Generational health improvement or decline? Exploring generational differences of British ethnic minorities in six physical health outcomes.

Objectives: To explore ethnic and generational differences in six physical health outcomes and whether these differences can be explained by health-related behaviors and socio-economic status. Design: Multivariate analyses using nationally representative data in 2010-2011 on self-assessed general health, activity-limiting illness, doctor-diagnosed diabetes, doctor-diagnosed high blood pressure, doctor-diagnosed asthma and body mass index from 21,651 White British, 997 Pakistanis, 695 Bangladeshis, 1,126 Indians, 573 Black Caribbeans and 873 Black Africans, adjusted for age, gender, health-related behaviors and socio-economic status. Results: While ethnicity is of great importance in patterning health differences, we find that ethnic differences in activity-limiting illness, diabetes, asthma and body mass index vary across generations. Health-related behaviors and socio-economic status are shown to partly explain ethnic and generational differences in some health outcomes. Conclusions: This study enables a better understanding of more nuanced patterns of ethnic and generational differences in health, highlighting the need to understand ethnicity as a fluid and changing characteristic, and the importance of socio-economic status and health-related behaviors in shaping ethnic differences in certain health outcomes.