The determinants of young adult social well-being and health (DASH) study: the influence of parenting and religious involvement on mental health

OBJECTIVE: The DASH longitudinal study found better mental health for ethnic minorities compared to White British adolescents in the UK, despite more disadvantage. This paper investigates the impact of parenting style and attendance at a place of worship on mental well-being from adolescence to young adulthood. DESIGN AND METHODS: In 2002/03, 6643 11-13 year olds in London, ~80% ethnic minorities, participated in the baseline survey. In 2005/06 4,782 were followed-up. In 2012-14 665 took part in a pilot follow-up aged 21-23y, including 42 qualitative interviews. Measures of socio- economic and psychosocial factors and health were collected. RESULTS: In adolescence, ethnic minorities generally experienced more adversity but reported better mental health. Regardless of ethnicity, low parental care vs. high parental care (e.g. males coefficient: 1.32, 95% confidence interval 0.94-1.70), high parental control vs. low parental control (males: 1.37, 1.00-1.74), and attendance to a place of worship vs. no attendance were independently associated with mental health. At 21-23y, the ethnic patterning of mental health appeared to track, with increasing parental care, but not religious involvement, continuing to have a protective effect on mental health. Education levels signalled potential for socio-economic parity across ethnic groups, and family support appeared to reduce stress of transitions to adulthood. CONCLUSIONS: DASH provides evidence for a protective effect from parenting styles and religious involvement for young people growing up in ethnically diverse and deprived urban contexts. This suggests the value of cultural and social resources for psychological well- being.

A pilot investigation into the definition of cultural competence of dental health professionals in a Trinidad context

Accreditation bodies in the United States, Europe and the Caribbean mandate have developed standards relating to cultural competence and the impact of culture on the provision or oral health care. The population and culture of Trinidad is diverse and dissimilar to the United States and Europe. The purpose of this study is to define what cultural competence means in a Trinidad context. Semi-structured elite interviews were conducted by one author of three persons from each of the following groups: dental academics, dental clinicians, Catholics, Hindus, Muslims and Protestants. Trinidadians were generally categorized as 'easy-going' and forgiving of errors in cultural competence. Communication and the ability to put the patient at ease were considered important skills. Knowledge of the various religions was considered to be important especially as it related to their diets- especially during religious festivals and their preferences for the treatment of females. The role of the extended family was identified as being important in history taking and in the management of paediactric patients. Aside from the knowledge specific to Trinidad, the introduction of cultural competence training may be guided by the publications and guidelines of the American Association of Medical Colleges.

Religiosity and HIV/ AIDS stigma in Jamaica

This chapter focuses on the nature of HIV/AIDS related stigma within faith-based organizations in Jamaica. Existing evidence points to AIDS related stigma as a significant contributor to the widespread epidemic alongside other social, cultural, economic and behavioural factors. Religious leaders have the potential to address the epidemic by promoting awareness and influencing social and behavioural change at various levels. They also have the potential to provide leadership in mitigating stigma in their communities. The information presented here was gathered qualitatively through focus groups and in-depth interviews with members of faith-based organizations and persons living with HIV / AIDS in Jamaica. Key findings reiterate that stigma in Jamaica is sanctioned by faith-based organizations, but given the social influences of religious leaders, the chapter also recognizes the need to include them as crucial partners in the struggle against HIV / AIDS stigma and related health communication interventions. The chapter offers recommendations for HIV / AIDS communication and suggests areas for further research in relation to religiosity in health communication.

Response of religious groups to HIV/AIDS as a sexually transmitted infection in Trinidad

