Bangladeshi Men Research Articles

Growing Up and Living with Neurofibromatosis1 (NF1): A British Bangladeshi Case‐study

In this article, I analyse a narrative by Rohima(1), a Bangladeshi woman now living in the UK who was diagnosed in adulthood as having NF1 (neurofibromatosis). While some themes in her narrative account resemble those of persons with NF1 in the general European and American population, other themes relate specifically to Bangladeshi cultural issues and practices. These particularly concern gender, sexual identity and marriage. As a young woman, Rohima's dark skin coloration and the tumors or lumps associated with her condition led her parents and relatives to regard her as unmarriageable and in effect, despite her evident intelligence and competence, to deny that she was a woman. Bangladeshi men and women alike found her appearance a bar to any social acceptability. Even after her marriage (to a non-Bangladeshi man), her family have been unwilling to accept her and her children fully into their kinship network. The article explores the consequences of genetic disorders such as NF1 in cultures where social identity and concepts of personhood, particularly for women, are inextricably related to appearance and to judgements regarding marriageability.

Concurrent Tobacco Use in a Random Sample of UK‐Resident Bangladeshi Men

The literature on concurrent tobacco (CCT) use, i.e., regularly using both smoked and chewed tobacco, is sparse. This study aims to establish the point prevalence of CCT use in a randomly selected sample of UK-resident Bangladeshi males, compare CCT users with other tobacco users (smokers alone and chewers alone), and model the factors for CCT use and chewing tobacco use alone. A cross-sectional bilingual interview survey collecting data on age, marital status, social class, employment status, home ownership and overcrowding, self-assessed health and chronic illness episodes, social capital, nicotine dependence, and oral pain was used. Carbon monoxide readings validated smoked tobacco use. Logistic regressions were used for data analysis. The initial response rate was 59 percent. Sample mean age was 40.7 years. CCT prevalence was estimated at 22 percent, practiced by older respondents of limited educational status. CCT users more likely had only average or poor self-rated health and more likely reported current oral pain compared with tobacco smokers. A wife chewing tobacco distinguished CCT users, as compared with tobacco smokers alone. In this sample of adult Bangladeshi males, CCT use was prevalent. CCT users more likely had a partner who was also a tobacco chewer, as compared with tobacco smokers.

Folate and cobalamin deficiencies and hyperhomocysteinemia in Bangladesh

Indian Asian men residing in the United Kingdom have a higher prevalence of hyperhomocysteinemia than do their European counterparts. This has been largely attributed to dietary deficiencies in cobalamin associated with vegetarianism among these Indian Asians. We aimed to ascertain the prevalence of folate and cobalamin deficiencies and hyperhomocysteinemia in Bangladesh. Plasma concentrations of homocysteine, folate, and cobalamin and urinary concentrations of creatinine were assessed in 1650 adults in Bangladesh. The prevalence of hyperhomocysteinemia (men: >11.4 micromol/L; women: >10.4 micromol/L) was markedly (P < 0.0001) greater among men (63%; x +/- SD: 15.3 +/- 9.5 micromol/L) than among women (26%; 9.5 +/- 4.7 micromol/L). Folate was lower (9.8 +/- 6.5 and 12.3 +/- 7.6 nmol/L, respectively), whereas cobalamin was higher (281 +/- 115 and 256 +/- 118 pmol/L, respectively) (P < 0.0001 for both) among men than among women. Folate explained 15% and cobalamin explained 5% of the variation in homocysteine concentrations. For men, folate (P = 0.005) and cobalamin (P = 0.03) were positively correlated with urinary creatinine. Smoking (P < 0.0003) and betelnut use (P < 0.0002) were independent negative predictors of folate. Bangladeshi men have a high prevalence of hyperhomocysteinemia, which is more closely associated with folate than with cobalamin, although other factors, eg, smoking and betelnut use, may also contribute to its cause. The positive correlations between urinary creatinine and plasma folate and cobalamin were unanticipated and could suggest that, in marginal nutrition, these vitamins may be limiting for creatine biosynthesis.

