Pakistani Ethnicity Research Articles

British Pakistani Muslim Masculinity, (In)fertility, and the Clinical Encounter

ABSTRACTThe experiences of men facing fertility disruptions are understudied. For British Pakistanis, the impact of infertility is heightened for women because of normative pressures to bear children. But what of men? I present data from in-depth interviews in North East England with infertile British Pakistani Muslims and relevant health professionals. British Pakistani men’s level of participation in clinical encounters and responses to diagnoses of male factor infertility must be understood in the context of kinship, the construction of Pakistani ethnicity in the UK, and the subordinated forms of masculinity which accompany this identity.

Recent household transmission of tuberculosis in England, 2010\u20132012: retrospective national cohort study combining epidemiological and molecular strain typing data

BackgroundWe estimate the proportion of tuberculosis (TB) in England due to recent household transmission, identify factors associated with being a household transmitter, and investigate the impact that identification of a case has on time to treatment of subsequent cases.MethodsTB cases notified between 2010 and 2012 in England in the same household as another case were identified; 24 locus MIRU-VNTR strain typing (ST) was used to identify household cases with likely recent transmission. Treatment delay in index and subsequent cases was compared. Risk factors for being a household transmitter were identified in univariable and multivariable analyses.ResultsOverall, 7.7% (1849/24,060) of TB cases lived in a household with another case. We estimate that 3.9% were due to recent household transmission. ST data was unavailable for 67% (1242) of household pairs. For those with ST data, 64% (386) had confirmed, 11% probable (66) and 25% (155) refuted household transmission. The median treatment delay was 65 days for index cases and 37 days for subsequent asymptomatic cases. Risk factors for being a household transmitter included being under 25 years old, UK-born with Black African, Indian or Pakistani ethnicity, or born in Somalia or Romania.ConclusionsThis study has a number of implications for household TB contact tracing in low incidence countries, including the potential to reduce the diagnostic delay for subsequent household cases and the benefit of using ST to identify when to conduct source contact tracing outside the household. As 25% of TB cases in households had discordant strains, households with multiple TB cases do not necessarily represent household transmission. The additional fact that 25% of index cases within households only had extra-pulmonary TB demonstrates that, if household contact tracing is limited to pulmonary TB cases (as recently recommended in UK guidelines), additional cases of active TB in households will be missed. Our finding that no lineage of TB was associated with recent household transmission and with no increased transmissibility in the Beijing lineage compared to others, suggests that the lineage need not impact contact tracing efforts. Improvements in contact tracing have the potential to reduce transmission of TB in low incidence countries.

O31 Explaining ethnic variations in sti diagnosis: results from britain’s third national survey of sexual attitudes and lifestyles (NATSAL-3)

IntroductionIn Britain, ethnic inequalities in STIs diagnoses persist. We hypothesised that these inequalities are associated with variations in sexual behaviour, which are influenced by differences in socioeconomic deprivation (SED) and mediated by substance use.MethodsData from 14,563 participants of Britain’s third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey (N=15,162), were analysed by gender and ethnicity: white British (WB, reference category), black Caribbean (BC), black African (BA), Indian, Pakistani, white other (WO), and mixed ethnicity (ME). Using multivariable regression we examined ethnic variations in reported STI diagnoses adjusted for age, partner numbers (last 5y), recreational drug use (last 1y), and SED, and calculated adjusted odds ratios (AOR).ResultsSED was higher in BC, BA, and Pakistani participants than other ethnicities (50% vs. 16%-38%, p<0.0001). compared with men from other ethnicities, BC and BA men reported higher partner numbers (p<0.0001), and concurrent partnerships (27% and 39% respectively vs. 4%–15%, p=0.001). compared with women from other ethnicities, ME women reported higher partner numbers (p<0.0001) and concurrency (14% vs. 2%–8%, p=0.0005). Recreational drug use was highest among WO and ME participants (26% vs. 4%-15% among other ethnicities; p<0.0001). Reported STI diagnosis was highest among BC men (8.7) and ME women (6.7%), and remained AOR high after adjustment for BC men (2.68, 95%CI: 1.13–6.34) and ME women (2.03, 95%CI: 1.11–3.68).DiscussionEthnic variations in sexual behaviours, mediators, and SED partially explain higher STI diagnoses among BC men and ME women highlighting need for holistic interventions addressing these broader determinants.

