Chronic Fatigue & Ethnicity
Lead Research Organisation:
Queen Mary University of London
Department Name: UNLISTED
Abstract
This study investigates fatigue and chronic fatigue like illnesses in six ethnic groups. Previous studies show that chronic fatigue related illnesses are uncommon among ethnic groups. Studies in the US show a higher prevalence of fatigue and associated illnesses among ethnic groups. In the UK we have inadequate information on the largest ethnic groups.
If there are ethnic variations in prevalence, then risk factors may differ across groups, and this may give us clues about how fatigue and related illnesses are influenced by cultural factors, or whether they can be understood as a response to cultural adaptation, isolation, or other stressors such as discrimination. We can also find out if the frequency of service use, and personal explanations that people give for their condition, influence the likelihood of having a fatigue related illness. Therefore, at the moment, we do not know whether the interventions offered should be changed for ethnic groups, or whether ethnic groups present with similar syndromes that are just not recognized, perpetuating disability and a lack of timely intervention. We also do not know whether there are cultural rather than social factors that are neglected, not only in ethnic groups, but also in majority population. For example, coping behaviours such as social support, or exercise, or leisure activities, or religious activities may help some ethnic groups to reduce their risk of fatigue like illness. Findings such as this may help refine or develop future interventions.
The study we propose exploits data that is already collected and is available for further analysis. It is deposited in a data archive which is accessible to the public and research community. Therefore the costs of the work are minimized. We will be able to analyze these data to identify which social, and cultural risk factors are influential related to having fatigue like illnesses, and to common mental health problems. The risk factors can be discerned from the statistical analyses, from the qualitative interviews and transcripts, and from questions about what the subject thought was the cause of fatigue: amongst the explanations is exercise, medication, illness etc. We therefore have a personal view from the subject, alongside statistical information to assess relevance of specific risk factors.
If there are ethnic variations in prevalence, then risk factors may differ across groups, and this may give us clues about how fatigue and related illnesses are influenced by cultural factors, or whether they can be understood as a response to cultural adaptation, isolation, or other stressors such as discrimination. We can also find out if the frequency of service use, and personal explanations that people give for their condition, influence the likelihood of having a fatigue related illness. Therefore, at the moment, we do not know whether the interventions offered should be changed for ethnic groups, or whether ethnic groups present with similar syndromes that are just not recognized, perpetuating disability and a lack of timely intervention. We also do not know whether there are cultural rather than social factors that are neglected, not only in ethnic groups, but also in majority population. For example, coping behaviours such as social support, or exercise, or leisure activities, or religious activities may help some ethnic groups to reduce their risk of fatigue like illness. Findings such as this may help refine or develop future interventions.
The study we propose exploits data that is already collected and is available for further analysis. It is deposited in a data archive which is accessible to the public and research community. Therefore the costs of the work are minimized. We will be able to analyze these data to identify which social, and cultural risk factors are influential related to having fatigue like illnesses, and to common mental health problems. The risk factors can be discerned from the statistical analyses, from the qualitative interviews and transcripts, and from questions about what the subject thought was the cause of fatigue: amongst the explanations is exercise, medication, illness etc. We therefore have a personal view from the subject, alongside statistical information to assess relevance of specific risk factors.
Technical Summary
Chronic fatigue syndrome (CFS) causes significant disability. Early work suggested that CFS was more common in Caucasians than other ethnic groups; recent research casts doubt on this. The Ethnic Minorities Psychiatric Illness Rates in the Community study (EMPIRIC) provides a unique opportunity to answer this question. It included population samples of six ethnic groups: Black Caribbean (N=694), Irish (733), Indian (643), Pakistani (724), Bangladeshi (650), and White British (837). Questions assessed physical health, common mental disorders (CIS-R), physical function (SF-12), emotional strain, social support, work stress, coping and health service use. Ten questions about fatigue assessed duration, intensity, and effort to overcome fatigue; from these a CFS-like illness can be defined. A qualitative component assessed illness models and coping behaviours. The proposed two year quantitative and qualitative investigation of EMPIRIC data will assess ethnic variations of the prevalence of a CFS-like illness, associations with potential risk factors, and coping behaviours.
