Objectives. Although there is evidence in the USA and UK to suggest that ethnic minority groups have an inferior experience of cancer care, few studies investigate ethnic disparities in satisfaction and care experiences among survivors. Patients' illness perceptions (lay explanations for illness) and coping styles (emotional and behavioural) are influenced by ethnicity-related cultural beliefs and expectations. Depressive illness or fears of recurrence of cancer may also lead to poorer recovery and function. This paper investigates whether ethnic influences explain different coping behaviours, care experiences and help-seeking behaviours. Design. Eight participants of African or Black Caribbean origin were recruited from a London support group for a series of qualitative in-depth interviews. The interviews were recorded and transcribed, and the transcripts analysed using a framework method of qualitative data analysis. The emergent themes were tested and documented to reflect the issues of importance to patients. Results. Lay explanations of causes of cancer were complex and diverse reflecting cultural influences and the impact of contact with health professionals. Generally, positive views about cancer care were found, especially at the secondary care level. Primary care attracted mixed views. In contrast to American studies, no acknowledgement of discrimination on the basis of ethnicity was reported. The need to be resilient and think positively were widely acknowledged as coping strategies. Some coped by avoiding contemplation of their condition or diagnosis. Religious beliefs and practices provided coping mechanisms for some, and a means to improve confidence and avoid distressing contemplation about their condition. Family, friends and charitable groups also provided emotional and practical support. Conclusions. Subjects were generally satisfied with their care; different coping styles included positive attitudes, minimisation of difficulties or more realistic consideration of the impact of cancer.
Objectives. To investigate the influence of ethnicity on suicide, and related risk indicators including psychiatric symptoms, among patients committing suicide whilst admitted to psychiatric hospitals. Design. The suicide rates and standardized mortality ratios (SMRs) for inpatient suicides between 1996 and 2001 were calculated from national suicide data on the four largest ethnic groups in England and Wales: Black Caribbean, Black African, South Asian (Indian, Pakistani, and Bangladeshi), and a White British comparison group. The symptoms and risk indicators at the time of the suicide were retrospectively reported by the lead clinician who was responsible for the hospital care of the patient. Results. Classical suicide risk indicators such as suicidal ideas, depressive symptoms, emotional distress, and hopelessness were significantly more common among White British inpatients than other ethnic groups. Male inpatients from Black African backgrounds were significantly more likely to have committed suicide than White British men (SMR 2.05, 95% confidence interval (CI): 1.12-3.43). Women committing suicide as inpatients were significantly less likely to be of South Asian (SMR 0.4, 95% CI: 0.17-0.78) and Black Caribbean (SMR 0.26, 95% CI: 0.09-0.62) backgrounds than White British women. Conclusions. Suicide rates and classical indicators of suicide risk among inpatients committing suicide vary by ethnic group. Black African men have the highest rates of suicide compared to the White British group.
Williams,David R. (Author), Haile,Rahwa (Author), Mohammed,Selina A. (Author), Herman,Allen (Author), Sonnega,John (Author), Jackson,James S. (Author), and Stein,Dan J. (Author)
Format:
Journal Article
Publication Date:
2012
Location:
African American Research Center, Library, University of Illinois at Urbana-Champaign
Objective. To explore levels of perceived racial and non-racial discrimination and their associations with self-esteem and mastery in the USA and South Africa. Design. We used ordinary least square regressions to test the cross-sectional associations between discrimination and psychological resources using two national probability samples of adults: the National Survey of American Life and the South African Stress and Health Study. Results. Levels of perceived racial discrimination were higher in the USA than in South Africa. In the USA, both African-Americans and Caribbean Blacks have comparable or higher levels of self-esteem and mastery than Whites. In contrast, South African Whites have higher levels of both self-esteem and mastery than Africans, Coloureds, and Indians. Perceived discrimination, especially chronic everyday discrimination, is inversely related to self-esteem and mastery in both societies. In South Africa, stress and socioeconomic status (SES) but not discrimination are important determinants of racial differences in self-esteem and mastery. Conclusions. In two racialized societies, perceived discrimination acts independent of demographic factors, general stressors, social desirability bias, racial identity, and SES, to negatively affect the psychological resources of self-esteem and mastery.
