Exploring the ethnic density effect: a qualitative study of a London electoral ward.

ABSTRACT

BACKGROUND: The ethnic density effect describes a phenomenon whereby adverse mental health outcomes among individuals from ethnic minorities are greater in neighbourhoods where they comprise a smaller proportion of the population. Most previous studies of the ethnic density effect have been quantitative in design, and thus have only been able to speculate on some of the underlying mechanisms explaining this phenomenon. AIMS: This paper attempts to remedy this deficit, using in-depth qualitative methodology to explore mechanisms underlying the ethnic density effect. METHODS: We chose an inner-London electoral ward, Gospel Oak, with a relatively low proportion of ethnic minorities, as a case study. Thirty-two residents, eight of whom were from minority ethnic groups, participated in either focus groups or in-depth interviews. We also conducted participant observation and collected relevant quantitative data. RESULTS: We found four principal overlapping mechanisms that may help to explain why minorities living in predominantly white electoral wards may have greater risk of adverse mental health outcomes. These were perceived exclusion from local networks, a need to rely on geographically dispersed culturally specific services and facilities, perceived risk of physical and psychological intimidation and damaging effects of everyday racism. CONCLUSIONS: These mechanisms are presented as a framework, grounded in a qualitative case study, which can be applied in future study. They may help to explain the causes behind the ethnic density effect on mental health although further research in other settings is necessary in order to test the framework's external validity.