scholarly journals Does racial discrimination cause mental illness?

2002 ◽  
Vol 180 (06) ◽  
pp. 475-477 ◽  
Author(s):  
Apu Chakraborty ◽  
Kwame McKenzie
Keyword(s):  
Mental Illness ◽  
Racial Discrimination ◽  
Ethnic Groups ◽  
South Asian ◽  
Prevalence Rates ◽  
High Incidence ◽  
African Caribbean ◽  
The Uk ◽  
Caribbean Populations

Different rates of mental illness have been reported in ethnic groups in the UK (Nazroo, 1997). Early work was criticised because of methodological flaws but more rigorous studies have confirmed high community prevalence rates of depression in both South Asian and African-Caribbean populations (Nazroo, 1997), high incidence and prevalence rates of psychosis in African-Caribbean groups (see Bhugra & Cochrane, 2001, for review), and higher rates of suicide in some South Asian groups (Neeleman et al, 1997) compared with the White British population. Similarly high rates have not been reported in the countries of origin of these groups (Hickling & Rodgers-Johnson, 1995; Patel & Gaw, 1996), which has led to a search for possible causes within the UK.

scholarly journals Racializing Mental Illness

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Clare Xanthos
Keyword(s):  
Mental Illness ◽  
Racial Bias ◽  
Minority Status ◽  
Induced Stress ◽  
Minority Status Stress ◽  
African Caribbean ◽  
Caribbean Population ◽  
Area Of Concern ◽  
The Uk ◽  
Significant Factors

All multiracial societies have to grapple with the benefits versus the costs of the integration of minorities into majority communities. Indeed, in relation to the costs of integration, it could be argued that integration and assimilation increases non-White people’s exposure to racialized experiences and racism, which in turn predisposes them to mental illness. As such, it is worth considering the case of the UK, where Black integration and assimilation is particularly intense, and where the high rates of schizophrenia in the African-Caribbean population have been an area of concern for over three decades. This paper argues that the interplay between racial minority status stress, racism-induced stress, and racial bias in diagnosis may be significant factors influencing the high Black incidence rate of schizophrenia in the UK.

scholarly journals Ethnic differences in guideline-indicated statin initiation for people with type 2 diabetes in UK primary care, 2006–2019: A cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (6) ◽  
pp. e1003672
Author(s):  
Sophie V. Eastwood ◽  
Rohini Mathur ◽  
Naveed Sattar ◽  
Liam Smeeth ◽  
Krishnan Bhaskaran ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
South Asian ◽  
Ethnic Differences ◽  
Asian Ethnicity ◽  
African Caribbean ◽  
South Asian Ethnicity ◽  
Ascvd Risk ◽  
The Uk ◽  
To Receive

Background Type 2 diabetes is 2–3 times more prevalent in people of South Asian and African/African Caribbean ethnicity than people of European ethnicity living in the UK. The former 2 groups also experience excess atherosclerotic cardiovascular disease (ASCVD) complications of diabetes. We aimed to study ethnic differences in statin initiation, a cornerstone of ASCVD primary prevention, for people with type 2 diabetes. Methods and findings Observational cohort study of UK primary care records, from 1 January 2006 to 30 June 2019. Data were studied from 27,511 (88%) people of European ethnicity, 2,386 (8%) people of South Asian ethnicity, and 1,142 (4%) people of African/African Caribbean ethnicity with incident type 2 diabetes, no previous ASCVD, and statin use indicated by guidelines. Statin initiation rates were contrasted by ethnicity, and the number of ASCVD events that could be prevented by equalising prescribing rates across ethnic groups was estimated. Median time to statin initiation was 79, 109, and 84 days for people of European, South Asian, and African/African Caribbean ethnicity, respectively. People of African/African Caribbean ethnicity were a third less likely to receive guideline-indicated statins than European people (n/N [%]: 605/1,142 [53%] and 18,803/27,511 [68%], respectively; age- and gender-adjusted HR 0.67 [95% CI 0.60 to 0.76], p < 0.001). The HR attenuated marginally in a model adjusting for total cholesterol/high-density lipoprotein cholesterol ratio (0.77 [95% CI 0.69 to 0.85], p < 0.001), with no further diminution when deprivation, ASCVD risk factors, comorbidity, polypharmacy, and healthcare usage were accounted for (fully adjusted HR 0.76 [95% CI 0.68, 0.85], p < 0.001). People of South Asian ethnicity were 10% less likely to receive a statin than European people (1,489/2,386 [62%] and 18,803/27,511 [68%], respectively; fully adjusted HR 0.91 [95% CI 0.85 to 0.98], p = 0.008, adjusting for all covariates). We estimated that up to 12,600 ASCVD events could be prevented over the lifetimes of people currently affected by type 2 diabetes in the UK by equalising statin prescribing across ethnic groups. Limitations included incompleteness of recording of routinely collected data. Conclusions In this study we observed that people of African/African Caribbean ethnicity with type 2 diabetes were substantially less likely, and people of South Asian ethnicity marginally less likely, to receive guideline-indicated statins than people of European ethnicity, even after accounting for sociodemographics, healthcare usage, ASCVD risk factors, and comorbidity. Underuse of statins in people of African/African Caribbean or South Asian ethnicity with type 2 diabetes is a missed opportunity to prevent cardiovascular events.

