African-Caribbean Groups Research Articles

A vitalist approach to sugar-cane breeding in Barbados: In the context of the European Union Sugar Reform

The European Union (EU) recently terminated the Sugar Protocol, which had provided a guaranteed minimum price for sugar exports from countries in the African Caribbean and Pacific (ACP) group. Caribbean sugar producers have responded in a variety of different ways. This paper engages with the adjustment of the Barbadian sugar sector; in particular, the agronomic cane breeding and selection program currently underway.This paper demonstrates the value that vitalist materialism, as a philosophical approach, has for understanding the situated practices and politics of cane variety selection in Barbados. Approaching agronomic practices from a more-than-human, vitalist perspective has political as well as practical significance, illuminating the lack of attention given to the specific material relations and temporalities of sugarcane in national ‘adjustment’ plans.

Prevalence of Heart Failure and Atrial Fibrillation in Minority Ethnic Subjects: The Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES)

BackgroundLimited data exists on the prevalence of heart failure amongst minority groups in the UK. To document the community prevalence and severity of left ventricular systolic dysfunction, heart failure, and atrial fibrillation, amongst the South Asian and Black African -Caribbean groups in the UK.Methods and ResultsWe conducted a cross-sectional study recruiting from September 2006 to July 2009 from 20 primary care centres in Birmingham, UK. 10,902 eligible subjects invited, 5,408 participated (49.6%) and 5,354 had complete data (49.1%). Subjects had median age 58.2 years (interquartile range 51.0 to 70.0), and 2544 (47.5%) were male. Of these, 1933 (36.3%) had BMI>30 kg/m2, 1,563 (29.2%) had diabetes, 2676 (50.0%) had hypertension, 307 (5.7%) had a history of myocardial infarction, and 104 (1.9%) had history of arrhythmia. Overall, 59 (1.1%) had an Ejection Fraction<40%, and of these 40 (0.75%) were NYHA class ≥2; 51 subjects (0.95%) had atrial fibrillation. Of the remaining 19 patients with an EF<40%, only 4 patients were treated with furosemide. A further 54 subjects had heart failure with preserved ejection fraction.ConclusionsThis is the largest study of the prevalence of left ventricular systolic dysfunction, heart failure and atrial fibrillation in under-researched minority communities in the UK. The prevalence of heart failure in these minority communities appears comparable to that of the general population but less than anticipated given the high rates of cardiovascular disease in these groups. Heart failure continues to be a major cause of morbidity in all ethnic groups and preventive strategies need to be identified and implemented.

102 Ethnic differences in endothelial function in chronic heart failure

<h3>Background</h3> Endothelial dysfunction is characteristic of patients with heart failure (HF) and is associated with an increased risk of future cardiovascular events. However, data on ethnic differences in endothelial function in HF are scarce. In this study we aimed to compare parameters of macro- and micro-vascular endothelial function and arterial elasticity in HF age- and sex-matched patients of different ethnic origin: (i) white European, (ii) south Asian and (iii) African-Caribbean. Additionally, SA patients with systolic HF were compared to two matched control groups: (i) south Asian patients with coronary artery disease without HF(disease controls)and (ii) south Asian “healthy controls”. <h3>Methods</h3> We recruited 186 age/sex-matched patients with HF (ejection fraction &lt;40%) of SA (n=43, age 66.5±11.1 years), white (n=44, age 68.4±9.4 years) and African-Caribbean (n=21, age 69.2±10.3 years) origin; as well as 36 disease controls (age 64.0±10.6 years) and 40 healthy controls (n=40, age 63.3±9.24 years). Macrovascular endothelial function was assessed as brachial artery flow mediated dilation in response to hyperaemia (FMD) and glyceryltrinitrate were assessed by vascular ultrasonography (iE33, Philips, USA). Microvascular endothelial function was evaluated by laser Doppler flowmetry of forearm skin (DRT4, Moor Instruments, UK) after iontophoresis of acetylcholine and sodium nitroprusside. Arterial stiffness was quantified by pulse wave velocity and augmentation index using (Sphygmocor, Australia). <h3>Results</h3> Compared to disease controls and healthy controls south Asian patients with HF had impaired microvascular response to acetylcholine (390±302%, 549±264%, and 123±95.5%, respectively, p&lt;0.05) and reduced FMD (7.12±3.64%, 11.8±4.66%, and 4.86±4.88%, respectively). HF patients of south Asian origin had impaired microvascular endothelial function (response to acetylcholine123±95.5%) compared to white (258±15.6%) and African-Caribbean (286±17.3%) groups (p&gt;0.05). HF patients of white origin had higher FMD than south Asian (4.86±4.88%) and African-Caribbean (5.36±3.24%) patients (p&lt;0.05). No difference in glyceryltrinitrate- and sodium nitroprusside-mediated (endothelial-independent) response was observed between study groups. In south Asian subjects, parameters of pulse wave velocity and augmentation index did not differ between those with HF and those in control groups. No ethnic differences were detected in pulse wave velocity. Conclusion: South Asian patients with HF have impaired micro- and macro-vascular endothelial function, but preserved arterial elastic properties. Significant ethnic differences in endothelial function are present in patients with HF.

