Research into practice: understanding ethnic differences in healthcare usage and outcomes in general practice.

INTRODUCTION Why is recording ethnicity important? The Race Relations Act of 1968 required all public bodies to consider the race equality implications in all policies. Since then, the official collection of ethnic group statistics has been mandated as an essential first step towards identifying and addressing ethnic inequalities. Capturing ethnic group information in routine health records is recognised in the UK as a necessary prerequisite to addressing need and inequalities in health service usage and health-related outcomes. As recommended by the Commission for Racial Equality, ethnic identity must be chosen by the individual. As such, ethnicity refers to the individual’s self-perception, rather than how he or she appears to others, and recognises that an individual’s selfconceptualisation may change over time. The concept of ethnicity draws on a range of socially constructed characteristics, hence the meaning and interpretation of ethnic differences is entirely context dependent. Despite this temporal instability, ethnicity is currently the best marker we have for defining population subgroups that may have differing needs. This is because it can serve as a surrogate for shared exposures or risks for people with similar social, biological, and cultural characteristics. This article describes how the Clinical Effectiveness Group at Queen Mary University London has, over the past 20 years, worked alongside the east London primary care community to identify and describe ethnic differences in the local population, and their impact on disease management in primary care.