COMMON AILMENTS AMONGST BLACK, ASIAN, MINORITY ETHNIC COMMUNITIES IN BEDFORD © ACCM (UK) September 2015 Supporting communities, enterprising minds and active citizens © ACCM (UK) September 2015 Nobody is allowed to disseminate the information in this report in any form without a written permission from: ACCM (UK) 3A Woburn Road Bedford MK40 1EG Telephone: +44 (0)1234 356 910 Mobile: +44(0)7712482568 Email: [email protected] Website: www.accmuk.com Contents Acknowledgement 1 Methodology 2 Key Findings 3 SECTION 1: ETHNICITY AND HEALTH INEQUALITIES PART 1: DEFINITION AND INEQUALITIES  People and Their Ethnic Origins 4  Ethnic Health Inequalities 5  Tackling ethnic health inequalities 6 PART 2: COMMON ILLNESS & CONDITIONS  Diabetes 7  High Blood Pressure – Hypertension 10  Arthritis 12 SECTION 2: SURVEY ANALYSIS 15 PERSONAL DETAILS & AILMENT TYPES  Activities or events attended by respondents 16  Respondents were asked if you attended the events 17 how have you benefited?  Respondents who said they have not attended 18 ACCM (UK)’s activities because SECTION 3: RESPONDENTS AND CHRONIC ILLNESSES 19 SECTION 4: SUMMARY AND CONCLUSION 27 INDEX:  Questionnaire 29  References 32 Recent government initiatives to tackle health inequalities 33 ABOUNT ACCM (UK) 35 ACKNOWLEDGEMENTS First, we would like to thank all the people who volunteered to participate in this research. Without them, it would have not been possible to identify and substantiate the ailments that were ‘common’ to Black, Asian and Minority Ethnic (BAME) people of Bedford. We are aware that some of you are often cynical about research as if you feel it never make any difference and therefore would not like to be used as ‘research subjects’. We understood, because researchers have used you in the past for their own theoretical benefits, without any positive feedback. As we promised those of you who signified that you would like to be involved in the health needs of BAME people, we shall contact you with results of the findings and discuss how we can implement your suggestions in future programmes and events. You have told us that you were much more interested in ‘what we should do in Bedford about the health of BAME people. We also thank all the members of our research team made up of staff, volunteers and supported form various businesses who were willing to hand out questionnaires to their clients and monitor completion. All those involved did a wonderful job. We should acknowledge the support from our Funders including Big Lottery Fund, Bedford Borough Council, Awards for All, St Andrews Church, Bedfordshire and Luton Community Foundation and others. 1 BACKGROUND  ACCM (UK) Charity commissioned itself to do research on the health needs and concerns of Black, Asian and Minority people mostly living in Castle, Queens Park, Cauldwell and Harpur Wards in Bedford. Some major work done locally on ‘black Asian and Minority Ethnic people’ before this research only mentioned BAME in passing and has not been specific about ailments suffered by these people. OBJECTIVES  The core objective was to find out the health needs and concerns of BAME people firstly in Bedford and then in the near future the UK overall.  To discover the common ailments that face BAME people in the Bedford.  To discover the treatment that BAME people are offered and how effective these treatments are in treating the ailments.  To find out what BAME people think are reason why they suffer the listed ailments and ways to tackle them.  We were only looking at the needs and ailments of BAME people and not the views of stake holders, service providers or professionals whose feedback can be found in our independent evaluations reports 2014 and 2015. METHODOLOGY  Desk research Detailed desk research was carried out in order to review what has been said on ‘common ailments’ in relation to BAME people.  Fieldwork - Staff and volunteers were given trained in research methods to conduct the fieldwork. They carried out interviews during ACCM (UK)’s activities, events or talks held at ACCM (UK)’s offices, religious and community centres. All our users who were willing to take part in the survey were given the opportunity. We tried to cover both sexes and age ranges. - We also made use our links with Religious and Community leaders who helped encourage some respondents to undertake the survey as we often run some of our activities in these settings.  We also made self-completion questionnaires available with our local business supporters to help capture wider BAME people including those who have never heard of or used ACCM (UK)’s services or events. these places.  One staff and volunteer held two discussion groups with a groups of women who have little understanding or are unable to read or write in English to give them an opportunity to participate in the survey.  Analysis and Interpretation - The Director who has knowledge and expertise in research analysis did the analysis and interpretation of data supported the Administrative Officer. 2 KEY FINDINGS  Common Ailments Amongst Black, Asian and Minority People Report is a research project that has been conceived by ACCM (UK). Through information gathered in Bedford, the project highlights the most prevalent health problems amongst BAME people, provides definitions and possible causes of these problems, and proposes several solutions.  According to other scholars, the most common and serious ailments suffered by BAME people particularly (but by no means exclusively) are Diabetes, Hypertension and Arthritis. In response to this, each of these ailments is defined and briefly discussed and the present project highlights confusion surrounding the racial implications of each.  However, most of the project discusses the results of the research conducted in Castle, Cauldwell, Queens Park and Harpur Wards in Bedford. The aim of this research was to discover ailments affecting BAME people from across the ranges of age and sex. As a result of these findings, the rest of the document concentrates on Diabetes, Hypertension and Arthritis, for these were found to be the most common problems although we do touch on other ailments their possible link to Diabetes.  