Showing papers in "Ethnicity & Health in 1997"
TL;DR: Well-designed, relevant, ethical research in conjunction with an appreciation of the many barriers to participation are paramount to increasing African American presence in clinical research.
Abstract: Objectives. In accordance with the NIH Revitalization Act of 1993, the National Institutes of Health and the Alcohol, Drug and Mental Health Administration require grant applicants and cooperative agreement participants to include minorities in human subject research. In an environment characterized by diminishing research dollars, this mandate has increased the pressure on investigators to determine factors that impede minority participation and to develop strategies to overcome these impediments. Methods. An extensive review of the literature was conducted to identify the factors possibly responsible for the low participation levels of African Americans in medical research studies and to highlight areas for further research. The items examined included the historical relationship between African Americans and medical researchers and the attitudes, perceptions and beliefs of potential participants and researchers as they relate to the low representation of African Americans in medical research. ...
364 citations
TL;DR: The lower uptake of services by elderly Asian Gujarati is not the result of better health but may be explained by greater family support together with a lack of knowledge of and dissatisfaction with what is available.
Abstract: Objectives. To investigate factors affecting the uptake of health and social services by elderly Asian Gujarati. Methods. Four hundred and five Hindu Gujaratis and 381 whites aged 65 years and over residing in Leicester were randomly sampled from the Leicestershire District FHSA list by a computerized method based on linguistic analysis of the patient's name. One hundred and fifty Hindu Gujaratis and 152 whites were interviewed with response rates of 72% for the Asian Gujaratis and 80% for the white groups. The outcome measures were the activities of daily living (ADLs), incontinence, auditory/ visual deficits, cardiovascular disease, cognitive impairment (measured by the Mini‐mental State Examination), depression, use of GP and hospital services, knowledge of community health and social services, willingness to use, suitability and cultural accessibility. Results. The poorer uptake of services by elderly Asian Gujarati could not be explained by better health. They were significantly more likely ...
89 citations
TL;DR: Major findings include: there was a significant increase in knowledge scores from pre to post1 and post2, and education, age and number of years with HBP explained 49% of the variance associated with H BP knowledge.
Abstract: The goals of this education outreach demonstration study were to prepare a cadre of registered nurses (RN) as Church Health Educators (CHE), and to test the efficacy of a hypertension (HBP) education and support program in African American (AA) churches for persons with HBP in managing blood pressure (BP). In this two-phase study, RNs were prepared as CHEs in phase 1 and a convenience sample of 97 subjects with HBP was taught by the CHEs in phase 2. The intervention's content included the bases of HBP and HBP management strategies, and was taught in eight 1-hour sessions. Using a pre-test-post-test design, data on knowledge, social support and BP were collected at baseline (pre), post-intervention (post1) and 3 months post-intervention (post2). Major findings include: (1) there was a significant increase in knowledge scores from pre to post1 and post2 (P < or = 0.0001; F = 95.08; df = 1.79); (2) education, age and number of years with HBP explained 49% of the variance associated with HBP knowledge; (3) systolic BP (SBP) and mean arterial BP (MAP) significantly decreased from pre to post1 and post2 (SBP-p < or = 0.0001, F = 18.35, df = 1.91; MAP-p < or = 0.0001, F = 17.80, df = 1.86); (4) DBP significantly decreased from pre to post1 only (p < or = 0.008, F = 17.48, df = 1.91); and (5) relationships were found between social support and DBP, and social support and MAP. Issues that emerged from this study with implications for outreach programming include recruitment and retention, randomization, selective sampling, intervention design and use of volunteers.
59 citations
TL;DR: South Asians may differ from British caucasians in relation to their beliefs about internal and external influences on health, as well as ratings of religiousness, health status and occupational status.
