African-Caribbean Groups Research Articles

Promoting lifestyle changes in patients with prediabetes from African-Caribbean backgrounds in the United Kingdom

ABSTRACT Objectives Diabetes is a non-communicable disease where the patient’s glucose level in the blood is too high. Diabetes is prevalent among ethnic minority groups in the United Kingdom (UK). Type 2 diabetes is a major cause of premature mortality in England. Unfortunately, the lifestyle of these minority groups has become a barrier to diabetes healthcare treatment. The timely intervention of programmes targeting risk factors associated with diabetes may reduce the prevalence of diabetes among these ethnic minority groups. This review critically explores and identifies barriers that hinder specific African-Caribbean groups from accessing diabetes healthcare and how nurses can promote lifestyle changes in patients with prediabetes from African-Caribbean backgrounds. Design An extended literature review (ELR). The process consisted of a search of key databases and other nursing and public health journal articles with the keywords defined in this extended review (prediabetes, diabetes, lifestyle of Afro-Caribbean). Thematic analysis is then applied from a socio-cultural theoretical lens to interpret the selected articles for the review. Results Three main barriers were identified: (a) the strong adherence to traditional diets, (b) a wrong perception about diet management and (c) ‘Western medication’ as a key barrier that hinders effective diabetes management in ethnic minorities, including the African-Caribbean in the UK. Conclusion To address these barriers, it is important for policymakers to prioritise well-tailored interventions for African-Caribbean groups as well as support healthcare providers with the requisite capacity to provide care.

Prevalence and Comparison of the Profile of Patients Who Did Not Attend (DNA) Their Appointments Through Face-Face, Pre-Pandemic vs. Telephonic Consultations, Pandemic at the Complex Care Service- South, Wolverhampton - a Service Evaluation

AimsPatients who do not attend the appointments (DNA) pose a significant financial burden on the health care system. During the COVID-19 pandemic, there has been a shift from face-face to telephonic consultations. Our hypothesis was that pandemic can affect the prevalence of profile of clients who DNA. With this background, the aim of the current service evaluation was to assess the prevalence and profile of patients who did not attend their appointments through face-face consultation and telephonic consultations at the Complex care service south [CCS-South], Wolverhampton over a period of one year.MethodsRetrospective evaluation of records of DNA appointments at CCS- South, Wolverhampton of Face-face appointments during March 17th 2019- March 16th 2020 [Pre-pandemic group] and telephonic consultations during March 17th 2020 – March 16th 2021 [pandemic group] was done. Prevalence of DNA was calculated as the number of DNA in CCS South/ number of DNA in total CCS × 100. Student t test, Mann U Whitney test, Chi square test were used to analyse the data.ResultsThe number of DNA in the pandemic group (625) was significantly higher than the pre-pandemic group (376) [χ2 = 86.31, p <0.00001]. Males had significantly higher DNA in pre-pandemic group (59.52%) whereas females had significantly higher DNA in the pandemic group (66.76%) [χ2 = 72.97, p <0.00001]. The mean (SD) age of clients in the pandemic group was 41.17 (12.39) years was significantly lower than the mean (SD) age of clients in the pre-pandemic group, 42.87 (13.72) years [t = 1.97; p = 0.049].There was an increase in the Caucasian British (49.73% vs 38.40%) and Asian (29.52% vs 26.41%) in the pandemic group compared to pre-pandemic group. There was a decrease in the African-Caribbean group (10.11% vs 16.11%) and the mixed/other/unstated group (10.64% vs 19.20% vs) in the pandemic group compared to pre-pandemic group. It was the first DNA for twenty-four service users in the pre-pandemic group and none in the pandemic group. Those in the pandemic group (6.39 (6.79)) had significantly higher mean (SD) number of previous DNA than the pre-pandemic group (5.41 (7.50) [U = 98145; W = 293770; Z= -4.40; p = 0.000). There was no significant difference between the time of the appointment in both groups.ConclusionThere was an increased number of DNA during the pandemic period and the profile of those who DNA during the pandemic was of that a female with a mean age of about 41 years with previous DNAs.

Access to mental healthcare in the year after first fit note: a longitudinal study of linked clinical records

ObjectivesSickness absence is strongly associated with poor mental health, and mental disorders often go untreated. In this population-based cohort study, we identified people receiving fit notes from their general practitioner...

