Black African Ethnic Groups Research Articles

Improving adult behavioural weight management services for diverse UK Black Caribbean and Black African ethnic groups: a qualitative study of insights from potential service users and service providers.

A significantly higher proportion of UK Black ethnic adults live with overweight or obesity, compared to their White British counterparts. The role of obesity in excess infection rates and mortality from COVID-19 has increased the need to understand if weight management interventions are appropriate and effective for Black ethnic groups. There is a paucity of existing research on weight management services in Black populations, and whether anticipated or experienced institutional and interpersonal racism in the healthcare and more widely affects engagement in these services. Understanding the lived experience of target populations and views of service providers delivering programmes is essential for timely service improvement. A qualitative study using semi-structured interviews was conducted in June-October 2021 among 18 Black African and Black Caribbean men and women interested in losing weight and 10 weight management service providers. The results highlighted a positive view of life in the United Kingdom (UK), whether born in the UK or born abroad, but one which was marred by racism. Weight gain was attributed by participants to unhealthy behaviours and the environment, with improving appearance and preventing ill health key motivators for weight loss. Participants relied on self-help to address their overweight, with the role of primary care in weight management contested as a source of support. Anticipated or previously experienced racism in the health care system and more widely, accounted for some of the lack of engagement with services. Participants and service providers agreed on the lack of relevance of existing services to Black populations, including limited culturally tailored resources. Community based, ethnically matched, and flexibly delivered weight management services were suggested as ideal, and could form the basis of a set of recommendations for research and practice. Cultural tailoring of existing services and new programmes, and cultural competency training are needed. These actions are required within systemic changes, such as interventions to address discrimination. Our qualitative insights form the basis for advancing further work and research to improve existing services to address the weight-related inequality faced by UK Black ethnic groups.

COVID-19 Hospital Activity and Outcomes During the First and Second Waves of the Pandemic in England: Analysis of the Hospital Episodes Statistics Database

Background: The aim of this study was to examine the profile of, and outcomes for, all people hospitalised with COVID-19 across the first and second waves of the pandemic in England.Methods: This was a retrospective observational study that used data from the Hospital Episode Statistics dataset for England. All patients aged ≥ 18 years in England with a diagnosis of COVID-19 who had a hospital stay that was completed (discharged alive or died) between 1st March 2020 and 31st March 2021 were included. In-hospital mortality was the primary outcome of interest. The first wave was defined as 1st March-31st August 2020 and the second wave as 1st September 2020 to 31st March 2021. Multivariable logistic regression was used to model the relationship between mortality and the covariates: age, sex, deprivation, ethnicity, discharge/admission date and a number of comorbidities.Findings: Over the 13 months, 374,244 unique patients had a diagnosis of COVID-19 during a hospital stay, of whom 93,701 (25.0%) died in hospital. Adjusted mortality rates fell from 40-50% in March 2020 to 11% in August 2020 before rising to 21% in January 2021 and declining steadily to March 2021. Improvements in mortality rates were less apparent in older and comorbid patients. Although mortality rates fell for all ethnic groups from the first to the second wave, declines were less pronounced for Bangladeshi, Indian, Pakistani, Other Asian and Black African ethnic groups, with all having higher odds of mortality during the second wave than White ethnicity patients.Interpretation: There was a substantial decline in adjusted mortality rates during the early part of the first wave which was largely maintained during the second wave. The underlying reasons for consistently higher mortality risk in some ethnic groups merits further study.Funding Information: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.Declaration of Interests: The authors declare that there is no conflict of interest.Ethics Approval Statement: Consent from individuals involved in this study was not required for this analysis of the Hospital Episodes Statistics (HES) administrative dataset. The analysis and presentation of data follows current NHS Digital guidance for the use of HES data for research purposes. Reported data are anonymised to the level required by ISB1523 Anonymisation Standard for Publishing Health and Social Care Data.

Inequalities in referral pathways for young people accessing secondary mental health services in south east London

Differences in health service use between ethnic groups have been well documented, but little research has been conducted on inequalities in access to mental health services among young people. This study examines inequalities in pathways into care by ethnicity and migration status in 12–29 years old accessing health services in south east London. This study analyses anonymized electronic patient record data for patients aged 12–29 referred to a south east London mental health trust between 2008 and 2016 for an anxiety or non-psychotic depressive disorder (n = 18,931). Multinomial regression was used to examine associations between ethnicity, migration status, and both referral source and destination, stratified by age group. Young people in the Black African ethnic group were more likely to be referred from secondary health or social/criminal justice services compared to those in the White British ethnic group; the effect was most pronounced for those aged 16–17 years. Young people in the Black African ethnic group were also significantly more likely to be referred to inpatient and emergency services compared to those in the White British ethnic group. Black individuals living in south east London, particularly those who identify as Black African, are referred to mental health services via more adverse pathways than White individuals. Our findings suggest that inequalities in referral destination may be perpetuated by inequalities generated at the point of access.

