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Van Bortel T, Lombardo C, Guo L, Solomon S, Martin S, Hughes K, Weeks L, Crepaz-Keay D, McDaid S, Chantler O, Thorpe L, Morton A, Davidson G, John A, Kousoulis AA. The mental health experiences of ethnic minorities in the UK during the Coronavirus pandemic: A qualitative exploration. Front Public Health 2022; 10:875198. [PMID: 36276403 PMCID: PMC9582845 DOI: 10.3389/fpubh.2022.875198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022] Open
Abstract
Background Worldwide, the Coronavirus pandemic has had a major impact on people's health, lives, and livelihoods. However, this impact has not been felt equally across various population groups. People from ethnic minority backgrounds in the UK have been more adversely affected by the pandemic, especially in terms of their physical health. Their mental health, on the other hand, has received less attention. This study aimed to explore the mental health experiences of UK adults from ethnic minorities during the Coronavirus pandemic. This work forms part of our wider long-term UK population study "Mental Health in the Pandemic." Methods We conducted an exploratory qualitative study with people from ethnic minority communities across the UK. A series of in-depth interviews were conducted with 15 women, 14 men and 1 non-binary person from ethnic minority backgrounds, aged between 18 and 65 years old (mean age = 40). We utilized purposefully selected maximum variation sampling in order to capture as wide a variety of views, perceptions and experiences as possible. Inclusion criteria: adults (18+) from ethnic minorities across the UK; able to provide full consent to participate; able to participate in a video- or phone-call interview. All interviews took place via MS Teams or Zoom. The gathered data were transcribed verbatim and underwent thematic analysis following Braun and Clarke carried out using NVivo 12 software. Results The qualitative data analysis yielded seven overarching themes: (1) pandemic-specific mental health and wellbeing experiences; (2) issues relating to the media; (3) coping mechanisms; (4) worries around and attitudes toward vaccination; (5) suggestions for support in moving forward; (6) best and worst experiences during pandemic and lockdowns; (7) biggest areas of change in personal life. Generally, participants' mental health experiences varied with some not being affected by the pandemic in a way related to their ethnicity, some sharing positive experiences and coping strategies (exercising more, spending more time with family, community cohesion), and some expressing negative experiences (eating or drinking more, feeling more isolated, or even racism and abuse, especially toward Asian communities). Concerns were raised around trust issues in relation to the media, the inadequate representation of ethnic minorities, and the spread of fake news especially on social media. Attitudes toward vaccinations varied too, with some people more willing to have the vaccine than others. Conclusion This study's findings highlight the diversity in the pandemic mental health experiences of ethnic minorities in the UK and has implications for policy, practice and further research. To enable moving forward beyond the pandemic, our study surfaced the need for culturally appropriate mental health support, financial support (as a key mental health determinant), accurate media representation, and clear communication messaging from the Governments of the UK.
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Affiliation(s)
- Tine Van Bortel
- Faculty of Health and Life Sciences, Leicester School of Allied Health Sciences, Gateway House, De Montfort University, Leicester, United Kingdom,Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom,*Correspondence: Tine Van Bortel ;
| | - Chiara Lombardo
- Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom,Mental Health Foundation, London, United Kingdom
| | - Lijia Guo
- Cambridge Public Health, Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom,Department of Sociology, School of Humanities and Social Sciences, University of Cambridge, Cambridge, United Kingdom
| | | | - Steven Martin
- Faculty of Health and Life Sciences, Leicester School of Allied Health Sciences, Gateway House, De Montfort University, Leicester, United Kingdom
| | - Kate Hughes
- Mental Health Foundation, London, United Kingdom
| | - Lauren Weeks
- Mental Health Foundation, London, United Kingdom
| | | | - Shari McDaid
- Mental Health Foundation, London, United Kingdom
| | | | - Lucy Thorpe
- Mental Health Foundation, London, United Kingdom
| | - Alec Morton
- Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, United Kingdom
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, United Kingdom
| | - Ann John
- Health Data Research UK, Swansea University Medical School, Swansea, United Kingdom
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Chu JY, Kaliwal Y, Koh M, Chen R, Chow CM, Ko DT, Liu PP, Moe GW. COVID-19 and its Cardiac and Neurological Complications among Ontario Visible Minorities. Can J Neurol Sci 2022; 49:504-513. [PMID: 34162448 PMCID: PMC8365110 DOI: 10.1017/cjn.2021.148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/19/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Due to lack of data on the epidemiology, cardiac, and neurological complications among Ontario visible minorities (Chinese and South Asians) affected by coronavirus disease (COVID-19), this population-based retrospective study was undertaken to study them systematically. METHODS From January 1, 2020 to September 30, 2020 using the last name algorithm to identify Ontario Chinese and South Asians who were tested positive by PCR for COVID-19, their demographics, cardiac, and neurological complications including hospitalization and emergency visit rates were analyzed compared to the general population. RESULTS Chinese (N = 1,186) with COVID-19 were found to be older (mean age 50.7 years) compared to the general population (N = 42,547) (mean age 47.6 years) (p < 0.001), while South Asians (N = 3,459) were younger (age of 42.1 years) (p < 0.001). The 30-day crude rate for cardiac complications among Chinese was 169/10,000 (p = 0.069), while for South Asians, it was 64/10,000 (p = 0.008) and, for the general population, it was 112/10,000. For neurological complications, the 30-day crude rate for Chinese was 160/10,000 (p < 0.001); South Asians was 40/10,000 (p = 0.526), and general population was 48/10,000. The 30-day all-cause mortality rate was significantly higher for Chinese at 8.1% vs 5.0% for the general population (p < 0.001), while it was lower in South Asians at 2.1% (p < 0.001). CONCLUSIONS Chinese and South Asians in Ontario affected by COVID-19 during the first wave of the pandemic were found to have a significant difference in their demographics, cardiac, and neurological outcomes.
