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CHAPTER 1
WHAT IS ‘ETHNICITY, RACE AND CULTURE’?
Language conveys many things; some intended and others not. An attempt to achieve precision in the use of terms specific to any area of study can be viewed as pedantic or futile. Terminology develops as a means to establish a shared understanding but people intend or hear different meanings. This chapter sets out definitions of ethnicity, race and culture (ERC). The aim is to establish a common understanding between author and reader about the intended meanings for terms used in this book.
A lack of precision in understanding terms and concepts leads to confusion and poorer response to need. For example, a focus on culture in a context where race (and racism) is the issue, fails to address the real problem appropriately.
Definitions
Fernando (1991) provides a succinct description of the difference between ethnicity race and culture. His helpful chart is reproduced in Table 1.1:
Table 1.1 Race, ethnicity and culture |
| Characterised by | Determined by | Perceived as |
Race | Physical appearance | Genetic ancestry | Permanent (genetic / biological) |
Culture | Behaviour Attitudes | Upbringing Choice | Changeable (assimilation, acculturation) |
Ethnicity | Sense of belonging Group identity | Social pressures Psychological need | Partially changeable |
(Fernando 1991, p.11) |
Cashmore and Troyna (1990) provide a useful glossary including definitions of less frequently used terms such as colonialism and social Darwinism. Many contemporary writers in the field of mental health provide helpful insights into the distinction between terms (e.g. Bhugra and Bhui 2002; Moodley and Palmer 2006).
Race
Race is the most fundamental of the terms to be considered because of the historical backdrop of systematic forms of racial oppression, for example slavery. Race was considered to be fixed through biology, however as science progressed it has become clear that the old assumptions about race were inaccurate. Arguments have been made since the early 20th century that the biological basis for the division of humans into races is flawed (Banton 1967). Rack (1982) sets out persuasive arguments for dismantling the concept that races are well-defined groups of people who are biologically and genetically alike. The genetic differences within so-called racial groups are sometimes greater than those between people of different races. There is no complete set of genetic characteristics that defines a race (Senior and Bhopal 1994). Therefore the use of race as a reliable biogenetic divide is flawed. Race cannot reliably be used to provide a genetic explanation for trends and patterns (Bhopal 1997). The main benefits of applying the concept of race are social (Banton 1967).
The distinction being made here is that science is based on the pursuit of reliability and certainty. The genetic concept of race cannot provide this; in the social world, however, interactions between people based on assumptions about race serve the purpose of stratifying global and national populations (Altman 2006; Banton 1965). It serves societies well to continue to promote the concept of race and to accentuate difference as it creates a social order.
Many social and economic concerns about disparities associated with race could potentially be tackled by considering class as the salient characteristic (Alexander 1987). This would perhaps be more honest as it would apply social analysis to social ills as opposed to the use of a term that implies a scientific coherence where there is none. People are attacked and killed because of their perceived race so though class does provide a paradigm it does not hold all the answers.
This discussion is clearly not a theoretical argument about whether or not race exists. It is absolutely apparent in injustices of everyday life and in the more extreme cases of murder, that race does exist. It is important, however, that people in mental health services understand that the patterns and trends that seem to relate to race are at best seen as a negative consequence of how people are initially perceived. Searches for biological explanations have failed (McKenzie and Chakroborty 2003). Of the three terms being explored here (ERC), race is the one that is considered to be within the person and fixed (see Table 1.1). In practice it is utilised as a signifier for ethnicity and/or culture and, erroneously, for class (Williams 1997).
BOX 1.1 ILLUSTRATION
A black man in his mid-twenties is being assessed. He appears to be black African or African Caribbean. His ancestry is in fact part South American and part Caribbean. He was brought up in an upper-middle-class environment in Ecuador, has a university degree and has a strong South American identity. When assessed in the English mental health services for the first time the social worker considers race as part of the process. The physical appearance of this man, i.e. that he is black, offers no reliable or useful information other than the knowledge that he is probably perceived as having particular experiences and attributes because he looks black. It is the relationship between his blackness and society that creates meaning. His ethnic identity will in its own right bring richer information, which will include his ‘race’ as well as culture, geographical heritage, language and religion.
