title: 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.
  
  
  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.
authors.affiliation: Department of Psychiatry, Dartmouth Medical School, NH-Dartmouth Psychiatric Research Center, Lebanon, 03766, USA. rob.whitley@dartmouth.edu
authors.forename: Rob
authors.initials: R
authors.lastname: Whitley
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
authors.forename: Kwame
authors.initials: K
authors.lastname: McKenzie
authors.forename: Rob
authors.initials: R
authors.lastname: Stewart
mesh_terms: 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