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Showing results for tags 'Health inequalities'.
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EventuntilThe Health Foundation is exploring the pandemic’s implications for health and health inequalities. In this webinar, we share our learning so far, focusing on groups of people who have been particularly affected including young people and Black and minority ethnic groups. We’ll explore what the economic impact of the pandemic means for the wider determinants of health. And, as we move towards post-COVID-19 recovery, we’ll look at what's needed to address health inequalities and to create the conditions for everyone to live a healthy life. Register
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Content ArticleIn this blog, published by the Institute for Healthcare Improvement, Kedar Mate discusses the need to explicitly address race and racism in order to work towards health equity. "We never legislated long waiting times. We never imposed rules, regulations, customs, and norms for ineffective care. We did, however, legislate inequity."
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Content ArticleIn a project led by the Race Equality Foundation, the Men’s Health Forum teamed up with Faith Action and Clinks to develop a community-centred programme to offer blood pressure testing and raise awareness amongst black African and Caribbean males. The programme was piloted in barbershops, a bus depot and a local church in three London boroughs. It demonstrated that offering blood pressure checks in community settings could help overcome the reluctance amongst black African and Caribbean men to have their blood pressure checked. The report, following evaluation between February-March 2020 in the London boroughs of Southwark, Hackney and Brent, concluded: 'The community blood pressure programme was welcomed in all community settings. The pilots engaged a considerable number of men in an accessible environment that they were comfortable in. There was a willingness from community stakeholders for the programme to be implemented over a longer period of time, and healthcare providers may wish to consider the practicalities of delivering blood pressure testing in similar settings for specific target groups.'
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Content ArticleHeralded as an easy fix for health services under pressure, data technology is marching ahead unchecked. In this article for the BMJ, Poppy Noor asks whether there a risk it could compound inequalities.
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Content ArticleIn this blog, Stephanie O'Donohue, Content and Engagement Manger for Patient Safety Learning, discusses some of the patient safety issues that specifically impact on women. Drawing on recent inquiries, patient testimonials and research, Stephanie focuses on three main issues; consent, patient engagement and bias. She highlights the need for people to work in partnership to understand the barriers to safe care for women and to prevent future harm.
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Content ArticleIn this short analysis from the Health Foundation, data from the GP patient survey, an annual independent survey run by Ipsos MORI on behalf of NHS England, was used to explore who gets good access to general practice, unpicking how patient satisfaction with the service they receive varies by deprivation, age and ethnicity. Note: The 2020 GP patient survey data were mostly collected before the COVID-19 pandemic, therefore this analysis doesn’t reflect patient experiences or service changes during the pandemic.
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Content ArticleThe term “racism” is rarely used in the medical literature. Most physicians are not explicitly racist and are committed to treating all patients equally. However, they operate in an inherently racist system. Structural racism is insidious, and a large and growing body of literature documents disparate outcomes for different races despite the best efforts of individual healthcare professionals. If we aim to curtail systematic violence and premature death, clinicians and researchers will have to take an active role in addressing the root cause. Structural racism, the systems-level factors related to, yet distinct from, interpersonal racism, leads to increased rates of premature death and reduced levels of overall health and well-being. Like other epidemics, structural racism is causing widespread suffering, not only for black people and other communities of colour but for our society as a whole. It is a threat to the physical, emotional, and social well-being of every person in a society that allocates privilege on the basis of race. Hardeman et al. believe that as clinicians and researchers, we wield power, privilege, and responsibility for dismantling structural racism — and in this New England Journal of Medicine article the authors highlight recommendations for clinicians and researchers who wish to do so.
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Content Article
Diagnosing and treating systemic racism (16 July 2020)
Sam posted an article in Health inequalities
For physicians, the words “I can’t breathe” are a primal cry for help. As many physicians have left their comfort zones to care for patients with COVID-19–associated respiratory failure, the role of the medical profession in addressing this life-defining need has rarely been clearer. But as George Floyd’s repeated cry of “I can’t breathe” while he was being murdered by a Minneapolis police officer has resounded through the country, the physician’s role has seemed less clear. Police brutality against black people, and the systemic racism of which it is but one lethal manifestation, is a festering public health crisis. Can the medical profession use the tools in its armamentarium to address this deep-rooted disease? Evans et al. explore this further in an Editorial in the New England Journal of Medicine. -
Content ArticleMedicine is a mirror for the racial injustice in our society; it is a field riddled with racial disparities in everything from research funding to patient care to life expectancy. There may be no population of patients whose healthcare and outcomes are more affected by racism than those with sickle cell disease (SCD). Patients with SCD are too often marginalised and dismissed while seeking medical care when their bodies hurt and they cannot breathe. As medical leaders around the United States issue statements denouncing racial injustice and calling for us to “dismantle racism at every level,” we must ensure that these pledges translate into durable improvements for patients with SCD. Alexandra Power-Hays and Patrick T. McGann propose a number of changes to reduce the impact of racism on patients with SCD in the US.
