Time travel

US blog Decisions Based on Evidence highlights some research from the States on differences in life expectancy on the basis of ethnicity and educational achievement.  The summary puts it starkly: “Despite advances in health care and increases in life expectancy overall, Americans with less than a high school education have life expectancies similar to adults in the 1950s and 1960s."  The study's authors conclude: "The message for policy makers is clear: implement educational enhancements at young, middle, and older ages for people of all races, to reduce the large gap in health and longevity that persists today."

Not so fast

Mining data from the Born in Bradford cohort, researchers examine the relationship between proximity to fast food outlets, deprivation, obesity and ethnicity.  They found that the South Asian women in the study had greater access to fast food outlets but were less likely to be obese (17% with BMI > 30 as compared with 24% amongst non-South Asian women).  The study calls into question the usual assumption that area level deprivation and density of fast food outlets are strongly linked to obesity: other factors are at play, too.  Another UK based study attempts to make some connections between ethnicity density, neighbourhood food and physical activity environments.

The long view

Analysis of ethnic group differences in self-reported limiting long term illness maps the changing situation in the UK population during the 1990s.  While all ethnic groups reported a higher prevalence in 2001 than in 1991, the rise was largest amongst the White Irish, Pakistani and Bangladeshi groups.  Early analysis of data from the GP Patient Survey, which for the first time included health-related quality of life questions, reveals significant geographical and socioeconomic variation, particularly as regards long term conditions.

Culturally aware?

A review of interventions to increase takeup of breast and cervical cancer screening amongst Asian women takes a look at what works, finding that there's no quick fix, although a combination of multiple strategies, such as cultural awareness training for healthcare staff and use of outreach workers, is most effective.  There was little evidence for cost effectiveness or long-term sustainability of any of the programmes.  Another review assesses interventions to improve patient participation in the cancer treatment process for culturally and linguistically diverse groups.

Keep active

A review of physical activity programmes targeted at disadvantaged populations concluded that multi-component group-cased programmes were effective for adults, although not for children. Community-wide interventions tended to produce small improvements in physical activity. However, there was only limited evidence for the effectiveness of interventions aimed at hard to reach groups. Those programmes that had some kind of theoretical underpinning tended to work better, as did those that combined physical activity with education and social support. A study from the US offers a meta-analysis of behaviour and health outcomes for physical activity interventions amongst healthy ethnic minority adults. An article in the European Journal of Public Health examines the economic appraisal behind NICE's guidance on environmental interventions to promote physical activity.

Born in Bradford

Mining data from the Born in Bradford cohort study, a team from the University of Leeds assesses how the association between maternal mental health and infant growth differs between ethnic groups. A study of women in the north west of England considers the effects of prenatal depression on infant outcomes amongst British Pakistani women. Another output from Born in Bradford tests the diagnostic accuracy of case-finding questions to identify perinatal depression. Finally, a team from the University of York's Mother and Infant Research Unit uses qualitative data to tailor public health messages about breastfeeding to meet the needs of British Bangladeshi women.

Place matters

Diabetes is signficantly more prevalent amongst the poorest in the population than the richest. A handful of recent studies examine how the disease affects people in more deprived neighbourhoods. From the US the SEARCH for diabetes in Youth study looks at prevalence of type 1 diabetes amongst young people. Research from Sweden assesses incidence of coronary heart disease amongst people with diabetes. The Diabetes Study of Northern California (DISTANCE) takes a look at the association between neighbourhood deprivation and cardiometabolic risk factors amongst adults with diabetes. Work carried out by the Centre for Primary Care and Public Health at St Barts in London considered ethnic differences in glycaemic control amongst people with type 2 diabetes.

Deciding to make a difference

As England's public health system is on the brink of enormous change, a timely study of how public health decisions are made comes from a team at Liverpool University. Taking cardiovascular disease as a case study, researchers looked at decision-making by healthcare and public service professionals in an effort to reduce health inequalities. A study in the European Journal of Public Health compares Scotland and Belgium's policies to tackle ethnic inequalities in health, in which Scotland is shown to have played the better game (score: Belgium 1 Scotland 4, the study's authors claim).

Screen daze

A special issue of Ethnicity and Health provides a survey on haemoglobin disorders. Articles include a consideration of the ethical issues related to screening , familial influence in screening and the implications of living with sickle cell disease.

Cancer survival rates

The King's Fund considers the UK's record on cancer survival and the government's Cancer outcomes strategy. The report looks at variations in survival rates, where there remains a notable north-south divide and significant variations for some ethnic groups. However one particularly strong variation is in the survival rates of older people, where the UK lags significantly behind other European countries, especially for lung, ovarian and colorectal cancer. Focus for improvement, the report stresses, should be on reducing delays in diagnosis and improving access to radiotherapy and surgery, as well as primary prevention. Tackling health inequalities and addressing cancer care for older people will also improve cancer outcomes.

Smoking Cessation

While smoking has declined amongst the UK population, prevalence amongst ethnic minority groups has not reduced at the same rate, a briefing from the Race Equality Foundation observes. As well as setting out the demographics and providing some examples of cessation interventions, the briefing also gives a helpful overview of smokeless tobacco products used by ethnic minority groups in the UK.

Drug and alcohol round-up

From the Department for Education, a cost benefit analysis of specialist drug and alcohol services for young people. Key findings from the Alcohol Harm Reduction National Support Team visits up to the end of the programme in March this year focus substantially on organisational and leadership aspects with emphasis on design of services, integration and assessment. The Journal of Epidemiology and Community Health includes a study on the ethnic density effect on alcohol use amongs ethnic minority people in the UK.

Diabetes care

Ethnicity disparities in diabetes management are starting to be addressed effectively, according to a study of patients with diabetes in North West London. The study's authors conclude that, along with specific attendtion being paid to South Asian groups, all ethnic groups in the population benefit from recent quality improvement measures. A systematic review of physical activity and dietary interventions for people at risk of developing type 2 diabetes found that the most effective interventions were associated with higher levels of contact frequency and certain types of behaviour change techniques (goal-setting, self-monitoring)

Face to faith

A study of religious differences as represented in the Health Survey for England reveals patterns of health inequality and their relation to socio-economic status and ethnicity. Another article in Ethnicity and Health looks at how faith affects communication between healthcare professionals and Pakistani Muslim patients, focusing particularly on long-term conditions.

Ethnicity

NHS Evidence Ethnicity runs its Annual Evidence Update from 18-22 October. This round-up of the year's research highlights the much discussed topic of rising breast cancer rates in South Asian women, along with carers from BME communities, end of life care and healthcare for torture survivors.

Motivating factors

There's been a lot of attention in the literature to uptake of cancer screening, especially uptake of breast cancer screening. A review published in Quality in Primary Care considers poor uptake amongst British South Asian women, as compared with the general UK population. A critical examination of information brochures provided to women about to undergo screening appears in the European Journal of Public Health, looking at brochures issued in Germany, Italy, Spain and France.

Road injuries, ethnicity and location

An article in the latest issue of Health and Place looks at ethnic as well as socio-economic inequalities in road injuries to children. Researchers examining data from London found that children categorised as "Black" had higher injury rates than their White or Asian counterparts. BBC News reports on road accident deaths over the past decade, featuring a mapping tool.

Uncovering the evidence

NHS Evidence - diabetes has published its round-up of systematic reviews on the subject. Another Annual Evidence Update is provided by NHS Evidence - Ethnicity and Health; topics include obesity and South Asian children and using analysis of cancer by ethnicity to improve commissioning.