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Affiliation(s)
- Joseph Y. Chu
- Division of Neurology, Department of Medicine, Toronto Western Hospital-University Health Network and William Osler Health System, University of Toronto, Toronto, Canada
| | | | | | - Robert Chen
- Krembil Research Institute, University Health Network and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Chi-Ming Chow
- Division of Cardiology, Department of Medicine, St. Michael’s Hospital, University of Toronto, Toronto, Canada
| | - Dennis T. Ko
- ICES, Toronto, Canada
- Schulich Heart Program, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Peter P. Liu
- University of Ottawa Heart Institute and Department of Medicine and Cellular & Molecular Medicine, University of Ottawa and Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Gordon W. Moe
- Division of Cardiology, Department of Medicine, St. Michael’s Hospital, University of Toronto, Toronto, Canada
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Epidemiology of COVID-19 and Its Cardiac and Neurologic Complications Among Chinese and South Asians in Ontario: Waves 1, 2, and 3. CJC Open 2022; 4:894-904. [PMID: 36254328 PMCID: PMC9568686 DOI: 10.1016/j.cjco.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/21/2022] [Indexed: 11/21/2022] Open
Abstract
Background Although we had previously reported the cardiac and neurologic outcomes of Chinese and South Asian Ontarians in wave 1 of COVID-19, data on subsequent waves of COVID-19 remain unexamined. This is an extension study of this cohort in waves 2 and 3. Methods We identified adult Ontarians with a positive COVID-19 polymerase chain reaction test from January 1, 2020 to June 30, 2021, and they were classified as being Chinese or South Asian using a validated surname algorithm; we compared their outcomes of mortality, and cardiac and neurologic complications with those of the general population using multivariable logistic regression models. Results Compared to the general population (n = 439,977), the Chinese population (n = 15,208) was older (mean age 44.2 vs 40.6 years, P < 0.001) and the South Asian population (n = 46,333) was younger (39.2 years, P < 0.001). The Chinese population had a higher 30-day mortality (odds ratio [OR] 1.44; 95% confidence interval [CI] 1.28-1.61) and more hospitalization or emergency department visits (OR, 1.14; 95% CI, 1.09-1.28), with a trend toward a higher incidence of cardiac complications (OR, 1.03; 95% CI, 0.87-1.12) and neurologic complications (OR, 1.23; 95% CI, 0.96-1.58). South Asians had a lower 30-day mortality (OR, 0.88; 95% CI, 0.78-0.98) but a higher incidence of hospitalization or emergency department visits (OR, 1.17; 95% CI, 1.14-1.20) with a trend toward a lower incidence of cardiac complications (OR, 0.76; 95% CI, 0.67-0.87) and neurologic complications (OR, 0.89; 95% CI, 0.73-1.09). There was also a significant difference in these outcomes between wave 1, 2 and 3, with a greater mortality in all groups in waves 2 and 3. Conclusions Ethnicity continues to be an important determinant of mortality, cardiac and neurologic outcomes, and healthcare use among patients with COVID-19, requiring further studies to understand factors driving these differences.
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Jones LK, McClean JC, Avitzur O. US Health Care System in 2035: The Neurology Future Forecasting Series. Neurology 2022; 98:402-408. [PMID: 35256518 DOI: 10.1212/wnl.0000000000200057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/28/2021] [Indexed: 11/15/2022] Open
Abstract
Evolution of the US health care system has been punctuated by periods of rapid change. In the coming decades there will be meaningful and potentially disruptive developments in health care delivery mechanisms, the policy environment, and the populations for whom we provide care. Neurologists will need to adapt to changing patient expectations, market dynamics, and regulatory structures to thrive in the future health care environment. This article describes a forecast of potential changes in the US health care system by 2035, an assessment of the implications for the field of neurology, and a rationale for long-term strategic planning to prepare.
