Young people of Chinese origin in western countries: a systematic review of their sexual attitudes and behaviour

People of Chinese origin are a growing population group in western countries. The community is seen to be marginalised, under‐researched and neglected, in fact the least understood ethnic minority. This paper reports on a systematic review of sexual attitudes and behaviour among ethnic Chinese young people (mainly aged 13–25 years) living in western countries. An extensive literature search was conducted to cover the period of 1989 and 2009 using Medline, CINAHL, PsycINFO and ScienceDirect databases. There has been a dearth of literature in this area. However, results from existing literature show that ethnic Chinese youth reported poorer sexual health knowledge than white young people in their host countries, while they were found to be more likely to disapprove of uncommitted sex, be virgins, lose their virginity at a later age and have fewer sexual partners. Factors associated with their sexual attitudes and behaviour have also been identified. Countries like the United Kingdom, United States and Canada have become multicultural societies with many diverse ethnic groups. Without doubt educators and sexual health professionals need to provide sex education and services which should be culturally appropriate to people from diverse ethnic backgrounds. An understanding of their sexual values, sexual behaviour and associated factors is the first step towards achieving this goal.     

Sexual discourses and strategies among minority ethnic youth in the Netherlands

This study explores the way minority ethnic youth in the Netherlands evaluate their sexual experiences, how they frame these experiences in different sexual discourses and how they deal with conflicts between different sexual discourses, both at home and in Dutch society. During 46 narrative interviews, Dutch young people (aged 12–22 years) from different minority ethnic communities shared their sexual histories and their dreams for the future relating to love and sexuality. Different sexual discourses can be identified in the language they used to describe their ideas and their experiences. Young people grow up with a variety of discourses but actively re-shape them according to circumstances and need. In many cases, young people experience a conflict between the discourses of the home and those that are prevalent more generally in Dutch society. Young people's ways of negotiating these contradictory discourses comprise four main strategies: (1) conforming to parents' values, (2) breaking up with parents, (3) leading a double life and (4) integrating competing discourses. By bringing together different sexual discourses and acknowledging diverse strategies, sexual health policies can become more effective in promoting sexual health for minority ethnic youth. Findings from the study add fuel to debate on understanding (sexual) agency among young people, exhibiting the social ‘embeddedness’ of individual agency.     

Ethnic density effects on health and experienced racism among Caribbean people in the US and England: A cross-national comparison

Studies indicate an ethnic density effect, whereby an increase in the proportion of racial/ethnic minority people in an area is associated with reduced morbidity among its residents, though evidence is varied. Discrepancies may arise due to differences in the reasons for and periods of migration, and socioeconomic profiles of the racial/ethnic groups and the places where they live. It is important to increase our understanding of how these factors might promote or mitigate ethnic density effects. Cross-national comparative analyses might help in this respect, as they provide greater heterogeneity in historical and contemporary characteristics in the populations of interest, and it is when we consider this heterogeneity in the contexts of peoples' lives that we can more fully understand how social conditions and neighbourhood environments influence the health of migrant and racial/ethnic minority populations.     

A Critical Interdisciplinary Analysis of Culturally Appropriate Research Approach and Practices in Health Care and Social Work

This paper presents a critique of research approaches used in health and social care research with vulnerable and socially disadvantaged groups, and children and young people from minority ethnic backgrounds in Britain. The paper aims to critically examine research processes in health and social care from a psychological perspective and a social work perspective. This paper argues that a conceptual framework that incorporates a cross-cultural perspective for understanding the development of minority ethnic children is critical in order to address omissions in existing theoretical formulations and research in social work and health care theory and research. In the United Kingdom there is a lack of social work research from a cross-cultural perspective. Research knowledge and information from a cross-cultural perspective on minority ethnic family life, minority ethnic children and young people are vital to the health care and social work profession.     

