Ethnic differences in self-assessed health in Scotland : the role of socio-economic status and migrant generation

Abstract

This study investigates ethnic differences in self-assessed health in Scotland and their determinants, focusing on socio-economic status and migrant generations. We use the Scottish Health and Ethnicity Linkage Study (SHELS) and apply regression analysis to data for 4.6 million people. The analysis shows that the White British, Other White and Chinese groups reported better health than the White Scottish population, whereas Pakistani and Indian populations had worse health outcomes. For the latter two groups, this contrasts with previous findings of mortality advantage and thus highlights a morbidity-mortality paradox in these South Asian populations. Our findings imply that socio-economic deprivation, health selection and acculturation explain health inequalities for some ethnic groups, but for other groups, especially those of Pakistani origin, other mechanisms deserve further exploration.