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Douglass CH, Block K, Eghrari D, Horyniak D, Hellard ME, Lim MSC. "You have to drink with a little bit of shame": Alcohol and other drug use among young people from migrant and ethnic minority backgrounds in Melbourne, Australia. J Ethn Subst Abuse 2024; 23:340-364. [PMID: 35758222 DOI: 10.1080/15332640.2022.2091703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Migrant and ethnic minority groups are underrepresented in alcohol and other drug (AOD) research. This qualitative study explored AOD use among young people from migrant and ethnic minority backgrounds in Melbourne, Australia. We conducted one focus group and 16 interviews and thematically analyzed data drawing on the social-ecological model of health. Theme one showed AOD use was considered a "normal" part of youth identity, particularly for participants who had grown up with peer groups in Australia. Theme two highlighted participant's sense of responsibility to meet expectations and make informed decisions about AOD use to protect themselves and their friends. Theme three highlighted participant's risk of experiencing AOD-related stigma through negative stereotypes and fear of consequences within families and communities, particularly among female participants. Participants' perceptions and experiences differed by individual factors, interpersonal relationships, AOD accessibility across settings and broader gender, cultural and religious norms. Interventions developed with young people from migrant and ethnic minority backgrounds are needed to target the social-ecological factors underpinning AOD use, particularly stigma.
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Affiliation(s)
- Caitlin H Douglass
- Burnet Institute, Melbourne, Victoria, Australia
- University of Melbourne, Carlton, Victoria, Australia
| | - Karen Block
- University of Melbourne, Carlton, Victoria, Australia
| | - Donya Eghrari
- University of Melbourne, Carlton, Victoria, Australia
| | - Danielle Horyniak
- Burnet Institute, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Margaret E Hellard
- Burnet Institute, Melbourne, Victoria, Australia
- University of Melbourne, Carlton, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, Victoria, Australia
- University of Melbourne, Carlton, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
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2
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Wells J, Manera KE, Kaur K, Smith BJ. Supporting Physical Activity Maintenance in Older Adults Following Supervised Group Exercise: A Mixed-Methods Study Among Culturally Diverse Older Adults. J Appl Gerontol 2024:7334648241230876. [PMID: 38323912 DOI: 10.1177/07334648241230876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Physical activity (PA) is important for prevention of falls and chronic disease in older adults. We aimed to examine the interrelated influences upon PA in culturally diverse older adults who completed a short-term exercise program, to inform maintenance strategies, using a mixed-methods design. Eighty-two past participants from the "Stepping On"© program were surveyed examining ongoing participation, social and cognitive determinants of PA, mental and physical functioning, and fear of falls. Semi-structured interviews were undertaken with 34 respondents regarding enablers and barriers, cultural factors, and preferences for PA. Data were collected in English, Chinese, Arabic, Punjabi, or Hindi. Cultural factors minimally affected PA participation. There was low perceived availability of PA opportunities. Health difficulties not only discouraged but also motivated participation. Social connection was a facilitator and could be used to support maintenance. Older adults may benefit from assistance in accessing PA opportunities and clinical guidance about the benefits of ongoing PA.
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Affiliation(s)
- Jessica Wells
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Karine E Manera
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
- Research and Education Network, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Kitty Kaur
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Ben J Smith
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
- Research and Education Network, Western Sydney Local Health District, Westmead, NSW, Australia
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Zimbudzi E, Lo C, Ranasinha S, Usherwood T, Polkinghorne KR, Fulcher G, Gallagher M, Jan S, Cass A, Walker R, Russell G, Johnson G, Kerr PG, Zoungas S. A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds. Health Expect 2023; 26:2584-2593. [PMID: 37635378 PMCID: PMC10632627 DOI: 10.1111/hex.13859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/15/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Little is known about the relationship between patients' cultural and linguistic backgrounds and patient activation, especially in people with diabetes and chronic kidney disease (CKD). We examined the association between culturally and linguistically diverse (CALD) background and patient activation and evaluated the impact of a codesigned integrated kidney and diabetes model of care on patient activation by CALD status in people with diabetes and CKD. METHODS This longitudinal study recruited adults with diabetes and CKD (Stage 3a or worse) who attended a new diabetes and kidney disease service at a tertiary hospital. All completed the patient activation measure at baseline and after 12 months and had demographic and clinical data collected. Patients from CALD backgrounds included individuals who spoke a language other than English at home, while those from non-CALD backgrounds spoke English only as their primary language. Paired t-tests compared baseline and 12-month patient activation scores by CALD status. RESULTS Patients from CALD backgrounds had lower activation scores (52.1 ± 17.6) compared to those from non-CALD backgrounds (58.5 ± 14.6) at baseline. Within-group comparisons showed that patient activation scores for patients from CALD backgrounds significantly improved by 7 points from baseline to 12 months follow-up (52.1 ± 17.6-59.4 ± 14.7), and no significant change was observed for those from non-CALD backgrounds (58.5 ± 14.6-58.8 ± 13.6). CONCLUSIONS Among patients with diabetes and CKD, those from CALD backgrounds report worse activation scores. Interventions that support people from CALD backgrounds with comorbid diabetes and CKD, such as the integrated kidney and diabetes model of care, may address racial and ethnic disparities that exist in patient activation and thus improve clinical outcomes. PATIENT OR PUBLIC CONTRIBUTION Patients, caregivers and national consumer advocacy organisations (Diabetes Australia and Kidney Health Australia) codesigned a new model of care in partnership with healthcare professionals and researchers. The development of the model of care was informed by focus groups of patients and healthcare professionals and semi-structured interviews of caregivers and healthcare professionals. Patients and caregivers also provided a rigorous evaluation of the new model of care, highlighting its strengths and weaknesses.