2011年四川省公民健康知识现状分析

目的了解四川省2011年居民掌握健康知识情况,为制订干预策略提供科学依据。方法采用多阶段分层整群随机抽样进行问卷调查。结果本次共调查6 546人,健康知识知晓率为72.6%,49个知识点中有5个知识点知晓率低于60%。结论城乡之间、民族地区与非民族地区、性别、是否从事医药卫生工作的调查对象知识知晓率差异具有统计学意义,需要更深层次了解居民对这些知识点的看法。     

The buffering effects of ethnic density on experienced racism and health

Studies in the United Kingdom (UK) show a consistent inequality between the health of ethnic minorities and that of white people. This is exacerbated by the over-representation of ethnic minorities in deprived areas, which have been associated with poorer infant and child health, chronic disease, and high mortality rates. Ethnic density, defined as the proportion of ethnic minority residents in an area, is generally thought of in relation to the negative impacts of area effects on health. However, it can be considered in terms of social networks and supportive communities, possibly mitigating the detrimental impact of racism on the health of ethnic minority people. This study investigated the ethnic density effect and hypothesised that ethnic minority people who live in areas of high ethnic density would report decreased experienced racism and better health outcomes compared to their counterparts living in areas of low ethnic density. Multiple logistic regressions were conducted using data from the Fourth National Survey of Ethnic Minorities and the 1991 UK Census. Results showed a negative association between ethnic density and psychotic symptomatology, but no evidence of an association between ethnic density and general self-rated health. Findings confirm that the experience of racism is lower in places of higher ethnic density and indicate a tendency for a weaker association between racism and health as ethnic density increases.     

Chinese health behaviour: breaking barriers to better understanding

Research into health behaviour among people of Chinese ethnic origin in Britain has been piecemeal and provides an inadequate basis for health prevention initiatives. A better understanding to direct future research and to facilitate the development of new health prevention initiatives among the Chinese community might be achieved by use of the Health Action Model.     

Ethnic Density Effects on Physical Morbidity,Mortality, and Health Behaviors: A Systematic Review of the Literature

It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Ethnic density effects are still contested, and the pathways by which ethnic density operates are poorly understood. The aim of this study was to systematically review the literature examining the ethnic density effect on physical health, mortality, and health behaviors. Most studies report a null association between ethnic density and health. Protective ethnic density effects are more common than adverse associations, particularly for health behaviors and among Hispanic people. Limitations of the literature include inadequate adjustment for area deprivation and limited statistical power across ethnic density measures and study samples.IT HAS BEEN SUGGESTED THAT people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own racial/ethnic group, a so-called ethnic density effect.1,2 Ethnic density, defined as the proportion of ethnic minority residents in an area, is generally thought of in relation to the negative association between residential segregation and health. However, when the detrimental association between concentrated area deprivation and health is accounted for, and the focus is placed on the association between living among other ethnic minority people and health, ethnic density can also be considered in terms of social networks and supportive communities.Theoretical discourses of the ethnic density effect propose that positive health outcomes are attributed to the protective and buffering effects that enhanced social cohesion, mutual social support, and a stronger sense of community and belongingness provide from the direct or indirect consequences of discrimination and racial harassment, as well as from the detrimental effects of low-status stigma.3–6Studies to date on ethnic density and health have yielded inconsistent results, with some studies finding a protective ethnic density effect and others reporting a detrimental or null association. The discrepancy in results may arise because of numerous study differences. Variations in national and migration contexts have led to a wide range of racial/ethnic groups and densities being investigated, and studies have used a variety of area definitions to operationalize ethnic density, and have adjusted for different demographic and socioeconomic confounding factors. In addition to inconsistent findings, the possible mechanisms by which ethnic density affects health have not yet been fully explained, leaving the relationship between ethnic density and health poorly understood. A clear understanding of the literature on the ethnic density effect would contribute to current debates on the individual and community assets available in diverse communities. And given repeated, albeit not consistent, reports of ethnic density effects on health despite the increased levels of deprivation found in areas with high proportions of ethnic minority residents,3,7,8 an appreciation of the ethnic density effect and the pathways by which it operates might also help in disentangling psychosocial influences on health from the effects of material factors,5 making an important contribution to the field of social epidemiology.In a parallel piece of work we have undertaken a systematic review of the ethnic density literature on mental health.9 Our purpose in this study was to systematically review the literature examining the ethnic density effect on physical health, mortality, and health behaviors. We employed a systematic search to eliminate potential biases caused by study selection, and we utilized the flexibility of a narrative synthesis to accommodate the diversity of studies.     