An Update on the Consequences of EU Sugar Reform

Since its formation the European Union (EU) has employed a rather complicated policy to ensure high prices to domestic sugar growers and trade preferences to certain sugar exporting countries, e.g. the African Caribbean and Pacific (ACP) group. One result of this policy is that the EU has been both the second largest importer and second largest exporter in the world market. Under pressure from the World Trade Organization (WTO), the EU agreed to reform its policies toward sugar in 2001, with the full effect of the reforms being fully implemented in 2006. In this paper, the impact of the sugar reform on EU production, consumption, imports, and exports is examined especially with regard to how it all affects the ACP countries who receive preferential treatment regarding access to EU sugar markets. Preliminary analysis indicates that lowering domestic EU prices, while quotas requirements for ACP countries remain intact might have negative revenue implications for poor sugar producers.

Income-related inequalities in common mental disorders among ethnic minorities in England

The relative prevalence of common mental health problems among different ethnic groups in Britain is one of the least researched topics in health variations research. We calculate and compare income-related inequalities in common mental disorders among ethnic groups in Britain. Data from a nationally representative survey of ethnic minorities (the EMPIRIC survey) were used to calculate concentration index values to indicate the extent of income-related inequalities within and across ethnic groups. Looking at income-related inequalities in common mental disorders within each of the ethnic groups, it was found that the burden of these disorders were greater for the lower income groups among the Irish, White and African Caribbean communities. Within-group inequality was less clearly defined for each of the three Asian communities: Indian, Bangladeshi and Pakistani. However, when the data were pooled and individuals were assigned income ranks in the pooled set (not within their own ethnic group), the relative position of those in lower income groups among the different groups was striking. The poor among the Bangladeshi, Pakistani and the African Caribbean groups clearly suffered both from low income and a greater burden of mental health morbidity than the other three groups. The effect of lower income is thus worse for the mental health of populations if they are African Caribbean, Pakistani or Bangladeshi than if they are White, Irish or Indian. Inequality in mental health morbidity between and within ethnic groups is at least partly linked to income, and thus to employment and education. Tackling disadvantage and discrimination in these areas could help to tackle the challenge of mental ill-health.

Racial variability of glaucoma risk factors between African Caribbeans and Caucasians in a Canadian urban screening population

Background: The significance of race in the development and progression of glaucoma remains controversial, although in most cases the evidence shows greater prevalence and progression of the disease in African American populations. The purpose of this study was to determine the impact of the African Caribbean race on the variability of risk factors for glaucoma in an urban Canadian screening population. Study Design: Population-based, cross-sectional study. Participants: Participants with high risk for development of open-angle glaucoma. Methods: Participants underwent confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomograph), frequency-doubling technology (FDT) perimetry, and complete ophthalmic examination during a high-risk glaucoma screening clinic. Statistical analysis was performed comparing the data gathered from these tests in the different racial groups. Student's t tests as well as Pearson's χ 2 tests were done. Results: Racial breakdown included 64 African Caribbeans (22%) and 224 Caucasians (78%). Racial groups had similar female/male ratios, but Caucasians were significantly older (66 [SD 12] years) than African Caribbeans (56 [SD 12] years) ( p = 0.001). African Caribbeans had significantly higher intraocular pressure (IOP) ( p < 0.001); thinner central corneal thickness (CCT) ( p < 0.001); greater cup/disc ratio ( p = 0.016), disc area ( p < 0.001), cup area ( p = 0.002), and cup/disc area ratio ( p = 0.009); and smaller rim/disc area ratio ( p = 0.009). The latter optic disc parameter differences were not statistically different when corrected for disc area differences. Conclusions: In this study, African Caribbeans in a Canadian urban setting were associated with increased risk factors for open-angle glaucoma development, including higher IOP and thinner CCT. The larger cup/disc and cup/disc area ratios of the African Caribbean group were directly correlated to disc area differences between the 2 groups.

