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Found 1,218 results
  1. Content Article
    The COVID-19 pandemic has brought health inequalities into sharp focus. The unequal impacts of the virus are also extending inequalities in mental health. This briefing paper, produced by Centre for Mental Health and supported by 13 other national mental health charities, explores the mental health inequalities that are associated with the pandemic in the UK. It finds that the virus and the lockdown are putting greater pressure on groups and communities whose mental health was already poorer and more precarious. Groups of people whose mental health is at greatest risk include those with existing mental health problems, people with long-term physical conditions, women and children experiencing violence and abuse, and Black, Asian and minority ethnic communities. The combination of existing structural inequalities and the unequal impacts of the pandemic mean that people whose mental health was at greatest risk prior to COVID-19 are likely to bear the brunt of the emergency longer term.
  2. Content Article
    More Inclusive Healthcare helps healthcare organisations in the United States do the good work of making healthcare more inclusive and equitable so that everyone will have the opportunity to achieve their full health potential.
  3. News Article
    The architects behind the new NHS Race and Health Observatory have vowed that it will deliver actionable recommendations within months to tackle the structural racism that exists throughout healthcare. Victor Adebowale and Mala Rao called for an observatory to tackle the ethnic health inequalities in the UK in a special issue of The BMJ that they co-edited in February (bmj.com/racism-in-medicine) and NHS England confirmed at the end of the May that the centre would go ahead. Speaking at a meeting to discuss the aims of the observatory on 12 June, Adebowlae told more than 20 assembled stakeholders that he wanted the new centre “to fire on all cylinders,” making recommendations for changes to services that are likely to affect the health outcomes of people from black and ethnic minority backgrounds “within a couple of months.” Read full story Source: BMJ, 15 June 2020
  4. Content Article
    This editorial, published by the Lancet, highlights that racism is the root cause of continued disparities in health and mortality rates between black and white people in the USA and a global public health emergency. It discusses what medical journals can and must do to help.
  5. 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
  6. Content Article
    Professor Donna Kinnair, the head of the Royal College of Nursing, in her blog to the Guardian talks about why the health service is failing people of colour – both those using it and its workforce. "As a black leader, you are always aware that if you are not a good role model, someone coming up behind you may not be afforded the same opportunity you’ve been given. There are, sadly, too few of us. We only have 10 black, Asian and minority ethnic (BAME) chief nurses across the whole of the NHS in England. The leadership of the NHS is not reflective of the workforce, or the communities we serve."
  7. News Article
    An independent investigation into working conditions at a unit of the NHS’s blood and organ transplant service has concluded that it is “systemically racist” and “psychologically unsafe.” The internal investigation was commissioned in response to numerous complaints from ethnic minority staff working in a unit of NHS Blood and Transplant (NHSBT) in Colindale, north London. The report, carried out by the workplace relations company Globis Mediation Group, concluded that the environment was “toxic” and “dysfunctional.” The report found evidence that ethnic minority employees had faced discrimination when applying for jobs and that white candidates had been selected for posts ahead of black applicants who were better qualified. “Recruitment is haphazard, based on race and class and whether a person’s ‘face fits,’” it said. “Being ignored, being viewed as ineligible for promotion and enduring low levels of empathy all seem to be normal,” the report noted. “These behaviours have created an environment which is now psychologically unsafe and systemically racist.” Chaand Nagpaul, BMA council chair, commented, “This report highlights all too painfully the racial prejudices and discrimination we are seeing across healthcare. We must renew efforts to challenge these behaviours and bring an end to the enduring injustices faced by black people and BAME healthcare workers here in the UK.” Read story Source: BMJ, 10 June 2020
  8. News Article
    "Structural racism and social inequality" should be taken into account when looking at the impact of COVID-19 on Britain's black, Asian and minority ethnic, according to an expert involved in a recent review. Professor Kevin Fenton was a major part of a Public Health England (PHE) report ordered by the government into why the BAME community has been disproportionately affected by coronavirus. It found people from BAME groups were up to twice as likely to die with COVID-19 than those from a white British background. The review was also meant to offer recommendations, but sources have told Sky News that these were "held back" by the government. Health Secretary Matt Hancock said coming from a non-white background was a Speaking at a public meeting for Hackney Council, Prof Fenton said: "Over the last six weeks I've worked with over 4,000 individuals to understand what are some of the contextual issues that are driving the excess risk amongst, black, Asian and minority ethnic groups." "Some of the structural issues, like racism, discrimination, stigma, distrust, fair, these are real issues that are challenging for the communities and are seen as underpinning some of the disparities we see for COVID. Any conversation about what we need to do, should take into consideration these things." Read full story Source: Sky News, 9 June 2020
  9. Content Article
    There have been about 1,500 deaths in police custody since 1990, and about one third of those who died were from black and minority ethnic backgrounds.
