Search

Postwar migrants from the Caribbean and Indian subcontinent (Bangladesh, India, and Pakistan) to the UK are now experiencing the onset of age‐related diseases such as dementia. Our evidence base, both quantitative and qualitative, documenting the experiences of family caregivers of people with dementia is largely drawn from studies undertaken with white European, North American, and Australasian populations. Consequently, there is a need for research in the field of dementia caregiving to reflect the increasing diversity in ethnic identities of the older adult population of the UK. Using semistructured interviews, we investigated the experiences of 18 caregivers of people with dementia in Black Caribbean, Black African, and South Asian (Indian, Pakistani, and Bangladeshi) communities in England. Participants were recruited from the Join Dementia Research platform and were predominantly female intergenerational carers. We identified the following three themes: motivation to care (spending time with the care recipient and reciprocity), positive and negative consequences of caregiving (rewards and consequences), and the cultural context of caregiving (cultural norms and values supporting caregiving and negative attitudes towards dementia). Our findings develop existing literature by identifying (a) the importance of spending time with the person they care for, (b) the absence of faith as a caregiving driver, and (c) the challenge of watching the declining health of a parent. We highlight how the different motivations to care are intertwined and dynamic. This is illustrated by the linking of obligation and reciprocity in our dataset and positive and negative experiences of caregiving. [ABSTRACT FROM AUTHOR]

This paper explores the explanatory models of mental challenges among Black Africans in England. It argues that understanding these models is critical for providing culturally appropriate care to this population. The study employed qualitative methodology, and interpretative phenomenological analysis (IPA). Twelve mental health service users who are living in England and self‐identified as first or second‐generation Black Africans were purposively selected. The data were gathered using face‐to‐face semistructured interviews. Data were manually analysed in accordance with IPA concepts of searching for common, unique and idiosyncratic themes across transcripts. The findings revealed three themes Black Africans associated to their explanatory model of mental health challenges: complexities of migration, African‐centred worldview and negative life experiences. To help alleviate the Eurocentric nature of mental health practice in England, it is hoped that this explanatory model will become an integral part of mental health practice in England and around the world. [ABSTRACT FROM AUTHOR]

U.K. higher education research routinely pinpoints the racialized nature of academic performance, but it often fails to even consider if racism contributes to such a pervasive racial or ethnic disparity. While research in the area often focuses on comparing the attainment of home white and ethnic minority students, little attention is given to the experiences of black African international students (BAIS), particularly in U.K. higher education. Using semi-structured qualitative interviews, this study documents how "race" shapes academic performance and achievement by exploring the experiences of 21 BAIS undergraduates studying in ten universities in England. Factors identified, inter alia, include racism and discrimination, and the analysis challenges the narrative of assessment as neutral and objective technology that rewards merit, and lifts the voices of BAIS which are normally silent in the literature about international student experience. 'Race' and ethnicity jeopardize perception of BAIS's academic ability and judgment of their assessed work. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Religion plays important role in recovery from mental illness.Religion can have both positive and negative effects on recovery. What does this paper add to existing knowledge?: It is conceivable for Black African service users (BASUs) to engage with the mainstream mental health services at the onset of their symptoms.BASUs see mental illness and recovery through the lens of religion. They mostly use Pentecostalism and traditional African healing systems to aid their recovery.The mainstream mental health system and the traditional African healing system exist in harmony for BASUs who are open to simultaneously access both services. What are the implications for practice?: There is a need to recognize that most Black Africans have unique ways of practising their Christianity. Thus, broad changes are needed in the services to support religious coping tailored to the individual persons in their recovery journey.There is a need for service providers and healthcare professionals to integrate Pentecostalism and traditional African healing systems into the recovery processes. It should equally be recognized that such changes could trigger confusion, dilemmas and paradoxes.Service providers and healthcare professionals must build partnership and collaborative working with cultural practitioners and the clergy from the Black African communities to facilitate recovery and address any misunderstandings. Introduction: Religion is an important impetus for recovery. However, there has been little work examining the role of religion in recovery for Black African service users (BASUs) in England. Aim: The aim of this study was to explore how religion influences recovery from mental illness for BASUs in England. Method: Twelve Black African service users were purposively selected and interviewed using face‐to‐face semi‐structured interviews. Data were analysed using interpretative phenomenological analysis (IPA). Results: The study generates fascinating insights that BASUs views about mental illness and recovery are influenced by Pentecostalism and traditional African healing systems. Discussion: The participants' perceptions of their mental illness experiences and recovery which are characterized by the pragmatism of Pentecostalism and cultural beliefs are consistent with what is reported in the literature. Implications for practice: The findings of the study show that broad changes are needed to accommodate the religious coping of BASUs in their recovery journey. [ABSTRACT FROM AUTHOR]