Barriers to effective uptake of cancer screening among black and minority ethnic groups

To describe some of the factors that act as barriers to effective uptake of breast and cervical cancer screening services among black minority ethnic (BME) groups living in Brent and Harrow in the UK. A series of focus groups among African Caribbean, African, Gujarati, Pakistani, Greek and Arabic groups were held to discover their perceptions of cancer screening, the barriers to effective uptake and some strategies for intervention. This consisted of 135 participants: 85 women and 50 men. Analysis of focus group data has revealed poor knowledge, underlying health and cultural beliefs, attitudes, language and unhelpful attitudes of health professionals to be important barriers. In terms of strategies for effective intervention, the most popular strategy for improving uptake of screening services was community-based cancer awareness education that is sensitive to religious and cultural needs. There is a need to provide community-based education to increase the uptake of screening services among BME groups. It is essential to plan concurrently to educate GPs and other health professionals in cultural beliefs and customs, language needs, racial awareness and communication skills.

Visual impairment in ethnic minorities in the UK

We have conducted a research review of visual impairment in ethnic minorities in the UK to make recommendations for future research strategies. In the UK ethnic minorities represent about 6% of the population, but locally they may form a third or more of certain city totals. The age profile is relatively young, so that there are fewer older people, and thus less age-related blindness. The incidence of ethnically specific disease patterns has implications for service providers. Some are recognised, although there is less knowledge about the implications for eyesight. More common diseases, notably hypertension and diabetes show ethnic variation (specifically, raised prevalence). There are raised levels of glaucoma (in African-Caribbean groups) and cataract (in Asians), and possibly lower levels of myopia. Visual impairment may have a greater functional impact on minorities because they have worse levels of health and outcomes, and that other forms of social exclusion combine to result in worse quality of life. We conclude that: there is a need for greater cultural sensitivity in the provision of services and information; there is a need for more training and awareness of ethnic diversity among service providers; low levels of registration and apparent under-utilisation of preventive, rehabilitation and support services by black and minority ethnic groups should be studied; more research is needed into the contrast between interest and health issues and willingness to prevent ill-health, and low levels of knowledge among minority groups; and there is a need for greater sophistication in ethnic categorisation in research.

Risk factors and the prevalence of neurosis and psychosis in ethnic groups in Great Britain

Our aim was to examine whether variations in the prevalence of neurosis and psychosis between ethnic minorities throughout Great Britain are explained by social disadvantage. A total of 10,108 adult householders throughout Great Britain were assessed in a two-stage survey with the Revised Clinical Interview Schedule (CIS-R) and Psychosis Screening Questionnaire (PSQ). Respondents with a positive PSQ or who received a diagnosis of, or treatment for, psychosis were examined by a psychiatrist using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Data on respondents' preferred ethnic group were collapsed into four groups: Whites, African-Caribbean or Africans, south Asians and other. Ethnic grouping was strongly associated with: unemployment; lone parent status; lower social class; low perceived social support; poverty (indicated by lack of car ownership) and having a primary social support group of less than three close others. All these associations applied to the group Africans and Afro-Caribbeans, but only some applied to the other groups. No ethnic group had significantly increased rates of neurosis. Only the African-Caribbean group were at significantly increased risk of a psychotic disorder (odds ratio 4.55; 95% CI: 1.13, 18.30). After adjustment for risk factors, the odds of psychosis were lower (odds ratio 2.97; 95% CI: 0.66, 13.36). The excess of psychosis in Africans and Afro-Caribbeans in Great Britain appears to be partly explained by socio-economic disadvantage, but larger studies are needed to confirm this.