BACKGROUND: HIV/AIDS-related stigma and discrimination are significant determinants of HIV transmission in the Caribbean island nation of Trinidad and Tobago (T&T), where the adult HIV/AIDS prevalence is 2.5%. T&T is a spiritually-aware society and over 104 religious groups are represented. This religious diversity creates a complex social environment for the transmission of a sexually transmitted infection like HIV/AIDS. Religious leaders are esteemed in T&T's society and may use their position and frequent interactions with the public to promote HIV/AIDS awareness, fight stigma and discrimination, and exercise compassion for people living with HIV/AIDS (PWHA). Some religious groups have initiated HIV/AIDS education programs within their membership, but previous studies suggest that HIV/AIDS remains a stigmatized infection in many religious organizations. The present study investigates how the perception of HIV/AIDS as a sexually transmitted infection impacts religious representatives' incentives to respond to HIV/AIDS in their congregations and communities. In correlation, the study explores how the experiences of PWHA in religious gatherings impact healing and coping with HIV/AIDS. METHODS: Between November 2002 and April 2003, in-depth interviews were conducted with 11 religious representatives from 10 Christian, Hindu and Muslim denominations. The majority of respondents were leaders of religious services, while two were active congregation members. Religious groups were selected based upon the methods of Brathwaite. Briefly, 26 religious groups with the largest followings according to 2000 census data were identified in Trinidad and Tobago. From this original list, 10 religious groups in Northwest Trinidad were selected to comprise a representative sample of the island's main denominations. In-depth interviews with PWHA were conducted during the same study period, 2002-2003. Four individuals were selected from a care and support group located in Port of Spain based upon their perceived willingness to discuss religious affiliation and describe how living with a terminal infection has affected their spiritual lives. The interviewer, a United States Fulbright Scholar, explained the nature and purpose of the study to all participants. Relevant ethical procedures associated with the collection of interview data were adopted: interviews were conducted in a non-coercive manner and confidentiality was assured. All participants provided verbal consent, and agreed to be interviewed without financial or other incentive. Ethics approval was granted on behalf of the Caribbean Conference of Churches Ethics Committee. Interview questions followed a guideline, and employed an open-ended format to facilitate discussion. All interviews were recorded and transcribed by the interviewer. RESULTS: Religious representatives' opinions were grouped into the following categories: rationale for the spread of HIV/AIDS, abstinence, condom use, sexuality and homosexuality, compassion, experiences with PWHA, recommendations and current approach to addressing HIV/AIDS in congregations. Religious representatives expressed a measure of acceptance of HIV/AIDS and overwhelmingly upheld compassion for PWHA. Some statements, however, suggested that HIV/AIDS stigma pervades Trinidad's religious organizations. For many representatives, HIV/AIDS was associated with a promiscuous lifestyle and/or homosexuality. Representatives had varying levels of interaction with PWHA, but personal experiences were positively associated with current involvement in HIV/AIDS initiatives. All 4 PWHA interviewed identified themselves as belonging to Christian denominations. Three out of the 4 PWHA described discriminatory experiences with pastors or congregation members during gatherings for religious services. Nonetheless, PWHA expressed an important role for faith and religion in coping with HIV. CONCLUSION: Religious groups in Trinidad are being challenged to promote a clear and consistent response to the HIV/AIDS epidemic; a response that may reflect personal experiences and respect religious doctrine in the context of sex and sexuality. The study suggests that (1) religious leaders could improve their role in the fight against HIV/AIDS with education and sensitization-specifically aimed at dismantling the myths about HIV transmission, and the stereotyping of susceptible sub-populations, and (2) a consultative dialogue between PWHAs and religious leaders is pivotal to a successful faith-based HIV intervention in Trinidad.

Social environment and substance misuse: a study of ethnic variations among inner London adolescents

OBJECTIVES: To explore ethnic variations in drug, tobacco and alcohol use and their correlation with other factors which operate through peer, familial and religious influences. DESIGN: Semi-structured interviews with 132 12-13-year-old young people from four ethnic groups attending secondary schools in two inner London boroughs and a follow-up interview completed approximately 17 months later. RESULTS: The data was analysed using chi-square and McNemar tests. Familial, religious and peer influence closely correlated with ethnicity. Bangladeshi young people showed lower levels of peer and higher levels of religious and familial involvement and lower levels of substance use. White young people reported higher levels of peer, lower levels of religious and familial involvement, and a higher level of substance use. Black African and Black Caribbean young people lay between the two extremes. CONCLUSION: The findings suggest that young people with lower levels of familial and religious influence, or higher levels of peer influence, have higher levels of substance consumption than other young people. Health education initiatives need to promote personal decision-making skills within the context of the young people's individual culture. Cultural diversity should be recognised within local health education needs assessment.(Au)

Some factors associated with substance abuse among secondary school students in Trinidad and Tobago - abstract

