Categorisation and Minoritisation

Using culturally sensitive language for race.

Queering Hip-Hop, Queering the City: Dope Saint Jude’s Transformative Politics

Honoring Asian diversity by collecting Asian subpopulation data in health research.

BackgroundNHS hospitals do not have clearly defined geographic populations to whom they provide care, with patients able to attend any hospital. Identifying a core population for a hospital trust, particularly those in urban areas where there are multiple providers and high population churn, is essential to understanding local key health needs especially given the move to integrated care systems. This can enable effective planning and delivery of preventive interventions and community engagement, rather than simply treating those presenting to services. In this article we describe a practical method for identifying a hospital’s catchment population based on where potential patients are most likely to reside, and describe that population’s size, demographic and social profile, and the key health needs.MethodsA 30% proportional flow method was used to identify a catchment population using an acute hospital trust in West London as an example. Records of all hospital attendances between 1st April 2017 and 31st March 2018 were analysed using Hospital Episode Statistics. Any Lower Layer Super Output Areas where 30% or more of residents who attended any hospital for care did so at the example trust were assigned to the catchment area. Publicly available local and national datasets were then applied to identify and describe the population’s key health needs.ResultsA catchment comprising 617,709 people, of an equal gender-split (50.4% male) and predominantly working age (15 to 64 years) population was identified. Thirty nine point six percent of residents identified as being from Black and Minority Ethnic (BAME) groups, a similar proportion that reported being born abroad, with over 85 languages spoken. Health indicators were estimated, including: a healthy life expectancy difference of over twenty years; bowel cancer screening coverage of 48.8%; chlamydia diagnosis rates of 2,136 per 100,000; prevalence of visible dental decay among five-year-olds of 27.9%.ConclusionsWe define a blueprint by which a catchment can be defined for a hospital trust and demonstrate the value a hospital-view of the local population could provide in understanding local health needs and enabling population-level health improvement interventions. While an individual approach allows tailoring to local context and need, there could be an efficiency saving were such public health information made routinely and regularly available for every NHS hospital.

UK universities are achieving some success in attracting increasingly diverse undergraduate cohorts, although distributed unevenly across different types of institutions. It is therefore a concern that once at university, students from black and minority ethnic (BME) backgrounds perform less well in their final degree classifications, even when entry qualifications, subject of study and student characteristics are taken into account. This paper firstly, reviews the research on what is understood about the BME attainment gap, described by an independent university governor as “the great unspoken shame of higher education” and secondly tells the story of institutional change initiated by Kingston University, which is a large, “modern” and widening participation institution in South West London. The multifaceted change involved: defining the problem; establishing an institutional key performance indicator; engaging the university leadership and academy; using a value added metric; and measuring attainment outcomes over a four year period. Results show significant improvement in attainment and qualitative evidence of improved staff awareness. The paper discusses the ethical challenges of complex and institutional change, including, the importance of committed leadership, the value of data as a vehicle for initiating engagement when staff are reluctant to discuss race, equality and social justice, and the implications for moving away from a student deficit to an institutional deficit model through developing inclusive cultures and an inclusive curriculum. It reflects on the parallels with higher education chances and success for young black South Africans and concludes with describing Kingston University’s role in influencing change across the sector.

South African identity has always been shaped by racial quotas; that is, divisions, assignments, allowances and allocations based on socially created ideas of race and difference. Both law and custom assigned a hierarchy which separated the rulers from the ruled, and allocated and rationed goods, services and enjoyments in all spheres of life, including sport. ‘Superior’ whites were layered above the Cape coloured people, followed by the Indian community and, lastly, the Africans, the black majority. This article looks briefly at the historical context of racial divisions and, with the downfall of apartheid, the rhetoric of an avowedly de-racialized ‘new South Africa’. Given the chronic history of negative discrimination, it is understandable that affirmative action has become a major policy framework in the building of a post-apartheid society. But sport is a sobering example of how a domain can be ‘re-racialized’ in this quest. How does the African National Congress justify the (re)introduction into sport of a proportional or numerical quota system based on racial categories? Is there a need for demographic representativeness in white-dominated sports like cricket and rugby, but seemingly not in black-dominated soccer? Is an arithmetic quota system not merely a logical extension of the reviled racial genres and divides of previous centuries?