The project’s most telling findings are that there is a strong link between Diabetes and Hypertension, that the majority of those questioned did not suffer from their respective illness before arriving in the UK, and that the information and treatment received by sufferers is often inadequate. These findings lead in several proposals regarding what can be done by both the authorities and the black community itself.  We recommend that more research into the causes of the illnesses that affect BAME people more than the general population must be conducted. Ensuring that any information gained was to be passed onto the BAME community in order to help current and future sufferers. Although there are currently various health promotion authorities, such as Clinical Commissioning Groups formerly Primary Care Trusts, Public Health and Health Watch, that are intended for this purpose, they are clearly not succeeding as almost all the sufferers questioned had never used them or heard of them. Also, a suggestion is made for more health professionals of BAME background, although there are now many doctors of Asian background they are mainly form India, in health care to improve understanding of BAME people’s ailments as it appears that currently many white doctors are unaware of the particular needs of BAME people.  Nonetheless, the overriding message in the project is that the dietary aspects of Western life and the weather are unhealthy for BAME people. Many of the ailments now being endured by those questioned have only arisen since they arrived in the UK though many were born and brought up in the UK the family diet affect their health. It is concluded that traditional food, healthier cooking methods and active lifestyles must be promoted amongst the BAME community so they rediscover healthy lifestyle, reduce health inequality for future generations. 3 SECTION 1: ETHNICITY AND HEALTH INEQUALITIES PART 1: DEFINITION AND INEQUALITIES People and Their Ethnic Origins ACCM (UK) is a community-based organisation that, among other things, raises awareness of issues that affect BAME people and has undertaken this research to complement our two independent evaluation reports provided by Bedford Rural Communities Charity (BRCC) April 2014 and Egemole & Co Accountants June 2015. Since 2009 ACCM (UK) has been working with Bedford’s BAME communities and there has been throughout this period there has been claims in reports that there are higher prevalence of certain ill-health amongst BAME people than white communities especially in amongst those residing in Queens Park, Castle, Cauldwell and Harpur Wards. Ethnicity results from many aspects of difference which are socially and politically important to the individual in the UK. These include race, culture, religion and nationality, which impact on individual person’s identity and how they are seen by others. People identify with ethnic groups at many different levels. They may see themselves as British, Asian, Indian, Punjabi or Black British at different times and in different circumstances that suit them. By ethnicity, in this survey, we have decided to make the categories simple and similar to those used by Bedford Borough Council and breaking them down according to allow data to be collected focusing on our users or beneficiaries instead of the general Bedford population. The categories used include Pakistani, Indian, Bangladeshi, Africans, African Caribbean, Mixed Asian, British White, Black Caribbean and Mixed Caribbean / African ACCM (UK) has done this research on BAME communities in some Wards in Bedford. We hope that what we have found out will benefit other people outside the Borough. The present investigation will be made available to people in the community and beyond. It has brought together the views, opinions and activities of our users / beneficiaries who want to share them to promote the health of other minority and disadvantaged people. Our Health Promotion & Research Programme embraces the impact of health and wellbeing programmes and activities we organise and run including nutrition and healthy eating a person’s well-being. These activities run in community centres or at ACCM (UK)’s offices are to empower people to change their lifestyles to improve their health and that of their families. Black, Asian and minority ethnic (BAME) people generally have worse health than the overall population, although some BAME people fare much worse than others, and patterns vary from one health condition to the next.1 Several local and central Government policies have aimed at tackling health inequalities in recent years, although to date, ethnicity has not been a consistent focus. This research is to establish whether there is some truth in these claims by undertaking a mini survey of Black, Asian and Minority Ethnic (BAME) people living in some Wards in Bedford who attend our activities and events. This in-house survey will also help establish if what we are doing is actually making a difference to our users, to find out what are their main ailments or health concerns and whether they are receiving appropriate support and treatment. 1 Ethnicity and Health: Parliamentary Office of Science and Technology. January 2007 Number 276 4 Ethnic Health Inequalities Health Inequalities are differences in health status that are driven by inequalities in society. Health is shaped by many different factors, such as lifestyle, material wealth, educational attainment, job security, housing conditions, psycho-social stress, discrimination and appropriate user friendly health services. Health inequalities represent the cumulative effect of these factors over the life-course; they can be passed on from one generation to the next through maternal or social community influences. Health inequalities reflect inequalities in the distribution of health determinants, such as access to good housing, transport, education and employment opportunities. McNaught (1984:10) believes that some illnesses can be present in all peoples including Strokes, cancers and hernia. Health Surveys for England, and in Bedford itself, show that BAME groups