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Affiliation(s)
- Edward Zimbudzi
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Monash Nursing and MidwiferyMonash UniversityMelbourneVictoriaAustralia
- Department of NephrologyMonash HealthMelbourneVictoriaAustralia
| | - Clement Lo
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Diabetes and Vascular Medicine Unit, Monash HealthMelbourneVictoriaAustralia
| | - Sanjeeva Ranasinha
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Tim Usherwood
- The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia
- Department of General Practice, Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia
| | - Kevan R. Polkinghorne
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Department of NephrologyMonash HealthMelbourneVictoriaAustralia
- School of Clinical SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Gregory Fulcher
- Department of Diabetes, Endocrinology and Metabolism, Royal North Shore HospitalUniversity of SydneySydneyNew South WalesAustralia
- Northern Clinical SchoolUniversity of SydneySydneyNew South WalesAustralia
| | - Martin Gallagher
- The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia
- Concord Clinical SchoolUniversity of SydneySydneyNew South WalesAustralia
| | - Stephen Jan
- The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia
| | - Alan Cass
- The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia
- Menzies School of Health ResearchCharles Darwin UniversityCasuarinaNorthern TerritoryAustralia
| | - Rowan Walker
- Department of Renal MedicineAlfred HealthMelbourneVictoriaAustralia
| | - Grant Russell
- School of Primary Health CareMonash UniversityMelbourneVictoriaAustralia
| | - Greg Johnson
- Diabetes AustraliaCanberraAustralian Capital TerritoryAustralia
| | - Peter G. Kerr
- Department of NephrologyMonash HealthMelbourneVictoriaAustralia
- School of Clinical SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Sophia Zoungas
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Diabetes and Vascular Medicine Unit, Monash HealthMelbourneVictoriaAustralia
- The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia
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Renzaho AMN. The Lack of Race and Ethnicity Data in Australia-A Threat to Achieving Health Equity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085530. [PMID: 37107811 PMCID: PMC10138746 DOI: 10.3390/ijerph20085530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Collecting meaningful race and ethnicity data must be part of the national agenda and must be one of its primary objectives in order to achieve public good and support public interests. Yet, Australia does not collect data on race and ethnicity, and prefers the use of collective cultural groups, whose information is not consistently collected and reported at all levels of government and service delivery. This paper examines the current discrepancies in race and ethnicity data collection in Australia. The paper begins with examining the current practices related to collecting race and ethnicity data and then moves on to examine the various implications and public health significance of not collecting data on race and ethnicity in Australia. The evidence suggests that (1) race and ethnicity data matter, are imperative to ensuring proper advocacy and to reducing inequities in health and social determinant factors; (2) that White privilege is constructed as realized or unrealized personal and systemic racism; and (3) the use of non-committal collective terminologies makes visible minorities invisible, leads to the distorted allocation of governmental support, and legitimises and institutionalises racism and othering, hence perpetuating exclusion and the risk of victimisation. There is an urgent need for the collection of customized, culturally competent racial and ethnicity data that can be consistently integrated into all policy interventions, service delivery and research funding across all levels of governance in Australia. Reducing and eliminating racial and ethnic disparities is not only an ethical, social, and economic imperative, but must also be a critical item on the national agenda. Bridging the racial and ethnic disparities will require concerted whole-of-government efforts to collect consistent and reliable data that depict racial and ethnic characteristics beyond collective cultural groupings.
