African-Caribbean People Research Articles

Get Your Freak on: How black girls sexualise identity

Despite reported increasing levels of teenage pregnancy, and sexually transmitted infection among African-Caribbean young people in the UK, young Black women express sexual identities that are both over- and non-sexualised and exclude themselves from reference to sexual desire and experience. This article will argue that through engaging in complex processes of denigrating the sexual activity of other peers, young Black women attempt to portray themselves as sexually respectable. In doing so, they become entangled in the tensions created by such positions within school-based discourses of heterosexism. This discussion will explore the processes and implications of hiding/silencing Black female sexuality both for the emerging identities of Black girls and the sex educational discourses which attempt to engage with them.

Surveying older people from minority ethnic groups: an evaluation of a primary care sampling method for UK African-Caribbean elders.

There are substantial logistical difficulties in conducting community surveys of minority ethnic group populations. Primary care lists have been identified as an important potential resource but the representativeness of samples derived through this method has received little evaluation. In a community survey of psychiatric morbidity, African-Caribbean people aged 55-75 were identified by practice staff from registration lists for seven primary care teams in south London. The sensitivity of the process was evaluated by contacting a random sample of people whose ethnicity was not known. Participants aged 65-75 (n = 174) were also compared to a similarly aged group sampled through household enumeration (n = 34) with respect to demographic factors, risk factors for vascular disease, depression and cognitive function. For those with correct addresses, the identified group was estimated to include 72% of the potentially eligible population. Only 8% of contacted people were found not to be eligible in terms of ethnicity. Compared to the household enumeration sample, the primary care sample had marginally higher socio-economic status but was similar with respect to all other measured characteristics. Primary care list sampling with staff-assigned ethnicity therefore appeared highly specific, reasonably sensitive, and did not seem to introduce substantial bias for this population.

Ethnic identities, social capital and health inequalities: factors shaping African-Caribbean participation in local community networks in the UK

This paper examines the impact of ethnic identity on the likelihood of peoples’ participation in local community networks, in the context of recent policy emphasis on the participation of marginalised communities in such networks as a means of reducing health inequalities. Conceptually, the paper is located against the background of debates about possible links between health and social capital—defined in terms of grassroots participation in local community networks—and an interest in the way in which social exclusion impacts on social capital. The paper draws on lengthy semi-structured, open-ended interviews with 25 African-Caribbean residents of a deprived multi-ethnic area of a south England town. While African-Caribbean identity played a central role in peoples’ participation in inter-personal networks, this inter-personal solidarity did not serve to unite people at the local community level beyond particular face-to-face networks. Levels of participation in voluntary organisations and community activist networks were low. Informants regarded this lack of African-Caribbean unity within the local community as a problem, saying that it placed African-Caribbean people at a distinct disadvantage—furthering their social exclusion through limiting their access to various local community resources. The paper examines the way in which the construction of ethnic identities—within a context of institutionalised racism at both the material and symbolic levels—makes it unlikely that people will view local community organisations or networks as representative of their interests or needs, or be motivated to participate in them. Our findings highlight the limitations of policies which simply call for increased community participation by socially excluded groups, in the absence of specific measures to address the obstacles that stand in the way of such participation.

African and African Caribbean users' perceptions of inpatient services.

It has been suggested that well-documented differences in African and African Caribbean people's contact with mental health services may stem from the organization, processes and practices of services themselves. This article presents the findings of a qualitative study which explored the inpatient experiences of a sample of African and African Caribbean people. Although some positive experiences were described, in the main, participants' accounts revolved around a sense of loss of control and around experiences of overt and implicit racism. Underpinning these experiences were relationships with staff that were perceived to be unhelpful. On the basis of both the positive and negative experiences described, we draw conclusions about the changes required to ensure that inpatient services more effectively meet the needs of this group.

