Review

Built-in racism

BLACK HEALTH: A POLITICAL ISSUE
Ntombenhle Protasia Khotie Torkington
Catholic Association for Racial Justice and Liverpool Institute of Higher Education, 1991, £7.95

Pro Torkington is one of the few researchers with the socio-political awareness and the analytical sophistication to deal with issues around Black peoples’ health in a serious manner. For this reason alone this report is to be welcomed.

This is a report of the Health and Race Project conducted by the author in Liverpool during 1986-88. The style is not academic; the book consists of twelve chapters and consultative papers of varying length depth and style. The opening chapter sets the context by focusing on the interrelationship between ‘race’ and class and the reproduction of racism though ‘common sense’ and institutional procedures. She rightly stresses that racism cannot be considered in isolation from other forms of oppression or as individual prejudice. It can only be understood in relation to its historical, power and structural context.

The manner in which it becomes institutionalised in health and social services - through restrictive practices, rigid application of rules, differential worth attached to problems faced by white and black people - is well illustrated. The chapter on ‘politics in action research’ forwards important arguments in favour of a ‘value-committed’ approach to research, with the researcher as an ally in achieving just change.

Then follow six ‘consultative papers’ produced during the project. These cover high blood pressure, screening, issues around the health needs of the local Somali community, Black elders, interpreting services and mental illness. They vary in style, depth of analysis and comprehensiveness. The one on mental health provides a good overview of the major debates, and supplements this with local case studies.

The last part of the book focuses on ‘fruits of action research’. Torkington is quick to point out that, by the nature of action research, it is difficult for action researchers to claim whole (or even partial) credit for positive policy outcomes. Torkington’s particular strength is her ability to analyse the institutionalisation of racism through the workings of administrative procedures, and an adherence to an ideology of professionalism. This is significant for any analysis of racism in social policy. To focus on ‘warped’ individuals or personal prejudice is to miss the point about the reproduction of racism.

The author shows a certain carelessness in proof reading. The references are not always given in full, it is difficult to know the status of some of the reports she cites or where they can be obtained, page numbers for cited articles are often missing and she is careless with the names of people and publications (’Mashmi’ for Hashmi, p155; ‘Radical Community Care Medicine’ for Radical Community Medicine, p38).

Those with an interest in health and ‘race’ or the reproduction of racism in bureaucracies will find it a useful book.