Centre for Health and Social Care Research, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield, S10 2BP, UK.
BMC Public Health. 2011 Jun 29;11:514. doi: 10.1186/1471-2458-11-514.
Public health researchers are increasingly encouraged to establish international collaborations and to undertake cross-national comparative studies. To-date relatively few such studies have addressed migration, ethnicity and health, but their number is growing. While it is clear that divergent approaches to such comparative research are emerging, public health researchers have not so far given considered attention to the opportunities and challenges presented by such work. This paper contributes to this debate by drawing on the experience of a recent study focused on maternal health in Canada, Germany and the UK.
The paper highlights various ways in which cross-national comparative research can potentially enhance the rigour and utility of research into migration, ethnicity and health, including by: forcing researchers to engage in both ideological and methodological critical reflexivity; raising awareness of the socially and historically embedded nature of concepts, methods and generated 'knowledge'; increasing appreciation of the need to situate analyses of health within the wider socio-political setting; helping researchers (and research users) to see familiar issues from new perspectives and find innovative solutions; encouraging researchers to move beyond fixed 'groups' and 'categories' to look at processes of identification, inclusion and exclusion; promoting a multi-level analysis of local, national and global influences on migrant/minority health; and enabling conceptual and methodological development through the exchange of ideas and experience between diverse research teams. At the same time, the paper alerts researchers to potential downsides, including: significant challenges to developing conceptual frameworks that are meaningful across contexts; a tendency to reify concepts and essentialise migrant/minority 'groups' in an effort to harmonize across countries; a danger that analyses are superficial, being restricted to independent country descriptions rather than generating integrated insights; difficulties of balancing the need for meaningful findings at country level and more holistic products; and increased logistical complexity and costs.
In view of these pros and cons, the paper encourages researchers to reflect more on the rationale for, feasibility and likely contribution of proposed cross-national comparative research that engages with migration, ethnicity and health and suggests some principles that could support such reflection.
公共卫生研究人员越来越多地被鼓励建立国际合作关系，并进行跨国比较研究。迄今为止，只有相对较少的此类研究涉及移民、族裔和健康问题，但这方面的研究数量正在增加。虽然显然正在出现对这种比较研究的不同方法，但公共卫生研究人员尚未认真考虑此类工作带来的机会和挑战。本文通过借鉴最近一项关于加拿大、德国和英国的孕产妇健康的研究经验，为这一辩论做出了贡献。
本文强调了跨国比较研究可能会增强对移民、族裔和健康问题研究的严谨性和实用性的各种方式，包括：迫使研究人员对思想和方法进行批判性反思；提高对概念、方法和生成的“知识”的社会和历史背景的认识；增强对在更广泛的社会政治背景下对健康进行分析的必要性的认识；帮助研究人员（和研究使用者）从新的角度看待熟悉的问题并找到创新的解决方案；鼓励研究人员超越固定的“群体”和“类别”，研究认同、包容和排斥的过程；促进对影响移民/少数群体健康的地方、国家和全球因素的多层次分析；并通过不同研究团队之间的思想和经验交流来促进概念和方法的发展。同时，本文提醒研究人员注意潜在的缺点，包括：在跨背景的情况下制定有意义的概念框架具有重大挑战；为了在各国之间协调一致，有将概念和移民/少数群体“群体”本质化的倾向；分析表面化的危险，仅限于对各国的独立描述，而不是产生综合的见解；平衡在国家一级获得有意义的发现和更全面的产品的需求的困难；以及增加后勤复杂性和成本。
鉴于这些利弊，本文鼓励研究人员更多地思考拟议的跨国比较研究的理由、可行性和可能的贡献，该研究涉及移民、族裔和健康问题，并提出了一些可以支持这种思考的原则。
