Contributions and challenges of cross-national comparative research in migration, ethnicity and health: insights from a preliminary study of maternal health in Germany, Canada and the UK

Abstract

BackgroundPublic health researchers are increasingly encouraged to establish international collaborations and to undertake cross-national comparative studies. To-date relatively few such studies have addressed migration, ethnicity and health, but their number is growing. While it is clear that divergent approaches to such comparative research are emerging, public health researchers have not so far given considered attention to the opportunities and challenges presented by such work. This paper contributes to this debate by drawing on the experience of a recent study focused on maternal health in Canada, Germany and the UK.DiscussionThe paper highlights various ways in which cross-national comparative research can potentially enhance the rigour and utility of research into migration, ethnicity and health, including by: forcing researchers to engage in both ideological and methodological critical reflexivity; raising awareness of the socially and historically embedded nature of concepts, methods and generated 'knowledge'; increasing appreciation of the need to situate analyses of health within the wider socio-political setting; helping researchers (and research users) to see familiar issues from new perspectives and find innovative solutions; encouraging researchers to move beyond fixed 'groups' and 'categories' to look at processes of identification, inclusion and exclusion; promoting a multi-level analysis of local, national and global influences on migrant/minority health; and enabling conceptual and methodological development through the exchange of ideas and experience between diverse research teams. At the same time, the paper alerts researchers to potential downsides, including: significant challenges to developing conceptual frameworks that are meaningful across contexts; a tendency to reify concepts and essentialise migrant/minority 'groups' in an effort to harmonize across countries; a danger that analyses are superficial, being restricted to independent country descriptions rather than generating integrated insights; difficulties of balancing the need for meaningful findings at country level and more holistic products; and increased logistical complexity and costs.SummaryIn view of these pros and cons, the paper encourages researchers to reflect more on the rationale for, feasibility and likely contribution of proposed cross-national comparative research that engages with migration, ethnicity and health and suggests some principles that could support such reflection.

Targeting the Use of Reminders and Notifications for Uptake by Populations (TURNUP): a systematic review and evidence synthesis

“…180 It is not, therefore, surprising to find that our review yielded rather inconsistent evidence on the association between (minority) ethnicity and attendance behaviour. Furthermore, compared with measures of deprivation, race/ethnicity appears to have been less often considered in attendance research, particularly outside the USA.…”

Immigrant women's experience of maternity services in Canada: A meta-ethnography

“…Immigrant women having recently arrived in their host country and with poor social networks, limited language proficiency and lack of knowledge about accessing or inability to legitimately access medical or obstetric care are at the greatest risk for receiving poor maternity care (Sanmartin and Ross, 2006;Sword et al, 2006a;Hayes et al, 2011). A previous report has indicated that potential barriers for receiving effective Contents lists available at ScienceDirect journal homepage: www.elsevier.com/midw Midwifery health care in the United Kingdom (UK), Canada and Germany may include cultural misunderstandings, communication problems and racism (Salway et al, 2011). Other international studies include those in the United Kingdom (UK) looking at variables related to maternal morbidity and mortality (Ameh and Van den Broek, 2008;Knight et al, 2009) which found that black and ethnic minority women who do not access or receive optimal care can have higher risk of morbidity and death, partly due to factors related to care during pregnancy, labour, and birth.…”

National Human Research Ethics: A Preliminary Comparative Case Study of Germany, Great Britain, Romania, and Sweden

“…Researchers in continental Europe are more wary of collecting data on participants' ethnicity and tend to categorize ethnicity by the country of origin of, and/or the language spoken by, participants and/ or their parents (Verkuyten, 2009). Ethnicity can be an important variable in terms of vulnerability, but these definitional inconsistencies raise issues over the validity of given categorizations and intercountry comparisons (Salway et al, 2011).…”