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Showing results for tags 'Health Disparities'.
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News ArticleMedical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours. Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races. The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.” The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain. Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients. Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.” The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. “Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.” Read full story (paywalled) Source: The New York Times, 20 February 2022
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EventuntilThe Royal College of Midwives education and research conference 2022 - Ensuring every voice is heard: promoting inclusivity in education, research and midwifery care This exciting annual conference is aimed at all those involved or interested in midwifery education and research and the overall theme is promoting inclusivity in research and education. The conference is free for RCM members and £75 plus an admin fee for non-RCM members. The objectives of the conference are to: Give a platform to midwifery researchers and educators to highlight their work and spread understanding of their findings and of good practice Provide an opportunity for midwifery researchers and educators, those aspiring to be researchers and educators and others working in the maternity field to build their professional networks Enable those attending to learn about the latest evidence and innovations in midwifery education and research, particularly in relation to promoting inclusivity and reducing inequalities in midwifery education, research and practice. The conference has shared plenary sessions which include both education and research and breakout parallel sessions that focus on either education or research. The conference will have both invited speakers and those who have submitted an abstract that has been accepted for presentation. There will also be panel discussions for audience Q&As and practical workshops on literature searching and writing for publication. Overall conference themes The contribution of midwifery education and research to reducing inequalities and improving inclusion in maternity care, Hearing lesser heard voices to improve education, research and practice, Embedding the future midwife standards in education, research and practice Supporting the mental health of midwives, maternity staff, educators, student midwives and the women and families we serve. Book a place
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Content ArticleThe Collaboration for Change is a group of two UK universities, nine community organisations and two small and medium size enterprises, who have conducted research on how to improve vaccine uptake among ethnic minority groups. This report outlines the results of a co-produced research study by the Collaboration for Change that combines research, evidence and lived experience to understand and improve vaccine uptake in ethnic minority communities. The report highlights the following factors influencing vaccine uptake: Using trusted messengers to encourage vaccine uptake may be a useful strategy to increase uptake in communities with low vaccination rates A lack of trust in the organisations and individuals encouraging vaccine uptake impacts vaccine uptake across many ethnic minority communities People are less likely to accept the offer of vaccination if little culturally and linguistically appropriate information is available to them, especially when their concerns are not covered Alongside the report, the Collaboration for Change has produced some recommended strategies to improve vaccine confidence and uptake.
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News Article
111 callers eight times more likely to abandon calls in some areas
Patient Safety Learning posted a news article in News
Callers to NHS 111 services are twice as likely to be judged as needing an ambulance in some regions as others – and up to eight times more likely to abandon their calls. An HSJ investigation has revealed striking differences in performance between 111 providers. The new integrated urgent care data set, published by NHS England, shows the differences in performance across the country. HSJ analysed data from April to December last year – the first year this data set has been produced. For example, 15.7% of answered calls to North East Ambulance Service Foundation Trust resulted in an “ambulance disposition” while just 7.7% of calls to London Ambulance Service Trust did so. A total of 14.2% of callers to the privately owned Practice Plus Group were judged to require an ambulance. 41.9% of calls were abandoned before being answered by NEAS and 30.6% of those made to the West Midlands Ambulance Service University FT ended the same way. In contrast just 5.2%of callers from Lincolnshire to services provided by Derbyshire Health United abandoned their calls. The “standard” for abandoned calls is just 3%, but the average performance across England was 24.1%. In a statement, the Practice Plus Group said its staff were trained to a high standard on NHS Pathways and it was confident its staff were making appropriate and safe decisions. Over 70 per cent of decisions to instigate a category 3 or 4 ambulance callout were validated in January. As a result ambulances were dispatched in just 20 per cent of those cases, with other patients being directed to alternative pathways. “We are always looking to enhance the service which is why we are running developmental training for our call handlers in more effective probing to reduce the category 2 ambulance disposition numbers and have introduced GoodSam video technology as part of an NHSE pilot which will support clinicians with eyes on with a patient,” the company added. Read full story (paywalled) Source: HSJ, 18 February 2022 -
Content ArticleIn this article for the Maternity & Midwifery Forum, Kirstin Webster, NMPA Neonatal Clinical Fellow, describes the role of the National Maternity and Perinatal Audit. She presents results from research using the audit’s data on births during the major period of the pandemic, and the recent audit report of the effects of ethnicity and socio-economic deprivation on maternity and perinatal care. She highlights inequalities in outcomes and joins the call to investigate the causes of these disparities.
