Black And Minority Ethnic Groups Research Articles

‘We must name ourselves’: ERI construction within the supplementary schooling context

ABSTRACT Ethnic and racial identity (ERI) has long been considered a central component of psychological wellbeing, particularly for adolescents and young people from Black and minority ethnic (BME) communities. Supplementary schools are geared towards the cultivation of positive group identification and a sense of belonging; central components of ERI. These institutions therefore have a potentially vital role to play in facilitating the wellbeing of the BME young people they serve. Within current literature, there has been very little direct reference to this promotion of wellbeing within supplementary schooling. This paper addresses this dearth by exploring the identity work carried out by a diverse cohort of supplementary schools in the UK. Drawing on in-depth qualitative interview data gathered from the leaders of 16 schools, representing several different BME groups. The data was analysed using thematic analysis and revealed that schools facilitate positive group identity and a sense of belonging through several means, namely: the preservation and perpetuation of emblematic identity traits, the counteraction of negative identity discourses, the transformation of community social standing and the recovery of depleted or lost identities.

Black and minority ethnic groups and forensic mental health

AimsTo review the existent literature base regarding Black and Minority Ethnic (BAME) groups care pathway into and experience of care and treatment within secure services. This includes any differences (between BAME and majority ethnic groups) in rates of sentencing, sectioning, length of stay, received treatment and use of restrictive practice. Our overarching aim is to highlight the severe lack of research in this area and the corresponding need for increased research to both consolidate and progress the existing evidence base in order to inform and improve culturally competent service provision.BackgroundResearch suggests that BAME groups have an increased risk of involuntary psychiatric care, longer-stays within services and higher rates of re-admission. Several explanations have been proposed for this observed disparity, however few of these proposed explanations have provided sufficient or consistent supporting evidence.MethodA review of both quantitative and qualitative research regarding BAME groups within secure services was conducted. Approximately twenty journal articles, literature reviews and meta-analysis published between 1988 and 2019 were included. The current study should be considered a snapshot and not reflective of the full extent of published literature on the subject. For inclusion, studies should have been conducted in either a forensic mental health setting or a prison and differentiate a minimum of two ethnic groupsConclusionResearch suggest that BAME individuals continue to experience an increased risk of involuntary psychiatric care, longer stays within secure services and higher rates of re-admission. Whilst many explanations for this disparity have been proposed, few have provided adequate supporting evidence. The ongoing lack of research within this field has led to a limited evidence base from which to inform culturally competent practice. The research which has been conducted has tended to produce inconsistent findings, in part due to the reliance on small scale studies with limited generalisability. Research within this area has been further complicated by varying definitions of culture and ethnicity across studies, leading to some suggestion that the issue of ethnic inequalities and pathways to care, has been misconceptualised. This highlights a critical need for increased research efforts to:Understand why BAME individuals are at increased risk of involuntary psychiatric care, and how this disproportionate risk can be addressedExplore potential disparities in the care and treatment of BAME individuals within services and how this might impact upon higher rates of re-admissionAscertain how best to improve culturally competent service provision.

‘They want to give our children to white people and Christian people’: Somali perspectives on the shortage of Somali substitute carers

Children from some black and minority ethnic (BME) backgrounds are routinely placed with substitute carers who do not match their cultural, linguistic, religious and ethnic backgrounds. The shortage of foster carers and adopters of specific backgrounds means that the demand in the care population often outweighs the availability of matched placement options. While the shortages of BME foster carers and adopters are widely recognised, there is virtually no research into the barriers faced by specific BME groups, so there are no informed recruitment strategies to increase the pool of potential matches. This research focuses on Somalis living in a large English city where there is a significant shortage of Somali foster carers and adopters despite people of Somali heritage comprising a sizeable proportion of the care and city population. Findings from the study suggest that there is no lack of motivation among the Somali population to foster or adopt, but participants felt that potential applicants are either rejected or deterred by institutional barriers, social exclusion and negative perceptions of social care, and that these factors are closely interlinked. The study makes practical suggestions for recruitment and assessment practice, but also stresses the importance of cultural competence and community engagement in a wider context of social care if welfare agencies wish to see more disenfranchised communities volunteering to work with them.

