Studying ethnicity and substance use: ontological considerations and methodological implications

In this paper we elaborate on the conceptual premises of studying ethnicity in an ongoing community based participatory research project (Green et al. 1995, Minkler et al. 2004, Israel etal. 2010) about the nature of substance use and access to treatment facilities in the Turkish community in Ghent (Belgium). Due to a lack of prevalence studies in ethnic and cultural minorities in Belgium and to the growing medicalization of research on substance use and mental health (Bracke, 2015), researchers often feel compelled to rely on US based epidemiological studies when grounding knowledge on the link between ethnicity and substance use (Derluyn, 2008). We argue that the bulk of US based epidemiological research suffers from crucial methodological and conceptual flaws that impel us to reconsider their usefulness in the European context. First, US community research starts out from overly simplified and static concepts of ethnicity and race as primordial analytical categories. Second, and as a consequence of the first argument, this research rarely distinguishes sufficiently between ethnic and non-ethnic determinants and mechanisms influencing substance use and access to treatment. And third, these studies often depart from methodological individualism and subordinates contextual and structural determinants and mechanisms. This paper aims at re-evaluating (the factors and mechanisms mediating) the relation between ethnicity, the nature of substance use, access to drug treatment and at overcoming some of the gaps in existing research methods mentioned above. More specifically, this implies (1) a dynamisation and critical revision of the concept of ethnicity with a focus on ethnic boundary making practices, (2) the inclusion of non-ethnic determinants and mechanisms, and (3) the broadening of methodological individualism so as to include all levels (from meso to macro) and loci (individual, community, society) of research. Such doubled research practices (Lather, 2007) allow researchers to both analyze and impact upon unequal social outcomes.