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Recognising structural inequalities for Muslim families and communities

Dr Sufyan Dogra explains the importance of recognising diversity and contextual factors when designing health interventions and promotion.
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Can you say a little bit about Muslims, families and communities being pathologised? What does that mean? And how can people avoid doing that? So, for example, any ill health indicator and I mean in a privileged country like Britain, there is a fashion. And the fashion is that we say oh things are wrong in that neighborhood, or in that community, or in that particular religious group because of their family or culture, or religion, or the way of life or that term lifestyle. So they say it’s the lifestyle that’s causing this and this and this health related problems in the lives of families and children and everybody.
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And this is what I will call pathologising the whole community for living with health inequalities that are a direct consequence of structural inequalities, environmental Factors. And, you know, the whole process of because we are talking about most of ethnic minorities happen to have this history of migration. So migrant communities experiencing acculturation by adjusting the second and third generation, adjusting to new circumstances. Their food habits are changing. Their housing is a big challenge. Employment, if you look where they are and what most of the jobs they do. So if you look at these structural and environmental factors, they are directly impacting on health and well-being of these communities.
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Now, what happens is that we say when we see the data and data tells us oh, you know, look at Afro-Caribbean community and their children have highest number of obesity or overweight. And the same goes for Pakistani and Bangladeshi children. Well, then we say oh because they eat this and they don’t exercise. And, you know, and this is kind of we blame them for living with these structural inequalities. And then our scientific knowledge that we produce as a solution actually become a kind of pathologising the whole community. And then through that language, when we pathologize community, we say the problem lies with your family or with your community or with your culture or with your religion.
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And then actually, we close that door of communication by telling people that they are not good enough to sort out their problem. If you ask people who happen to be from a working class background, all they want is a good life for them, for their children to grow, have upward social mobility, enjoy the benefits and the kind of opportunities that this amazing country provides to everybody. But somehow they are deprived of that and then comes the experts and commentators and media and scientists and researchers and then say, all this is because of the family, culture and religion. Now, I am not here giving a clean chit to the ill practices within those families and culture.
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I mean some of them have been kind of victim of horrific abuse and violence and other kind of errors which we can find in every human society, within every social class. But to determine the whole idea of living with health inequalities, ill health indicators or mental health issues and to say oh this is because of the family, culture and religion, now that is not fair and that is pathologising the whole community. And looking at them the way that often when planners and designers, when they start to plan something new, some new intervention, and then the first thing that they think of, oh, look at the barriers. And these are the barriers in that community, in that culture, in that setting.
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Well, I will say, let’s start our conversation from facilitators and see what is good about that, which can help implement kind of any delivery of any intervention. So if we look at facilitators from within those cultures and religions and communities and families, and then we can kind of come up with a solution that is more human, that is more acceptable. And, you know, we do not have to kind of label or stigmatise the community before kind of providing a service. So in that sense, we can have greater benefits from any health promotion. So for example, the mental health service that is co-produced and co-developed with communities without stigmatising them will have broader benefits.
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Social and maybe emotional and maybe economic benefits for the community if it is delivered in a sensitive way.

In this video, Dr Sufyan Dogra explains the importance of recognising diversity and contextual factors when designing health interventions and promotion.

Dr Dogra is Principal Research Fellow at the Bradford Institute for Health Research, and is editor of the book ‘British Muslims, Ethnicity and Health Inequalities’ which will be published in November 2022.

Dr Dogra explains what is meant by the ‘pathologisation’ of Muslim communities in Britain. This is when culturally or religiously informed lifestyle preferences are taken as primary causes of health problems, and structural inequalities for ethnic and migrant communities are not considered sufficiently.

Dr Dogra suggests that the conversation should shift from a focus on barriers, to that of facilitators. Ethnic cultures, religious communities, and families are all potential facilitators of better mental health. He recommends co-production in the development of health intervention and promotion.

In the next step, we introduce a topic for discussion among learners.

Over to you

Summarise the key points from this video below – try to include a definition of pathologisation and describe at least one example of a ‘facilitator’ for better mental health.

You may want to include a note in your reflective diary on whether you think Muslim communities are pathologised in relation to mental health, and what you might do as a practitioner to address this.

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Understanding Muslim Mental Health

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