Comparing policies to tackle ethnic inequalities in health: Belgium 1 Scotland 4
The European Journal of Public Health Advance Access
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Date
05/2010Author
Lorant, Vincent
Bhopal, Raj
Metadata
Abstract
Ethnic-minority health is a public health priority in Europe. This study compares strategies
for tackling ethnic inequalities in health from two countries, Scotland and Belgium. Methods: We
compared the countries using the Whitehead framework. Official policy documents were retrieved
and reviewed and two databases related to immigrant health policies were also used. Ethnic inequalities
in health were compared using the UK and Belgian Censuses of 2001. We analysed the recognition of
the problem, the policies and the services and described ethnic health inequalities. Results: Scotland has
recognized the problem of ethnic inequalities in health, thanks to better data and the Scottish
Government has come up with a bold strategy. Belgium is a later starter, unable to properly monitor
ethnic inequalities. In addition, there is no clear government commitment to tackling either health
inequalities or ethnic inequalities in health. Both countries provide health-care services to ethnic
minority groups through the mainstream services, although ethnic minority groups have more choice
in Belgium than in Scotland. Overall, ethnic heath inequalities are lower in Scotland than in Belgium.
Conclusion: Scotland has provided a more advanced and comprehensive response to tackling ethnic
inequalities in health than Belgium. It has acknowledged that discrimination exists and that ethnic
minority groups may have different needs. Belgium still assumes non-discrimination in health care
and effectively denies the need for policy to tailor services to meet these needs. In Scotland, public
organizations have been made accountable for promoting equality in health. This is an important
contribution to European health policy.