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Content Article
The Health Literacy Place toolkit
Patient-Safety-Learning posted an article in Health inequalities
It is easy to underestimate people’s health literacy needs, because those needs can be hidden or people can be reluctant to admit that they haven’t understood the information they have been given. This toolkit by The Health Literacy Place contains a range of resources to help healthcare professionals better understand and meet the health literacy needs of their patients. -
Content ArticleThe #SolvingTogether platform is a place for people to post their ideas on how to recover services, redesign care delivery and address health inequalities. #SolvingTogether invites colleagues working on elective recovery to contribute their experiences, good practices, ideas, and comments on these challenges before it is opened for contributions more widely. Once #SolvingTogether is fully live, all stakeholders will have the opportunity to contribute and engage through tweet chats and a range of connect sessions.
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Event
Public Mental Health Virtual Symposium 2022
Patient-Safety-Learning posted an event in Community Calendar
untilThe National Institute for Health Research (NIHR) is hosting its second virtual symposium showcasing the latest research conducted within the NIHR School for Public Health Research Public Mental Health (PMH) Programme. At the symposium, you will be able to: hear updates on the latest research from across the PMH programme, provide comments and feedback on the findings, ask academic and peer researchers questions about public mental health research, improve your own knowledge of public mental health research, build connections with others interested in public mental health. Audience This event is free to attend and open to anyone interested in public mental health, including members of the Public Mental Health (PMH) Network. Programme This is a one-day event with morning and afternoon sessions that need to be booked separately. Morning session: 10.00am – 12.30pm This session will showcase the work from Phase 2 of the Public Mental Health Programme, which has been focused on evaluating promising approaches (activities, programmes, etc.) for mental health. This programme of work is divided into eight projects: five that explore public mental health in adults, and three projects which explore public mental health in children and young people: Adult mental health projects Co-located services for working-age adults Community interventions for older adults Economic evaluation of public mental health interventions Using big data to understand public mental health interventions and inequalities Public perspectives on inequalities in public mental health Children & young people mental health projects School culture and student mental health: a participatory action research study Qualitative case study examining the links between school culture and student mental health Creating a Health Research Network to improve young people’s mental health and well-being There will be presentations on all eight projects co-facilitated by academic researchers and peer researchers who have worked together throughout this phase of the programme. Afternoon session: 2.00 – 4.30pm The afternoon session will be made up of a series of short presentations showcasing the SPHR public mental health work from: PhD students Public Health Practice Evaluation Scheme (PHPES) Pre-doctoral and Post-doctoral Fellows Our Research Network (ResNet) members A full programme for the event will be made available soon. Inclusion Both the morning and afternoon sessions will include a series of presentations. In the morning session, you will have the opportunity to ask questions after the presentations, in breakout rooms, and in the chat box on Zoom. Your question will then be read by a moderator and either responded to directly in the chat or read out loud and answered. In the afternoon session, presenters will be monitoring the chat and using it to respond directly to any questions. Presentation slides used during the event will be read out loud. This will be through a mixture of live and pre-recorded presentations, which will also be made available to view on the SPHR website after the event. If there are any access requirements you would like us to be aware of, please answer the question when completing your registration form. Any information given regarding personal access requirements will be used to inform access during the event. All information will be kept confidential. Register Morning and afternoon sessions must be booked separately. Please click on the links below to register for these sessions. Morning session Afternoon session Contact Please email publicmentalhealth@ucl.ac.uk if you have any questions. -
Content ArticleThe NHS Race & Health Observatory (RHO) has published a rapid review into ethnic health inequalities across a range of areas. This report is the first of its kind to analyse the overwhelming evidence of ethnic health inequality through the lens of racism. The NHS has longstanding problems with ethnic inequalities in terms of access to, experiences of, and outcomes of healthcare. These issues are rooted in experiences of structural, institutional and interpersonal racism. The review focussed on priorities set by the RHO relating to ethnic inequalities in: mental healthcare maternal and neonatal healthcare digital access to healthcare genetic testing and genomic medicine the NHS workforce.
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Content ArticleThis report was commissioned by the Royal College of Obstetricians and Gynaecologists, with research led by Leeds Beckett University in collaboration with the University of Sheffield and the University of Oxford. It aims to inform those involved in the care of pregnant women in the UK about the relationship between social determinants of health and the risk of maternal death.
