Table 3.
Summary of final (Round 3) scores
| Consensus statements are indicated in bold font | Number of scored responses | Mean score | Number >4 | >4 of total responses (%) | |
|---|---|---|---|---|---|
| Importance and purpose | |||||
| 1 | The purpose of research on ethnicity and health should be for the well-being and betterment of populations being studied. | 30 | 4.50 | 28 | 93.3 |
| 2 | Ethnicity is significantly correlated with disadvantage and ill-health and researchers in the field of health inequalities have both a professional and ethical responsibility to incorporate evidence on ethnicity into their work and recommendations | 30 | 4.52 | 27 | 90.0 |
| 3 | Equity should be the guiding ethical principle for ethnic health research; researchers must be alert to the dangers of discriminatory thinking and behaviour and guard against actual and potential harm | 30 | 4.22 | 24 | 80.0 |
| 4 | A better understanding of similarities and differences between ethnic groups can potentially improve the health of the entire population. | 30 | 3.93 | 20 | 66.7 |
| Framing and focus of research | |||||
| 5 | There is a need to examine diversity within ethnic groups and avoid homogenization. For example, age, gender, religion, education, socio-economic position, geography or periodicity of migration will all impact on the generation of ethnic health inequalities. Investigation of ethnic health inequalities should pay due regard to the ways in which ethnicity intersects with other forms of difference in order to understand how and why it may be relevant. | 30 | 4.69 | 29 | 96.7 |
| 6 | It is important to be explicit about the assumptions and theories that underlie research on ethnic health inequalities | 30 | 4.40 | 27 | 90.0 |
| 7 | There is a need to improve the participation of minority ethnic communities in all stages of the research process. Appropriate participation should be defined by these communities then promoted by researchers and statutory agencies and resourced by funding bodies. | 30 | 4.28 | 27 | 90.0 |
| 8 | Where quantitative data are lacking, such as in the case of asylum seekers and refugees, qualitative studies are an important means of generating knowledge | 30 | 3.93 | 23 | 76.7 |
| 9 | All research involving minority ethnic communities should use (and publish) validation techniques to ensure that research tools, especially those developed as diagnostic or quality of life measures, operate similarly across participants regardless of ethnic/linguistic background. | 29 | 4.02 | 22 | 73.3 |
| 10 | Research must engage more effectively with the inter-related issues of migration, ethnicity and religion, as separate and interlinked social factors that impact on health inequalities | 29 | 4.00 | 21 | 70.0 |
| 11 | The role of racism in perpetuating ethnic health inequalities should be taken as given and more energy devoted to exploring its forms and the means by which it can be addressed. | 30 | 3.83 | 21 | 70.0 |
| 12 | There is a need to establish the cost-effectiveness of interventions while not neglecting other principles of ethnic health research. | 29 | 3.88 | 20 | 66.7 |
| 13 | Single-discipline and inter-disciplinary research along with overarching reviews of evidence are needed to improve the evidence base for reducing ethnic health inequalities. | 30 | 3.83 | 19 | 63.3 |
| 14 | Researcher-led models for developing research should be integrated with those led by service users | 29 | 3.86 | 18 | 60.0 |
| 15 | Methodologies for ethnic health research will vary across disciplines and inter-disciplinary approaches should be flexible enough to recognize differences | 29 | 3.43 | 16 | 53.3 |
| Data collection | |||||
| 16 | The use of ethnic categories and labels should be meaningful in relation to the particular experiences and outcomes being explored | 30 | 4.38 | 26 | 86.7 |
| 17 | Census categories are useful for exposing disadvantage but additional measures may be needed to explore the processes through which disadvantage is created | 30 | 4.23 | 24 | 80 |
| 18 | Ethnic monitoring records should wherever possible include use of self-assigned Census categories. This would enable researchers to draw on data that is consistent at a national level. | 30 | 3.95 | 22 | 73.3 |
| 19 | Where possible, researchers should draw on terms and categories that are understood and agreed within the existing literature on ethnicity and health | 29 | 3.91 | 21 | 70.0 |
| 20 | Research samples should be appropriate for the aim of the research: | 29 | 3.97 | 20 | 66.7 |
| • Representative samples of diverse ethnic groups should be used where the aim of the research is to produce representative research findings | |||||
| • Exclusive samples that do not include all ethnic groups should only be used when either there are good grounds for supposing (i) that there is no ethnic variation in the outcome being explored or (ii) there is a need to extend existing research to include under-researched groups within the sample | |||||
| • In quantitative studies representative samples of diverse ethnic groups should not be used for comparative analyses unless the sample sizes meet a minimum threshold | |||||
| 21 | It is important to balance the potential benefits of including ethnicity in research design (i.e. to expose, explore and reduce ethnic disadvantage) alongside the potential negative impact (e.g. in stereotyping and stigmatizing ethnic groups) | 30 | 3.90 | 19 | 63.3 |
| 22 | Data that would be useful for research include: place of birth; parent's place of birth; national identity; language/need for interpreter; religious affiliation/practice; and experience of discrimination | 29 | 3.71 | 18 | 60.0 |
| 23 | Researchers should explore the processes through which ethnic identification occurs and the acceptability of collecting a wider range of ethnicity-related markers and characteristics (including religious affiliation, national identity, language and observer-ascribed ethnicity) | 30 | 3.43 | 16 | 53.3 |
| 24 | New categories for exploring the causes of disadvantage and ways to address these should be developed with the input of minority ethnic communities | 29 | 3.59 | 15 | 50.0 |
| 25 | The concept of ethnicity is dynamic and self-assignment to ethnic groups can vary depending on situation and context. Measures such as family ethnic origins and ancestry have a weak evidence base but may be useful where stability/reproducibility of data is an important issue. | 29 | 3.09 | 10 | 33.3 |
| Data analysis | |||||
| 26 | Analysis of health inequalities should pay attention to the social context in which ethnic differences in health outcomes are measured and health behaviours occur. | 30 | 4.50 | 27 | 90.0 |
| 27 | Research on ethnicity and health should always make clear how the relationship between ethnicity and health outcomes is being framed, for example, is a causal relationship suggested and if so, is the cause linked to behaviour or genetics? | 30 | 4.05 | 23 | 76.7 |
| 28 | Researchers should seek to determine the impact of racial discrimination on the health of people from minority ethnic groups. This is potentially very important in understanding the relationships between ethnicity and health. | 30 | 3.72 | 17 | 56.7 |
| Future directions | |||||
| 29 | There is a need to focus on intervention studies that help identify effective ways of reducing inequalities. | 30 | 4.38 | 25 | 83.3 |
| 30 | More research is needed on appropriate models for involving minority ethnic communities in research For example, models for community capacity building, empowerment, representativeness and continuity of engagement | 28 | 4.25 | 25 | 83.3 |
| 31 | The research community for ethnicity and health needs to target a diverse community of practice and establish the next generation of researchers in this field | 30 | 4.13 | 23 | 76.7 |
| 32 | International collaborations exploring the feasibility of ethnic monitoring/data collection (and collection on some of the other equality dimensions protected by law in the UK) are helpful for the development of research on ethnic health inequalities and for comparative studies. | 30 | 3.90 | 20 | 66.7 |