Microvascular Angina : A Diagnosis Hidden in Plain Sight

Background: Patients who are initially suspected of having ischemic heart disease, but in whom normal coronaries are discovered at angiography, are frequently believed to have pain of a non-cardiac aetiology. Micro vascular angina is hardly ever diagnosed save in peri-menopausal women. Physicians traditionally tend to view coronary microvascular disease and obstructive coronary artery disease as two separate entities. Notwithstanding, recent studies have begun to focus on endothelial dysfunction as being a key component in all cardiovascular diseases, with or without obstructive coronary lesions. Hypothesis: Patients suspected of having obstructive coronary disease associated with a significant risk factor burden, but in whom normal coronaries are found at angiography, in reality possess microvascular dysfunction. Objectives: • To determine the prevalence of normal coronaries at elective angiography compared to subjects with significant obstructive lesions. • To examine the influence of risk factor burden in patients who present normal coronaries in comparison with those who demonstrate obstructive lesions at angiography. • To suggest endothelial dysfunction as the common nexus underlying the disparities in cardiovascular morbidity observed among population samples. Methods: A group of 90 patients were randomly selected from clinical files of those who underwent elective coronary angiography between January, 2013 and May, 2017. The study cohort was comprised of 55 males and 35 females between the ages of 43 to 84 years. All subjects presented chest pain suspected of being coronary in origin. Coronary risk factors were recorded for each patient and the results were compared with findings at coronary angiography and then correlated with those encountered in medical literature. Results: Normal coronary angiograms were more prevalent in the African-Caribbean population (54.16%), than within the Mestizo-Mayan population (37.5%) Conversely, the finding of an obstructive lesion was more common in the Mestizo-Mayan population (56.25%), than within the African-Caribbean group (31.25%). The African-Caribbean group generally possessed a greater risk factor burden than their Mestizo-Mayan counterparts. Mayan counterparts. The percentage of women with normal coronaries (52.94%) showed a slight increase over that of men (47.05%). Males possessed a prevalence for obstructive disease of almost 4 times greater (79.48% vs. 20.5%) than females, yet females demonstrated a greater risk factor burden than males in most risk parameters. Hypertension was the most prevalent risk factor followed by dyslipidaemia and diabetes mellitus but these factors were more commonly encountered in patients with “normal” coronaries, than in those with obstructive lesions. Conclusion: Our study reported a significant number (56.66%) of “normal” coronaries at angiography. The majority (54.16%) of this figure pertained to the African-Caribbean sub-group, which in other studies also appeared to have a lesser coronary disease morbidity and mortality than their white counterparts despite having a greater risk factor burden. This is particularly true in the female African-Caribbean population. Several research papers have made reference to racial, ethnic and gender disparities in the manifestation of cardiovascular diseases. Paradoxically in some cases risk factor burden may be higher in the non-obstructive group rather than in the obstructive population. Convincing research has led us to believe that the vascular endothelium in its state of dysfunction plays a key role in explaining these disparities. Wherever cardiovascular risk factors exert their damage, endothelial injury and dysfunction ensues. Therefore, having an established risk factor burden portends microvascular dysfunction independently of any angiographic result.

Loneliness in mid-life and older adults from ethnic minority communities in England and Wales: measure validation and prevalence estimates

We investigated the prevalence of loneliness among 1206 adults aged 40 + from six minority communities in England and Wales: Black Caribbean, Black African, Indian, Pakistani, Bangladeshi and Chinese. Replicating the approach from the previous studies, we demonstrate robust acceptability, reliability and validity for both the six-item De Jong Gierveld (DJG) and single-item loneliness scales in our six ethnic groups. The prevalence of loneliness using a single-item question (loneliness reported as often/always) ranges from 5% (Indian) to 14% (Chinese) compared with approximately 5% for the general population aged 40 + in Britain. Levels of loneliness are very much higher using the DJG scale. Using a loneliness threshold score of 5 +, the percentage ranged from 13% (Indian) to 36% (Chinese). We explored the importance of six established loneliness vulnerability factors for our sample using regression modelling. Three factors were not associated with loneliness—number of children, gender and health rating, and three factors were protective: younger age, being married and low financial strain. The addition of ethnicity did not change these relationships or enhance statistical power of our models. Being a member of the African Caribbean group was protective against loneliness but not for the other groups included in our study. We suggest that exposure to loneliness vulnerability factors rather than ethnicity per se or measurement artefact underpins differences in loneliness across ethnic groups.

