Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community:a cross-sectional study

OBJECTIVE—The purpose of this study was to compare prevalence and risk factors for diabetic retinopathy among U.K. residents of South Asian or white European ethnicity. RESEARCH DESIGN AND METHODS—This was a community-based cross-sectional study involving 10 general practices; 1,035 patients with type 2 diabetes were studied: 421 of South Asian and 614 of white European ethnicity. Diabetic retinopathy, sight-threatening retinopathy, maculopathy, and previous laser photocoagulation therapy were assessed after grading of retinal photographs. Data were collected on risk factors including age, duration, and treatment of diabetes, blood pressures, serum total cholesterol, and A1C. RESULTS—Patients of South Asian ethnicity had significantly higher systolic (144 vs. 137 mmHg, P < 0.0001) and diastolic (84 vs. 74 mmHg, P < 0.0001) blood pressure, A1C (7.9 vs. 7.5%, P < 0.0001), and total cholesterol (4.5 vs. 4.2 mmol/l, P < 0.0001). Diabetic retinopathy was detected in 414 (40%) patients (189 South Asian [45%] versus 225 white European [37%]; P = 0.0078). Sight-threatening retinopathy was detected in 142 (14%) patients (68 South Asian [16%] versus 74 white European [12%]; P = 0.0597). After adjustment for confounders, there were significantly elevated risks of any retinopathy and maculopathy for South Asian versus white European patients. CONCLUSIONS—Patients of South Asian ethnicity had a significantly higher prevalence of diabetic retinopathy and maculopathy, with significantly elevated systolic and diastolic blood pressure, A1C, and total cholesterol; lower attained age; and younger age at diagnosis. Earlier onset of disease and higher levels of modifiable risk factors make early detection of diabetes, annual referral for retinal screening, and intensive risk factor control key elements in addressing this health inequality.

Premature cardiovascular events and mortality in south Asians with type 2 diabetes in the United Kingdom Asian Diabetes Study - effect of ethnicity on risk

Background/Aim - People of south Asian origin have an excessive risk of morbidity and mortality from cardiovascular disease. We examined the effect of ethnicity on known risk factors and analysed the risk of cardiovascular events and mortality in UK south Asian and white Europeans patients with type 2 diabetes over a 2 year period. Methods - A total of 1486 south Asian (SA) and 492 white European (WE) subjects with type 2 diabetes were recruited from 25 general practices in Coventry and Birmingham, UK. Baseline data included clinical history, anthropometry and measurements of traditional risk factors – blood pressure, total cholesterol, HbA1c. Multiple linear regression models were used to examine ethnicity differences in individual risk factors. Ten-year cardiovascular risk was estimated using the Framingham and UKPDS equations. All subjects were followed up for 2 years. Cardiovascular events (CVD) and mortality between the two groups were compared. Findings - Significant differences were noted in risk profiles between both groups. After adjustment for clustering and confounding a significant ethnicity effect remained only for higher HbA1c (0.50 [0.22 to 0.77]; P?=?0.0004) and lower HDL (-0.09 [-0.17 to -0.01]; P?=?0.0266). Baseline CVD history was predictive of CVD events during follow-up for SA (P?ethnicity specific targets and effective treatments are needed if these inequalities are to be reduced.

Place, ethnicity and poverty in England’

Examination of the relationship between ethnicity, poverty and place has tended to focus on the spatial distribution of minority ethnic groups. This summary paper reviews some key themes in this literature, in order to review the following key questions: •Where are different ethnic groups located, and how does this location relate to their experience of poverty? •Is clustering a good or bad thing, and what is the role of location – regardless of concentration – in terms of impacts on access to housing, employment, and other resources? However, it is notable that existing research in this area continues to present ethnicity as a factor that shapes outcomes only for minority ethnic groups. A wider discussion increasingly recognises the working of ethnicity in the lives of majority communities. Some of the most consistently impoverished areas in Britain, for example, are in regions with relatively small minority ethnic communities. For example, examinations of poverty in Cornwall (Cemlyn, et al., 2002) and Wales (Kenway and Palmer, 2007) identify longstanding concentrations of poverty and social exclusion among relatively static populations. Instead of assuming that ethnic identity influences propensity to poverty when concentrated in particular places, the experiences of Cornwall and Wales encourage us to consider the manner in which places of poverty also have an ethnic character and the impact of this in the wider experience of poverty. In what follows, and in order to reflect the existing literature, we review key points in the debate about the spatial concentration of minority ethnic groups and the impact of this concentration on experiences of poverty. Where possible, we seek to extend these ideas to consider possible implications for spaces of poverty characterised by concentrations of majority ethnic groups.

Negotiating ethnicity, class, and gender:German associational culture in Glasgow 1864-1914

One feature of nineteenth-century German migrant communities was a dense network of religious and secular ethnic institutions in virtually all destination countries. The article is a microhistorical study of a representative German community in Britain. Ethnic institutions in Glasgow included two protestant congregations and a variety of associations fostering sociability, culture and philanthropy. The institutions served as a platform to negotiate questions of ethnicity, class and gender. They were mostly financed by a small elite within the German business community which, in turn, used them to exercise power and confirm social stratification. In the pre-war years, ethnic life was increasingly permeated by nationalism. © 2013 Copyright Taylor and Francis Group, LLC.

Everyday ethnicity in Sri Lanka:up-country Tamil identity politics

Everyday ethnicity in Sri Lanka: up-country Tamil identity politics, by Daniel Bass, Abingdon, Routledge, 2012, 248 pp., ISBN 978-0-451-52624-1

Culture, ethnicity and migration after communism:the Pontic Greeks

This book addresses the issue of emerging transnationalism in the conditions of post-socialism through focussing on migrants’ identity as a social construction resulting from their experience of the ‘transnational circuit of culture’ as well as from post-Soviet shifts in political and economic conditions in their home regions. Popov draws upon ethnographic research conducted among Greek transnational migrants living on the Black Sea coast and in the North Caucasus regions of Russia who have become involved in extensive cross-border migration between the former Soviet Union (the Russian Federation, Kazakhstan and Georgia) and Greece (as well as Cyprus). It is estimated that more than 150,000 former Soviet citizens of Greek origin have resettled in Greece since the late 1980s. Yet, many of those who emigrate do not cut their connections with the home communities in Russia but instead establish their own transnational circuit of travel between Greece and Russia. This study demonstrates how migrants employ their ethnicity as symbolic capital available for investment in profitable transnational migration. Simultaneously they rework their practices of family networking, property relations and political participation in a way which strengthens their attachment to the local territory. The findings presented in the book imply that the social identities, economic strategies, political practices and cultural representation of the Russian Greeks are all deeply embedded in the shifting social and cultural landscape of post-Soviet Russia and extensively influenced by the global movement of ideas, goods and people.

Higher education, equality & ethnicity:the attainment gap – what should we be doing?

This brief paper draws upon part of the findings of a HEA Sponsored evaluation of work conducted in 8 Universities across UK aimed at addressing the attainment gap between BME and White students. Following a grounded theory approach, semi-structured interviews with staff at each of the institutions were analysed and three main themes identified: Organisational Sensitivities: Language: and, Ownership. This paper provides a brief discussion of the issues identifying two areas where positive change is needed in institutional practice. The conclusion highlights the complexities of the underlying issues impacting and shaping the Attainment Gap before reaffirming the need to identify and evaluate which interventions are most likely to be transferable across the Sector so as to address the issues and thus enhance the experiences of all students.