Daily consumption of Indian spinach (Basella alba) or sweet potatoes has a positive effect on total-body vitamin A stores in Bangladeshi men

Recent evidence suggests that the vitamin A equivalency of beta-carotene from plant sources is lower than previously estimated. We assessed the effect of 60 d of daily supplementation with 750 microg retinol equivalents (RE) of either cooked, puréed sweet potatoes; cooked, puréed Indian spinach (Basella alba); or synthetic sources of vitamin A or beta-carotene on total-body vitamin A stores in Bangladeshi men. Total-body vitamin A stores in Bangladeshi men (n = 14/group) were estimated by using the deuterated-retinol-dilution technique before and after 60 d of supplementation with either 0 microg RE/d (white vegetables) or 750 microg RE/d as sweet potatoes, Indian spinach, retinyl palmitate, or beta-carotene (RE = 1 microg retinol or 6 microg beta-carotene) in addition to a low-vitamin A diet providing approximately 200 microg RE/d. Mean changes in vitamin A stores in the vegetable and beta-carotene groups were compared with the mean change in the retinyl palmitate group to estimate the relative equivalency of these vitamin A sources. Overall geometric mean (+/-SD) initial vitamin A stores were 0.108 +/- 0.067 mmol. Relative to the low-vitamin A control group, the estimated mean changes in vitamin A stores were 0.029 mmol for sweet potato (P = 0.21), 0.041 mmol for Indian spinach (P = 0.033), 0.065 mmol for retinyl palmitate (P < 0.001), and 0.062 mmol for beta-carotene (P < 0.002). Vitamin A equivalency factors (beta-carotene:retinol, wt:wt) were estimated as approximately 13:1 for sweet potato, approximately 10:1 for Indian spinach, and approximately 6:1 for synthetic beta-carotene. Daily consumption of cooked, puréed green leafy vegetables or sweet potatoes has a positive effect on vitamin A stores in populations at risk of vitamin A deficiency.

How physically active are South Asians in the United Kingdom? A literature review.

Moderate physical activity is protective against coronary heart disease (CHD) and diabetes, both important public health problems among UK South Asian (Indian, Pakistani and Bangladeshi) ethnic groups. We assessed the evidence that physical activity is lower in South Asian groups than in the general population. We carried out a systematic literature review of studies describing levels of physical activity and fitness in UK South Asians using MEDLINE, EMBASE, the Cochrane databases, hand searching of relevant journals and review of reference lists. We identified 12 studies in adults and five in children. Various methods were used to assess physical activity and fitness, but all the studies reported lower levels among South Asian groups. The differences were substantial, particularly among women and older people. For example, the Health Survey for England found that Indian, Pakistani and Bangladeshi men were 14, 30 and 45 per cent less likely than the general population to meet current guidelines for physical activity. Limited information was provided about translation and adaptation of questionnaires. Levels of physical activity were lower in all South Asian groups than the general population and patterns of activity differed. No studies used validated measures. Insufficient attention has been paid to issues of cross-cultural equivalence. With these caveats, low levels of physical activity among UK South Asian ethnic groups may contribute to their increased risk of diabetes and CHD. Closer attention to validity, translation and adaptation is necessary to monitor changes and assess the effectiveness of interventions to increase physical activity.

The effect of ethnicity and gender on first-contact rates for schizophrenia-like psychosis in Bangladeshi, Black and White elders in Tower Hamlets, London.

A recent study of very-late onset schizophrenia-like psychosis (SLP) in South London showed an increase in first contact rates amongst African- and Caribbean-born elders compared to British-born ones. This study investigates incident first contact rates in an area of East London with a high Bangladeshi population, to investigate if Bangladeshi-born elders also have an increased referral rate for SLP. Retrospective case note review of first contacts to the old age psychiatry service from 1997 to 2002 identifying cases of schizophrenia-like psychosis. In addition, a one-year review of first contacts for all diagnostic categories was completed. Gender, ethnicity and place of birth were established from the case notes. Among the African- and Caribbean-born, but not the Bangladeshi-born, the odds ratio (OR) of being referred with SLP was significantly higher than for the British-born population. We observed a loss of the reported effect of female gender. For Whites the odds ratio for female gender and psychosis was 2.5 (1.0-6.1) and for non-Whites 0.8 (0.3-2.7) which was a trend away from the expected male to female ratio. In the one-year review there was a higher rate of referrals for organic disease in Bangladeshi men compared to Bangladeshi women and British-born men and women. Bangladeshi elderly migrants do not have an increased rate of SLP compared to indigenous elders. The usual female preponderance of SLP is not apparent in this elderly migrant population. Old age psychiatry services in the UK should take into account the increasing needs of Bangladeshi elders with dementia.

