Black Caribbean Research Articles

Emergency hospital admissions for stress-related presentations among secondary school-aged minoritised young people in England.

Minoritised young people face a double burden of discrimination through increased risk of stress and differential treatment access. However, acute care pathways for minoritised young people with urgent mental health needs are poorly understood. To explore variation in stress-related presentations (SRPs) to acute hospitals across racial-ethnic groups in England. We examined rates, distribution, duration and types of SRPs across racial-ethnic groups in a retrospective cohort of 11- to 15-year-olds with one or more emergency hospital admissions between April 2014 and March 2020. SRPs were defined as emergency admissions for potentially psychosomatic symptoms, self-harm and internalising, externalising and thought disorders. White British (8-38 per 1000 births) and Mixed White-Black (9-42 per 1000 births) young people had highest rates of SRPs, whereas Black African (5-14 per 1000 births), Indian (6-19 per 1000 births) and White other (4-19 per 1000 births) young people had the lowest rates of SRPs. The proportion of readmissions were highest for Pakistani (47.7%), White British (41.4%) and Mixed White-Black (41.3%) groups. Black Other (36.4%) and White Other (35.8%) groups had the lowest proportions of readmissions. The proportion of admission durations ≥3 days was higher for Black Other (16.6%), Bangladeshi (16.3%), Asian Other (15.9%) and Black Caribbean (15.8%) groups than their White British (11.9%) and Indian (11.8%) peers. The type of SRPs varied across racial-ethnic groups. Patterns of SRP admissions systematically differed across racial-ethnic groups, indicative of inequitable triage, assessment and treatment processes. These findings highlight the need for implementation of race equality frameworks to address structural racism in healthcare pathways.

Ethnic Inequalities in the Functional Dentition Among British Adults: A Multilevel Analysis.

To explore the role of socioeconomic factors, area deprivation and behaviours in explaining ethnic differences in the functional dentition among East London adults using multilevel modelling. Data from a community-based health survey in East London included information on 1898 adults aged between 16 to 65 years old and belonging to 9 ethnic groups. Supervised questionnaires gathered information on demographic characteristics, socioeconomic indicators, dental behaviours and area deprivation (IMD 2007). A functional dentition was defined as having all 6 anterior plus at least 4 posterior contacts in clinical examination. The multilevel logistic regression showed that Black Africans were 75% (95%CI: 1.21-2.52) and Black Caribbean 77% (95%CI: 1.05-2.98) more likely to have a non-functional dentition than White British participants in fully adjusted models. Other factors associated with a non-functional dentition were older age and no educational attainment. Black adults are at greater risk of non-functional dentition independently from sociodemographic characteristics, oral health-related behaviours and area-level characteristics. Proportionate universalism could be effective in reducing these health gaps.

Barriers to and enablers of the early diagnosis of breast cancer among women from ethnic minority backgrounds in the UK: protocol for a qualitative evidence synthesis

IntroductionBreast cancer is the most commonly diagnosed cancer in women of all ethnic groups in the UK. The largest single ethnic groups in the UK are white, Indian, Pakistani, black...

Ethnic inequalities in primary care experiences for people with multiple long-term conditions: Evidence from the general practice patient survey

ObjectivesTo examine the relationship between ethnicity and experiences of primary care for people with multiple long-term conditions (MLTCs) and assess the relative importance of demographic, practice, and area-level factors as influences on primary care experiences across ethnic groups. Study designA retrospective study using 2018–19 GP Patient Survey data linked to General Practice Workforce data and small area data published by the Office for National Statistics. MethodsWe conducted multilevel regression analysis to assess the relationship between ethnicity and experience of accessing primary care and interacting with healthcare professionals. We built separate regression models for each outcome and included (i) each covariate separately, (ii) demographic factors and (iii) demographic, practice, and area-level factors. ResultsUpon full adjustment Arab, Bangladeshi, Chinese, Indian, Pakistani, other Asian, mixed white and Asian, and other white people with MLTCs have lower levels of satisfaction with primary care access and interacting with healthcare professionals compared with white British people. The influence of demographic, practice and area-level factors is not uniform across ethnic groups; demographic factors account for the inequalities in levels of satisfaction with access to primary care between white British people and Black other, mixed other, mixed white & Black Caribbean and Gypsy & Irish Travellers. However, practice and area-level factors strengthen inequalities in the experience of accessing primary care for Bangladeshi, Indian and Pakistani people. ConclusionsGiven the link between patient satisfaction and patient-related health outcomes, the lower levels of satisfaction with accessing primary care and interacting with healthcare professionals among the aforementioned minoritised ethnic groups are concerning and require further scrutiny. Qualitative studies are required to understand and address the sources of poor experiences in primary care for minoritised people with MLTCs to improve patient-centred healthcare and outcomes.

