Associations of blood pressure with body composition among Afro-Caribbean children in Barbados

Despite complex presentation of adult hypertension and a concomitant obesity epidemic, little is known about overweight in relation to blood pressure among Caribbean children. We examined blood pressure in relation to body size in a cross-sectional study of 573 Barbadian children aged 9–10 years (2010-2011).The United States normative blood pressure percentiles were used to identify children with high (≥ 95th percentile) or high normal blood pressure (90th – 95th percentile). The World Health Organization body mass index cut-off points were used to assess weight status. Major findings: Thirty percent of children were overweight/obese. Percentage fat mass differed between girls (20.4%) and boys (17.72%) (p< 0.05). Mean systolic blood pressure among girls was 106.11 (95% CI 105.05, 107.17) mmHg and 105.23 (104.09, 106.38) for boys. The percentages with high or high-normal mean systolic blood pressurewere14.38% (10.47, 18.29) for girls and 8.08% (4.74, 11.41) for boys. Height and body mass index were independent correlates of systolic and diastolic blood pressure. Mean systolic blood pressure was related to lean mass but not fat mass, while diastolic blood pressure was associated with fat mass index and overweight. Principal conclusion: One third of 9-10 year old children in Barbados were overweight/obese and 12% had elevated mean systolic blood pressure. BP was related to body size. These findings signal potential adverse trends in weight gain and BP trends for children growing up in the context of a country that has recently undergone rapid economic transition

Trends in suicide among migrants in England and Wales 1979–2003

Objective. Trends in suicide death rates among migrants to England and Wales 1979–2003 were examined

Effect of air pollution and racism on ethnic differences in respiratory health among adolescents living in an urban environment

Recent studies suggest that stress can amplify the harm of air pollution. We examined whether experience of racism and exposure to particulate matter with an aerodynamic diameter of less than 2.5 µm and 10 µm (PM2.5 and PM10) had a synergistic influence on ethnic differences in asthma and lung function across adolescence. Analyses using multilevel models showed lower forced expiratory volume (FEV1), forced vital capacity (FVC) and lower rates of asthma among some ethnic minorities compared to Whites, but higher exposure to PM2.5, PM10 and racism. Racism appeared to amplify the relationship between asthma and air pollution for all ethnic groups, but did not explain ethnic differences in respiratory health

Ethnic differences in and childhood influences on early adult pulse wave velocity: the determinants of adolescent, now young adult, social wellbeing, and health longitudinal study

Early determinants of aortic stiffness as pulse wave velocity are poorly understood. We tested how factors measured twice previously in childhood in a multiethnic cohort study, particularly body mass, blood pressure, and objectively assessed physical activity affected aortic stiffness in young adults. Of 6643 London children, aged 11 to 13 years, from 51 schools in samples stratified by 6 ethnic groups with different cardiovascular risk, 4785 (72%) were seen again at aged 14 to 16 years. In 2013, 666 (97% of invited) took part in a young adult (21–23 years) pilot follow-up. With psychosocial and anthropometric measures, aortic stiffness and blood pressure were recorded via an upper arm calibrated Arteriograph device. In a subsample (n=334), physical activity was measured >5 days via the ActivPal. Unadjusted pulse wave velocities in black Caribbean and white UK young men were similar (mean±SD 7.9±0.3 versus 7.6±0.4 m/s) and lower in other groups at similar systolic pressures (120 mm Hg) and body mass (24.6 kg/m2). In fully adjusted regression models, independent of pressure effects, black Caribbean (higher body mass/waists), black African, and Indian young women had lower stiffness (by 0.5–0.8; 95% confidence interval, 0.1–1.1 m/s) than did white British women (6.9±0.2 m/s). Values were separately increased by age, pressure, powerful impacts from waist/height, time spent sedentary, and a reported racism effect (+0.3 m/s). Time walking at >100 steps/min was associated with reduced stiffness (P<0.01). Effects of childhood waist/hip were detected. By young adulthood, increased waist/height ratios, lower physical activity, blood pressure, and psychosocial variables (eg, perceived racism) independently increase arterial stiffness, effects likely to increase with age

A scoping review of the evidence available for the use of salons as health promotion environments, for the prevention and management of non-communicable diseases in women from different ethnic backgrounds

