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The relationship between frailty, ethnicity and health inequality – a scoping review
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This scoping review highlights the need for research to address the intersectional relationship between racialisation, health inequality and frailty in older age. We map research addressing the relationship between frailty and ethnicity across literature exploring health inequality in order to collate findings, identify trends and highlight research gaps. Our most significant finding is the absence of attention to the role of racism despite the majority of studies identifying a positive correlation between frailty and minority ethnicity. In countries with ageing populations, ill health and frailty was generally found to strike earlier and more severely in racially minoritised groups. However, there is a paucity of research addressing ageing and ethnicity. To focus the review, we asked: how are frailty and ethnicity/race related in the current literature addressing health inequality? We map the existing literature, commenting on terminology, findings and methodology. While social, economic and cultural factors are speculated to be explanations for inequality, there has been little analysis of the association between frailty, ethnicity and socioeconomic inequality, no explicit attention to the role of racism and little qualitative research to explore the lived experience of frailty and ethnicity. Despite the contested nature of both frailty and ethnicity, the majority of studies lacked definitions of the terms used, particularly with respect to ‘identifying terms’ used for ethnicity. We call for further research (particularly qualitative research) to address frailty and ethnicity in the context of racialisation and health inequality and for critical engagement with ‘identifying terms’ used.
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