Letters, calls and emails: Ethnicity details can help with diagnosis

Dear Editor,

The article on ethnicity and culture in medicine made some important omissions (GP, 13 April).

In ethnicity, the list showed paucity in ethnic origins in the Middle East and eastern Europe — including various varieties of Judaic or Hebrew descent — and non-Irish Celtic peoples for a start.

I would point out that differences in disease incidence rates meant that these are actually important.

Paganism was also omitted, which is strange, seeing as it is of indigenous existence in Britain, and important as a re-emerging religion.

It is also important to GPs to know country of birth (and rearing) beyond those listed, because this has bearing on vaccination history and illness susceptibility.

Finally, circumcision is a religious ritual for women in some cultures, and both this and many other religious rituals may be considered beneficial to health in certain circumstances, and harmful to health in others.

We need to be gentle and sympathetic, but some practices harmful out of context of origin do need to be openly discussed if they are a cause of risk.

I agree it is important to recognise these religious differences, as it is other variations in cultural norms.

The difficulty is in knowing when they exist. They are not limited to the named religions mentioned, but may be of extremely limited local validity even within our own county.

Dr David Church
Machynlleth, Powys

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