Factors that affect the food choices made by girls and young women, from minority ethnic groups, living in the UK

BACKGROUND: Lower birth weight, often found in infants from minority ethnic groups, may be partly because of the disproportionate representation of ethnic minority groups in low-income areas. To develop an intervention, to improve the nutritional intake of young women from populations at risk of low-birth-weight babies, which would be culturally sensitive and well received by the intended recipients, a community development approach was used to investigate factors that might influence food choice and the nutritional intake of girls and young women from ethnic minority groups. METHODS: Focus group discussions were conducted across the UK, to explore factors that might affect the food choices of girls and young women of African and South Asian decent. The data was analysed using deductive content analysis (Qual. Soc. Res., 1, 2000, 1). Discussions were around the broad themes of buying and preparing food, eating food and dietary changes, and ideas for an intervention to improve diet. RESULTS: The focus group discussions indicated that all the communities took time, price, health and availability into consideration when making food purchases. The groups were also quite similar in their use of 'Western' foods which tended to be of the fast food variety. These foods were used when there was not enough time to prepare a 'traditional' meal. CONCLUSION: Many issues that affect the food choice of people who move to the UK are common within different ethnic groups. The idea of a practical intervention based on improving cooking skills was popular with all the groups.     

2019年云南省少数民族居民健康素养现状分析

目的通过监测和分析2019年云南省少数民族居民健康素养现状,了解云南省少数民族人口的健康素养水平,为在云南省少数民族人群中开展健康教育与健康促进工作和制定干预措施提供科学依据。方法采用多阶段抽样方法,在云南省129个县(市、区)随机抽取15~69岁少数民族居民19343名作为研究对象。结果云南省少数民族居民健康素养水平为12.21%。3个方面健康素养水平从高到低依次为基本知识和理念(20.34%)、健康生活方式与行为(11.88%)、基本技能(10.32%);6类健康问题素养水平从高到低依次为安全与急救(34.59%)、科学健康观(25.99%)、基本医疗(15.79%)、健康信息(14.79%)、传染病防治(14.51%)、慢性病防治(12.53%)。结论云南省少数民族居民健康素养水平总体较低,应针对少数民族居民健康问题加大力度开展健康教育宣传与干预,提升少数民族居民健康素养水平。     

Quality of health care for ethnic/racial minority populations

This article reviews the composition and characteristics of the health professions, the demographics of the national population, and factors that influence access to health care and satisfaction with care for ethnic/racial minority populations in the United States. In addition, an overview of publicly funded US health insurance programs for the poor is provided along with a discussion of the impact that managed care is having on the American health care system. Finally, the paper summarizes conference discussions regarding the problems, strategies, and approaches that the UK and the US have experienced with respect to providing quality health care for ethnic/racial minority populations.     

Perceptions of schizophrenia in multi-cultural Britain

Objectives: The importance of perceptions of mental health problems from the perspectives of different ethnic populations is especially pertinent within a society such as Britain, which is culturally diverse, but employs a classification of psychopathology which is based upon western models. This study aimed to investigate differences in the lay perceptions of mental health problems, particularly schizophrenia, across different ethnic populations living in Britain. Further it aimed to look at the influence ethnic background had in relation to other variables such as age, gender, religion and contact with people with mental health problems. Design: 190 participants from five broad ethnic groups (Afro-Caribbean, Bangladeshi, Indian, Sub-Saharan African and White British) reported their perceptions of schizophrenia symptoms using the Perceptions of Mental Health Problems Questionnaire. Results: Differences were found across ethnic groups in participants' perceptions of schizophrenia symptoms. Differences were consistently shown across the specific symptoms of hallucinatory behaviour, suspiciousness, unusual thought content and alogia. In particular, in comparison with the white British group, Bangladeshi participants were less likely to view suspiciousness or hallucinatory behaviour as indicative of mental health problems, and the Afro-Caribbean participants were less likely to view unusual thought content as a symptom. As expected, differences in perceptions were also associated with religion, education, gender and contact with people with mental health problems. However, ethnicity was the best predictor of perceptions of schizophrenia symptoms. Conclusion: Ethnicity was found to be an important factor in influencing perceptions of schizophrenia. The specific differences found across ethnic groups are useful in beginning to understand more fully public perceptions of mental health problems in Britain today. The findings raise interesting discussion in relation to ethnic and cultural factors in planning services for people from ethnic minorities, and considering in more detail issues concerning diagnosis and engagement.     

Ethnic minority under-representation in clinical trials. Whose responsibility is it anyway?

