Library Bulletin – Journal Articles – February 2010
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ETHNIC AND MINORITY GROUPS
CHAUDHRY, Nasim and WAHEED, Waquas and others. Development and pilot testing of a social intervention for depressed women of Pakistani family origin in the UK. Journal of Mental Health Vol 18, No 6 - December 2009: 504-509
Abstract: Background: Depressive disorders are common in women of Pakistani origin living in the UK. In a pilot study we developed and tested a culturally sensitive social group intervention for persistently depressed Pakistani women. Methods: A total of 55 persistently depressed women were identified in a population-based study. The first consecutive 18 who agreed to participate were enrolled into the study. Out of these, eight women dropped out before the start of the intervention, one woman attended the first session only and nine women attended 10 weekly sessions of the group. Outcome measures at baseline and at the end of the intervention were the 20 item Self Reporting Questionnaire (SRQ) and the Schedule for Clinical Assessment in Neuropsychiatry (SCAN).Results: All 9 women attended at least six of the 10 sessions. Mean SRQ score at baseline was 15.0 (SD??3.08) and 11.7 (SD??5.95) at the end of the intervention (p??0.039). Three women reported reduction in suicidal ideas. Conclusions: A culturally appropriate social intervention successfully brought together a group of isolated chronically depressed Pakistani women, enabling them to form informal networks and forming the basis of an RCT to treat the depression.
MARLOW, L A V and WARDLE, J and others. Ethnic differences in human papillomavirus awareness and vaccine acceptability. Journal of Epidemiology and Community Health Vol 63, No 12 - December 2009: 1010-1015
Abstract: Background: Studies of human papillomavirus (HPV) awareness and HPV vaccine acceptability have included few non-white participants, making it difficult to explore ethnic differences. This study assessed HPV awareness and HPV vaccine acceptability in a sample of women representing the major UK ethnic minority groups. Methods: A cross-sectional study design was used to assess awareness of HPV and acceptability of HPV vaccination. Participants were recruited using quota sampling to ensure adequate representation of ethnic minority women: Indian, Pakistani, Bangladeshi, Caribbean, African and Chinese women (n?=?750). A comparison sample of white British women (n?=?200) was also recruited. Results: Awareness of HPV was lower among ethnic minority women than among white women (6-18% vs 39% in white women), and this was not explained by generational status or language spoken at home. In a subsample who were mothers (n?=?601), ethnicity and religion were strongly associated with acceptability of HPV vaccination. Acceptability was highest among white mothers (63%) and lowest among South Asians (11-25%). Those from non-Christian religions were also less accepting of the vaccine (17-34%). The most common barriers to giving HPV vaccination were a need for more information, sex-related concerns and concern about side-effects. South Asian women were the most likely to cite sex-related concerns, and were also least likely to believe the vaccine would offer their daughters protection. Conclusion: These findings suggest some cultural barriers that could be addressed in tailored information aimed at ethnic minority groups. They also highlight the importance of recording ethnicity as part of HPV vaccine uptake data.
NAZROO, J Y and FALASCHETTI, E and others. Ethnic inequalities in access to and outcomes of healthcare: analysis of the Health Survey for England. Journal of Epidemiology and Community Health Vol 63, No 12 - December 2009: 1022-1027
Abstract: Background: Ethnic/racial inequalities in access to and quality of healthcare have been repeatedly documented in the USA. Although there is some evidence of inequalities in England, research is not so extensive. Ethnic inequalities in use of primary and secondary health services, and in outcomes of care, were examined in England. Methods: Four waves of the Health Survey for England were analysed, a representative population survey with ethnic minority over samples. Outcome measures included use of primary and secondary healthcare services and clinical outcomes of care (controlled, uncontrolled and undiagnosed) for three conditions - hypertension, raised cholesterol and diabetes. Results: Ethnic minority respondents were not less likely to use GP services. For example, the adjusted odds ratios for Indian, Pakistani and Bangladeshi versus white respondents were 1.29 (95% confidence intervals 1.07 to 1.54), 1.32 (1.10 to 1.58) and 1.35 (1.10 to 1.65) respectively. Similarly, there were no ethnic inequalities for the clinical outcomes of care for hypertension and raised cholesterol, and, on the whole, no inequalities in outcomes of care for diabetes. There were ethnic inequalities in access to hospital services, and marked inequalities in use of dental care. Conclusion: Ethnic inequalities in access to healthcare and the outcomes of care for three conditions (hypertension, raised cholesterol and diabetes), for which treatment is largely provided in primary care, appear to be minimal in England. Although inequalities may exist for other conditions and other healthcare settings, particularly internationally, the implication is that ethnic inequalities in healthcare are minimal within NHS primary care.
