Learning to live with complexity: Ethnicity, socioeconomic position, and health in Britain and the United States

The relation between ethnicity, socioeconomic position, and health is compl ex, has changed over time, and differs between countries. In the United Sta tes there is a long tradition of treating ethnic group membership simply as a socioeconomic measure, and differentials in health status between Africa n Americans and groups of European origin have been considered purely socio economic. A contrary position sees the differences as either "cultural" or due to inherent "racial' differences. Although conventional socioeconomic indicators statistically explain much o f the health difference between African Americans and Americans of European origin they do not tell the full story. Incommensurate measures of socioec onomic position across ethnic groups clearly contribute to this difference. Additional factors, such as the extent of racism, are also likely to be im portant. The interaction of ethnicity, social position, and health in Britain is sim ilarly complex. Studies that inadequately account for socioeconomic circums tances when examining ethnic-group differences in health can reify ethnicit y (and its supposed correlates), however, the reductionist attribution of a ll ethnic differences in health to socioeconomic factors is untenable. The only productive way forward is through studies that recognize the contingen cy of the relations between socioeconomic position, ethnicity, and particul ar health outcomes.