Month: July 2024

Abstract

The paper examines how an NGO, established by a group of Hong Kong students, an academic (myself) and a group of asylum-seekers and refugees from South Asia, Southeast Asia and Africa, have worked through different barriers to create a network which builds on diversity to achieve cross-ethnic solidarity within the local community. It seeks to understand what makes a cross-ethnic solidarity network work in a local community. Using the concept of solidarity, the study looks into how the local NGO builds on a mix of diversity of race and gender and (non-)citizenship status to establish solidarity through community activities, advocacy and friendship. Based on ongoing ethnography between 2014 and 2020 and continuous activism work through 2014 until current, and interviews with 50 members of a local NGO, I argue that empowerment through solidarity needs to adopt a ‘neighbourhood’ approach based on mutual support, respect for diversity and empathy when building a solidarity network. An organization which takes on a ‘community’ and ‘neighbourhood’ approach by establishing friendship, focusing on relational aspect amongst local people and the asylum-seekers, is very effective in creating a lasting solidarity with trust. The study shows how solidarity built on differences could work effectively when migrants are in the host countries. More importantly, the results suggest that local population will need to take a more proactive approach to connect to the migrant community so as to build solidarity and achieve recognition and support from a wider community.

Abstract

Although the need to train clinicians to provide effective mental health care to individuals from diverse backgrounds has been recognized worldwide, a bulk of what we know about training in cultural competence (CC) is based on research conducted in the United States. Research on CC in mental health training from different world populations is needed due to the context-dependent nature of CC. Focusing on India and USA, two diverse countries that provide complementary contexts to examine CC, we explored graduate students’, practicing clinicians’, and faculty members’ perspectives regarding CC training they received/provided and future training needs using mixed-methods. The data were collected using focus groups (n = 25 groups total: 15 in India, 11 in USA), and a survey (n = 800: 450 in India, 350 in USA). Our data highlight the salient social identities in these countries, and the corresponding constituents of CC training. Participants in India described a practical emphasis to their CC training (e.g., learning about CC through life experiences and clinical practice experiences) more so than through coursework, whereas participants in USA described varying levels of coursework related to CC along with practice. Participants in both countries considered enormity of CC as a challenge, while those in the US also identified CC training limited to a white, straight, male perspective, hesitancy in engaging with diversity topics, and limited time and competence of the faculty. Strengths of CC training in India and USA are mutually informative in generating recommendations for enhancing the training in both countries.

Abstract

Background

Ethnic inequalities in acute health acute care are not well researched. We examined how attendee ethnicity influenced outcomes of emergency care in unselected patients presenting with a gastrointestinal (GI) disorder.

Methods

A descriptive, retrospective cohort analysis of anonymised patient level data for University Hospitals of Leicester emergency department attendees, from 1 January 2018 to 31 December 2021, receiving a diagnosis of a GI disorder was performed. The primary exposure of interest was self-reported ethnicity, and the two outcomes studied were admission to hospital and whether patients underwent clinical investigations. Confounding variables including sex and age, deprivation index and illness acuity were adjusted for in the analysis. Chi-squared and Kruskal–Wallis tests were used to examine ethnic differences across outcome measures and covariates. Multivariable logistic regression was used to examine associations between ethnicity and outcome measures.

Results

Of 34,337 individuals, median age 43 years, identified as attending the ED with a GI disorder, 68.6% were White. Minority ethnic patients were significantly younger than White patients. Multiple emergency department attendance rates were similar for all ethnicities (overall 18.3%). White patients had the highest median number of investigations (6, IQR 3–7), whereas those from mixed ethnic groups had the lowest (2, IQR 0–6). After adjustment for age, sex, year of attendance, index of multiple deprivation and illness acuity, all ethnic minority groups remained significantly less likely to be investigated for their presenting illness compared to White patients (Asian: aOR 0.80, 95% CI 0.74–0.87; Black: 0.67, 95% CI 0.58–0.79; mixed: 0.71, 95% CI 0.59–0.86; other: 0.79, 95% CI 0.67–0.93; p < 0.0001 for all). Similarly, after adjustment, minority ethnic attendees were also significantly less likely to be admitted to hospital (Asian: aOR 0.63, 95% CI 0.60–0.67; Black: 0.60, 95% CI 0.54–0.68; mixed: 0.60, 95% CI 0.51–0.71; other: 0.61, 95% CI 0.54–0.69; p < 0.0001 for all).

Conclusions

Significant differences in usage patterns and disparities in acute care outcomes for patients of different ethnicities with GI disorders were observed in this study. These differences persisted after adjustment both for confounders and for measures of deprivation and illness acuity and indicate that minority ethnic individuals are less likely to be investigated or admitted to hospital than White patients.

Abstract

For more than two decades, Latina/o critical theory (LatCrit) scholars have called for moving beyond the Black/White binary in conversations on race. By emphasizing Black people, proponents have argued, we ignore Latinx and other racialized minorities who are neither Black nor White and who often live in transnational contexts with transnational identities. This article engages with those scholars who call for moving beyond the Black/White binary by asking how their arguments stimulate anti-Black discourse. Ultimately, LatCrit writers fail to engage with Black Latinx critical race theorists in both the United States and Latin America and, as a result, reproduce anti-Blackness. The call to move beyond a Black/White binary is really a call to make Latinx Blackness invisible. As such, it is not a step toward racial justice but another articulation of anti-Blackness presented as progressive racial thinking. Here I engage with Black Latinx and Black Latin American critical race scholars who challenge US LatCrit scholars to think about how anti-Blackness is part of Latinidad.