This research study quantifies and describes suicide among South Asian Americans (SAAs), an emerging population that are underrepresented group in suicide research. The purpose of this study was to examine key characteristics of suicide deaths among SAAs. Data were employed from DuPage County, IL, a county with a large SAA population. Following federal recommendations for disaggregating Asian American data at a granular level, four SAA researchers used name recognition to identify all SAA cases classified as suicide in the DuPage County coroner’s database from 2001 to 2017 (N = 38). Coroner’s reports were analyzed for contextual details and correlating factors specific to each suicide. Overall, 76.3% of victims were male and 45.0% were married. An analysis of the coroner reports established that 71.1% of decedents showed behavioral disorders that were predisposing risk factors for suicide including mental health diagnoses (57.9%), and a reported prior suicide attempt (21.1%). Among these decedents only 34.2% had received any prior psychiatric care. Significant errors in racial classification of SAAs, lead to a gross undercount of SAA deaths by suicide with 55% of South Asian suicides assigned to a different race or ethnic group. Future studies must increase the scope of this research to other geographic locations with high concentrations of SAAs and examine the risk factors for suicide among SAAs, one of the fastest growing ethnic populations in the U.S.

Extant scholarship has paid considerable attention to exploring the impact of people-dependent intangible resources on business success but in large organisations only. Research about the role of these resources in small businesses, in general, and in ethnic minority small businesses, in particular, is scarce. The current study attempts to narrow this gap. Since it is impossible to study all the ethnic minority small businesses, this study uses a case study strategy that focuses on South Asian ethnic minority small businesses that deal in fashion. The study adopts a qualitative research methodology, it uses the semi-structured in-depth interview method to collect data, and it espouses an inductive thematic technique for coding/analysis of the data. Five overarching themes emerged from the interview data. These are: business success; compassionate customer service; relationships; knowledge, experience, training and education; and ethnic culture and the wider economic and political environment. Discussion of these themes leads to the formation of the culture-induced entrepreneurship model. According to this model, the continued success of these businesses is driven by the ethnic culture, while the existence of these businesses helps to maintain the culture in return. However, overdependence on the coethnic base might risk the future success of these businesses. This thesis concludes by highlighting its theoretical contributions to the culturalist view and the mixed embeddedness model of ethnic minority entrepreneurship and small business literature. The implications of this study for researchers, practitioners, and policy-makers, as well as its limitations and the possible future research paths, are also discussed.

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<p> <b>Background:</b> As the world becomes more urban and slums continue to grow in developing countries, research is needed to measure utilization of health services, health outcomes, and access to health care providers among urban slum residents. Estimating trends in urban health among slum residents relative to other urban inhabitants provides evidence of health disparities for priority-setting by program implementers and policy-makers. Research on the negative effects of slum environments on human health has started to emerge, yet there remains a paucity of evidence on morbidity trends over time and inequalities between slum residents and other urban residents. The goal of this study is to quantify maternal and child health care access, utilization and outcomes among urban slum dwellers in selected countries in sub-Saharan Africa and South Asia over time. These three areas are addressed in three separate dissertation manuscripts. </p><p> <b>Methods:</b> This dissertation offers an in-depth analysis of household and health facility data to measure trends in maternal and child health care utilization and health outcomes among slum residents over time, as well as inequalities in access, utilization and outcomes between other urban and rural populations. Manuscripts 1 and 2 apply a unique spatial inequality approach to existing population-based household data from the Demographic and Health Surveys (DHS) to identify a sample of slum residents. Manuscript 1 assesses trends in maternal and child health care (MCH) utilization and health outcomes using DHS data in Bangladesh, Ethiopia, Kenya, Malawi, Nepal, Nigeria and Tanzania between 2003 and 2011. In Manuscript 2, a trend analysis is performed in Kenya to examine diarrheal disease and acute respiratory infection (ARI) in children under-five in both slums and other urban and rural areas during the roll-out of a national slum upgrading program. Manuscript 3 further explores local-level dimensions of health care access from two slums in Kenya, generating evidence on service availability and readiness in slums. In this section, we analyze health facility data collected using a modified version of the World Health Organization&rsquo;s (WHO) Service Availability and Readiness Assessment (SARA). </p><p> <b>Results:</b> Manuscript 1 reports significant disparities between slum dwellers and other urban residents&rsquo; utilization of key maternal health interventions&mdash;appropriate antenatal care (ANC), tetanus toxoid vaccination, and skilled delivery&mdash;in Bangladesh, Ethiopia, Kenya and Nigeria. In addition, child health outcomes examined in Manuscript 1 suggest that the prevalence of diarrheal disease in children under-five is declining among other urban and rural residents, but not significantly among slum residents. Nigeria was the only exception, with significant declines in diarrheal disease prevalence in slums over the study period. Because ARI improvements are found across populations, the data suggests this condition is not unique to slum settings. The trend analysis in Manuscript 2 supports these findings&mdash;ARI is declining steadily over time not only among slum residents, but also among other urban and rural residents as well. Diarrheal disease prevalence, on the other hand, has not changed significantly over time, with stable levels among slum dwellers between 1993 and 2014. In Manuscript 3, analysis of general service availability and readiness in two locations&mdash;the Nyalenda slum of Kisumu and the Langas slum of Eldoret&mdash;reveals that slums perform far below recommended benchmarks set by WHO. When we compare service availability and readiness indicators with regional, urban, and national averages, in general slums in Kisumu and Eldoret perform poorly. However, there were some instances&mdash;typically involving standard precautions for infection control&mdash;where Kenyan slums actually performed better than comparison sites. </p><p> <b>Conclusions:</b> This research provides a comprehensive view of health systems dimensions in urban slums in sub-Saharan Africa and South Asia. Manuscript 1 confirms evidence of an urban penalty and emphasizes a need to focus on maternal health care utilization in slums. Manuscript 2 detects little improvement in child health outcomes among slum dwellers in Kenya during the roll-out of the country&rsquo;s national slum upgrading program. An integrated approach to health and urban policy development is recommended based on these results. Manuscript 3 identifies areas of service availability and readiness in two Kenyan slums that fall below global targets and are in need of improvement in order to achieve desired health outcomes. Taken together, this study makes a significant contribution to the crucial demand for research on growing marginalized urban populations in developing countries.</p>