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News Article
Vulnerable women are being failed by maternity services, report finds
Patient Safety Learning posted a news article in News
Current models of maternity care in the UK are failing to reach pregnant women living in adverse social circumstances, research commissioned by the Royal College of Obstetricians and Gynaecologists has found. Georgina Jones, one of the report’s authors and professor of health psychology at Leeds Beckett University, told The BMJ, “Women are often living in a tangled web of complex inequalities that is beyond their control, and this impacts on the care they receive and the outcomes of that care . . .We’ve really been letting down these women in the way that our maternity and reproductive health services are currently delivered, and strategies and care pathways need to be identified and put in place to remedy this.” A number of recommendations have been made in the paper including: Understanding it is the vulnerable, minoritised and disadvantaged women in society that have an increased risk of maternal death. These women are often living in an entangled web of complex inequalities that is beyond their control, which impacts on the care they receive and the outcomes of that care. Strategies and care pathways need to be identified and put in place to improve their situation. These women have been let down in the way that our maternity and reproductive health services are currently delivered. We need to find a better way of recording social determinant data. The current way of doing this is inadequate and not fit for purpose, and it doesn’t provide us with enough information to really understand how the complex circumstances of the woman impacts on her maternal outcomes. The research shows current models of care are still failing pregnant women who have lived in adverse social circumstances prior to, during and after pregnancy. Maternal outcomes are particularly poor for socially disadvantaged women affected by pre-existing physical or mental health problems; those who misuse substances; those who have a lower level of education; those who are overweight, undernourished or poorly sheltered; and those who are at increased risk due to the threat of abusive and unsupportive partners, families and peers. Read full story (paywalled) Source: BMJ, 10 February 2022 -
News ArticleRadical action is needed urgently to tackle “overwhelming” minority ethnic health inequalities in the NHS, leading experts have said, after a damning study found the “vast” and “widespread” inequity in every aspect of healthcare it reviewed was harming the health of millions of patients. Racism, racial discrimination, barriers to accessing healthcare and woeful ethnicity data collection have “negatively impacted” the health of black, Asian and minority ethnic people in England for years, according to the review, commissioned by the NHS Race and Health Observatory, which reveals the true scale of health inequalities faced by ethnic minorities for the first time. “Ethnic inequalities in health outcomes are evident at every stage throughout the life course, from birth to death,” says the review, the largest of its kind. Yet despite “clear”, “convincing” and “persistent” evidence that ethnic minorities are being failed, and repeated pledges of action, no “significant change” has yet been made in the NHS, it adds. From mental health to maternity care, the sweeping review led by the University of Manchester paints a devastating picture of a healthcare system still failing minority ethnic patients despite concerns previously raised about the harm being caused. “By drawing together the evidence, and plugging the gaps where we find them, we have made a clear and overwhelming case for radical action on race inequity in our healthcare system,” said Habib Naqvi, the director of the NHS Race and Health Observatory, an independent body established by the NHS in 2020 to investigate health inequalities in England. Read full story Source: The Guardian, 13 February 2022
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Content ArticleThis free e-learning course by the World Health Organization (WHO) examines the five general steps of inequality monitoring in the context of immunisation programmes. The 'WHO Immunization Agenda 2030: a global strategy to leave no one behind' envisions “a world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being.” The course is approximately two hours long and is primarily aimed at monitoring and evaluation officers for immunisation, and people who have basic knowledge and experience working with immunisation data.
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Content ArticleThis article in Translational and Clinical Pharmacology aims to highlight the need to reconsider current medication dosing strategies in reproductive women. It uses the example of schizophrenia to illustrate how a woman's clinical symptoms can change throughout the ovulatory cycle, leading to fluctuations in medication responses. The authors found that healthcare professionals need to consider hormonal and clinical changes that occur with the menstrual cycle when prescribing treatments. They also call for further research to increase knowledge of the issues and find better treatment strategies in women whose symptoms change with cyclical changes in ovarian hormones. However, they warn that results from such studies should never override the symptoms and treatment responses experienced by individual clinical patients.
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Content ArticleIn this blog, Gwen Nightingale and Katherine Merrifield from The Health Foundation highlight measures to tackle health inequalities that they would like to see included in the government's White Paper on health disparities, due to be published in Spring 2022. They argue that significant investment and ambitious policy are needed to tackle differences in health outcomes. They highlight five areas of focus: Tackle the wider determinants of health head on A new, whole-government approach to improving health Policy ideas backed with immediate investment Meaningfully measuring success Learning from the past
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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 ArticleThis study in the International Journal for Equity in Health aimed to listen to the views of community leaders from seven diverse urban communities in Minneapolis-Saint Paul, Minnesota, around quality healthcare and financial reimbursement. In the US, healthcare quality is measured by insurers, professional organisations and government agencies, with little input from diverse communities. The researchers found that community leaders identified several ideal characteristics of quality primary healthcare, most of which are not currently measured. Community leaders expressed concern that health inequalities are perpetuated when social and structural determinants of health are not considered in determining quality.
