The aim of this study was to determine the level of usage of National Health Service Direct (NHSD) by ethnic and gender groups within an urban population. The study population comprised all individuals in the City of Preston, Lancashire, United Kingdom, who had used NHS Direct between 01 July 2003 and 31 December 2003. The ethnic and gender composition of this population was compared with that of the total population within the study area. The United Kingdom census information was analyzed to determine the ethnic composition of the total population studied. The expected and actual usage of NHS Direct was determined for each section of the population and compared by means of Chi-square analysis and the use of standardized residuals. Females from the white ethnic group used the service more than expected, whereas females from all ethnic groups combined used the service less than predicted. For male callers, Black-African, Indian, Pakistani, Bangladeshi, and Asian groups used the service more than expected. Particularly high usage was observed in Indian and Pakistani groups. The findings of this study show that NHS Direct is being under-used by certain ethnic groups and a difference in usage exists depending on gender. As the NHSD is intended to be the first port-of-call for healthcare advice, determining why certain groups use the service more than others is important. Census data show that the ethnic minority communities have grown significantly in recent years. Information is lacking, however, on the differences in the usage of healthcare services by different ethnic components of the population. A consequence of this situation is that certain decisions relating to health care policy cannot be targeted effectively. This limitation is important as the Race Relations (Amendment) Act 2000 places a statutory duty on NHS organizations to promote race equality, in policy and service delivery. Our findings also raise questions relating to the reliability of some current forms of disease surveillance and also show that NHS Direct data to determine patterns of disease, within the population, will be biased by the uneven usage of the service.
The current research explores the concept of survivance in The Heirs of Columbus by Vizenor (1991) and in Shadows of Pomegranate Tree (2014) by Ali. The selected novels were analyzed through the qualitative content analysis technique under the concepts of the theoretical framework of anarchism. The analysis shows that the Moors in The Shadows of Pomegranate Tree and the Red Indians in The Heirs of Columbus have always survived through anarchist survivance (survival through resistance) when they were expropriated of their lands, properties and culture by the Euro-American colonizers. The analysis shows that Moors and Red Indians in the late fifteen century as depicted in the novel had survived through resistance for securing their unique civilizations against foreign oppression. The dispossession of their properties was openly resisted in spite of the acceptance of other types of dispossessions. The protagonists Zuhayr-al-fahl and Stone Columbus at the end of both novels symbolize the concept of survivance as a tactic through continued struggle against colonial encroachment. It was concluded that the cruelties of the colonizers were resisted by the colonized people with an anarchist concept and spirit of survivance.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.