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Found 179 results
  1. Content Article
    The prevalence and impact of musculoskeletal conditions (MSK) are not experienced equally across the population. Musculoskeletal conditions are linked to deprivation and age, are more prevalent in women and disproportionately affect some minority ethnic groups. Although the issue of health inequalities is a current area of focus for the NHS, MSK receives a low profile in this work. This presentation by Liz Lingard, Delivery Partner for System Improvement at NHS England (North East & Yorkshire), looks at what drives inequalities in musculoskeletal health, and what can be done to address this.
  2. Content Article
    This PowerPoint presentation looks at Solent NHS Trust's approach to reducing barriers faced by minority ethnic people to accessing and using mental health services. It highlights: the conclusions of a 2019 audit the work of the patient engagement and experience team recommendations from service users wider recommendations for mental health services next steps for community engagement training plans community engagement and patient experience future plans key lessons for services.
  3. Content Article
    For the 20th year, the Agency for Healthcare Research and Quality (AHRQ) is reporting on healthcare quality and disparities. The annual National Healthcare Quality and Disparities Report is mandated by Congress to provide a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeconomic groups. The report is produced with the help of an Interagency Work Group led by AHRQ.
  4. News Article
    Patients from minority groups are facing longer wait times for potentially life-saving lung cancer treatment compared to their white counterparts, according to a study. Experts warn that disparities can have real consequences – the earlier treatment is initiated, the better the health outcomes for patients. Researchers at the University of Virginia (UVA) Cancer Centre reviewed data from more than 222,700 patients with non-small cell lung cancer across the US. The findings, published in the scientific journal Health Equity, showed that the mean time for radiation initiation was 61.7 days. Broken down by ethnicity, white patients had to wait only 60.9 days, while Black patients had a wait time of 65.9 days, meanwhile for Asian patients, it was 71.9 days. A single-week delay in treatment could lead to a 3.2% and 1.6% increase in the risk of death for patients with stage I and stage II non-small cell lung cancer, respectively. “Our results suggest that non-white lung cancer patients have delayed time to cancer treatment compared with white patients, and this is not limited to a particular type of treatment facility,” said senior researcher Rajesh Balkrishnan, PhD, of UVA Cancer Center and the University of Virginia School of Medicine’s Department of Public Health Sciences. “Collaboration among providers and community stakeholders and organisations is much needed to increase accessibility and patient knowledge of cancer and to overcome existing disparities in timely care for lung cancer patients.” Scientists cite multiple reasons for the racial disparities, including health insurance – non-white patients are more likely to be uninsured, face greater socioeconomic barriers to care and may be perceived by doctors as being at risk for not following through with treatment plans. Read full story Source: The Independent, 26 October 2022
  5. News Article
    Researchers in the US have found a genetic link between people with African ancestry and the aggressive type of breast cancer. They hope their findings will encourage more black people to get involved in clinical trials in a bid to improve survival rates for people with the disease. Triple negative breast cancer (TNBC) is more common in women under 40 and disproportionately affects black women. A study published in the journal JAMA Oncology found that black women diagnosed with TNBC are 28% more likely to die from it than white women with the same diagnosis. Now a new study has confirmed a definitive genetic link between African ancestry and TNBC. Lisa Newman, of Weill Cornell Medicine, has been part of an international project studying breast cancer in women in different regions of Africa for 20 years. She says representation of women with diverse backgrounds on clinical trials is absolutely critical. "Unfortunately, African-American women are disproportionately under-represented in cancer clinical trials and we see this in the breast cancer clinical trials as well," says Dr Newman. "If you don't have diverse representation, you don't understand how to apply these advances in treatment. "Part of it is because there is some historic mistrust of the healthcare system. "We do continue to see systemic racism in the healthcare delivery system where it has been documented, tragically, that many cancer care providers are less likely to offer clinical trials to their black patients compared with their white patients."