Background: Stroke incidence is increased in Black individuals but the reasons for this are poorly understood. Exploring the differences in aetiological stroke subtypes, and the extent to which they are explained by conventional and novel risk factors, is an important step in elucidating the underlying mechanisms for this increased stroke risk.Methods: Between 1999 and 2010, 1200 black and 1200 white stroke patients were prospectively recruited from a contiguous geographical area in South London in the UK. The Trial of Org 10172 (TOAST) classification was used to classify stroke subtype. Age- and sex-adjusted comparisons of socio-demographics, traditional vascular risk factors and stroke subtypes were performed between black and white stroke patients and between Black Caribbean and Black African stroke patients using age-, sex-, and social deprivation-adjusted univariable and multivariable logistic regression analyses.Results: Black stroke patients were younger than white stroke patients (mean (SD) 65.1 (13.7) vs. 74.8 (13.7) years). There were significant differences in the distribution of stroke subtypes. Small vessel disease stroke was increased in black patients versus white patients (27 % vs. 12 %; OR, 2.74; 95 % CI, 2.19-3.44), whereas large vessel and cardioembolic stroke was less frequent in black patients (OR, 0.59; 95 % CI, 0.45-0.78 and OR, 0.61; 95 % CI, 0.50-0.74, respectively). These associations remained after controlling for traditional vascular risk factors and socio-demographics. Black Caribbean patients appeared to have an intermediate risk factor and stroke subtype profile between that found in Black African and white stroke patients. Cardioembolic stroke was more strongly associated with Black Caribbean ethnicity versus Black African ethnicity (OR, 1.48; 95 % CI, 1.04-2.10), whereas intracranial large vessel disease was less frequent in Black Caribbean patients versus Black African subjects (OR, 0.44; 95 % CI, 0.24-0.83).Conclusions: Clear differences exist in stroke subtype distribution between black and white stroke patients, with a marked increase in small vessel stroke. These could not be explained by differences in the assessed traditional risk factors. Possible explanations for these differences might include variations in genetic susceptibility, differing rates of control of vascular risk factors, or as yet undetermined environmental risk factors. [ABSTRACT FROM AUTHOR]

The author discusses different aspects of multiethnic residential areas of England and Wales. Information on changing ethnic population of England and Wales is presented. It further details about Black Africans and Black Caribbeans, the Indian, Pakistani, and Bangladeshi populations whose all increased by c.25-50%, and together in 2011.

Background: Rates of obesity among black African and black Caribbean women in the UK are consistently higher than among white women. Cultural, attitudinal and behavioural differences may contribute to ethnic variation in weight, and the present study aimed to explore attitudes towards weight and weight control among black and white British women using a qualitative approach. Methods: Ethnically homogeneous focus groups were carried out with 25 white women [mean (SD) body mass index (BMI, kg m-2) = 26 (7.2) kg m-2] and 24 black women [mean (SD) BMI = 29 (6.6) kg m-2]. Women were recruited from London boroughs (Lambeth, Southwark and Croydon) and Guildford, Surrey, and focus groups were conducted in London. Focus groups were recorded and transcribed verbatim, and were analysed using thematic analysis. Results: All participants had fairly good knowledge of the causes, consequences and treatment of being overweight. However, black women primarily emphasised the health consequences of being overweight, whereas white women were more likely to focus on the perceived social and emotional consequences. White women associated being overweight with negative character traits, whereas black women had a broadly positive attitude towards larger body sizes. Conclusions: Black women were as well-informed about the causes and health risks of obesity as white women in this sample of mainly educated, working women, although they were more accepting of larger body sizes and experienced less social pressure to be slim. [ABSTRACT FROM AUTHOR]

The achievement of integration and a reduction in the social exclusion of ethnic minority communities in England are policy matters of major concern. This paper argues that policy-makers and service providers pursuing these aims need to understand the language support needs of minority ethnic groups at a fine level of detail: groupings such as 'Black' or even 'Black African' are of limited utility. Although much ethnicity research has tended to view Black Africans as a homogenous group, appreciation of their diverse language use is important because people from different parts of sub-Saharan Africa face different language barriers on arrival in the UK. This paper examines evidence available from large-scale survey data on the association between language and indicators often used to assess integration and social exclusion. The paper provides empirical statistical evidence on Black Africans living in England and languages in the form of tables and maps using data-sets not previously analysed for this purpose. These are (1) the Labour Force Survey (LFS); and (2) the National Pupil Database (NPD). The results show that Black Africans speak a very wide range of languages at home. Somalis are by far the least integrated and most socially excluded of the major language groups, followed by Ghanaians. Zimbabweans and Nigerians, on the other hand, face only slight language barriers. The paper concludes with some implications of the findings for policy-makers and service providers. [ABSTRACT FROM AUTHOR]

