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At the start of 2025, the NHS Race and Health Observatory sponsored an infographic, explaining how healthcare professionals can spot the signs of jaundice in babies with dark skin tones. This infographic below, designed by Dr Helen Gbinigie and Dr Oghenetega Edokpolor, in collaboration with FiveXMore and Bliss, serves as a guide for parents' for recognising jaundice in Black and Brown babies, including where and how to seek help.- Posted
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Women, people from minority ethnic backgrounds, and those living in the most deprived areas of England are less likely to receive treatment after a diagnosis of a deadly heart disease, according to one of the largest studies of its kind. Researchers at the University of Leicester analysed data from almost 155,000 people diagnosed with aortic stenosis – a narrowing of the valve between the heart’s main pumping chamber and the main artery – between 2000 and 2022 across England, from a database of anonymised GP records. The study found that patients living in the most deprived areas were 7% less likely to be referred for secondary care after their diagnosis compared with patients in the least deprived areas, and 4% less likely to undergo a procedure to replace their aortic valve. The analysis, funded by the National Institute for Health and Care Research (NIHR) and presented at the British Cardiovascular Society conference in Manchester, also found that women were 11% less likely to be referred to secondary care, such as a hospital specialist, after their diagnosis than men. Women were also 39% less likely to have a procedure to replace their aortic valve. The study also found that black patients were 48% less likely to undergo a procedure to replace their aortic valve than white patients, with south Asian patients being 27% less likely. Both groups were more likely to be referred to secondary care, although the researchers say that this could reflect referrals for other heart issues not related to their aortic stenosis. Read full story Source: The Guardian, 5 June 2025- Posted
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NHS Race and Health Observatory Review of Neonatal Assessment and Practice in Black, Asian, and Minority Ethnic Newborns highlighted the need for educational resources to help healthcare professionals assess babies with dark skin tones, who are at higher risk of developing jaundice and experiencing delayed diagnosis and treatment. This new infographic for health care professionals, “10 Steps to spot Jaundice in Black and Brown babies” was designed by Dr. Helen Gbinigie, Neonatal Consultant at Medway Hospital and Clinical Lead for KM LMNS; and Dr. Oghenetega Edokpolor, ST5 Paediatric Trainee at Medway Hospital, in collaboration with the NHS Race and Health Observatory. It’s a vital tool in pursuing the Observatory’s aims to reduce neonatal ethnic health inequalities. Related reading on the hub: A parents’ guide to recognising jaundice in Black and Brown babies- Posted
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Top picks: Race and ethnic health inequalities
Patient Safety Learning posted an article in Health inequalities
Race and ethnic inequalities in health are widely recognised, with much work needed to improve care, diagnosis and treatment, and outcomes for patients. Racism is also evident within healthcare organisations and the impact on staff can be devastating. In this blog, we’ve collated a wide range of resources, including the latest research, the barriers patients face, improvement initiatives, health inequalities in maternity, and staff discrimination to evidence some of the key patient safety issues and the need for greater investment in this area. Barriers to diagnosis and treatment 1 Perceived barriers to accessing mental health services among black and minority ethnic communities: a qualitative study In most developed countries, substantial disparities exist in access to mental health services for black and minority ethnic populations. This study sought to determine perceived barriers to accessing mental health services among people from these backgrounds to inform the development of effective and culturally acceptable services to improve equity in healthcare. 2 ‘Mistreatment’ due to the colour of your skin A blog highlighting the barriers in healthcare faced by patients due to the colour of their skin. Impacting factors can include explicit racial bias, which includes discrimination and prejudice; implicit racial bias; missing data; lack of trust; and reduced access. These can lead to misdiagnoses and delays in treatment, which can ultimately cause harm and preventable death. 3 95% of healthcare professionals do not feel confident diagnosing dermatology conditions across skin tones This blog by Pastest, a provider of medical exam preparation resources, explores how different organisations are developing transformative initiatives to diversify clinical practice. It highlights the results of a global survey that reveals a critical gap in dermatological diagnosis across skin tones and explores the need for a multifaceted approach to anti-racist medicine. 4 Equity in medical devices: independent review A core responsibility of the NHS is to maintain the highest standards of safety and effectiveness of medical devices available for all patients in its care. Evidence has emerged, however, about the potential for racial and ethnic bias in the design and use of some medical devices commonly used in the NHS, and that some ethnic groups may receive sub-optimal treatment as a result. In response to these concerns, the UK Government commissioned this independent review on equity in medical devices. In its final report, the Review sets out the need for immediate action to tackle the impact of ethnic biases in the use of medical devices. 