Gender and Ethnicity at Work: Occupational Segregation and Disadvantage in the 1991 British Census

This article uses detailed occupational data from the 1991 Census to investigate patterns of occupational segregation for women and men in the different ethnic groups. Gini index values suggest that the Black minority ethnic groups identified in the Census were less gender segregated than White people.There was less ethnic variation in women’s employment than in men’s. Chinese and Bangladeshi men were heavily concentrated within catering occupations. The association between women’s part-time work, gender segregation and occupational disadvantage does not hold for all ethnic groups. Some minority ethnic groups were occupationally advantaged relative to White people and, among Bangladeshi people, women were more occupationally advantaged than men.The data suggest that gender and ethnicity do not combine to create double disadvantage for minority women in the labour force; patterns of occupational advantage and disadvantage are more complex. However, lack of detail on ‘women’s jobs’ and the invisibility of hierarchies within occupational groups mean that some inequality is obscured.

Lesbian and Gay Refugees in Australia: Now that 'Acting Discreetly' is no Longer an Option, will Equality be Forthcoming?

This paper will analyse a recent decision of the Australian Refugee Review Tribunal in which a young gay Iranian man was denied refugee status on the basis that he could avoid persecution in Iran by ‘acting more discreetly’ and by leading a less ‘public’ sexual profile. Contrasting this decision with a recent decision of the High Court of Australia in which the ‘discretionary option’ was explicitly rejected by a majority of the Court hearing the case of two gay Bangladeshi men, this paper will highlight that the reasoning used by the Tribunal misunderstands the nature of sexuality-based discrimination and offers a line of reasoning that is central to ensuring the types of inequalities and biases that are at the heart of sexuality-based discrimination and that perpetuate the inequalities which international human rights instruments seek to eradicate. While applauding the High Court's rejection of the ‘discretionary option’ used by the Refugee Review Tribunal, this paper will argue that a much stronger understanding of the sex equality implications of the Tribunal's decisions in this regard is needed if lesbian and gay refugee claimants are to find real protection in Australia. Some have criticised the High Court's latest judgment on lesbian and gay refugees as ‘interventionist’, even ‘radical’. These critics do so because they fail to recognise what homophobia is and what the demands of equality require of the Court in its interpretation of the Convention Relating to the Status of Refugees. Overall, it will be argued that, applying a sex equality analysis of anti-lesbian and anti-gay discrimination, it is clear that, while the High Court has now recognised the errors of discretion, it has yet to find the voice that true systemic equality demands.

Ethnic Penalties in Unemployment and Occupational Attainment: Evidence for Britain

In spite of progress made since the 1950s and 1960s, black, Indian, Pakistani and Bangladeshi workers remain disadvantaged relative to whites in terms of their labour market opportunities. In general, they experience higher rates of unemployment and tend to be under-represented in higher paid, non-manual occupations. They can therefore be said to pay an ethnic penalty in the competition for jobs although the penalties paid vary considerably between the minority groups. In this paper we examine the different employment experiences of black, Indian, Pakistani and Bangladeshi men and women in terms of their unemployment propensities and occupational attainment.We use maximum likelihood methods to show that the ethnic penalties experienced by minority workers are not fully explained by differences in human capital endowments and personal characteristics. We conclude that at least some of the disadvantage experienced by ethnic minorities in the British labour market can be attributed to discriminatory selection practices by employers.

Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study

Objective: To compare coronary risk factors and disease prevalence among Indians, Pakistanis, and Bangladeshis, and in all South Asians (these three groups together) with Europeans.Design: Cross sectional survey.Setting: Newcastle upon...

