Review

Care in whose community?

’Race’ and community care
Waqar Ahmed and Karl Atkin (eds)
Open University Press, 1996, £12.99

This book is a good introduction to the subject and is another fine example of the Open University’s textbooks, being the first in a new series called ‘Race’, health and social care.

It attempts to fill a gap in the existing literature, but cannot ignore the fact that the delivery of services to Asian and Afro-Caribbean people is in need of systematic research, as most existing research focuses on the experiences of the majority white population.

The book is set out in three parts. The first provides the historical context of the debates, including the ‘influence of the eugenics movement 1913-1939’, and broadens the discussion to contemporary Britain. It examines the problematic nature of the concept of community care within a multi-ethnic Britain and the exclusion of those who are not believed by the dominant group to belong to the ‘nation’.

The second part explores family obligations and care. It emphasises that this area is under-researched, and debates issues which affect behaviour and cultural ‘norms’, and relationships within minority groups, while considering physical, emotional and material aspects of care.

The third part presents case studies, focusing on disability, mental health, the contribution of social security benefits to the alleviation of poverty, and the role of the voluntary sector.

There is a considered critique of the provision of care in the community for minority ethnic groups. The book suggests racist notions were not just a historical lapse, but that there is still the tendency for policy makers to ‘blame’ minority groups for not fitting in, and that Care in the Community has been fitted around the ‘dominant white norm’.

The book requires a critical read, but in its turn provides a successful critique. The authors discuss the origins of inequality, how carers within ethnic minorities often find it very difficult to obtain formal support, and how race has become yet another factor which exacerbates the effects of poverty when considering health inequalities.

It concludes that the marketing of services and the mixed economy of care continue to reflect the disadvantage faced by minorities. The service does not appear to be working properly for ethnic minority groups, and this book, aimed at undergraduates, educators, health and community workers, reminds them of the dangers of racist and ‘nationalist’ ideas.