5 Skin assessment in patients with dark skin tone This article in the American Journal of Nursing provides basic information about the assessment of dark skin tone and calls for action in academia and professional practice to ensure the performance of effective skin assessments in all patients. 6 “We’re not taken seriously”: Describing the experiences of perceived discrimination in medical settings for Black women Cervical cancer disparities persist for Black women despite targeted efforts. Reasons for this vary; one potential factor affecting screening and prevention is perceived discrimination in medical settings. Inequalities in maternity 1 For black women in the UK, a fear of pregnancy is far from irrational In this blog for Refinery 29, journalist L'Oréal Blackett discusses the additional risk and associated worries faced by black pregnant women in the UK. With black women four times more likely to die in childbirth than white women, and 40% more likely to suffer a miscarriage, she examines what action the government is taking to improve outcomes for black women and their babies. She speaks to a number of campaigners who highlight the importance of including black women at every stage of research and policy to tackle race-based health inequalities. 2 Five X More campaign: Improving maternal mortality rates and health outcomes for black women In this interview, Patient Safety Learning talks to Tinuke, co-founder of the Five X More campaign and founder of the mothers group, Mums and Tea. Tinuke started the Five X More campaign as a response to the MBRRACE 2018 report which highlighted that black women in the UK are five times more likely to die in pregnancy and childbirth in comparison to a white woman. 3 Review of neonatal assessment and practice in Black, Asian and minority ethnic newborns: Exploring the Apgar score, the detection of cyanosis, and jaundice The results of a commissioned review undertaken by Sheffield Hallam University highlights a number of ‘reliability concerns’ around three current neonatal assessments and perinatal practices – the Apgar score and the detection of cyanosis and jaundice. It calls for immediate update of maternity guidelines that refer to assessments by skin colour and the increased use of screening tool devices, including oximeters and bilirubinometers. Urgent research is also needed which focuses on enhancing the reliability of these tools especially for darker skinned babies. 4 Addressing critical gaps in Black maternal mental healthcare: a new partnership project is launched Sandra Igwe is the Founder and CEO of The Motherhood Group. In this interview Sandra tells us about a new partnership project, bringing together The Motherhood Group, Centre for Mental Health, and the Maternal Mental Health Alliance to address critical gaps in Black maternal mental healthcare. Staff discrimination 1 NHS Confederation - Shattered hopes: black and minority ethnic leaders’ experiences of breaking the glass ceiling in the NHS This report by NHS Confederation looks at the lived experience of senior black and minority ethnic leaders in the NHS. The report highlights that more than half of those surveyed considered leaving the health service in the last three years because of their experience of racist treatment while performing their role as an NHS leader. Colleagues, leaders and managers seemed to be a particular source of racist treatment, more so than members of the public. This suggests that more focused efforts are required at every level to reduce the incidence of racist behaviour and to improve awareness among all staff of the impact of this type of discrimination. 2 Resource for nursing and midwifery professionals to combat racial discrimination against minority ethnic nurses, midwives and nursing associates Racism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. 3 Too hot to handle? Why concerns about racism are not heard... or acted on This report aims to understand the NHS response to racism, what trusts and healthcare organisations do about it and how effective they are at addressing it. It brings together key learning from a number of significant tribunal cases and responses from 1,327 people to a survey about their experiences of raising allegations of racism within their organisations. 4 Closing the gap: A guide to addressing racial discrimination in disciplinaries A guide from NHS Providers to help health service trusts tackle racial discrimination in disciplinary procedures and promote inclusivity. 5 Nursing narratives: Racism and the pandemic This report describes the findings of a study that collected stories of the working lives of Black and Brown healthcare staff during the Covid-19 pandemic. The study asked them to reflect on their experiences and highlight the changes they would like to see. It highlights a number of issues around victimisation, access to PPE, speaking up and risk assessments. 6 Racism which impacts healthcare staff endangers patient care As well as a moral issue, tackling racism affecting NHS staff is a crucial part of improving patient safety and care, says MDX Research Fellow Roger Kline. In this blog, Roger looks at the risks of racism on patient safety. Improvement initiatives 1 How Lambeth is closing the health inequality gap for Black and minority ethnic patients with high blood pressure Black and minority ethnic patients with high blood pressure have benefited from a project which was run by two Lambeth GP practices. The project aimed to reduce the very significant difference in blood pressure control (hypertension) between Black and minority ethnic patients and white patients. The year-long project resulted in the two practices achieving some of the best outcomes ever seen in South East London for overall hypertension control, with a 12% inequality gap for blood pressure control between black and white patients completely eradicated. In addition, over 300 patients from the local community were newly diagnosed with hypertension. 