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Showing results for tags 'Health Disparities'.
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Content ArticleIn the face of record high waiting times for elective care, The King's Fund undertook research to understand the strategies that have been used to reduce waiting times in England and elsewhere in the past 20 years. Elective care waiting lists and waiting times are a product of the fluctuations in and disparities between the demand for and available supply of healthcare. Understanding the root causes of these disparities and taking corrective action to restore balance between demand and supply and optimising the conditions within the health care system is therefore considered key to any strategy to reduce waiting times and sustain them at that level.
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Content ArticleFundamentals of Health Care Improvement: A Guide to Improving Your Patient’s Care, 4th edition, is intended to help health professional learners diagnose, measure, analyse, change and lead improvements in healthcare, with the aim to shape reliable, high-quality systems of care in partnership with patients. Copublished by Joint Commission Resources and the Institute of Healthcare Improvement, this fourth edition includes updated resources, including examples, figures, tables, and tools. New to this edition is a focus on health equity and disparities of care brought to light by the COVID-19 pandemic. This focus explores the relationship between social determinants of health and how improvement methods and skills can help identify and close disparity gaps in systems of care. Also new to this edition is an expanded discussion of effective teamwork and the importance of creating multidisciplinary health care teams that partner with patients and families.
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Content ArticleFor 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.
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Content Article
NHS Atlas of Variation Series
Patient Safety Learning posted an article in Data and insight
The Atlases of Variation help to identify unwarranted variation and assess the value that healthcare provides to both populations and individuals. This is produced in collaboration with PHE, NHS England and RightCare and many other organisations. Products include Compendium atlases and themed atlases for areas such as Diagnostic Services and Liver Disease. A defining aspect of the atlases is that each of the indicator’s maps, column chart and box-and-whisker plot is accompanied by text which provides: the context for the indicator, a description of the variation and trend data, options for action and a list of evidence-based resources to support action. Interactive Atlases services can be accessed via the NHS England website. -
Content ArticleRacism, xenophobia, and discrimination exist in every modern society causing avoidable disease and premature death among groups who are often already disadvantaged. This Lancet series examines how the historic systems and structures of power and oppression, and discriminatory ideologies have shaped policy and practice today, and are root causes of racial health inequities. Furthermore, by applying a global lens and intersectional framework, overlapping forms of oppression such as age, gender, and socioeconomic status and their impact on discrimination are analysed. Interventions to address the spectrum of drivers of adverse health outcomes with a focus on the structural, societal, legal, human right, institutional and system level are reviewed. Research recommendations and key approaches for moving forward are proposed.
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Content ArticleIn this HSJ article, Gemma Dakin and George Croft from the Health Innovation Network share their reflections on the HSJ Patient Safety Congress. They highlight key themes that emerged including the need to listen to patients, service users, and carers stories, and encourage their involvement to bring about a cultural change. They argue that humanity will be central to making progress in quality improvement and patient safety.
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Content ArticleMaternal Mortality Review Committees (MMRCs) in the US are multidisciplinary committees that convene at the state or local level to comprehensively review deaths during or within a year of pregnancy. MMRCs have access to clinical and non-clinical information to more fully understand the circumstances surrounding each death, determine whether the death was pregnancy-related, and develop recommendations for action to prevent similar deaths in the future. This article summarises the data from MMRCs in 36 US states between 2017 and 2019, demonstrating variations in prevalence and cause of death according to race, ethnicity and geographical area. The data suggests that over 80% of pregnancy-related deaths examined were determined to be preventable.
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Content ArticleReducing socioeconomic inequalities in cancer is a priority for the public health agenda. In this study, cancer-specific mortality data by socioeconomic status, as measured by educational level, were collected and harmonised across 18 countries in Europe and for multiple points in time over the period 1990–2015. The study found that everywhere in Europe, lower-educated individuals have higher mortality rates for nearly all cancer-types relative to their more highly educated counterparts, particularly for tobacco/infection-related cancers. However, the magnitude of inequalities varies greatly by country and over time, predominantly due to differences in cancer mortality among lower-educated groups, as for many cancer-types higher-educated have more similar (and lower) rates, irrespective of the country. Inequalities were generally greater in Baltic/Central/East-Europe and smaller in South-Europe, although among women large and rising inequalities were found in North-Europe. These results call for a systematic measurement, monitoring and action upon the remarkable socioeconomic inequalities in cancer existing in Europe.