Length of stay among multi-ethnic psychiatric inpatients in the United Kingdom

BackgroundDisproportionate rates of psychiatric admissions and length of stay (LOS)11Length of stay is a term used to describe the duration of time in which an individual is hospitalized. have been repeatedly observed among Black and Minority Ethnic (BME)22Black and Minority Ethnic Groups is a term used to describe people of non-white descent or non-majority ethnicity. groups with severe mental illness (SMI), specifically those of Black Caribbean heritage. Commensurate understanding of the mechanisms underlying this observation remains poorly understood, warranting further attention. MethodA quasi-experimental retrospective cohort design was used to examine 11,617 psychiatric inpatient admissions in London, U.K. Variations in LOS across four ethnic groups (i.e., Black Caribbean, Black African, White British, and Asian) were recorded. Multivariate logistic regression was then used to determine the extent to which demographic (age, marital status, gender, homeless at admission), clinical (primary diagnosis, substance misuse), and behavioral variables (violent behavior, deliberate self-harm, victimization) explained any observed differences across ethnic groups. ResultsUnivariate analyses revealed that while Black Caribbean and African minority group admissions were significantly more likely to be a longer (>28 days) than shorter (≤28 days) LOS, White British admissions demonstrated the opposite association. After adjusting for demographic, clinical, and behavioral factors, the multivariate logistic regression only partially explained the association between Black Caribbean and African admissions and longer LOS compared to White British admissions. The regression model explained approximately 18% of the observed variance in LOS. ConclusionsThese findings indicate that additional variables, such as treatment, system related, and discrimination-based factors, should be examined to better understand the complex relationship between BME groups and LOS in order to improve the experience and outcomes of these vulnerable psychiatric populations.

Barriers to accessing psychological treatment for medium to high risk male young offenders

ABSTRACT Within the young offender population, rates of personality disorder and mood disorders are considerably higher than both the general and adult offender population. Despite this high level of need and high risk of harm, psychological services within prisons are widely underutilized. Little is known about the barriers to accessing treatment for young offenders. This study investigated barriers to accessing psychological treatment for male young offenders detained in a UK prison. There were 128 participants, aged 18–21. A cross-sectional design compared self-reported barriers and psychological distress for Black and Minority Ethnic (BME) and White young offenders not accessing treatment, as well as those who were. A preference for self-reliance, a lack of trust in the prison system, lengthy waiting times and a general reluctance to talk about emotions were the most commonly cited barriers. BME young offenders not engaged in treatment reported significantly more barriers to accessing treatment than BME young offenders who were engaged in treatment, but both BME groups had equal levels of psychological distress. There was no significant difference between BME and White young offenders in the number of barriers reported, including stigma barriers. Future research should evaluate interventions to increase access for this marginalised population.

‘Same old story, just a different policy’: race and policy making in higher education in the UK

ABSTRACTEvidence suggests that Black and minority ethnic (BME) students and staff continue to be disadvantaged in higher education institutions (HEIs) in the UK. Policy making has been introduced to specifically address such inequalities. This article draws on critical policy analysis and 45 interviews to explore the impact of the recently introduced Race Equality Charter (REC) as a measure to address such inequalities. By using principles of Critical Race Theory (CRT), we argue that racism continues to play a key role in the experiences of BME groups in HEIs and policy making. Consequently, the enactment of policy making on race through the REC works to benefit HEIs by adhering to White normative practices and behaviours which contribute to a system which reinforces and perpetuates White privilege.

For whose benefit? Black and Minority Ethnic training programmes in higher education institutions in England, UK

Inequalities continue to exist in higher education, with Black and minority ethnic (BME) academics less likely to be professors or occupy senior decision‐making roles compared to their White colleagues. In order to increase BME representation in senior decision‐making roles, specific programmes targeted at BME groups have recently been introduced in higher education institutions (HEIs). This article draws on research carried out on two such programmes in England. By using principles of critical race theory (CRT), I argue that racism continues to play a key role in the lack of BME groups in senior leadership roles and that such programmes benefit HEIs rather than contributing to a commitment to inclusion, equity and creating a diverse workforce. Furthermore, such programmes work for the benefit of HEIs to perpetuate and reinforce White privilege, rather than addressing structural inequalities.

