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Found 1,227 results
  1. News Article
    Health leaders have called for the routine recording of ethnicity and faith during the registration of deaths to help fight COVID-19, but the government appears to have rejected the idea. Leaders at West Yorkshire and Harrogate Health and Care Partnership, the second largest integrated care system in England, wrote to registrar general Abi Tierney last month and said the lack of routine collection and analysis of this data “means there is a structural barrier to understanding of inequalities in mortality”. The Home Office replied and said it is considering “a range of reliable and proportionate ways to collect the necessary information”. But HSJ understands the Home Office has indicated no immediate action will be taken on the issue. The letter said: “This absence has undoubtedly led to delays in identifying the inequalities of COVID-19 mortality and means that we remain unclear about the disparities in deaths outside of hospital. These delays have risked contributing to further loss of life in our places in recent weeks, as we have not had robust data to enable us to address impacts at sufficient pace as we have been dealing with this crisis.” Read full story (paywalled) Source: HSJ, 8 July 2020
  2. Content Article
    The tragic higher COVID-19 mortality in African Americans and other racial/ethnic minorities confirms inadequate societal efforts to eliminate disparities in cardiovascular disease (CVD) and is a sentinel event, highlighting deep-rooted US healthcare failures. The Joint Commission defines a sentinel event as an unexpected occurrence resulting in death or serious physical or psychological injury, or the risk thereof. Conventionally identified sentinel events, such as unintended retention of foreign objects and fall-related events, are used to evaluate quality in hospital care. Similarly, disparate African Americans COVID-19 mortality reflects long-standing, unacceptable US racial/ethnic and socioeconomic CVD inequities and unmasks system failures and unacceptable care to be caught and mitigated. Ferdinand and Nasser explore this further in their article in the Journal of the American College of Cardiology.
  3. Content Article
    A recent Health Foundation long read suggests that the COVID-19 pandemic could 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. The global pandemic and the wider governmental and societal response, is certainly bringing health inequalities into sharp focus. And it has been apparent from the early stages of the pandemic that some groups are at much higher risk of catching and dying from the virus than others. Factors such as age, gender, ethnicity and socioeconomic deprivation are all known to be important. Critically, these factors combine in complex ways to put some people at much greater risk. In addition, the measures taken to control the spread of the virus are having unequal socioeconomic impacts, which are likely to deepen health inequalities in the long term. Over the coming months, the Health Foundation will continue to round up key evidence on COVID-19 and inequalities. In this article the Health Foundation give an overview of some key themes emerging from recent work on the unequal impact of COVID-19, focusing on how children and young people are being affected, and the economic effects of the pandemic.
  4. Content Article
    Black women in the UK are five times more likely to die during pregnancy and after childbirth compared to white women (MBRRACE, 2019). A petition recently called for more research into why this is happening and recommendations to improve healthcare for Black Women as urgent action is needed to address this disparity. The petition exceeded the threshold of 100,000 signatures required in order to be considered for debate in Parliament. The Government issued this written response on 25 June 2020.
  5. Content Article
    More than 1 in 10 women will experience postnatal depression within the first year after giving birth. With a recent study showing that postnatal depression is 13% higher among black and ethnic minority women than it is among white women, it raises significant questions around whether these women are receiving the right treatment and support.
  6. Content Article
    There is clear evidence that COVID-19 does not affect all population groups equally. Many analyses have shown that older age, ethnicity, male sex and geographical area, for example, are associated with the risk of getting the infection, experiencing more severe symptoms and higher rates of death. This work has been commissioned by the Chief Medical Officer for England to understand the extent that ethnicity impacts upon risk and outcomes. The Public Health England (PHE) review of disparities in the risk and outcomes of COVID-19 shows that there is an association between belonging to some ethnic groups and the likelihood of testing positive and dying with COVID-19. Genetics were not included in the scope of the review.
  7. News Article
    Incoming Health Education England chief executive Navina Evans said the momentum created by the death of George Floyd and the Black Lives Matter movement meant there was now increased “pressure on white leaders” to act on racism and discrimination in the service. Dr Evans praised a letter written by Birmingham and Solihull Mental Health Foundation Trust chief executive Roisin Fallon-Williams, in which she admitted to being “culpable” and “complicit” in failing to fully understand the inequality and discrimination faced by people with black, Asian or other minority ethnic backgrounds. “That was great to see, and as you can see from the reactions to her letter people were really, really pleased to have it acknowledged,” she said. However, Dr Evans added: “As well as that [acknowledgement] there needs to be action”. Read full story Source: HSJ, 22 June 2020
  8. Content Article
    Six years ago The Snowy White Peaks of the NHS highlighted the scale of race discrimination in the NHS, the UK’s biggest employer of Black and Minority Ethnic (BME) staff. COVID-19 has shown so much more needs to be done. 300 health and social care staff have died so far from COVID-19, a disproportionate number of BME heritage. We know NHS staff infection was overwhelmingly due to occupational exposure whose causes are varied but include the disproportionate BME staff role in patient-facing services, their poorer access to appropriate PPE, the greater reluctance of BME staff to raise concerns, disproportionate deployment into “hotter” roles, and the greater presence of BME colleagues amongst agency staff. BME staff have been largely absent from decision-making. The COVID-19 impact on BME staff, and Black Lives Matter, has prompted promises to tackle racism more resolutely. So what should NHS leaders do to ensure faster progress to tackle workforce race discrimination? Roger Kline, in this BMJ Leader blog, has ten suggestions for Boards and Integrated Care System system leaders.
  9. News Article
    The COVID-19 pandemic could entrench and exacerbate inequalities in mental health for a generation unless action is taken, the Centre for Mental Health has warned. In a report published on Thursday, the charity warned that the lockdown would put greater pressure on groups whose mental health was already poor beforeCOVID-19 hit, such as women and children experiencing violence and abuse, and ethnic minority communities. The pandemic will leave an “unequal legacy of complicated bereavement, trauma, and economic repercussions which will push more people towards financial insecurity and poverty, significant risk factors for poor mental health,” the report said. “Unequal experiences of grief, loss, trauma, injustice, and abandonment all add to the psychological damage caused by COVID-19.” The report, backed by 12 mental health charities and the Royal College of Psychiatrists, said that the government must prioritise race equality and support “trauma informed” approaches for all people whose lives had been affected by COVID-19. Read full story Source: BMJ, 19 June 2020
  10. 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.
  11. 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.
  12. 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
  13. 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.
  14. 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
  15. 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."
  16. 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
  17. 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
  18. 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.
  19. 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.
  20. 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
  21. 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
  22. 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. 
  23. 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
  24. 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.
  25. 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.
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