FLUJOS MIGRATORIOS EN EL SUR DE CHIAPAS: UNA NARRATIVA LOCAL DEL IMPACTO DE LAS CARAVANAS MIGRANTES Y LOS GRUPOS AFRICANOS

El presente artículo es una revisión documental cuyo objetivo es presentar una narrativa que plantea el impacto de la migración que se está dando en la ciudad de Tapachula, Chiapas. Se aplicó el método cualitativo y en particular el etnográfico utilizando como técnica de investigación la revisión documental, considerando como insumo las narrativas locales encontradas en las noticias, reportajes y artículos que los periódicos locales generan. Se parte de la narrativa cronológica de la migración centroamericana a través de las caravanas, y los grupos de África-caribeños los cuales están impactando en dimensiones como la cotidianeidad de la vida local y la mutación de las formas y maneras de migrar, todo ello en el periodo de octubre 2018- septiembre 2019. Se encontró que desde el año pasado el flujo de migrantes ha aumentado exponencialmente provocando una serie de interrelaciones culturales que están reconfigurando la cotidianidad; emergiendo así nuevas realidades y culturas como las muestras de xenofobia y discriminación que se están dando dentro de una política strictu sensu implementada desde el mismo gobierno. Se concluye con el planteamiento del nacimiento de una comunidad africana atrapada, avizorando nuevas crisis latentes en la cotidianidad.

Is the rule of halves still relevant today? A cross-sectional analysis of hypertension detection, treatment and control in an urban community.

To estimate percentages of patients with undiagnosed hypertension, diagnosed untreated hypertension and diagnosed, treated and uncontrolled hypertension and to identify sociodemographic factors for diagnosed, uncontrolled hypertension and not having a blood pressure (BP) reading recorded. Data from 320 094 patients aged 18 to less than 80 years from general practices in inner London was analysed using both last recorded BP (blood pressure) and mean BP. Logistic regression models identified factors associated with uncontrolled hypertension and no recorded BP. Twenty-nine thousand, seven hundred and nineteen (9.3%) patients had a recorded diagnosis of hypertension. On the basis of analysis of the last BP value, 14.2% (n = 4207) were untreated and 46.3% (n = 13 749) had uncontrolled hypertension; 10.0% (n = 28 274) without a prior hypertension diagnosis had undiagnosed hypertension. Corresponding values based on mean BP analysis were 8.9% (n = 2367) untreated, 51.5% (n = 13 734) uncontrolled; 4.1% (n = 11 446) undiagnosed. 17.5% (n = 55 960) had no recorded BP value.Black ethnicity was a predictor of uncontrolled hypertension: compared with the White British population, the adjusted odds ratio (AOR) for the Black African population was 1.39 (95% CI: 1.25-1.53) and for the Black Caribbean was 1.31 (95% CI: 1.19-1.45). The White Other group were most likely to have no record of BP measurement (AOR: 1.52; 95% CI: 1.47-1.57); conversely, unrecorded BP was less likely in the Black African (AOR: 0.79; CI: 0.74-0.83) and Black Caribbean (AOR: 0.71; CI: 0.66-0.76) groups, relative to the White British population. In an inner-city, multiethnic population, the 'rule of halves' still broadly applies to the diagnosis and control of hypertension, although only a small proportion were untreated.

Cerebral Blood Flow and Cognitive Functioning in a Community-Based, Multi-Ethnic Cohort: The SABRE Study.

Introduction: Lower cerebral blood flow (CBF) is associated with cardiovascular disease and vascular risk factors, and is increasingly acknowledged as an important contributor to cognitive decline and dementia. In this cross-sectional study, we examined the association between CBF and cognitive functioning in a community-based, multi-ethnic cohort.Methods: From the SABRE (Southall and Brent Revisited) study, we included 214 European, 151 South Asian and 87 African Caribbean participants (71 ± 5 years; 39%F). We used 3T pseudo-continuous arterial spin labeling to estimate whole-brain, hematocrit corrected CBF. We measured global cognition and three cognitive domains (memory, executive functioning/attention and language) with a neuropsychological test battery. Associations were investigated using linear regression analyses, adjusted for demographic variables, vascular risk factors and MRI measures.Results: Across groups, we found an association between higher CBF and better performance on executive functioning/attention (standardized ß [stß] = 0.11, p < 0.05). Stratification for ethnicity showed associations between higher CBF and better performance on memory and executive functioning/attention in the white European group (stß = 0.14; p < 0.05 and stß = 0.18; p < 0.01 respectively), associations were weaker in the South Asian and African Caribbean groups.Conclusions: In a multi-ethnic community-based cohort we showed modest associations between CBF and cognitive functioning. In particular, we found an association between higher CBF and better performance on executive functioning/attention and memory in the white European group. The observations are consistent with the proposed role of cerebral hemodynamics in cognitive decline.