Differences in cardiovascular disease mortality between local authorities in England: an ecological analysis

BackgroundLarge inequalities in age-standardised mortality rates of cardiovascular disease (CVD) exist at the local authority level within England, with particular areas consistently having the highest rates. Higher deprivation is associated with higher CVD mortality, but we know little about how the demographics and environments of local areas contribute to variations in mortality rates. The aim of this study was to explore the extent to which demographic, health, and environmental factors explain differences in all ages and premature CVD mortality between local authorities in England. MethodsAll data were sourced for each local authority in England. Outcome variables were age-standardised CVD mortality for all ages and those under 75 years in 2012–14. Data obtained were prevalence of ethnic and socioeconomic groups from the UK 2011 census; Public Health England data on index of multiple deprivation (IMD) score; prevalence of smoking, physical activity, obesity and overweightness; and Ordnance Survey environmental data on percentage of food shops, eating out shops, green or blue space, sporting facilities, and health facilities. We used the Akaike Information Criterion to assess which types of variables provided the best statistical model to explain variation in CVD mortality between local authorities. FindingsInclusion of health, demographic, environment, and IMD variables provided the best fit for explaining variation in CVD mortality at all ages (adjusted r2=0·60). Indian and Pakistani ethnicity and the IMD score in local authorities remained significantly associated with the outcome, with corresponding p values all less than 0·01. CVD mortality was 44 per 100 000 population greater in areas with the highest proportions of Indian and Pakistani ethnicities and 110 per 100 000 greater in the most deprived local authorities than in the least deprived areas. For CVD mortality below age 75, exclusion of environmental data improved the fit of the model (adjusted r2=0·82). Overweight prevalence (p=0·0481), Indian (p=0·0111), Pakistani (p=0·0003), and Bangladeshi (p=0·003) ethnicity, and the IMD score (p<0·0001) all remained significantly associated with premature CVD mortality when the best fitting model was used. Premature mortality was 13 per 100 000 and 18–25 per 100 000 greater in local authorities where the proportion of overweight people and Asian ethnicities was highest. Premature mortality in the most deprived local authorities was 68 per 100 000 greater than in the least deprived authorities. InterpretationThese findings are valuable for understanding which factors might be most useful for local authorities to target to reduce CVD mortality. This study combined a large amount of existing data; however, it was conducted at an ecological level, so analyses using individual-level mortality outcomes are also needed. FundingThe authors' posts are funded by the British Heart Foundation.

Ethnic and socio-economic differences in the prevalence of wheeze, severe wheeze, asthma, eczema and medication usage at 4 years of age: Findings from the Born in Bradford birth cohort

BackgroundAsthma, wheeze and eczema are common in early childhood and cause considerable morbidity. Generally rates of these conditions are higher in high income compared to low income countries. Rates in developed nations are generally higher than in less developed countries. After migration to Western countries, differences in risks of developing these conditions may between migrant and non-migrant may diminish. MethodsA convenience sample of 1648 children of White British, Pakistani or Other ethnicity aged between 4 and 5 years were recruited from the main Born in Bradford cohort. Children's parents or guardians were asked to report on a range of potential risk factors and their associations with wheeze, asthma and eczema. Relationships between ethnicity and disease outcomes were examined using logistic regression after adjustment for other relevant risk factors and confounders. ResultsEthnic differences in doctor diagnosed asthma were evident, with children of other ethnic Origin being less likely and children of Pakistani origin more likely to have a diagnosis than White British or other origin children, although after adjustment for other risk factors this difference only remained significant for the Other Ethnic group. Ethnic differences were not observed in other outcomes including wheeze in the past 12 months, severe wheeze and taking medications for breathing problems. ConclusionsIn UK born children, traditional risk factors such as gender, family history, socio-economic status and child's medical history may be stronger risk factors than ethnicity or familial migration patterns.

