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.     

Agency and structure: the impact of ethnic identity and racism on the health of ethnic minority people

Abstract To understand ethnic inequalities in health, we must take account of the relationship between ethnic minority status, structural disadvantage and agency. So far, the direct effects of racial oppression on health, and the role of ethnicity as identity, which is in part a product of agency, have been ignored. We set out to redress this balance using data from the Fourth National Survey of Ethnic Minorities. Factor analysis suggested that dimensions of ethnic identity were consistent across the various ethnic minority groups. Initially some of these dimensions of ethnic identity appeared to be related to health, but in a multivariate model the factor relating to a racialised identity was the only one that exhibited any relationship with health. These findings suggest that ethnic identity is not related to health. Rather, the multivariate analyses presented here showed strong independent relationships between health and experiences of racism, perceived racial discrimination and class.     

甘肃省藏族青少年牙周病调查报告

目的:为了解甘肃省藏族青少年牙周状况以及为开展牙周病预防工作提供资料,我们对甘肃省的藏族青少年进行了口腔健康调查。方法:对甘肃藏族聚集区学校内12岁、15岁及18岁3个年龄组藏族青少年共1039人的牙周状况进行调查。结果:受检儿童12岁牙龈出血率21.4%,牙石检出率24.8%;15岁牙龈出血率19.8%,牙石检出率41.8%;18岁牙龈出血率23.9%,牙石检出率60.7%,小于全国各年龄组牙龈出血及牙石检出率的平均水平。讨论:藏族少儿牙周病发病率较低,但我们仍应加强口腔健康教育,使他们提高口腔保健意识,建立良好的口腔卫生。才能促进儿童的健康成长,提高少数民族身体素质。     

Views on smoking cessation methods in ethnic minority communities: a qualitative investigation

OBJECTIVE: The purpose of this qualitative analysis is to increase our understanding of minority smokers' experiences and beliefs about guideline-recommended smoking cessation treatments. METHODS: We conducted sixteen focus groups (N=95) among current and former smokers from four ethnic minority communities in Minneapolis/St. Paul in 2005. Focus groups were conducted separately for American Indians, Vietnamese, Hmong and African Americans. RESULTS: Participants reported little experience with counseling and views on seeking help from physicians were mixed. African American and American Indian participants expressed feelings of mistrust and negative experiences with doctors. Hmong and Vietnamese smokers viewed doctors positively but did not regard them as an important resource to help with quitting, and especially for Vietnamese, the cultural value of mental control and self-determination was seen as most important to quit smoking. Across all the groups, pharmacotherapy was rarely utilized and participants had low knowledge and poor understanding of the benefits of pharmacotherapy. CONCLUSIONS: Personal beliefs, views toward doctors, and lack of knowledge are important determinants of the use of tobacco treatments among ethnic minority smokers. In order to increase minority smokers' utilization of evidence-based tobacco cessation treatments, effective strategies are needed to deliver accurate information about treatment from trusted sources.     

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.     

少数民族大学生生殖健康状况调查

目的:分析少数民族学生生殖健康现状、知识知晓程度以及需求,探索开展生殖健康教育的方法,便于有针对性地为少数民族大学生健康生活提供指导。方法:采用分层整群随机抽样法,抽取西北民族大学中少数民族大学生870名,以匿名问卷形式进行生殖健康状况调查。结果:少数民族大学生生殖健康知识不足,对女性排卵、艾滋病的传播途径以及避孕措施的知晓情况较差,相关知识知晓率男生高于女生,城市高于农村;大学生性态度较开放,24.9%的学生愿意接受婚前性行为,33.0%能接受大学生发生性行为,21.1%能接受未婚先孕,27.3%希望体验性生活经历,不同性别、生源学生间均有差异;性行为方面,44.8%有过接吻经历,23.2%的人有过性爱抚经历,20%有过性经历,29.2%有过自慰经历,这些行为在男女生之间、不同生源之间差异较大。结论:少数民族大学生生殖健康知识水平较低,性态度较开放。应积极开展少数民族大学生生殖健康教育,提高相关知识水平,培养科学健康的生活行为。     

Child mental health differences amongst ethnic groups in Britain: a systematic review

Background  

Inter-ethnic differences have been reported for many mental health outcomes in the UK, but no systematic review on child mental health has been published. The aim of this review is to compare the population-based prevalence of child mental disorders between ethnic groups in Britain, and relate these findings to ethnic differences in mental health service use.     

Variations in associations of health risk behaviors among ethnic minority early adolescents

PurposeTo investigate patterns of vulnerability and protection factors associated with risk behaviors and the co-occurrence of risk behaviors in minority ethnicity early adolescents.MethodsAnalysis of data from the Research with East London Adolescents Community Health Survey (RELACHS), a school-based study of a representative sample of 2789 adolescents age 11–14 in 2001 (sample 73% non-Caucasian, 21% born outside the United Kingdom). Questionnaire data were obtained on sociodemographic variables, ethnicity, smoking, drinking, drug use, psychological well-being, physical health, and social support from family and peers. Models of associations for each behavior and co-occurrence of risk behaviors (defined as engaging in ≥ 2 behaviors) were developed by hierarchical stepwise logistic regression.ResultsTwo hundred ninety-two (10.9%) reported 1 risk behavior, 84 (3.1%) reported 2, and 25 (0.9%) reported 3 behaviors. In multivariate models, psychological morbidity was associated with higher risk of all behaviors and co-occurrence, while higher family support was associated with lower risk in all models. Non-Caucasian ethnicity was associated with lower risk of regular smoking and co-occurrence but not drinking or drugs. Birth outside the United Kingdom was associated with lower risk for individual behaviors but not co-occurrence. Religion and religious observance were associated with lower risk of smoking and drinking but not drug use or co-occurrence. Peer connectedness was associated with drug use, but with increased risk. Socioeconomic status was associated only with smoking.ConclusionsPatterns of associations of personal, family, and environmental factors appear to differ between smoking, drinking, lifetime drug use, and the co-occurrence of these behaviors. Hypotheses regarding common factors related to health risk behaviors may be misleading in ethnic minorities and immigrants. Co-occurrence may represent a distinct behavioral domain of risk that is partly culturally determined.     