Abstract: Objective. To compare health locus of control scores in women from different ethnic backgrounds. Method. One‐hundred and twenty‐eight Caucasian, South Asian and Afro‐Caribbean women completed written or orally presented versions of the multidimensional health locus of control scale, as well as ratings of religiousness, health status and occupational status. Results. South Asian women scored higher on ‘chance’ and ‘powerful others’ locus of control as predicted. They also had higher scores on internality. The ethnic differences persisted after controlling for occupation and health status. High religiousness among the South Asians appeared to explain some, but not all, of their higher scores. Conclusion. South Asians may differ from British Caucasians in relation to their beliefs about internal and external influences on health.
58 citations
TL;DR: Hypertension is no longer rare in Alaska Natives and is associated with overweight, non-indigenous diet, mechanized activities, and glucose intolerance, while race was significantly associated with blood pressure > or = 140/90.
Abstract: Objective. Determine the prevalence of hypertension in Alaska Natives and evaluate risk factors. Design. Population‐based univariate and multivariate analysis of blood pressure in 1124 Alaska Natives over 20 years of age. Results. The sample had mean: age 45 years, body mass index 27, systolic pressure 123 mmHg and diastolic pressure 73 mmHg. The age‐adjusted rate of hypertension ≥ 160/95 mmHg was 9.1% and 6.8% among Athabascan Indians and Yup'ik Eskimos, respectively. After controlling for age and sex there was significantly more hypertension among Athabascan Indians (OR=1.53, CI = 1.07–2.2, p = 0.019) compared to Yup'ik Eskimos. Race was significantly associated with blood pressure 3 ≥ 140/90 when controlled for age and overweight (p = 0.07, OR = 0.78, CI = 0.69–0.95). The presence of hypertension was significantly associated with the following: intake of non‐indigenous food (p = 0.01); mechanized activities (p = 0.01); and glucose intolerance in both women (p = 0.043) and men (p = 0.001). Mult...
53 citations
TL;DR: Prevalence rates of past heavy drinking among Mexican American and Puerto Rican males are approximately three times higher than rates reported for non-Hispanic male populations.
Abstract: Objectives. Self‐reports of past heavy drinking correlate with the current drinking practices and with risk of mortality in non‐Hispanic males. The prevalence of past heavy drinking has not been reported in Hispanic populations. Methods. Using data from the Hispanic Health and Nutrition Examination Survey (HHANES) we (1) report on the prevalence, duration and severity of past heavy drinking in three Hispanic groups, (2) compare the current alcohol consumption patterns among past heavy drinkers and those who do not report a history of past heavy drinking and (3) compare the risk factor profiles and health indicators in these two groups. Results. The prevalence of past heavy drinking among Mexican American and Puerto Rican males ranged from 28–35% while the rates for Cuban American males ranged from 7–16%. The rates for Hispanic women were much lower (1–8%). The average years of past heavy drinking ranged from 2.3–14.9 years, while the alcohol consumption during the past heavy drinking period range...
52 citations
TL;DR: Both the quantitative and qualitative data revealed problem areas with the intervention protocol related to cultural norms and the possible fragmentation of information based on the behavioral transmission categories.
Abstract: Author(s): Flaskerud, JH; Nyamathi, AM; Uman, GC | Abstract: ObjectivesThe purpose of this study was to assess the effects of an HIV antibody testing, counseling and education programme on the knowledge and practices of low-income Los Angeles Latina women.MethodsThe study design was prospective and longitudinal involving pre-test, post-test and retest measures over a 2-year period. The study employed an experimental group and a comparison group which did not receive the intervention. The study group was comprised of a convenience sample of 508 low-income Latina women who were recruited from the Public Health Service nutrition programme for women, infants and children (WIC). The comparison group (n = 51) was recruited from the same setting. A battery of instruments was selected to measure HIV knowledge and practices, the social support received, self-esteem, the level of acculturation and sociodemographic characteristics. The instruments were administered at pre-test, 2 weeks post-test and 1 year retest. The HIV antibody serostatus was assessed at pre-test and retest. An intervention protocol based on cultural competence, women as traditional health care givers and the major transmission categories was provided after the pre-test and was reinforced post-test. Finally, qualitative data were collected from the focus group participants (n = 55) to evaluate the intervention protocol.ResultsThe participants in the study made significant improvements in HIV knowledge and reported condom use practices from pre-test to post-test that were retained on retest. The comparison group subjects did not make significant pre-test-post-test improvements on these measures.ConclusionsIt should be noted that the changes in practices made by the study group did not necessarily reduce their risk of HIV infection or transmission and were not related to the demonstrated knowledge and skills improvement. Of special significance to programme planners, educators and researchers, both the quantitative and qualitative data revealed problem areas with the intervention protocol related to cultural norms and the possible fragmentation of information based on the behavioral transmission categories.