This article explores how travel influences American attitudes to South Africa and Africa. It draws on long-term ethnographic relationships with American study abroad students in Cape Town, South Africa. Travel is often assumed to be an ideal way of changing how the ``other'' is perceived, but most research on travelers shows only how the traveler is changed. This article is a rare contribution to discussions of what travelers can learn about their destinations. Africa tends to be imagined in the US as a homogeneous entity either good in its primitiveness and wildness or bad in its violence, poverty, and disease. These perceptions color the expectations of students traveling to South Africa and frame their experiences there. Some of their preconceptions are shaken, especially the assumption that racial categories are the same everywhere. The students frequently assert, ``South Africa is not Africa.'' They also learn through their volunteer work, and conversations with South Africans, that poverty is not necessarily a homogenizing, debilitating force and that despite lack of material possessions, poor South Africans have ambitions and pride. The students' image of Africa is disturbed by the combination of their cosmopolitan experiences in South Africa and this unsettling of their preconceptions about poverty

The anti-apartheid struggle was characterized by tensions between the opposing ideologies of non-racialism (exemplified by the Freedom Charter) and racialism (exemplified by Black Consciousness). These tensions have remained prevalent in public policies and discourse, and in the writings of social scientists, in the post-apartheid period. In this paper I examine some ways in which issues of whether, when, and how race matters become visible in everyday interactions in South Africa, and what insights this may offer with respect to these ongoing tensions. Specifically, I employ an ethnomethodological, conversation analytic approach to examine some ways in which racial categories are treated as resources for action or constraints on action. I conclude by arguing that these findings point to the contingent and situational operation of a practical non-racialism (as well as practical racialism), and thus to the achievement of these ideologies in the moment-by-moment unfolding of interactions.

The nation-state is one powerful entity that makes race. For instance, the mid-twentieth-century South African apartheid racial state cultivated a triracial hierarchy through officially naming three groups into law: White, Black (native African), and Coloured, with Coloured being defined and situated in the “racial middle” as neither White nor Black African. Yet because race is a social construction that is adaptive and dynamic, the state’s role in making race is also malleable and changing. This study offers a case study of how modern racial states re-make racial categories by focusing on the potential for re- or de-formation of the Coloured racial category since the end of apartheid in 1994 and 25 years into democracy. In conducting a critical race discourse analysis of official state forms and laws, the author finds that the post-apartheid nation-state challenges Coloureds’ racial categorization and position in the racial middle. It does this by simultaneously supporting nonracialist (i.e., color-blind racist) strategies and rewriting Coloured as Black as a means for racial redress. Moreover, the author argues that contemporary South Africa practices coloured blindness through both de-formation and then re-making of the Coloured racial category, thus contributing to the potential shift to a dichotomous racial hierarchy. This project demonstrates how the racial middle can be re-made to uphold state racial projects transformed by changes in the sociopolitical context.

During pregnancy, the oral cavity is characterised by an acidic environment and an inflammatory response brought about by vomiting and changes in hormonal levels, respectively, thereby increasing the mother's risk of developing caries. Although evidence exists to support an association between pregnancy-associated periodontal disease and adverse pregnancy outcomes, there is a paucity of studies which focus on the caries prevalence and other oral manifestations of pregnant women. The aim of this study was to assess the oral health status and treatment needs of pregnant women attending antenatal clinics in KwaZulu-Natal, South Africa. Randomly selected mothers (n=443) attending a maternal obstetrics unit participated in the study. A questionnaire elicited demographic information about the participants, while the measurement of decayed, missing, and filled indices (DMFT) determined their caries status. Oral lesions were noted if present. Descriptive statistics for independent variables described frequencies in the various categories of race, location, pregnancy stage, etc., with the association between 2 independent variables tested by chi-square. Dependent variables such as DMFT were expressed as means and standard deviations, and ANOVA was used to examine whether independent variables significantly influenced the DMFT. The mean DMFT was 7.18 (±4.22) with significant correlations observed between DMFT, D, M, and age. F scores differed significantly between races, location, and educational levels and showed a significant correlation with pregnancy stage. Pregnancy epulis was diagnosed in 38 (8.5%), oral lesions in 65 (14.7%), and tooth mobility in 26 (5.9%) mothers. Early oral health screening during pregnancy can ensure the overall well-being of both the mother and the foetus.

The New Delhi Metallo-β-lactamase (NDM) resistance mechanism in Enterobacteriaceae threatens to render serious Gram-negative infections untreatable. The NDM-1 enzyme hydrolyses all available penicillin, cephalosporin and carbapenem antibiotics, and is commonly accompanied by additional resistance mechanisms to multiple antibiotic classes. Initially identified as a significant healthcare risk on the Indian sub-continent, it has rapidly become a global problem, posing significant diagnostic and management challenges. Here we report the first laboratory-confirmed case of NDM-1 in South Africa.

