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At first glance, it might seem from the statistics that 18- to 20-year-old members of minority ethnic groups are doing relatively well in terms of higher education. They are in fact better represented in UK colleges and universities than young whites. However, this is far from the whole story. Certain black groups, such as African–Caribbean males and Bangladeshi females, are significantly underrepresented in higher education in general and certain programmes in particular. For example, there has been difficulty recruiting Black and ethnic minority students into teacher training programmes (DfEE, 1998). The experience of participating in higher education is also often different for black and white students. Black and minority ethnic students are more likely to be concentrated in the new universities. In the mid-1990s, only 0.5 percent of the students at the older established universities came from a Black or minority ethnic background, compared with 14.4 percent in the new universities (DfEE, 1998). This inequality helps to perpetuate a system of white privilege, one that is entrenched in other areas of public life in the UK. Black and minority ethnic students are also more likely to study part-time than white students, are more likely to drop out of courses, and more frequently opt for lower-level qualifications (i.e., a diploma rather than a degree).

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.

A fairly consistent finding in research on trust in physicians is that racial and ethnic minorities cite lower levels than whites. This research typically samples only health care users, which limits our understanding of what underlies distrust. It remains unclear whether the distrust is generalized, which is distrust that is unrelated to using health care regularly or recently.

Using data from the Health Information National Trends Survey, multivariable logistic regressions assessed whether racial and ethnic differences in distrust (1) are equivalent among health care users and non-users; (2) regardless of respondents’ health and socio-economic status; and (3) manifest in other health information sources.

Racial and ethnic minorities are less likely than whites to trust physicians as health information sources. These racial and ethnic differences are equivalent among health care users and non-users, regardless of respondents’ health and socio-economic status. The racial and ethnic patterns do not manifest when predicting trust in other health information sources (Internet, family or friends, government health agencies, charitable organizations).

Data are derived from a cross-sectional survey, which makes it difficult to account comprehensively for self-selection into being a health care user. Despite the limitations, this research suggests that racial and ethnic minorities possess a generalized distrust in physicians, necessitating interventions that move beyond improving health care experiences.

Many researchers have surmised that a generalized distrust in physicians exists among racial and ethnic minorities. This chapter is the first to explicitly examine the existence of such distrust.

This chapter presents a summary of existent evidence regarding the effects of the COVID-19 pandemic on Minority Ethnic Groups (MEGs) in the United Kingdom Compared to White British, MEGs have historically experienced lower levels of health and socioeconomic outcomes and the COVID-19 crisis seems to have widened these inequalities. In particular, evidence gathered between 2020 and early 2021 suggests that MEGs, and especially MEGs women, experienced a substantive deterioration in mental health. Furthermore, Black and South Asian groups were more likely to contract the infection and die than any other ethnic group. Access to preventative services and healthcare, plus residential and employment segregation seem to be important factors in explaining mortality rates due to COVID-19. Finally, data released by NHS on vaccinations (until August 2021) show that Black, Pakistani and Bangladeshi communities are lagging behind the rest, with a very low proportion of these groups receiving the first dose. Getting everyone vaccinated should be a priority for the Government in order to reduce the impact of COVID-19 and avoid new outbreaks. The evidence collected and summarised in this chapter calls for further attention on, and action to mitigate, the widening gaps in health and socioeconomic attainments across ethnic groups.

An overview of the impact of dementia that focuses on underdeveloped countries across the globe, and migrant and minority ethnic communities within the developed world. Increased longevity increases the risk of dementia and brings new challenges in terms of cultural perspectives and cultural obligations in the care of elders. The chapter examines these challenges in detail and their consequences in planning for support and care.

