Racism in health and health care in Europe: reality or mirage?

Racism is a belief that some races are superior to others, justifying actions that create inequality by favouring the supposedly superior groups. In practice, the definition of race is broadened to include ethnic, religious, and other similar groups, so discrimination on such grounds is also termed racism. Some people deny that racism is common in modern, industrialized, multi-ethnic societies. Wherever research is done, however, it shows racism is important. In a national representative survey in the 1990s by the UK Policy Studies Institute, for example, 20–26% of the White participants admitted in an interview to have prejudice against Asian, Caribbean or Muslim ethnic minorities.1 In fact, the figure is likely to be larger, for some people do not give publicly unacceptable answers in interview. It would be interesting to see comparable data from other European countries; the results would surely be equally and perhaps even more uncomfortable. Among the many historical lessons Europe should never forget is the one from Nazi Germany. Hitler's views were published in Mein Kampf (vol. 1 in 1925) to widespread acclaim and support, acting as an inspiration to much of the German public, and the medical professionals in particular.2,3 Silver's review demonstrates the central role of the medical profession—the staunchest supporter of the Nazi regime—in issues important to ethnic minority groups, for example, eugenics and race medicine.3 The economic, social, scientific, and political circumstances that allowed Hitler's policies to flourish could return. Eugenics is currently out of favour but its return is a likely outcome of the genetic revolution. Only open racism remains off-side in mainstream politics though there are signs that racism as a component of right-wing political policy is making a comeback. A rapid rise in ethnic minority populations in European cities, easy international travel, increasing pressures of …