  6. News Article
    New patient data shows significant regional differences in the effectiveness of primary care in getting cancer sufferers diagnosed – with an even more alarming picture when the data is broken down by ethnicity. A survey of cancer patients asked how many times they had “spoken to a healthcare professional at [their] GP practice about health problems caused by cancer” before they were diagnosed, with a range between one and more than five times. The overall figure for five times or more in England was 7% – but all four cancer alliances in London scored significantly above this. Cancer Research UK said this could reflect the greater concentration of ethnic minority patients in the capital, and the data bore this out. Nationally, 6.6% of white cancer patients had seen five or more primary care staff before getting a diagnosis. This compared to 11.7% for Asian cancer patients and 12.9% for Black cancer patients. Read full story (paywalled) Source: HSJ, 18 October 2022
  7. News Article
    Imtiaz Fazil has been pregnant 24 times, but she only has two living children. She first fell pregnant in 1999 and, over the subsequent 23 years, has had 17 miscarriages and five babies die before their first birthdays due to a rare genetic condition. The 49-year-old, from Levenshulme in Manchester, told BBC North West Tonight her losses were not easy to talk about, but she was determined to do so, in part because such things remained a taboo subject among South Asian groups. She said she wanted to change that and break down the stigma surrounding baby loss. She said her own family "don't talk to me very much about the things" as they think "I might get hurt [by] bringing up memories". "It's too much sadness; that's why nobody approaches these sort of things," she said. Sarina Kaur Dosanjh and her husband Vik also have the hope of breaking the silence surrounding baby loss. The 29-year-olds, from Walsall in the West Midlands, have set up the Himmat Collective, a charity which offers a virtual space for South Asian women and men to share their experiences. The couple, who have had two miscarriages in the past two years, said the heartache was still not something that people easily speak about. "I think it's hidden," Sarina said. "It's really brushed under the carpet." Read full story Source: BBC News, 13 October 2022
  8. News Article
    Research suggests there are higher rates of stillbirth and neonatal death for those living in deprived areas and minority ethnic groups. A report from a team at the University of Leicester shows that while overall stillbirth and neonatal mortality rates have reduced, inequalities persist. MBRRACE-UK, the team that carried out the research, said it had looked at outcomes for specific ethnic groups. The report showed the stillbirth rate in the UK had reduced by 21% over the period 2013 to 2020 to 3.33 per 1,000 total births. Over the same period the neonatal mortality rate has reduced by 17% to 1.53 per 1,000 births. However despite these improvements, the authors found inequalities persisted, with those living in the most deprived areas, minority ethnic groups and twin pregnancies all experiencing higher rates of stillbirth. Elizabeth Draper, professor of perinatal and paediatric epidemiology at the university, said: "In this report we have carried out a deeper dive into the impact of deprivation and ethnicity on stillbirth and neonatal death rates. "For the first time, we report on outcomes for babies of Indian, Pakistani, Bangladeshi, Black Caribbean and Black African, rather than reporting on broader Asian and black ethnic groups, who have diverse backgrounds, culture and experiences. "This additional information will help in the targeting of intervention and support programmes to try to reduce stillbirth and neonatal death." Read full story Source: BBC News, 14 October 2022
  9. Content Article
     In the wake of the Covid-19 pandemic, we are all too aware of the urgent health inequalities that plague our world. But these inequalities have always been urgent: modern medicine has a colonial and racist history. Here, in an essential and searingly truthful account, Annabel Sowemimo unravels the colonial roots of modern medicine. Tackling systemic racism, hidden histories and healthcare myths, Sowemimo recounts her own experiences as a doctor, patient and activist. Divided exposes the racial biases of medicine that affect our everyday lives and provides an illuminating - and incredibly necessary - insight into how our world works, and who it works for.
  10. Content Article
    This article in the American Journal of Nursing provides basic information about the assessment of dark skin tone and calls for action in academia and professional practice to ensure the performance of effective skin assessments in all patients.
  11. Content Article
    A recording of the conference from Midwifery Conversation on ‘action to reduce the disparate deaths and damage to Black mothers and babies in England.'
  12. Content Article
    The 2022 Workforce Race Equality Standard (WRES) report enables organisations to compare their performance with others in their region and those providing similar services, with the aim of encouraging improvement by learning and sharing good practice. It provides a national picture of WRES in practice, to colleagues, organisations and the public on the developments in the workforce race equality agenda The WRES provide detailed analysis to enable employers to understand how their staff experience compares with others in their region and with similar specialism.
