Search Results (93)

Background: Endometrial cancer outcomes differ among Black women when examined by nativity, and timely evaluation of postmenopausal bleeding (PMB), the most common presenting symptom, may contribute to these disparities. Methods: This qualitative study explored cultural, societal, and behavioral factors shaping PMB appraisal and anticipated care-seeking among US-born Black, Caribbean-born Black, and Haitian Creole-speaking women in South Florida, guided by the Safer–Andersen Model of Total Patient Delay. Ten focus groups were conducted with 55 Black women aged ≥50 years recruited through purposive and snowball sampling. Discussions were held in English or Haitian Creole, audio-recorded, professionally transcribed, translated when needed, and analyzed thematically using a hybrid deductive–inductive approach. Reporting followed the Consolidated Criteria for Reporting Qualitative Research. Results: Three themes emerged: limited awareness and information-seeking regarding menopause and PMB; cultural and societal influences, including faith-based coping, traditional remedies, and limited family discussion of health history; and healthcare system barriers, including cost, lack of insurance, distrust, and communication challenges with providers. Subgroup differences were noted in preferred information sources, perceived susceptibility, and the role of religion in care-seeking. Conclusions: Findings suggest that PMB appraisal and anticipated care-seeking vary by nativity and language among Black women. Nativity- and language-tailored community education and navigation strategies may improve symptom recognition and support timely evaluation, but future quantitative studies are needed to test whether these approaches reduce pre-diagnostic intervals for endometrial cancer. Full article

Background: In Canada, racialized communities, including African, Caribbean, and Black (ACB) people, are disproportionately affected by HIV and COVID-19. Experiencing multiple forms of discrimination in healthcare settings compromises care engagement and health outcomes. The objective of this study was to assess the forms of discrimination ACB people experienced during the COVID-19 pandemic, discrimination levels experienced before and during the pandemic and the demographic factors associated with the increased experiences of discrimination among ACB people when accessing healthcare services during the pandemic. Methods: Data were collected via an online survey co-led by the Public Health Agency of Canada, University of Ottawa, ACB community leaders and researchers across Canada. Participants were recruited via email contact. To be eligible, a participant had to be living in Canada, be aged 18 years or older, be able to read English or French, and self-identify as an ACB individual. The survey captured information on access to health services and experiences of multiple forms of discrimination before and during the pandemic. We used multivariable logistic regression to identify factors associated with discrimination. Results: Of 1556 participants, 39.6% were aged 25–39, 42.7% were resident in Ontario, and 63.2% were of African origin. Prior to the COVID-19 pandemic, 62.1% reported having experienced at least one form of discrimination in a healthcare setting. During the COVID-19 pandemic, over 66% reported having experienced at least a form of discrimination, with 25% reporting a perceived increase in the frequency with which they experienced discrimination. The perceived increase in the frequency of discrimination was 10.8%, 15.3%, 15.9%, 17.0%, 18.1%, 18.7%, and 31.2% among participants who reported having experienced sexual orientation-, gender-, substance use-, disability-, age-, economic status-, and race-based discrimination, respectively. In the multivariate logistic regression, the odds of reporting increased experiences of discrimination in participants aged 50 and above were 0.38 times (95%CI: 0.21, 0.69) those in participants who were 31–40 years of age. Conclusions: The proportion of participants who reported an increased experience of discrimination during the pandemic was high. Although there is variation in levels of experienced discrimination, the different forms of discrimination (race-, gender-, sexual orientation-, substance use-, economic status-, disability- and age-based discrimination) that participants experienced are alarming. This underscores the need for concerted efforts to address multiple forms of discrimination in healthcare settings to improve care engagement and health equity among ACB communities. There was a significant association between perceived increased experience of discrimination and only one sociodemographic factor—older age (50 and above); other factors contributing to participants’ perceived increased experience of discrimination when accessing healthcare services need to be explored. Full article