  10. Content Article
    Knight et al. in a study published in the BMJ describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants. Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.
  11. News Article
    The high proportion of pregnant women from black and ethnic minority (BAME) groups admitted to hospital with COVID-19 "needs urgent investigation", says a study in the British Medical Journal. Out of 427 pregnant women studied between March and April, more than half were from these backgrounds - nearly three times the expected number. Most were admitted late in pregnancy and did not become seriously ill. Although babies can be infected, the researchers said this was "uncommon". When other factors such as obesity and age were taken into account, there was still a much higher proportion from ethnic minority groups than expected, the authors said. But the explanation for why BAME pregnant women are disproportionately affected by coronavirus is not simple "or easily solved," says Professor Knight, lead author. "We have to talk to women themselves, as well as health professionals, to give us more of a clue." Gill Walton from the Royal College of Midwives says, "Even before the pandemic, women from black, Asian or ethnic minority backgrounds were more likely to die in and around their pregnancy," She said they were "still at unacceptable risk" and getting help and support to affected communities was crucial. Ms Walton added: "The system is failing them and that has got to change quickly, because they matter, their lives matter and they deserve the best and safest care." Read full story Source: BBC News, 8 June 2020
  12. 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
  13. Content Article
    This perspective published in the The New England Journal of Medicine examines the problem of racial disparities and the COVID-19 pandemic. The Chowkwanyun and Reed highlight the importance of viewing the data emerging from the crisis in the appropriate socioeconomic and deprivation contexts to protect against ineffective compartmentalisation of the populations being affected. 
  14. News Article
    The risk of dying from coronavirus is more than twice as great in the most deprived areas of England – with the disparity largest for women, analysis shows. A study by the Health Foundation of deaths from COVID-19 showed women in the most deprived parts of the country had a risk of dying that was 133% higher than those in the least deprived neighbourhoods. Between men the difference in risk was 114% higher in worse-off areas, suggesting that while deprivation is a key factor in risk of death from coronavirus for both sexes, its effect is worse for women. Experts say the evidence shows the impact of COVID-19 is falling disproportionately on the poorest in society. Mai Stafford, principal data analyst at the Health Foundation, told The Independent: “This pandemic could and should be a watershed moment in creating the social and political will to build a society that values everyone’s health now and in the long term. Without significant action, there is a real risk that those facing the most disadvantage will eventually pay the highest price.” Read full story Source: The Independent, 21 May 2020
  15. Content Article
    No one can say with certainty what the consequences of this pandemic will be in 6 months, let alone 6 years or 60. Some “new normal” may emerge, in which novel systems and assumptions will replace many others long taken for granted. But at this early stage, it is more honest to frame the new, post–COVID-19 normal not as predictions, but as a series of choices. In this article in JAMA, Donald Berwick proposes six properties of care for durable change: tempo, standards, working conditions, proximity, preparedness, and equity.
  16. Content Article
    The impact of COVID-19 on communities of colour in the US is dramatically and disproportionately affecting African-Americans most of all. The reasons are complex, with underlying health conditions (e.g., hypertension, diabetes) acting as one contributing factor. Yet, these health problems, public health experts say, largely reflect the history and ongoing realities of racism in the US that have created barriers to accessing quality health care and the conditions that can lead to better health.
  17. Content Article
    The impact of the virus that causes COVID-19 could hardly be more disparate. While billions are stuck at home and restricted by social-distancing guidelines, millions of people must still put themselves and their families at risk by continuing to go to work. Millions are coping with the requirement of effectively working from home, but millions more have lost their jobs and don’t know how they will pay for housing or food. And for those who contract the virus, its effects span from nothing at all to death. Derek Feeley discusses these inequities in an article for the Institute of Healthcare Improvement.
  18. Content Article
    The COVID-19 pandemic has affected some sections of the population more than others, and there are growing concerns that the UK’s minority ethnic groups are being disproportionately affected. Following evidence that minority groups are over-represented in hospitalisations and deaths from the virus, Public Health England has launched an inquiry into the issue. In the short term, ethnic inequalities are likely to manifest from the COVID-19 crisis in two main ways: through exposure to infection and health risks, including mortality; through exposure to loss of income. This report brings together evidence on the unequal health and economic impacts of COVID-19 on people in minority ethnic groups in the UK, presenting information on risk factors for each of the largest minority ethnic groups in England and Wales: white other, Indian, Pakistani, Bangladeshi, black African and black Caribbean. The analysis focuses on a limited but crucial set of risk factors in terms of both infection risk and economic vulnerability in the short term.