Normative data for ultrasound measurement of the calcaneus within different female ethnic groups.

The purpose of this study was to generate normative broadband ultrasound attenuation data for UK resident Indian-Asian, African-Caribbean and Chinese women, aged 20-80 years, using the McCue Cubaclinical II device. Additionally, comparisons were made against available Caucasian data previously collected by the authors. Exclusions were: use of hormone replacement therapy, corticosteroids or thyroxine for more than 6 months; menopause before the age of 45 years; oophrectomy; lactation within the preceding year; rheumatoid arthritis or a previous osteoporotic fracture. 977 women were recruited from various community centres, from a local GP surgery and from university colleges in the London area. Broadband ultrasound attenuation and velocity of sound were determined for the left and right os calces. Repeat measures on each side after re-positioning, to allow for anatomical variation, were averaged. Significance was set at a minimum level of 0.05. There were significant differences in non-dominant and dominant measures in all ethnic groups except African-Caribbean. For comparison purposes the means of the non-dominant measurements were plotted against age using a polynomial model to give the best data fit. No significant difference was found between non-dominant broadband ultrasound attenuation measurements for either Asian or Chinese when compared with the Caucasian sample populations. A significant difference in broadband ultrasound attenuation was found between African-Caribbean and Caucasian, with African-Caribbean between 10% (age group 20-30 years) and 29% (age group 70-80 years) higher. There was no significant difference in body mass index between Caucasian and Chinese groups, but significant differences were found between Caucasian and Asian, and between Caucasian and African-Caribbean groups.

"Don't know enough about it!": awareness and attitudes toward organ donation and transplantation among the black Caribbean and black African population in Lambeth, Southwark, and Lewisham, United Kingdom.

The current demand for transplant organs, particularly kidneys, far outweighs the supply in the United Kingdom. This problem is particularly severe for the black African and black Caribbean population, who have been shown to have a disproportionately greater presentation on kidney transplant waiting lists in some regions of the United Kingdom. The situation is clear: There is an urgent need to address the number of black African and black Caribbean patients requiring a kidney transplant, otherwise the human and economic costs will be high. An exploratory study was undertaken to assess the current awareness of organ donation and transplantation and to explore attitudes toward these issues in a cross-section of the black African and black Caribbean population in Lambeth, Southwark, and Lewisham. It was found that there was a lack of available information for the black African and black Caribbean communities. This precipitated low levels of awareness about organ donation and transplantation issues. In an effort to redress this, effective methods for targeting black African and black Caribbean groups are required. From this study, there are indications that appeals for organ donors may be more effectively communicated by using a grass-roots, community-network approach. For this reason, consideration should be given to language and cultural needs, and to the provision of culturally sensitive material and information.

Attitudes to self-sampling for HPV among Indian, Pakistani, African-Caribbean and white British women in Manchester, UK.

Objective: To examine attitudes to self-sampling for human papillomavirus (HPV) testing among women from contrasting ethnic groups. Setting: Manchester, UK. Methods: Two hundred women of Indian, Pakistani, African-Caribbean and white British origin were recruited from social and community groups to participate in a questionnaire survey. The questionnaire included items on attitudes to self-sampling and intention to use the test. Results: Willingness to try to use the test was high, and women did not foresee religious or cultural barriers to self-sampling; however, a large proportion of women were concerned about doing the test properly. This concern was greatest in the Indian and African-Caribbean groups. Conclusions: Although women's willingness to try self-sampling for HPV is encouraging, worries about carrying out the procedure correctly must be addressed if women are to feel confident about the results of self-sampling methods and reassured by a negative result.

Nutrient intakes of an adult Pakistani, European and African-Caribbean community in inner city Britain.