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Affiliation(s)
- Andre M N Renzaho
- Translational Health Research Institute, School of Medicine, Campbelltown Campus, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571, Australia
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James PB, Renzaho AMN, Mwanri L, Miller I, Wardle J, Gatwiri K, Lauche R. The prevalence of anxiety, depression, and post-traumatic stress disorder among African migrants: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114899. [PMID: 36252417 DOI: 10.1016/j.psychres.2022.114899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evidence exists reporting a high mental health burden among migrants globally. However, there is no global estimate of mental ill-health among African migrants despite their adverse pre-migration environments. This systematic review and meta-analysis summarise the current scholarship regarding the prevalence of anxiety, depression and Post-traumatic Stress Disorder (PTSD) in the global African migrant population. METHODS We searched six databases (Medline (EBSCOHost), PsycINFO (EBSCOHost), Web of Science, PubMed, Scopus and Cumulative Index to Nursing and Allied Health (CINAHL) from 1st January 2000 to 31st August 2021. We screened retrieved articles using strict inclusion and exclusion criteria. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools. Random-effects meta-analyses were employed using DerSimonian and Laird estimator based on inverse variance weights. The I2 statistic was used to measure heterogeneity. RESULTS Our search retrieved 1091 articles, of which 46 were included representing a total of 28,367 African migrants. The weighted mean age of African migrants was 32.98 years, and nearly half were male (n= 12852, 45.31%). Among the included studies, almost nine out of ten (n=41, 89.1%) were cross-sectional studies. The pooled prevalence of anxiety, depression and PTSD was 34.60%;95%CI (26.30-43.00), 33.20%;95%CI (27.70-38.37) and 37.9%;95%CI (23.5- 52.4) respectively. Significant heterogeneity (I2 >98%) existed in the prevalence estimates for anxiety, depression, and PTSD. Sub-group analyses indicate a significantly higher prevalence of anxiety and depression but PTSD for studies conducted in Africa than outside Africa. Similarly, higher prevalence rates for anxiety, depression, and PTSD were seen in studies that used a screening tool than in those that used a diagnostic tool, although a significant difference was observed for depression only. CONCLUSION Despite significant heterogeneity among included studies, our systematic review and meta-analysis show a high prevalence of anxiety, depression, and PTSD among African migrants. Our findings underscore the need to develop and implement serious, culturally appropriate mental health interventions that address post-migration stressors that increase their risk of mental ill-health and successful integration into host communities.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Andre M N Renzaho
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lillian Mwanri
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia
| | - Ian Miller
- Sport and Exercise Science, Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
| | - Kathomi Gatwiri
- Centre for Children & Young People, Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
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Marcus K, Balasubramanian M, Short S, Sohn W. Culturally and linguistically diverse (CALD): terminology and standards in reducing healthcare inequalities. Aust N Z J Public Health 2021; 46:7-9. [PMID: 34902191 DOI: 10.1111/1753-6405.13190] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Kanchan Marcus
- Population Oral Health, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Madhan Balasubramanian
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Stephanie Short
- Discipline of Behavioural & Social Sciences in Health, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Woosung Sohn
- Population Oral Health, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, New South Wales
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Liem A, Renzaho AMN, Hannam K, Lam AIF, Hall BJ. Acculturative stress and coping among migrant workers: A global mixed-methods systematic review. Appl Psychol Health Well Being 2021; 13:491-517. [PMID: 33811751 DOI: 10.1111/aphw.12271] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/03/2021] [Accepted: 03/13/2021] [Indexed: 02/02/2023]
Abstract
No existing review has synthesized key questions about acculturation experiences among international migrant workers. This review aimed to explore (1) What are global migrant workers' experiences with acculturation and acculturative stress? (2) What are acculturative stress coping strategies used by migrant workers? And (3) how effective are these strategies for migrant workers in assisting their acculturation in the host countries? Peer-reviewed and gray literature, without time limitation, were searched in six databases and included if the study: focused on acculturative stress and coping strategies; was conducted with international migrant workers; was published in English; and was empirical. Eleven studies met the inclusion criteria. Three-layered themes of acculturation process and acculturative stress were identified as: individual layer; work-related layer; and social layer. Three key coping strategies were identified: emotion-focused; problem-focused; and appraisal-focused. These coping strategies were used flexibly to increase coping effectiveness and evidence emerged that a particular type of acculturative stress might be solved more effectively by a specific coping strategy. Migrant workers faced numerous challenges in their acculturative process. Understanding this process and their coping strategies could be used in developing research and interventions to improve the well-being of migrant workers.