46 citations
TL;DR: A novel methodology combining last name and country of birth is developed to study mortality patterns of Canadians of South Asian and Chinese ethnic origin and compared death rates among SA, CH, and White (WH) Canadians.
Abstract: The study of ethnic differences in disease is a methodological challenge as ethnicity is often not identified in existing datasets and surrogate measures need to be used. We have developed a novel methodology combining last name and country of birth to study mortality patterns of Canadians of South Asian (SA) and Chinese (CH) ethnic origin and have compared death rates among SA, CH, and White (WH) Canadians. Methods. SA and CH were identified in the Canadian Mortality Data Base (CMDB) using the last name and country of birth of the deceased. Records of people who had been born in countries with large South Asian and Chinese populations (e.g. India, Pakistan, China, Hong Kong) were selected and manually screened by last name. A name directory was then created of distinct South Asian and Chinese names and this directory was used to search all other records in the CMDB for SA and CH deaths. Where necessary, other identifying characteristics such as first name and parents’ last name were also used. P...
45 citations
TL;DR: Age-specific prevalence rates for learning disabilities among the Asian communities in three Metropolitan Boroughs in the North of England are presented and it is indicated that below school age there is little difference in the apparent prevalence of severe learning disabilities between the Asian and non-Asian communities.
Abstract: Age-specific prevalence rates for learning disabilities among the Asian communities in three Metropolitan Boroughs in the North of England are presented. These data indicate that: (1) below school age there is little difference in the apparent prevalence of severe learning disabilities between the Asian and non-Asian communities; (2) between 5 and 34 years of age, however, the apparent prevalence of severe learning disabilities is approximately three times higher among the Asian community when compared with the non-Asian community.
42 citations
TL;DR: It is concluded that a substantial proportion of the black to white difference in post-neonatal mortality is associated with specific environmental conditions.
Abstract: Objectives. To investigate the extent to which the place of residence affects the black to white differential in post‐neonatal (28–365 days) mortality, we performed a univariate analysis and multivariate logistic regression of the 1982–1983 Illinois vital records, Chicago Police violent crime information and 1980 US Census income data. Methods. Four environmental predictors of post‐neonatal death were examined: a median family income of 50%, violent crime rates of > 11/1000 and limited community access to primary medical care based on physician supply ratios. Results. The post‐neonatal mortality rate of black (n = 50 765) infants was three times that of white (n = 50 690) infants: 10/1000 versus 3/1000, respectively. Thirty‐six percent of the white infants had none of the environmental risk factors, whereas only 13% of the black infants had none of the risk factors. For black infants, the presence of any one factor was associated with a slightly incre...
40 citations
TL;DR: The findings establish significant variations in the recent health experiences of Bangladeshi men living in England and Wales, posing a major challenge for purchasers of care.