IntroductionWomen from different ethnic backgrounds are disproportionately affected by non-communicable diseases (NCDs). Underpinned by the community capital they harness, hairdressers have successfully delivered NCD prevention programmes, particularly for African-American women in disadvantaged areas. Integrating community organisations and networks into existing primary care pathways can provide a sustainable process to address inequalities in access to health care. This scoping review aimed to map the evidence about interventions based in beauty salons, particularly formative research phases, including co-development, community participation, theoretical or conceptual underpinnings, as well as aspects related to training and incentivisation of salon staff, evaluation and equity.MethodsThe methodological framework was based on the seminal guidance of Arksey and O’Malley, using the ‘PCC’ (participants, concept, context) structure with incorporation of other relevant materials. Studies eligible for inclusion were salon-based health interventions (concept) focused on NCDs prevention (context), targeting women (participants) from different ethnic backgrounds and published in English. The searches were conducted across PubMed, Web of Science and OVID in June 2020 and updated in January 2023, with reference lists also screened. The Reach, Effectiveness, Adoption, Implementation, and Maintenance RE-AIM framework was used to explore the potential public health impact.Results419 titles and abstracts were screened, with eight (2%) meeting the inclusion criteria, all based in the United States of America. Two used formative phases to inform intervention development, three described evidence of co-development with key stakeholders or experts within the community and five studies referred to theoretical or conceptual frameworks. Incentivisation was provided to salon staff in five of the studies, and to clients in three of the studies. Four of the investigations collated data on socioeconomic characteristics of the target population.DiscussionFormative research in the scoped studies was weakly reported upon. Community participation was implicit in each of the scoped studies, yet its application varied considerably. Theoretical and conceptual frameworks were not consistently used, and there was inadequate process evaluation to ensure equitable reach and retention of targeted groups, suggesting a more concerted effort to address health equity is needed for future interventions

Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social well-being and Health longitudinal study

Objective. To investigate the effect of racism, own-group ethnic density, diversity and deprivation on adolescent trajectories in psychological well-being

The influence of racism on cigarette smoking: longitudinal study of young people in a British multiethnic cohort

Introduction: Studies, predominantly from the US, suggest that positive parenting, social support, academic achievement, and ethnic identity may buffer the impact of racism on health behaviours, including smoking, but little is known about how such effects might operate for ethnically diverse young people in the United Kingdom. We use the Determinants of young Adult Social well-being and Health (DASH), the largest UK longitudinal study of ethnically diverse young people, to address the following questions: a) Is racism associated with smoking? b) Does the relationship between racism and smoking vary by gender and by ethnicity? (c) Do religious involvement, parenting style and relationship with parents modify any observed relationship? and d) What are the qualitative experiences of racism and how might family or religion buffer the impact? Methods: The cohort was recruited from 51 London schools. 6643 were seen at 11-13y and 4785 seen again at 14-16y. 665 participated in pilot follow-up at 21-23y, 42 in qualitative interviews. Self-report questionnaires included lifestyles, socio-economic and psychosocial factors. Mixed-effect models examined the associations between racism and smoking. Results: Smoking prevalence increased from adolescence to age 21-23y, although ethnic minorities remained less likely to smoke. Racism was an independent longitudinal correlate of ever smoking throughout adolescence (odds ratio 1.77, 95% Confidence Interval 1.45–2.17) and from early adolescence to early 20s (1.90, 95% CI 1.25–2.90). Smoking initiation in late adolescence was associated with cumulative exposure to racism (1.77, 95% CI 1.23–2.54). Parent-child relationships and place of worship attendance were independent longitudinal correlates that were protective of smoking. Qualitative narratives explored how parenting, religion and cultural identity buffered the adverse impact of racism. Conclusions: Racism was associated with smoking behaviour from early adolescence to early adulthood, regardless of gender, ethnicity or socio-economic circumstances adding to evidence of the need to consider racism as an important social determinant of health across the life course

‘They’re more like ordinary stroppy British women’: Attitudes and expectations of maternity care professionals to UK-born ethnic minority women

Objective To explore the attitudes and expectations of maternity care professionals to UK-born ethnic minority mothers. Methods Qualitative in-depth interviews with 30 professionals from eight NHS maternity units in England that provide services for large proportions of women of black Caribbean, black African, Indian, Pakistani and Irish descent. Results All the professionals reported providing care to both UK-born and migrant mothers from ethnic minorities. Most of them felt that they could differentiate between UK-born and migrant mothers based mainly on language fluency and accent. ‘Westernized dress’ and ‘freedom’ were also cited as indicators. Overall, professionals found it easier to provide services to UK-born mothers and felt that their needs were more like those of white English mothers than those of migrant mothers. UK-born mothers were generally thought to be assertive and expressive, and in control of care-related decision-making whereas some South Asian Muslim women were thought to be constrained by family influences. Preconceived ideas about ethnic minority mothers' tolerance of pain in labour, use of pharmacological pain relief measures and mode of delivery were recurring themes. Women's education and social class were felt to be major influences on the uptake of maternity care, regardless of ethnicity. Conclusions Professionals appeared to equate the needs of UK-born ethnic minority women with those of white English women. Overall, this has positive implications for care provision. Despite this, specific behavioural expectations and unconscious stereotypical views were evident and have the potential to affect clinical practice