Purpose - The main objective of the study is to investigate unmet needs of Black African and Caribbean Heritage (BAH) patients with and without a concurrent diagnosis of antisocial personality disorder (ASPD).Design/methodology/approach - A total of 79 participants were recruited from ten psychiatric inpatient wards across two hospital sites in South London. Personality disorder was assessed using the SCID-II for DSM-IV, the prevalence of unmet needs was assessed by The Camberwell Assessment of Need Short Assessment Schedule and substance misuse problems measured using well validated drug and alcohol use disorder identification tools.Findings - The presence of a concurrent ASPD was independently associated with a greater number of unmet needs. ASPD was associated with lower qualifications and a greater risk of homelessness and substance misuse. Unmet need was associated with lower qualifications and substance misuse. In a stepwise linear regression model alcohol dependence and drug misuse were the most significant predictors of unmet need.Research limitations/implications - Further research is required to identify the reasons why these needs are not being met and establish reasons for these patients' high-dropout rates from treatment.Practical implications - The present findings suggest BAH psychiatric inpatients with ASPD are at greater risk of alcohol dependence and drug misuse and report a greater number of unmet needs thus requiring a greater volume of services; however, current services are not meeting these needs. Mental health teams should ensure thorough needs assessment procedures are incorporated into general psychiatric service practice ensuring effective treatment packages are tailored to these patients needs.Originality/value - The research identifies a previously under-researched sub-group of psychiatric inpatients with a high proportion of unmet health and social needs and suggests further research to develop service improvements supporting their management. [ABSTRACT FROM AUTHOR]

'Black Africans' in England are disproportionately and highly affected by the heterosexually contracted HIV epidemic. Policy and practice frameworks have advocated ethnic matching in HIV prevention. We explore how self-identifying 'black African' workers in London were co-producers of 'black African' identities to target in preventative HIV interventions. Drawing on a focused literature review and 12 in-depth interviews with workers, the paper identifies themes associated with co-production of an African identify by workers. The historical inclusion of the category 'black African' in the 1991 census coincided with the emergence of Africans as at higher HIV 'risk'. In co-producing an African public, the workers projected their heterosexual and Christian affiliations on to the targeted population, perceiving themselves as 'insiders' knowledgeable about rumours that had historically co-produced African identities. Fear of those in authority galvanised the formation of African-led agencies, offering entry points for HIV prevention to Africans. By projecting aspects of their complex 'selves' on to the 'other', encounters in public spaces were deemed 'opportunities' for outreach interventions. The ethics of 'cold calling', confidentiality and informed consent were taken as 'given' in these socially produced 'private' spaces located in 'public' venues. In following HIV prevention frameworks as advocated by Pulle et al (2004), the workers endorsed yet problematised the notion of ethnic matching. [ABSTRACT FROM AUTHOR]

The current study examined the prevalence of and motivation for drug and alcohol use among black African minorities in England. Participants, comprising 82 males (i.e., 71.9%) and 32 females (i.e., 28.1%), aged 18 to 60 years, were recruited through contact on the streets, and from recreation centres, bus stations, train stations, and shopping centres in Liverpool, Manchester, and London. A self-report anonymous questionnaire covering drug and alcohol use and measures of impulsivity (i.e., sensation seeking, lack of premeditation, lack of perseverance and urgency) was administered. Although the results suggest a low level of illicit drug use, a significant number of the participants admitted to alcohol use. While predicting the motivation for alcohol use via the Whiteside and Lynam (2001) measures of impulsivity, a lack of premeditation was significantly attributed to motivation for alcohol use among the participants. Other impulsivity measures, such as sensation seeking, urgency, and lack of perseverance, do not appear to be significant predictors of alcohol use, but there were significant relationships between urgency, lack of premeditation and patterns of alcohol use. The implications of the findings in terms of policy formulation on drug treatment services are emphasised. [ABSTRACT FROM AUTHOR]

Most social science research on HIV has focused on prevention. The arrival of new therapies generated more studies on life with HIV. However most have been carried out in developed world contexts. Much less is known about the vast majority of those living with HIV and dying from AIDS. If this gap is to be filled, more qualitative research will be needed on affected individuals in the developing world and also among migrants who have left developing countries to live in the diaspora. It will also be essential to explore the lives of individuals from the same communities who may experience HIV in very different ways as a result of their gender and/or sexuality. This paper presents findings from three studies of Black African migrants living with HIV in London. It uses an intersectional approach to examine the similarities and the differences between the experiences of heterosexual women, heterosexual men and gay and/or bisexual men. The article highlights the importance of research of this kind both for providing the evidence base for context-specific policy development and also for making better conceptual and theoretical sense of the impact of HIV on individuals and their lives. [ABSTRACT FROM AUTHOR]

The pilot aim was to assess the feasibility and acceptability of undertaking anonymous HIV testing using oral fluid samples as part of a community-based survey of sexual attitudes and lifestyles of black African communities in London. The three components of the study were administered in various venues across London: (1) a cross-sectional self-completion anonymous questionnaire survey, (2) an optional oral fluid sample for anonymous HIV testing and (3) a nested in-depth interview study in a sub-set of respondents. A total of 114 black African men and women were recruited. A large number of African countries were represented among respondents from newly-migrant and well-established communities. The response rate to the oral fluid sample was high at 82% and all samples collected were of sufficient quality to be tested for HIV. In-depth interviews with respondents revealed positive views and experiences about participating in the study whilst understanding of the questionnaire was good. We therefore conclude that anonymous HIV testing as part of a community-based survey is feasible and acceptable, whilst a set of recommendations was produced to refine the survey methodology and questionnaire. Participatory research methods are essential for achieving successful community-based surveys among black Africans in Britain. [ABSTRACT FROM AUTHOR]