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Content Article“Structural racism” refers to the ways in which historical and contemporary racial inequities in outcomes are perpetuated by social, economic, and political systems, including mutually reinforcing systems of health care, education, housing, employment, the media, and criminal justice. It results in systemic variation in opportunity according to race or ethnic background — for example, in racial differentials in access to health care. Ansell et al. use the case study of a 60-year-old Black woman with breast cancer as an example of structural racism and propose three critical strategies for addressing structural racism in health care. These strategies hinge on shifting the focus of work on racial differences in health outcomes from biologic or behavioural problems to the design of health care organisations and other social institutions.
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Content ArticleThe COVID-19 pandemic clearly illustrates the intersection of structural racism, social risk factors, and health. Data from the Centers for Disease Control and Prevention on COVID-19 infection and mortality rates show high incidences in specific geographic regions. Further investigation within Louisiana revealed that rates of hospitalisation and death in Black patients were twice as high as would be expected on the basis of demographic representation. It has been hypothesised that increased exposure to COVID-19 among Black Americans is attributable to greater representation in service occupations and a greater likelihood of living in inner cities with high population density.
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Content Article
Stolen breaths (16 July 2020)
Patient Safety Learning posted an article in Improving patient safety
In this perspective for the New England Journal of Medicine, Harderman et al. recommend that healthcare systems engage, at the very least, in five practices to dismantle structural racism and improve the health and well-being of the black community and the country. -
Content ArticleBlack, Latinx, and Native Americans are experiencing disproportionate burdens of infections, hospitalisations, and deaths from COVID-19. Similar disparities are observed in other countries where minority groups face hurdles in accessing health, education, and social services as well as affordable, healthy food. These stark manifestations of health inequities have emerged in the wake of a body of evidence linking obesity and obesity-related chronic diseases, such as hypertension, diabetes, and cardiovascular disease — conditions that disproportionately affect disadvantaged populations — with severe outcomes from COVID-19. Though the factors underlying racial and ethnic disparities in COVID-19 in the United States are multifaceted and complex, long-standing disparities in nutrition and obesity play a crucial role in the health inequities unfolding during the pandemic.
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Content ArticleAs the race to develop a vaccine for COVID-19 has reached phase 3 clinical trials, concerns are increasing about the low rates of trial participation in important subgroups, including Black communities. Recent data show that although Black people make up 13% of the US population, they account for 21% of deaths from COVID-19 but only 3% of enrollees in vaccine trials. This problem threatens both the validity and the generalisability of the trial results and is of particular concern in vaccine trials, in which differences in lifetime environmental exposures can result in differences in immunologic responses that could affect both safety and efficacy. Despite long-standing calls from the Food and Drug Administration (FDA) and the National Institutes of Health (NIH) to improve the participation of underrepresented subgroups in drug trials, the problem persists. Warren et al., in an article in the New England Journal of Medicine, explore what the barriers are to greater participation of Black people in COVID-19 trials.
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Content ArticleAppalling racial inequities in health exist in nearly every realm that researchers have examined. These inequities are a dramatic manifestation of the structural violence that plagues our society. Deborah Cohan, an obstetrician, gives her perspective on this in her article in the New England Journal of Medicine. "How am I confronting the underlying forces that facilitate increased suffering and death among certain groups because of their skin color? Although it’s necessary, it is not enough for me to provide respectful health care to pregnant women of color. If I truly want to be part of the solution, I need to explore those parts of me that are most unwholesome, embarrassing, unflattering, and generally not discussed in the context of one’s career." Her goal is to dismantle the insidious thoughts that reinforce a hierarchy based on race, education, and other markers of privilege that separate her from others. "These thoughts, fed by implicit bias, are more common than I find easy to admit. Although I know not to believe everything I think, I also know that thoughts guide attention, and attention guides actions. Until I bring to light and hold myself accountable for my own racist tendencies, I am contributing to racism in health care."