Abstract: Objectives. To investigate the patterns of mortality among Bangladeshis living in England and Wales. Methods. An analysis of national mortality data, classified by country of birth, for the latest period (1988–1992), using the method of indirect standardization for deriving standardized mortality ratios (SMRs) with the age‐ and sex‐specific rates for England and Wales as the standard ( = 100). The SMRs were derived for Bangladeshi‐born men and women aged 20–69 years for major disease entities. Results. The mortality among Bangladeshi men was significantly higher (SMR 118 and 95% CI 111–126) than the levels prevalent in England and Wales. In contrast, the mortality among Bangladeshi women was significantly lower (SMR 71 and 95% CI 61–82). The cancer mortality overall was lower than expected in both sexes, with the exception of cancer of the liver and gall bladder. The mortality from breast cancer (SMR 16 and 95% CI 6–34) and cervical cancer (SMR 51 and 95% CI 14–131) was lower than expected. Bangl...
TL;DR: This study demonstrates that post-intervention, both African American and Caucasian study participants showed a decrease in emergency department visits and an increase in asthma self-management, especially important for African Americans, who face increasing asthma mortality and morbidity.
Abstract: Objectives. Re‐analysis of a randomized trial of an asthma education program designed to assess the effects of the intervention on emergency department visits, limited days of activity and asthma knowledge and beliefs separately for African American and Caucasian adults with asthma. Design. Two hundred and forty‐one respondents between the ages of 18 and 70 were evaluated in two emergency departments (one inner city and one suburban location) of a large, midwestem health care system and were randomized to an intervention or control group. Results. Regardless of race, members of the intervention group showed a decrease in the number of post‐intervention emergency department visits (ANOVA interaction between race and group effect p value = 0.93). The greatest decrease occurred during the first four post‐intervention months. No differential effect of the asthma education intervention by race was found on the change in asthma knowledge and beliefs over the study period (ANCOVA interaction between rac...
TL;DR: Clinical measures may have under-estimated distress in several South Asian groups, due to a preference for a particular language of emotion in the affected groups or to a higher frequency of stressful situations which provoke distinctive reactions.
Abstract: Objectives. Previous work has shown low levels of psychological distress among UK South Asians, but some argue that the distress is under‐reported. The present paper assesses distress on one clinic...
TL;DR: In this paper, the authors describe factors that contribute to variations in health-related behaviours and attitudes among inner city 12-year-olds, using semi-structured interviews with a stratified sample of students and their parents attending state secondary schools in two inner London boroughs.
Abstract: Objectives. To describe factors that contribute to variations in health‐related behaviours and attitudes among inner city 12‐year‐olds. To see if there was an identifiable patterning by ethnic group. Design. Semi‐structured interviews with a stratified sample of 12‐year‐old students and their parents from four ethnic groups, attending state secondary schools in two inner London boroughs. Results. Bangladeshi young people were significantly more likely to receive school meals. There was no variation in reported snacking between the groups. Girls and Bangladeshi students were less likely to report exercising outside school (33% of Bangladeshi boys reported not exercising outside school compared to 5% of boys from all other groups). Bangladeshi boys and their parents were more likely to report that bullying or worries about racial violence prevented them from going out after school. White young people were more likely to report experimenting with and the regular use of cigarettes and alcohol. Use of...
TL;DR: The increasing prevalence of obesity and diabetes in the Mohawk Community of Akwesasne led to the formation of an advisory group whose mission was to increase community awareness and strengthen the infrastructure necessary to create a community coalition to promote healthy lifestyles.
Abstract: The increasing prevalence of obesity and diabetes in the Mohawk Community of Akwesasne led to the formation of an advisory group who's mission was to increase community awareness and strengthen the infrastructure necessary to create a community coalition to promote healthy lifestyles. The methodology used to reach these goals included: obtaining an understanding of the community's knowledge, attitudes and behaviors about diabetes, diet and exercise using semi‐structured interviews and focus groups; analyzing data from a case control study of diabetes and it complications using a medical record review; exploring methods for evaluating energy expenditure in children; and identifying influential community members and organizations. In the last 50 years people had become less physically active and high fat, high caloric foods were more available. Community members were concerned about health and the well‐being of their children, had knowledge about healthy lifestyles but lacked confidence and social ...
TL;DR: More research is needed to further explore the apparent greater risk for psychiatric disorders among gay and bisexual men, and to determine whether being African American and lower social class exacerbate this risk.
