Asian Ethnic Minority Research Articles

The effect of post‐natal mental distress amongst Indian and Pakistani mothers living in England on children's behavioural outcomes

Low socio-economic status (SES), post-natal mental distress and parenting impact child mental health and future well-being. There are unexplained differences in child mental health between South Asian ethnic minority groups living in the UK that may be due to variation in, and differential mediation of, these factors. We used multivariate multiple regression analysis of the effect of symptoms of mental distress, socio-demographic variables and warmth of parenting on child internalizing and externalizing scores at age seven (measured in 2010) in a population cohort of English children whose mothers were of Indian (n = 211) and Pakistani (n = 260) origin. In the fully adjusted models the legacy of mental distress was visible for both internalizing (β coefficient 1.52, P = 0.04) and externalizing (1.68, P = 0.01) behaviour in the Pakistani children, and on the Indian children's internalizing (2.08, P = 0.008) but not externalizing (0.84, P = 0.204) behaviour. Lower SES was associated with worse behavioural scores for the Pakistani children, and warmth of parenting on Indian children's externalizing scores. Symptoms of post-natal mental distress are associated with Indian and Pakistani child outcomes at age seven. The finding that warmth of parenting had a stronger association on Indian children's externalizing scores than mental distress might be explained by differences in the expression of SES on family characteristics and functioning between the two ethnic groups.

Embodying Gender, Age, Ethnicity and Power in ‘the Field’: Reflections on Dress and the Presentation of the Self in Research with Older Pakistani Muslims

In recent years, there has been an increasing interest in researching people growing older in the South Asian ethnic minority communities in the UK. However, these populations have received comparatively little attention in wide-ranging discussions on culturally and socially appropriate research methodologies. In this paper, we draw on the experiences of a young female Pakistani Muslim researcher researching older Pakistani Muslim women and men, to explore the significance of gender, age and ethnicity to fieldwork processes and ‘field’ relationships. In particular, we highlight the significance of dress and specific presentations of the embodied self within the research process. We do so by focusing upon three key issues: (1) Insider/Outsider boundaries and how these boundaries are continuously and actively negotiated in the field through the use of dress and specific presentations of the embodied ‘self’; (2) The links between gender, age and space - more specifically, how the researcher's use of traditional Pakistani dress, and her differing research relationships, are influenced by the older Pakistani Muslim participants’ gendered use of public and private space; and (3) The opportunities and vulnerabilities experienced by the researcher in the field, reinforced by her use (or otherwise) of the traditional and feminine Pakistani Muslim dress. Our research therefore highlights the role of different presentations of the embodied ‘self’ to fieldwork processes and relationships, and illustrates how age, gender and status intersect to produce fluctuating insider/outsider boundaries as well as different opportunities and experiences of power and vulnerability within research relationships.

The prevalence of personality disorder among ethnic minorities: findings from a national household survey

ABSTRACTStudies that have examined the ethnicity of people with personality disorder (PD) in contact with mental health services have generally reported that those from ethnic minorities are under‐represented. However, the relationship between ethnicity and PD in the community is unclear. We therefore conducted a secondary analysis of data from a national household survey of people living in Great Britain to compare levels of PD among people from different ethnic backgrounds. Personality was assessed using the SCID‐II screening questionnaire. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated for the likelihood of people from Black, Asian and other ethnic minority groups having PD. Compared with White subjects, PD was more prevalent among people from Black (OR = 1.44; 95% CI = 1.07–1.96) and other ethnic minority groups (OR = 1.50; 95% CI = 1.07–2.10). These data suggest that in Great Britain, PD is at least as prevalent among Black and other minority ethnic groups as it is among White people. Further efforts need to be made to ensure that people with PD have access to suitable services regardless of their ethnicity. Copyright © 2012 John Wiley & Sons, Ltd.

Perceived Ethnic Stigma Across the Transition to College

Ethnicity-based negative treatment during the transition to college may affect the long-term adjustment of ethnic-minority youth. We examined within-person changes in youths' perceptions of overt discrimination and their sense of their ethnic group being devalued by the larger society among 563 Latino, European, Asian, and other ethnic minority emerging adults across the transition to college (M (age)=17.79, SD=.37, 54.7% female). Analyses tested for group and context differences and associations between perceived discrimination and societal devaluation of their group and adjustment. Results indicate that although perceived discrimination decreases over time, perceived devaluation by society increases. Social context did not affect changes in perceived discrimination and societal devaluation. Whereas perceived discrimination was associated with depressive and somatic symptoms for everyone, perceived societal devaluation was only consequential for ethnic minorities. Future research should identify possible moderators to help students cope with experiences of discrimination and feelings of not being valued by society.