Corrigendum

‘We All Black Innit?’ Analysing Relations Between African and African-Caribbean Groups in Britain Louise Owusu-Kwarteng University of Greenwich, UK Sociological Research Online 22(2): 9 http://www.socresonline.org.uk/22/2/9.html DOI: 10.5153/sro.4265 Published: 29 May 2017 The author wishes to make clear that the work of Godfrey Mwakigale cited as 2009 in paragraph 1.3, 3.10, 5.4, 8.3 was actually published in 2007. The author apologises for this oversight.

Patterns of illness and care over the 5\xa0years following onset of psychosis in different ethnic groups; the GAP-5 study

PurposePrevious research has not provided us with a comprehensive picture of the longitudinal course of psychotic disorders in Black people living in Europe. We sought to investigate clinical outcomes and pattern of care in Black African and Black Caribbean groups compared with White British patients during the first 5 years after first contact with mental health services for psychosis.Methods245 FEP cases aged 18–65 who presented to psychiatric services in 2005–2010 in South London (UK). Using the electronic psychiatric clinical notes in the South London and Maudsley NHS Foundation Trust (SLaM), extensive information was collected on three domains—clinical, social, and service use.ResultsDuring the 5-year follow-up (mean = 5.1 years, s.d. = 2.4; 1251 person years) after first contact with mental health services, a higher proportion of Black African and Black Caribbean ethnicity had compulsory re-admissions (χ2 = 17.34, p = 0.002) and instances of police involvement during an admission to a psychiatric unit (χ2 = 22.82, p < 0.001) compared with White British ethnic group. Patients of Black African and Black Caribbean ethnicity did not differ from the ethnic group in overall functional disability and illness severity, or frequency of remission or recovery during the follow-up period. However, patients of Black ethnicity become increasing socially excluded as their illness progress.ConclusionsThe longitudinal trajectory of psychosis in patients of Black ethnicity did not show greater clinical or functional deterioration than white patients. However, their course remains characterised by more compulsion, and longer periods of admission.

?We All Black Innit??: Analysing Relations between African and African-Caribbean Groups in Britain

‘We all Black innit?’ examines relationships between African and African-Caribbean communities in Britain. Historically, these groups have formed coalitions, especially in times of difficulty, for example in resistances against racism. Yet media coverage and academic research studies have highlighted ‘tensions’ between African and Caribbean migrants, especially those arriving from the latter stages of World War 2 and during the 1960s (Mwakigale 2007, Benson 1981). However, this research is limited and focuses specifically on the views and experiences of that particular generation. Very little, if any academic research considers the views and perceptions of second and third generation British born people of African and African-Caribbean descent, although plays, books and, more recently films have begun to explore this issue (see for example, Femi Oguns, Torn (2008) and Bola Agbaje's Gone Too Far (2013). Therefore, the following research draws on interviews with second and third generation British African and African Caribbean people to assess whether tensions still exist between the two groups, and if so, the potential causes, and if they replicate those of previous generations. Conversely it may be that there has been reconcilement between them, and establishment of new ‘race based coalitions’ (Rogers 2004). Again, the research considers the factors which may have contributed to this.

Engaging communities to improve mental health in African and African Caribbean groups: a qualitative study evaluating the role of community well-being champions.

Over the last decade, Britain has undergone reforms to promote engagement in local structures of governance. These reforms have encouraged the promotion of active citizenship and have been central to the government's public service modernisation agenda. This article presents the findings from a study evaluating a pilot outreach intervention which adopted a community engagement model to address the mental health needs of African and African Caribbean groups, which entailed a partnership between faith-based organisations, local public services and community organisations to co-produce the pilot project. Lay people were trained to raise awareness about mental health among these communities in South London. Between 2012 and 2013, a qualitative participatory approach was used to evaluate the pilot project, which enabled a researcher to take part in the engagement phase of the pilot project, and the project co-ordinators to be involved in the research process. Semi-structured, one-to-one interviews were carried out with 13 community and well-being champions (CWBCs) recruited from African and African Caribbean communities (seven male and six female). This study examines the impact of the relationship between the intervention and community through the participants' engagement in the pilot outreach project and the action undertaken as champions. We found that although CWBCs used circles of influence to share ideas about mental health and well-being and to encourage change, they encountered resistance on the part of the people they engaged with, which resulted from a lack of knowledge about mental health, taboos and ascribed stigma. We argue that CWBCs acted as healthy examples to communicate mental health knowledge to those approached, but that they needed to be equipped with bespoke communication skills to be able to talk about such sensitive issues as mental health.