2 Patient and Carer Race Equality Framework - community This video provides an introduction to Sheffield Health and Social Care NHS Foundation Trust's (SHSCFT's) Patient and Carer Race Equality Framework (PCREF). The PCREF aims to help the Trust's staff and communities understand how to have sensitive conversations with patients and carers and to get better information from them. This will mean the Trust is more culturally aware and able to offer culturally appropriate care by understanding the barriers ethnic minority communities face in getting healthcare services for diagnosis and treatment. 4 Excellence through equality: Anti-racism as a quality improvement tool This report from the BME Leadership Network comprises examples of anti-racist initiatives from BME Leadership Network members, to help advance equality within the workforce and for service users. 5 Be the Change: How to tackle racial inequalities in health and care charities A few years ago, National Voices created an inclusion action plan to try to narrow the gaps in racial inequalities by driving improvements in their recruitment practices, organisational culture, influencing activities and work with people with lived experience. A key part of that plan was convening their members to learn from each other, so they organised a series of four members-only roundtables for focused, pragmatic and open discussion. This report, highlights the main learnings in each of the areas, and draws out general advice from all these conversations. They hope it will give colleagues in the health and voluntary sectors ideas for what they could do, alongside practical tools to take action. 6 Mind the Gap: A handbook of clinical signs in Black and Brown skin Mind the Gap is a Handbook to raise awareness of how symptoms and signs can present differently on darker skin as well as highlighting the different language that needs to be used in descriptors. The aim of this booklet is to educate students and essential allied health care professionals on the importance of recognising that certain clinical signs do not present the same on darker skin. 7 The Health Foundation: Bringing an anti-racism approach to quality improvement in maternity care Black Maternity Matters is a collaboration supporting perinatal staff to reduce the inequitable maternity outcomes faced by Black mothers and their babies. Through a ground-breaking programme of training, including anti-racist education, peer support, and quality improvement, it supports maternity systems to provide safer, equitable care. In a recent episode of the Leading Improvement in Health and Care podcast, Penny Pereira, Q Managing Director, spoke to three improvement leaders from the Black Maternity Matters programme. Structural racism 1 Institute of Health Equity: Structural racism, ethnicity and health inequalities in London Racism in London is widespread and persistent causing damage to individuals, communities and society as a whole. Its impacts are experienced in different ways and to varying levels of intensity related to individual experiences, socioeconomic position and other dimensions of exclusion such as disability, age and gender. The intersections with other dimensions of exclusion can amplify the effects of racism. The focus of this review is on the effects of racism on health and its contribution to avoidable inequalities in health between ethnic groups – a particularly unacceptable form of health inequity. It is urgent that society tackle the damage to health and wellbeing as a result of racism. 2 Structural racism as a contributor to lung cancer incidence and mortality rates among Black populations in the United States Although racial disparities in lung cancer incidence and mortality have diminished in recent years, lung cancer remains the second most diagnosed cancer among US Black populations. Many factors contributing to disparities in lung cancer are rooted in structural racism. To quantify this relationship, Robinson-Oghogho et al. examined associations between a multidimensional measure of county-level structural racism and county lung cancer incidence and mortality rates among Black populations, while accounting for county levels of environmental quality. 3 Interrogating and uprooting systemic racism in the emergency department Systemic racism refers to systems in which norms and practice patterns reinforce racial and ethnic inequalities even in the absence of individual intentions to do so. Uncovering subtle, overt and pervasive instances of racism that influence and change the trajectory of patient care is important. Emergency departments (EDs) offer a distinct environment where equity is not just a concept, but a fundamental practice that should be woven through all interactions between the patient, healthcare professionals and the system. For this reason, EDs are poised to lead health equity advocacy in the delivery of high-quality care. This JAMA Health Forum viewpoint article looks at evidence relating to ED systems’ vulnerability to systemic racism and maps a path forward to dismantle racism in the ED. 4 Women from ethnic minorities face endemic structural racism when seeking and accessing healthcare 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. 5 Structural racism — A 60-year-old Black woman with breast cancer This study uses 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. Research 1 Language-based exclusion associations with racial and ethnic disparities in thyroid cancer clinical trials Racial and ethnic disparities in thyroid cancer care may be reduced by improving enrolment of more diverse patient populations in clinical trials. This study in the journal Surgery looked at trial eligibility criteria and enrolment to assess barriers to equitable representation. 