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Affiliation(s)
- Andrian Liem
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Andre M N Renzaho
- School of Social Sciences, Western Sydney University, Penrith South, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Penrith South, NSW, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Vic, Australia
| | - Kevin Hannam
- University of Saint Joseph, Macau, China
- University of Johannesburg, Johannesbuurg, South Africa
- Nebrija University, Madrid, Spain
- Technological Higher Education Institute, Hong Kong, China
| | - Agnes I F Lam
- Department of Communication, Centre for Macau Studies, University of Macau, Macau, China
| | - Brian J Hall
- NYU Shanghai, Shanghai, China
- School of Global Public Health, New York University, New York, NY, USA
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8
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An Overview of Food Security Statuses in Afghan Refugees in Iran. NUTRITION AND FOOD SCIENCES RESEARCH 2021. [DOI: 10.52547/nfsr.8.2.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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9
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Arora A, Maharaj R, Naidu S, Chimoriya R, Bhole S, Nash S, Jones C. Views of Indian Migrants on Adaptation of Child Oral Health Leaflets: A Qualitative Study. CHILDREN-BASEL 2021; 8:children8010028. [PMID: 33430177 PMCID: PMC7825597 DOI: 10.3390/children8010028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 12/18/2022]
Abstract
The aim of this study was to gain insight on the views of Hindi-speaking mothers on readily available English language oral health education materials and to evaluate the acceptability of Hindi language adapted versions of these materials. This qualitative study is nested within an ongoing multi-centre birth cohort study in Greater Western Sydney, Australia. Following purposive selection of Hindi-speaking mothers (n = 19), a semi-structured interview was conducted. Two English leaflets were mailed to participants prior to the interview. The simplified English and translated Hindi versions of the leaflets were provided at the interview, and the participants were asked to compare and evaluate all three versions. Interviews were audio recorded, and thematic analysis was used to analyse data from interview transcripts. A majority of the participants reported a certain degree of difficulty in reading and comprehending oral health messages in Hindi. Although Hindi translations were accurate, mothers preferred the simplified English as opposed to the Hindi version. Visual illustrations and a simple layout facilitated the understanding of oral health messages. Developers of oral health education leaflets should thoroughly research their prospective user groups, particularly migrant populations, and identify the need for simplified or translated oral health education leaflets.
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Affiliation(s)
- Amit Arora
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; (R.C.); (S.N.)
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia;
- Correspondence:
| | - Roneel Maharaj
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia; (R.M.); (S.N.)
| | - Seemagni Naidu
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia; (R.M.); (S.N.)
| | - Ritesh Chimoriya
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; (R.C.); (S.N.)
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia;
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia; (R.M.); (S.N.)
| | - Simone Nash
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; (R.C.); (S.N.)
| | - Charlotte Jones
- Faculty of Medicine, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
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Joshi S, Jatrana S, Paradies Y. Tobacco smoking between immigrants and non-immigrants in Australia: A longitudinal investigation of the effect of nativity, duration of residence and age at arrival. Health Promot J Austr 2017; 29:282-292. [PMID: 30511489 DOI: 10.1002/hpja.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 10/16/2017] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Earlier research evidence suggests that there is a difference and over time change in the prevalence of tobacco smoking between immigrants and native-born population. This study investigates the differences in smoking among immigrants from English speaking (ESC) and non-English speaking (NESC) countries relative to native-born (NB) Australians, and how those differences change with duration of residence (DoR) and age at arrival (AA). METHODS Information on 12 634 individuals from the first twelve waves (2001-2012) of Household, Income and Labour Dynamics in Australia (HILDA) longitudinal survey was analysed using multilevel group-mean-centred mixed logistic regression models. Smoking status as an outcome was dichotomized as current vs non-current smokers. RESULTS After adjusting for covariates, relative to native-born respondents, there was no difference in the odds of smoking for English speaking countries immigrants, while immigrants from non-English speaking countries had lower odds of smoking. The smoking prevalence of immigrants from non-English speaking countries converged towards the native-born after 20 years of residence in Australia. The association between duration of residence and smoking was modified by age at arrival, with immigrants (combined ESC and NESC) who arrived as children or adolescents and had lived 20 years or longer were significantly more likely to smoke than native-born Australians. CONCLUSION The results suggest that the initially lower smoking prevalence among non-English speaking countries immigrants converges with that of native-born Australians after twenty years of residence, and immigrants (combined ESC and NESC) who arrived as children or adolescents more than 20 years ago were more likely to be smokers. SO WHAT?: Current health promotion and anti-smoking programs should ensure that immigrants from non-English speaking background have access to education and information about the hazards of tobacco consumptions and are aware of the available smoking cessation services. Efforts to prevent smoking uptake among NESC immigrants and those who arrive as children or adolescents and live longer than 20 years is especially important for tobacco control interventions.