Variations in hospitalization rates for asthma among Black and minority ethnic communities

In response to the introduction of ethnic monitoring within the U.K. hospital inpatient data set, this study investigates the variations in secondary healthcare utilization by Black and minority ethnic communities whose cause of admission is related to asthma. The study examines all residents of the West Midlands: over 5 million people, of whom 8·5% are from Black and minority ethnic groups. A retrospective study of 15 921 asthma-related hospital admissions, from 1 April 1995 to 31 March 1996, was carried out. Age-standardized admission rates were higher in all Black and minority ethnic groups studied than in the White group. There were elevated rates in Black children aged 5–14 years, and particular differences were observed for Indian and Bangladeshi men and women aged 65 years or over. Emergency admissions to hospital for asthma were strongly associated with patients' socioeconomic background but this was largely observed for Black and minority ethnic groups that also generally experience high levels of deprivation. The findings support previous studies which suggest that hospital utilization rates for asthma among people from Black and minority ethnic groups are high compared with the White group, despite little evidence in measured prevalence. This study suggests that ethnic background is more important in asthma admissions than deprivation, which raises serious concerns on the appropriateness and quality of asthma care for these patient groups within our society. Future studies need to examine pathways to care, that is the health-seeking behaviour of Black and minority ethnic groups, the type of treatment received at the primary care level and referral patterns to secondary care.

Gastric acid secretion and enteric infection in Bangladesh

In developing countries many enteric infections are caused by acid-sensitive pathogens. Failure of the gastric acid barrier to infection has been reported in cholera but gastric acid secretion has been little studied in other enteric infections. We therefore studied basal and stimulated gastric acid in 185 Bangladeshi men admitted to hospital for the treatment of enteric infection. Patients with dysentery (amoebiasis, n = 24 and shigellosis, n = 19) and culture-negative diarrhoea ( n = 69) had similar mean gastric acid levels (basal, 3–5 mmol/h; stimulated, 11–17 mmol/h), which remained stable in those patients studied throughout 12 weeks of convalescence. In contrast, patients with secretory diarrhoea caused by cholera or enterotoxigenic Escherichia coli (ETEC) had low gastric acid levels ( P < 0·05 compared with other groups) (cholera, n = 34: basal mean 1·8 mmol/h [SD = 2·2], stimulated mean 7·9 mmol/h [SD = 6·4]; ETEC, n = 39: basal mean 2·7 mmol/h [SD = 2·8], stimulated mean 9·4 mmol/h [SD = 7·5]). Cholera patients' gastric acid level rose during convalescence to similar levels to the dysentery patients'. Low gastric acid level was associated with severe disease in patients with cholera ( P < 0·02) or ETEC ( P < 0·05). Gastric acid level fell with increasing age ( P < 0·007) but this did not account for the differences between groups. Gastric acid levels were not associated with Giardia duodenalis or Strongyloides stercoralis co-infection, fever, use of tobacco, or chewing betel nut. Cholera and secretory diarrhoea caused by ETEC may, therefore, partly result from a reduction in gastric acid level which does not occur during dysentery. Factors which impair gastric acid secretion may predispose to diarrhoeal disease in developing countries.

Patterns of mortality among Bangladeshis in England and Wales

Objectives. To investigate the patterns of mortality among Bangladeshis living in England and Wales. Methods. An analysis of national mortality data, classified by country of birth, for the latest period (1988–1992), using the method of indirect standardization for deriving standardized mortality ratios (SMRs) with the age‐ and sex‐specific rates for England and Wales as the standard ( = 100). The SMRs were derived for Bangladeshi‐born men and women aged 20–69 years for major disease entities. Results. The mortality among Bangladeshi men was significantly higher (SMR 118 and 95% CI 111–126) than the levels prevalent in England and Wales. In contrast, the mortality among Bangladeshi women was significantly lower (SMR 71 and 95% CI 61–82). The cancer mortality overall was lower than expected in both sexes, with the exception of cancer of the liver and gall bladder. The mortality from breast cancer (SMR 16 and 95% CI 6–34) and cervical cancer (SMR 51 and 95% CI 14–131) was lower than expected. Bangladeshi men experienced high mortality from diabetes (SMR 685 and 95% CI 529–874), coronary heart disease (SMR 148 and 95% CI 134–163) and cerebrovascular disease (SMR 267 and 95% CI 222–319); they also experienced excess deaths from cirrhosis of the liver (SMR 254 and 95% CI 175–357). Conclusions. The findings establish significant variations in the recent health experiences of Bangladeshi men living in England and Wales, posing a major challenge for purchasers of care. If the Health of the Nation strategy is to ensure that equity in health and health care is to apply to all those living in this country, the Bangladeshi population needs special targeting.