Background/Objectives: The Black Caribbean population of Honduras, also referred to locally as Negro Inglés, constitutes one of the country’s nine recognized indigenous and Afro-descendant peoples. Predominantly settled in the Bay Islands and sections of the Caribbean coast, this community traces its ancestry predominantly to West Africa and has remained culturally and linguistically distinct for more than three centuries. Despite its demographic and historical relevance, no population-specific short tandem repeat (STR) database has been established for this group. Methods: Allele frequencies for 23 autosomal STR loci were characterized in 100 unrelated Black Caribbean individuals from the department of Islas de la Bahía. DNA was extracted from blood on FTA cards and amplified with the PowerPlex Fusion 6C System (Promega Corporation). Statistical parameters were computed using Genepop v4.2, Arlequin v3.5 and GDA v1.0. Results: A total of 241 distinct alleles were detected across all 23 loci (mean 10.48 ± 3.85 alleles/locus). Expected heterozygosity ranged from 0.6541 (D13S317) to 0.9350 (SE33), with a mean of 0.8150 ± 0.0664—values consistent with a population of predominantly West African origin. No locus exhibited a significant departure from Hardy–Weinberg equilibrium after Bonferroni correction (α = 0.0022). The combined power of discrimination exceeded 99.9999% and the combined chance of exclusion surpassed 99.9999%. Conclusions: This first genetic characterization of the Honduran Black Caribbean population delivers an essential, population-specific reference dataset for forensic casework, paternity testing, and population genetics research. The data also deepen the understanding of Afro-descendant genetic diversity in Central America and constitute a critical step towards equitable forensic genetic services for all Honduran ethnic communities. Full article

Background. Cardiometabolic diseases (CMDs) have become a major health concern among adults living with HIV (ALWH) as antiretroviral therapy (ART) extends life expectancy. Metabolic syndrome (MetS)—a cluster of abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and hypoalphalipoproteinemia—is a key predictor of CMD risk. Despite high HIV prevalence in Panama, data on MetS among ALWH are scarce. Thus, the Colón C3 Study aimed to estimate the prevalence of MetS and its criteria in a large cohort of ALWH in Colón, Panama. Methods. Between April–December 2024, 659 ALWH aged ≥18 years were enrolled at the province’s sole ART Clinic (78.1% of active patients). Participants completed a computer-assisted survey on demographics and social determinants of health (SDoH), underwent anthropometry and body composition assessment, and provided ≥8 h fasting blood samples for glucose, lipid profiles, HbA1c, and high-sensitivity C-reactive protein (hsCRP). MetS was defined using NCEP-R ATP-III criteria, and analyses were stratified by sex. Results. Mean age was 43.9 (range 18–79) years; 55% were female, and 51% identified as Black/Afro-Caribbean. The overall prevalence of MetS was 38.6% (binomial 95% CI 34.5%, 42.9%), exceeding pooled estimates for ALWH in the Americas (30.4%). Among individual criteria, hypoalphalipoproteinemia (59.6%) and hypertension (52.6%) were most prevalent, followed by abdominal obesity (45.2%), hyperglycemia (33.5%), and hypertriglyceridemia (22.5%). Women exhibited significantly higher body fat mass and BMI than men. Mean hsCRP was 7.2 mg/L, indicating persistent inflammation despite virologic suppression. Socioeconomic vulnerabilities, food insecurity (30%), and housing instability (>40%) were common. Conclusions. Findings reveal a substantial cardiometabolic burden among ALWH in Colón and underscore the need for integrated HIV–CMD care models, earlier screening, and natal sex–responsive interventions. The results provide foundational evidence for improving long-term, equitable cardiometabolic outcomes in HIV care across Panama and the broader Latin American region. Full article

This study examines the mobilization of social and cultural capital among first and second-generation Afro-Caribbeans in Canada, focusing specifically on Jamaican and Haitian populations. Employing an analytical model grounded in resistance and identity multi-positionality, this research utilizes Yosso’s theory of cultural wealth as a theoretical framework. Qualitative data were collected through focus groups and an intake survey aimed at exploring the dual objectives of defining Blackness and constructing an in-group Black identity alongside the establishment and contestation of social capital within these groups. The findings reveal a dynamic interplay between resistance and identity, highlighting how marginalized groups leverage their resilience to build robust social networks that challenge hegemonic norms. Significant generational differences were identified in experiences of racism, discrimination, and cultural preservation among the participants. This study contributes to the broader discourse on immigrant integration, social cohesion, and the role of cultural capital in mitigating systemic inequalities. The results underscore the necessity for intersectional approaches to comprehend the complexities of identity formation and social integration in multicultural societies. Moreover, the research emphasizes the critical importance of cultural heritage, identity, and community support as sources of strength and resilience for Afro-Caribbean communities in Canada. Full article