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Content ArticleThis report by LCP Health Analytics, looks at how inequalities across the medicine life cycle impact patients and populations. It paints a vision of what success could look like, and proposes specific, feasible calls to action across industry, health technology assessment (HTA) bodies and players that could transform the role of the life science sector in reducing inequalities and fostering healthy populations. The report identifies two key challenges in addressing health inequalities that are tractable, and where the life science sector is most likely to make commitments and contributions: Multimorbidity is increasing and embedding inequalities in health Financial incentives across health systems are not aligned with patient and population health
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Content ArticleThe Health Equity Network will launch in January 2023 and aims to build momentum for health equity across the UK. It will provide an opportunity for public and private sector organisations, community and voluntary groups and individuals to share their work on health equity and to engage across the country with others with the same interests. This article describes how the Network will work and offers the opportunity to register interest in joining.
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Content ArticleCore20PLUS5 is NHS England's approach to reducing health inequalities at both national and system level. The approach defines a target population cohort and identifies five focus clinical areas that require accelerated improvement. This infographic outlines the specific Core20PLUS5 approach to reducing health inequalities for children and young people.
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News Article
‘Alarming’ rise in type 2 diabetes among UK under-40s
Patient Safety Learning posted a news article in News
The number of people under 40 in the UK being diagnosed with type 2 diabetes is rising at a faster pace than the over-40s, according to “shocking” and “incredibly troubling” data that experts say exposes the impact of soaring obesity levels. The UK ranks among the worst in Europe with the most overweight and obese adults, according to the World Health Organization. On obesity rates alone, the UK is third after Turkey and Malta. The growing numbers of overweight and obese children and young adults across the UK is now translating into an “alarming acceleration” in type 2 diabetes cases among those aged 18 to 39, analysis by Diabetes UK suggests. There is a close association between obesity and type 2 diabetes. There is a seven times greater risk of type 2 diabetes in obese people compared with those of healthy weight, and a threefold increase in risk for those just overweight. “This analysis confirms an incredibly troubling growing trend, underlining how serious health conditions related to obesity are becoming more and more prevalent in a younger demographic,” Chris Askew, the chief executive of Diabetes UK, said. He added: “While it’s important to remember that type 2 diabetes is a complex condition with multiple other risk factors, such as genetics, family history and ethnicity, these statistics should serve as a serious warning to policymakers and our NHS. “They mark a shift from what we’ve seen historically with type 2 diabetes and underline why we’ve been calling on the government to press ahead with evidence-based policies aimed at improving the health of our nation and addressing the stark health inequalities that exist in parts of the UK.” Read full story Source: The Guardian, 1 November 2022 -
News Article
MRSA reported at Manston in migrant who tested positive for diphtheria
Patient Safety Learning posted a news article in News
A case of MRSA has been reported at the congested asylum processing centre at Manston in Kent, the Guardian has learned, after it emerged that Suella Braverman ignored advice that people were being kept at the centre unlawfully. The antibiotic-resistant bacteria was identified in an asylum seeker who initially tested positive for diphtheria. But the asylum seeker was moved out of the site in Ramsgate to a hotel hundreds of miles away before the positive test result was received, raising concerns about the spread of the infection. The Manston site is understood to now have at least eight confirmed cases of diphtheria, a highly contagious and potentially serious bacterial infection. Migrants are meant to be held at the short-term holding facility, which opened in January, for 24 hours while they undergo checks before being moved into immigration detention centres or asylum accommodation such as a hotel. But giving evidence to a committee of MPs last week, David Neal, the independent chief inspector of borders and immigration, said he had spoken to a family from Afghanistan living in a marquee for 32 days, and two families from Iraq and Syria sleeping on mats with blankets for two weeks. Conditions at the site left him “speechless”, he said. On a visit to the site on 24 October, Neal was told there were four confirmed cases of diphtheria. Protective medical equipment for staff has now been brought on to the site. Although diphtheria is a notifiable disease, meaning cases must be reported to authorities, those at Manston have not appeared on weekly public health reports. A Home Office spokesperson said it was “aware of a very small number of cases of diphtheria reported at Manston”, and that proper medical guidance and protocols were being followed. Read full story Source: The Guardian, 30 October 2022 -
News ArticlePatients 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
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News Article
Public health cuts must be avoided, new PM told
Patient-Safety-Learning posted a news article in News
Cuts to public health budgets will hit poorest communities the hardest, the new government is being warned. Directors of public health say local authorities - which pay for initiatives such as smoking cessation services - are on a financial cliff edge. Rising inflation means ventures will cost more to run. Any reduction in funding in next week's spending announcement will have a direct impact on the lives of the most vulnerable, they said. David Finch, assistant director of healthy lives at The Health Foundation, said: "Public health interventions have been shown to be really cost effective. Investing in these preventative measures that help to keep people in good health in the first place means you're protecting against future costs to the economy and society by keeping people healthy and reducing poor health in the future." Read full story Source: BBC News, 26 October 2022 -
News ArticleResearchers 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."