The Promotion of Family Planning by Financial Payments: The Case of Bangladesh

The government of Bangladesh and the World Bank commissioned a Compensation Payments Study, carried out in 1987, to assess the merits and demerits of payments for sterilizations to clients, medical personnel, and intermediaries who motivate and refer clients. The study conclusively shows that the decision of Bangladeshi men and women to undergo sterilization is a considered and voluntary act, taken in knowledge of the nature and implications of the procedure, and in knowledge of alternative methods of regulating fertility. There is a high degree of client satisfaction among those who have been sterilized, although among clients who had fewer than three children, 25 percent expressed regret that they had been sterilized. Money may be a contributing factor to the decision to become sterilized in a large majority of cases, but a dominant motive for only a very small minority. Payments to referrers have fostered a large number of unofficial, self-employed agents--particularly men who recruit vasectomy cases. These agents provide information about the procedures for being sterilized, particularly to the poor. They also concentrate on sterilizations to the exclusion of other methods, and are prone to minimize the disadvantages and exaggerate the attractions of sterilization.

Diabetes, hyperinsulinaemia, and coronary risk factors in Bangladeshis in east London.

Immigrants from the Indian subcontinent (South Asians) in England and Wales have higher morbidity and mortality from coronary heart disease than the general population; this seems to apply to both Hindus and Muslims. Studies in north west London and Trinidad found that the increased risk of coronary heart disease in Indians was not explained by dietary fat intakes, smoking, blood pressure, or plasma lipids. In the present study the distribution of coronary risk factors was measured in an East London borough where the mortality and attack rate from coronary heart disease are higher in the Asian population, predominantly Muslims from Bangladesh, than in the rest of the population. In a sample of 253 men and women aged 35-69 from general practice, mean plasma cholesterol concentrations were lower in Bangladeshi than in European men and women. Mean systolic blood pressures were 10 mm Hg lower in Bangladeshis. Plasma fibrinogen concentrations were similar in Bangladeshis and Europeans and factor VII coagulant activity was lower in Bangladeshi than in European men. In contrast with the findings in Hindus in north west London, smoking rates were high in Bangladeshi men and the ratio of polyunsaturated fatty acids to saturated fatty acids in plasma lipids was lower in Bangladeshis than in Europeans. Diabetes was three times more common in Bangladeshis than in Europeans and serum insulin concentrations measured after a glucose load were twice as high in Bangladeshis. High insulin concentrations in Bangladeshis were associated with high plasma triglyceride and low high-density lipoprotein cholesterol concentrations. Insulin resistance, leading to diabetes, hyperinsulinaemia, and secondary lipoprotein disturbances, is a possible mechanism for the high rates of coronary heart disease in South Asians in Britain and overseas.

High dietary fat intake and cigarette smoking as risk factors for ischaemic heart disease in Bangladeshi male immigrants in East London.

A study was made of smoking and dietary habits in middle aged Bangladeshi men living in East London to investigate possible causes of the previously described high ischaemic heart disease risk in this group. The results showed that these individuals were 50% more likely to smoke than Caucasians living in the same area, after adjusting for age and social class. More striking, however, was the very high fat intake of over 200 g/day, which is twice the national average and accounted for nearly 60% of total energy intake. Interestingly, much of the dietary fat was from vegetable oil, and the ratio of polyunsaturated to saturated fatty acids exceeded the accepted recommended minimum.