Recruiting South Asians to a lifestyle intervention trial: experiences and lessons from PODOSA (Prevention of Diabetes & Obesity in South Asians)

BackgroundDespite the growing emphasis on the inclusion of ethnic minority patients in research, there is little published on the recruitment of these populations especially to randomised, community based, lifestyle intervention trials in the UK.MethodsWe share our experience of recruitment to screening in the PODOSA (Prevention of Diabetes and Obesity in South Asians) trial, which screened 1319 recruits (target 1800) for trial eligibility. A multi-pronged recruitment approach was used. Enrolment via the National Health Service included direct referrals from health care professionals and written invitations via general practices. Recruitment within the community was carried out by both the research team and through our partnerships with local South Asian groups and organisations. Participants were encouraged to refer friends and family throughout the recruitment period.ResultsHealth care professionals referred only 55 potential participants. The response to written invitations via general practitioners was 5.2%, lower than reported in other general populations. Community orientated, personal approaches for recruitment were comparatively effective yielding 1728 referrals (82%) to the screening stage.ConclusionsThe PODOSA experience shows that a community orientated, personal approach for recruiting South Asian ethnic minority populations can be successful in a trial setting. We recommend that consideration is given to cover recruitment costs associated with community engagement and other personalised approaches. Researchers should consider prioritising approaches that minimise interference with professionals' work and, particularly in the current economic climate, keep costs to a minimum. The lessons learned in PODOSA should contribute to future community based trials in South Asians.Trial RegistrationCurrent Controlled Trials ISRCTN25729565

Rural Policing and Policing the Rural. By Rob I. Mawby and Richard Yarwood (Farnham, Surrey: Ashgate Publishing, 2011, 261pp. 60.00 hb)

As the editors explain, this volume is aiming to cross geographical and criminological barriers. As outlined in their introduction, they have drawn authors from geography and criminology, using ‘international, inter-disciplinary perspectives’. This mix appears to enrich the text in terms of both academic disciplines and what is known about policing in various places and spaces across the world. The book is more than a ‘niche’ publication in the world of policing texts, however. It provides an insight that says a great deal about policing in general. For example, it explores how police priorities alter in terms of crime volume and powerful voices who demand attention. It is illustrative of the way police culture will find a group, such as travellers or Gypsies to ‘other’ if no black, Asian or visible ethnic minorities are available. It also shows how the police believe themselves to be ‘in charge’ of law and order and how they ‘know best’ how areas should be policed.

Aliens: A Comparative Study of South Asian Ethnic Minority Entrepreneurs in Great Britain

Within this introduction the study seeks to provide background information to the subject which will identify the rationale and focus of the research. While doing Masters at University College Northampton I have found little research on the diversity of the entrepreneurial activity of the South Asian minority groups in Britain. However, there has been an increasing recognition to highlight the diversity of business characteristics and experience between different South Asian minority groups, rather than simply treating them as a single group. The understanding of this diversity is important as it will help both policy and research practitioners become flexible and responsive in developing appropriate banking or public policy for South Asian business(Smallbone, Bertotti and Ekanem, 2003; Basu and Altinay, 2002; Ram, Smallbone and Deakins, 2002). Despite a range of cultural and structural literature on ethnic entrepreneurship, there are only preliminary answers which explain the increased heterogeneity among South Asian entrepreneurs. Moreover, most of the previous research was not statistically rigorous and hence the findings are open to doubt. Hence in order to avoid the pitfalls of earlier research and to have a complete picture of the diversity of South Asian entrepreneurial activities, it was decided to undertake research on three South Asian groups in the UK

Neighborhood Air Quality, Respiratory Health, and Vulnerable Populations in Compact and Sprawled Regions