as a whole are more likely to report ill-health and that ill-health among BAME people starts at a younger age than in the White British. There is more variation in the rates of some diseases by ethnicity than by other socio-economic factors2. However, patterns of ethnic variation in health are extremely diverse, and inter-link with many overlapping factors. Some BAME groups experience worse health than others. For example, research studies on health inequalities commonly show that Pakistani, Bangladeshi and Black-Caribbean people report the poorest health, with Indian, East African Asian and Black African people reporting the same health as White British while Chinese people report better health. When it comes to a specific group, such as black people, the situation may change. In addition, Caribbean people are said to experience greater levels of mental illness. It is said that Hypertension and its complications are responsible for nearly twice as many deaths among Caribbean-born people than the general population. Moreover, it has been said that 40 % of Caribbean people with Hypertension also have Diabetes. (High blood pressure – Hypertension, HEA publication, London p.3) Chinegwendoh states that prostate cancer is much more common among black people than other races. (Frank Chinegwendoh, 2013)3. According to Prostate Cancer UK 1 in 4 black men will get prostate cancer in their lives4. Going by what the author says ″various likely reasons” are attributed to this disease, especially diet. Chinegwendoh argues that vegetarians have a lower rate of prostate Cancer than meat eaters do. However, he does not explain which hormones he believes Cancer is linked to in black men. He also speculates that it could be linked to sexual activities. That, the more sexual partners you have, the higher risk later in life of developing prostate Cancer. It is common for African men to have several wives though there should be further investigations or research on this issue. Due to inequalities in health, the health of black people is not given priority in the NHS. Chinegwendoh believes that though Hypertension (See below) and tuberculosis have been given some attention, other illnesses have not. 2 Bhopal, R, Race, Ethnicity and Health in Multicultural Societies, Oxford 2007 3 www.youtube.com/watch?v=7fi9Qdl0900, 2013 – Uploaded by Voxafrica 4 A Black man’s risk: Prostate Cancer UK – July 2015 5 Tackling ethnic health inequalities The Acheson Inquiry made three recommendations for reducing ethnic health inequalities. These were that: • Policies on reducing socio-economic inequalities should consider the needs of BME groups; • Services should be sensitive to the needs of BME groups and promote awareness of their health risks; • The needs of BME groups should be specifically considered in planning and providing health care. However, ethnicity has not been a consistent focus of health inequalities policies to date and few policies have been specifically targeted at BME groups. This is evident in the recent Bedford Borough Joint Strategic Needs Assessment (JSNA) 5 report issues in March 2015 or The Public Health Report on Mental Health 2015. Two important cross-cutting factors affecting the feasibility and likelihood of action on ethnic health inequalities are the availability of data on ethnicity, and legal obligations towards racial equality. ACCM (UK) hopes that this mini survey on ailments amongst minority people in Bedford will go some way to address the problem on data. PART 2: COMMON ILLNESS & CONDITIONS In this section we shall talk briefly on some illnesses that came on top of the list of common ailments amongst our users who helped complete the survey. Table 1: Showing Listed Ailments: Ailment No who listed % Bronchitis 7 2 Cancer 8 3 Sickle Cell 13 5 Skin disease 13 5 Dementia 14 5 Stroke 16 6 Heart Disease 17 6 Mental Illness 22 8 Hearing problems 22 8 Asthma 23 8 Eye problems 23 8 Arthritis 31 11 Blood pressure (Hypertension) 34 12 Diabetes 39 14 5 Joint Strategic Needs Assessment, March 2015, Bedford Borough Council 6 Graph 1: Showing listed Ailments by percentage Diabetes Blood pressure (Hypertension) Arthritis Eye problems Asthma Hearing problems Mental Illness Heart Disease Stroke Dementia Skin disease Sickle Cell Cancer Bronchitis 0 10 20 30 40 50 DIABETES • This came top of the list as the most common ailment amongst our respondents with 39 (14%) out of 56 listing it. This tallies responses or feedback we have received from our users overtime through our work in all Wards we have covered (Queens park, Cauldwell, Castle and Harpur). Every user has informed us that either they or someone in their extended family has been diagnosed with diabetes. Majority said they had diabetes Type II. Although majority of participants who listed diabetes as an ailment were of Indian origin, Africans, African Caribbean and Bangladeshi people also listed the ailment with majority female listing it. • This is a condition in which the pancreas (an organ that produces digestive juices) does not produce enough insulin. This deficiency leads to too much sugar in the blood and body tissues. It can affect people of any age and both sexes, especially if they are obese. Symptoms include thirst, fatigue, and weight loss, frequent urination, itching genitals and poor vision. • Diabetes is a medical group of chronic disease in which the body fails to complete the conversion of glucose into energy. Women, the overweight, those with a family history of Diabetes, people over forty and those of African and Asian descent are most likely to get Diabetes. The most common forms of Diabetes are Type I and Type II. In Type I, the person does not produce enough insulin to meet the supply of glucose. In the absence of insulin, the resulting metabolic abnormalities can be quite severe. Type I Diabetes usually develops quickly and is common in children and young adult. Diet, exercise and close monitoring of the blood sugar with insulin therapy usually treat it. Type II Diabetes usually develops slowly over time. Obesity and a family tendency towards Type II seem to be contributing factors, as are stress and smoking. 7