BACKGROUND: It is recognised that the risk of prostate cancer is higher in black men than in white men worldwide. Recent studies suggest that a number of genetic mutations in black men predispose them to this disease; hence, race as well as environmental factors such as diet and migration are thought to be the determining factors. METHODS: This review compares data from the United States (US), which suggest that African-American men have a 60% higher risk for developing prostate cancer with poorer prognosis in comparison with their white counterparts, with similar studies carried out in the United Kingdom (UK) and also in African and Caribbean countries. CONCLUSIONS: Studies from the United States and the United Kingdom came to significantly different conclusions, and this has implications for policy development, awareness raising among black men in each country and clinical practice. British Journal of Cancer (2011) 105, 481-485. doi:10.1038/bjc.2011.273 www.bjcancer.com (C) 2011 Cancer Research UK
Objectives: This study investigates sociodemographic and health-related correlates of use of a spiritual healer for medical help. A large national, multiracial-multiethnic data source permits a more comprehensive investigation than was possible in previous studies. It also enables a closer focus on socioeconomic disadvantage and health need as determinants of utilization. Design and setting: Respondents are from the National Survey of American Life: Coping with Stress in the 21st Century (NSAL), a nationally representative multi-stage area-probability survey of U.S. adult African Americans, Caribbean Blacks, and non-Hispanic Whites conducted from 2001 to 2003. The sample contains 6082 adults aged 18 and over. Main outcome measures: NSAL respondents were surveyed about lifetime use of alternative providers for medical care or advice. Response categories included two types of spiritual healers: faith healers and psychics. These outcomes were logistically regressed, separately, onto 10 sociodemographic or health-related indicators: race/ethnicity, age, gender, marital status, education, household income, region, medical care use, insurance coverage, and self-rated health. Results: Lifetime utilization of a faith healer is more prevalent among respondents in good health and less prevalent among Caribbean Blacks and never married persons. Users of a psychic healer are more likely to be educated, residents of the Northeast or West, and previously married, and less likely to report excellent health. Conclusions: Use a spiritual healer is not due, on average, to poor education, marginal racial/ethnic or socioeconomic status, dire health straits, or lack of other healthcare options. To some extent, the opposite appears to be true. Use of a spiritual healer is not associated with fewer social and personal resources or limitations in health or healthcare. (C) 2011 Elsevier Ltd. All rights reserved.
Purpose: To describe the methodology, sampling strategy and preliminary results for the Aston Eye Study (AES), a cross-sectional study to determine the prevalence of refractive error and its associated ocular biometry in a large multi-racial sample of school children from the metropolitan area of Birmingham, England. Methods: A target sample of 1700 children aged 6-7 years and 1200 aged 12-13 years is being selected from Birmingham schools selected randomly with stratification by area deprivation index (a measure of socio-economic status). Schools with pupils predominantly (>70%) from a single race are excluded. Sample size calculations account for the likely participation rate and the clustering of individuals within schools. Procedures involve standardised protocols to allow for comparison with international population-based data. Visual acuity, non-contact ocular biometry (axial length, corneal radius of curvature and anterior chamber depth) and cycloplegic autorefraction are measured in both eyes. Distance and near oculomotor balance, height and weight are also assessed. Questionnaires for parents and older children will allow the influence of environmental factors on refractive error to be examined. Results: Recruitment and data collection are ongoing (currently N = 655). Preliminary cross-sectional data on 213 South Asian, 44 black African Caribbean and 70 white European children aged 6-7 years and 114 South Asian, 40 black African Caribbean and 115 white European children aged 12-13 years found myopia prevalence of 9.4% and 29.4% for the two age groups respectively. A more negative mean spherical equivalent refraction (SER) was observed in older children (-0.21 D vs +0.87 D). Ethnic differences in myopia prevalence are emerging with South Asian children having higher levels than white European children 36.8% vs 18.6% (for the older children). Axial length, corneal radius of curvature and anterior chamber depth were normally distributed, while SER was leptokurtic (p < 0.001) with a slight negative skew. Conclusions: The AES will allow ethnic differences in the ocular characteristics of children from a large metropolitan area of the UK to be examined. The findings to date indicate the emergence of higher levels of myopia by early adolescence in second and third generation British South Asians, compared to white European children. The continuation of the AES will allow the early determinants of these ethnic differences to be studied.