Costs and outcomes of routine HIV oral pre-exposure prophylaxis implementation across different service delivery models and key populations in South Africa: a retrospective cohort study.

Part I: The Clash of British Imperialism and Afrikaner Nationalism:. 1. Prelude to War: Afrikaner and British Imperial Nationalism. 2. War, Peace and Reconstruction. 3. Afrikaners, Blacks and Reconstruction. Part II: The White Union and Black Reaction:. 4. Responsible Government and the Union. 5. The New Union: White and Black Political Activity. 6. The Great War and its Aftermath. 7. The Pact Government and Segregation 1924--9. 8. From Pact to Fusion: Economic Depression and Black Opposition: 1929--39. Part III: World War II and Apartheid:. 9. World War II and its Aftermath 1939--48. 10. African Nationalism Transformed: 1939--48. 11. The National Party Government 1948--61. 12.African Opposition: Communists, Congress and the Pan Africanist Congress. Part IV: The Wind of Change:. 13. The New Republic, Sharpeville and the Granite Response. 14. Vorster and the Development of the Bantustans. 15. Black Resistance Inside and Outside the Republic. Part V: Renewed Black Challenge: . 16. Soweto and its Aftermath. 17. Reform, Security and White Divisions Under P. W. Botha. 18. The Black Rising: and Answering Fire with Fire. 19. Retreat from the Rubicon: The Failure of Reform. Part VI: Forging the New South Africa:. 20. In Search of a New South Africa. 21. Reaching Agreement: Negotiation, Tension and Violence. 22. Towards the Promised Land. References. Index.

BackgroundFocusing on healthcare referral processes for children with severe acute malnutrition (SAM) in South Africa, this paper discusses the comprehensiveness of documents (global and national) that guide the country’s SAM healthcare. This research is relevant because South African studies on SAM mostly examine the implementation of WHO guidelines in hospitals, making their technical relevance to the country’s lower level and referral healthcare system under-explored.MethodsTo add to both literature and methods for studying SAM healthcare, we critically appraised four child healthcare guidelines (global and national) and conducted complementary expert interviews (n = 5). Combining both methods enabled us to examine the comprehensiveness of the documents as related to guiding SAM healthcare within the country’s referral system as well as the credibility (rigour and stakeholder representation) of the guideline documents’ development process.ResultsNone of the guidelines appraised covered all steps of SAM referrals; however, each addressed certain steps thoroughly, apart from transit care. Our study also revealed that national documents were mostly modelled after WHO guidelines but were not explicitly adapted to local context. Furthermore, we found most guidelines’ formulation processes to be unclear and stakeholder involvement in the process to be minimal.ConclusionIn adapting guidelines for management of SAM in South Africa, it is important that local context applicability is taken into consideration. In doing this, wider stakeholder involvement is essential; this is important because factors that affect SAM management go beyond in-hospital care. Community, civil society, medical and administrative involvement during guideline formulation processes will enhance acceptability and adherence to the guidelines.

Integrating mental health care into HIV services is critical to addressing the high unmet treatment needs for people living with HIV and comorbid major depressive disorder. Introducing routine mental health screening at the primary health care level is a much needed diagonal approach to enhancing HIV care. In low-resource settings with a shortage of mental health care providers, eMental Health may provide a novel opportunity to attenuate this treatment gap and strengthen the health system. To conduct formative health systems research on the implementation of routine depression screening using a digital tool - Mood in Retroviral Positive Individuals Application Monitoring (MIR+IAM) - in an HIV primary care setting in South Africa. A Theory of Change (ToC) approach was utilised through individual and group session interviews to design an intervention that is embedded in the local context. Ten experts and local stakeholders were selected from the UK and South Africa. Data were analysed thematically using Atlas.ti to identify interventions, assumptions, barriers and facilitators of implementation. The participants considered digital depression screening in HIV care services relevant for the improvement of mental health in this population. The six main themes identified from the ToC process were: (1) user experience including acceptability by patients, issues of patient privacy and digital literacy, and the need for a patient-centred tool; (2) benefits of the digital tool for data collection and health promotion; (3) availability of treatment after diagnosis; (4) human and physical resource capacity of primary health care; (5) training for lay health care workers; and (6) demonstration of the intervention's usefulness to generate interest from decision-makers. Digital depression screening coupled with routine mental health data collection and analysis in HIV care is an applicable service that could improve the mental and physical health outcomes of this population. Careful consideration of the local health system capacity, including both workers and patients, is required. Future research to refine this intervention should focus on service users, government stakeholders and funders.