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Affiliation(s)
- Suresh Joshi
- School of Humanities and Social Sciences, Faculty of Arts and Education, Deakin University, Geelong, VIC, Australia
| | - Santosh Jatrana
- Centre for Social Impact Swinburne, Swinburne University of Technology, Hawthorn, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC, Australia
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Renzaho AMN. Dissecting and customising the Childhood Obesity Prevention Advisory Council (COPAC): the development and application of a community engagement framework to improve childhood obesity prevention among migrant populations. Glob Health Action 2017; 10:1321822. [PMID: 28573912 PMCID: PMC5496055 DOI: 10.1080/16549716.2017.1321822] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Migrant communities in Australia bear a disproportionate childhood obesity burden. They also show poor engagement in obesity prevention initiatives which may contribute to widening obesity disparities. Community engagement has been shown to be effective in reducing health disparities by improving migrant communities’ participation in prevention programmes. Objective: This study aimed to develop a community engagement framework to improve childhood obesity prevention among migrants. Design: Based on the African Review Panel model and the Community-Based Participatory Research conceptual logic model, the Childhood Obesity Prevention Advisory Council (COPAC) framework was developed and established in four disadvantaged areas in Victoria, Australia. The COPAC included service providers and migrant community members from the same project’s site. Results: COPAC demonstrated several benefits including cross-organisational and multidisciplinary collaborations; understanding of the cultural barriers in childhood obesity prevention; enthusiasm from the COPAC members in addressing childhood obesity in their multicultural communities; equitable involvement, motivation, and empowerment of COPAC members in research development; and establishing organisational affiliations to foster long-term community involvement. This study also documented several challenges in community engagement including lack of prioritisation of migration-related childhood obesity disparities by the policymakers; staffing constraints among service providers leading to frequent disruptions in COPAC members’ contributions; and lack of adequate training and skill-building of bicultural workers. Conclusions: The COPAC model adopted a flexible and dynamic community engagement process to suit the ongoing needs of the migrant community which incorporated the existing talents and resources within the community. For effective community engagement of migrant communities, it is important for policymakers to develop the knowledge, capacity and skills of the bicultural migrant workforce. Integrating both service providers and migrant community members in the COPAC has demonstrated that a multifaceted community-led approach has the potential to reduce childhood obesity-related disparities in Australia.
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Affiliation(s)
- A M N Renzaho
- a Humanitarian and Development Studies, School of Social Sciences and Psychology , Western Sydney University , Penrith , NSW , Australia
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12
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Cyril S, Nicholson JM, Agho K, Polonsky M, Renzaho AM. Barriers and facilitators to childhood obesity prevention among culturally and linguistically diverse (CALD) communities in Victoria, Australia. Aust N Z J Public Health 2017; 41:287-293. [PMID: 28245512 DOI: 10.1111/1753-6405.12648] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/01/2016] [Accepted: 10/01/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Childhood obesity is rising among culturally and linguistically diverse (CALD) groups who show poor engagement in obesity prevention initiatives. We examined the barriers and facilitators to the engagement of CALD communities in obesity prevention initiatives. METHODS We used the nominal group technique to collect data from 39 participants from Vietnamese, Burmese, African, Afghani and Indian origins living in disadvantaged areas of Victoria, Australia. Data analysis revealed ranked priorities for barriers and facilitators for CALD community engagement in obesity prevention initiatives. RESULTS CALD parents identified key barriers as being: competing priorities in the post-migration settlement phase; language, cultural and program accessibility barriers; low levels of food and health literacy; junk food advertisement targeting children; and lack of mandatory weight checks for schoolchildren. Key facilitators emerged as: bicultural playgroup leaders; ethnic community groups; and school-based healthy lunch box initiatives. CONCLUSION This study has identified several policy recommendations including: the implementation of robust food taxation policies; consistent control of food advertising targeting children; improving CALD health literacy using bicultural workers; and matching health promotional materials with CALD community literacy levels. Implications for Public Health: These recommendations can directly influence public health policy to improve the engagement of CALD communities in obesity prevention services and ultimately reduce the widening obesity disparities in Australia.