Ethnic minority people are frequently under-represented in clinical trials. This potentially affects the generalisability/external validity of the trial findings. This not only has important repercussions regarding the safety and the efficacy of new drug use in ethnic minority groups, but also reduces opportunities for subgroup analysis. There can be no scientific basis for excluding this group of people from clinical trials. Aims to provide a mix of theoretical and empirical debates, in order to make sense of ethnic minority exclusion from clinical trials, and suggest possibility of change. Recommends that educational programmes should be directed at clinical trial investigators and funding bodies, to increase their awareness of under-representation of ethnic minority people in clinical trials. Ethics committees could also redress this inequality by providing guidance for investigators, and by being more rigorous about reviewing clinical trial protocols. Provides a set of guidelines to "enlighten" and aid health professionals in working with ethnic, linguistic and culturally diverse populations. The guidelines require additional work and have cost implications. Argues that cost should not be allowed as an acceptable excuse for excluding ethnic minority people from clinical trials.     

Determinants and beliefs of health information mavens among a lower-socioeconomic position and minority population

People of lower-socioeconomic position (SEP) and most racial/ethnic minorities face significant communication challenges which may negatively impact their health. Previous research has shown that these groups rely heavily on interpersonal sources to share and receive health information; however, little is known about these lay sources. The purpose of this paper is to apply the concept of a market maven to the public health sector with the aims of identifying determinants of high health information mavenism among low-SEP and racial/ethnic minority groups and to assess the information they may be sharing based on their own health beliefs. Data for this study were drawn from the baseline survey (n = 325) of a US randomized control intervention study aimed at eliciting an understanding of Internet-related challenges among lower-SEP and minority individuals. Regression models were estimated to distinguish significant determinants of health information mavenism among the sample. Similarly, bivariate and logistic multivariable models were estimated to determine the association between health information mavenism and accurate health beliefs relating to diet, physical activity and smoking. The data illustrate that having a larger social network, being female and being older were important factors associated with higher mavenism scores. Additionally being a moderate consumer of general media as well as fewer years in the US and lower language acculturation were significant predictors of higher mavenism scores. Mavens were more likely than non-mavens to maintain accurate beliefs regarding diet; however, there was no distinction between physical activity and smoking beliefs between mavens and non-mavens. These results offer a unique understanding of health information mavenism which could better leverage word-of-mouth health communication efforts among lower-SEP and minority groups in order to reduce communication inequalities. Moreover, the data indicate that health information mavens may serve as an ideal point of intervention in attempts to modify health beliefs with the goal of reducing health disparities among these populations.     

Exploring the health visiting service from the view of South Asian clients in England: a grounded theory study

The fact that health inequalities disproportionately affect the minority ethnic population is not new and projections are that the minority ethnic population will continue to increase. The importance of early intervention and the key role that health visitors can play in attempting to reduce health inequalities is well documented as is the requirement for health providers to establish culturally sensitive services. To date, much of the research has focused on the perspectives of healthcare professionals caring for minority ethnic clients in hospital‐based settings and little is known about the perspectives of minority ethnic clients regarding the health visiting service (HVS). The aim of this study was to explore the perspectives of South Asians regarding their experiences with the HVS. The study was conducted in a small town in the South of England between March and June 2013. A qualitative study using a grounded theory approach was used to capture the perspectives of this group regarding their interactions with the HVS. The sample consisted of 15 participants and data were collected through audio‐recorded semi‐structured interviews and analysed using constant comparative approach. Three key categories were identified: ‘understanding the health visitor's role’, ‘sensitivity of services’ and ‘the significance of family’. While clients valued one‐to‐one support from health visitors, there was some evidence of poor communication and ethnocentric tendencies within the service. It was found that South Asian clients distinguish between health and parenting advice, being more likely to accept health advice from their health visitor and more likely to accept parenting advice from their family. The findings, although limited in their generalisability, offer important insights into how South Asians perceive the service and will equip health visitors with a better understanding of how best to improve the experience of South Asian clients accessing the health visiting.     

Use of health care services by ethnic minorities in The Netherlands: do patterns differ?