  19. 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
  20. News Article
    The NHS faces a new set of wide-ranging requirements as part of a comprehensive plan to mitigate the impact of COVID-19 on black, Asian and minority ethnic staff, HSJ has discovered. A draft NHS England/NHS Improvement document, seen by HSJ, proposes trusts ensure every staff member has “a risk assessment to keep them safe”. It says the centre will provide: “Guidance and support to employers on creating proactive approaches to risk assessment for BAME staff, including physical and mental health.” The document, Addressing Impact of Covid-19 on BAME Staff in the NHS, will call for five actions: 1. Every member of staff, current and returning, will have a risk assessment to keep them safe. 2. Every organisation with a CEO, and for primary care CCGs and ICSs, needs a BAME co-leader. 3. Diversity at every level of the health and care system starts with the podium, through our senior decision-making forums and across all organisations and at all levels of the workforce. 4. A bespoke health and wellbeing (including rehab and recovery) offer for BAME staff will be developed and rolled out for the system. 5. Every part of the system will use guidance on increasing diversity and inclusion in communications will be produced, led by the system. Read full story Source: HSJ, 6 April 2020
  21. Content Article
    Could prisons be an opportunity to address serious health inequalities? Or do they lead to worse health for people living in prison? In this podcast from the Kings Fund, Anna Charles explores the health and wellbeing of people living in prison, their access to health and care services, and what happens on release. She’s joined by: Dr Jake Hard, Chair of the Royal College of General Practitioners Secure Environments Group Christina Marriott, Chief Executive Officer of Revolving Doors Chantal Edge, Public Health registrar and NIHR research fellow  Kate Morrissey, National Implementation Lead for RECONNECT at NHS England and NHS Improvement.
  22. News Article
    A leading doctor has called on the government to address regional health inequalities surrounding coronavirus. Dr George Rae, the British Medical Association's regional chairman for the North East, has written an open letter saying the area is "suffering disproportionately". He said it was "time to ask why" and wanted action to "close the gap". A government spokesman said it was working "incredibly hard" to protect the nation's public health. "This is gravely disconcerting," Dr Rae wrote. "Not only does this mean that we're suffering from a disproportionate amount of serious cases and deaths but also that, as a consequence, gradual lockdown measures may be affected - prolonging the hurt caused to our local economy. Covid-19 has shone a light on the health inequalities in the North East". "What we need now is action from the government to close this gap and reduce the vulnerability of people in the North East to many medical conditions and, indeed, any future viruses." Read full story Source: BBC News, 5 May 2020
  23. Content Article
    Radio 4's Women's Hour programme discusses coronavirus and the impact the current pandemic is having on access to cervical screening services. Later in the programme, the discussion turns to the topic of dealing with addiction during the lockdown. Cervical screening (listen from the start of the recording) Speakers, Kate Sanger, Head of Public Affairs at Jo's Cervical Cancer Trust, and consultant gynaecologist Dr Christine Ekechi stress that patients should not hesitate to contact their GP if they have any concerns or symptoms. Symptoms might include: abnormal bleeding, bleeding after sex, bleeding after the menopause, bleeding in between periods, unexplained pelvic pain and in some cases increased vaginal discharge. Addiction (21:45) According to the charity Action on Addiction, one in three people are addicted to something. How difficult can it be to remain sober or clean in lockdown, and what support can you still access? Speakers include Holly Sexton, Substance Misuse Practitioner at We Are With You, and Caroline Turriff, a freelance journalist who is 15 years in recovery. They discuss whether opiate painkillers and methadone being more easily available through pharmacies creates safety issues. Caroline argues that it will reduce the risk of people obtaining opiates online or heroin via street dealers which she says could enable them to obtain life-threatening amounts. 
  24. Content Article
    Patient experience data has long been used as a measure of quality of healthcare, but there remains a gap between measurement and improvement. The focus of the study discussed in this blog, was on understanding how staff approached patient experience projects, why some struggled, and how they made sense of the tasks.
  25. Content Article
    This webpage from the Primary Care Women's Health Forum (PCWHF), contains the latest guidelines, patient materials and articles from the board alongside recommended external resources. Resources include: Intrauterine methods for all indications. How to manage contraceptive provision without face to face consultations. Having a pessary fitted for a vaginal prolapse. Advice following insertion or removal of your contraceptive implant.
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