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News ArticleMore than a third of the 3143 counties in the US are maternity “deserts” without a hospital or birth centre that offers obstetric care and without any obstetric providers—and the situation is getting worse, says a report from the March of Dimes organisation. Maternity deserts have increased by 2% since the 2020 report, said the organisation which seeks to improve the health of women and babies. Care is diminishing where it is needed most—especially in rural areas. It affects nearly seven million women of childbearing age and about half a million babies. Read full story (paywalled) Source: BMJ, 17 October 2022
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News Article
Slow cancer diagnosis twice as likely for ethnic minority patients, survey shows
Patient Safety Learning posted a news article in News
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 -
News Article
University of Leicester team finds more stillbirths in deprived areas
Patient Safety Learning posted a news article in News
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 -
News Article
Give all women a menopause check at 45, MPs told
Patient Safety Learning posted a news article in News
Women should be invited for a menopause check-up when they turn 45, a report for MPs says, criticising the current support as completely inadequate. The Menopause All-Party Parliamentary Group says it has listened carefully to women's experiences, including difficulties getting a diagnosis and accessing hormone-replacement therapy (HRT). Many had long waits or were offered antidepressants, against guidelines. The report covers a year-long inquiry. It says action is needed to improve the situation for those going through the menopause, and the families, friends and colleagues affected by it. And a health check offered to all women in their mid-40s, as they approach the perimenopause - when hormones decline and menopausal symptoms, such as hot flushes and night sweats, can begin - should help ensure the necessary support and care as early as possible. The inquiry heard a 39-year-old who suspected she was perimenopausal was turned away by her GP and told to "wait and see". Some 18 months later, she was "almost at the verge of collapsing, struggling to keep my usually happy marriage on track and not functioning well physically or mentally". The report also warns a socio-economic divide is emerging between women able to access the right treatment and those who lose out in the postcode lottery and do not have the financial means to seek treatment elsewhere. Read full story Source: BBC News, 12 October 2022 -
News ArticleHundreds of thousands more women than men have been prescribed powerful anti-anxiety drugs which experts warn are harder to come off than heroin, The Independent can reveal. New information obtained under freedom of information (FOI) laws shows women in England were 59% more likely to be prescribed benzodiazepines – better known by the brand names of Valium, Xanax and Temazapam – than men between January 2017 and December 2021. Benzodiazepines are commonly prescribed for anxiety and insomnia, with the drug’s withdrawal symptoms including depression, acute anxiety, insomnia, vivid nightmares, headaches, vomiting, shakes, cramps and, in the worst cases, seizures which can cause death. Many countries explicitly state benzodiazepines should not be taken for more than four weeks, while research has found benzodiazepines can cause memory loss and Alzheimer’s. In September 2020, the US Food and Drug Administration announced its “black box warning” must be placed on all benzodiazepines to inform patients withdrawal from the drugs can be life-threatening. Stephen Buckley, head of information at Mind, a leading UK mental health charity, told The Independent it was difficult to “know the exact reasons behind why women are more likely to be prescribed benzodiazepines than men” but said the FOI “findings support others which show gender discrepancies in prescribing have been occurring for a long time”. “Previous research in some parts of the world has found that male prescribers were more likely to prescribe benzodiazepines to female patients than male patients. Research into the reasons behind gender differences in prescribing psychiatric medication is important.” Read full story Source: The Independent, 3 October 2022 Related reading: Medicines, research and female hormones: a dangerous knowledge gap Gender bias: A threat to women’s health
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News Article
Cost of living: Young cancer patients 'in a desperate situation'
Patient Safety Learning posted a news article in News
Charities are warning that young cancer patients facing soaring living costs are in a "desperate" situation. Both Macmillan Cancer Support and Young Lives vs Cancer say they've seen dramatic increases in the number of people asking for emergency grants. Research suggests tens of thousands of 18 to 39-year-olds with cancer are struggling to pay basic living costs. Shell Rowe was among those who told BBC Newsbeat they're worried about becoming financially independent. She was diagnosed with stage four non-Hodgkin's lymphoma at age 20 in 2019, just as she was about to study film in California for her third year of university. "Prices have skyrocketed. I haven't been able to work and haven't been able to save and get a job," she says. "How am I ever going to be able to be financially independent? It really scares me." More than half of the 18 to 39-year-olds with cancer surveyed by Macmillan and Virgin Money said they needed more financial support to manage the rising cost of living. One in four young people are getting further into debt or have fallen behind paying rent and energy bills because of increased living costs, according to the survey of 2,000 people across all age groups. More than a tenth (11%) of those surveyed say they've had to delay or cancel medical appointments due to the rising cost of petrol. Many people have to travel long distances for treatment, often in their own cars or a taxi because the risk of infection rules out taking public transport. "It's never been as bad as this. Young people with cancer are in really desperate circumstances, because of the cost-of-living crisis," says Rachel Kirby, chief executive of Young Lives vs Cancer. "No young cancer patient should have to think about the choice of putting fuel in the car to get to treatment, or whether they can heat their homes. But those are the kinds of situations they're facing," Read full story Source: BBC News, 3 October 2022 -