Class and Ethno-Gender Differences in Education and Labour Market Position—An Intersectional Analysis of Ethnic Integration in the UK

This paper analyses the socio-economic disadvantages of women from different ethnic minority heritages in the UK. Using data from the Labour Force Survey (2014–2023), which contains detailed information on parental class and respondents’ socio-economic conditions, we examine four domains of life chances which are crucial for ethnic integration: educational attainment at the degree level, risks of unemployment, access to professional-managerial (salariat) position and earning power. We proceeded with the gross differences and then examined the differences by ethno-gender status and parental class combinations, controlling for many confounding factors. We also examined the net ethno-gender differences over the life course and the trends of social fluidity over the period covered and across the ethno-gender groups. We found that women from all ethnic origins were doing well in education but faced multiple disadvantages in the labour market, especially in access to the salariat and in earning power. Women of Pakistani/Bangladeshi heritages faced pronounced unemployment risks, especially at the earlier life stages. There is a significant increase in fluidity over the period covered, but this is marked by considerable ethnic and class differences, with Black Caribbean, Black African, Pakistani and Bangladeshi women from more advantaged class origins being unable to secure advantaged class positions and those from working-class families unable to make long-range upward mobility as effectively as White men. Overall, Bangladeshi, Pakistani, Black African and Black Caribbean women are found to be considerably disadvantaged, but there are also signs of social progress.

Long term mortality trends in people with severe mental illnesses and how COVID-19, ethnicity and other chronic mental health comorbidities contributed: a retrospective cohort study.

People with schizophrenia-spectrum and bipolar disorders (severe mental illnesses; 'SMI') experience excess mortality. Our aim was to explore longer-term trends in mortality, including the COVID-19 pandemic period, with a focus on additional vulnerabilities (psychiatric comorbidities and race/ ethnicity) in SMI. Retrospective cohort study using electronic health records from secondary mental healthcare, covering a UK region of 1.3 million people. Mortality trends spanning fourteen years, including the COVID-19 pandemic, were assessed in adults with clinician-ascribed ICD-10 diagnoses for schizophrenia-spectrum and bipolar disorders. The sample comprised 22 361 people with SMI with median follow-up of 10.6 years. Standardized mortality ratios were more than double the population average pre-pandemic, increasing further during the pandemic, particularly in those with SMI and psychiatric comorbidities. Mortality risk increased steadily among people with SMI and comorbid depression, dementia, substance use disorders and anxiety over 13-years, increasing further during the pandemic. COVID-19 mortality was elevated in people with SMI and comorbid depression (sub-Hazard Ratio: 1.48 [95% CI 1.03-2.13]), dementia (sHR:1.96, 1.26-3.04) and learning disabilities (sHR:2.30, 1.30-4.06), compared to people with only SMI. COVID-19 mortality risk was similar for minority ethnic groups and White British people with SMI. Elevated all-cause mortality was evident in Black Caribbean (adjusted Rate Ratio: 1.40, 1.11-1.77) and Black African people with SMI (aRR: 1.59, 1.07-2.37) during the pandemic relative to earlier years. Mortality has increased over time in people with SMI. The pandemic exacerbated pre-existing trends. Actionable solutions are needed which address wider social determinants and address disease silos.

Living less safely through the pandemic in England for people with serious mental and physical health conditions: qualitative interviews with service users and carers of Black African, Caribbean, and South-Asian descent.

