Worlds of Health: Exploring the Health Choices of British Asian Mothers

Reed, Kate
Praeger, London
2003
0897899148

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The current UK social science research agenda seems to have embraced the idea of health and ethnicity, without in many cases, actively engaging in the wider issues related to identity, politics and health. Reed's work is a huge leap forward in this respect, following the work of others who have emphasised the socio-political nature of health and ethnicity dynamics. The author has managed to address issues of gender, identity and health choices by locating people's experiences in both a global and local context, while maintaining the importance of individual experiences and the meanings they hold for people.

Reed conducted interviews in Leicester with British South Asian women. She is careful in pointing out the complexities of using categories of difference and identity, and specifies precisely what she means when she talks of 'South Asians' in the UK and abroad. It is this type of carefully thought out argument, which allows this work to stand apart from other research in this huge area. The burden of responsibility for sophisticated avoidance of using ideological categories does not however end with labels. Sophisticated analyses in the field of ethnicity and health choices necessarily need to recognise the complexities of concepts such as ethnicity and culture. Reed shows us that these are complex entities, and need to be seen as such, with attention paid to the ways in which 'culture' changes in response to people adapting to the their environments and the social contexts of their health choices.

Reed's participants talk openly about their experiences of health and illness, and the choices they make. The central question being explored is how people's ethnicity, gender and generational position affects health choices the book then develops a number of different areas related to this core issue (e.g. use of alternative medicines, global family ties, religious rituals, community interactions, migration experiences). It is Reed's identification of a number of important themes that is interesting. Many researchers have discussed the structural and political landscape within which health choices are made, but few are able to make the required link between peoples' individual experiences and the socio-cultural landscape in which they live. Reed's reflexive engagement with her methodology and consequently her thoughts about identity both hers and the participants makes for an honest and robust sociological base.

The book consists of five chapters, moving from a general discussion of sociological debates within health and illness, to more well defined and thematic content, dealing with family, generation and life course, religion and community, geography and globalisation.

The author ventures into an array of theoretical standpoints, including race and ethnicity politics, lay health beliefs, feminism and cultural anthropology, and mentions the 'major players' in each of these areas. This willingness to look outside a narrow field and engage with a variety of related areas, resulted in an informative and thorough theoretical review.

The core of the study centres on the analytical fluidity of the syncretic approach, in this study applied to the mixing and matching of health remedies. Thankfully, Reed avoids a simplistic and reifying model of homogenising and collapsing systems, and points to a more synergistic model, indicating dynamic and reciprocal interactions. Reed maintains theoretical fluidity in this work through this emphasis on 'process' rather than 'state'. This particular method appears to have been chosen in order to allow a more powerful explanatory model to look at the intersection of health, ethnicity, gender, generation and globalisation.

There is substantial discussion of identity, relative to the various social and material factors which play crucial roles in the forming of identity. Using a variety of authors, Reed highlights the use of syncretic approaches to race and identity, and the dearth in research which has resulted in a neglect of careful analyses of the intersection of ethnicity and identity in health choices.

Essentially the book is about how a particular group of people think about their positions in a structural landscape, in which they have to make decisions about their health and illness. The research asks vital questions about what the participants themselves actually do in the event of an illness, the type and source of help they seek, and their own thoughts about who they are in relation not only to their migration history, but also in relation to their social networks in the UK and abroad. These are vital questions indeed both for addressing minority health needs, and for understanding the nature of cultural identity in the UK.

The author has managed to integrate wider sociological debates surrounding health and ethnicity with the power of individual experiences. The result is an insightful, informative and reflexive account, with the added bonus of being refreshingly well written and accessible.

Harshad Keval
University of Surrey