Development and evaluation of an intervention for the prevention of childhood obesity in a multiethnic population: the Born in Bradford applied research programme

BackgroundThere is an absence of evidence about interventions to prevent or treat obesity in early childhood and in South Asian populations, in whom risk is higher.ObjectivesTo study patterns and the aetiology of childhood obesity in a multiethnic population and develop a prevention intervention.DesignA cohort of pregnant women and their infants was recruited. Measures to compare growth and identify targets for obesity prevention, sensitive to ethnic differences, were collected. A feasibility randomised controlled trial (RCT) was undertaken.SettingBradford, UK.ParticipantsA total of 1735 mothers, 933 of whom were of South Asian origin.InterventionA feasibility trial of a group-based intervention aimed at overweight women, delivered ante- and postnatally, targeting key modifiable lifestyle behaviours to reduce infant obesity.Main outcome measuresThe feasibility and acceptability of the pilot intervention.Data sourcesRoutine NHS data and additional bespoke research data.Review methodsA systematic review of diet and physical activity interventions to prevent or treat obesity in South Asian children and adults.ResultsRoutine measures of growth were accurate. The prevalence of risk factors differed between mothers of white British ethnicity and mothers of Pakistani ethnicity and weight and length growth trajectories differed between Pakistani infants and white British infants. Prediction equations for risk of childhood obesity were developed. An evidence-based intervention was evaluated in a pilot RCT and was found to be feasible and acceptable.LimitationsThis was a single-centre observational study and a pilot evaluation.ConclusionsThe programme has been successful in recruiting a unique multiethnic childhood obesity cohort, which has provided new evidence about modifiable risk factors and biethnic growth trajectories. A novel group-based behavioural change intervention has been developed and successfully piloted. A multisite cluster RCT is required to evaluate effectiveness.Trial registrationCurrent Controlled Trials ISRCTN56735429.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

Do early-life exposures explain why more advantaged children get eczema? Findings from the U.K. Millennium Cohort Study.

SummaryBackgroundAtopic dermatitis (eczema) in childhood is socially patterned, with higher incidence in more advantaged populations. However, it is unclear what factors explain the social differences.ObjectivesTo identify early‐life risk factors for eczema, and to explore how early‐life risk factors explain any differences in eczema.MethodsWe estimated odds ratios (ORs) for ever having had eczema by age 5 years in 14 499 children from the U.K. Millennium Cohort Study (MCS), with a focus on maternal, antenatal and early‐life risk factors and socioeconomic circumstances (SECs). Risk factors were explored to assess whether they attenuated associations between SECs and eczema.ResultsOverall 35·1% of children had ever had eczema by age 5 years. Children of mothers with degree‐level qualifications vs. no educational qualifications were more likely to have eczema (OR 1·52, 95% confidence interval 1·31–1·76), and there was a gradient across the socioeconomic spectrum. Maternal atopy, breastfeeding (1–6 weeks and ≥ 6 months), introduction of solids under 4 months or cow's milk under 9 months, antibiotic exposure in the first year of life and grime exposure were associated with an increased odds of having eczema. Female sex, Pakistani and Bangladeshi ethnicity, smoking during pregnancy, exposure to environmental tobacco smoke and having more siblings were associated with reduced odds for eczema. Controlling for maternal, antenatal and early‐life characteristics (particularly maternal smoking during pregnancy, breastfeeding and number of siblings) reduced the OR for eczema to 1·26 (95% confidence interval 1·03–1·50) in the group with the highest educational qualifications compared with the least.ConclusionsIn a representative U.K. child cohort, eczema was more common in more advantaged children. This was explained partially by early‐life factors including not smoking during pregnancy, breastfeeding and having fewer siblings.

Anaphylaxis and ethnicity: higher incidence in British South Asians.

The incidence of anaphylaxis in South Asians (Indian, Pakistani and Bangladeshi ethnicity) is unknown. Birmingham is a British city with a disproportionately large population of South Asians (22.5%) compared with the rest of the UK (4.9%). The main aims of this study were to determine the incidence and severity of anaphylaxis in this population and to investigate the differences between the South Asian and White populations. A retrospective electronic search of emergency department attendances at three hospitals in Birmingham during 2012 was carried out. Wide search terms were used, medical notes were scrutinized, and the World Allergy Organization diagnostic criteria for anaphylaxis were applied. Patients' age, sex, ethnicity and home postal code were collected, reactions were graded by severity, and other relevant details including specialist assessment were extracted. Multivariate analysis was undertaken using 2011 UK census data. Age-, sex- and ethnicity-standardized incidence rate of anaphylaxis was 34.5 per 100 000 person-years. Multivariate logistic regression which controlled for the confounders of age, sex and level of socioeconomic deprivation showed that incidence was higher in the South Asian population (OR 1.48, P = 0.005). Incidence rate in the South Asian population was 58.3 cases per 100 000 person-years compared to 31.5 in the White population. South Asian children were more likely to present with severe anaphylaxis (OR 5.31, P = 0.002). Incidence of anaphylaxis is significantly higher in British South Asians compared to the white population. British South Asian children are at a greater risk of severe anaphylaxis than White children.

