Most economically developed nations are now multiethnic, and, given current demographic trends, there is reason to believe that societies will continue to become more ethnically and culturally diverse. For example, the 1991 and 2001 UK censuses, which both included a mandatory question on ethnic identity, revealed that the proportion of the UK population classifying themselves as belonging to a non-white minority ethnic group increased by 53% over this 10-year period, from 3 million to 4.6 million (or 7.9% of the UK population) .
We have more than two decades of research highlighting ethnic inequalities for a range of long-term disorders , such as asthma (Table 1), but despite the policy imperative to improve health outcomes for marginalised populations, there has, unfortunately, been little progress toward this end [3,4]. Perversely, data indicate that for some conditions these health inequalities may actually be increasing.
Why this is the case is almost certainly dependent on an array of complex socio-economic factors . Hampering efforts to reverse these trends is the lack of long-term investment into researching the health needs of minority ethnic communities and, as is increasingly being shown, evidence of their systematic under-representation in research studies in general. This lack of investment and under-representation are concerning as it may reasonably be argued that greater resources and effort should be directed toward researching those sections of society that have the greatest capacity to benefit from such research. A study in this month's PLoS Medicine by David Wendler and colleagues investigates one possible source of under-representation—the willingness of ethnic minorities to participate in health research .