Research suggests that African-Caribbeans are less likely than their white British counterparts to ask for mental health support (Cooper et al., 2013). This is despite research identifying that minority groups as a whole, when compared to the white majority, report higher levels of psychological distress and a marked lack of social support (Erens, Primatesta, & Prior, 2001). Those who do request support are less likely to receive antidepressants (British Fourth National Survey of Ethnic Minorities, 1994; Cooper et al., 2010) even when controlling for mental health symptom severity, with African-Caribbeans less likely to make use of medication for depression even when prescribed (Bhui, Christie, & Bhugra, 1995; Cooper et al., 2013). Studies reporting on reasons for black people being less likely to attend for mental health consultation with their GP suggest a variety of explanations why this may be, focussing both on the suspicion of what services may offer (Karlsen, Mazroo, McKenzie, Bhui, & Weich, 2005) and the concern of black clients that they may experience a racialised service with stigma (Marwaha & Livingstone, 2002). Different understandings and models of mental illness may also exist (Marwaha & Livingstone, 2002). Different perspectives and models of mental health may deter black people from making use of antidepressants even when prescribed. Despite a random control trial showing that African-Caribbean people significantly benefit from targeted therapy services (Afuwape et al., 2010), the government, despite a report by the Department of Health in 2003 admitting there was no national strategy or policy specifically targeting mental health of black people or their care and treatment has not yet built on evidence-based success. One important aspect recognised by the Department of Health (2003), was that of the need to develop a mental health workforce capable of providing efficacious mental health services to a multicultural population. Although there were good strategic objectives little appeared to exist in how to meet this important objective, particularly in the context of research showing that such service provision could show real benefit. The Department of Health Guidelines (2003) focussed on the need to change what it termed as ‘conventional practice’, but was not specific in what this might be, or even how this could improve services to ethnic minorities. There was discussion of cultural competencies without defining what these were or referencing publications where these would be identified. There was a rather vague suggestion that recent work had begun to occur, but no indication that this had been evaluated and shown to have value (Royal College of Psychiatrists, 2001). Neither British Association for Counselling and Psychotherapy nor British Psychological Society makes mention of the need for cultural competencies in organisational service delivery to ethnic minority clients. This chapter will describe, explore and debate the need for individual and organisational cultural competencies in delivering counselling and psychotherapy services to African-Caribbean people to improve service delivery and efficacious outcomes.

This article explores the neglected issue of the overrepresentation in the child protection system of children from ethnic, cultural, religious, racial, and linguistic minorities. It focuses on the accommodation of children’s diverse backgrounds within the s 31(2) threshold and s1 “best interests” stages of intervention under the Children Act 1989. First, it introduces the ethnic child protection penalty as a new tool for capturing the complex nature of overrepresentation of these children. Second, it proposes a framework for understanding the judicial approach in higher court decisions on the current extent and nature of accommodation. Third, it employs the penalty concept to help explain why case law analysis reveals difficulties with the current factor-based approach, whereas empirical research suggests generally satisfactory accommodation in practice. It concludes by proposing a contextualized framework for decision-making in relation to child protection.

This chapter addresses Bangladeshi female students’ experiences of higher education in the United Kingdom through the race/gender trajectory. Research shows that although minority ethnic women invest heavily in education, they go on to face obstacles in the labour market. However, there is a strong desire to study which is evident in the increasing numbers of Bangladeshi women applying to university since 1994. The chapter draws on empirical research with women who have claimed a kind of ‘agentic autonomy’ to pursue education in the face of structural inequalities.

The chapter is based on research conducted with a sample of Bangladeshi women studying at or recently graduated from university. Qualitative research was carried out in the form of semi-structured interviews with 13 participants.

The study finds that Bangladeshi women are undeterred by structural inequalities in higher education and employment. Although they expect to face some difficulty finding suitable employment, they are optimistic about the future. They represent a group of women who have been able to achieve their objectives to study at degree level and show aspirations towards achieving similar objectives after graduation.

Bangladeshi women show agency and agentic behaviour to negotiate access to higher education institutions. This will, in the future have a knock-on effect in employment.

The practice of transracial adoption often triggers strong emotions, effecting views on its ethical validity, both from individuals who are pro transracial adoption and those who strongly resist transracial adoption. This chapter will consider transracial adoption of children of African-Caribbean origin and its psychological impact along a continuum of psychological wellbeing, psychological adjustment and aspects of mental health. The chapter will draw on literature from the USA and, where available, from the UK.

One of the earliest publications on transracial adoption by Grow and Shapiro (1974) explored the psychological adjustment of African-American children placed within white American families. This study along with later studies (Silverman & Feigelman, 1981) concluded that the children were adjusting well in placement. Further early research appeared to suggest that transracial placements have little negative impact on issues of self-esteem, racial or self-identity or intellectual development (Curtis, 1996; Hayes, 1993; Hollingsworth, 1997, 1998; McRoy, 1994; Simon, Altstein & Melli, 1994; Vrogeh, 1997).

The undermining impact on mental health for transracial adoptees appears to be an argument related to the disconnect between the child’s developing racial identity and lack of preparation for racism and the cultural and ethnic group social devaluation likely to be experienced in a white racist society. The impact of loss of ethnic identity is said to be a key issue in the research on transracial adoption. Ethnic identity is the connection or recognition that one is a member of a specific ethnic or racial group and coming to adopt those associated characteristics into the group associated cultural and historical connections into oneself identity (Rotheram & Phinney, 1987). The establishment of a secure and accurate racial identity is said to be a protective factor in psychological adjustment. This chapter will explore issues and narratives related to this argument.