COVID-19 Ethnic Inequalities in Mental health and Multimorbidities (COVEIMM) is a mixed methods study to explore whether COVID-19 exacerbated ethnic health inequalities in adults with serious mental and physical health conditions. We analysed data from electronic health records for England and conducted interviews in Birmingham and Solihull, Manchester, and South London. Sites were selected because they were pilot sites for the Patient and Carer Race Equality Framework being introduced by NHS England to tackle race inequalities in mental health. Prior to the pandemic people in England with severe mental illnesses (SMIs) faced an 11-17-year reduction in life expectancy, mostly due to preventable, long-term, physical health conditions. During the pandemic there was a marked increase in deaths of those living with an SMI. This qualitative interview study aimed to understand the reasons underlying ethnic inequalities in mortality and service use during the COVID-19 pandemic for adult service users and carers of Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi backgrounds living with serious multiple long-term mental and physical health conditions. We took a participatory action research approach and qualitative interviews undertaken by experts-by-experience and university researchers Participants were purposively sampled by ethnicity, diagnoses, and comorbidities across three geographically distinct sites in England. Transcriptions were coded inductively and deductively and analysed thematically. Findings indicated multiple points along primary and secondary health pathways for mental and physical health that have the potential to exacerbate the unjust gap in mortality that exists for Black and Asian people with SMIs. Issues such as timely access to care (face-to-face and remote), being treated in a culturally appropriate manner with empathy, dignity and respect, and being able to use services without experiencing undue force, racism or other forms of intersectional discrimination were important themes arising from interviews. These poor experiences create systemic and enduring healthcare harms for racialised groups with SMIs that need to be addressed. Our findings suggest a need to address these, not only in mental health providers, but across the whole health and care system and a need to ensure more equitable healthcare partnerships with service users, carers, and communities from racialised backgrounds who are often excluded.

Digitalised primary care in the UK: a qualitative study of the experiences of minoritised ethnic communities.

Barriers to accessing and using primary care services among minoritised ethnic communities have been extensively evidenced in the UK. However, the impact of the rapid digitalisation of these services on these communities remains under-researched. To explore the impact of digitalisation on access to and use of primary care services among minoritised ethnic communities. Underpinned by a critical realist intersectional approach, and employing qualitative research methods, this study explores minoritised ethnic individuals' experiences of digital primary care in the UK. In total, 100 minoritised ethnic adults who identify as Black African, Black Caribbean, Bangladeshi, Indian, Pakistani, Chinese, and of mixed or multiple ethnic heritage in four sites in the UK were purposively recruited and interviewed. Interviews were thematically analysed to increase understanding of how individuals' ethnicity intersects with other characteristics (for example, language, age, gender, socioeconomic status) to identify constraints and enablements to accessing health care. Minoritised ethnic individuals' access to digital primary care is impeded by factors such as digital precarity (for example, inadequate devices, internet connectivity, and digital literacy skills), a lack of language support, and staff shortcomings in responding to ethnically diverse populations. Intergenerational support and bespoke offerings by general practices in some areas enable some individuals to overcome some of the constraints. The rapid digitalisation of primary care services is replicating and potentially exacerbating barriers to using these services among minoritised ethnic communities, a finding that merits urgent attention by practitioners and policymakers.

Are ethnic inequalities in adult oral health-related quality of life modified by immigration status?

To explore ethnic inequalities in oral health-related quality of life (OHRQoL) and the role of nativity status on them. Data from 1868 adults (16-65 years) of 9 ethnic groups participating in a community-based health survey in East London. Participants completed a supervised questionnaire including the Oral Health Impact Profile (OHIP-14) to calculate prevalence, extent and severity of oral impacts. Associations between ethnicity and nativity status (individually and combined) with OHRQoL were assessed in regression models, crude and adjusted for socio-demographic factors and clinical oral health indicators. Black others showed higher prevalence (OR: 1.91; 95%CI 1.05-3.46), severity (IRR: 2.87, 95%CI 1.63-5.06) and extent of oral impacts (IRR: 1.86, 95%CI 1. 35-2.59). Oral impacts were more severe among Black Caribbeans (IRR: 2.85, 95%CI 1.31-6.18) and Bangladeshis (IRR: 3.08, 95%CI .07-8.91); whereas impacts were more extensive among Pakistanis (IRR: 1.54, 95%CI 1.05-2.25) and Bangladeshis (IRR: 1.87, 95%CI 1.16-3.00). Nativity status individually showed no association with OHRQoL, although when combined with ethnicity resulted in many minority groups showing worse OHRQoL than White British participants. Ethnicity and nativity status have a combined and important role in OHRQoL: ethnic minority groups showed worse OHRQoL even when controlling for clinical oral status.