2 Differences in care team response to patient portal messages by patient race and ethnicity The use of patient portals to send messages to healthcare teams is increasing. This JAMA Network Open cross-sectional study of nearly 40,000 US patients aimed to find out whether there are differences in how care teams respond to messages from Asian, Black and Hispanic patients compared with similar White patients. The authors found that messages asking for medical advice sent by patients who belong to minoritised racial and ethnic groups were less likely to receive a response from doctors and more likely to receive a response from registered nurses. This suggests these patients receive lower prioritisation during triaging. The differences observed were similar among Asian, Black and Hispanic patients. 3 Racial implicit bias and communication among physicians in a simulated environment This JAMA Network Open study aimed to explore whether standardised patients in a simulated environment can be effectively used to explore racial implicit bias and communication skills among doctors. For this cross-sectional study, 60 doctors were placed in an environment calibrated with cognitive stressors common to clinical environments. The results reflected expected communication patterns based on prior research (performed in actual clinical environments) on racial implicit bias and physician communication. The authors believe that this simulation and the process of its development can inform interventions that provide opportunities for skills development and assessment of skills in addressing racial implicit bias. 5 Racial differences in shared decision-making about critical illness This US study looked at how critical care doctors approach shared decision-making with Black compared with White caregivers of critically ill patients. The authors found that racial disparities exist in critical care clinicians' approaches to shared decision-making and suggest potential areas for future interventions aimed at promoting equity. 6 Impact of healthcare algorithms on racial and ethnic disparities in health and healthcare This systematic review conducted for the Agency for Healthcare Research and Quality (AHRQ) aimed to examine the evidence on whether and how healthcare algorithms exacerbate, perpetuate or reduce racial and ethnic disparities in access to healthcare, quality of care and health outcomes. The results showed that algorithms potentially perpetuate, exacerbate and sometimes reduce racial and ethnic disparities. Disparities were reduced when race and ethnicity were incorporated into an algorithm to intentionally tackle known racial and ethnic disparities in resource allocation (for example, kidney transplant allocation) or disparities in care (for example, prostate cancer screening that historically led to Black men receiving more low-yield biopsies). 7 Characteristics of publicly available skin cancer image datasets: a systematic review Artificial intelligence (AI) is increasingly being used in medicine to help with the diagnosis of diseases such as skin cancer. To be able to assist with this, AI needs to be ‘trained’ by looking at data and images from a large number of patients where the diagnosis has already been established, so an AI programme depends heavily upon the information it is trained on. This review, published in The Lancet Digital Health, looked at all freely accessible sets of data on skin lesions around the world. These are just a selection of the resources we have on the hub, read more in the health inequalities section of the hub. Share your insights We'd like to hear from patients about your experiences and how it has impacted your care. Or perhaps you are clinician or researcher with a perspective to share on health inequalities? Please leave a comments below (sign up here first for free), or contact us directly at [email protected].- Posted
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untilDeNPRU Exeter is a Policy Research Unit in Dementia and Neurodegeneration based at the University of Exeter. This webinar will share learning from DeNPRU Exeter's policy research project on reducing inequalities for minority ethnic communities living with dementia, Parkinson's disease, motor neurone disease or Huntington's disease. The United Kingdom is composed of diverse range of ethnic and cultural groups. However, people from minority ethnic communities living with dementia or other neurodegenerative conditions often face significant inequalities in accessing healthcare. This can result in delayed diagnoses, poorer health outcomes and a reduced quality of life. This project has: identified and examined community campaigns aimed at raising awareness and/or reducing stigma around neurodegenerative conditions in minority ethnic populations. reviewed existing research on the barriers and facilitators influencing access to care and support for people from minority ethnic communities. learned from people with lived or professional experience about raising awareness of neurodegenerative conditions and addressing barriers to accessing services. Join the DeNPRU Exeter Reducing Ethnic Inequalities Project Team to hear about the findings. Deputy Director of DeNPRU, Professor Jan Oyebode Research Fellow, Dr Maria Caulfield There will be a chance to ask questions of the speakers. Register for the webinar- Posted
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Black communities asked to join health research
Patient Safety Learning posted a news article in News
eople from black ethnic backgrounds are being encouraged to take part in a research programme aimed at tackling health inequalities. The Improving Black Health Outcomes (IBHO) BioResource programme at University Hospital Southampton (UHS) will explore how African-Caribbean communities develop and experience different health conditions. Those taking part would be tested and matched with various research programmes into conditions including sickle cell, diabetes, heart and kidney disease. David Stockley, NIHR BioResource Southampton Manager at UHS, said the volunteers would be playing a "vital role" in developing future healthcare provision. UHS said the study was set up as historically, people from African and Caribbean heritage have been under-represented in health studies, meaning knowledge and treatments as a result of research have been predominantly based on white populations. Mr Stockley said the new initiative aimed to "close the gap". "The IBHO BioResource will help us better understand and address health conditions and their unique impacts on black people and their loved ones, ensuring everyone benefits from fair and inclusive research," he added. Read full story Source: BBC News, 20 March 2025- Posted