Dementia in a Black and minority ethnic population: characteristics of presentation to an inner London memory service.

Aims and method To examine data on referrals to an inner-city London memory service to explore any differences in referral rates, cognitive assessments and stages of dementia at presentation between ethnic groups.Results African–Caribbean patients were well represented in the memory service. They were diagnosed with dementia on average 4.5 years younger than their White British counterparts and were more likely to be diagnosed with a vascular or mixed type dementia. However, scores on initial cognitive testing were significantly lower in the African–Caribbean group, possibly representing more advanced disease at presentation.Clinical implications Initiatives to access Black and minority ethnic populations earlier in the course of their illness should be considered. Professionals need to consider the potential for cultural bias in memory testing and diagnosing dementia in these populations, and the importance of cultural competency in assessments.

Ethnic differences in associations between fat deposition and incident diabetes and underlying mechanisms: the SABRE study.

ObjectiveTo examine ethnic differences in ectopic fat and associations with incident diabetes.MethodsIn a UK cohort study, 1338 Europeans, 838 South Asians, and 330 African Caribbeans living in London were aged 40-69 years at baseline. Baseline assessment included blood tests, anthropometry, and questionnaires. Anthropometry-based prediction equations estimated baseline visceral adipose tissue (VAT). Incident diabetes was ascertained from record review, self-report, or oral glucose tolerance testing.ResultsSouth Asians had more and African Caribbeans less estimated VAT than Europeans. Both ethnic minorities had larger truncal skinfolds than Europeans. In men, adjustment for risk factors (BMI, smoking, systolic blood pressure, and HDL-cholesterol) markedly attenuated the association between estimated VAT and diabetes in Europeans (standardized subhazard ratios [95% CI]: from 1.74 [1.49, 2.03] to 1.16 [0.77, 1.76]) and African Caribbeans (1.72 [1.26, 2.35] to 1.44 [0.69, 3.02]) but not South Asians (1.60 [1.38, 1.86] to 1.90 [1.37, 2.64]). In women, attenuation was observed only for South Asians (1.80 [1.01, 3.23] to 1.07 [0.49, 2.31]). Associations between truncal skinfolds and diabetes appeared less affected by multivariable adjustment in South Asians and African Caribbeans than Europeans (1.24 [0.97, 1.57] and 1.28 [0.89, 1.82] versus 1.02 [0.77, 1.36] in men; 1.91 [1.03, 3.56] and 1.42 [0.86, 2.34] versus 1.23 [0.74, 2.05] in women).ConclusionsDifferences in overall truncal fat, as well as VAT, may contribute to the excess of diabetes in South Asian and African Caribbean groups, particularly for women.

The North–South Dialogue in an Age of Exaggerated Development Ambitions

The decades of the 1960s and 70s can be characterised as a period of great excitement and euphoria with regard to expectations for wide-scale economic growth and development in the African Caribbean and Pacific (ACP) group of countries. Despite the vast array of literature on the reasons for the failure of most of these ACP states to achieve development, very little has been written regarding the way initial exaggerated development expectations and ambitions among ACP states contributed to their eventual disappointment. This paper, therefore, discusses the two main sets of factors which contributed to some of these initial development expectations and the general mood of optimism which helped to fuel the mood for radical demands from the developing countries for political and economic change. The discussion takes places with particular reference to the first ACP-EEC Agreement signed in 1975, known as the Lomé Convention, which at the time, was regarded the ‘litmus test’ of North–South relations.

