Changing patterns in marriage choice and related health risk in the Pakistani heritage community in Bradford UK: a qualitative study.

Abstract

Background Children born to blood relations (consanguineous parents), primarily cousins, have higher mortality and morbidity than children born to non-consanguineous parents. Consanguinity is low in the UK but high in some communities, including the Pakistani heritage community in Bradford. There has been a marked decrease in consanguinity in the last decade and that is likely to result in reductions in excess mortality and morbidity. Methods Drawing on patterns of child health reported by the Born in Bradford study, augmented with a summary of the literature on motivations for choosing consanguineous unions and on the shifting characteristics of those who make this choice, questions about marriage choice and knowledge of allied health risk were devised. They were explored in four focus groups with self-identified members of the Pakistani heritage community. Groups were divided by age and gender. Discussions were analysed using Thematic Analysis. Results There was agreement that rates of consanguinity were declining. Older group members were concerned this might indicate a shift away from tradition and damage community cohesion. Younger participants were positive about the benefits of a shift towards individual choice. They felt this could be achieved without damaging community strengths. Reasons for the fall in numbers were attributed to changes within the community, including higher numbers of people staying in education beyond school. External factors, including new immigration rules, were also considered. There was not a consensus about health risks, some older respondents were sceptical of links between marriage choice and child health and concerned about how health risks were communicated. All were concerned that marriage choice should not be used to demonise this community. Conclusion A commitment to sustaining community cohesion is shared by all groups. Younger people think this can be achieved despite falls in consanguinity. There are continuing challenges in communicating health risk.