Coercive and voluntary referrals: How ethnic minority adults get into mental health treatment

Two hypotheses are typically invoked to examine the referral of adults into mental health care. The first is the clinical behavior hypothesis that suggests the psychiatric problem defines people as dangerous and risky. Accordingly, people with severe mental disorders are more likely to be coercively placed into mental health facilities. The second hypothesis suggests that people with less power are more likely than the powerful to be coercively placed in psychiatric care. We examine the extent to which these hypotheses are supported in a large urban community by investigating referrals into community mental health clinics that serve predominantly poor populations. The data set is unique because it includes four ethnic categories, whites, African Americans, Asian Americans, and Mexican Americans. The findings indicate that the clinical behavior hypothesis is applicable to whites and the stratification hypothesis is consistent with the data for African American, particularly African American men. The referral pattern for Mexican Americans and Asian Americans do not conform to the findings for whites and African Americans. It is likely that other sociocultural factors influence the referrals of these ethnic categories.     

Accessibility and use of touchscreens by black and ethnic minority groups in the three cities project

Design

Results

Conclusion

The public are being encouraged by Government, at a national level, to take a greater role in the management of their health and healthcare but information to support this is not always accessible to black and ethnic minority group members who do not speak or read English. This study looks at the feasibility of providing health-related information in a multilanguage format through a touchscreen kiosk.

Three touchscreen kiosks were programmed with information on 10 health topics translated into five languages: Chinese, Bengali, Gujarati, Urdu and Mirpuri Punjabi. Information was provided orally and in written format. Over an 18-month period the touchscreens were rotated between settings including health centres and libraries, located in deprived areas of Leicester, Sheffield and Nottingham. Information was logged on each individual user with respect to language used, topic selected, age group and gender of user. A number of users were invited to complete a short questionnaire about their use and ease of use of the touchscreen.

Touchscreens were accessed by 2,456 people across all ages, 53% of whom were male. Urdu and Gujarati were the most frequently accessed languages (37 and 38%, respectively) and Bengali used least (9%). There was some variation in use by setting. Most of the 508 people questioned who had used the touchscreen found it easy to use. Ease of use was related to home computer use and to being younger in age. The five most popular topics accessed by 12% or more users were stress, diabetes, blood pressure, healthy eating and exercise. Topic choice varied by language used by males but not by females.

Touchscreens providing health information in ethnic minority languages can be successfully accessed by black and ethnic minority groups, particularly those living in deprived areas. Touchscreens proved acceptable to, and were used by, the targeted audience.     

构建西部民族地区农村新型公共卫生服务体系

建立适宜于西部民族地区农村新型公共卫生服务体系．对保障西部民族地区人民群众身体健康,为建设边疆民族地区社会主义新农村。文章在分析目前存在问题的基础上,提出的包括“六个体系”和“两个机制”的农村新型公共卫生服务体系,是一个适应西部民族地区农村且有效、可行的公共卫生服务系统。     

Race-based experiences of ethnic minority health professionals: Arab physicians and nurses in Israeli public healthcare organizations

Increasing workforce diversity was found to contribute to the narrowing of disparities in health. However, racism toward ethnic minority health professionals has not been adequately researched. In Israel, public healthcare organizations that serve a mixed Jewish-Arab population employ Arab minority healthcare professionals. Instances of prejudice and manifestations of racism toward them, which frequently surface in public discussion and the media, have unfortunately gained little scholarly attention. We used the intergroup contact approach and the theory of the social process of everyday racism as a theoretical framework. The objective of the research was to study race-based experiences of Israeli Arab healthcare professionals.

Methodology: We used a qualitative research method that allows respondents to describe their views, experiences, beliefs and behavior in the way they think about them. During 2013 and 2014 we conducted in-depth interviews with a snowball sample of 10 Arab physicians and 13 Arab nurses who work in Israeli public hospitals. The study protocol was ethically approved.

Findings: Interviewees noted institutional efforts to maintain egalitarianism and equality. However, at the micro-level, interviewees, mostly nurses, reported instances that ranged from refusal to accept treatment from an Arab nurse, through verbal abuse, to the use of physical violence against them. At the meso-level, interviewees, mostly physicians, reported experiences of institutional discrimination. At the macro-level, one physician reported policy-related discrimination in the context of the immigration of Russian Jewish physicians to Israel.

Conclusions: We recommend combining the intergroup contact approach with the social process theory of racism to examine minorities’ subjective perceptions, especially in conflictual and violent contexts; conducting broad-based quantitative research in Israeli healthcare organizations, which may have important implications for the specific strategies to be used; and emphasizing the importance of institutional support. By reconstructing race-based experiences of ethnic minority health professionals, health organizations can better manage racial situations and reduce their frequency.     

Sexual health services in school: a project in a multi-agency drop-in

This article describes how sexual health services for young people can be successfully offered through a multi-agency drop-in session at a secondary school. Funding from the local Teenage Pregnancy Unit's Co-ordinator to the Reproductive Health Department led to training family planning nurses and school nurses to develop drop-in sessions in high schools and deliver sexual health to young people.