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Content ArticleDisparities in healthcare exist because of socioeconomic factors, structural racism and implicit bias. The panelists in this video identify the problems and discuss what solutions are in place that could improve health disparities such as medical education, more training for underrepresented minority physicians, more funding for research, and fast-tracking publication of research. Furthermore, the panelists explore how the field of dermatology and other medical specialties can address these issues.
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Content ArticleThis report is the product of a review by Baroness Doreen Lawrence, commissioned by the Labour Party, into the disproportionate impact of Covid-19 on Black, Asian and minority ethnic communities. In her introduction to the report, Baroness Lawrence says: "Black, Asian and minority ethnic people have been overexposed, under protected, stigmatised and overlooked during this pandemic – and this has been generations in the making. The impact of Covid is not random, but foreseeable and inevitable – the consequence of decades of structural injustice, inequality and discrimination that blights our society. We are in the middle of an avoidable crisis. And this report is a rallying cry to break that clear and tragic pattern."
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Content Article
Independent Living: Keeping in touch (14 October 2020)
Patient Safety Learning posted an article in Blogs
In this article for Independent Living, Philip Anderson reflects on the significance of touch, and possible impact of COVID-19 for those who are deprived of touch. Philip is an advocate for barrier-free accessibility, equality, and inclusiveness for persons with disabilities. He is involved in several initiatives in the NHS, and with various disability, and accessibility advisory groups. -
Content ArticleTelemedicine has potential to address inequity in healthcare but not until certain barriers are addressed. This article from Joanna Pearlstein in Wired discusses how physicians and care organisations have to be creative and rely on partnerships and local resources, such as school district hot spots or public library broadband access, to make the system reliably work for all their patients.
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Content ArticleThe State of Care is the Care Quality Commission (CQC) annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. The care that people received in 2019/20 was mostly of good quality. But while the quality of care was largely maintained compared with the previous year, there was generally no improvement overall. And in the space of a few short months since then, the pandemic has placed the severest of challenges on the whole health and care system in England.
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Content Article
Black women’s health matters (October 2020)
PatientSafetyLearning Team posted an article in Women's health
To mark Black History Month 2020, blog site Hysterical Women has launched it's first mini series, exploring black women’s healthcare experiences. The contributions of five black writers, shine a light on: black health and healthcare experiences black motherhood, black pain black mental health the experiences of black healthcare professionals. -
Content ArticleThe Health Foundation has launched a time-limited UK-wide inquiry to consider:how people’s experience of the pandemic was influenced by their health and existing inequalitiesthe likely impact of actions taken in response to the pandemic on people’s health and health inequalities – now and in the future.The inquiry is gathering evidence from a wide range of sources to highlight implications for the government decision making and the investment needed to ensure everyone can enjoy the same opportunity for good health and wellbeing. The Health Foundation aim to share the findings from the inquiry in Summer 2021.
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Content ArticleLockdown has been a seismic shock for every family and community. Sadly, the voices of the hardest hit have been heard the least. This report sets about to change this by exploring pandemic and lockdown reflections from a diverse group of expectant and new parents during the critical first months and years of their babies’ development. Charities Best Beginnings, Home-Start UK and Parent-Infant Foundation were alarmed that the voices of parents with new babies have been absent from key pandemic responses. As a result, they worked with Critical Research to survey 5,000 new and expectant parents on their lockdown experiences and found a mixed picture, shining a light on huge disparities between different families and communities.
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Content ArticleConvened shortly after President Trump’s inauguration in 2017, the Lancet Commission on public policy and health in the Trump era, offers the first comprehensive assessment of the detrimental legislation and executive actions during Trump’s presidency with devastating effects on every aspect of health in the USA. The Lancet Commission traces the decades of policy failures that preceded and fueled Trump’s ascent and left the USA lagging behind other high-income nations on life expectancy. The report warns that a return to pre-Trump era policies is not enough to protect health. Instead, sweeping reforms are needed to redress long-standing racism, weakened social and health safety nets that have deepened inequality, and calls on the important role of health professionals in advocating for health care reform in the USA.
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Content ArticleMost primary care clinicians are well aware that the climate crisis is a health crisis and of the immediate and significant health co-benefits of climate action, such as through reduced air pollution. However, when it comes to taking action, in our experience many clinicians do not make the link with clinical practice. This is perhaps a result of extrapolating from actions to reduce one’s personal carbon footprint in areas like energy, waste, and transport. Yet, the majority of general practice’s carbon footprint results from clinical activity. In this article, Aarti Bansal and Grant Blashki focus on clinical practice and outline six practical steps that primary care can take towards sustainable healthcare that align with evidence-informed and person-centred practice.