Abstract: The AAHP investigated the neurobehavioral and psychosocial sequelae of HIV‐1 and substance use in urban African American men. A community resident sample of 502 African American men stratified by HIV‐1 serostatus, drug use and sexual orientation were recruited. A comprehensive battery of measures of neurobehavioral and health status, lifestyle and psychosocial characteristics were administered to all participants, and a stratified sub‐sample of 120 participants were tested using state of the art brain imaging techniques to investigate differences in the functional and neurophysiologic effects of HIV‐1 and substance use. An overview of the methodology of the AAHP and results on high risk sexual and substance use behaviors, and psychiatric disorders are presented and discussed. The sample was primarily HIV‐negative (63%), heterosexual (49% gay or bisexual) and a high percentage used substances during the past year (56% used drugs and 30% moderate/heavy drinkers). High‐risk sexual practices were rel...
TL;DR: A questionnaire survey of journal editors' views on terminology in relation to health research on ethnic minority groups found that although most of the journals surveyed did not have a clear policy on terminology, they recognised the importance of this issue and welcomed guidance to resolve the problem of inappropriate terminology in ethnicity and health research.
Abstract: There has been a burgeoning of literature on ethnicity and health in recent years. Although quality research in this field is most welcome, concern is mounting over the confusing and often inappropriate labelling of populations under study. We have undertaken a questionnaire survey of journal editors' views on terminology in relation to health research on ethnic minority groups. We found that although most of the journals surveyed did not have a clear policy on terminology, they recognised the importance of this issue and welcomed guidance to resolve the problem of inappropriate terminology in ethnicity and health research.
TL;DR: It is concluded that the FFQ performed better in European than Maori and Pacific Island participants, and obese Europeans and Maori were more likely to under-report dietary intakes by the 3-day diary method.
Abstract: The reproducibility and validity of a self‐administered 142‐item food‐frequency questionnaire (FFQ) was assessed in a population comprising 124 European and 52 Polynesian (17 Maori and 35 Pacific Island) New Zealanders aged 40–65 years. Reproducibility correlation coefficients, determined by administration of the same questionnaire on two occasions 3 years apart, were higher in European than Maori and Pacific Island. participants, ranging from 0.47 to 0.87 in Europeans (median 0.66) and from 0.41 to 0.79 in Maori and Pacific Island people (median 0.44). In general, there were no significant differences in mean nutrient intakes calculated from the two FFQs by Europeans or Maori and Pacific Island participants despite their cultural and language differences. When the FFQ was compared with a 3‐day food diary in a sub sample of 101 Europeans, 15 Maori and 22 Pacific Islanders, the validity was good for most nutrients, with overestimation of a few nutrients in each ethnic group. Correlation coefficien...
TL;DR: Longitudinal studies using diet diaries are needed in these Hispanic populations to add to the limited information of dietary fat intake of US Hispanic adults, in particular for subgroups other than Mexican Americans.
Abstract: Objective. To add to the limited information of dietary fat intake of US Hispanic adults, in particular for subgroups other than Mexican Americans. Methods. The frequency of eating 13 high‐fat food items commonly consumed in the US was examined in 665 Hispanic adults 20–74 years old in Connecticut and Long Island, New York, sampled from Spanish‐surname telephone listings and surveyed by telephone in 1992. Results. Mean estimated fat intake from the 13 items was significantly greater for the 357 men than the 308 women; the largest gender differences were for hamburgers/ cheeseburgers and French fries. Whole milk was an important contributor to the fat intake of persons with the highest fat intakes. In multiple linear regression analyses, age (negative association) and gender, but not education and acculturation (based on language spoken, read and written), were statistically significant predictors of fat intake from the 13 items. Conclusions. Longitudinal studies using diet diaries are needed in t...
TL;DR: The enhanced vascular sensitivity to norepinephrine may have contributed to the greater exercise pressor response in the blacks, as evidenced by a significant race x time interaction.