scholarly journals POS0111 DEVELOPMENT OF DAMAGE AND MORTALITY IN AN INCEPTION COHORT OF SLE PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 266.2-267
Author(s):  
C. S. Yee ◽  
V. Farewell ◽  
M. Akil ◽  
P. Lanyon ◽  
C. J. Edwards ◽  
...  
Keyword(s):  
Incidence Rate ◽  
South Asian ◽  
Drug Exposure ◽  
Inception Cohort ◽  
Research Support ◽  
Rate Of Development ◽  
Caroline Gordon ◽  
African Caribbean ◽  
The Uk

Background:There had been very limited data on the development of damage and mortality in an inception cohort of SLE patients who were recruited very soon after diagnosis.Objectives:This study aimed to analyse the development of damage and death in an inception cohort of SLE patients recruited within 1 year of diagnosis with up to 13 years of follow-up.Methods:This was a prospective multi-centre longitudinal study in the UK of SLE patients recruited within 12 months of achieving 1997 ACR revised criteria for SLE. Data were collected on BILAG-2004, BILAG2004-Pregnancy Index (during pregnancy), SLICC/ACR DI (SDI), cumulative drug exposure and death at every visit. Information on cardiovascular risk factors and antiphospholipid syndrome status were also collected. This study ran from 1st January 2005 to 31st December 2017. Mortality and development of damage were analysed.Results:There were 273 patients recruited (91.2% female, 59.3% Caucasian, 17.2% African/Caribbean, 17.2% South Asian) with mean age at recruitment of 38.5 years (SD 14.8). 97.8% had no damage at recruitment (2.2% had SDI score of 1). Median follow-up was 73.4 months (range: 1.8, 153.8) with total follow-up of 1767 patient-years.There were 13 deaths (4.8%): 76.9% female, 84.6% Caucasian, 15.4% South Asian, mean age 62.6 years (± SD 15.8) and mean disease duration 3 years (± SD 1.8). Causes of death were cancer in 5 (38.5%), infection in 3 (23.1%), ischaemic heart disease in 1 (7.7%) and unknown in 4 (30.8%).114 new damage items in 83 patients occurred during follow-up. The distribution of damage was musculoskeletal (21, 18.4%), ophthalmic (18, 15.8%), neuropsychiatric (18, 15.8%), renal (14, 12.3%), malignancy (12, 10.5%), cutaneous (7, 6.1%), GIT (7, 6.1%), cardiac (6, 5.3%), pulmonary (4, 3.5%), diabetes mellitus (4, 3.5%) and vascular (3, 2.6%). The rate of development of damage appears to be higher in the first 3 years which subsequently stabilised (Table 1).Table 1.Incidence rate of development of damage over period of follow-up at 3 yearly intervalsPeriod of follow-up (year)Person-years at riskNumber of new items of damageIncidence rate, per 1000 person-years (95% CI)0 – 3753.46079.6 (61.8, 102.6)3 – 6534.03158.1 (40.8, 82.6)6 – 9321.21237.4 (21.2, 35.8)9 – 12152.5532.8 (13.6, 78.7)> 125.90-Conclusion:Mortality is uncommon during the first 12 years of follow-up for newly diagnosed SLE patients. However, development of damage appears to be higher in the first 3 years before stabilizing to a lower rate subsequently.Acknowledgements:Versus Arthritis, VIfor PharmaDisclosure of Interests:Chee-Seng Yee Consultant of: Bristol Myer Squibb, ImmuPharma, Grant/research support from: Vifor Pharma, Vernon Farewell: None declared, Mohammed Akil: None declared, Peter Lanyon: None declared, Christopher John Edwards Consultant of: Glaxo Smith Kline, Roche, Grant/research support from: Glaxo Smith Kline, Roche, David Isenberg: None declared, Anisur Rahman: None declared, Lee-Suan Teh: None declared, Sofia Tosounidou: None declared, Robert Stevens: None declared, Ahtiveer Prabu: None declared, Bridget Griffiths: None declared, Neil McHugh: None declared, Ian N. Bruce: None declared, Yasmeen Ahmad: None declared, Munther Khamashta: None declared, Caroline Gordon Speakers bureau: UCB, Consultant of: Center for Disease Control, Astra-Zeneca, MGP, Sanofi and UCB

scholarly journals Perceptions of disadvantage, ethnicity and psychosis

2008 ◽  
Vol 192 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Claudia Cooper ◽  
Craig Morgan ◽  
Majella Byrne ◽  
Paola Dazzan ◽  
Kevin Morgan ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Black People ◽  
Religious Affiliation ◽  
Population Based ◽  
First Episode ◽  
Black African ◽  
Episode Psychosis ◽  
African Caribbean ◽  
The Uk ◽  
Control Study