Ethnicity, deprivation and mortality due to 2009 pandemic influenza A(H1N1) in England during the 2009/2010 pandemic and the first post-pandemic season.

The relationship between risk of death following influenza A(H1N1)pdm09 infection and ethnicity and deprivation during the 2009/2010 pandemic period and the first post-pandemic season of 2010/2011 in England was examined. Poisson regression models were used to estimate the mortality risk, adjusted for age, gender, and place of residence. Those of non-White ethnicity experienced an increased mortality risk compared to White populations during the 2009/2010 pandemic [10·5/1000 vs. 6·0/1000 general population; adjusted risk ratio (RR) 1·84, 95% confidence interval (CI) 1·39-2·54] with the highest risk in those of Pakistani ethnicity. However, no significant difference between ethnicities was observed during the following 2010/2011 season. Persons living in areas with the highest level of deprivation had a significantly higher risk of death (RR 2·08, 95% CI 1·49-2·91) compared to the lowest level for both periods. These results highlight the importance of rapid identification of groups at higher risk of severe disease in the early stages of future pandemics to enable the implementation of optimal prevention and control measures for vulnerable populations.

P01 Incidence and clinical associations of acute pancreatitis in children aged 0–14 years in the united kingdom

Aims To establish the incidence and clinical associations of acute pancreatitis (AP) in children aged 0–14 years in the UK. Methods Monthly surveillance of new cases of AP in children under 15 years of age through the British Paediatric Surveillance Unit. Results A total of 94 cases (48 boys and 46 girls) of AP, clinician-diagnosed from April 2013 to April 2014, fulfilled the diagnostic criteria. The median age of diagnosis was 11.2 years (range 1.30–14.89 years). White children accounted for 60% of cases compared to 40% from ethnic minorities (71% Asian and 13% Black). Pakistani children alone made up 19% of the cohort. The reported incidence of AP in children under age 15 in the UK was 0.78 per 100,000 (95% CI 0.62–0.96). Of the 94 cases: 36 (38%) were idiopathic, drugs 18 (19%), gallstones 12 (13%), hereditary 7 (7.5%), organic acidaemia 7 (7.5%), anatomical anomalies 4 (4%), viral infections 3 (3%), vasculitis 3 (3%), trauma 1 (1%) and others 3 (3%). The most common drug associations were asparaginase (28%), azathioprine (17%) and sodium valproate (17%). Of the 12 gallstone-associated cases, 5 were boys; body weight of 5 cases were above the 91st centile (4 were above the 98th centile). Overall, 6 of 7 organic acidaemia cases (86%) and 3 of 5 asparaginase-associated cases (60%) were of Pakistani ethnicity. Conclusion This is the first estimate of incidence of AP in children in the UK. In children, AP is associated with a wide variety of potential aetiologies and more than one third of cases have no cause identified. The associations of AP have changed significantly since the 1970/80s. Drug therapy and gallstones are now the commonest associations, whilst trauma and mumps have become uncommon. Children from some ethnic minorities are greatly over-represented, which possibly reflect the greater frequency of inborn errors of metabolism in some ethnicities. However the over-representation of asparaginase associated AP in Pakistani children merits further investigation.

Pregnancy glycaemia and cord-blood levels of insulin and leptin in Pakistani and white British mother-offspring pairs: findings from a prospective pregnancy cohort.