Abstract: OBJECTIVES The objectives of the present study were (1) to evaluate the pressor response to an isometric handgrip exercise in normotensive black and white males; (2) to measure plasma catecholamine levels pre- and post-exercise, as an index of sympathetic nervous system activity; and (3) to quantify the pressor response to bolus intravenous injections of phenylephrine (an alpha-specific agonist). METHODS Cardiovascular and catecholamine responses to an isometric handgrip exercise (3 minutes at 30% MVC) were measured in 15 normotensive blacks and whites. In another phase of the study, pressor responses to bolus injections of phenylephrine were assessed to evaluate alpha-adrenergic sensitivity. RESULTS The blood pressure in the blacks increased from 119/69 to 160/120 mm HG during isometric exercise, while in the whites it increased from 118/67 to 153/110 mm HG. The blacks exhibited a greater diastolic blood pressure reactivity, as evidenced by a significant race x time interaction (p < 0.05). The heart rate responses were not significantly different between the two groups. The plasma levels of norepinephrine were similar at rest, but were 25% lower in the blacks than in the whites following isometric exercise (p < 0.01). Black subjects also demonstrated an increased pressor response to intravenous injections of phenylephrine at rest (p < 0.05). CONCLUSIONS The enhanced vascular sensitivity to norepinephrine may have contributed to the greater exercise pressor response in the blacks.
TL;DR: Lp(a) concentrations are high in Nigerians, particularly among women, and the association between the Lp( a) concentrations and other lipoproteins is stronger than in white populations.
Abstract: Objectives. To determine the distribution and determinants of lipoprotein (a) (Lp(a)) concentration among Nigerians. Methods. Subjects were recruited from civil servants living in Benin City, Nigeria. The height and weight of the individuals were measured and their use of alcohol and tobacco estimated by questionnaire. Laboratory analyses of blood samples involved Lp(a), total cholesterol (TC), high‐density lipoprotein (HDLC), HDL2c, HDL3c, triglyceride (TG) and insulin. Results. The analyses indicate that the Lp(a) concentrations are elevated among Nigerian populations and more skewed towards high levels than is observed for Caucasian and oriental groups. The median levels for Lp(a) were 24.0 mg dl‐1 and 19.0 mg dl‐1 for women and men, respectively. This difference was significant (p < 0.05) but after stratifying by age, only the 45–54 year‐old group of women (30.1 mg dl‐1) had significantly higher (p < 0.001) median concentrations of Lp(a) than men (18.4 mg dl‐1). Age, 20–64, had no influence o...
TL;DR: Retrospective review of records of all patients notified with TB in Birmingham during 1989-1994 suggests that from about the second decade of the next century, TB in the UK will almost be entirely a problem of ethnic minorities and that even if new infection was eliminated now in Asian people, cases due to reactivation would continue to occur until the third quarter of thenext century.
Abstract: Objectives. To describe the epidemiology of tuberculosis (TB) in Birmingham, UK, by ethnic group and to assess the implications of the findings for future trends in TB in the UK. Methods. Retrospective review of records of all patients notified with TB in Birmingham during 1989–1994. Results. The decline in TB notifications in Birmingham halted and then reversed in 1987–1992. Trends in overall notifications were mainly influenced by trends in cases of Asian origin. Crude notification rates in 1989–1994 are 17 times higher in Asian than Caucasian residents (p < 0.01). Rates in African Caribbean residents are also statistically significantly higher than in Caucasians (p < 0.01) but significantly lower than in Asians. Crude rates for Asian people born abroad are 4.1 times higher than for Asians born in the UK (p < 0.01) but only 3.8% of Asian patients had been resident in the UK for less than 1 year. The group accounting for the highest number of cases were female Asians aged 20–29, followed by male...
TL;DR: Assessing ethnocultural characteristics, in addition to maternal and infant characteristics, improves the prediction of 'Infant-Care Behaviours' scores.
