Health and Ethnicity (review)

136 Review HEALTH AND ETHNICITY, edited by Helen Macbeth and Prakash Shetty. New York: Taylor and Francis, 2001.250 pp. $84.95 (hardback), $32.95 (paperback ). ISBN 0-415-24166-9 (hardback), ISBN 0-415-24167-7 (paperback). During the past 20 years, the topic of "ethnic" factors affecting the health conditions of different population groups has gained increasing attention. In multicultural societies, understanding the variations of the risk of disease among ethnic groups is necessary for effective public health policy. However, academic coverage on this important subject has been scattered in the specialist literature of multiple disciplines. Ethnicity and Health, edited by Helen Macbeth and Prakash Shetty, presents a comprehensive, interdisciplinary collection of scientific articles on the subject. The book is organized into 16 chapters written by authors from diverse academic backgrounds in the biomedical sciences as well as in the social sciences. The initial chapters address the conceptual and methodological complexities of defining ethnicity, race, socioeconomic condition, and health in relation to epidemiological indicators. The authors underscore the need to be extremely cautious in defining "ethnic" causes of health behavior and health outcomes in order to avoid bringing about discrimination by stereotyping ethnic groups. The next section of the book is dedicated to more specialized research topics on ethnicity, race, and specific health conditions and methodological approaches to investigating the genetic and social-behavioral bases of disease risk. Specific topics include human inbreeding; inherited disorders of hemoglobin ; diabetes, ancestral diets, and dairy foods; ethnic variations and cardiovascular disease; ethnicity and the risk of cancer; culture, race, and mental health; and sexual health and ethnicity, among others. The concluding chapter overviews the challenges and policy implications of ethnic diversity and health, with a focus on interventions to improve the health status of ethnic minority populations. This book joins two primary but quite different streams of scientific Uterature on the topic: studies from the biomedical sciences, on one hand, and studies from the social sciences, on the other. Of particular significance in this work is its contribution in clarifying the role that human genetic makeup and socioeconomic and behavioral characteristics play in health outcomes. Perhaps one of the most important conclusions is that, rather than interacting independently , genetic makeup and sociocultural and behavioral factors interact. The examinations of the evolutionary history of populations and its impact on biological and physiological capacities to handle disease are particularly insightful . It is worth mentioning that the book contains a rich bibliography for the reader interested in pursuing any of these topics in more depth. Journal of Health Care for the Poor and Underserved · Vol. 14, No. 1 · 2003 DOI: 10.1177/1049208902238828 Torres Zeno 137 The major limitation of this book is the inclusion of chapters with highly technical language and statistics on matters related to biomedical research and gene-related investigation. For the nonspeciaUst, this is out of reach. Even professionals in other specialties might have real problems handling these sections of the book. The chapter "'Culture' in the Field of Race and Mental Health" is awkwardly written and does not add to the value of the publication. In sum, this collection provides an accurate, interdisciplinary view of the relationships between poverty, socioeconomic conditions, ethnic characteristics , culture, health behavior, and health outcomes. Selected chapters, or the entire book as a textbook, could be used in graduate courses covering ethnicity and health. Roberto E. Torres Zeno, PhD University of Puerto Rico Graduate School of Public Health ...