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Affiliation(s)
- Sheila Cyril
- School of Social Sciences and Psychology, Western Sydney University, New South Wales.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria
| | | | - Kingsley Agho
- School of Science and Health, Western Sydney University, New South Wales
| | | | - Andre M Renzaho
- School of Social Sciences and Psychology, Western Sydney University, New South Wales
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Jaworski A, Brown T, Norman C, Hata K, Toohey M, Vasiljevic D, Rowe R. Developing a guide for community-based groups to reduce alcohol-related harm among African migrants. Health Promot J Austr 2017; 27:21-28. [PMID: 26726816 DOI: 10.1071/he15030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/15/2015] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Alcohol-related harm is an issue of concern for African migrant communities living in Australia. However, there has been little information available to guide workers in developing culturally sensitive health promotion strategies. Methods A three-step approach, comprising a literature review, community consultations and an external review, was undertaken to develop a guide to assist organisations and health promotion groups working with African migrant communities to address alcohol-related harms. Discussion There was a high level of agreement between the three steps. Addressing alcohol harms with African migrant communities requires approaches that are sensitive to the needs, structures and experiences of communities. The process should incorporate targeted approaches that enable communities to achieve their resettlement goals as well as strengthening mainstream health promotion efforts. Conclusions The resource produced guides alcohol harm prevention coalitions and workers from the first steps of understanding the influences of acculturation and resettlement on alcohol consumption, through to planning, developing and evaluating an intervention in partnership with communities. So what? This paper advances knowledge by providing a precise summary of Australian African migrant focused alcohol and other drug research to date. It also describes a three-step approach that aimed to incorporate a diversity of community views in the creation of a health promotion and community capacity-building resource.
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Affiliation(s)
- Alison Jaworski
- Drug and Alcohol Multicultural Education Centre, PO Box 2315, Strawberry Hills NSW 2012, Australia
| | - Tony Brown
- Hunter Multicultural Community Drug Action Team, c/o Hunter Multicultural Community Drug Action Team Secretary, PO Box 119, Wallsend, NSW 2287, Australia
| | - Catherine Norman
- Hunter New England Local Health District, PO Box 119, Wallsend, NSW 2287, Australia
| | - Kiri Hata
- Penola House, Catholic Diocese of Maitland/Newcastle, 3 Wilson Street, Mayfield, NSW 2304, Australia
| | - Mark Toohey
- Ethnic Communities Council Newcastle & Hunter Inc., 2a Platt Street, Waratah, NSW 2298, Australia
| | - Dubravka Vasiljevic
- Hunter New England Local Health District, PO Box 119, Wallsend, NSW 2287, Australia
| | - Rachel Rowe
- Drug and Alcohol Multicultural Education Centre, PO Box 2315, Strawberry Hills NSW 2012, Australia
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14
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Riggs E, Rajan S, Casey S, Kilpatrick N. Refugee child oral health. Oral Dis 2016; 23:292-299. [PMID: 27385659 DOI: 10.1111/odi.12530] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/30/2022]
Abstract
The number of people forced to flee their homes and move around the world is increasing rapidly. Such refugee populations are not only more likely to have poor physical, mental and social health outcomes but also to experience difficulties accessing health services in their new country. In particular, children from refugee backgrounds are at increased risk of poor oral health which in time is associated with poor adult oral health and impacts on child health (e.g. growth and development) and well-being. To date, there is little evidence about the nature and extent of their oral health problems nor interventions to improve their oral health status. This article summarises the evidence surrounding the oral health status of children from refugee backgrounds. In addition, a systematic review of the international literature over the past 10 years is presented which identifies interventions to improve the oral health of these vulnerable paediatric populations. Based on this evidence, potential strategies available to dental service providers to optimise provision of responsive dental care are discussed.
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Affiliation(s)
- E Riggs
- Healthy Mothers Healthy Families, Murdoch Childrens Research Institute, The Royal Children's Hospital, Victoria, Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Victoria, Australia
| | - S Rajan
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - S Casey
- Sector Development & Partnerships, Foundation House, The Victorian Foundation for Survivors of Torture Inc, Melbourne, Victoria, Australia
| | - N Kilpatrick
- Cleft Services, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Victoria, Australia
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15
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Cyril S, Smith BJ, Possamai-Inesedy A, Renzaho AMN. Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review. Glob Health Action 2015; 8:29842. [PMID: 26689460 PMCID: PMC4685976 DOI: 10.3402/gha.v8.29842] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/02/2015] [Accepted: 11/20/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. DESIGN The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. RESULTS Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. CONCLUSIONS The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way.