Background: Cancer survivors represent a growing proportion of the UK population and often experience higher multimorbidity and healthcare needs. However, limited research in the UK has explored ethnic and socioeconomic disparities in healthcare resource use among long-term cancer survivors. Methods: Using linked primary care (Clinical Practice Research Data) and secondary care (Hospital Episode Statistics–Admitted Patient Care) data between 2010 and 2020, this population-based cohort study compared healthcare utilisation among 170,352 cancer survivors and 415,975 matched controls without a cancer diagnosis. Outcomes included primary care consultations and hospital admissions (planned and emergency). Analyses adjusted for age, sex, body mass index, smoking, ethnicity, and the Index of Multiple Deprivation. Negative binomial models were used to estimate incidence rate ratios (IRRs). Results: Cancer survivors averaged 33 more primary-care consultations over ten years than controls, with Pakistani, Indian, and White survivors recording the higher rates. Hospital admissions were consistently higher among survivors across all age groups, peaking in those aged 60–75 years. Planned admissions were highest among Black Caribbean (IRR 1.80 (95% CI 1.73–1.87)), Pakistani (IRR 1.71 (1.63–1.78)), and Bangladeshi (IRR 1.66 (1.53–1.80)) groups. Emergency admissions followed a similar trend, remaining statistically significant only for Pakistani survivors (IRR 1.23 (1.16–1.30)). A strong socioeconomic gradient was observed, with healthcare utilisation increasing as deprivation worsened. Conclusions: Cancer survivors experience substantially greater healthcare use than matched controls, with persistent ethnic and socioeconomic disparities. Strategies to reduce disparities should focus on earlier diagnosis, enhanced long-term care coordination, and culturally informed interventions addressing both cancer survivorship and multimorbidity. Full article

Critics often cast the Creole woman of color in Lafcadio Hearn’s circum-Caribbean writings as a figure of cultural moribundity—an emblem of a Creole world fading under the pressures of modernization. However, Hearn also presents Creole women as vivacious counterdecadent agents, disruptors of the political decline experienced by Martinique’s white Creoles after citizenship was restored to the colony’s men of African descent. Through historical contextualization of Hearn’s periodical writing and his correspondence with journalist Elizabeth Bisland, this paper explains why he employs the strategies of Decadent conservatism to imagine a moment in which formerly enslaved Creole women prevent an iconoclastic Republican attack on a sculpture of the Empress Joséphine. Erected in a reactionary period after slavery’s abolition, this monument originally commemorated the reinstatement of plantocratic dominance over the Black population, but by the time Hearn saw the statue, it had become an ironic reminder of weakened white authority. The imagined actions of Hearn’s Creole women resignify the monument, making its survival attest to the limited victory of Republican egalitarianism and the survival of pre-modern traditions of racial deference. Full article

Son of the “rebellious” Rosanna, and grandson of an obeah woman, ‘Talkee Amy’, Robert Wedderburn was a formerly enslaved ultra-radical prophet, pamphleteer, and anti-abolitionist campaigner who migrated to England from Jamaica in 1778. A recent uptick in Wedderburn scholarship, in the words of Shelby Johnson, centers “Caribbean history in our approaches to Wedderburn, whose career in London looms large in critical assessments of his work.” However, even this tradition overlooks the place of Black political actors in Wedderburn’s audiences. By reading spy reports of “West Indian” attendees at Wedderburn’s debates and his frequent address of “ye Africans” in his periodical The Axe Laid to the Root, I argue there is an important difference between approaching Caribbean history as a means of explaining where Wedderburn’s political orientations came from versus regarding the Caribbean as a place where Afrodiasporic people developed critical apparatuses of their own which were themselves used to interpret Wedderburn’s work in his own time. By reapproaching Wedderburn’s archives through interpretive frameworks that may have been available to his Afro-Caribbean audiences, I argue Wedderburn curated spaces of Black political belonging through which Black political agents circulated Black political thought around the Atlantic world of his time. Full article