News Article
Thérèse Coffey scraps promised paper on health inequality
Patient Safety Learning posted a news article in News
Thérèse Coffey is ditching the government’s long-promised white paper on health inequalities, despite the 19-year gap in life expectancy between rich and poor, the Guardian has been told. The health secretary has decided to not publish a document that was due to set out plans to address the stark inequalities in health that the Covid-19 pandemic exposed. It was meant to appear by last spring and be a key part of then prime minister Boris Johnson’s declared mission to level up Britain. It was due to set out “bold action” to narrow the wide inequalities in health outcomes that exist between deprived and well-off areas, between white and BAME populations, and between the north and south of England. "It’s dead. It’s never going to appear. The white paper is being canned,” said one source familiar with the situation. Health experts reacted with dismay to reports of the paper being scrapped. “We expect the government to keep its commitment to addressing health disparities in an upcoming white paper and would have grave concerns if this long-planned paper were delayed or shelved,” said Dr Habib Naqvi, director of the NHS Race and Health Observatory. “We need to see priorities and an action plan set out to address a number of serious and longstanding health inequalities. This should be a priority, particularly given the cost of living crisis and the impact this is having on diverse communities.” Read full story Source: The Guardian, 29 September 2022 -
News Article
Women's symptoms ignored by GPs
Patient Safety Learning posted a news article in News
Too many women feel fobbed off or not listened to when they raise concerns about their health, according to a women's health campaign group. The Women's Health Wales coalition says women are often misdiagnosed or have to push for a diagnosis. The theme has emerged repeatedly during BBC Wales interviews with women. The Welsh government said it had set out what's expected of the NHS on women's health, and a full plan is due to be published this autumn. "From the moment I went to my GP about my symptoms in my late teens, I have always felt dismissed," said Jessica Ricketts, 35, who was diagnosed with endometriosis. But the feeling of being fobbed off has cropped up in countless conversations with women whether it be in relation to a heart attack, UTI, stroke, autism or even brain tumour. Patients have told us that clinicians thought they were having a panic attack rather than a heart attack," said Gemma Roberts, policy and public affairs manager at British Heart Foundation Cymru, and co-chair of the Women's Health Wales coalition. "We hear from patients and from clinicians that women have to see their GPs multiple times before they get a diagnosis. Women often aren't listened to. "They are told that pain is a normal part of the female experience but actually that isn't the case. I think we need to be listening to women more about what's going on with their own bodies." The coalition wants: Greater focus on women's health from the very beginning of medical training. Health data to be broken down by protected characteristics because "the stories of women with those backgrounds goes untold". Equitable access to healthcare, including specialist care, regardless of where women live in Wales. Read full story Source: BBC News, 28 September 2022 Related blogs on the hub ‘Women are being dismissed, disbelieved and shut out’ The normalisation of women’s pain Gender bias: A threat to women’s health -
News Article
Sickle cell: NHS to investigate racial inequalities for first time
Patient Safety Learning posted a news article in News
Sickle cell patients’ experiences of barriers to treatment and racial inequalities will be investigated by an NHS body next month, The Independent has learned. The NHS Race and Health Observatory has collaborated with Public Digital, a consultancy group, to lead original research into the experiences of people with sickle cell, including listening to NHS patients’ and carers’ first-hand accounts of acute emergency hospital admissions and managing the condition at home. Research will focus on a series of interviews and ‘experience mapping’ workshops, the findings of which are anticipated to inform recommendations that will help improve emergency care and treatment pathways. “As a priority, we need to discover new measures and treatment plans that can help eradicate the often unacceptable, substandard care people with sickle cell have historically received whilst being unwell and in acute pain,” Dr Habib Naqvi, Director of the NHS Race and Health Observatory, said. This move comes after a parliamentary inquiry into avoidable sickle cell deaths called upon the Observatory to undertake work into sickle cell care in relation to race and ethnicity. The inquiry published a report, ‘No one’s listening’, in November 2021, which uncovered the bleak reality of patients grappling with racism in the NHS while attempting to access healthcare. Only half of healthcare professionals feel they have sufficient tools to manage the long-term damage that sickle cell disease brings, new research from Global Blood Therapeutics found, following extensive studies carried out across 10 countries including the UK, US and Canada. Read full story Source: The Independent, 22 September 2022