  13. News Article
    The rate of people from black backgrounds being restrained in mental healthcare has more than doubled in the past six years, widening the gap with other racial groups, according to official NHS data. Standardised rates of black and black British people subject to restrictive interventions – including physical, chemical and mechanical restraints – have leapt from 52.1 per 100,000 people in 2016-17 to 106.2 in 2021-22. That is compared to a much smaller increase of 30% in the same period for people from white backgrounds, from 15.8 per 100,000 to 20.5. NHS race and health observatory director Habib Naqvi told HSJ he was “very concerned” at the rise. He said a “range of complex causes are likely to be presented to account for this pattern”, including disparities in care pathways, late presentation and lack of timely diagnosis, and general overuse of restrictive practice on people from minority ethnic backgrounds. He added: “It is critical we also focus on ‘causes of the causes’ of these disparities, including the impact of discrimination and bias on access, experience and therefore outcomes of mental health services.” Read full story (paywalled) Source: HSJ, 24 November 2022
  14. News Article
    A clinical commissioning group (CCG) has ordered an independent review of its culture which it said was prompted by the “injustices experienced by black Asian and minority ethic colleagues” during the pandemic, HSJ has learned. The review at Surrey Heartlands CCG, due to report in the autumn, is being led by Duncan Lewis, emeritus professor of management at Plymouth University. He has led several major reviews into culture at NHS organisations, including one into bullying and harassment at South East Coast Ambulance Service Foundation Trust in 2017 and one into workplace culture at Whittington Health Trust in 2018. HSJ asked the CCG for the terms of reference of the review and the reasons why it felt it necessary to commission such an inquiry. It said the review’s scope would be determined by what staff felt was important regarding “our organisational culture, policy and practice – things we do well and things we need to improve”. It added in a statement: “We will listen to the findings of the review and we will make any changes that are necessary.” It is not yet clear if specific events within the organisation itself prompted the CCG to take the unusual step of commissioning the work. But the commissioner’s interim chief did say “feedback from staff” had been a driver. Read full story (paywalled) Source: HSJ, 26 August 2020
  15. News Article
    African American children are three times more likely than their white peers to die after surgery despite arriving at hospitals without serious underlying conditions, the latest evidence of unequal outcomes in health care, according to a study published in the journal Pediatrics, “We know that traditionally, African Americans have poorer health outcomes across every age strata you can look at,” said Olubukola Nafiu, the lead researcher and an anaesthesiologist at Nationwide Children’s Hospital in Columbus, Ohio. “One of the explanations that’s usually given for that, among many, is that African American patients tend to have higher comorbidities. They tend to be sicker.” But his research challenges that explanation, he said, by finding a racial disparity even among otherwise healthy children who came to hospitals for mostly elective surgeries. Out of 172,549 children, 36 died within a month of their operation. But of those children, nearly half were black – even though African Americans made up 11% of the patients overall. Black children had a 0.07% chance of dying after surgery, compared with 0.02% for white children. Postoperative complications and serious adverse events were also more likely among the black patients and they were more likely to require a blood transfusion, experience sepsis, have an unplanned second operation or be unexpectedly intubated. Read full story Source: The Independent, 20 July 2020
  16. News Article
    The latest annual report into the deaths of people with learning disabilities has criticised the “insufficient” national response to past recommendations and called for “urgent” policy changes. The national learning disabilities mortality review programme has criticised the response from national health bodies to its previous recommendations. To date, just over 7,000 deaths have been notified to the programme and reviews have been completed for just 45%. There have been four annual reports for programme to date, and in the latest published today, the authors warned: “The response to these recommendations has been insufficient and we have not seen the sea change required to reassure [families] that early deaths are being prevented." “It is long over-due that we should now have concerted national-level policy change in response to the issues raised in this report and previous others. A commitment to take forward the recommendations in a meaningful and determined way is urgently required.” The latest report also warns that black, Asian and ethnic minority children with learning disabilities die “disproportionately” younger compared to other ethnicities. It also found system problems and gaps in service provision were more likely to contribute to deaths in BAME people with learning disabilities. Read full story Source: HSJ, 16 July 2020
  17. News Article