Problem: Recently, public health researchers have argued that infill development and sprawl reduction may improve respiratory outcomes for urban residents, largely by reducing vehicle travel and its attendant mobile-source emissions. But infill can also increase the number of residents exposed to poor air quality within central cities. Aside from emissions studies, planners have little information on the connections between urban form, ambient pollutant levels, and human exposures or how infill changes these. Purpose: We examined neighborhood exposures in 80 metropolitan areas in the United States to address whether neighborhood-level air quality outcomes are better in compact regions than in sprawled regions. Methods: We used multilevel regression models to find the empirical relationship between a measure of regional urban form and neighborhood air quality outcomes. Results and conclusions: Ozone concentrations are significantly lower in compact regions, but ozone exposures in neighborhoods are higher in compact regions. Fine particulate concentrations do not correlate significantly with regional compactness, but fine particulate exposures in neighborhoods are also higher in compact regions. Exposures to both ozone and fine particulates are also higher in neighborhoods with high proportions of African Americans, Asian ethnic minorities, and poor households. Takeaway for practice: Compact development and infill do not solve air quality problems in all regions or for all residents of a given region. Planners should take differences in neighborhood air quality and human exposure into account when planning for new compact developments rather than just focusing on emissions reductions. Research support: This project was supported by a grant from the ShenAir Institute at James Madison University and by the National Oceanographic and Atmospheric Administration.

Survival of patients from South Asian and Black populations starting renal replacement therapy in England and Wales

Background. South Asian and Black ethnic minorities in the UK have higher rates of acceptance onto renal replacement therapy (RRT) than Caucasians. Registry studies in the USA and Canada show better survival; there are few data in the UK.Methods. Renal Association UK Renal Registry data were used to compare the characteristics and survival of patients starting RRT from both groups with those of Caucasians, using incident cases accepted between 1997 and 2006. Survival was analysed by multivariate Cox's proportional hazards regression split by haemodialysis and peritoneal dialysis (PD) due to non-proportionality, and without censoring at transplantation.Results. A total of 2495 (8.2%) were South Asian and 1218 (4.0%) were Black. They were younger and had more diabetic nephropathy. The age-adjusted prevalence of vascular co-morbidity was higher in South Asians and lower in Blacks; other co-morbidities were generally common in Caucasians. Late referral did not differ. They were less likely to receive a transplant or to start PD. South Asians and Blacks had significantly better survival than Caucasians both from RRT start to Day 90 and after Day 90, and for those on HD or PD at Day 90. Fully adjusted hazard ratios after Day 90 on haemodialysis were 0.70 (0.55–0.89) for South Asians and 0.56 (0.41–0.75) for Blacks.Conclusion. South Asian and Black minorities have better survival on dialysis. An understanding of the mechanisms may provide general insights for all patients on RRT.

Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics.

BackgroundA number of studies have reported low uptake of cancer screening programmes by South Asian populations in the UK. However, studies to date have not adjusted findings for differences in demographics and socio-economic status of these populations.MethodsSubjects: All residents in Coventry and Warwickshire, UK, eligible for screening. Uptakes compared for round 1 (2000–02) and round 2 (2003–05) of a national bowel cancer screening pilot, and for rounds 1, 2 and 5 of the established NHS breast cancer screening programme (commenced 1989).Data: Bowel screening data were analysed for 123,367 invitees in round 1 and 116,773 in round 2 (total 240,140 cases). Breast screening data were analysed for 61,934, 62,829 and 86,749 invitees in rounds 1, 2 and 5 respectively (total 211,512 cases).Analysis: Screening uptake was compared for two broad meta-categories (South Asian and non-Asian) and for five Asian subgroups (Hindu-Gujarati; Hindu-Other; Muslim; Sikh; South Asian Other). Univariate and multivariate analyses examined screening uptake and various demographic attributes of invitees, including age, gender, deprivation and ethnic group.ResultsSouth Asians demonstrated significantly lower (p < 0.001) unadjusted bowel screening uptake; 32.8% vs. 61.3% for non-Asians (round 1). Rates were particularly low for the Muslim subgroup: 26.1% (round 1), 21.5% (round 2). For breast screening, a smaller difference was observed between South Asians and non-Asians; initially 60.8% vs. 75.4% (round 1) and later 66.8% vs. 77.7% (round 5). Thus, the disparity reduced gradually over time, alongside an overall trend of increased uptake. However, figures remained consistently low for Muslims (51% in rounds 1 and 5). After adjusting for age, deprivation (and gender), bowel screening uptake remained significantly lower for all South Asian subgroups. After similar adjustments, breast screening uptake remained lower for all subgroups except Hindu-Gujaratis.For Muslims registered with an Asian (vs. non-Asian) GP, bowel screening uptake was significantly lower (p < 0.001). However, breast screening uptake for Muslims with an Asian (vs. non-Asian) GP showed no difference (p = 0.12) in the same period.Colonoscopy and breast assessment uptakes were similar for both meta-categories, but Asian response time appeared slower for colonoscopy. The percentage of abnormal FOBT results was significantly higher for South Asian invitees. A slight increase in abnormal mammograms was observed for Muslims over time (2.7% to 4.2% in rounds 1 and 5 respectively).ConclusionThe lower cancer screening uptakes observed for the South Asian population cannot be attributed to socio-economic, age or gender population differences. Although breast screening disparities have reduced over time, significant differences remain. We conclude that both programmes need to implement and assess interventions to reduce such differences.