The academic and the community meet: two Black, female voices

This paper focuses on some of the life histories and presents experiences of two Black, professional women: one, a university, academic researcher (Doreen), and the other, a state nursery head teacher and research gate-keeper (Syble). We united with a mutual purpose, that is to embark on research into the success of Black children, now adults, of a 1970s Black-led, inner-city community nursery. Although sharing a research stage/agenda, the same gender, racial and social class grouping and thus seemingly having much in common, this paper will show that our stories sometimes vary substantially due to distinctive social, geographical, time-frame, career-choice factors, and personal and professional values. Issues such as identity, culture, citizenship, and race and racism will feature strongly here among some matters arising with regards to femininity and social class. The paper will conclude by emphasizing that among a homogeneous, gender and racial grouping of apparent generalities, individuals exist—a frequent oversight, especially with regards to African-Caribbean people.

Screening for cognitive impairment in older African-Caribbeans.

There are increasing numbers of older African-Caribbeans in the United Kingdom. Screening instruments are commonly used in the detection of cognitive impairment, but have not been assessed within this population. This study aimed to develop culturally modified versions of screening instruments for cognitive impairment (Mini-Mental State Examination (MMSE) and Abbreviated Mental Test (AMT)) and to determine their sensitivity and specificity in the diagnosis of dementia. The instruments were modified using a process involving a community group of African-Caribbeans and an academic group of health professionals. They were used in a two-stage study involving community resident African-Caribbeans aged 60 years or over in inner-city Manchester, comparing the screening instruments against a computerized diagnostic interview. One hundred and thirty people completed the study. The results for the largest subgroup, the Jamaicans (N = 96) were analysed. Effects of gender, age and education on the MMSE and AMT scores were evaluated. The correlations between the screening instruments and diagnostic interview were highly significant (P < 0.001). At appropriate cut-offs both screening instruments demonstrated high sensitivity and acceptable specificity levels. A defined process with lay input has assisted in producing culturally modified versions of the MMSE and AMT that perform well compared with a diagnostic interview, if an appropriate cut-off is used. They are easy to administer and acceptable to older African-Caribbean people. The results need to be viewed within the limitations of the current study.

The Deadly Triad

The Deadly Triad

First-contact incidence rate of schizophrenia on Barbados.

The incidence rate for broad schizophrenia among second-generation African-Caribbean people in the United Kingdom has been reported as high. Ethnicity, migration and psychosocial stressors have been suggested as causal factors. To determine the incidence of schizophrenia for the whole population of Barbados using an identical methodology to two previous studies in Trinidad (Bhugra et al, 1996) and London (Bhugra et al, 1997). A 12-month study of all persons in the 18-54-year age group presenting with a psychosis for the first time was carried out on the population of Barbados. Information was collected using World Health Organization screening and measurement instruments. On an island of just over a quarter of a million, 40 out of the 53 patients that met the inclusion criteria were categorised as S+ (narrow) schizophrenia, giving an incidence rate of 2.8/10,000 (95% CI 1.97-3.7). The incidence rate for broad schizophrenia was calculated at 3.2/10,000 (95% CI 2.3-4.1), which is significantly lower than the comparable rate for London's African-Caribbeans of 6.6/10,000 (95% CI 4.5-8.7). The very high rate for broad schizophrenia among African-Caribbean people in the UK is probably due to environmental factors.

Disparate diasporas: identity and politics in an African Nicaraguan community

Based on a decade the author spent among the African-Caribbean people on Nicaragua's southern Caribbean coast, Disparate Diasporas is a study of identity formation and politics in that community. Edmund Gordon lived in Bluefields, Nicaragua, during most of the 1980s, a turbulent period during which he participated in the community's search for solutions to problems ranging from a crumbling economic base to the mutual mistrust and animosity between most Creole people and the Sandinista revolutionary government. Disparate Diasporas is not a conventional ethnography. Rather than being just an observer, Gordon actively participated in the life of the community, intent on contributing to its political processes. A basic premise of his book is that engagement and activity can enhance ethnographic insights and sharpen theoretical understanding. Disparate Diasporas shows how a particular Black community can evolve distinct types of diasporic consciousness, and, depending on the historical moment, how different types of memories, consciousness, and politics come to predominate. The author uses the Gramscian notion of common sense to understand the Creole community's history of shifting politics and ideologies, focusing on the period of the 1970s and 1980s. His work explains the inability of the Sandinistas to come to terms with the racial and cultural challenge to the Nicaraguan nation posed by the Creole community.

