Culture, Ethnicity and Chronic Conditions

The global burden of chronic non-communicable diseases (NCDs), such as hypertension, diabetes and cancers, and of common mental disorders such as depression and anxiety, has a disproportionate impact on the low- and middle-income countries (LMICs) of Africa, Asia and Latin America. The pattern persists in African and Asian migrant populations in European and North American countries, despite the higher standards of living and improved health infrastructure. The consensus of experts is that pragmatic, cost-effective and sustainable interventions are required, and that these must prioritise the social determinants of NCDs as well as the social participation of affected communities. Despite the growing emphasis on the role of social processes in health system responses to chronic disease in LMICs, there has been no definitive volume that brings together LMIC perspectives on these issues. This book aims to address this major gap by presenting new conceptual and empirical perspectives on the interconnections between culture, ethnicity and chronic conditions in LMICs and their implications for research, intervention and policy. The chapters focus on lay and institutional meanings, experiences and responses to chronic conditions in selected countries in Africa, Europe and the Caribbean. This book was originally published as a special issue of Ethnicity and Health.

Charles Agyemang is a senior researcher and PI in Academic Medical Centre, University of Amsterdam, The Netherlands. He is currently the vice President for European Public Health Association, Migrant Health section. His research focuses on cardiovascular diseases among ethnic minority and migrant groups in Europe and cardiovascular diseases in low resource settings. Ama de-Graft Aikins is Associate Professor of Social Psychology at the Regional Institute for Population Studies, University of Ghana, Ghana, and African Initiative Fellow at LSE Health, London School of Economics and Political Science, UK. Her research focuses on experiences of, and interventions for, diabetes and related chronic physical and mental conditions.

1. Introduction: Culture, ethnicity and chronic conditions: reframing concepts and methods for research, interventions and policy in low-and middle-income countries Ama de-Graft Aikins, Emma Pitchforth, Pascale Allotey, Gbenga Ogedegbe and Charles Agyemang 2. Cardiovascular disease in low- and middle-income countries: an urgent priority Haja R. Wurie and Francesco P Cappuccio 3. Ethnicity and cardiovascular health research: pushing the boundaries by including comparison populations in the countries of origin Charles Agyemang, Ama de-Graft Aikins and Raj Bhopal 4. 'A chronic disease is a disease which keeps coming back... it is like the flu': chronic disease risk perception and explanatory models among French- and Swahili- speaking African migrants Maxwell Cooper, Seeromanie Harding, Kenneth Mullen and Catherine O'Donnell 5. Explanatory models of hypertension among Nigerian patients at a University Teaching Hospital Kelly D. Taylor, Ayoade Adedokun, Olugbenga Awobusuyi, Peju Adeniran, Elochukwu Onyia and Gbenga Ogedegbe 6. Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands Erick Vloeberghs, Anke van der Kwaak, Jeroen Knipscheer and Maria van den Muijsenbergh 7. Differences in working conditions and employment arrangements among migrant and non-migrant workers in Europe Elena Ronda Pérez, Fernando G. Benavides, Katia Levecque, John G. Love, Emily Felt and Ronan Van Rossem 8. Review of community-based interventions for prevention of cardiovascular diseases in low- and middle-income countries Steven van der Vijver, Samuel Oti, Juliet Addo, Ama de-Graft Aikins and Charles Agyemang 9. Policy initiatives, culture and the prevention and control of chronic non-communicable disease (NCDs) in the Caribbean T. Alafia Samuels, Cornelia Guell, Branka Legetic and Nigel Unwin