Clinicians’ Self-assessment of Cultural and Spiritual Competency: Working with Asians and Asian Americans

This study examines clinicians' own assessment of their cultural and spiritual competency in working with Asians and Asian Americans. Thirty clinicians, who are Asian Ethnic Minority Mental Health Specialists in the Northwest region of the United States, were surveyed to assess their perceived levels of cultural and spiritual competency. The study found that clinicians perceived themselves as being less spiritually competent than culturally competent and that most clinicians acknowledged the need for more training in spirituality.

Asians, Pacific Islanders, and Ethnoburbs in Auckland, New Zealand

ABSTRACT. Recent work on Asian ethnic minority immigrants to cities in the Anglophone Pacific Rim argues that their settlement patterns do not conform to those of earlier migrant streams. Instead of concentrating in high‐density, low‐quality, inner‐city housing, these new residents are moving directly to suburban areas where they form much less intensive concentrations—ethnoburbs—than has been typical of other culturally distinct migrant groups. We evaluate this thesis for Asian migrants in the Auckland metropolitan area, whose numbers more than quadrupled between 1991 and 2006. Their residential pattern is compared with that of Pacific Islanders also resident there, providing supporting evidence for the ethnoburb hypothesis.

Understanding the reasons for poor asthma outcomes in ethnic minorities: welcome progress, but important questions remain

Understanding the reasons for poor asthma outcomes in ethnic minorities: welcome progress, but important questions remain

Determining aspects of ethnicity amongst persons of South Asian origin: The use of a surname-classification programme (Nam Pehchan)

Name-based classification systems are potentially useful in identifying study samples based on probable ethnic minority group. The aim of the current study was to assess the validity of the Nam Pehchan name classification programme of religion and language against subject self-report. A population-based cross-sectional survey conducted in areas of the North-West and West Midland regions of England with a relatively high density of South Asian ethnic minority groups. The sampling frame was age-sex registers of selected general practices and subjects were classified according to language and religion using the Nam Pehchan programme. These were compared with responses by subjects on a self-complete postal questionnaire. One thousand nine hundred and forty-nine subjects who participated, classified themselves as South Asian. Sensitivity in identifying religion was high amongst Muslims (92%) and Sikhs (86%), and somewhat lower in Hindus (62%). Specificity exceeded 95% for all ethnic groups. The vast majority of subjects assigned Punjabi or Gujarati as their main South Asian language indicated that they did in fact speak these languages (97% and 94%, respectively). Subjects assigned Urdu or Bengali, however, were less likely to do so (61% and 35%, respectively). The name-based classification system Nam Pehchan has demonstrated high levels of accuracy in some sub-groups of the South Asian population in determining subjects likely language spoken and religion-and is likely to be a useful additional tool when information on ethnicity is not already available.

Racism in health and health care in Europe: reality or mirage?

Racism is a belief that some races are superior to others, justifying actions that create inequality by favouring the supposedly superior groups. In practice, the definition of race is broadened to include ethnic, religious, and other similar groups, so discrimination on such grounds is also termed racism. Some people deny that racism is common in modern, industrialized, multi-ethnic societies. Wherever research is done, however, it shows racism is important. In a national representative survey in the 1990s by the UK Policy Studies Institute, for example, 20–26% of the White participants admitted in an interview to have prejudice against Asian, Caribbean or Muslim ethnic minorities.1 In fact, the figure is likely to be larger, for some people do not give publicly unacceptable answers in interview. It would be interesting to see comparable data from other European countries; the results would surely be equally and perhaps even more uncomfortable. Among the many historical lessons Europe should never forget is the one from Nazi Germany. Hitler's views were published in Mein Kampf (vol. 1 in 1925) to widespread acclaim and support, acting as an inspiration to much of the German public, and the medical professionals in particular.2,3 Silver's review demonstrates the central role of the medical profession—the staunchest supporter of the Nazi regime—in issues important to ethnic minority groups, for example, eugenics and race medicine.3 The economic, social, scientific, and political circumstances that allowed Hitler's policies to flourish could return. Eugenics is currently out of favour but its return is a likely outcome of the genetic revolution. Only open racism remains off-side in mainstream politics though there are signs that racism as a component of right-wing political policy is making a comeback. A rapid rise in ethnic minority populations in European cities, easy international travel, increasing pressures of …