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For people living with type 2 diabetes, achieving the best health outcomes requires good self-management and sticking to agreed treatment. While some studies suggest an association between poor medication adherence and lower levels of health literacy, the evidence for this association remains inconclusive. This systematic review aimed to examine the evidence on the association between health literacy and medication adherence among adults from ethnic minority backgrounds living with type 2 diabetes.- Posted
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Inside the fight to improve outcomes for Black cancer sufferers
Patient Safety Learning posted a news article in News
Getting tested for prostate cancer should’ve been easy for Paul Campbell. He wanted a check-up after seeing an advert on TV calling for men in their 40s to get thorough health checks. He asked his GP but was immediately questioned about why he – a man who seemed otherwise healthy – would want a check-up. “I had to fight my ground, I had to raise my voice. And eventually, I got the test,” Mr Campbell told The Independent. He was later diagnosed with aggressive prostate cancer. “Had I not been assertive and pushy, by the time I found out, it would have been stage 4.” Mr Campbell is far from being alone in his experience. New research from the NHS Race and Health Observatory found “alarming levels” of discrimination towards patients from ethnic minorities and huge levels of mistrust in the NHS system. The survey of 2,680 people found only 55% trusted primary care to meet their health needs most or all of the time, while a third of south Asian participants said they either rarely or never trusted primary care to meet their health needs. On Friday, the NHS Race and Health Observatory roundtable brought together 20 key partners from local communities, the volunteer sector, the government and broader NHS to discuss the findings. Professor Habib Naqvi, chief executive, NHS Race and Health Observatory, said: “We cannot have a two-tier NHS based upon patient ethnicity, background or circumstances. This report reflects the clear need to bring speed and urgency to reform the NHS, so that patients do not face discrimination and systemic barriers when seeking healthcare.” These issues have a real impact on health outcomes. Read full story Source: The Independent, 9 March 2025 -
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People from ethnic minority backgrounds who have a learning disability face ‘double discrimination’ when accessing healthcare services. Culturally sensitive psychotropic deprescribing is just one way this can be improved. Health inequalities are pervasive across our healthcare system, affecting different patients in different ways and requiring an increasingly nuanced approach to tackle them. For individuals from an ethnic minority background, health inequalities are well documented. Evidence from the NHS Race and Health Observatory indicates that these individuals often receive poorer healthcare and experience worse health outcomes compared with their white counterparts. People with a learning disability also experience inequitable health outcomes. People from ethnic minority backgrounds who also have a learning disability may face ‘double discrimination’, encountering complex and significant barriers that shape their healthcare experiences. One area that has been of growing concern for this group is the overprescribing of psychotropic medicines. Psychotropic medicines are commonly prescribed to manage various mental health conditions and certain neurological disorders, such as epilepsy. People from ethnic minority backgrounds are at a greater risk of being prescribed psychotropic medicines to manage behaviours that challenge, with audits highlighting that these medicines are not reviewed as frequently as they should be. Overprescribing in this way not only exposes these individuals to unnecessary health risks, but also imposes significant burdens on them and their carers.- Posted
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Ten-year plan development ‘lacking diversity’
Patient Safety Learning posted a news article in News
Government must “move quickly” to address a lack of diversity in responses to its 10-year plan consultation, an adviser on the work has warned. Health and social care secretary Wes Streeting admitted last month that several groups have been heavily under-represented in the high-profile online engagement exercise, which began in October. Just 1% of responses are from Black African, Caribbean and Black British groups, who make up 4% of England’s population, while 3% are from an Asian background, who represent 10% of the population. Mr Streeting, acknowledging these “disparities and inequalities” to the Commons health and social care committee last month, said: “I want to nail [them] in the rest of this consultation period.” Jacob Lant, CEO of service user group National Voices and lead of one of the 10-year plan policy workstreams, said: “The public engagement exercise has been very ambitious in both its scale and speed, and it is good to see the [Department of Health and Social Care] actually investing in this sort of activity to ensure policy decisions are based on what matters most to patients. “It’s also encouraging the [health and social care secretary] is in reflective mode and is acknowledging the groups who have not had their say so far. It’s vital the process moves quickly now to fill those engagement gaps, and with the right support the VCSE sector can play a vital role in helping the government reach key communities over the next few months as the 10-year plan takes shape.” Read full story (paywalled) Source: HSJ, 3 January 2025 -
