© 2007 The Authors. Journal compilation © 2007 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd. Published by Blackwell Publishing Ltd., 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA Sociology of Health & Illness Vol. 29 No. 6 2007 ISSN 0141– 9889, pp. 811–830 doi: 10.1111/j.1467-9566.2007.01043.x Blackwell Publishing Ltd Oxford, UK SHIL Sociology of Health & Illness 0141-9889 © 2007 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd XXX Original Articles The Black diaspora and health inequalities James Nazroo, James Jackson et al. The Black diaspora and health inequalities in the US and England: does where you go and how you get there make a difference? James Nazroo 1 , James Jackson 2 , Saffron Karlsen 3 and Myriam Torres 2 1 Sociology, University of Manchester, UK 2 University of Michigan, USA 3 University College London, UK Abstract The relatively poor health of Black American people in the US and Black Caribbean people in England is a consistent finding in the health inequalities literature. Indeed, there are many similarities between the health, social, economic and demographic profiles of these two groups. However, there is evidence that Caribbean people in the US are faring considerably better. This paper explores differences in the social and economic position of Black American, Black Caribbean and white people in the US and Black Caribbean and white people in England, how these relate to ethnic inequalities in health, and may be underpinned by differences in patterns and contexts of migration. We use similar surveys from the US and England to explore these questions. The US data were drawn from the National Survey of American Life and the English data were drawn from the Health Survey for England and a follow up study. Findings show the advantaged health position of Caribbean American people in comparison with both Caribbean people in England and Black American people. Multivariate analyses indicate that these differences, and the differences in health between Black and white people in the two countries, are a consequence of social and economic inequalities. Keywords: ethnicity, race, Caribbean, Black, inequalities in health, international comparison Introduction Differences in health across ethnic groups, in terms of both morbidity and mortality, are a dominant feature of developed countries and of great significance to population health. They have been repeatedly documented in England (Marmot et al. 1984, Harding and Maxwell 1997, Nazroo 2001, Bhopal et al. 1999, Erens et al. 2001), the US (Department of Health and Human Services 1985, Rogers 1992, Davey Smith et al. 1998, Pamuk et al. 1998, Williams 2001), Canada (Sheth et al. 1999, Wu et al. 2003, Wu and Schimmele 2005), Latin America (Pan American Health Organization 2001), South Africa (Sidiropoulos et al. 1997), Australia (McLennan and Madden 1999) and elsewhere (Polednak 1989).