Hypertension awareness, treatment, and control among diabetic and nondiabetic individuals in a multiethnic population in the Netherlands: the HELIUS study

The socio-colonial history of Surinamese surnames applied to a validated surname list to identify ancestry in health research

Around half of the population of Suriname, who are mainly of African and South Asian descent, migrated to the Netherlands at the end of the previous century, where they face higher perinatal and maternal mortality and up to 5 years lower life expectancy than European-Dutch. Analyses by ancestry are needed to address these inequalities, but the law prohibits registration by ancestry. Therefore, a list of Surinamese surnames was compiled and validated to identify the largest groups, African-Surinamese or South Asian-Surinamese ancestry in health research. A complete database of Surinamese surnames was provided by the National Population Registry of Suriname. Surname recognition by researchers of Surinamese ancestry was used. Disagreement was resolved using historical registers and through discussion. The list was further validated against contemporary lists of Surinamese surnames with self-defined ancestry, obtained during population and clinical studies in Suriname and the Netherlands. All 71,529 Surinamese surnames were encoded, as African-Surinamese (34%), South Asian-Surinamese (18%), Brazilian or other Iberian (17%), Indonesian-Surinamese (13%), Chinese-Surinamese (5%), First Nation (2%), and other (10%). Compared to self-defined ancestry, South Asian-Surinamese surname coding had 100% sensitivity, 99.8% specificity, and 99.9% accuracy. For African-Surinamese, who may have Dutch surnames, these values depended on geocoding. With a known Surinamese origin, sensitivity, specificity, and accuracy were, respectively, 97.3%, 100%, and 98.6%, but without this information, there was interference of African-Surinamese with European-Dutch surnames in the Dutch validation sample. In conclusion, the Surinamese Surname List has a high accuracy in identifying persons of Surinamese ancestry. This quick, inexpensive, and nonintrusive method, which is unaffected by response bias, might be a valuable tool in public health research to help address the profound health disparities by ancestry.

Superdiversity, population health and health care: opportunities and challenges in a changing world

OBJECTIVES

Ethno-national approaches to research public health and migrant outcomes have dominated for decades but lack efficacy in a globalised world and in view of the intractable nature of health outcome inequalities for migrant and minority groups. This article highlights some of the challenges and opportunities associated with a superdiversity perspective in public health research.

SUPERDIVERSITY AND ETHNO-NATIONAL APPROACHES

Migration patterns have changed with more people arriving from more places and the diversification of diversity meaning that the ethno-national categories utilised in public health research have reduced explanatory potential. THE EXAMPLE OF MATERNAL AND PERINATAL MORTALITY IN THE UNITED KINGDOM: Adjusting UK perinatal mortality rates by five ethnic groups based on assumptions of relationships between high levels of risk and ethnic groups masks the scale of inequality faced by groups wherein mortality rates are increasing and highlights some of the difficulties associated with using ethno-national classifications.

A SUPERDIVERSITY PERSPECTIVE

A superdiversity approach moves beyond ethno-nationalism to socially locate groups focussing on commonalities and differences across spaces and characteristics and employing intracategorical or anticategorical approaches.

CONCLUSIONS

Superdiversity brings new levels of demographic complexity and fluidity. Greater reflexivity is needed in diversity research with justification of classifications used for analysis necessary when research questions are developed.

The prevalence of pre-diabetes and diabetes and their associated factors in Northeast China: a cross-sectional study

This study investigates the prevalence of pre-diabetes and diabetes and their associated risk factors among adults in Northeast China. A multistage stratified cluster sampling method was used to select adults from Jilin Province. Out of an initial recruitment of 23,050 individuals, 21,435 participants completed an interview and medical examination. The estimated prevalence of diabetes and pre-diabetes were 9.1% and 19.8%, respectively. The prevalence of hypertension, dyslipidemia, and obesity were the highest in participants with previously diagnosed diabetes. Participants who were previously diagnosed with diabetes were more likely to be aware of their hypertension and dyslipidemia status. Participants who were older, male, more educated, or who were widows or widowers were at greater risk for pre-diabetes. Similarly, those who were current drinkers or smokers, had higher BMI or waist circumference, had a family history of diabetes, or who reported they lived in urban areas or had low physical activity levels had increased pre-diabetes risk. The observed levels of diabetes and pre-diabetes in this study indicate that the medical authority needs to focus more attention in this area, and that health monitoring is essential to improving the health awareness of its residents.