Social determinants of ethnic minority health in Europe

Social determinants may impact ethnic minority health, but the evidence is largely from the US. Using data from ethnic minority groups in Europe, we studied this topic by looking at three specific domains: perceived ethnic discrimination (PED); social contextual factors; and national-level integration policies.
PED was associated with depression and cardiovascular risk factors, although the associations differed by ethnicity. We consistently found associations in Surinamese subgroups, while the pattern was inconsistent for Ghanaians, Turks and Moroccans.
For social contextual factors, we found that strong ethnic identity, religiosity, and large ethnic social network weakened the association of PED with depression, with the effects differing by group. Parental smoking was strongly associated with adult offspring’s smoking behaviours in all ethnic minority groups. The co-presence of Turks in the residential environment was associated with better self-rated health among Moroccans in Amsterdam (but not vice versa).
At policy-level, we found that mortality of Turks and Moroccans was higher in an exclusive country, as compared to their peers living in assimilationist and inclusive countries. The mortality gap with the host population was also largest in the exclusive country. This country categorisation was based prior analysis of integration policies. Similar findings were observed for depression, with income and discrimination largely explaining the gap with the host population.
In conclusion, this thesis shows that social determinants at various levels may play an important role in shaping ethnic minority health in Europe. Better understanding of these determinants and their impact may help develop effective social interventions.