P085 An audit of nice guidance PH33; increasing the uptake of HIV testing in black africans

IntroductionIn 2015, Wolverhampton had the highest rates (15.8 per 100,000) of newly diagnosed HIV in West Midlands and In the West Midlands incidence rates in the black African ethnic group remain much higher than those for other ethnic groups, with a relative risk of 34 compared with the white group in 2015. This clearly shows the importance of the NICE Guidelines PH33 which was published in 2011 which aimed to increase the uptake of HIV testing in Black Africans and we wanted to audit this guidance.MethodsA list of patients classified as being of Black African ethnicity who were admitted to the Acute Medical Unit at Royal Wolverhampton NHS Trust between April 2015 and January 2016 was obtained. Their medical notes and blood test results were retrospectively analysed for evidence of testing or any discussion of HIV tests.Results50 case notes were retrospectively reviewed. An HIV test was not offered in 87% of admissions despite 15% of them presenting with signs of clinical indicator diseases. Only 6 patients were offered a test during their admission, of which 5 of them accepted. 1 of these tests was HIV positive and the patient was referred for further care to the HIV service within the trust.DiscussionThere remains a barrier to HIV testing in high risk populations in non-GUM settings despite NICE guidance published several years ago. Recommendations include the need to identify existing barriers by surveying doctors and providing education on how to overcome them, and the addition of prompts on clerking proformas may encourage universal testing.

Ethnicity and self-reported experiences of stigma in adults with intellectual disability in Cape Town, South Africa.

Studies have shown that individuals with intellectual disability (ID) are aware of stigma and are able to describe experiences of being treated negatively. However, there have been no cross-cultural studies examining whether self-reported experiences of stigma vary between ethnic groups. Participants with mild and moderate ID were recruited from a number of different settings in Cape Town, South Africa. Self-reported experiences of stigma in three ethnic groups were measured using the South African version of the Perceived Stigma of Intellectual Disability tool, developed by the authors. One-way anova was used to test whether there were differences in the total stigma score between the ethnic groups. Regression analysis was performed to identify factors associated with stigma. A total of 191 participants agreed to take part; 53 were Black, 70 were of mixed ethnicity and 68 were Caucasian. There were no differences in the levels of stigma reported by the three groups but the Black African ethnic group were more likely to report being physically attacked and being stared at, but were also more likely to report that they thought they were 'the same as other people'. There was an interaction effect between ethnicity and level of ID, with participants with mild ID from the Black African group reporting higher levels of stigma compared with those with moderate ID. Younger age was the only factor that was associated with stigma but there was a trend towards ethnicity, additional disability and socio-economic status being related to stigma. Interventions should target the Black African community in South Africa and should include the reduction of both public stigma and self-reported stigma.

Epidemiology and treatment outcome of childhood tuberculosis in England and Wales: 1999–2006

Objective: To describe the recent trends in demographic, clinical and microbiological characteristics and outcome of treatment in paediatric cases of tuberculosis. Design: National surveillance study. Setting: England and Wales. Patients:...

Beyond Humanitarian Bandages — Confronting Genocide in Sudan

The basic contours of what is happening in the Darfur region of western Sudan have been extensively documented. In May, I traveled to Chad, Sudan's neighbor to the west, and interviewed dozens of refugees spread out over hundreds of miles. The stories I heard were remarkably consistent. Person after person, the refugees told me that they had fled after attacks on their villages by Arab Janjaweed militias, which have burned hundreds of villages and murdered tens of thousands of civilians from so-called black African ethnic groups. The distinction between Arab and African has a heavy subjective component, but it is . . .

An estimate of the contribution of HIV infection to the recent rise in tuberculosis in England and Wales

Background: The number of patients with tuberculosis has been increasing slowly in England and Wales since the late 1980s. HIV infection has been a contributory factor to increases in tuberculosis...

Tuberculosis in England and Wales in 1993: results of a national survey. Public Health Laboratory Service/British Thoracic Society/Department of Health Collaborative Group.

BACKGROUND: A national survey of tuberculosis notifications in England and Wales was carried out in 1993 to determine the notification rate of tuberculosis and the trends in the occurrence of...