We conducted a case-control study to examine risk factors for isoniazid-monoresistant Mycobacterium tuberculosis in an ongoing outbreak in London. Cases were defined as individuals with an isoniazid-monoresistant strain diagnosed from 1995 to the third quarter of 2006 with an indistinguishable restriction fragment length polymorphism (RFLP) or mycobacterial interspersed repetitive unit (MIRU)-variable number tandem repeats (VNTR) pattern who were resident in or had epidemiological links with London. Controls were all other individuals reported with tuberculosis to the Health Protection Agency London regional epidemiology unit or the HPA London TB Register during 2000 to 2005. Of 293 cases, 153 (52%) were sputum smear-positive compared with 3,266 (18%) of controls. Cases were more likely to be young adults (aged between 15 and 34 years), born in the United Kingdom (OR: 2.4; 95% CI: 1.7-3.4) and of white (OR: 2.9; 95% CI: 1.8-4.8) or black Caribbean (OR: 12.5; 95% CI: 7.7-20.4) ethnicity, a prisoner at the time of diagnosis (OR: 20.2; 95% CI: 6.7-60.6), unemployed (OR: 4.1; 95% CI: 3.0-5.6), or a drug dealer or sex worker (OR: 187.1; 95% CI: 28.4-1,232.3). A total of 113 (39%) of cases used drugs and 54 (18%) were homeless. Completion of treatment gradually improved in cases from 55% among those diagnosed up to the end of 2002 compared with 65% by the end of 2006. Treatment completion increased from 79% to 83% in controls from 2000 to 2005. There are complex social challenges facing many cases in this outbreak that need to be addressed if medical interventions are to be successful.
Manly,Jennifer J. (Author), Schupf,Nicole (Author), Stern,Yaakov (Author), Brickman,Adam M. (Author), Tang,Ming-X (Author), and Mayeux,Richard (Author)
Format:
Journal Article
Publication Date:
2011
Location:
African American Research Center, Library, University of Illinois at Urbana-Champaign
Background: Telephone-based interviews can be used for screening and to obtain key study outcomes when participants in longitudinal studies die or cannot be seen in person, but must be validated among ethnically and educationally diverse people. Objective: To determine the accuracy of a telephone interview in classifying (1) demented from nondemented participants, (2) cognitively impaired participants from cognitively normal participants, and (3) participants with mild cognitive impairment (MCI) from those with normal cognition or (4) MCI from dementia among an ethnically and educationally diverse community-based sample. Method: The sample consisted of 377 (30.5% non-Hispanic white, 34.7% non-Hispanic black, and 33.7% Caribbean Hispanic) older adults. The validation standard was diagnosis of dementia and MCI based on in-person evaluation. The Telephone Interview for Cognitive Status (TICS) and the Dementia Questionnaire (DQ) were administered within the same assessment wave. Results: The sample included 256 people (67.9%) with normal cognition, 68 (18.0%) with MCI, and 53 (14.1%) with dementia. Validity of the TICS was comparable among non-Hispanic whites, non-Hispanic blacks, and Hispanics. Among non-Hispanic whites, the DQ had better discrimination of those with dementia from those without dementia and from those with MCI than among other racial/ethnic groups. Telephone measures discriminated best when used to differentiate demented from nondemented participants (88% sensitivity and 87% specificity for the TICS; 66% sensitivity and 89% specificity for DQ) and when used to differentiate cognitively normal participants from those with cognitive impairment (ie, MCI and dementia combined; 73% sensitivity and 77% specificity for the TICS; 49% sensitivity and 82% specificity for DQ). When demographics and prior memory test performance were used to calculate pretest probability, consideration of the telephone measures significantly improved diagnostic validity. Conclusions: The TICS has high diagnostic validity for identification of dementia among ethnically diverse older adults, especially when supported by the DQ and prior visit data. However, telephone interview data were unable to reliably distinguish MCI from normal cognition.
