The interface between ethnicity, health, and health care delivery is complex, and studying this area is known to throw up somewhat paradoxical findings. In this issue, Yoong and colleagues raise two important observations that we wish to comment on, namely the persistence of consanguineous marriage patterns in British Pakistani Muslim families and, in those families with children with deafness, their access to relevant health care services.¹ We consider each of these issues—the first predictable and the second unexpected—in turn.

It is now well known among health professionals that consanguineous kinship patterns increase the risk of recessively inherited disorders such as congenital deafness. It is estimated that the birth prevalence of infants with recessively inherited disorders rises by about 7 per 1000 for every 0.01 increase in the coefficient of consanguinity (F). Among British Muslim Pakistanis, F is estimated at 0.0431 compared with 0.003 for most North European populations. But despite this knowledge being widespread within professionals, it is our impression that a large proportion of Britain’s Pakistani Muslim population remain unaware of the relation between consanguinity and adverse outcomes. This may go some way to explaining why consanguinity persists as a social practice in this community.

Our belief that the process of acculturation (whereby immigrant minorities begin to take on the characteristics of the host population) would rapidly lead to the demise of the acceptable kinship pattern has not as yet been …