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Health disparities are systemic and deeply rooted in social and economic inequities. Patients living in deprived areas, from racially minoritised communities, or facing additional challenges such as homelessness or intellectual disabilities experience worse health outcomes. These disparities are compounded by mistrust in healthcare, low health literacy, cultural barriers, and discrimination. This report focuses on patients with blood disorders and/or cancers who experience health inequalities, and therefore have worse outcomes and experiences of care than patients who don’t. We looked at how social and economic factors affect the health of people living with blood disorders and cancer. Report key findings: Patients living with cancer and/or blood disorders experience significant barriers to care including delays in diagnosis, unequal access to services, and systemic discrimination, These patients also reported challenges navigating healthcare, a lack of communication, and economic burdens such as high transportation and medication costs, Social determinants of health like inadequate housing and living in deprived areas further worsened outcomes, Participants emphasised mistrust in the healthcare system, particularly among racially minoritised and LGBTQ+ communities, and highlighted the need for better coordination, cultural sensitivity training, and localised services. The project involved a literature review on health disparities and social determinants affecting patients with cancer and blood disorders. Discussions were held with local and condition-specific charities, and we conducted focus groups and a case study interview with patients and carers. These efforts aimed to gather diverse perspectives and first-hand accounts of lived experiences.- Posted
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Black and minority ethnic patients with high blood pressure have benefited from a project which was run by two Lambeth GP practices. The project aimed to reduce the very significant difference in blood pressure control (hypertension) between Black and minority ethnic patients and white patients. The year-long project resulted in the two practices achieving some of the best outcomes ever seen in South East London for overall hypertension control, with a 12% inequality gap for blood pressure control between black and white patients completely eradicated. In addition, over 300 patients from the local community were newly diagnosed with hypertension.- Posted
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British Bangladeshi men have highest rates of lung cancer in England
Patient Safety Learning posted a news article in News
British Bangladeshi men have the highest rates of lung cancer in England, according to a study that reveals clear patterns in how the disease affects different communities in the country. Disparities that go beyond smoking have been revealed by the University of Oxford researchers’ analysis of 17.5 million people’s health records and 84,000 lung cancer cases. The findings, from Oxford’s Nuffield Department of Primary Care Health Sciences, coincide with the rollout of the targeted lung health check programme across England, which aims to reach 40% of the eligible population by March 2025 and 100% by 2030. The new research found “ethnic background and social circumstances” are crucial factors in cancer risk, how it develops, and the type. Lung cancer occurred twice as frequently in the most deprived areas compared with the least – with 215 cases per 100,000 people among men in the poorest areas, compared with 94 cases in the most affluent, the study found. For women, rates in the most deprived areas were at 147 per 100,000, compared with 62 in the least deprived. Bangladeshi men showed the highest lung cancer rates, followed by white, Chinese and Caribbean men. Prof Julia Hippisley-Cox, a senior author of the study, said: “We need to ensure our cancer services are reaching all communities effectively and that everyone has the same opportunity for early diagnosis. “Tackling these disparities isn’t just about lung cancer: when we address these fundamental inequalities in healthcare access and social deprivation, we can improve health outcomes across many conditions.” Read full story Source: The Guardian, 14 November 2024 -
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This review by the UCL Institute of Health Equity (IHE) concludes that racism damages health and wellbeing and drives inequalities in London. Racism in the capital is widespread and persistent causing damage to individuals, communities and society as a whole. Its impacts are experienced in different ways and to varying levels of intensity related to individual experiences, socioeconomic position and other dimensions of exclusion such as disability, age and gender. The intersections with other dimensions of exclusion can amplify the effects of racism. The focus of this review is on the effects of racism on health and its contribution to avoidable inequalities in health between ethnic groups – a particularly unacceptable form of health inequity. It is urgent that society tackle the damage to health and wellbeing as a result of racism. The review is part of a series of evidence reviews funded by the Greater London Authority (GLA) to build the evidence for reducing health inequalities in London through action on specific social determinants of health. The other three reviews cover housing, the cost of living and adult skills.- Posted
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Patient satisfaction surveys rely largely on numerical ratings, but applying artificial intelligence (AI) to analyse respondents’ free-text comments can yield deeper insights. AI presents the ability to reveal insights from large sets of this type of unstructured data. The authors’ analysis here presents AI-enabled insights into what different racial and ethnic groups of patients say about physicians’ courtesy and respect. This analysis illustrates one method of leveraging AI to improve the quality and value of care. -