Size and clustering of ethnic groups and rates of psychiatric admission in England.

There was an eightfold difference in admission rates between ethnic groups for schizophreniform and mania admissions, and a fivefold variation in depression admissions. On average, Black and minority ethnic (BME) groups had higher rates of admission for schizophreniform and mania admissions but not for depression. This increased rate was greatest in the teenage years and early adulthood. Larger ethnic group size was associated with lower admission rates. However, greater clustering was associated with higher admission rates.Clinical implicationsOur findings support the hypothesis that larger ethnic groups have lower rates of admission. This was a between-group comparison rather than within each group. Our findings do not support the hypothesis that more clustered groups have lower rates of admission. In fact, they suggest the opposite: groups with low clustering had lower admission rates. The BME population in the UK is increasing in size and becoming less clustered. Our results suggest that both of these factors should ameliorate the overrepresentation of BME groups among psychiatric in-patients. However, this overrepresentation continues, and our results suggest a possible explanation, namely, changes in the delivery of mental health services, particularly the marked reduction in admissions for depression.Declaration of interestNone.

Learning Alliance Methodology Contributions to Integrated Care Research

The regular cycle of conducting research when applied to human services is considered linear and rarely beneficial to all stakeholders involved directly or indirectly in a research project (service users, policy-makers, funders, local authorities, taxpayers). Funders of research, taxpayers, policy-makers and governments are increasingly questioning the linear process of conducting research and are demanding a higher socio-economic and scientific impact. New approaches seeking to re-think the utilisation, appropriation and impact of research outcomes in the health services area in more integrated ways, include the Learning Alliance (LA) methodology. Formally defined, an LA is “a series of connected multi-stakeholder platforms or networks (practitioner, researchers, policy-makers, service users) at different institutional levels (local, national) involved in two basic tasks: knowledge innovation and its scaling up. Methods: The methodological tools in an LA are various and can be used according to the convenience, context, theme and needs of a project. The most common ones are stakeholder analysis, research or action research, process documentation, dissemination and capacity building, among others. By applying the LA, the three projects briefly mentioned here sought to demonstrate that this approach could contribute to increasing their scientific and socio-economic impact while simultaneously generating learning among all stakeholders in more integrated ways. Results: Three projects using the LA have been completed as recently as 2017 and have covered different health themes, services and locations: identification of health needs of Black and Minority Ethnic (BME) groups in the South East of England; perpetration of Intimate Partner Violence by Males in Substance Abuse Treatment in Brazil and England; and Attitudes to Palliative and End of Life Care Services among BME Groups in the South East of England. Overall, the three research experiences in combination with the use of stakeholders’ participation and documentation revealed that the role of the LA methodology demonstrates significant issues. First, it contributed to narrowing the dominant gap between research and practice that is so common in health services by bringing together several stakeholders (policy-makers, service users, service providers) who are not involved in research on a daily basis. Through knowledge sharing, all stakeholders benefited from the research projects’ outcomes. Second, the documentation of events in the projects become a significant source of additional data in which impact and the know-how got captured. Similarly, documentation and dissemination of preliminary findings in the three cases comprised a tool for promoting changes in attitudes and mindsets that translated faster into adoption of integrated changes in practice. Third, the work undertaken as a network, enabled all stakeholders to understand that the research projects could be more than the traditional linear processes. The research projects’ outcomes benefited stakeholders in different ways beyond the traditional research products (academic papers or technologies) to include other social, personal and institutional processes that occur in a project, and demonstrated a better impact. Conclusion: The application of the LA methodology maximised the value of conducting research as a network by including various stakeholders and not only researchers to integrate research, practice, learning and policy issues in health services.