Breast cancer is the most common cancer among women in Canada. Its presentation and outcomes vary significantly by race/ethnicity. This study explores breast cancer incidence, age at diagnosis, stage, subtype, and mortality, comparing Black and White women aged 20 years and older, using the 2011 and 2016 Canadian Census Health and Environment Cohorts databases. Black women were disaggregated into Caribbean, Central/West African (C/WA), Southern/East African (S/EA), and “Other” ancestry groups. The Black female study population had a lower mean age (43.0 years) than the White (50.5 years). Black women had lower overall age-standardized breast cancer incidence than White women. The age-specific incidence in Black women ages 30–39 of Caribbean origin was higher (RR 95% CL, 1.36, 1.04–1.79; 58.7 vs. 43.1 cases/100,000 person-years) than in White. White women had 14.6% of cases diagnosed at ages 20–49 compared to over 50% in Black women of C/WA and S/EA origins, with highest proportions of diagnoses occurring at least 10 years earlier among Black women (C/WA 46, S/EA 48, Caribbean 57, White 67). Proportions of prognostic stage I diagnoses were less common among Black vs. White women (53.2% vs. 65.9%, p < 0.0001), and triple negative breast cancer was more frequent among Black women (17.1% vs. 9.9%, p < 0.0001), particularly those of Central/West African ancestry (21.8%). Higher age-specific mortality was observed among Black women with Caribbean origins aged 40–49 (RR 95% CL, 1.70, 1.19–2.42) and 50–59 (RR 95% CL, 1.42, 1.08–1.88) compared to White women. Breast cancer characteristics and outcomes vary substantially by ancestry within Canada’s Black population. Tailored screening strategies accounting for earlier onset and aggressive subtypes may help mitigate disparities. Full article

Previous studies have found that support that is uplifting in nature (i.e., positive social support) can have a positive influence on the spiritual well-being of individuals with chronic diseases. However, few studies have explored positive and negative social support’s (i.e., the individual receiving the support feeling unsupported) impact. The purpose of this study is to assess the relationship between positive and negative social support and spiritual well-being among individuals of African descent with chronic illnesses. Survey items that focused on positive and negative social support as well as spiritual well-being were obtained from a secondary dataset, the National Survey of American Life. Missing imputation models were adjusted by demographic characteristics (gender, age, income, education, marital status, employment, length of stay in the U.S., insurance, and religious service attendance). Findings from the analysis revealed a positive association between positive social support and spiritual well-being (β: 0.07, SE: 0.01, p < 0.0001). No significant associations were observed between negative social support and spiritual well-being (β: 0.01, SE: 0.01, p = 0.51). Future researchers should continue to explore the impact of social support on the spiritual well-being of individuals of African descent through the implementation of a culturally tailored program designed to reduce chronic diseases within this population. Full article

From the late seventeenth century onward, the central aim of missionary Christianity in the British Atlantic was to Christianize slavery; that is, to render the institution morally and theologically acceptable within a Christian framework. This work of “amelioration” was envisioned as a gradual process, with missionaries from both the established Church of England and a host of dissenting denominations playing a central role in its advancement. Collectively, they promoted a discourse of Christian slavery that aimed both to reassure slaveowners of the compatibility between slavery and Christianity and to frame the conversion of enslaved people as a means of producing a more obedient, industrious, and morally disciplined labor force. To be sure, in promoting a Christianized vision of slavery, missionary societies were deeply complicit in the exploitation of enslaved Africans. Yet, ironically, the very tools they employed to pacify and discipline (biblical instruction and literacy) were repurposed to articulate a platform of resistance, ultimately contributing to slavery’s undoing. This essay employs critical discourse analysis to examine how these dynamics unfolded in two pivotal uprisings in the British Atlantic world: the Demerara Rebellion of 1823 and the Christmas Rebellion of 1831 in Jamaica. In both cases, missionary endeavors contributed to the counter-discursive appropriation of biblical theology that played a critical role in transforming enslaved people into agents of political change. Still, reimagining scripture was only part of the story. Crucially, it was the alignment of a new religious consciousness with unfolding political events, that transformed simmering discontent into open revolt. Full article

