The consequences of the COVID-19 pandemic are still working through health systems worldwide, and further reflections about the nature of health and disease, and about how to design and implement effective public health interventions are much needed. For numerous diseases and conditions, as well as for COVID-19, our knowledge base is rich. We know a lot about the biology of the disease, and we have plenty of statistics that relate health to socio-economic factors. In this paper, we argue that we need to add a third dimension to this knowledge base, namely a thorough description of the lifeworld of health and disease, in terms of the mixed biosocial mechanisms that operate in it. We present the concepts of lifeworld and of mixed mechanisms, and then illustrate how they can be operationalised and measured through mixed methodologies that combine qualitative and quantitative approaches. Finally, we explain the complementarity of our approach with the biological and statistical dimensions of health and disease for the design of public health interventions.
White blood cell (WBC) and mean platelet volume (MPV) counts are related to stroke events, but relationship between their combined indicator (WBC count-to-MPV count ratio (WMR)) and the risk of fatal stroke occurrence is unclear so far. In this retrospective analysis, we enrolled 27,163 participants aged 50 years or older without a stroke history in the Guangzhou Biobank Cohort Study. After a mean follow-up time of 15.0 (SD = 2.2) years with 389,242 person-years, 816 stroke (401 ischaemic, 259 haemorrhagic and 156 unclassified) deaths were recorded. Cox’s proportional hazards regression was used to estimate the hazard ratios (HRs) and the 95% confidence intervals (CIs). Compared with those in the lowest quartile, participants with the highest WMR had different risks for fatal all stroke and fatal ischaemic stroke, respectively, although an increased risk for fatal ischaemic stroke was observed among participants in the fourth WMR quartile and further hs-CRP adjustment; those in the WMR change with 10% increase had a 36% increased risk of fatal all stroke and a 79% increased risk of fatal haemorrhagic stroke, compared to those in a stable (the WMR change between −10% and 10%). Our findings suggest that higher WMR and its longitudinal change were associated with an increased risk of fatal stroke occurrence in middle-aged to older Chinese; it may be a potential indicator for the future fatal stroke occurrence in relatively healthy elderly populations.
Previous studies have shown that highly educated women are more likely to realise their fertility aspirations, or experience a faster progression to a higher order birth, compared to lower educated women. This is often explained by improved economic or social resources among the higher educated. However, it is unclear whether educational differences in health behaviours may also contribute to these differential fertility outcomes. In this study, we use data from Waves 1–7 of the UK Longitudinal Household Study, combined with data from the Nurse Health Assessment from Wave 2 to estimate couples’ likelihood of experiencing additional childbirth within six years. A discrete-time event history model is employed to analyse the transition to a higher order birth, while accounting for both partners’ level of education as well as smoking patterns and body mass index. We find that couples in which the female partner is highly educated are more likely to experience childbirth within six years compared to others. In addition, female smoking is negatively associated with the likelihood of childbirth, while no significant effect has been found for male health factors. Female health indicators explain some of the variation in fertility outcomes for women with lower secondary education compared to degree-educated women. However, education remains a significant predictor of the transition to higher order births, also after accounting for male and female health indicators. It is therefore important to consider both socio-economic and health factors in order to understand variations in fertility outcomes.
The Progressive Era was a time of tremendous growth in the US higher education system. Framed by Critical Race Theory, this chapter explores how the prevailing hierarchal ideologies of the time led to the biased evaluation and closure of Black medical schools, as well as the marginalisation of Black medical professionals. The chapter links the historical racial discrimination in education to the contemporary healthcare disparities and distrust in Black community.
I wrote this improvised piece in response to the UK government’s delay in the release of their Disparities in the risk and outcomes of COVID-19 report. Findings from the report identified disproportionately higher BAME mortality rates from COVID-19. The delay of this report to the backdrop of a revival of Black Lives Matter (BLM) activism after the death of George Floyd compounded issues surrounding everyday racisms. Fear among UK officials of nationwide anti-racist uprisings because of glaring disparities in the report were highlighted. Perhaps the biggest irony of all was that the very services that were supporting the public during this terrifying pandemic, such as the NHS, were mostly made up of BAME employees. BLAME the BAME reflects my racial frustrations with us as a nation state amid narratives of Brexit, COVID-19 and BLM – all compounded by the delay of this report and the confirmation of being othered.
Whether denied, derided or determined to overcome it, COVID-19 has impacted many lives in ways that we are only now beginning to witness, as we move from old configurations of normality and adapt to new realities, be it flexible ways of working and learning or working to change social systems. This conclusion summarises the reflections from the preceding chapters, and ends with a call to develop and maintain critical, anti-racist, decolonial and intersectional approaches that acknowledge the complexities and affects of diverse lived experiences in long COVID society.
This book addresses the prejudices that emerged out of the collision of two pandemics: COVID-19 and racism.
Offering a snapshot of experiences through counter story-telling and micro narratives, this collection assesses the racialised responses to the pandemic and investigates acts of discrimination that have occurred within social, political and historical contexts.
Capturing the divisive discourses which have dominated this contemporary moment, this is a unique and creative resource that shows how structural racism continues to operate insidiously, offering invaluable insights for policy, practicend critical race and ethnic studies.
This chapter is an opinion piece, using examples from healthcare and policing to demonstrate colour-blind, or colour-evasive, responses to the COVID-19 crisis. It describes the findings of a public health report and explores the way in which stakeholder recommendations were ignored. Using illustrations of health inequality, colour-blindness or colour evasiveness will be explored in action.
Moving on to law and order, the chapter will explain how COVID-19 additional policing powers added to the discrimination faced by people of colour in the UK, and how this was not acknowledged, mitigated or recognised by wider society or those in positions of power in the UK. The chapter shines a light on specific examples of discrimination during the COVID-19 crisis.
Colonial honourifics to land grabs, genocide, white supremacy, and other forms of violence (aka Honours), are awarded biannually as part of the political calendar. Today, it is also jarring to see so-called activists, anti-imperialists, and ‘allies’ take these medals. Since March 2020, imperial gongs have gone to people for combatting the same institutional violence that has been manufactured and/or upheld by the state. This chapter uses auto-ethnography to discuss the intimate links between Honours, COVID-19, Black Lives Matter – and the cognitive dissonance required to take state recognition while pontificating about social justice. All while hereditary aristocracy appears to have pervaded through the allocation of senior jobs in the UK government’s COVID-19 response. How can anyone take Honours or a life peerage in proximity to state power, while also positioning themselves as anti-oppression and/or against the government’s gaslighting of the public sector? It is deplorable.
This chapter explores the links between existing collective terminologies and their effect on identity and the collective mental health of racialised communities in the UK. It considers the existing literature on collective racial language, taking issue with terms ‘BAME’, ‘BME’, ‘POC’, ‘Minority Ethnic’, ‘Ethnic Minorities’, ‘Visible Minorities’, with attempts to methodically move towards a more Compassionate, Accurate, Linguistically sound and Contextually conscious (CALC) collective phrase for people who experience racism. The chapter notes the detrimental impact of combining a global pandemic, which problematises ‘BAME’ people with ambiguity and confusion, and its effect on individual and collective consciousness. Through this analysis I argue the need for a new collective term determined by the people. The result of my investigation, however, is that an objective outcome cannot be achieved when dealing with identity and the subjective.