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Found 125 results
  1. Content Article
    Women from ethnic minorities are voicing their concerns that they face endemic structural racism when seeking and accessing healthcare, and they feel that their symptoms and signs are more often dismissed. It is vital that patients are listened to when they say that they feel this is also due to structural racism in healthcare.
  2. News Article
    A review of a clinical commissioning group has discovered “microaggressions and insensitivities” towards Black, Asian and minority ethnic staff, and the use of derogatory slurs about other groups. The report into Surrey Heartlands CCG also uncovered incidents of shouting, screaming and bullying among other inappropriate behaviour. And it was reported some staff were unwilling to accept Black Lives Matter events as important, stating “all lives matter”. The review also discovered a culture of denial and turning a blind eye to consistent concerns, with staff fearful of speaking up. In particular, the HR department was said to have been repeatedly told about the behaviour of one staff member but had chosen to ignore or delay dealing with the issues. However, the review found “no evidence for widespread discriminatory practices” and “no clear evidence for a widespread culture of bullying and ill-treatment” — but it added the systems to deal with concerns had failed and there was a sense of “organisational inaction”. Read full story (paywalled) Source: HSJ, 27 November 2020
  3. Content Article
    In medical schools, students seek robust and mandatory anti-racist training. Activists especially want to see their institutions recognise their own missteps, as well as the racism that has accompanied past medical achievements. Read Elizabeth Lawrence's article in the Washington Post.
  4. Content Article
    In 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."
  5. Content Article
    Heralded 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.
  6. Content Article
    Disparities 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.
  7. News Article
    The staff-side committee of a major hospital trust has stopped working with its leadership, with its chair alleging an ‘endemic’ culture of ‘racism, discrimination and bullying’. Irene Pilia, staff-side committee chair at King’s College Hospital Foundation Trust, told colleagues that the decision was taken “in the interests of staff”, especially black, Asian and minority ethnic workers, and expressed concerns about the organisation’s disciplinary procedures. She said the decision had the backing of staff committee officers and delegates. Ms Pilia, who is also the senior KCHFT Unite representative, said she was open to resuming partnership working again, but told trust executives: “I have lost trust and confidence in the ability of [KCHFT] to conduct fair, impartial and no-blame investigations. “Until there is tangible and credible evidence that racist behaviour at all levels is proactively eliminated, such that perpetrators face real consequences (including to the detriment of their careers) for their actions and are no longer allowed to behave in racist ways with impunity, I take a stand for the hundreds, possibly thousands of KCHFT staff whose voices are not being heard." Read full story (paywalled) Source: HSJ, 22 October 2020
  8. News Article
    Doctors from black, Asian and minority ethnic backgrounds have been hindered in their search for senior roles because of widespread “racial discrimination” in the NHS, according to a report from the Royal College of Physicians. The RCP, which represents 30,000 of the UK’s hospital doctors, found that ingrained “bias” in the NHS made it much harder for BAME doctors to become a consultant compared with their white counterparts. “It is clear from the results of this survey that racial discrimination is still a major issue within the NHS,” said Dr Andrew Goddard, the RCP’s president. “It’s a travesty that any healthcare appointment would be based on anything other than ability.” Read full story Source: The Guardian, 21 October 2020
  9. News Article
    There is growing distrust for the NHS and government in communities that are of fundamental importance to the national effort to counter covid, according to research by NHSX. People in so-called “hard to reach” communities are faced with stigma and racism due to the covid pandemic but have dwindling trust in the health service, the research found. They are worried about how their personal data will be used by the NHS and other state bodies. They are particularly concerned that their details will be passed on to the police or immigration services. Read full story (paywalled) Source: HSJ, 20 October 2020
  10. Content Article
    The 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.
  11. Content Article
    Medicine 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.
  12. Content Article
    Appalling 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."
  13. News Article
    Almost two-thirds of black Britons think the NHS does less to protect their health than that of white people, research has found. That negative view of the health service is shared by a majority of black people of almost all ages, and is held especially strongly by black women, according to findings of a study commissioned by a parliamentary committee. Overall, 64% of black people do not believe that their health is as protected by the NHS compared with white people’s. When asked if they thought it was, 34.3% disagreed and another 29.6% disagreed strongly, while just 19.9% agreed and a further 2.4% agreed strongly. The survey was commissioned by MPs and peers on the joint committee on human rights as part of its inquiry into black people, racism and human rights in the UK. The report will be published and debated with the authors at an evidence session today. Read full story Source: The Guardian, 7 September 2020
  14. Content Article
    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.
  15. News Article
    A major British medical school is leading the drive to eliminate what it calls "inherent racism" in the way doctors are trained in the UK. The University of Bristol Medical School says urgent action is needed to examine why teaching predominantly focuses on how illnesses affect white people above all other sections of the population. It comes after students pushed for reform, saying gaps in their training left them ill-prepared to treat ethnic minority patients – potentially compromising patient safety. Hundreds of other UK medical students have signed petitions demanding teaching that better reflects the diversity of the country. The Medical School Council (led by the heads of UK medical schools) and the regulator, the General Medical Council, say they are putting plans in place to improve the situation. A number of diseases manifest differently depending on skin tone, but too little attention is given to this in training, according to Dr Joseph Hartland, who is helping to lead changes at the University of Bristol Medical School. "Historically medical education was designed and written by white middle-class men, and so there is an inherent racism in medicine that means it exists to serve white patients above all others," he said . "When patients are short of breath, for example, students are often taught to look out for a constellation of signs – including a blue tinge to the lips or fingertips – to help judge how severely ill someone is, but these signs can look different on darker skin." "Essentially we are teaching students how to recognise a life-or-death clinical sign largely in white people, and not acknowledging these differences may be dangerous," said Dr Hartland. Read full story Source: BBC News, 17 August 2020
  16. Content Article
    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.
  17. Content Article
    The MBRRACE-UK Saving Lives, Improving Mothers' Care report found that black women in the UK are five times as likely as white women to die during pregnancy or childbirth.
  18. 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.
  19. 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
  20. 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
  21. 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."
  22. 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
  23. 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
  24. Content Article
    The 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.
  25. 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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