Aims/hypothesisTo determine the extent to which gestational fasting and postload levels of glucose explain differences in infant fat mass between UK-born Pakistani and white British infants.MethodsAnalyses were undertaken in a prospective pregnancy cohort study of 1,415 women and their singleton live-born infants (629 white British and 786 Pakistani). Infant fat mass was assessed by cord-blood leptin levels and fetal insulin secretion by cord-blood insulin levels. Maternal OGTTs were completed at 26–28 weeks of gestation.ResultsPakistani women had higher fasting and postload glucose levels and greater incidence of gestational diabetes than white British women. Higher fasting and postload glucose levels were associated with higher cord-blood levels of insulin and leptin in all participants, irrespective of ethnicity. Cord-blood leptin levels were 16% (95% CI 6, 26) higher in Pakistani than in white British infants. After adjustment for fasting glucose levels, this difference attenuated to 7% (−3, 16), and with additional adjustment for cord-blood insulin levels it attenuated further to 5% (−4, 14). Path analyses supported the hypothesis that fasting glucose levels mediate the relationship of Pakistani ethnicity to greater fat mass at birth, as measured by cord-blood leptin levels; on average, 19% of this mediation involved fetal insulin secretion. Postload glucose levels did not act as an important mediator of ethnic differences in cord-blood leptin levels. Results were very similar when 130 women with gestational diabetes were removed.Conclusions/interpretationThese novel findings suggest a role of maternal pregnancy glycaemia in mediating differences in fat mass between Pakistani and white British infants.Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-014-3386-6) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

Exploring the Musical Culture of an African American Child with Developmental Disabilities in Group Music Therapy

The purpose of this study was to explore the role of the musical culture of an African American child with developmental disabilities in group music therapy. Qualitative methods were employed in an early childhood education setting. First, interview questions were sent home to parents and guardians of participants regarding music in the home, and music examples were analyzed based on the genres reported in the interview answers. Then, one session of four male participants with developmental disabilities, ages 4-5, was conducted and analyzed. The participants were of African American, Hispanic, Pakistani, and Caucasian ethnicities. The researcher focused on the African American child, utilizing clinical data and an examination of the musical sources that represent the child’s musical culture in the home. The results indicated that the musical culture of the child played a significant role in the group music therapy process. The musical culture of the African American child in the study was found to be characterized by three main elements: emphasis on a strong rhythmic pulse, emphasis on movement, and singing or chanting as a means of expression. The child seemed to be less engaged when the music was syncopated, lacked a strong rhythmic pulse, was interspersed with verbal injections, or contained Spanish lyrics. Although some conclusions have been drawn to indicate the significance of musical culture in a group music therapy setting with children, there is a great need for further research in order to determine more precise ways in which musical culture influences the group music therapy process. Thus, this study serves as a catalyst for future music therapy research.

Differences in hepatitis B infection rate between ethnic groups in antenatal women in Birmingham, United Kingdom, May 2004 to December 2008

Hepatitis B virus (HBV) is a major cause of morbidity and mortality worldwide. Although the United Kingdom (UK) prevalence of HBV is low, it is increasing. There is some evidence that the rate of infection is much higher in some populations living in Britain of non-white ethnicity or who were not born in Britain, compared with the British-born white population. We examined the prevalence of HBV infection in pregnant women through hepatitis B surface antigen (HBsAg) or e-antigen (HBeAg) in Birmingham UK between May 2004 and December 2008 and the effect of ethnicity on the relative risk of infection. There was a significant increase in the number of antenatal HBV infections detected over the study period from 106 cases in 2005 to 161 cases in 2008 (p=0.037). Women who define themselves as of black African, non-British white and Pakistani ethnicity had a markedly elevated rate of HBV infection (relative risk (RR): 11.25, 5.87 and 2.33 respectively) compared to the England average. Health organisations that serve populations with a high or increasing proportion of women originating from intermediate and high HBV prevalence areas of the world such as Africa, some parts of Europe and Asia, should anticipate a need for perinatal and postnatal prophylaxis to children born to HBV infected mothers.

P1-286 Are differences in self-reported health behaviours in early pregnancy associated with ethnicity? Preliminary results from the born in Bradford birth cohort study

IntroductionPregnancy is a time of high motivation to initiate positive changes in health behaviours which have the potential to continue post pregnancy. Pregnancy outcomes vary between Pakistani and white British...

Do pakistani babies have more congenital heart defects? Preliminary findings from our birth cohort study

IntroductionA large prospective birth cohort study was established in March 2007 to look at health outcomes of 13 000 babies booked for delivery at our hospital. Nearly half the population...