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Affiliation(s)
- Sheila Cyril
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Ben J Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Alphia Possamai-Inesedy
- Office of the Pro-Vice Chancellor Arts (Education), Western Sydney University, Bankstown, NSW, Australia
| | - Andre M N Renzaho
- Humanitarian and Development Studies, School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia;
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16
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Horyniak D, Higgs P, Cogger S, Dietze P, Bofu T, Seid G. Experiences of and attitudes toward injecting drug use among marginalized African migrant and refugee youth in Melbourne, Australia. J Ethn Subst Abuse 2015; 13:405-29. [PMID: 25397639 DOI: 10.1080/15332640.2014.958639] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Little is known about injecting drug use (IDU) among people from culturally and linguistically diverse backgrounds in Australia. We interviewed 18 young people of African ethnicity (6 current/former injectors, 12 never injectors) about exposure and attitudes to IDU. Exposure to IDU was common, with IDU characterized as unnatural, risky and immoral. IDU was highly stigmatized and hidden from family and friends. There is a need for culturally appropriate programs to promote open dialogue about substance use to reduce stigma and prevent African youth who may use illicit drugs from becoming further marginalized.
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Affiliation(s)
- Danielle Horyniak
- a Burnet Institute and Monash University , Melbourne , Victoria , Australia
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17
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Abdollahi M, Abdollahi Z, Sheikholeslam R, Kalantari N, Kavehi Z, Neyestani TR. High occurrence of food insecurity among urban Afghan refugees in Pakdasht, Iran 2008: a cross-sectional study. Ecol Food Nutr 2015; 54:187-99. [PMID: 25574705 DOI: 10.1080/03670244.2013.834819] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This research aimed to evaluate food security and its association with anthropometric measures among Afghan refugees living in Pakdasht, one of the main harbors of Afghan refugees in the neighborhood of Tehran. A total of 414 registered Afghan refugee households were recruited in a cross-sectional study. About 88% of households were food insecure. Unemployment and socioeconomic status were the major determinants of food insecurity among the refugee households. While about 58% of women were overweight/obese, the prevalence of underweight and wasting were remarkable in children (11.0% and 12.7%, respectively), indicating a recent malnutrition. Government and organizations working for refugees must focus their activities on empowering Afghan refugees.
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Affiliation(s)
- Morteza Abdollahi
- a Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran
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18
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Hansen A, Nitschke M, Saniotis A, Benson J, Tan Y, Smyth V, Wilson L, Han GS, Mwanri L, Bi P. Extreme heat and cultural and linguistic minorities in Australia: perceptions of stakeholders. BMC Public Health 2014; 14:550. [PMID: 24889099 PMCID: PMC4107973 DOI: 10.1186/1471-2458-14-550] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 05/23/2014] [Indexed: 11/10/2022] Open
Abstract
Background Despite acclimatisation to hot weather, many individuals in Australia are adversely affected by extreme heat each summer, placing added pressure on the health sector. In terms of public health, it is therefore important to identify vulnerable groups, particularly in the face of a warming climate. International evidence points to a disparity in heat-susceptibility in certain minority groups, although it is unknown if this occurs in Australia. With cultural diversity increasing, the aim of this study was to explore how migrants from different cultural backgrounds and climate experiences manage periods of extreme heat in Australia. Methods A qualitative study was undertaken across three Australian cities, involving interviews and focus groups with key informants including stakeholders involved in multicultural service provision and community members. Thematic analysis and a framework approach were used to analyse the data. Results Whilst migrants and refugees generally adapt well upon resettlement, there are sociocultural barriers encountered by some that hinder environmental adaptation to periods of extreme heat in Australia. These barriers include socioeconomic disadvantage and poor housing, language barriers to the access of information, isolation, health issues, cultural factors and lack of acclimatisation. Most often mentioned as being at risk were new arrivals, people in new and emerging communities, and older migrants. Conclusions With increasing diversity within populations, it is important that the health sector is aware that during periods of extreme heat there may be disparities in the adaptive capacity of minority groups, underpinned by sociocultural and language-based vulnerabilities in migrants and refugees. These factors need to be considered by policymakers when formulating and disseminating heat health strategies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Peng Bi
- Discipline of Public Health, The University of Adelaide, Level 8, Hughes Building, Mail Drop DX650 207, Adelaide, South Australia 5005, Australia.