The aim of this study done in 1988 was to explore the relationship between substance abuse and attitudes of youth towards education, religion and family life in secondary school students, aged 14 to 18 years in Trinidad and Tobago. A random stratified sampling technique resulted in a selection of 30 secondary schools and 2000 students. Data were collected from 1,603 (80 per cent) students, using a self-administered questionnaire completed in the classroom and supervised by trained survey workers. Analysis of the data, using the Chi-square test, indicated a significant association (p<.001) between involvement in substance abuse (defined as regular or occasional usage of alcohol, marijuana or cocaine) and the following factors: grades at school, importance of religious involvement, amount of spending money obtained, confidence placed in parents/peers, parental involvement in alcohol consumption and educational expectations. Generally, the study indicated that youths who were less committed to traditional values, showed a greater tendency to be involved in substance abuse. Involvement also appeared to be associated with low self-esteem and low educational expectations (AU)

Sterilization patterns in a maternity unit

An evaluation of the characteristics of 425 women on whom surgical sterilizations were performed revealed that 40 percent were 35 years or older and 48 percent had 5 or more children. Thirty-five per cent were Roman Catholics, and there was an equal incidence among the two major ethnic groups in Trinidad. Parental desire was the chief indication for tubal ligation. Complications were few, regardless of the timing of the procedure. A plea is made for intensifying efforts in promoting postpartum sterilizations following vaginal delivery, particularly for mothers whose life circumstances would prohibit them from returning for interval sterilization (AU)

Association between stress and blood pressure variation in a Caribbean population

Based on the work of Selye (The Stress of Life, New York: McGraw Hill, 1976) it is hypothesized that stress can produce physiological abnormalities, i.e. elevated blood pressure, and that social variables can be used as indicators or risk factors for diseases. It is theorized that deviations from acceptable social patterns or traditional life-styles can produce stressful conditions that are associated with disease and that these situations can be demonstrated by examination of certain social characteristics. This association is examined among the Black Caribs of St. Vincent, West Indies. The social variables included in this analysis are marital status (single, married, widowed, or separated), frequency of church attendance (frequently, sometimes, seldom, or never), years of education, and number of children (for women only). The findings show that single individuals have higher pressures than married subjects and that males who never attended church have higher pressures than men who frequently attend church; a relationship was not demonstrated for females. Among males, as the years of education was increased, blood pressure also increased, but for females, increased education was associated with lower pressures. Family size was not associated with systolic or diastolic pressure. The analysis of these selected social variables suggest that these variables influence male systolic and diastolic pressures, but only female diastolic pressure. (AU)

A biocultural analysis of blood pressure variation among the Black Caribs and creoles of St. Vincent, West Indies

This present study is a biochemical examination of blood pressure variation among the Black Caribs and Creoles of St. Vincent, West Indies. In particular, it investigates the etiology of essential (primary) hypertension by examining both cultural and biological contributory components. Four asspects of Caribbean culture are examined: Marital status, family size

The impact of sociocultural factors on a church-based healing model

Since orthodox health practitioners and the church have tended to maintain different values with respect to sickness and care, little attention has been paid to models that combine religious healing and traditional medical and psychiatric care. This study describes such a tripartite collaborative model. Through participation observation and interviews of patients and staff, attention is focused on the impact that sociocultural factors have had on the practical workings of a church-based clinic. (AU)

Rastafarianism and the vegans syndrome

Low serum vitamin B12 concentrations are common in vegans. We report the first account of the syndrome in members of the Rastafarian cult, which started in Jamaica more than 40 years ago (AU)

Folk medicine and modern medicine in St. Lucia: current beliefs, attitudes and practices of consumers and providers of health care and the implications for primary health care

An investigation of current beliefs, attitudes and practices of consumers and providers of traditional and modern health care was carried out. The study revealed that there was a strong belief in folk healers and herbal remedies-folk medicine (54 percent). 33 percent of the subjects used only the modern health facilities. There is a direct correlation between the useage of folk medicine and the presence or absence of health clinics in the area. Folk healers were mostly consulted for psychological, psychosomatic and inter personal problems. (AU)

The Guyana tragedy - an international forensic problem

Through the efforts of many of the leading forensic scientists in the world efforts are being made to develop a regional group of forensic experts who will be willing to respond to requests for help with major problems such as were faced with the Tenerife crash in the Canary Islands in 1977 and this problem in Guyana. This matter will be discussed in a session of the International Academy Meeting in Lyon in August of 1979 (Summary)

Reverend Jones on suicide

This brief article presents a verbatim transcript of an extemporaneous speech made by Reverend Jim Jones at an anti-suicide rally on the San Francisco Golden Gate Bridge on Memorial Day, May 31, 1977 some 18 months before the disastrous events in Guyana (Summary)