Black Family Members' Experiences and Interpretations of Supportive Resources for Them and Their Relatives With Substance Use Disorders: A Focused Ethnography.

While previous research explored the utilization of culturally supportive resources in multiethnic communities, there is a paucity of information regarding culturally relevant resources for Black Canadian family members. The study explored Black family members' experiences and interpretations regarding access to culturally supportive resources for family members and their relatives who suffer from substance use disorders. Black family members are defined as African Canadians, Caribbean Canadians, or Caribbean Blacks. A focused ethnography was conducted with a purposive sample of 26 Black family members in Ontario, Canada. The interviews were conducted from June to September 2021. Seventeen participants originated from parts of Africa, and nine were from different parts of the Caribbean. The participants comprised mothers (n = 5), fathers (n = 2), step-fathers (n = 1), husbands (n = 1), wives (n = 2), uncles (n = 5), aunties (n = 2), siblings (n = 5), in-laws (n = 2), and guardians (n = 1). Leininger's four Phases of Ethnonursing Qualitative Data Analysis were used for data analysis. Three themes were generated: (1) Navigating Existing Options and Resources for Families and Their Relatives; (2) Drawing upon Religion and Spirituality as Perceived Resources; and (3) Call for Culturally Relevant Programs for Substance Use Disorders Harm Reduction. Participants described experiencing a lack of culturally relevant resources and subsequently opting to navigate other resources. One such option was to send their relatives back to their country of origin to access cultural rehabilitation treatment options. There is a significant need for guidelines and policies regarding creating timely access to culturally relevant resources in Canada that support families and their relatives towards harm reduction and recovery outcomes.

Raising awareness about physical activity’s role in reducing cancer risk: qualitative interviews with immigrant women and community agency managers

ObjectivesTo explore how to reach immigrant women through community agencies to raise awareness of the role of physical activity (PA) in reducing cancer risk.Study designQualitative description.MethodsWe conducted semi-structured telephone interviews with immigrant women and community agency managers to discuss the ideal design of an education session on PA and cancer risk, and identified themes using content analysis.ResultsParticipants included 22 women (6 African or Caribbean Black, 4 Chinese, 3 Filipino, 5 Indian, 4 Pakistani) and 16 agency managers from across Canada. Women were not familiar with Canada’s PA guidelines, and few were aware that PA reduces the risk of cancer. All expressed interest in education about PA and cancer. Diverse women and managers expressed similar preferences for education session design including content (e.g. PA amount/type), format (e.g. in person preferred but virtual more practical), personnel (external expert plus agency staff), cultural tailoring (e.g. translated supplemental take home information) and reinforcing (e.g. follow-up with participants) strategies. Women and managers identified few barriers to participating in education sessions, chiefly, that women lacked time due to work and family responsibilities; and noted several enablers of participation (e.g. emphasize social aspect, provide gift cards or recreation centre passes).ConclusionsWe generated insight on the ideal characteristics of a community-based education session that could raise awareness among immigrant women of the importance of PA in reducing cancer risk. Further research is needed to assess the feasibility and impact of PA education sessions designed based on these findings.

Message Factors Affecting the Recruitment of Black Caribbean and African American Participants for Clinical Trials

The need for effective and ethical recruitment of Black Caribbean and African American individuals for participation in research studies and clinical trials is urgent; without adequate representation, findings cannot be generalized to these populations. The factors affecting recruitment are complex, including many systems-based issues. However, communication issues have received relatively little attention. To advance knowledge of communication behaviors that impact recruitment of research participants from Black communities, we describe the findings from a study of 48 participants in 9 focus groups. Participants included 31 African American and Black Caribbean individuals who described their experiences being recruited for research studies and clinical trials as well as 17 (primarily Hispanic and African American) clinical research coordinators who described how message factors impacted recruitment and retention of Black Caribbean and African American participants. Using the lens of the Elaboration Likelihood Model (ELM), which describes the communication factors that help motivate the cognitive processing of information, we describe how the amount of information provided, the accessibility of information, and the complexity of information all impact study recruitment. Participants offered insights about the adequacy (and excess) of information provided, tensions related to deviation from consent form language when simplifying complex terminology, preemptively addressing common conspiracy theories during recruitment, the importance of using metaphors and analogies, and communicating complex information using multiple communication modalities.

Marcien Towa et la critique Senghorienne de la négritude : Une contribution à l’idéologie du panafricanisme ?