To report nutrient intakes for three different ethnic groups living in inner city Manchester and explore under-reporting in each group. Cross-sectional survey. All participants completed one of three food frequency questionnaires, specifically developed for each ethnic group, and took part in a larger international survey of risk factors for diabetes and hypertension. Participants were drawn randomly from seven GP registers in inner city Manchester, UK. Men and women aged 25-79 years, 86 European, 246 African-Caribbean origin and 84 Pakistani origin participants were included in the analysis. Body mass index was highest in the Pakistani women, 30.2 kg m-2. European participants had the highest reported energy intakes (EIs) for men and women (10.9 and 9.6 MJ, respectively). Pakistani men and women had the highest percentage of energy from fat (36.7 and 36.6%, respectively). Iron intakes were low in the African-Caribbean group and calcium intakes were low in the Pakistani group. Under-reporting [assessed as EI : basal metabolic rate (BMR) ratio <1.2] appeared to be high and occurred across all ethnic groups, with those apparently under-reporting having higher BMIs in all groups. The data provide nutrient intake estimates in three different ethnic groups using a similar method. Limitations include under-reporting across all ethnic groups in a similar pattern with under-reporters having higher BMIs in all groups, as found elsewhere.

African-Caribbean group activities, individual and collective consciousness, and enforced 'leisure'

The last two decades have been a period of enforced leisure time due to unemployment and under-employment. Although this type of leisure is unplanned, many people of African-Caribbean descent have used this period of their lives as a means of re-creating a sense of their selfhood through the use of group activities. This article is based on fieldwork data from Leeds and London and argues that work, leisure time, and the creation of individual and collective consciousness are combined as a survival strategy. Activities are usually a reactive response to create survival mechanisms that enhance positive portraits of self and community. Pendant les deux dernières deécennies, des 'loisirs forceés' sont devenus plus courants, à cause de facteurs tels que le chômage, le sous-emploi, et des changements de mode de vie. Bien que ce genre de loisir ne soit pas planifieé, beaucoup de personnes d'origine afro-caraïbeéenne ont utiliseé ce moment dans leur vie comme un moyen de recreéer leur personnaliteé propre à travers la pratique d'activiteés de groupe. Ce rapport d'un travail de terrain communautaire à Leeds et à Londres deémontre que le travail, les loisirs et la creéation d'une conscience individuelle et collective se combinent pour former une mode de strateégie de survie. En geéneéral, les activiteés permettent de reéagir en creéant des meécanismes de survie avec la promotion d'images positives de l'individu et de la communauteé.

Lower prevalence of pre-morbid neurological illness in African-Caribbean than White psychotic patients in England.

It has been suggested that the increased incidence of psychosis in African-Caribbeans living in England may be due to illnesses in which social stress plays an important aetiological role. If this is the case, the prevalence of factors associated with psychosis that predate illness onset such as obstetric complications, pre-morbid neurological illness and poor childhood social adjustment may be expected to be lower in African-Caribbean than Whites psychotic patients. Details of obstetric complications, pre-morbid neurological illness, and pre-morbid social adjustment were obtained for 337 psychotic patients by patient interview, interviews of mothers and chart review. The proportions of patients with each 'risk factor' in the African-Caribbean (N = 103) and White (N = 184) groups were compared using regression analysis; age, sex, social class, diagnosis and referral status were possible explanatory variables. African-Caribbean patients were less likely to have suffered a pre-morbid neurological disorder than their White counterparts (odds ratio 0.19, 95% CI 0.06-0.61). There was no significant difference in pre-morbid social adjustment or obstetric complications between the two groups, though fewer obstetric complications were reported in the African-Caribbean group (21.5%) than the White group (30.9%). African-Caribbean patients with psychosis have experienced less pre-morbid neurological illness.

A Comparison of Family Environment Characteristics Among White (Non‐Hispanic), Hispanic, and African Caribbean Groups

To investigate differences in the family environments of different cultural groups, the Family Environment Scale and a clinical interview were administered to 153 college students from White (non‐Hispanic), Hispanic, and African Caribbean backgrounds. A multivariate analysis of covariance and post hoc comparisons revealed significant differences between the groups on the Expressiveness, Independence, and Moral‐Religious Emphasis subscales.Para investigar las distinciones en los ambientes familiares entre grupos culturales diferentes, la Escala del Ambiente Familiar (FES) y una entrevista clínica fueron administradas a 153 estudiantes colegiales Blancos (no‐Hispanos), Hispanos, y Africano‐Caribeños. Un análisis de la covariancia multivariado y comparaciones post hoes revelarón diferencias significativas entre los grupos en Expresividad, Independencia, y Enfasis Moral‐Religioso.