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How can we ensure that health and care staff from all backgrounds feel respected, valued and listened to at work? Siva Anandaciva sits down with Karen Bonner, Chief Nurse at Buckinghamshire Healthcare NHS Trust, to talk about the value of having a diverse workforce, and how we can make the health and care system fairer for staff, patients, and communities from ethnic minority groups.- Posted
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Evidence suggests that maternal mortality has been increasing in the US. Comprehensive estimates do not exist. Long-term trends in maternal mortality ratios (MMRs) for all states by racial and ethnic groups were estimated. The objective of this study was to quantify trends in MMRs (maternal deaths per 100 000 live births) by state for five mutually exclusive racial and ethnic groups using a bayesian extension of the generalised linear model network. The study found that while maternal mortality remains unacceptably high among all racial and ethnic groups in the US, American Indian and Alaska Native and Black individuals are at increased risk, particularly in several states where these inequities had not been previously highlighted. Median state MMRs for the American Indian and Alaska Native and Asian, Native Hawaiian, or Other Pacific Islander populations continue to increase, even after the adoption of a pregnancy checkbox on death certificates. Median state MMR for the Black population remains the highest in the US. Comprehensive mortality surveillance for all states via vital registration identifies states and racial and ethnic groups with the greatest potential to improve maternal mortality. Maternal mortality persists as a source of worsening disparities in many US states and prevention efforts during this study period appear to have had a limited impact in addressing this health crisis. -
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Race and ethnicity have been associated with poor pregnancy outcomes in many countries. In the UK, the rates of baby death and stillbirth among Black and Asian mothers are double those for White women. Most studies examine trends for individual countries. This large database study explored how race and ethnicity is linked to pregnancy outcomes in wealthy countries. Key findings Black women consistently had worse outcomes than White women across the globe. Hispanic women were three times more likely to experience baby death compared with White women. South Asian women had an increased risk of early birth and having a baby with an unexpectedly low weight (small for the length of pregnancy) compared with White women. Racial disparities in some outcomes were found in all regions. The researchers call for a global, joined-up approach to tackling disparities. Breaking down barriers to care for ethnic minorities, particularly Black women, could help. More research is needed to understand why outcomes are for worse for ethnic minorities. The researchers recommend routine collection of data on race and ethnicity. The link below takes you to the Plain English summary of the research, you can also view the full research study.- Posted
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Medical defence organisation MDDUS's latest annual member attitude survey has found that many have experienced or witnessed persistent racist microaggressions at work. Almost two-thirds of International Medical Graduate members report they’ve been subject to racist microaggressions and have little faith in being heard and the issue being taken seriously. MDDU's 'We hear you' campaign aims to be a catalyst for positive change and help rebuild confidence in the way such abuses can be reported.- Posted
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A new guide to help health service trusts tackle racial discrimination in disciplinary procedures and promote inclusivity has been launched by NHS Providers. The report, which has been published in collaboration with specialist healthcare law firm Hempsons, features case studies from several NHS trusts, including: Barking, Havering and Redbridge University Hospitals NHS Trust Black Country Healthcare NHS Foundation Trust Pennine Care NHS Foundation Trust Yorkshire Ambulance Service NHS Trust. The guide has been developed to show health leaders actionable insights and practical interventions, ultimately giving them a roadmap to tackle racial discrimination and improve the experience for staff from diverse backgrounds. Some of the most common themes across the report are ensuring staff learn from mistakes and see them as opportunities for growth, deploying anti-racism training, and the power of data analysis to identify inequalities.- Posted
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Content Article
An independent review from the NHS Race & Health Observatory of services provided by NHS Talking Therapies has identified that psychotherapy services need better tailoring to meet the needs of Black and minoritised ethnic groups. Ten years of anonymised patient data found that historically, people from Black and minoritised ethnic backgrounds have experienced poorer access to, and outcomes from, NHS talking therapies. Over this time period, compared to White British groups, they are less likely to access services, tend to wait longer for assessment and to access treatments. The data also showed that poor outcomes were faced by people from South Asian communities, in particular Bangladeshi groups. People of mixed ethnicity, mostly White and Black Caribbean, are the least likely to access these services. The comprehensive assessment review was undertaken in partnership with the National Collaborating Centre for Mental Health (NCCMH). It noted poor outcomes can be tackled and even disappear when access is improved, and culturally sensitive therapy is provided. People from Black African backgrounds using IAPT services were sometimes more likely to improve and recover in comparison with White British people. It calls on commissioners, clinicians, and healthcare organisations to address ethnic health inequalities. This can be done by improving resources and training to enhance understanding of mental health inequality, and by recruiting culturally sensitive and ethnically diverse therapists.- Posted