    Some NHS trusts in England are yet to complete /cOVID-19 risk assessments for their staff from ethnic minority groups more than two months after the NHS first told them to do so, an investigation by The BMJ has found. On 29 April NHS England’s chief executive, Simon Stevens, wrote to all NHS leaders telling them to carry out risk assessments and make “appropriate arrangements” to protect ethnic minority staff, amid growing evidence that they were at greater risk of contracting and dying from COVID-19. However, The BMJ asked England’s 140 acute care trusts for details of risk assessments they had carried out and what subsequent actions they had put in place. Seventy trusts responded. Of these, 27 (39%) said that assessments were yet to be completed for all ethnic minority staff, and 43 (61%) indicated that assessments had been completed. But the other 70 trusts were unable to provide a response within the 20 day deadline, citing “unprecedented challenges” posed by the COVID-19 pandemic, so it is not known what stage they are at in risk assessing staff. Commenting on The BMJ’s findings, Chaand Nagpaul, the BMA’s chair of council, said, “Clearly, we know that a significant number of doctors have not been risk assessed. It is a shame that it has taken so long, because the risk assessments and mitigations would have been most useful and impactful during the peak of the virus.” Doctors’ leaders have suggested that systemic race inequalities in the workplace may have exacerbated delays in risk assessing staff. Nagpaul said, “The BMA survey found that doctors from a BAME [black, Asian, and minority ethnic] background felt under more pressure to see patients without adequate protection. So it does beg the question of whether there’s also been this added factor of BAME healthcare staff feeling unable to demand their right to being assessed and protected." “This is something the NHS needs to tackle. This is an issue that predates covid. It’s vital that we have an NHS where anyone is able to voice their concerns. No one should have to suffer or have fear in silence.” Read full story Source: The BMJ, 10 July 2020
  18. News Article
    After new analysis showed pregnant black women were eight times more likely and Asian women four times as likely to be admitted to hospital with COVID-19, the NHS is rolling out additional support for pregnant women of a Black, Asian and Ethnic Minority (BAME) background. Given evidence of the heightened risk to BAME expectant mums, urgent action is being taken in England including increasing uptake of Vitamin D and undertaking outreach in neighbourhoods and communities in their area. Research carried out by Oxford University has shown 55% of pregnant women admitted to hospital with coronavirus are from a BAME background, even though they represent only a quarter of the births in England and Wales. In response, England’s most senior midwife, Jacqueline Dunkley-Bent, has written to all maternity units in the country calling on them to take four specific actions to minimise avoidable COVID-19 risk for BAME women and their babies. The steps include: Increasing support of at-risk pregnant women – e.g. making sure clinicians have a lower threshold to review, admit and consider multidisciplinary escalation in women from a BAME background. Reaching out and reassuring pregnant BAME women with tailored communications. Ensuring hospitals discuss vitamins, supplements and nutrition in pregnancy with all women. Women low in vitamin D may be more vulnerable to coronavirus so women with darker skin or those who always cover their skin when outside may be at particular risk of vitamin D insufficiency and should consider taking a daily supplement of vitamin D all year. Ensuring all providers record on maternity information systems the ethnicity of every woman, as well as other risk factors, such as living in a deprived area (postcode), co-morbidities, BMI and aged 35 years or over, to identify those most at risk of poor outcomes. Read full story Source: NHE, 29 June 2020
  19. News Article
    More than two-thirds of black, Asian and minority ethnic pharmacists have not had workplace risk assessments for coronavirus, a survey suggests. Of the 380 hospital and community-based pharmacists surveyed by the Royal Pharmaceutical Society and the UK Black Pharmacists Association, 236 were from a BAME background. Of those, 166 (70%) said they had not been approached by their employer to have a risk assessment. The RPS called the results "shocking". It has called on employers to take urgent action to ensure ethnic minority pharmacists are risk assessed. Read full story Source: BBC News, 26 June 2020
  20. News Article
    Factors such as racism and social inequality may have contributed to increased risks of black, Asian and minority communities catching and dying from COVID-19, a leaked report says. Historic racism may mean that people are less likely to seek care or to demand better personal protective equipment, says the Public Health England (PHE) draft, seen by the BBC. Other possible factors include risks linked to occupation and inequalities in conditions such as diabetes may increase disease severity. The report, the second by PHE on the subject, pointed to racism and discrimination as a root cause affecting health and the risk of both exposure to the virus and becoming seriously ill. It said stakeholders expressed "deep dismay, anger, loss and fear in their communities" as data emerged suggesting COVID-19 was "exacerbating existing inequalities". And it found "historic racism and poorer experiences of healthcare or at work" meant individuals in BAME groups were less likely to seek care when needed or to speak up when they had concerns about personal protective equipment or risk. The report concluded: "The unequal impact of COVID-19 on BAME communities may be explained by a number of factors ranging from social and economic inequalities, racism, discrimination and stigma, occupational risk, inequalities in the prevalence of conditions that increase the severity of disease including obesity, diabetes, hypertension and asthma." Read full story Source: BBC News, 13 June 2020
