Impact of COVID-19 pandemic on ethnic minority communities: a qualitative study on the perspectives of ethnic minority community leaders

ObjectivesTo explore the perspectives of ethnic minority community leaders in relation to: the impact of the COVID-19 pandemic on their communities; and their community’s perception, understanding and adherence to government guidelines on COVID-19 public health measures.DesignA phenomenological approach was adopted using qualitative semistructured interviews.SettingsCommunity organisations and places of worships in the West Midlands, England.ParticipantsCommunity leaders recruited through organisations representing ethnic minority communities and religious places of worship.ResultsA total of 19 participants took part. Participants alluded to historical and structural differences for the observed disparities in COVID-19 morbidity and mortality. Many struggled with lockdown measures which impeded cultural and religious gatherings that were deemed to be integral to the community. Cultural and social practices led to many suffering on their own as discussion of mental health was still deemed a taboo within many communities. Many expressed their community’s reluctance to report symptoms for the fear of financial and physical health implications. They reported increase in hate crime which was deemed to be exacerbated due to perceived insensitive messaging from authority officials and historical racism in the society. Access and adherence to government guidelines was an issue for many due to language and digital barriers. Reinforcement from trusted community and religious leaders encouraged adherence. Points of support such as food banks were vital in ensuring essential supplies during the pandemic. Many could not afford or have access to masks and sanitisers.ConclusionThe study highlights the perceived impact of the COVID-19 pandemic on ethnic minority communities. Government agencies and public health agencies need to integrate with the community, and community leaders can enable dissemination of key messages to deliver targeted yet sensitive public health advice which incorporates cultural and religious practices. Addressing the root causes of disparities is imperative to mitigate current and future pandemics.

Mixed Methods Review of A Home-Grown School Feeding Pilot in A Poor Ethnic Minority Community in Vietnam

Background Undernutrition threatens the health and future of preschool children in disadvantaged ethnic minority communities. Home-grown school feeding (HGSF) in nursery schools could have a positive impact on children’s nutrition while creating multiple benefits for the community and local food system. Evidence is lacking on the implementation and sustainability of HGSF as part of multi-sectoral programs in remote areas. This study assessed a HGSF pilot intervention, implemented within a four-year nutrition-sensitive agriculture (NSA) program, in five nursery schools in a mountain ethnic minority community in Vietnam. It aimed to gain insights into the diversity and cost of school meals, food sources, effects on children’s nutritional status and on process aspects related to implementation and sustainability, especially HGSF synergy with other NSA program components. Methods Mixed-methods assessment covered school meal diversity and cost; food sources; anthropometric data; and the process, including changes triggered by HGSF, perceived barriers and facilitators to implementation, and prospects for sustainability. Data came from participants selected by purposive sampling for semi-structured interviews (n = 30) and seven focus group discussions (n = 76), and from field observations and transect walks. Results School meals increased daily dietary diversity; meals cost USD 0.65/child/day. About 44% of the foods used were home-grown. There was an indicative reduction in underweight children, an increase in school attendance, and improvements in food preferences and WASH practices. Parents’ caring and feeding practices improved and their willingness to pay for school meals increased. At community level, local food systems became less cash crop-oriented and more self-reliant in production of nutrient-rich foods, contributing to household food security and income generation. Social capital increased. Positive changes were attributed to HGSF and to synergy among NSA program components. Enhanced confidence and motivation, stimulated by role models and change agents, facilitated the process. Socio-economic conditions of poor households and limited resilience to external shocks were barriers that threatened sustainability. Conclusions This study showed that implementing HGSF in a mountain ethnic minority area with a high prevalence of undernutrition benefitted children and their communities, when integrated in a multi-sectoral program that mobilises all stakeholders and stimulates both supply and demand of nutritious food.

An Exploration of the Social, Economic, and Political Inclusion of the Thai Lao, Thailand’s Largest Ethnic Minority Community

Thailand is known to exhibit extreme horizontal structural inequalities by ethnicity. While these differences are not publicly recognised because Thailand’s 62 ethnic groups are not legally recognised, they nonetheless affect state-minority relations, particularly the relationship between the dominant Central Thai ethnic community and the Thai Lao, Thailand’s largest ethnic community, which generally votes as a bloc against Central Thai-dominated political parties. To promote greater social, economic, and political inclusion, UN Sustainable Development Goal 10 advocates policies to address inequalities by ethnicity. As the Thai government does not recognise the Thai Lao, this is problematic. This study analyses opinions obtained from ‘establishment’ and ‘local elite’ samples on how to promote greater inclusion for the Thai Lao. It illustrates some of the barriers towards promoting greater socio-economic and political inclusion, including the lack of recognition, as well as opportunities, such as campaigning against racial discrimination and disaggregating data by ethnicity.

Cultural Humility for People of Color: Critique of Current Theory and Practice

Cultural humility and the broader multicultural orientation approach (MCO) is important for clinicians of color as it is for White clinicians; however, the MCO framework does not address how experiences of racism and oppression impact how therapists of color think about and practice cultural humility. This article attempts to address important ways that the dialogue around cultural humility must be nuanced for therapists of color, and will provide examples of ways in which the framework for racial/ethnic minority community is fundamentally unique, both conceptually and in application: perspectives will be provided through responding to concepts within MCO framework such as “other-oriented” stance, leaning into cultural opportunities, and cultural comfort from a person-of-color lens. We contend that the traumatic effects of racism, microaggression, intergenerational trauma, and the pressures to assimilate to White culture make it difficult for therapists to practice cultural humility in the way that it is currently discussed in the literature. The authors provide potential resources for therapists of color, and explore how it is essential to have institutional and communal resources provided in White spaces.