Assessment And Comparison of Diet Quality And Physical Activity of African-Caribbean, South Asian and Caucasian Groups in The UK

Assessment And Comparison of Diet Quality And Physical Activity of African-Caribbean, South Asian and Caucasian Groups in The UK

A Systematic Review on Micronutrient Intake Adequacy in Adult Minority Populations Residing in Europe: The Need for Action

This systematic review evaluated micronutrient intake inadequacy of ten micronutrients for adult ethnic minority populations residing in Europe. Pubmed was searched for studies, related references were checked and experts consulted. Ten studies were identified and six were included in the final analysis representing Albanian, Roma, Sub-Saharan African, South Asian and African-Caribbean minority groups. The Estimated Average Requirement cut point was applied to estimate inadequate intake. With the exception of a sub-Saharan African study, of seven micronutrients analysed, inadequate intakes were markedly elevated (>50 % of the population in most cases) in both genders for folate, vitamin B(12), calcium and iron (the latter in females only). A pressing need exists for intake adequacy studies with sound methodologies addressing ethnic minority groups in Europe. These populations constitute a vulnerable population for inadequate intakes and results substantiate the need for further investigation, interventions and policy measures to reduce their nutritional risk.

Pathways to Forensic Mental Health Care in Toronto: A Comparison of European, African Caribbean, and other Ethnoracial Groups in Toronto

Pathways to Forensic Mental Health Care in Toronto: A Comparison of European, African Caribbean, and other Ethnoracial Groups in Toronto

Vitamin D deficiency amongst minority ethnic groups in the UK: a cross sectional study

BackgroundVitamin D deficiency is common amongst minority groups in Britain but its magnitude amongst South Asian (SA) and Black African-Caribbean (AC) groups is not well defined. The steroidal, endocrine nature of vitamin D provides it with a putative link with cardiovascular disease (CVD), and we hypothesised that aberrant levels of this hormone would reflect a heightened risk of CVD in these ethnic groups. MethodsSA (n=1105, 57% male) and AC (n=748, 51% male) were recruited as part of a community heart failure study from 20 primary care practices, Birmingham, UK. Vitamin D2/D3 levels were measured to determine rates of total vitamin D status, which were age/sex adjusted. ResultsThe majority of SAs had severe vitamin D deficiency (42.2%, 95% CI: 39.2–45.1), which was more frequent than in AC (12.5%, 10.2–14.9, p<0.001. Vitamin status in SA and AC was unrelated to the presence of osteoporosis, and on multivariate analysis of SA, vitamin D levels were independently associated with age (β=0.18, p<0.001), haemoglobin (β=0.12, p=0.002), and negatively with alkaline phosphatase (a marker of bone mineralisation, β=−0.11, p=0.022). Amongst AC, vitamin D was independently associated with having ever smoked (β=−0.13, p=0.006) and systolic blood pressure (β=0.10, p=0.038). ConclusionsVitamin D deficiency is a frequent biochemical observation amongst minority groups in Britain but the clinical significance is unclear, and ethnically specific. A proportionate susceptibility to bone disease is not apparent in either minority group.

Effect of ethnicity on erythropoietin therapy response for hemodialysis patients: A retrospective study

Anemia is a common feature in chronic kidney disease patients due to deficiency of erythropoietin (EPO). Diseased kidneys are unable to produce EPO, which enhances red blood cell production from the bone marrow. Recombinant human EPO in hemodialysis patients was introduced with perfect outcomes as a hormonal substitutive treatment. Some ethnic minority groups have high prevalence of anemia associated with chronic kidney diseases. The aim of this study is to evaluate the differences between African Caribbeans and Caucasians' EPO therapy response with regard to hemoglobin (Hb), some factors affecting it and some comorbid conditions. A retrospective study for 6 months of 100 patients on hemodialysis was conducted on two ethnic minorities groups; 46 patients were African Caribbean and 54 patients were Caucasian, who received EPO therapy at once or three times weekly dose at the Hanbury Dialysis Unit of Royal London Hospital. There were three types of EPO therapy used: Aranesp, Mircera and Neorecormon. Forty-six patients were African Caribbean and 54 patients were Caucasian. There were 63.4% of patients treated by Aranesp while 13% were given Mircera; 22.8% of the sample used Neorecorman. It was shown that the chosen comorbid conditions had higher percentage in the African Caribbeans than in Caucasians. Diabetic and/or hypertensive patients are almost double the patient numbers. In addition, sickle cell anemia is only present in African Caribbeans. There were 43.5% of African Caribbeans and 81.1% of Caucasians who met the standards of Hb level. There was no significant difference between African Caribbeans and Caucasians regarding parathyroid hormone, c-reactive protein, B12, mean corpuscular volume, ferritin, and folate. In this study, there was a significant difference in the Hb levels between African Caribbean and Caucasian groups. Sixty percent of African Caribbeans had mean Hb less than normal levels. However, they received lower EPO dose than Caucasians. As a result, this may affect the whole treatment and therapy which may lead to anemic complications.