Race is important because it affects how people are perceived, including the ascribing of a range of stereotypes. The ascribing stereotypes based on race is not something that is only done by white people. People within minority groups often hold negative stereotypes about their own ethnic group and will have a split created within themselves where they seek to have a positive sense of self whilst seeing their ethnicity as representative of negative attributes. Fanon (1967) describes very well the internalisation of the negative stereotypes. People of different backgrounds will perceive race as having some meaning because in essence race is shorthand, a cipher, for other assumptions ascribed through national and global socialisation processes.
Racism, that is discrimination on the basis of race (rather than ethnicity or culture), is an emotive subject as was evident around the launch of the government’s response to the Blofeld report of the investigation into the care and treatment of David ‘Rocky’ Bennett (NSCSTHA 2003).Govern- ment ministers were asked by the inquiry panel and some leaders in the field of race and mental health to accept the finding of the panel that the National Health Service (NHS) was institutionally racist. This position was never adopted by the government though senior officials in the Department of Health had said, in response to the inquiry panel’s questioning, that the NHS was institutionally racist. Ministers stated that discrimination was present in the NHS but refused to use the term ‘institutionally racist’ (Guardian 2005). This illustration highlights the sensitivity around race being the focus of discrimination.
Government audits and research findings highlight that the poorest experiences and outcomes of black and minority ethnic (BME) groups in mental health services relate to people from African and African Caribbean backgrounds (the African Diaspora) (Commission for Healthcare Audit and Inspection 2007a). This broad sweep of people with heritages in the second largest continent and a raft of islands are united singularly in the fact that they are perceived as belonging to the same race (rather than ethnic or cultural group). It stands to reason that if it can be accepted that discrimination occurs (which the government did) and that this consistently has a particular impact on people who are considered as belonging to a single race, the specific type of discrimination is racial discrimination.
The reluctance to accept a charge of racism may reflect a decoupling of closely related concepts. Bhugra and Bhui (2002) point out that racism, as opposed to racial discrimination, is more rooted in the ideological belief in the inferiority of races. Though racial discrimination may not be driven by individuals who consciously hold these beliefs, institutional racism is the consequence of the individual’s unwitting acts (see Figure 1.1 later in this chapter).
Mixed heritage
Each decade sees a massive upturn in international travel, interracial relationships and the erosion of the notion of three distinct races, however, Post-Darwinian classifications of the races into black, Asian and white have remained current (Cashmore and Troyna 1990). Banton (1967) conducted a study of the history of racial categorisations of humans, beginning with the work of Aristotle. His conclusions were that a primary function of race is to create social stratification manifested as racism, with the power of white people over all others creating the clearest divide. In an echo of his study Okitikpi (2005a) argues that racially the world is considered to be binary; people are either white or they are not! In Western societies and in urban areas in particular, however, there are many variations to perceived races and ethnicities. This means that old classifications are too narrow to capture the true heritage of people in mental health services (Hall 1996).
In mental health provision a failure to acknowledge the unique experiences of people from mixed heritage weakens assessments and limits the analysis of problems. The need to consider mixed heritage in its own right is discussed in Chapter 6. In the illustration in Box 1.1 the man considered to be black was in fact of mixed heritage. Based on physical characteristics alone assumptions can easily be made and attributes ascribed erroneously.
In summary, the physical characteristics of race tell us little more than the fact that someone is likely to have experienced discrimination on the basis of this attribute.
Ethnicity
Ethnicity encapsulates a range of factors used to identify individuals and may relate to language, geographical origin, skin colour, religion and cultural practices. As such, ethnicity is not a fixed or easily definable concept. Stuart Hall (1996) argues that in multicultural Britain new ethnicities are being developed. Ethnicity therefore can be fluid and is based largely on self-definition. As such, the term is not easily subjected to inflexible definitions (Senior and Bhopal 1994). For a practitioner, the ethnicity of service users is a gateway to issues that they consider ...
