Search

Despite the exponential growth in the number of studies addressing ethnicity and health, there is considerable debate about definitions of ethnicity, the appropriate use of ethnicity in health research and whether research focusing on ethnicity in the health field will ultimately result in reduced disadvantage or will simply contribute to the reification of ethnic origin as a cause of health problems. The authors present and discuss health outcomes among White (n = 227), African-Caribbean (n = 213) and Indian and Pakistani (n = 233) adults aged between 18 and 59 years living in Leeds as measured in a stratified population survey, with particular emphasis on the interaction between reports of health conditions and health status in relation to ethnicity and gender. The survey included both general and specific measures of health and impairment and was undertaken following extensive qualitative fieldwork. Overall the results of the study suggest that adults in both broad minority ethnic groups studied have a somewhat less favourable profile of physical and mental health and risk factors such as obesity and low birthweight. Despite an absence of ethnic differences in reporting of long-term conditions, minority groups had lower health status because those with long-term conditions were generally in worse health than their White counterparts. The study findings agree with previous research in suggesting that variation in health status was better explained by specific measures of actual limitations in daily activities than by general measures of limiting long-term illness. These data suggest that limiting long-term illness or disability questions may underestimate functional limitation relative to more specific measures and consequently their use in resource allocation may be problematic. [ABSTRACT FROM AUTHOR] more...

In this study we examine the relationship between education, racial discrimination and health among white (n =227), African Caribbean (n =213) and Indian and Pakistani (n =233) adults aged between 18 and 59 years living in Leeds, England, as measured in a stratified population survey. Measures of discrimination included any physical attack, verbal abuse and a combined variable, any discrimination due to race, colour, ethnicity or sex. Analyses were conducted examining the relationship between education and discrimination, discrimination and health, and discrimination and health controlling for education. People educated above secondary level were more likely than people educated to secondary level or below to report being physically attacked, verbally abused and exposed to discrimination. People from minority ethnic groups (African Caribbean and Indian Pakistani) were more likely to be verbally abused and exposed to discrimination than the white group. Ethnicity and education interacted for African Caribbeans, such that respondents with post-school qualifications were more likely to report verbal abuse or any discrimination. There was no association between having been exposed to any kind of discrimination and having fair or poor health. Physical attack and any discrimination were associated with anxiety, worry and depression. The results remained unchanged when ethnicity and education were included in the models. Education and ethnicity were associated with differences in exposure to discrimination. In turn, exposure to discrimination was associated with higher levels of anxiety, worry or depression although there was no association between discrimination and health. The results support the contention that racial discrimination may play an important role in modifying the relationship between ethnicity, socioeconomic position and health. The counter-intuitive relationship between education and levels of reported discrimination in non-minority ethnic groups highlights the value of explicitly modeling discrimination to gain a better understanding of the social determinants of health. [Copyright &y& Elsevier] more...

This paper engages with the dichotomous notions of caring underpinning social policy and practice in Britain, that splits up the 'carer' and 'cared for' into autonomous, unitary subjects, by locating personal care as an embodied, moral practice within a theoretical framework of relational ontology. Drawing on empirical accounts and narratives related to personal care within the context of advanced cancer, we argue that personal care involves negotiation of boundaries between notions of relatedness and legitimate dependence on one hand, and independence and integrity of the embodied self on the other; and we analyse how these boundaries are informed by particular cultural or religious scripts on gender, relatedness, conjugality and filial obligations. The paper draws on data and analysis based on observations and in-depth interviews with White and South Asian participants between 19 and 89 years of age receiving treatment for cancer, and family members closely involved in their personal care. In using a comparative method for analysis and understanding caring as an embodied moral practice and site of subjectivity across cultural/religious groups, it is suggested that ethnicity is not necessarily the only useful analytical concept to explore the illness and caring experiences of research participants from minority ethnic backgrounds. more...

Policy on care in the community was founded on the premise that the care of frail elderly people with disabilities would be a joint responsibility for health and social care professionals, and family carers, supported by people within their social networks. The policy assumes that such social networks are common features of all communities in contemporary Britain, containing a reserve of people who can be called upon to provide support to carers. The present paper draws on material gathered for a qualitative study of the experiences carers in South Asian communities to examine the quality and quantity of informal support that was available in different types of households. Male and female carers were selected from the Punjabi Sikh, Gujarati Hindu, and Bangladeshi and Pakistani communities. A total of 105 carers participated in the project. Participants were caring for people in all age groups with physical and/or mental distress, and in some cases, with multiple and complex impairments. The analysis of carers' accounts suggested that, for a variety of reasons, the main carer, irrespective of gender, had limited support both in nuclear and extended households. In addition, societal attitudes towards disability and the fear of obligation prevented the seeking and accepting of help from wider social networks. The paper concludes that the evidence does not support the assumption about extended families, and their willingness and ability to support carers. Many issues highlighted in this paper have far-reaching implications for policy makers in many countries in the West where South Asian people have made their homes. more...

Background: Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities., Aim: To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities., Design of Study: Qualitative study., Setting: Four South Asian communities in Leicestershire and West Yorkshire., Methods: Focus groups and in-depth interviews were used to assess male and female carers, supported by a literature review., Results: Failure to recognise carers' needs, gaps in service provision, and communication and language issues compromised carers' ability to care. While some carers were positive about the PHCT role, the main weaknesses concerned poor consultation, PHCT attitudes towards carers, and access to appropriate services., Conclusion: South Asian carers' experiences largely parallel those of others, but there are some issues that are distinct, namely, language and communication barriers, culturally inappropriate services, and implicit or explicit racism. The multi-ethnic nature of Great Britain requires that professional practice enhances the ability of minority ethnic communities to provide informal care. The findings underline the important role of the PHCT in ensuring that carers' needs are taken seriously and that appropriate services reach them. more...