Perinatal Mortality and Congenital Anomalies in Babies of Women with Type 1 or Type 2 Diabetes in England, Wales, and Northern Ireland: Population Based Study

A national population-based pregnancy cohort, compiled at 231 maternity units in the United Kingdom, enrolled 2359 diabetic women in a 12-month period. Type 1 diabetes was diagnosed in 1707 enrollees and type 2 diabetes in 652. Compared to women with type 1 diabetes, those with type 2 diabetes were more likely to come from a black, Asian, or other ethnic minority group, and also likelier to be from a deprived area. In addition, these women were older at the time diabetes was diagnosed and also at the time of delivery. They were less likely than women with type 1 diabetes to be primigravidas. Just over one-third of the 1606 women studied by 13 weeks' gestation had good glycemic control. Adjusting for maternal age, stillbirths were 4.7 times more frequent in diabetic women than in the general maternity population. Rates of perinatal and neonatal mortality were 3.8-fold and 2.6-fold greater, respectively, in cases of diabetes. Perinatal mortality rates were comparable in cases of type 1 and type 2 diabetes. The prevalence of major congenital anomalies in women with diabetes was more than double that expected. Much of the difference was accounted for by nervous system anomalies – particularly neural tube defects – and congenital heart disorders. Nearly two-thirds of infants with anomalies were diagnosed before birth. Congenital heart disease was diagnosed antenatally in 55% of offspring, and other anomalies in approximately 72%. Compared to the general maternity population, infants of women who have type 1 or type 2 diabetes are at increased risk of dying perinatally and of having congenital anomalies. The number of pregnant women with diabetes is expected to increase. There is evidence that good glycemic control at the time of conception and in early pregnancy can reduce adverse outcomes, but a majority of diabetic women fail to achieve such control.

Race, Class, and Space: Outcomes of Suburban Access for Asians and Hispanics

U.S. metropolitan areas have undergone major changes in their ethnic and racial composition in the past two decades. Now many large metropolitan areas are a complex mix of races and ethnicities, including large numbers of Asian and Hispanic populations in addition to African Americans. Moreover, these new arrivals are often in the suburbs as well as the centers of U.S. metropolitan areas. In the context of the changing ethnic patterns of Asians and Hispanics, three questions are posed for the analysis. Is there substantial suburbanization of Asian and Hispanic ethnic minorities, are those households in suburban locations more integrated with the majority White population, and do those who make the moves to suburban communities have higher status? They are important questions because they speak to the continuing evolution of assimilation and ethnic accommodation. The research provides evidence that suburban Asian and Hispanic populations do have higher socioeconomic status and that in general they are translating that increase in socioeconomic status into greater integration in the suburbs. The evidence from this analysis supports the notion that increased integration is an outcome of socioeconomic status and of suburbanization. However, it is also clear that the outcomes vary by metropolitan context and those outcomes suggest much greater mixing in California than in the United States as a whole.

Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study

Objective To provide perinatal mortality and congenital anomaly rates for babies born to women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland.Design National population based...

Burn patterns of Asian ethnic minorities living in West Yorkshire, UK

Whereas burn morbidity and mortality have been well studied among natives of Southeast Asia, few have studied the epidemiology of burn injury among UK Asian ethnic minority immigrants. A 1 year prospective study of all patients presenting with burns to Bradford Royal Infirmary was carried out. Four hundred and sixty patients were studied, 188 (41%) were Asian ethnic minorities. The average patient age was 17 years for the Asian group and 27 years for the non-Asian patients. Contact burns were responsible for 29% of injuries in Asian patients and 19% in the other group. Thirty-seven percent of contact burns in the Asian ethnic minority group were caused by hot irons. Eleven percent of Asian patients had treated their burn with inappropriate remedies including saiti, butter, and toothpaste. There were no significant differences between Asian and non-Asian patients in terms of large or deep burns, nor in mortality. Morbidity and mortality from burn injury among UK Asian patients and other groups in the UK are similar; however, a disproportionate number of Asian patients sustain smaller burns. Much of this is behaviour related, and it is hoped that through preventative measures a marked reduction in the number of Asian ethnic minority burns can be achieved.

Presentation of vitamin D deficiency

Aims: To describe the various ways in which vitamin D deficiency presents in children in selected districts of London and to identify which factors, if any, determine the mode of...