Nutrient intake trends among African-Caribbeans in Britain: a migrant population and its second generation.

To explore British African-Caribbean (AfC) nutrient intake by migration status (place of birth), diet (traditional Caribbean or more European) and age and relate this ecologically to coronary heart disease (CHD) mortality rates. Cross-sectional. Inner-city Manchester, UK. Two hundred and fifty-five adults of AfC origin aged 25-79 years, randomly sampled from population registers. Caribbean-born people (mean age 56, and mean time in Britain 30 years) had significantly lower per cent energy from total and saturated fat than younger British-born AfC people (mean age 29 years) (31.3% vs. 35%, difference in total fat 3.7%, 95%CI 2-5%; in saturated fat 10.9% vs. 12.6%, difference 1.7%, 95%CI 1-2.5%). The Caribbean-born group also ate more fruit (+84g/day-1, 95%CI 36-132g/day-1) and green vegetables (+26 g/day-1, 95%CI 3-49 g/day-1). Men following a traditional diet (> or = 5 days week-1) similarly had a lower per cent energy from fat, at 30.4%, than less traditional eaters, at 33.1% (difference 2.7%, 95%CI 0.7-4.8%). African-Caribbean women, at relatively greater CHD risk than AfC men, had higher body mass indices (BMIs) than AfC men. Compared with national data, AfC subjects consumed some 7% and 5% less energy from total fat and saturated fat, respectively, with over 9% more from carbohydrate. However, there was marked convergence towards the national average in the youngest AfC groups aged 25-34 years, whatever their place of birth. Caribbean birthplace has an independent effect on total fat intake and percentage of energy from fat. Together with higher fruit and vegetable intake, these results are consistent with the dietary fat/antioxidant/CHD hypothesis.

Abnormal eating attitudes and behaviours in two ethnic groups from a female British urban population

African-Caribbean (N = 136) and White British (N = 192) female family planning clinic attenders were administered the Bulimic Investigatory Test, Edinburgh (BITE) and the General Health Questionnaire (GHQ-28). A proportion of the participants were subsequently interviewed. The African-Caribbeans were found to have both significantly more disordered eating attitudes and a significantly higher level of abnormal eating behaviour than the White British. Although the African-Caribbean group had a significantly higher mean Body Mass Index this did not mediate the difference in levels of eating attitudes. When compared with the White British group more African-Caribbean women reported feelings of failure, guilt, abnormality and self-consciousness concerning their eating habits. The results indicate that eating problems may be highly prevalent in this ethnic minority population and suggest that there may be differences in the nature of eating disorder psychopathology between ethnic groups.

Abnormal eating attitudes and behaviours in two ethnic groups from a female British urban population

African-Caribbean (N = 136) and White British (N = 192) female family planning clinic attenders were administered the Bulimic Investigatory Test, Edinburgh (BITE) and the General Health Questionnaire (GHQ-28). A proportion of the participants were subsequently interviewed. The African-Caribbeans were found to have both significantly more disordered eating attitudes and a significantly higher level of abnormal eating behaviour than the White British. Although the African-Caribbean group had a significantly higher mean Body Mass Index this did not mediate the difference in levels of eating attitudes. When compared with the White British group more African-Caribbean women reported feelings of failure, guilt, abnormality and self-consciousness concerning their eating habits. The results indicate that eating problems may be highly prevalent in this ethnic minority population and suggest that there may be differences in the nature of eating disorder psychopathology between ethnic groups.

The geographic allocation of the European development fund under the Lomé Conventions

The bulk of the financial assistance provided by the European Community to members of the African Caribbean and Pacific Group of states under the Lomé Conventions has been channelled through “National Indicative Programs.” A statistical analysis of the allocation of these funds across countries (made by the European Community according to its own, unpublished, criteria) reveals that they may be related not only to a recipient's needs (as represented by population and income per capita) but also to its geographic location and to the nature of a recipient's prior association with the Community.