  21. News Article
    A report containing measures to protect ethnic minority groups from coronavirus has been drawn up for government, BBC News has learned. Public Health England (PHE) published a review last week confirming coronavirus kills people from ethnic minorities at disproportionately high rates. But a senior academic told BBC News a second report, containing safeguarding proposals to tackle this, also existed. And PHE now says this report will be published next week. Labour described the decision not to immediately publish the second report as "scandalous and a tragedy". Read full story Source: BBC News, 11 June 2020
  22. News Article
    The government removed a key section from Public Health England’s review (published Tuesday) of the relative risk of COVID-19 to specific groups, HSJ has discovered. The review reveals the virus poses a greater risk to those who are older, male and overweight. The risk is also described as “disproportionate” for those with Asian, Caribbean and black ethnicities. It makes no attempt to explain why the risk to BAME groups should be higher. An earlier draft of the review which was circulated within government last week contained a section which included responses from the 1,000-plus organisations and individuals who supplied evidence to the review. Many of these suggested that discrimination and poorer life chances were playing a part in the increased risk of COVID-19 to those with BAME backgrounds. HSJ understands this section was an annex to the report but could also stand alone. Typical was the following recommendation from the response by the Muslim Council of Britain, which stated: “With high levels of deaths of BAME healthcare workers, and extensive research showing evidence and feelings of structural racism and discrimination in the NHS, PHE should consider exploring this in more detail, and looking into specific measures to tackle the culture of discrimination and racism. It may also be of value to issue a clear statement from the NHS that this is not acceptable, committing to introducing change.” One source with knowledge of the review said the section “did not survive contact with Matt Hancock’s office” over the weekend. Read full story Source: HSJ, 2 June 2020
  23. News Article
    Amid warnings that BAME nursing staff may be disproportionately affected by the COVID-19 pandemic, a Royal College of Nursing (RCN) survey reveals that they are more likely to struggle to secure adequate personal protective equipment (PPE) while at work. The latest RCN member-wide survey shows that for nursing staff working in high-risk environments (including intensive and critical care units), only 43% of respondents from a BAME background said they had enough eye and face protection equipment. This is in stark contrast to 66% of white British nursing staff. There were also disparities in access to fluid-repellent gowns and in cases of nursing staff being asked to re-use single-use PPE items. The survey found similar gaps for those working in non-high-risk environments. Meanwhile, staff reported differences in PPE training, with 40% of BAME respondents saying they had not had training compared with just 31% of white British respondents. Nearly a quarter of BAME nursing staff said they had no confidence that their employer is doing enough to protect them from COVID-19, compared with only 11% of white British respondents. Dame Donna Kinnair, RCN Chief Executive & General Secretary, said: “It is simply unacceptable that we are in a situation where BAME nursing staff are less protected than other nursing staff. Read full story Source: Royal College of Nursing, 27 May 2020
  24. News Article
    The Office for National Statistics (ONS) has published its first figures analysis Covid-19 related deaths by ethnic group in England and Wales between March 2 and April 10. The results showed that the risk of death involving the coronavirus among Black, Asian, and minority ethnic (BAME) groups is “significantly higher” than that of those of white ethnicity. Researchers found that when taking age into account, in comparison to white men and women, black men are 4.2 times more likely to die from a Covid-19-related death and black women are 4.3 times more likely. People with Bangladeshi, Pakistani, Indian and mixed ethnicities have a raised risk of death, too. Read full story (paywalled) Source: The Telegraph, 7 May 2020
  25. News Article
    NHS staff from black, Asian and minority ethnic (BAME) backgrounds should be “risk-assessed” and possibly moved away from patient-facing roles during the coronavirus crisis, according to official guidance. A letter from NHS England acknowledges UK data showing these workers are being “disproportionately affected by Covid-19” and urges health trusts to make “appropriate arrangements”. Public Health England has been asked to look into the issue by the Department of Health, the letter from NHS chief executive Sir Simon Stevens and chief operating officer Amanda Pritchard said. “In advance of their report and guidance, on a precautionary basis we recommend employers should risk assess staff at a potentially greater risk and make appropriate arrangements accordingly,” he added. This could mean BAME health workers being relocated away from patient-facing roles or ensuring they are adequately fitted with personal protective equipment (PPE). Read full story Source: The Independent, 30 April 2020
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