Black and minority ethnic group involvement in health and social care research: A systematic review.

BackgroundPatient and public involvement (PPI) in research is growing internationally, but little is known about black and minority ethnic (BME) involvement and the factors influencing their involvement in health and social care research.ObjectivesTo characterize and critique the empirical literature on BME‐PPI involvement in health and social care research.Search strategySystematic searches of six electronic bibliographic databases were undertaken, utilizing both MeSH and free‐text terms to identify international empirical literature published between 1990 and 2016.Inclusion criteriaAll study designs that report primary data that involved BME groups in health or social care research. Screening was conducted by two reviewers.Data extraction and synthesisData extraction and quality appraisal were performed independently. Data extraction focused on the level(s) of PPI involvement and where PPI activity occurred in the research cycle. Studies were quality‐assessed using the guidelines for measuring the quality and impact of user involvement in research. Data were analysed using a narrative approach.Main resultsForty‐five studies were included with the majority undertaken in the USA focusing on African Americans and indigenous populations. Involvement most commonly occurred during the research design phase and least in data analysis and interpretation.ConclusionThis is the first systematic review investigating BME involvement in health and social care research internationally. While there is a widespread support for BME involvement, this is limited to particular phases of the research and particular ethnic subgroups. There is a need to understand factors that influence BME involvement in all parts of the research cycle.

Health and well-being promotion strategies for 'hard to reach' older people in England: a mapping exercise.

Older people from deprived areas, the oldest old and those from ethnic minorities engage less in health promotion interventions and related research, potentially generating inequities. Aim To explore and map the extent to which such 'hard to reach' groups of older people, are the focus of local health and well-being strategies in England. Document analysis of current health and well-being promotion strategies in a purposive sample of 10 localities in England with high proportions of some or all of the three hard to reach groups. Documents were analysed using an interpretive approach. Findings A total of 254 documents were retrieved and reviewed. Much of the content of the documents was descriptive and reported the implications for resources/services of population ageing rather than actual initiatives. All localities had an Older People's Strategy. Strategies to counter deprivation included redistribution of winter fuel payments, income maximisation, debt reduction and social inclusion initiatives, a focus on older owner occupiers and recruitment of village 'agents' to counter rural deprivation. The needs of the oldest old were served by integrated services for older people, a community alarm service with total coverage of the 85+ population, and dietary advice. The needs of black and minority ethnic (BME) older people were discussed in all localities and responses included community work with BME groups, attention to housing needs and monitoring of service use by BME older people. Three other themes that emerged were: use of telecare technologies; a challenge to the idea of 'hard to reach' groups; and outreach services to those at most risk. Document analysis revealed a range of policy statements that may indicate tailoring of policy and practice to local conditions, the salience of national priorities, some innovative local responses to policy challenges and even dissenting views that seek to redefine the policy problem.

Barriers to paramedic education in black and ethnic minority (BME) groups

Purpose: To gain an understanding of how Black and Minority Ethnic (BME) groups respond to information about paramedic courses, their experience of the enrolment processes and their experience of paramedic training. Methodology: Telephone interviews were conducted with qualified paramedics and student paramedics from BME groups. Findings: Interviews revealed issues in relation to the accessibility and understanding of information on paramedic education and a lack of information in preparation for paramedic courses, causing unrealistic expectations. A lack of diversity in the student population, incidences of racial offence (unconscious or conscious), and a lack of visibility of BME staff in the ambulance service as well as in the wider community were identified. Practical implications: The results produced from this evaluation may contribute towards a series of recommendations in order to better inform practice to increase the diversity of students entering into paramedic science and in order to avoid issues such as student attrition

Exploring Factors Contributing to Low Uptake of the NHS Breast Cancer Screening Programme among Black African Women in the UK