BACKGROUND: Human papillomavirus (HPV) vaccination offers a unique opportunity for the primary prevention of cervical cancer. Studies suggest that knowledge and attitudes about the vaccine are likely to influence uptake. One limitation of most studies assessing HPV vaccine knowledge, attitudes and acceptability is their under representation of ethnic minorities. It is important to ensure that our understanding of HPV knowledge and attitudes include all ethnic groups in the UK. This article reviews research that has considered knowledge, acceptability and attitudes about HPV and the HPV vaccine among ethnic minorities in the UK. METHODS: Articles in Medline, CINAHL and PsycINFO (January 2000-March 2010) were searched. RESULTS: A total of 17 UK-based papers examined knowledge, attitudes or acceptability related to HPV vaccination in the 'lay' population (parents, adolescents or the general population as opposed to health professionals) and reported findings by ethnicity. CONCLUSION: Findings seem to suggest lower awareness of HPV and lower acceptability of the vaccination, which could be important if they are reflected in uptake. More research is needed with ethnic minority groups, particularly in the context of the vaccination programme. British Journal of Cancer (2011) 105, 486-492. doi:10.1038/bjc.2011.272 www.bjcancer.com (C) 2011 Cancer Research UK
Objective. Differences in drug prescribing for coronary heart disease have previously been identified by age, sex and ethnic group. Set in the UK, our study utilises routinely collected data from 98 general practices serving a socially diverse population in inner East London, to examine differences in prescribing rates among patients aged 35 years and over with coronary heart disease. Design. 10,933 patients aged 35 years or more, with recorded coronary heart disease, from 98 practices in two Primary Care Trusts (PCT) in East London during 2009/2010 were included for this cross-sectional study. Multivariable logistic regression was used to assess the odds of prescribing for recommended coronary heart disease drugs by age, sex, ethnicity, social deprivation, co-morbidity and recorded reasons for not prescribing. Results. Women are prescribed fewer recommended coronary heart disease drugs than men; Black African/Caribbean patients are prescribed fewer lipid modifying drugs and other cardiovascular drugs than White patients. Patients over age 84 are prescribed fewer lipid modifying drugs and beta blockers than patients aged 45-54. South Asian patients had the highest levels of prescribing and higher prevalence of coronary heart disease and diabetes co-morbidity. No difference in prescribing rates by social deprivation was found. Discussion. Overall levels of prescribing are high but small differences between sex and ethnic groups remain and prescribing may be inequitable for women, for Black/African Caribbeans and at older ages. These differences were not explained by recorded intolerance, contraindications or declining treatment.
McMinn,Alison M. (Author), van Sluijs,Esther M. F. (Author), Nightingale,Claire M. (Author), Griffin,Simon J. (Author), Cook,Derek G. (Author), Owen,Chris G. (Author), Rudnicka,Alicja R. (Author), and Whincup,Peter H. (Author)
Format:
Journal Article
Publication Date:
2011
Location:
African American Research Center, Library, University of Illinois at Urbana-Champaign
Background: The influence of the family and home environment on childhood physical activity (PA) and whether this differs between ethnic groups remains uncertain. This paper investigates associations between family and home factors and childhood PA in a multi-ethnic population and explores whether associations differ between ethnic groups. Methods: Cross-sectional study of 9-10 year-old schoolchildren, in which PA was objectively measured by Actigraph GT1 M accelerometers for <= 7 days to estimate average activity counts per minute (CPM). Information on 11 family and home environmental factors were collected from questionnaires. Associations between these factors and CPM were quantified using multi-level linear regression. Interactions with ethnicity were explored using likelihood ratio tests. Results: 2071 children (mean +/- SD age: 9.95 +/- 0.38 years; 47.8% male) participated, including 25% white European, 28% black African-Caribbean, 24% South Asian, and 24% other ethnic origin. Family PA support and having a pet were associated with higher average CPM (adjusted mean difference: 6 (95% CI: 1,10) and 13 (95% CI: 3,23), respectively) while car ownership and having internet access at home were associated with lower average CPM (adjusted mean difference: -19 (95% CI:-30,-8) and -10 (95% CI:-19,0), respectively). These associations did not differ by ethnicity. Although the number of siblings showed no overall association with PA, there was some evidence of interaction with ethnicity (p for ethnicity interaction = 0.04, 0.05 in a fully-adjusted model); a positive significant association with number of siblings was observed in white Europeans (per sibling CPM difference 10.3 (95% CI 1.7, 18.9)) and a positive non-significant association was observed in black African-Caribbeans (per sibling CPM difference: 3.5 (-4.2, 11.2)) while a negative, nonsignificant association was observed in South Asians (per sibling CPM difference -6.0 (-15.5, 3.4)). Conclusions: Some family and home environmental factors have modest associations with childhood PA and these are mostly similar across different ethnic groups. This suggests that targeting these factors in an intervention to promote PA would be relevant for children in different ethnic groups.