PICKETT, Kate E and SHAW, Richard J and others. Ethnic density effects on maternal and infant health in the Millennium Cohort Study. Social Science and Medicine Vol 69, No 10 - November 2009: 1476-1483
Abstract: Studies have suggested that members of ethnic minority groups might be healthier when they live in areas with a high concentration of people from their own ethnic group - in spite of higher levels of f material deprivation typically found within such areas. We investigated the effects of area-level same-ethnic density on maternal and infant health, independent of area deprivation and individual socioeconomic status, in five ethnic minority groups. The study was a cross-sectional analysis within the UK Millennium Cohort Study and included mothers in five ethnic minority groups (Black African n = 367, Bangladeshi n = 369, Black Caribbean n = 252, Indian n = 462 and Pakistani n = 868) and their 9-month-old infants. Outcome measures included: low birth weight, preterm delivery, maternal depression, self-rated health and limiting long-standing illness. Compared to those who live in areas with less than 5% of people from the same-ethnic minority population, Indian and Pakistani mothers were significantly less likely to report ever being depressed in areas with high same-ethnic density. There was a protective effect of ethnic density for limiting long-term illness among Bangladeshi mothers at 5-30% density and Pakistani mothers at all higher densities. Ethnic density was unrelated to infant outcomes and maternal self-rated health, and unrelated to any outcomes in Black African and Black Caribbean mothers and infants, possibly because no families in these groups lived at higher levels of same-ethnic density. Results were similar whether we examined smaller or larger residential areas. We conclude that, among ethnic minority mothers and infants in England, the relationship of ethnic density to health varies by ethnicity and outcome. For some measures of maternal health, in some ethnic groups, the psychosocial advantages of shared culture, social networks and social capital may override the adverse effects of material deprivation.
REES, Philip Howell and WOHLAND, Pia N and others. The estimation of mortality for ethnic groups at local scale within the United Kingdom. Social Science and Medicine Vol 69, No 11 - December 2009: 1592-1607
Abstract: As an input to projections of sub-national populations by ethnicity, this paper develops the first estimates of the mortality risks experienced by the UK ethnic groups. Two estimates were developed using alternative methods. In the first, UK 2001 Census data on limiting long-term illness to predict mortality levels and regression equations between local Standardized Illness and Mortality Ratios for all ethnicities are assumed to apply to individual ethnic groups. In the second, the geographical distribution of ethnic groups by local areas is combined with local mortality for all ethnicities to estimate national mortality rates by ethnicity, which are then employed to estimate local ethnic mortality. A comparison of the two estimates indicates that the method based on illness rates produces more plausible outcomes. The local SMRs produced for each ethnic group were used to generate ethnic group life tables for 432 UK local authority areas in 2001, which included estimates of survivorship probabilities by single year of age, gender and ethnic group for each local area for use in a projection model.
WILLIAMS , E D and STEPTOE, A and others. Psychosocial risk factors for coronary heart disease in UK South Asian men and women. Journal of Epidemiology and Community Health Vol 63, No 12 - December 2009: 986-991
Abstract: Background: South Asian people in the UK and other western countries have elevated rates of coronary heart disease (CHD). Psychosocial factors contribute to CHD risk, but information about psychosocial risk profiles in UK South Asians is limited. This study aimed to examine the profile of conventional and novel psychosocial risk factors in South Asian compared with white men and women. Methods: Using a cross-sectional population study design, psychosocial profiles were assessed in 1130 South Asian and 818 white European healthy men and women aged between 35 and 75 years, who had previously participated in a cardiovascular risk assessment programme in West London. Psychosocial factors potentially contributing to CHD risk were assessed using standardised questionnaires. Results: UK South Asians reported significantly higher psychosocial adversity compared with UK whites. South Asian men and women experienced greater chronic stress, in the form of financial strain, residential crowding, family conflict, social deprivation and discrimination, than white Europeans. They had larger social networks, but reported lower social support and greater depression and hostility. These effects were largely independent of socioeconomic status. Conclusion: UK South Asians experience significant psychosocial adversity compared with UK white Europeans. This is consistent with the heightened vulnerability to CHD observed in this population.