BackgroundPeople from Black ethnic groups (African-Caribbean and Black African) are more prone to develop psychosis in Western countries. This excess might be explained by perceptions of disadvantage.AimsTo investigate whether the higher incidence of psychosis in Black people is mediated by perceptions of disadvantage.MethodA population-based incidence and case-control study of first-episode psychosis (Aetiology and Ethnicity in Schizophrenia and Other Psychoses (ÆSOP)). A total of 482 participants answered questions about perceived disadvantage.ResultsBlack ethnic groups had a higher incidence of psychosis (OR=4.7, 95% CI 3.1–7.2). After controlling for religious affiliation, social class and unemployment, the association of ethnicity with psychosis was attenuated (OR=3.0, 95% CI 1.6–5.4) by perceptions of disadvantage. Participants in the Black non-psychosis group often attributed their disadvantage to racism, whereas Black people in the psychosis group attributed it to their own situation.ConclusionsPerceived disadvantage is partly associated with the excess of psychosis among Black people living in the UK. This may have implications for primary prevention.

scholarly journals Type 2 diabetes risks and determinants in second-generation migrants and mixed ethnicity people of South Asian and African Caribbean descent in the UK

Diabetologia ◽  
2021 ◽  
Author(s):  
Aliki-Eleni Farmaki ◽  
Victoria Garfield ◽  
Sophie V. Eastwood ◽  
Ruth E. Farmer ◽  
Rohini Mathur ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
South Asian ◽  
First Generation ◽  
Second Generation ◽  
African Caribbean ◽  
First Generation Migrants ◽  
The Uk ◽  
Mixed Ethnicity ◽  
Second Generation Migrants

Abstract Aims/hypothesis Excess risks of type 2 diabetes in UK South Asians (SA) and African Caribbeans (AC) compared with Europeans remain unexplained. We studied risks and determinants of type 2 diabetes in first- and second-generation (born in the UK) migrants, and in those of mixed ethnicity. Methods Data from the UK Biobank, a population-based cohort of ~500,000 participants aged 40–69 at recruitment, were used. Type 2 diabetes was assigned using self-report and HbA1c. Ethnicity was both self-reported and genetically assigned using admixture level scores. European, mixed European/South Asian (MixESA), mixed European/African Caribbean (MixEAC), SA and AC groups were analysed, matched for age and sex to enable comparison. In the frames of this cross-sectional study, we compared type 2 diabetes in second- vs first-generation migrants, and mixed ethnicity vs non-mixed groups. Risks and explanations were analysed using logistic regression and mediation analysis, respectively. Results Type 2 diabetes prevalence was markedly elevated in SA (599/3317 = 18%) and AC (534/4180 = 13%) compared with Europeans (140/3324 = 4%). Prevalence was lower in second- vs first-generation SA (124/1115 = 11% vs 155/1115 = 14%) and AC (163/2200 = 7% vs 227/2200 = 10%). Favourable adiposity (i.e. lower waist/hip ratio or BMI) contributed to lower risk in second-generation migrants. Type 2 diabetes in mixed populations (MixESA: 52/831 = 6%, MixEAC: 70/1045 = 7%) was lower than in comparator ethnic groups (SA: 18%, AC: 13%) and higher than in Europeans (4%). Greater socioeconomic deprivation accounted for 17% and 42% of the excess type 2 diabetes risk in MixESA and MixEAC compared with Europeans, respectively. Replacing self-reported with genetically assigned ethnicity corroborated the mixed ethnicity analysis. Conclusions/interpretation Type 2 diabetes risks in second-generation SA and AC migrants are a fifth lower than in first-generation migrants. Mixed ethnicity risks were markedly lower than SA and AC groups, though remaining higher than in Europeans. Distribution of environmental risk factors, largely obesity and socioeconomic status, appears to play a key role in accounting for ethnic differences in type 2 diabetes risk. Graphical abstract

scholarly journals Association of chronic kidney disease, ethnicity and socioeconomic status with COVID-19 hospitalisation and mortality: a UK Biobank study

2021 ◽  
Author(s):  
Thomas J Wilkinson ◽  
Courtney J Lightfoot ◽  
Alice C Smith ◽  
Thomas Yates ◽  
Kamlesh Khunti ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Socioeconomic Status ◽  
Kidney Disease ◽  
Ethnic Groups ◽  
South Asian ◽  
Morbidity And Mortality ◽  
Uk Biobank ◽  
Policy And Practice ◽  
Increased Risk ◽  
The Uk

In individuals with chronic kidney disease (CKD), Black and South Asian ethnic groups are twice as likely to have severe COVID-19 compared to White participants, whilst the most socially deprived groups are at a 50-60% increased risk of severe COVID-19. This study is the first to highlight the association between ethnicity and socioeconomic deprivation and the risk of severe COVID-19 among those with CKD in the UK. Interventions to reduce morbidity and mortality amongst these groups and policy and practice improvements are needed to address the broad disparity among CKD patients.

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