Anophthalmos, Microphthalmos, and Typical Coloboma in the United Kingdom: A Prospective Study of Incidence and Risk

Anophthalmos, microphthalmos, and typical coloboma (AMC) form an interrelated spectrum of congenital eye anomalies that can cause significant visual loss and cosmetic disfigurement in children. This prospective study of children born in the United Kingdom was undertaken to determine the incidence of AMC diagnosed by ophthalmologists and to explore sociodemographic risks. Recruitment was achieved though an established active surveillance system of U.K. ophthalmologists supported by a new research network of interested specialists, the Surveillance of Eye Anomalies (SEA-UK) Special Interest Group. It started October 1, 2006, and continued over 18 months. One hundred thirty-five children were newly diagnosed with AMC. Typical colobomatous defects were the commonest phenotype, and anophthalmos was rare (n = 7). Both eyes were affected in 55.5% of the children. The cumulative incidence of AMC by age 16 years was 11.9 per 100,000 (95% CI, 10.9-15.4). Of the children examined, 41.5% had not seen an ophthalmologist by 3 months of age. The incidence in Scotland was nearly double that in England and Wales. The children of Pakistani ethnicity had a 3.7 (95% CI, 1.9-7.5) times higher risk of AMC than did white children. There was some evidence to suggest a higher incidence in the more socioeconomically deprived. The sibling risk ratio was 210 (95% CI, 25-722). This is the first prospective study of AMC, and it establishes the frequency across the United Kingdom. Comparisons with data quoted in the literature are difficult because study methodologies differ, but the frequency appears to be lower than that quoted for other developed countries. There are geographic and ethnic variations in incidence that warrant further investigation.

Ethnic Composition of Children Referred into North Manchester Social Communication Assessment and Intervention Team with Suspected Autistic Spectrum Disorder

The paper assessed the ethnicity of referrals into SCAIT for possible ASD in the last financial year. Ethnicity information was compared to data from Manchester City Council on ethnic populations in electoral wards. There was found to be a difference between the percentage of referrals of different ethnic groups and the ethnic composition of the North Manchester population. Patients of White British, Bangladeshi, Chinese and Other ethnic groups were found to be underrepresented in the sample, whereas patients of Black African, Black Caribbean, and Pakistani ethnicities were proportionally overrepresented. There is a need for further investigation into ethnicity of referrals for assessment of possible ASD.

Low birth weight persists in South Asian babies born in England and Wales regardless of maternal country of birth. Slow pace of acculturation, physiological constraint or both? Analysis of routine data

BackgroundThe mean birth weight of offspring of Bangladeshi, Indian and Pakistani women tends to be among the lowest of any ethnic groups regardless of country of residence. However, it is...

055 Comparison of distributions of common indicators of socio-economic position by ethnicity and migration: preliminary findings from the Born in Bradford Birth Cohort Study

ObjectiveTo describe and compare the distributions, including extent of missing data, in measures of socio-economic position (SEP) between women of white British and Pakistani ethnicity. We also compare distributions of...

ODOUR IDENTIFICATION ASSESSMENT IN SCHIZOPHRENIA PATIENTS USING A NEW OLFACTO-VISUAL TOOL: RELATIONS BETWEEN OLFACTORY DEFICIT AND SYMPTOMATOLOGY

one year (April 2009March 2010) by the Birmingham and Solihull mental Health Foundation Trust (BSHMFT). The study sample consists of an estimated 85 to 100 assessments per month. The study will be reporting findings for the first six months. The research assessment includes data on sociodemographics, diagnosis, ethnicity, objective and subjective measures of risk, level of social support, outcome of assessment and the availability and use of community alternatives to detention. Results: Preliminary results (N=322) show that the average age of those assessed is 40.13 (SD=14.95), with 58.3% men. The largest proportion of ethnic composition of those assessed was White British (44.9%), Black African-Carribean (11.4%), Pakistani (13.9%), Indian (5.3%) and Black African (5.1%). A significant association between ethnicity and gender was found, with more men assessed from Pakistani, Black African and Black African Carribean ethnicity. A significantly greater proportion of Black African and Black AfricanCarribean individuals assessed were living alone. Gender was a significant predictor of the outcome of the assessment, with significantly more men being put on a section 3 (detention for treatment) and a community treatment order (CTO). Discussion: A considerably large proportion of those assessed with the Mental Health Act (MHA) under the BSMHFT are from Black and Minority ethnic (BME) groups, with a significant proportion of the BME group being men and living alone. The gender differences with the outcome of the MHA assessment suggests that more women are likely to be detained under less restrivtive conditions (i.e. Section 2 or informal admission), as well as more men are being put on CTO's within the community. The risk factors associated with the outcomes will be presented and the implications of this research in improving outcomes for Black and Minority ethnic groups will be discussed.