Marcien Towa and the Senghorian Critique of Negritude: A Contribution to the Ideology of Pan-Africanism? After the first generation of Pan-Africans formed at the beginning of the 20th century mainly by black Americans and Caribbeans, the second generation is formed with black Africans. These black Africans are inspired and influenced by the founding fathers of Pan-Africanism. Marcien Towa (1931-2014) is one of them. The philosopher is a key figure in the intellectual history of Africa who has contributed ardently, alongside other renowned intellectuals, to the writing of the modern history of Africa. His fight very legitimately was to wash the Africans of opprobrium (the stereotyped images of Africa and its inhabitants created by the colonizers). Through his criticism of Senghorian negritude, he makes a remarkable contribution to the reflection on the movement, a considerable contribution to the ideology of Pan-Africanism. Keywords : Negritude, Pan-Africanism, Criticism, Contribution, Ideology

Primary Pterygium Excision Surgery: Analysis of Risk Factors and Clinical Outcomes.

Purpose To evaluate clinical outcomes of primary pterygium excision surgery and analyze risk factors for pterygium recurrence. Setting Eye Treatment Centre, Cornea and External Diseases Service, Whipps Cross Hospital, London, United Kingdom. Methods Retrospective case series of eyes undergoing primary pterygium excision between August 2017 and July 2022. Patients who underwent "pterygium excision" documented in the electronic patient record system were identified. Patients with recurrent pterygium and those lost-to-follow-up were excluded. The duration of follow-up, type of surgery performed (primary conjunctival closure, conjunctival autograft, and amniotic membrane transplantation), recurrences with respect to the type of surgery performed, and postoperative complications were collected and analyzed. Results In total, 83 eyes (from 79 patients) were included. The mean age of our patient cohort was 59.3 ± 5.9 years. The most common ethnic distribution was Black Caribbean (15.7%). Conjunctival autograft was performed in 76 eyes (91.6%), primary conjunctival closure was performed in five eyes (6%) and amniotic membrane transplantation was performed in two eyes (2.4%). The recurrence rate with conjunctival autograft was 1.3% with a median time to recurrence of 2.98 months. Recurrence was significantly more common in patients below the age of 40 years (p=0.03). Recurrence was not significantly associated with gender (p=0.23), ethnicity (p=0.17), or grade of surgeon (p=0.38). Conclusion Our findings demonstrate the effectiveness of conjunctival autograft with fibrin glue fixation for the surgical management of primary pterygium. Recurrence was found to be significantly more common in patients under the age of 40 years old. However, recurrence was not associated with ethnicity,gender, or surgeon grade.

Endometrial cancer survival in populations of African descent.

To examine whether the endometrial cancer (EC) survival disadvantage among Black populations is US-specific, a comparison between African-descent populations from different countries with a high development index is warranted. We analyzed 28 213 EC cases from cancer registries in Florida (2005-2018) and the French Caribbean islands of Martinique (2005-2018) and Guadeloupe (2008-2018) combined. Kaplan-Meier and all-cause Cox proportional hazards models were used to compare survival. Models were stratified by EC histology type and the main predictor examined was race/ethnicity (non-Hispanic White [NHW] and no-Hispanic Black [NHB] women in the United States versus Black women residing in the Caribbean). For endometrioid and nonendometrioid EC, after adjusting for age, histology, stage at diagnosis, receipt of surgery, period of diagnosis, and poverty level, US NHB women and Caribbean Black women had a higher risk of death relative to US NHW women. There was no difference between US NHB and Caribbean Black women (hazard ratio [HR] = 1.07; 95% CI, 0.88-1.30) with endometrioid EC. However, Caribbean Black women with nonendometrioid carcinomas had a 40% higher risk of death (HR = 1.40; 95% CI, 1.13-1.74) than US NHB women. The low EC survival among US Black women extends to foreign populations of African descent. For the aggressive nonendometrioid ECs, survival among Caribbean Black women outside of the United States is considerably worse. This article is part of a Special Collection on Gynecological Cancers.

The contribution of cannabis use to the increased psychosis risk among minority ethnic groups in Europe.

