwise and being left without enough food would be a shame among the Roma, which I know is something others won’t necessarily understand. So, we have our unhealthy lifestyles, we eat unhealthy dishes, we smoke, we don’t do sport and we don’t attend screening programs either. In fact we visit the doctor only when it is something serious.

But then, even if we decide to visit a healthcare facility we face discrimination and institutional racism many times. Many times we are denied healthcare services or if we aren’t, we usually don’t receive the same amount of attention and care as our white fellows do due to the prejudice and racism of the health workers.

Although we tend to follow medical advice, we don’t give up on our habits and we continue our lifestyle with our very bad health attitude. As a result, we develop later to be underlying health conditions, such as diabetes, or cancer, and so this is why we die 15- 20 years younger than those of the mainstream society, and this is why we have a nearly two-fold risk of dying from Covid-19, too.

So, even if age, living conditions, and the level of deprivation were taken into consideration in this analysis, ethnic, cultural heritage and attitude that influence health behaviors were not, and although the data of this research were limited to categories other than the Roma and Travellers, them also belonging to the group concerned, this explanation might give an answer to the question as to why more people from BAME backgrounds die from the coronavirus. 


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