Ethn Health. 1999 Aug; 4(3): 139-51.

Informal care and the empowerment of minority communities: comparisons between the USA and the UK.

Chen MS.

Division of Health Behavior and Health Promotion, School of Public Health/College of Medicine and Public Health, Ohio State University, Columbus, USA.

This paper examines informal care and the empowerment of minority communities with respect to health care and health promotion in the USA and the UK based upon work prepared for the workshop, 'Involving Black and Minority Ethnic Users in Delivery of Services and Empowering Communities' presented during the bi-national 1997 USA, UK. Conference, 'Health Gain for Black and Minority Ethnic Communities' and the information gained from that Conference. 'Informal care' is operationally defined as 'the practice of alleviating distressful physiological and psychological dysfunctions through all others (e.g. traditional healers, family members, self, etc.) using measures that do not require a physician's prescription or intervention (e.g. lifestyle modifications) typically outside of formal, institutionally based care mechanisms (e.g. homes and communities). Informal care is a significant force in health maintenance, health promotion, and disease prevention. In the USA, at least one-third of the population is estimated to engage in unconventional medical practices, and perhaps, one-half of racial/ethnic populations use informal care. An enormous potential exists to better utilize informal care because informal care is culturally more compatible, relatively low cost, and flexible. The policy of the Indian Health Service in accepting the use of traditional medicine was cited. The US Congress recognized the potential of alternative medicine by establishing such an Office within the National Institutes of Health. 'Empowerment of racial/ethnic minority communities is the right for minority populations to determine their own destinies. In the USA, racial/ethnic minority populations are Blacks, Hispanics, Asians or Pacific Islanders, and American Indian/Alaska Native. These classifications are based upon self-report; in the UK, the black and minority classifications are based upon countries of birth rather than self-reported racial/ethnic identities. Empowerment of these communities is important both demographically and historically. In demographic terms, racial/ethnic minority populations are increasing at higher rates than the majority population in the USA and hence, the health status of minorities will become the health status of the nation in the next half century. Historically, racial/ethnic minorities have not been empowered. As a consequence of the 1985 Secretary's Task Force Report on Black and Minority Health Federal measures to address disparities in the health status of minorities were initiated. In March 1994, the UK Government initiated the Ethnic Health Unit within the National Health Service. These measures are not mature enough to evaluate their impact. However, progress in implementing measures to empower minorities in the UK have begun and are illustrated by the work reported by Dr Pui-Ling Li, the UK counterpart to the workshop, 'Involving Black and Minority Ethnic Users in Delivery of Services and Empowering Communities'. Recommendations are made to increase use of informal care and the empowerment for racial/ethnic minority communities and to build upon the works in progress in both the USA and the UK.