We examined whether cannabis use contributes to the increased risk of psychotic disorder for non-western minorities in Europe. We used data from the EU-GEI study (collected at sites in Spain, Italy, France, the United Kingdom, and the Netherlands) on 825 first-episode patients and 1026 controls. We estimated the odds ratio (OR) of psychotic disorder for several groups of migrants compared with the local reference population, without and with adjustment for measures of cannabis use. The OR of psychotic disorder for non-western minorities, adjusted for age, sex, and recruitment area, was 1.80 (95% CI 1.39-2.33). Further adjustment of this OR for frequency of cannabis use had a minimal effect: OR = 1.81 (95% CI 1.38-2.37). The same applied to adjustment for frequency of use of high-potency cannabis. Likewise, adjustments of ORs for most sub-groups of non-western countries had a minimal effect. There were two exceptions. For the Black Caribbean group in London, after adjustment for frequency of use of high-potency cannabis the OR decreased from 2.45 (95% CI 1.25-4.79) to 1.61 (95% CI 0.74-3.51). Similarly, the OR for Surinamese and Dutch Antillean individuals in Amsterdam decreased after adjustment for daily use: from 2.57 (95% CI 1.07-6.15) to 1.67 (95% CI 0.62-4.53). The contribution of cannabis use to the excess risk of psychotic disorder for non-western minorities was small. However, some evidence of an effect was found for people of Black Caribbean heritage in London and for those of Surinamese and Dutch Antillean heritage in Amsterdam.

Singing Blackness

In this article I propose the exploration of racial discourse in recent Black Caribbean rap and hip-hop productions. Rap and hip-hop are often used as a sociopolitical tool that—through writing and language—achieve to create activist movements. Specifically, I study the work of the Cuban hip-hop group Obsesión [Obsession] and of Cuban rapper Robe L Ninho and the work of Dominican rappers Circuito Negro and JNoa. I particularly focus on some of their songs that make of the genre an opportunity to approach the racial topic in their communities and a way to celebrate Blackness. This way, these hip-hop and rap songs break the most commercial, common, and expected pattern of lyrics that focus on topics that oversexualize the female (Black) body, that often objectify women, and that reproduce a patriarchal and heteronormative discourse. Instead, these songs, through the topics that they explore, aim to create community and craft a space for social activism. They do so, for example, by singing about hair (Obsesión and Robe L Ninho) and by singing about their Afro-Caribbean communities and their existence as Black people in their neighborhoods (Circuito Negro, JNoa). Among a variety of tracks, I mainly focus on songs that are connected in topic and that represent a continuumin the production of approximately the last decade. So, for example I analyze the songs “Los pelos [Hair]” by Obsesión (2014) and “N.E.G.R.O. [N.E.G.R.O.]” by Robe L Ninho (2022) that focus on Afro hair, celebrate the beauty of it, and denounce the prejudices against it almost a decade apart from each other. Then, I focus on the song “Revolufunk” by Circuito Negro (2011) and the song “Qué fue[What Happened?]” (2022) by JNoa. In this case also there is a generational gap between the artists that symbolize both the evolution of the genre and the consistency of the topics that they cover and that are connected to Blackness. In addition to the racial discourse and the connection of topics across the last decade, these songs also create an inter-Caribbean discourse that transcends the concept of nation and nationality and instead identifies with and shapes a message for Black Spanish-speaking Caribbean people. These songs reveal a poetic that adds urban sounds to a spoken word tradition and that mixes writing, oral tradition, and language in lieu to create a sociopolitical activist movement for Afro-Caribbean people. Also, by focusing on race in countries where the Black communities are often made invisible, they shed light on minorities that usually are relegated to the lowest layers of society. Thus, through their music, these artists raise awareness on their Blackness and on their communities, but they also create a transversal Afro-Caribbean narrative that connects and creates a sense of community among Blacks in the Caribbean in their native Spanish language. This study, so, represents an opportunity to shift a US-centered discourse on Blackness and race and opens new ways of living and understanding the African diaspora in other geographies.

