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


OBJECTIVE
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.
Whitley
Rob
R
Department of Psychiatry, Dartmouth Medical School, NH-Dartmouth Psychiatric Research Center, Lebanon, 03766, USA. rob.whitley@dartmouth.edu
Prince
Martin
M
McKenzie
Kwame
K
Stewart
Rob
R
D000069:Acculturation; D000328:Adult; D015331:Cohort Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007406:Interview, Psychological; D008131:London; D008297:Male; D001523:Mental Disorders / Q000208:ethnology*; D011156:Population Density; D011287:Prejudice; D012931:Social Environment; D012938:Social Perception; D012944:Social Support; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People / Q000523:psychology