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- Health inequalities
- Health Disparities
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Content Article
Aortic valve replacement (AVR) is a life-saving procedure for symptomatic severe aortic stenosis (AS), which relieves symptoms, increases life expectancy and improves quality of life. Little is known about the rate of AVR provision by gender, race or social deprivation level in the NHS across England. However, a large analysis examining AVR on the health service in England – the first of its kind – reveals striking inequalities in its provision. Women, black and Asian people, and those living in the poorest parts of the country are much less likely to receive the life-saving procedure, the study shows. “In this large, national dataset, female gender, black or south Asian ethnicities and high deprivation were associated with significantly reduced odds of receiving AVR in England,” the authors wrote. Dr Clare Appleby, a consultant cardiologist at the Liverpool Heart and Chest hospital NHS foundation trust and an author of the study, said public health initiatives to understand and tackle these inequalities should be prioritised. “Severe symptomatic aortic stenosis is a serious disease that causes mortality and reduces quality of life for patients,” she said. “Left untreated it has a worse prognosis than many common metastatic cancers, with average survival being 50% at two years, and around 20% at five years.” Further research and public health initiatives to understand and address inequalities in the timely provision of AVR are important and should be prioritised in England.- Posted
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- Health inequalities
- Social determinants of health
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Content Article
In April 2023, National Voices held a workshop with members, supported by The Disrupt Foundation, on the unequal impact of the Covid-19 pandemic. It explored how communities and groups were affected differently by both the virus itself and the measures brought in to control it. It painted a grim picture of the ways in which the pandemic response exacerbated existing, deep-rooted inequalities across the UK and compounded the disadvantages experienced by people from minoritised communities, by disabled people and by people living with long term conditions. Just some examples include people who are immunocompromised, who were asked to go into isolation for huge periods of time and still feel completely overlooked as control measures have been lifted. Or the use of DNRs (Do Not Resuscitate orders) which were disproportionately applied to people with learning disabilities. With the Covid-19 Inquiry underway, it is imperative that we capture the lessons learnt from the pandemic, and use them to suggest action for the future. -
Content Article
The latest data from the Office for National Statistics (ONS) provides the most comprehensive and up to date national profile of ethnic inequalities in mortality overall and from common physical conditions. It shows a complex picture of ethnic inequalities in mortality in England, with differences between people from ethnic minority and the White British groups, between different ethnic minority groups, and across different health conditions. This King's Fund blog looks at the complex interplay of factors drives ethnic differences in health.- Posted
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- Ethnicity
- Health inequalities
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News Article
Black babies in England three times more likely to die than white babies
Patient Safety Learning posted a news article in News
Black babies in England are almost three times more likely to die than white babies after death rates surged in the last year, according to figures that have led to warnings that racism, poverty and pressure on the NHS must be tackled to prevent future fatalities. The death rate for white infants has stayed steady at about three per 1,000 live births since 2020, but for black and black British babies it has risen from just under six to almost nine per 1,000, according to figures from the National Child Mortality Database, which gathers standardised data on the circumstances of children’s deaths. Infant death rates in the poorest neighbourhood rose to double those in the richest areas, where death rates fell. The mortality for Asian and Asian British babies also rose, by 17%. The annual data shows overall child mortality increased again between 2022 and 2023, with widening inequalities between rich and poor areas and white and black communities. Most deaths of infants under one year of age were due to premature births. Karen Luyt, the programme lead for the database and a professor of neonatal medicine at Bristol University, said many black and minority ethnic women were not registering their pregnancies early enough and the “system needs to reach them in a better way”. “There’s an element of racism and there’s a language barrier,” Luyt said. “Minority women often do not feel welcome. There’s cultural incompetence and our clinical teams do not have the skills to understand different cultures.” Read full story Source: The Guardian, 9 November 2023- Posted
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- Health inequalities
- Health Disparities
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