The prevalence of common mental disorders across 18 ethnic groups in Britain during the COVID-19 pandemic: Evidence for Equality National Survey (EVENS)

BackgroundThe COVID-19 pandemic negatively impacted mental health in the general population in Britain. Ethnic minority people suffered disproportionately, in terms of health and economic outcomes, which may contribute to poorer mental health. We compare the prevalence of depression and anxiety across 18 ethnic groups in Britain during the COVID-19 pandemic. MethodsSecondary analysis of cross-sectional data (February–November 2021) from 12,161 participants aged 18–60 years old (N with data on outcomes = 11,540 for depression & 11,825 for anxiety), obtained from the Evidence for Equality National Survey (EVENS). Data were weighted to account for selection bias and coverage bias. Weighted regression models examined ethnic differences in depression (Centre for Epidemiologic Studies Depression Scale) and anxiety (Generalised Anxiety Disorder-7). Effect modification analyses explored whether ethnic differences in outcomes were consistent within age and sex sub-groups. ResultsCompared to White British people, greater odds of anxiety caseness (and greater anxiety symptoms) were observed for Arab (OR = 2.57; 95 % CI = 1.35–4.91), Mixed White and Black Caribbean (1.57; 1.07–2.30), any other Black (2.22, 1.28–3.87) and any other Mixed (1.58; 1.08–2.31) ethnic groups. Lower odds of depression caseness (and lower depressive symptoms) were identified for Chinese (0.63; 0.46–0.85), Black African (0.60; 0.46–0.79), and any other Asian (0.55; 0.42–0.72) ethnic groups. LimitationsCross-sectional data limits the opportunity to identify changes in ethnic inequalities in mental health over time. ConclusionsWe have identified certain ethnic groups who may require more targeted mental health support to ensure equitable recovery post-pandemic. Despite finding lower levels of depression for some ethnic groups, approximately one third of people within each ethnic group met criteria for depression.

Social determinants of health and long-term conditions in people of Black African and Black Caribbean ethnicity living with HIV in London: Aqualitative study.

People living with human immunodeficiency virus (HIV) are disproportionately impacted by socioeconomic deprivation and are at increased risk of developing other long-term conditions (LTCs). These illnesses require transformative action to tackle the adverse effects on their health. Data on lived experiences of LTCs among people living with HIV of Black African and Black Caribbean ethnicities are sparse, and how people with LTCs are impacted by social determinants of health (SDoH). Through a phenomenological study design this qualitative study, conducted in 2022, comprised four focus group discussions (FGDs) with 20 people of Black ethnicities living with HIV were purposively invited from a community organisation (CO) in London, including four semistructured interviews with CO staff. Following transcription, qualitative data were analysed thematically and measures to validate the findings were implemented. The findings are presented in terms of the following four levels of SDoH: (1) individual determinants (such as the impact of SDoH on lifestyle modification and self-management); (2) interpersonal determinants (such as positive experiences of accessing healthcare for LTCs); (3) clinical determinants (such as care pathway barriers)and (4) systemic determinants (such as systemic barriers related to race/ethnicity). It is necessary to provide ongoing and interactive education to community members who live with HIV, focusing on risks and management of LTCs. Additionally, individuals would benefit from support to navigate increasingly complex and fragmented health services. Health Service staff require cultural competence when caring for patients of Black African and Black Caribbean ethnicities with complex health and psychosocial needs. The research team collaborated with an HIVCOin South London from the very start of the project to agree the study design and learn about the realities of their daily lived experiences. Community collaborators helped to develop the semistructured interview and FGDtopic guides, and were directly involved in the data gathering, analysis and validation.

Correlates of Spirituality among African American and Black Caribbean Emerging Adults.

Spirituality is a significant cultural strength and resource for Black emerging adults. Numerous studies show that increasing numbers of emerging adults tend to identify themselves as being spiritual but not religious. However, no studies to date have identified the demographic correlates of spirituality for Black emerging adults from different ethnic groups (i.e., African American vs. Black Caribbean). Data from the National Survey of American Life was used to identify the demographic correlates of 2 indicators of spirituality (e.g., self-rated spirituality and subjective spirituality) for 802 African American and 428 Black Caribbean emerging adults using linear regression. For African Americans, being a woman predicted both greater self-rated spirituality and subjective spirituality. However, among Black Caribbeans men rated spirituality higher in importance than women. African Americans who reported higher educational attainment tended to report higher levels of self-rated spirituality and subjective spirituality. Romantic status for Black Caribbeans, whether they had no romantic involvement or a current romantic partner, was associated with lower self-ratings of spirituality. Unmarried cohabitating individuals in both ethnic groups tended to report lower levels of self-related spirituality. Unemployment for Black Caribbeans was associated with lower subjective spirituality. Findings are of interest to those who serve and work with Black emerging adults.