Background/Objectives: Race-based cardiac screening criteria in sports cardiology, including the “Black athlete’s heart” concept, assume biological distinctions that may not reflect physiological reality. This systematic review evaluates whether geographic ancestry provides more clinically relevant predictors of cardiac adaptation than racial categorization. Methods: PubMed was searched (January 2005–July 2025) for studies examining cardiac adaptations in athletes by ethnicity. Data extraction captured demographics, geographic origin, cardiac assessments, and outcomes. Narrative synthesis was employed due to methodological heterogeneity. Results: Forty-seven studies (n = 66,130) revealed substantial within-race heterogeneity. The “Black athlete repolarization variant” prevalence ranged from 1.8% (Brazilian) to 30% (Ghanaian) Black athletes. Left ventricular wall thickness >12 mm (normal <11 mm) occurred in 7.1% of Black versus 0.4% of White athletes, yet varied significantly within Black populations—10.8 ± 1.2 mm in Sub-Saharan versus 9.4 ± 1.1 mm in African-American athletes (p < 0.001). Relative wall thickness ≥0.44 (normal ≤0.42) was presented in 43% of West/Middle African, 23% of East African, and 7% of White athletes. T-wave inversion showed four-fold variation within Black populations (3.6–8.5% West African versus 0.5–2.0% African-American/Caribbean). Current International Criteria demonstrated inequitable specificity: 3.3% false-positive rate in Black versus 1.4% in White athletes. Conclusions: Geographic ancestry explains more cardiac variation than racial categories, supporting contemporary understanding of race as a sociopolitical construct. The persistent diagnostic disparities in ECG screening specificity highlight the need for reform. Transitioning toward protocols incorporating continental origin, anthropometric factors, and social determinants of health—while eliminating terminology like “Black athlete’s heart”—represents an important step toward achieving equity in cardiovascular care for diverse athletic populations. Full article

This essay expands the canon of sources for liberative theologies by examining the artwork of leading Caribbean muralist Sir Dunstan St. Omer. In conjunction with his close friend—Nobel Laureate Sir Derek Walcott—St. Omer pioneered a form of artistic expression which he used to great and imaginative effect as counter-narrative to dehumanizing colonial myth. The essay presents two of the artist’s best-known murals, discusses their significance in the arc of Caribbean religiosity, and extrapolates critical insight for a contemporary Black Catholic mysticism. Full article

While often framed as historical or ‘post’colonial, the pervasive legacies of anti-Black racism, rooted in the afterlives of slavery and the dehumanization of African, Caribbean, and Black (ACB) voices, continues to shape the health experiences of young ACB women in Ontario, Canada. Using an intersectional framework, this qualitative study utilized focus groups (n = 24) to understand factors influencing access to sexual and reproductive health services for young ACB women in southern Ontario. The findings reveal that fostering ACB youth engagement in the design and facilitation of healthcare programs will be vital for creating more responsive spaces to fully express sexual health concerns. It also demonstrates that Eurocentric biomedical frameworks continue to obscure young ACB women’s needs, emphasizing the necessity for culturally relevant care. Lastly, the findings indicate that internalized colonial narratives around health practices perpetuate intergenerationally, further complicating young ACB women’s access to adequate sexual and reproductive healthcare. This examination illuminates the need to address the colonial legacies within healthcare systems that continue to pathologize and hypersexualize young ACB women’s bodies. The study concludes by advocating for intersectional, youth-centered, and culturally competent approaches to dismantling the barriers young ACB women face in accessing sexual and reproductive health services. Full article

The reasons why patients cannot proceed with HCT, including cases where no suitable donor is identified, remain poorly described. We reviewed all referrals for allogeneic HCT to our programme between 1 January 2019 and 31 December 2023. Of 880 patients referred for allogeneic HCT, 494 (61.8%) proceeded to transplant (mean 52 ± 14.8 years, 61.5% male) using HLA-matched unrelated (64.2%) or related (19.4%) donors and HLA-mismatched (13%) or haploidentical (3%) donors. Of patients that did not proceed with HCT (386, 38.2%), disease-related causes (54.2%), patient preference (15.8%), and significant patient comorbidity (11.4%) were the most common reasons. Eleven patients (2.9% of transplants that did not proceed; 1.3% of all referrals) lacked a suitable donor and had HLA phenotypes most associated with Caucasian (six patients, 55%), First Nations, Inuit or Metis (two patients, 18%), Black African, Caribbean or African American (one patient, 9%), Asian or Pacific Islander (9%), or unknown ethnicity (one patient, 9%). Very few patients were unable to proceed with transplant due to lack of a suitable donor; however, those cases are overrepresented by non-Caucasian ethnicity relative to the population. Full article