BACKGROUND: This article examines the nature of ethnic differences in health care utilisation by assessing patterns of use in addition to single service utilisation. METHODS: Data were derived from the Second Dutch National Survey of General Practice. A nationally representative sample of 104 general practices participated in this survey. Data on health and health service utilisation were collected through face-to-face interviews. Based on a random sample per practice, a total of 12 699 Dutch-speaking people were interviewed, regardless of ethnic background. An additional study among a random sample of 1339 people from the four largest minority groups in The Netherlands was conducted. These four groups comprised people from Turkey, Surinam, Morocco, and The Netherlands Antilles. Multilevel analyses were performed to investigate ethnic differences in health care utilisation, adjusting for socio-economic status, health status, and level of urbanisation. RESULTS: Differences in utilisation patterns were particularly marked for people with a Moroccan, Turkish, or Antillean background. Compared to the other groups, Surinamese were more likely to have had contact with any professional health care service. No evidence was found that the gate keeping role of general practitioners in The Netherlands functions less effectively among the ethnic minority groups as compared to the indigenous population. CONCLUSION: The analysis of patterns of utilisation proved to supply useful information concerning the relationship between ethnicity and use of health care services in addition to figures concerning single service use only.     

Why ethnic minority groups are under-represented in clinical trials: a review of the literature

Randomised controlled trials (RCTs) are considered to be the gold standard in evaluating medical interventions; however, people from ethnic minorities are frequently under-represented in such studies. The present paper addresses a previously neglected debate about the tensions which inform clinical trial participation amongst people from ethnic minorities, in particular, South Asians, the largest ethnic minority group in the UK. In a narrative review of the available literature, based mainly on US studies, the present authors aim to make sense of the issues around under-representation by providing a theoretical reconciliation. In addition, they identify a number of potential barriers to ethnic minority participation in clinical trials. In so doing, the authors recognise that the recent history of eugenic racism, and more general views on clinical trials as a form of experimentation, means that clinical trial participation among people from ethnic minorities becomes more problematic. Lack of participation and the importance of representational sampling are also considered, and the authors argue that health professionals need to be better informed about the issues. The paper concludes by offering a number of strategies for improving ethnic minority accrual rates in clinical trials, together with priorities for future research.     

Health and social care needs in minority communities: an over‐problematized issue?

As far as Britain’s black and South Asian minority communities are concerned, the development of health and social care in the community is often perceived to be problematic. For some minority groups (or for some sections of particular communities) this view is justified. Firstly, significant numbers of people in minority ethnic communities are socially and economically disadvantaged and might lack the resources (income, satisfactory housing, access to transport, family support) to provide care to the level that is needed. Secondly, the planning and delivery of care services for people in minority communities can leave much to be desired. Among other problems, racism and institutional discrimination can result in services which neglect the needs of minority communities. However, the argument remains that to a degree the issue of community care in minority ethnic communities is an over‐problematized one. Are the problems faced by particular groups in the minority population experienced widely in every minority community? This paper examines the argument by focusing on the care of older people. It accepts that problems of racism in the planning and delivery of health and social services are serious and lead to limited access to, and under‐use of, social services by some. However, it is evident that some minority communities are in a much better position than others to meet the care needs of older people.     

The Use of Primary Care Services by the Chinese Population Living in England: Examining inequalities

Objective To assess general practitioner consultation among Chinese people compared with the general population and other minority ethnic groups, and to investigate the factors associated with general practitioner consultation among the Chinese population. Design. Survey of a representative sample of Chinese people aged 1674 living in private households in metropolitan areas of England. One thousand and twenty-two people who defined themselves as 'of Chinese origin' were interviewed. General practitioner consultations were analysed in relation to self-reported general health and long-standing illness or disability, gender, age, social class, country of birth, whether the respondent spoke English, use of traditional Chinese medicine, and the ethnicity and gender of the respondent's general practitioner. Results The self-reported general health status of Chinese people is similar to that of the general population and better than that of other minority ethnic populations. The level of general practitioner consultation by Chinese people is low compared with the general population and with other minority ethnic groups. Within the Chinese population, general practitioner consultation is related to gender, self-reported health status and the ability to speak English. Ability to speak English is the strongest positive predictor of general practitioner consultations. Conclusion Chinese people in England are less likely than people from other minority ethnic groups to consult their general practitioner, even after their relative health status is taken into consideration. Use of general practitioners by Chinese people in England is associated with a number of factors, of which the strongest predictor is the ability to speak English. Chinese people who speak English are more likely than those who do not, to consult their general practitioner. Health service providers should accommodate the needs of this group by providing access to advocacy services.