Emphasis has been placed on the importance of the participation of socially excluded groups in local initiatives to reduce health inequalities in England, in `partnerships' with government. We examine potential obstacles to such participation through a case study of factors shaping local participation by residents of a deprived multi-ethnic area who describe themselves as Pakistani. We draw on three-hour interviews with 26 men and women, aged 15—67 years. Assuming that a sense of common identification is a precondition for participation in local community networks, we examine how the construction of Pakistani identities, within conditions of material and symbolic social exclusion, constrains the likelihood of widespread, representative local participation by Pakistani people in our local area of interest. No matter how significant a category such as `Pakistani' might be in statistical analyses of health inequalities, an epidemiological category of this nature cannot simply be `mapped' onto policy recommendations.
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