This essay discusses the novel The Drift Latitudes (2006) by the Anglo-Sudanese author Jamal Mahjoub. By telling the stories of the German refugee Ernst Frager and his two British families, I argue that Mahjoub's novel utilizes the tropes of transnational travel and migration to present a critique of discourses of purity and nationalism. Through its uncovering of silenced family narratives, the novel hybridizes British and European identities and underlines the need to remember the stories of ordinary people omitted from official histories. As the novel's supposedly British families appear to possess transnational links with Sudan, Germany, and the Caribbean, the novel reconstructs European identity as transnational and in need of historical reassessment. As a further contribution to the importance of hybrid identity, the story of black cultural identity and its construction in post-Second World War Liverpool is told in tandem with the importance of black music as a means of constructing black diasporic identity.
This paper uses postcolonial theory to analyze Jamaica Kincaid's quasi-autobiographical book, A Small Place. Kincaid's critique of tourism in Antigua reverses traditional travel writing trends in which First World perceptions of the Third World dominate. She discursively dismantles the imaginative geographies of empire that cement binary oppositions, such as tourist/native and black/white. She collapses these binaries to illustrate the intricate ways in which the global neocolonial ethos created by economic dependencies manifest. Arguing that tourism is implicated in this hegemonic process, she utilizes the metaphor of a guided tour to redirect the imperial gaze. Kincaid argues that legacies of colonial oppression can change once tourist and host value the same things in the shared space of the contact zone.
Five wooden sculptures from the pre-contact Caribbean, long held in museum collections, are here dated and given a context for the first time. The examples studied were made from dense Guaiacum wood, carved, polished and inlaid with shell fastened with resin. Dating the heartwood, sapwood and resins takes key examples of 'Classic' Taino art back to the tenth century AD, and suggests that some objects were treasured and refurbished over centuries. The authors discuss the symbolic properties of the wood and the long-lived biographies of some iconic sculptures.
Owen,Christopher G. (Author), Rudnicka,Alicja R. (Author), Nightingale,Claire M. (Author), Mullen,Robert (Author), Barman,Sarah A. (Author), Sattar,Naveed (Author), Cook,Derek G. (Author), and Whincup,Peter H. (Author)
Format:
Journal Article
Publication Date:
2011
Location:
African American Research Center, Library, University of Illinois at Urbana-Champaign
Objective-To examine the association between cardiovascular risk factors and retinal arteriolar tortuosity in a multi-ethnic child population. Methods and Results-Cross sectional study of 986 UK primary school children of South Asian, black African Caribbean, and white European origin aged 10 to 11 years. Anthropometric measurements and retinal imaging were carried out and a fasting blood sample collected. Digital images of retinal arterioles were analyzed using a validated semiautomated measure of tortuosity. Associations between tortuosity and cardiometabolic risk factors were analyzed using multi-level linear regression, adjusted for gender, age, ethnicity, arteriole branch status, month, and school. Levels of arteriolar tortuosity were similar in boys and girls and in different ethnic groups. Retinal arteriolar tortuosity was positively associated with levels of triglyceride, total and LDL cholesterol, and systolic and diastolic blood pressure. One standard deviation increases in these risk factors were associated with 3.7% (95% CI: 1.2%, 6.4%), 3.3% (0.9%, 5.8%), 3.1% (0.6%, 5.6%), 2.0% (-0.3%, 4.2%), and 2.3% (0.1%, 4.6%) increases in tortuosity, respectively. Adiposity, insulin resistance, and blood glucose showed no associations with tortuosity. Conclusion-Established cardiovascular risk factors, strongly linked to coronary heart disease in adulthood, may influence retinal arteriolar tortuosity at the end of the first decade of life. (Arterioscler Thromb Vasc Biol. 2011; 31: 1933-1938.)