Breast cancer is the most common cancer among women in the United Kingdom (UK) accounting for about 15% of cancer deaths. The National Breast Cancer Screening Programme in the UK was introduced in 1988 to assist with early detection and better management of breast cancer. Black and Minority Ethnic (BME) women however have a low uptake of the National Breast Screening programme when compared to their White counterparts. Within the BME group, Black African women have the lowest uptake of screening services and are more likely to have an advanced stage of the disease at diagnosis, leading to poorer survival rates than White women. This study aimed to explore the factors that lead to low uptake of the National Breast Cancer Screening Programme among Black African women living in Luton and present action points to local breast cancer services. Using a qualitative research design, six focus groups were conducted with a total of twenty-five Black African women residing in Luton between May and June in 2013. Data was analysed thematically using the framework approach. Four main themes emerged across the focus group discussions: knowledge and beliefs about breast cancer and risk factors, prevention of breast cancer and awareness of the NHS breast screening service, delays in attending the NHS breast screening service and suggestions for improving information on breast cancer and the NHS breast cancer screening service. The findings from this study suggest the need for more targeted information on breast cancer and screening services for Black African women. This could help improve the uptake of the NHS breast screening service, promote early help-seeking behaviour and improve breast cancer outcomes for this ethnic group.

Can motivations for studying dentistry inform us about gender and BME differences in dental academic careers?

There are various motivators that prompt people to study dentistry but there is evidence that the salience of each varies according to gender and black and minority ethnic (BME) group. Given the current focus on inequality within the science, technology, engineering, medicine and mathematics (STEMM) academic disciplines where dentistry sits, it is important to understand the relevance of different motivators to different social groups if inequality is to be overcome. We carried out a survey of dental students from 11 out of the 18 dental schools in the UK to find out what prompted them to study dentistry. Our findings showed that most people make a personal choice to study dentistry and follow a patient-focused career while the prospect of an academic career was important for less than half of our sample. Differences according to gender and BME group were apparent but did not follow these trends. In order to continue to improve the diversity within dental academia dental schools should consider the different preferences of the workforce and work to broaden its potential.

A formative review of physical activity interventions for minority ethnic populations in England.

Physical activity (PA) levels are lower among some UK Black and minority ethnic (BME) groups than the majority White British population and a variety of tailored interventions have emerged. This study documents the characteristics and logic of local adaptations, a vital first step in evaluating such innovations. An English PA data set was examined to identify and characterize PA programmes focussed on BME populations. Three case studies were conducted, employing documentary analysis and qualitative interviews. Netto et al.'s principles of adapting health promotion interventions for BME populations guided the analysis. Out of 861 PA interventions, 57 focussed on BME populations. These were typically aimed to engage the most inactive groups, improve both health and social outcomes and were largely publically/charitably funded. Tailored approaches matched Netto et al.'s five principles: using community resources for publicity, identifying and addressing barriers, developing sensitive communication strategies, working with values and accommodating cultural identification. Another common principle was identified: building community capacity for sustainability. PA interventions tailored to the needs of BME groups reflect their largely disadvantaged position in society and focus on inactivity. The six principles could be used as a framework for developing, designing and evaluating tailored interventions for BME populations.

Ethnicity and the prostate cancer experience: a qualitative metasynthesis.

ObjectivesTo summarize black and minority ethnic (BME) patients' and partners experiences of prostate cancer by examining the findings of existing qualitative studies.MethodsWe undertook a systematic metasynthesis of qualitative studies using a modified version of Noblit and Hare's “meta‐ethnography” approach, with a 2000‐2015 search of 7 databases.ResultsThirteen studies of men from US and UK BME groups were included. We explored constructs with BME‐specific features. Health care provider relationships, formation of a spiritual alliance with God (which enhanced the participants' feeling of empowerment and ability to cope with the cancer), and living on for others (generally to increase cancer awareness), often connected to spiritual regrowth, were the 3 constructs most commonly reported. A magnified effect from erectile dysfunction was also common. Initially, this affected men's disclosure to others about their cancer and their sexual problems, but eventually men responded by shifting their conceptualizations of masculinity to sustain self and social identities. There was also evidence of inequality resulting from financial constraints and adversity that necessitated resilience in coping.ConclusionsThe prostate cancer experience of BME men and their partners is affected by a complex intersection of ethnicity with other factors. Health care services should acknowledge this. If providers recognize the men's felt masculinities, social identities, and spiritual beliefs and their shifting nature, services could be improved, with community as well as individual benefits. More studies are needed in diverse ethnic groups.

Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities.

Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin), to ”good” health (white British), and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an important role in helping address the health inequalities experienced by these groups.

Ethnic Differentials in Health: the Additional Effect of Ethnic Density

AbstractIt is well established that there are differentials in health among individuals of different Black and Minority Ethnic (BME) heritage. BME communities are unevenly concentrated across England and Wales. This paper examines the effect of residential density of one's own‐ethnic group on physical health outcomes in England and Wales. In addition, it explores whether the effects of ethnic density on physical health outcomes are concealed by area deprivation and whether individual economic deprivation and area deprivation play a role in this relationship. Data on BME and White British individuals from the first wave of the UK Household Longitudinal Study (Understanding Society) are linked with ethnic density characteristics from the 2011 UK Census and with the Index of Multiple Deprivation from the 2010 English and Welsh Governments. Multilevel logistic regression is then employed in the analysis. The results show that individuals from BME groups who live in areas with a high density of their own‐ethnic group are more likely to report poor health, but these effects are mediated by both individual economic deprivation and area deprivation. The results highlight that facilitating the improvement of economic and social conditions for individuals in deprived areas could help reduce the negative differentials in health outcomes experienced by individuals from BME communities. © 2016 The Authors Population, Space and Place Published by John Wiley & Sons, Ltd

Ethnic elders and pension protection in the United Kingdom

ABSTRACTPension receipt in later life is determined by the way in which individuals' pension contributions and circumstances over the lifecourse interact with eligibility rules. Within the British context, such pensions relate to sources such as the State Pension, an occupational or private pension, and Pension Credit. Existing research shows that membership of certain ethnic groups is associated with a lower likelihood of receiving occupational or private pensions. Data from Understanding Society allows us to build on existing evidence by examining the factors associated with the receipt of three different kinds of pension income – State, occupational/private and Pension Credit – among older men and women from separate Black and Minority Ethnic (BME) groups. The results show that belonging to certain BME groups reduces one's chances of receiving the State Pension or an occupational/private pension, but increases the chance of receiving Pension Credit. The gender-specific analysis shows that these results hold true for many BME groups of men, whereas among women, only Pakistani women are less likely than White British women to receive an occupational/private pension. Such findings provide up-to-date empirical evidence that ethnic inequalities in pension protection are still evident and contribute to the increasingly important debate in the United Kingdom and elsewhere regarding migrants' social security and welfare over the lifecourse and in later life.

The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups

Purpose: Very little is known about how older people from black and minority ethnic (BME) groups caring for someone after a stroke access and engage with social care services. This paper explores both the experiences of carers whose relative was receiving social care services in their own home and the value of a theory of humanising care to understand and explain these experiences.Method: Semi-structured interviews were undertaken with 50 carers from five different ethnic groups: Asian Indian, Asian Pakistani, Black African, Black Caribbean and White British. Data were thematically analysed within a phenomenological framework.Results: Five interacting themes emerged: communication and bureaucracy; time and timing; communication and rapport building; trust and safety; humanity and the human dimensions of care. Many of the experiences could be interpreted within a conceptual framework of humanising care underpinned by eight interacting dimensions of what it means to be treated as an individual and a human.Conclusions: Carers from BME and White British groups share many experiences of homecare although language and cultural difference may exacerbate common pressures and stresses. The framework for humanising care is a useful tool to evaluate aspects of homecare that are responsive to dignity and diversity.Implications for RehabilitationExplicitly identifying, describing and valuing the human dimensions of care may support services in responding appropriately to homecare users from black minority ethnic communities as well as those from white majority groups.Unresponsive services and poor communication may lead to loss of trust with care agencies and undermine BME carers’ sense of entitlement and competence in engaging with homecare services.Care worker continuity investing time in building relationships and care worker familiarity is important to many families who access social care services.