Research shows that in the UK, individuals from black and minority ethnic backgrounds are significantly less likely to access mental health services than the general population. In the absence of literature or robust mental health service access figures for Nepalese people living in the UK (NLU) there is little understanding of the mental health needs and help-seeking preferences of this group. This study aimed to examine factors which are associated with professional help-seeking for mental health difficulties in NLU. The Theory of Planned Behaviour (Ajzen, 1985) was used as a guiding theoretical framework to examine the strongest predictors of intention to seek professional help. Potential predictors, shame/izzat, acculturation, beliefs about the causes of mental distress and demographic variables were measured. The sample were 65 NLU recruited from community centres, health events and online groups across the UK. Results indicated that although a significant number of NLU reported having experienced mental health difficulties, very few had sought professional help. A number of variables significantly correlated with intention to seek professional help, including level of acculturation, non-Western physiological causal beliefs and izzat. According to a multiple-regression analysis of the whole sample, izzat was the most strongly related to intention to seek professional help. A number of barriers to help-seeking were identified such as hoping problems would go away or not wanting to burden others. A significant strength of the study was the use of both Nepalese and English language questionnaires which ensured that a large non-English speaking section of the NLU population was not excluded from the study. Limitations include methodological considerations such as the use of one measure which appeared to have limited validity. Furthermore, the exclusion of illiterate individuals by merit of using a self-report questionnaire limits the generalisability of these findings to the NLU more widely. Low mental health service access rates were identified within this sample relative to the prevalence of mental health difficulties. The clinical implications of this study highlight the need for policy and service level strategies to increase service access rates and the need for mental health services which are sensitive to the culturally specific issues within the population.

published_or_final_version / abstract / Linguistics / Master / Master of Arts in Applied Linguistics

This study is an investigation of embodiment. It is informed by the experiences and understandings of health, healing, violence and oppression among 15 young South Asian women living in Toronto, Canada. Their articulation of the importance of, and difficulties associated with, health and healing in contexts of social inequity contribute to understandings of embodiment as co-constituted by sentient and social experience. In my reading of their contributions, embodied learning – that is, an ongoing attunement to sentient-social embodiment – is a counter hegemonic healing strategy that they use. Their experiences and insights support the increasingly accepted claim that social inequity is a primary determinant of health that disproportionately disadvantages subordinated people. Furthermore, participants affirm that recovery and resistance to violence and oppression and its consequences must address sentient-social components of embodiment simultaneously. In this study, Yoga teachings provide a framework and practice to investigate embodiment and embodied learning. Following 12 Yoga workshops addressing health, healing, violence and oppression, I conducted individual interviews with 15 workshop participants, 3 Yoga teachers and 2 counsellor / social workers. Participants discuss Yoga as a resource for addressing mental, physical, emotional and spiritual consequences of violence and oppression. They resist New Age interpretations of Yoga in terms of individualism and cultural appropriation; they also challenge both New Age and Western biomedicine for a lack of attention to the consequences of social inequity for health and healing. This study considers embodied learning as an important healing resource and form of resistance to violence and oppression. Scholarship addressing embodiment in sociology, health research, anti-racism, feminism, anti-colonialism, decolonization and Indigenous knowledges are drawn upon to contextualize the interviews. This study offers insights relevant to health promotion and adult education discourse and policy through a careful consideration of the embodied strategies used by the participants in their nuanced negotiations of social inequity and pursuits of health and healing.