Aims Athletic training in male black athletes (BAs) is associated with marked ECG repolarization changes that overlap with hypertrophic cardiomyopathy (HCM). Differentiating between the two entities is prudent since BAs exhibit a higher prevalence of exercise-related sudden death from HCM compared with white athletes (WAs). Methods and results Between 1996 and 2010, 904 BAs underwent serial cardiac evaluations including ECG and echocardiography. Athletes exhibiting T-wave inversions were investigated further for HCM. Results were compared with 1819 WAs, 119 black controls (BCs), and 52 black HCM patients. Athletes were followed up for 69.7 +/- 29.6 months. T-wave inversions were present in 82.7% HCM patients, 22.8% BAs, 10.1% BCs, and 3.7% WAs. In athletes, the major determinant of T-wave inversions was black ethnicity. T-wave inversions in BAs (12.7%) were predominantly confined to contiguous anterior leads (V1-V4). Only 4.1% of BAs exhibited T-wave inversions in the lateral leads. In contrast, both BCs and HCM patients exhibited lower prevalence of T-wave inversions in leads V1-V4 (4.2 and 3.8%, respectively) with most T-wave inversions in HCM patients (76.9%) involving the lateral leads. During follow-up one BA survived cardiac arrest and two athletes (one BA, one WA) were diagnosed with HCM. All three exhibited T-wave inversions in the lateral leads. Conclusions T-wave inversions in leads V1-V4 appear to represent an ethnic variant of 'athlete's heart'. Conversely, T-wave inversions in the lateral leads may represent the initial expression of underlying cardiomyopathy and merit further evaluation and regular surveillance.
Objective: To examine trends in prevalence and odds of elevated body mass index (BMI) and obesity among ethnically diverse adolescents. Design and Setting: Data from countywide (Miami-Dade) health screenings from 1999 -2005. Weight, height, days/week of vigorous activity, hours/day of sedentary activity, parental hypertension, and eating habits were reported. Participants: 77,050 adolescents, average age 15.6 years (51% girls, 9.4% White non-Hispanic, 59.2% White Hispanic, 16.4% African American, 7% Black Hispanic, and 8% Black Caribbean). Outcome Measures: Prevalence and ethnic differences in odds of obesity (BMI >= 95th percentile) and elevated BMI (BMI >= 85th percentile), adjusting for academic years, days/week of vigorous activity, and hours/day of sedentary activity. Results: Prevalence of elevated BMI and obesity increased from 1999-2005. Overall, White non-Hispanics had lower odds of obesity and elevated BMI than African Americans and White Hispanics. African American girls displayed higher odds of obesity and elevated BMI than Black Hispanic girls and higher odds of elevated BMI than Black Caribbean girls. African American boys showed higher odds of obesity and elevated BMI than Black Caribbean boys. Black Hispanic girls had greater odds of obesity and elevated BMI than White Hispanic girls, but boys were similar. Conclusions: This study is among the first to examine BMI status in both Black and Hispanic subgroups. Viewing Black and Hispanic ethnic subgroups as homogeneous obscures important weight-related differences. Further research is warranted to determine factors contributing to differential risk. (Ethn Dis. 2011;21(2):176-182)
Sussner,K. M. (Author), Edwards,T. A. (Author), Thompson,H. S. (Author), Jandorf,L. (Author), Kwate,N. O. (Author), Forman,A. (Author), Brown,K. (Author), Kapil-Pair,N. (Author), Bovbjerg,D. H. (Author), Schwartz,M. D. (Author), and Valdimarsdottir,H. B. (Author)
Format:
Journal Article
Publication Date:
2011
Location:
African American Research Center, Library, University of Illinois at Urbana-Champaign
Assessed ethnic, racial and cultural identity and examined their relationships with perceived benefits and barriers related to genetic testing for cancer risk in a sample of 160 women of African descent (49% self-identified African American, 39% Black-West Indian/Caribbean, 12% Black-Other) who met genetic risk criteria and were participating in a larger longitudinal study including the opportunity for free genetic counseling and testing in New York City. Conclusions: Ethnic and racial identity may influence perceived benefits and barriers related to genetic testing for breast and/or ovarian cancer risk among at-risk women of African descent. Genetic counseling services may want to take into account these factors in the creation of culturally-appropriate services which best meet the needs of this heterogenous population.