Culturally sensitive validation of screening questionnaires for depression in older African-Caribbean people living in south London.

We tested the validity of two screens for depression in older African-Caribbean adults, the 15-item Geriatric Depression Scale (GDS) and a new Caribbean Culture-Specific Screen for emotional distress (CCSS). Two independent criteria were used for validity: (a) a psychiatric diagnosis derived from GMS-AGECAT, and (b) a culturally sensitive assessment of mental disorder, derived from a tool developed with local African-Caribbean religious healers. One hundred and sixty-four consecutive African-Caribbean primary care users, aged 60 years or older, were screened with the GDS and the CCSS. Diagnostic interviews were carried out on 80% of high scorers and 20% of low scorers. The number of cases detected by the two separate diagnostic approaches was similar. However, the agreement between who was and who was not a case was only modest. At a cut-off of > or = 5, the GDS was an adequate case detector for psychiatric depression, and, at a cut-off of > or = 4, for 'depressed/lost spirit', as defined by culture-specific criteria. It performed as well as the new CCSS. At a cut-off of > or = 4 the 15-item GDS can be recommended as a case detector for significant forms of depression in older African-Caribbean people living in south London.

The Oral Tradition of African-Caribbean People as a Resource for Black Christian Formation

The Oral Tradition of African-Caribbean People as a Resource for Black Christian Formation

Believing identity: Pentecostalism and the mediation of Jamaican ethnicity and gender in England

The complex and sometimes contradictory articulation of ethnicity, religion and gender informs this book on the cultural construction of identity for Jamaican migrants in Britain. The author argues that religion -- in this case Pentecostalism -- cannot be understood simply as a means of spiritual compensation for the economically disadvantaged. Rather, in the New Testament Church of God, one of Britain's largest African Caribbean churches, the cosmology of the church resolves the questions surrounding identity as well as suffering. Religious participation is one way in which African Caribbean people negotiate the terms of representation and interaction in British society.

Differences in mortality and morbidity in African Caribbean and European people with non-insulin dependent diabetes mellitus: results of 20 year follow up of a London cohort of a multinational study.

To examine differences in morbidity and mortality due to non-insulin dependent diabetes in African Caribbeans and Europeans. Cohort study of patients with non-insulin dependent diabetes drawn from diabetes clinics in London. Baseline investigations were performed in 1975-7; follow up continued until 1995. 150 Europeans and 77 African Caribbeans with non-insulin dependent diabetes. All cause and cardiovascular mortality; prevalence of microvascular and macrovascular complications. Duration of diabetes was shorter in African Caribbeans, particularly women. African Caribbeans were more likely than the Europeans to have been given a diagnosis after the onset of symptoms and less likely to be taking insulin. Mean cholesterol concentration was lower in African Caribbeans, but blood pressure and body mass index were not different in the two ethnic groups. Prevalence of microvascular and macrovascular complications was insignificantly lower in African Caribbens than in Europeans. 59 Europeans and 16 African Caribbeans had died by the end of follow up. The risk ratio for all cause mortality was 0.41 (95% confidence interval 0.23 to 0.73) (P = 0.002) for African Caribbeans v Europeans. This was attenuated to 0.59 (0.32 to 1.10) (P = 0.1) after adjustment for sex, smoking, proteinuria, and body mass index. Further adjustment for systolic blood pressure, cholesterol concentration, age, duration of diabetes, and treatment made little difference to the risk ratio. Unadjusted risk ratio for cardiovascular and ischaemic heart disease were 0.33 (0.15 to 0.70) (P = 0.004) and 0.37 (0.16 to 0.85) (P = 0.02) respectively. African Caribbeans with non-insulin dependent diabetes maintain a low risk of heart disease. Management priorities for diabetes developed in one ethnic group may not necessarily be applicable to other groups.