Abstract: Objectives. To determine, among immigrants, what ethnocultural variables predict postpartum infant‐care behaviours over and above other maternal and infant characteristics. Methods. We recruited a cohort of immigrant women on hospital postpartum units. Data on predictor variables were collected during face‐to‐face interviews in the early postpartum period. Follow‐up telephone interviews occurred at 3 months postpartum to assess infant‐care behaviours. We identified 411 women meeting our eligibility criteria, of these 77.3% agreed to participate and 94% received follow‐up interviews. Results. In the first stage of a multiple linear regression analysis, maternal and infant predictors accounted for 24.2% of the variance in the ‘Infant‐Care Behaviours’ score. In the second stage of model building, ethnocultural variables explained an additional 5.8% of the variance. Separate analyses for recent immigrants (resident in Canada less than 3 years) and less recent immigrants (3 or more years) yielded some...
TL;DR: The mortality impact of the epidemic of type 2 diabetes and cardiovascular disease now accelerating among the Navajo is described, with significant mortality differences between the diabetes and non-diabetes groups and the continuing rise in prevalence of type 1 diabetes underscore the need for an effective community-based approach to diabetes prevention.
Abstract: Objectives. We sought to determine the contribution of type 2 diabetes mellitus to mortality in a Navajo population, and to assess the impact of pre‐existing coronary heart disease on this relationship. Methods. A cohort of 77 Navajos with type 2 diabetes mellitus and 77 non‐diabetic controls matched on age, gender and community of residence were followed for an 18‐year period, from 1974 to 1992. Results. The vital status of 152 of the 154 study subjects was ascertained at 18‐year follow‐up. There were 30 deaths (39%) in the type 2 diabetes group and 13 (17%) in the control group during the 18‐year period which was significantly different in bivariate matched pairs analysis (risk ratio = 3.12, McNemar's χ2 = 7.76, p < 0.07). Multivariate conditional logistic response models (risk ratio = 3.02, 95% CI 1.21, 7.53) and stratification analysis (McNemar's Summary χ2 = 8.05, 2 df, p < 0.05), confirmed that survival was significantly different for the two groups, even when controlling for baseline cardi...
TL;DR: This paper theorizes the link between communal experience and activity to promote health, by drawing on sociological theory linking structure and agency, and examines how discourses of belonging and exclusion are enacted in struggles for health.
Abstract: Community development for health (CD4H) is defined as the mobilization of communities actually or potentially suffering from a health problem to eliminate its causes or alleviate its consequences. This paper links this with questions of social identity, focusing on issues of ethnicity and ‘race’, in health promotion. When combined with notions of ethnicity and ‘race’. CD4H is frequently a reaction to inequalities which are communally experienced and believed to increase risk of ill‐health for the group. This paper theorizes the link between communal experience and activity to promote health, by drawing on sociological theory linking structure and agency. It examines how discourses of belonging and exclusion are enacted in struggles for health. Via examples from the Caribbean and the UK, instances of ‘identity politics’ in CD4H are identified, viewed as the use of essentialist, binary notions of self and other in the attempt to gain an advantage over the other. It is argued that such instances sho...
TL;DR: Perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and the lower perinatal deaths is probably caused by their favourable birth weight distribution and lower exposure to risk factors ofperinatal death by their mothers.
Abstract: Objectives. To confirm the observation that has been occasionally reported in the literature that perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and to assess the reasons for this lower perinatal mortality rate. Methods. Secondary‐analysis based on published data. Results. This exercise demonstrates that the perinatal mortality rate was lower in ethnic Chinese than in ethnic whites. The birth weight distribution in ethnic Chinese was more favourable with reduced births at two extremes of the distribution, and the exposure to risk factors for perinatal death by their mothers was also lower. Conclusion: Perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and the lower perinatal mortality rate in ethnic Chinese is probably caused by their favourable birth weight distribution and lower exposure to risk factors of perinatal death by their mothers.