This study utilizes data from the National Survey of American Life to examine the sociodemographic and denominational correlates of religious involvement and spirituality among older African Americans and Black Caribbeans. Eleven measures of non-organizational religious participation, subjective religiosity, and spirituality are utilized. The findings indicate significant gender, income, region, marital status, denominational, and immigration status differences in religiosity and spirituality. Among older Black Caribbeans, income was a consistent correlate of religious participation and spirituality. The findings are discussed in relation to prior work in the area of religious involvement among older adults.
Investigates the associations between reproductive and menstrual risk factors for breast cancer and mammographic density, a strong risk factor for breast cancer, in a predominantly ethnic minority and immigrant sample. Interviewed women (42% African American, 22% African Caribbean, 22% White, 9% Hispanic Caribbean, 5% other) without a history of breast cancer during their mammography appointment (n = 191, mean age = 50). Concludes that the mean level of mammographic density did not differ across ethnic and nativity groups, but several risk factors for breast cancer were associated with density in ethnic minority and immigrant women.
This study examines how familial contexts affect poverty disparities between the children of immigrant and U.S.-born blacks, and among black and nonblack children of immigrants. Despite lower gross child poverty rates in immigrant than in U.S.-born black families, accounting for differences in family structure reveals that child poverty risks among blacks are highest in single-parent black immigrant families. In addition, within two-parent immigrant families, child poverty declines associated with increasing assimilation are greater than the respective declines in single-parent families. The heads of black immigrant households have more schooling than those of native-black households. However, increased schooling has a weaker negative association with child poverty among the former than among the latter. In terms of racial disparities among the children of immigrants, poverty rates are higher among black than nonblack children. This black disadvantage is, however, driven by the outcomes of first-generation children of African and Hispanic-black immigrants. The results also show that although children in refugee families face elevated poverty risks, these risks are higher among black than among nonblack children of refugees. In addition, the poverty-reducing impact associated with having an English-proficient household head is about three times lower among black children of immigrants than among non-Hispanic white children of immigrants.
Objective: to explore the factors that impact on UK-born ethnic minority women's experiences of and decisions around feeding their infant. Design: in-depth semi-structured interviews. Participants: 34 UK-born women of Black African, Black Caribbean, Pakistani, Bangladeshi, Indian and Irish parentage and 30 health-care professionals. Setting: women and health-care professionals were recruited primarily from hospitals serving large numbers of ethnic minority women in London and Birmingham. Findings and conclusions: despite being aware of the benefits of exclusive breast feeding, many women chose to feed their infant with formula. The main barriers to breast feeding were the perceived difficulties of breast feeding, a family preference for formula feed, and embarrassment about breast feeding in front of others. Reports from women of South Asian parentage, particularly those who lived with an extended family, suggested that their intentions to breast feed were compromised by the context of their family life. The lack of privacy in these households and grandparental pressure appeared to be key issues. Unlike other participants, Irish women reported an intention to feed their infant with formula before giving birth. The key facilitators to breast feeding were the self-confidence and determination of women and the supportive role of health-care professionals. Implications for practice: these findings point to common but also culturally specific mechanisms that may hinder both the initiation and maintenance of breast feeding in UK-born ethnic minority women. They signal potential benefits from the inclusion of family members in breast-feeding support programmes. (C) 2010 Elsevier Ltd. All rights reserved.