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19
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Halliday JA, Green J, Mellor D, Mutowo MP, de Courten M, Renzaho AMN. Developing programs for African families, by African families: engaging African migrant families in Melbourne in health promotion interventions. FAMILY & COMMUNITY HEALTH 2014; 37:60-73. [PMID: 24297008 DOI: 10.1097/fch.0000000000000011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Obesity is an emerging problem for African migrants in Australia, but few prevention programs incorporate their cultural beliefs and values. This study reports on the application of community capacity-building and empowerment principles in 4 workshops with Sudanese families in Australia. Workshop participants prioritized health behaviors, skill and knowledge gaps, and environments for change to identify culturally centered approaches to health promotion. The workshops highlighted a need for culturally and age-appropriate interventions that build whole-of-family skills and knowledge around the positive effects of physical activity and nutrition to improve health within communities while reducing intergenerational and gender role family conflicts.
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Affiliation(s)
- Jennifer A Halliday
- Global Health and Society Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (Mss Halliday and Mutowo and A/Prof Renzaho); Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia, and Parenting Research Centre, East Melbourne, Victoria, Australia (Dr Green); School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia (Prof Mellor); School of Global Health, University of Copenhagen, Copenhagen, Denmark (Prof de Courten); and Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia (Prof Renzaho)
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20
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Hansen A, Bi L, Saniotis A, Nitschke M. Vulnerability to extreme heat and climate change: is ethnicity a factor? Glob Health Action 2013; 6:21364. [PMID: 23899408 PMCID: PMC3728476 DOI: 10.3402/gha.v6i0.21364] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/21/2013] [Accepted: 06/27/2013] [Indexed: 01/28/2023] Open
Abstract
Background With a warming climate, it is important to identify sub-populations at risk of harm during extreme heat. Several international studies have reported that individuals from ethnic minorities are at increased risk of heat-related illness, for reasons that are not often discussed. Objective The aim of this article is to investigate the underpinning reasons as to why ethnicity may be associated with susceptibility to extreme heat, and how this may be relevant to Australia’s population. Design Drawing upon literary sources, the authors provide commentary on this important, yet poorly understood area of heat research. Results Social and economic disparities, living conditions, language barriers, and occupational exposure are among the many factors contributing to heat-susceptibility among minority ethnic groups in the United States. However, there is a knowledge gap about socio-cultural influences on vulnerability in other countries. Conclusion More research needs to be undertaken to determine the effects of heat on tourists, migrants, and refugees who are confronted with a different climatic environment. Thorough epidemiological investigations of the association between ethnicity and heat-related health outcomes are required, and this could be assisted with better reporting of nationality data in health statistics. Climate change adaptation strategies in Australia and elsewhere need to be ethnically inclusive and cognisant of an upward trend in the proportion of the population who are migrants and refugees.
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Affiliation(s)
- Alana Hansen
- Discipline of Public Health, University of Adelaide, Adelaide, Australia.
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21
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Riggs E, Gussy M, Gibbs L, van Gemert C, Waters E, Priest N, Watt R, Renzaho AMN, Kilpatrick N. Assessing the cultural competence of oral health research conducted with migrant children. Community Dent Oral Epidemiol 2013; 42:43-52. [DOI: 10.1111/cdoe.12058] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/03/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Elisha Riggs
- Jack Brockhoff Child Health and Wellbeing Program; McCaughey VicHealth Centre for Community Wellbeing; The University of Melbourne; Melbourne Vic. Australia
- Healthy Mothers Healthy Families Research Group; Murdoch Childrens Research Institute; Melbourne Vic. Australia
| | - Mark Gussy
- Department of Dentistry and Oral Health; La Trobe Rural Health School; La Trobe University; Bendigo Vic. Australia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program; McCaughey VicHealth Centre for Community Wellbeing; The University of Melbourne; Melbourne Vic. Australia
| | | | - Elizabeth Waters
- Jack Brockhoff Child Health and Wellbeing Program; McCaughey VicHealth Centre for Community Wellbeing; The University of Melbourne; Melbourne Vic. Australia
| | - Naomi Priest
- McCaughey VicHealth Centre for Community Wellbeing; The University of Melbourne; Melbourne Vic. Australia
| | - Richard Watt
- Epidemiology and Public Health; University College London; London UK
| | - Andre M. N. Renzaho
- Global Health and Society Unit; School of Public Health and Preventive Medicine; Monash University; Melbourne Vic. Australia
- Centre for International Health; Burnet Institute; Melbourne Vic. Australia
| | - Nicky Kilpatrick
- Plastic and Maxillofacial Surgery Research Group; Murdoch Childrens Research Institute; Melbourne Vic. Australia
- Department of Paediatrics; The University of Melbourne; Melbourne Vic. Australia
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