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Content ArticleThis resource from the Health Foundation includes data, insights and analysis exploring how the circumstances in which people in the UK live shape their health.
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News Article
Miscarriage: 'I was in pain and they did not listen'
Patient Safety Learning posted a news article in News
Research shows black women are at a 40% higher risk of pregnancy loss than white women. It is an urgent problem, which the Royal College of Obstetricians and Gynaecologists says needs greater attention, with many complex reasons driving this higher risk. These include a lack of quality research involving all ethnicities - but RCOG head Dr Edward Morris says implicit racial bias is also affecting some women's experience of care. Isabel Gomes Obasi and her husband, Paulson, from Coventry, are expecting a baby boy in March. They are extremely anxious as almost a year ago their baby boy Andre died four months into Isabel's pregnancy. Giving birth to Andre was extremely traumatic, Isabel says, but how she was treated when in severe pain and bleeding, in the days before her loss, made the experience worse. "We knew something was wrong, so we went into hospital and waited five hours to be seen by a doctor," she says. "I remember being laughed at by one of the nurses, who said, 'Just go home. Why do you keep coming in?'" Isabel was checked over and told the baby was fine but says her intuition and pain were belittled and ignored. Within 48 hours of going home, Isabel began bleeding heavily. There is little doctors can do at this relatively early stage of pregnancy to save a baby's life. But the feeling of not being listened to has stayed with Isabel ever since. "I just shut down," she says. "The experience made me anxious and depressive, if not suicidal." Asked why she was not listened to, she said: "The colour of my skin," the attitude of some staff was: "'You have black skin - you are not from here - you can wait.'" Dr Morris says it is "unacceptable" women belonging to ethnic minorities face worse outcomes than white women - especially in maternity care. "Implicit racial bias from medical staff can hinder consultations and negatively influence treatment options," he says. This can stop some women engaging with healthcare. Read full story Source: BBC News, 8 February 2022 -
Content ArticleIn this blog, Dr Charlotte Paddison, Senior Fellow at the Nuffield Trust, discusses whether the shift towards digital primary care risks making access easier for people with less need and harder for those more likely to be in poorer health. She also describes the actions that would help make access to primary care easier for different groups of patients.
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Content ArticleThis study in the International Journal for Equity in Health used an online survey to measure and assess relationships between health behaviours and outcomes, and measures of wealth and civic engagement. The relationships found in the survey results support the interrelationships of constructs within the conceptual model. The model can serve as a guide for future equity research, encouraging a more thorough assessment of equity.
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Content ArticleThis guidance from the Chartered Institute of Ergonomics and Human Factors (CIEHF) outlines how human factors as a discipline can help address issues relating to equality, diversity, and inclusion (EDI). It looks at situations that cause EDI issues, including: confusing user interface language and terminology. ill-fitting personal protective equipment (PPE). biases in equipment design. It also examines the role of human factors in overcoming these issues, by: adopting a systems approach. using a participatory design process. applying specific HF methods to enhance EDI delivery.
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Content ArticleIn this blog for the Hospital Times, Tracy Bignall, Senior Policy and Practice Officer at the Race Equality Foundation, writes about how ethnicity impacts on women's health experiences. She argues that the The Department for Health and Social Care (DHSC) Vision for the Women's Health Strategy released in December 2021 does not give adequate attention to the influence that ethnicity has on women's experience of, and outcomes in healthcare. The article outlines instances in healthcare where ethnicity has an impact on women's health and calls for specific action to address how ethnicity influences health inequalities.
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Content ArticleThis study in BMJ Quality & Safety aimed to determine whether areas with higher levels of socioeconomic deprivation or larger ethnic minority populations saw larger falls in emergency and planned admissions in England during the Covid-19 pandemic. The study found that Covid-19 did not have an evenly spread impact on NHS hospital care for non-Covid patients, with disparities corresponding to deprivation and ethnicity. Although it is hard to determine the mechanisms behind these differences, the authors argue that they could make pre-pandemic health inequalities worse.
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Content Article
Systemic safety inequities for people with learning disabilities: a qualitative integrative analysis of the experiences of English health and social care for people with learning disabilities, their families and carers (28 January 2022)
Patient-Safety-Learning posted an article in Learning disabilities
This study in the International Journal for Equity in Health aimed to understand the care experiences of people with learning disabilities, and explore the potential patient safety issues that they and their carers raised. The authors examined the lived experience of care for people with learning disabilities through focus groups and narratives posted on the public platform Care Opinion. The study identified a series of safety inequities and gaps in systems affecting people with learning disabilities. The authors recommend considering interventions to protect against these inequities at a policy and organisational level and highlight that policy needs to span both health and social care.