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Affiliation(s)
- Lyell K Jones
- From the Mayo Clinic (L.K.J.), Rochester, MN; San Antonio Military Medical Center (J.C.M.), TX; and American Academy of Neurology (O.A.), Tarrytown, NY.
| | - Jeffrey C McClean
- From the Mayo Clinic (L.K.J.), Rochester, MN; San Antonio Military Medical Center (J.C.M.), TX; and American Academy of Neurology (O.A.), Tarrytown, NY
| | - Orly Avitzur
- From the Mayo Clinic (L.K.J.), Rochester, MN; San Antonio Military Medical Center (J.C.M.), TX; and American Academy of Neurology (O.A.), Tarrytown, NY
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Lamba S, Omary MB, Strom BL. Diversity, equity and inclusion: organizational strategies during and beyond the COVID-19 pandemic. J Health Organ Manag 2021. [DOI: 10.1108/jhom-05-2021-0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented health, economic and social ramifications. Cumulative stressors for healthcare organizations during the pandemic have an impact on the morale of the workforce. The impact of magnified health disparities with ongoing disproportionate loss of lives of people of color combined with the racial injustices has left many colleagues and communities traumatized and seeking solutions. This is a moment in time for organizations to lean into the strengths of their diversity leadership to strengthen a culture of inclusion and build resilience for their employees.Design/methodology/approachThe authors use an organizational case study to describe the initiatives and experiences related to fostering a culture of inclusion and belonging at an academic health center during the initial epicenter of the pandemic.FindingsThe authors weekly community building virtual cafes, leveraging funding for diversity initiatives and visible ways to showcase the work of colleagues have been feasible, sustainable and had positive outcomes. Similar processes may assist other institutions and organizations seeking to enhance efforts for inclusion while distancing.Research limitations/implicationsStrategies described are generalizable but the authors report on one organization's experience.Originality/valueIntentional strategies that help build a deeper sense of community are essential for institutions during the disruption of pandemic related physical distancing. Inclusive decisions anchored in equity and inclusion as core institutional values will be essential to sustain resilience as the authors seek to build the new “equitable” normal.
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Begasse de Dhaem O, Kiarashi J, Armand CE, Charleston L, Szperka CL, Lee YS, Rajapakse T, Seng EK, VanderPluym JH, Starling AJ. Ten Eleven things to facilitate participation of underrepresented groups in headache medicine research. Headache 2021; 61:951-960. [PMID: 34125956 PMCID: PMC10091268 DOI: 10.1111/head.14124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022]
Affiliation(s)
| | - Jessica Kiarashi
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Cynthia E Armand
- Department of Neurology, Albert Einstein College of Medicine, Montefiore Headache Center, Bronx, NY, USA
| | - Larry Charleston
- Department of Neurology and Ophthalmology, Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Christina L Szperka
- Department of Neurology, Children's Hospital of Philadelphia & Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Yeonsoo S Lee
- Department of Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Thilinie Rajapakse
- Department of Neurology, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Elizabeth K Seng
- Department of Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Department of Psychology, Albert Einstein College of Medicine, Bronx, NY, USA
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The Pediatric Neurology 2020 Research Workforce Survey: Optimism in a Time of Challenge. Pediatr Neurol 2021; 116:62-67. [PMID: 33486423 DOI: 10.1016/j.pediatrneurol.2020.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The past decades have seen a transformational shift in the understanding and treatment for neurological diseases affecting infants and children. These advances have been driven in part by the pediatric neurology physician-scientist workforce and its efforts. However, pediatric neurology research faces substantial challenges from internal and external forces including work-life balance demands, COVID-19 pandemic effects, and research funding. Understanding the impact of these challenges on the perceptions, planning, and careers of pediatric neurology physician-scientists is needed to guide the research mission. METHODS Our objective was to survey the research challenges, goals, and priorities of pediatric neurologists. In 2020 we conducted a cross-sectional, 28-question survey emailed to 1,775 members of the Child Neurology Society. RESULTS One hundred fifty-one individuals responded to the survey. Most respondents were grant investigators (52%) and conducted clinical research (69%). Research areas included epilepsy (23%), neurodevelopmental and autism (16%), neurocritical care and stroke (11%), neurogenetics and neurometabolics (9%), neonatal neurology (8%), and others. The most common funding source was the National Institutes of Health (37%). Shared major research concerns were funding, utilization of remote technology, overcoming disparities, natural history and multicenter studies, global neurology, and diversification of the research portfolio. Commitment to continuing and increasing research efforts was evident. CONCLUSIONS Our survey demonstrates obstacles for physician-scientist researchers in pediatric neurology, but it also shows optimism about continued opportunity. Creative approaches to address challenges will benefit the research mission, maximize the current and future pool of researchers, and help improve the lives of children with neurological disorders.
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What's happening in Equity, Diversity, & Inclusion. Neurology 2020. [DOI: 10.1212/wnl.0000000000011086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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