This page forms part of the Transcultural Health resource, published in 2004, and is preserved as a historical document for reference purposes only. Some information contained within it may no longer refer to current practice. More information

Transcultural communication and health care practice: Politics of diversity

Author: Charles Husband

Introduction

About this module

  • Learning outcomes
  • Assignment
  • Module texts

Introduction / Overview

Section 1 - The nature/origins of diversity

  • Reasons for migration
  • Patterns of migration
  • Demographic impact of migration
  • The interplay between immigration and race relations

Section 2 - The creation of 'Us' and 'Them'

  • National identity
  • Race
  • Ethnicity

Section 3 - Different definitions of 'the problem'

  • 'The minority is the problem'
  • 'Cultural deficits' of minority ethnic groups are the problem
  • Personal prejudice is the problem
  • Cultural racism is the problem
  • Institutional racism is the problem

Section 4 Changing definitions and changing responses

  • The 'immigration problem' approach
  • The cultural deficits' approach
  • The personal racism approach
  • The cultural racism approach
  • The institutional racism approach

Section 5 - Differentiated citizenship and the politics of difference

  • Formal citizenship and substantive citizenship
  • Universal and differentiated citizenship
  • Differentiated rights for minority groups
  • Self government rights

Section 6 - Final Reflections

Bibliography

About this module

Learning Outcomes

When you have completed your study of this module, you should be able to:

  • critically examine the concepts of:
    • 'national identity', 'race' and ethnicity
    • personal, cultural and institutional racism
  • compare and contrast a number of different approaches to 'multiculturalism' and their impact on provision for minority ethnic groups.

You should be able to illustrate your explanations with examples from your own experience (or that of colleagues in your Health Service).

This module aims to enable you to become confident in your understanding of key concepts that are essential in the planning and delivery of health care in multi-ethnic Britain. Although the content of this module may seem somewhat distant from the immediate practice of health care delivery the topics discussed here will enable you to be clear about the fundamental issues that must be addressed in developing culturally safe transcultural health care practice.

Introduction / Overview

Ethnic diversity is a defining characteristic of contemporary societies - an indisputable truth about the 'demographics' or makeup of the population living in any one country. What is not so indisputable is the concept of multiculturalism - the complex mix of politics, attitudes and beliefs, which shape how a society understands and seeks to manage that diversity. These concerns lie at the heart of this module.

In Section 1 you'll take a look at one of the processes by which societies become multi-ethnic - the process of migration. You'll learn about some of the factors that lead people to migrate - sometimes based on factors drawing them to a new country, sometimes on factors pushing them away from their country of origin. You will be encouraged to relate the five main patterns of migration to the demographic make up of your own area - and your own family history. No doubt you will find that most family histories include experiences of emigration and immigration. The question then arises: 'If the process of migration is not alien to our personal experience, why is it so easy for current immigrants to be presented as threatening and alien?' The answer to this question is tied up with 'identity' - the key topic of Section 2.

Section 2 considers nationality, 'race' and ethnicity, providing psychological and sociological explanations of the ways in which 'other people' come to be defined - and treated - as 'different'. The subjective experience of having an ethnic or national 'identity' will be related to the social and political forces that impact upon the definition and maintenance of those identities. Recognition of the ways in which identities are constructed and maintained provides a valuable basis for understanding the invention of 'racial' identities. The dynamics of 'identity politics' become important as we see how modern states define 'the problem' of ethnic diversity - the primary topic of Section 3.

In Section 3 you will discover that the reality of ethnic diversity has been seen - by governments and policy makers - to generate a number of 'problems'. Not surprisingly, the definition of 'the problem' in ethnic relations sets the agenda for policy formulation about What Should Be Done, which is the province of Section 4.

Section 4 considers various approaches to multiculturalism, arising from the different 'definitions of the problem'. You will be encouraged to think about the model of multiculturalism that you employ, and about how that has implications for your response to multicultural initiatives and demands for ethnically sensitive practice in health care delivery.

In Section 5 you will be introduced to current debates about the ways in which states come to a political understanding of ethnic diversity. You will be encouraged to think about what citizenship means. How shall we show respect for individuals and protect collective identities. The politics of difference is very much about how groups mobilise to protect their rights, and you must consider how these concerns can be made compatible with the multicultural policies developed by the state and health care trusts.

And finally, in Section 6, you will find some 'final reflections'.

There are four main elements to the learning materials - in this and other modules of the programme:

  • The text of the module is intended to take you through the key points as clearly and concisely as possible, referring you to important texts which are listed in the bibliography, for you to follow up in accordance with your wishes/needs.
  • Throughout this module you will be referred to a recent review of multiethnic Britain which provides an expert overview of ethnic diversity and offers one perspective on how ethnic diversity should be managed. The text, The Future of Multi-Ethnic Britain (2000) (known as The Parekh Report) was commissioned by the Runnymede Trust and will provide valuable frameworks for your thinking.
  • The Runneymede Trust (2000) The Future of Multiethnic Britain, London: Profile Books.
  • Throughout the module guide you will find exercises to help you consolidate your learning. In many of these exercises, you will be given both personal reflection and group discussion tasks. For the latter, you could either work with fellow students or discuss the topics with colleagues.

Distance learning allows you the flexibility to work at your own pace and in your own style. It means you can take the route through the material that you find most helpful. Some people will prefer to read through the whole module first and then start on the exercises and further reading. Others will do the exercises as they go along. It all depends on the type of learner you are. Some like to collect the detail step by step, others like to familiarise themselves with the structure and key concepts before filling in the details.

The important thing is to be active in your learning - asking questions, completing the exercises, setting yourself goals for your further reading, working out how it applies to your own situation. The more active and reflexive your learning, the more likely it is that you will understand the key principles and be able to apply them in your work, both now and in the future.