SURVEYING AFRICAN CARIBBEAN ELDERS IN THE COMMUNITY: IMPLICATIONS FOR RESEARCH ON HEALTH AND HEALTH SERVICE USE

We established a population-based register of African Caribbean people aged 65 and older by door knocking every other household within an electoral ward. The remaining households within the ward were either approached or eliminated on the basis of information from neighbours. The number of residents aged 65 and older found during our door knocking was fewer than those specified by the 1991 census for the black Caribbean and white ethnic categories, although the percentage of the census accounted for was higher for black Caribbeans. The discrepancy between our register and the 1991 census was inversely proportional to age. Based on information provided at the doorstep, there was no significant difference between African Caribbean and white elders in extent of GP registration and in time since last attendance at a GP appointment. We conclude that door knocking provides a feasible method for developing a register of African Caribbean elders residing within a defined geographical area. However, care must betaken in enumerating the young elderly.

SURVEYING AFRICAN CARIBBEAN ELDERS IN THE COMMUNITY: IMPLICATIONS FOR RESEARCH ON HEALTH AND HEALTH SERVICE USE

We established a population-based register of African Caribbean people aged 65 and older by door knocking every other household within an electoral ward. The remaining households within the ward were either approached or eliminated on the basis of information from neighbours. The number of residents aged 65 and older found during our door knocking was fewer than those specified by the 1991 census for the black Caribbean and white ethnic categories, although the percentage of the census accounted for was higher for black Caribbeans. The discrepancy between our register and the 1991 census was inversely proportional to age. Based on information provided at the doorstep, there was no significant difference between African Caribbean and white elders in extent of GP registration and in time since last attendance at a GP appointment. We conclude that door knocking provides a feasible method for developing a register of African Caribbean elders residing within a defined geographical area. However, care must be taken in enumerating the young elderly.

Bereavement counselling among African Caribbean people in Britain

(1995). Bereavement counselling among African Caribbean people in Britain. Contact: Vol. 118, No. 1, pp. 9-14.

The African Caribbean Eye Survey: risk factors for glaucoma in a sample of African Caribbean people living in London.

The purpose of the study was to estimate the prevalence of and risk factors for chronic glaucoma in a sample of African Caribbean people over 35 years of age living in the London Borough of Haringey. A cross-sectional voluntary sample of persons were subjected to detailed ophthalmic assessment including automated tangent screen suprathreshold visual field testing, applanation tonometry and stereoscopic disc evaluation in 50 community-based survey clinics over an 8 month period. Cases and suspects were referred to Moorfields Eye Hospital for more detailed assessment and confirmation of the diagnosis. Of 873 eligible persons examined (out of a total of 1022), 32 definite cases of glaucoma were identified, a prevalence of 3.9%; 42% of these had been previously diagnosed. Approximately 10% of the sample required further assessment and follow-up when ocular hypertensives and glaucoma suspects were included. An age-standardised comparison with the findings of the Roscommon survey revealed a relative risk for glaucoma for Haringey blacks compared with Irish whites of 3.7. Significant risk factors for glaucoma included age, African birthplace and darker skin colour. Neither diabetes nor hypertension reached significance. Despite the lack of a population base, this study provides strong evidence that the 4 times greater risk of glaucoma estimated for American blacks compared with whites applies equally to the United Kingdom population. Community-based facilities are required to raise awareness of the risk among this ethnic minority in this country and case-finding resources should be provided to meet local needs.