TL;DR: The main concerns this paper sets out to explore is that translated information is decontextualised from the sets of knowledge and meanings of the population group to whom the information is directed, which can result in a disempowering experience for the community.
Abstract: Availability and access to correct information is a pre-requisite for people to be able to make informed decisions about their health. This paper will examine the effect of the sole reliance on translation in producing health promotion materials for people from Non English Speaking Background (NESB). In Australia since 1978 there has been a considerable quantitative increase in health-related information translated from English into other languages. The translation of pamphlets from English into other languages presents health educators with a number of problematic issues which often drastically undermine the material's effectiveness. One of the main concerns this paper sets out to explore is that translated information is decontextualised from the sets of knowledge and meanings of the population group to whom the information is directed. Thus, the cultural context underpinning the original version is transferred to different cultural contexts which are treated as homogeneous groups. The paradox here is that the translation model developed as a means of redressing the inequities created by the assimilation policy of the Australian post-war period, in practice maintains the philosophy that underpinned that policy. This can result in a disempowering experience for the community.
TL;DR: The data suggested that US regional differences in cancer ratios among African Americans exist, and among those African Americans that migrate to the north from the south, some cancer ratios also change, and that Illinois native had statistically significantly different ratios than both migrant groups and the southern homeland.
Abstract: We compared the proportional cancer incidence of Illinois‐born African Americans with those who migrated to Illinois from southern US states as children and adults, and with African American residents of the south. Adult Illinois residents, born between 1913 and 1966, who were diagnosed with cancer from 1986 through 1991 were classified by both birthplace and the state and year their social security number was assigned to determine their migration status: native, early (as child) migrant or late (as adult) migrant. African Americans of Atlanta were used to represent southern homeland ratios. Only lung cancer in African American females showed a statistically significant trend among the four groups, with Illinois natives having the highest ratio. Although no trend was identified, Illinois natives had statistically significantly different ratios than both migrant groups and the southern homeland for cancers of the oral cavity (males), colon (females) and leukemias (females). The data also suggested...
TL;DR: This study clearly needs to be replicated with a larger sample and also with interviews with both children and parents in order to validate the Rutter B2 questionnaires as an appropriate measure of disturbance in Bangladeshi children.
Abstract: Objectives. Bangladeshi children are less frequently referred to a child psychiatric clinic than their British peers. This study aimed to ascertain if teachers observed less psychological symptoms in Bangladeshi than British children. Method. Teachers completed a Rutter B2 Scale on samples of 113 ‘Bangladeshi’ and 61 British children aged between 5 and 11 years. Results. Teachers recognised less symptomatology in the Asian children than their British peers. This trend was significant in children under the age of 8, but there was no significant difference in those aged 8–11 years. Only 13% of Bangladeshi children were fully fluent in English. Conclusions. Two alternate hypotheses are put forward to explain these findings: (a) because more of the younger children could not speak English and communicate freely with their teachers, their symptoms were not noted by teachers; (b) the symptoms of the older children were a response to the pressures both the children and families faced as new immigrants. ...
TL;DR: It is found that Southern-born blacks had the highest homicide rates among the population 35+ years old in the Northeast, Midwest, South and West, yet non-migrants (region-born population) had higher rates than their Southern- born counterparts among the Population 15-34 years old.
Abstract: A study was made of all homicide deaths among black Americans during the period 1979-1991 in order to test two competing hypotheses about region of birth and region of death. One hypothesis was that Southern-born blacks had the highest homicide rates in every region of the US. The competing hypothesis was that blacks who did not migrate out of their region of birth had the highest homicide rates. We found that Southern-born blacks had the highest homicide rates among the population 35+ years old in the Northeast, Midwest, South and West. Yet non-migrants (region-born population) had higher rates than their Southern-born counterparts among the population 15-34 years old. Long distance migrants who were born in the Northeast, West or were foreign-born had the lowest homicide rates, by far. The distressing implications of these findings for public health efforts to prevent violent death are discussed.