It’s a well-known fact that racial disparities exist within our National Health Service, both with regard to patients and staff members (Salway et al, 2016; Tonkin, 2022). These disparities lead to poor health outcomes, both in the UK and globally (Salway et al, 2022). It is important that we as medical students understand these inequalities so that we do not actively encourage them in our future practice and can challenge them whilst on placement and for the rest of our careers.
Some of the disparities illustrated in our health service are striking. For example, the risk of material death amongst Black women is four times higher than White women (MBRRACE-UK, 2023). These disparities also exist for women of Asian and mixed ethnicity (MBRRACE-UK, 2023). For many of us, this statistic is (and should be) shocking. Our patients, the ones we work and vow to protect, should not be experience such equality based on the colour of their skin or the group that they identify themself with.
It is not currently undertook the exact cause behind Black and Asian mothers dying at an increased frequency as compared to their White counterparts, however, pre-existing conditions, comorbidities and poorer quality of care, can all be considered to play a role (Women and Equalities Committee, 2023). The true investigation into differing maternal health outcomes requires a much more in-depth exploration than can be delivered in this blog post (but will come in the future).
Regarding overall healthcare disparities, it seems that access to healthcare at the level of primary care is similar across ethnicities, however wider gaps arise regarding access to hospital and dental services (Nazroo et al, 2009). There is also evidence that the experiences of ethnic minorities in healthcare is poorer due to factors such as higher levels of dissatisfaction with care and language barriers (Rudat, 1994). Furthermore, ethnically minoritised older individuals are more likely to report poor self-rated health, even after controlling for social and economic disadvantages (Evandrou et al, 2016)
Where do we go from here?
When faced just such disheartening statistics, it can feel overwhelming as a student to know what to do in the face of a possibly insurmountable task. However, even by educating yourself on the issue, you are taking an important step towards tackling injustice. Moving forward, it’s important to educate our current and budding healthcare professionals on these issues, how to recognise them, and them empowering them with methods to overcome these disparities. This can involve having a more inclusive education, teaching about medical conditions on a variety of ethnicities, something that Anatome is hoping to achieve. The ways we address these inequalities are not quite ironed out, and will likely take a systemic overhaul to truly see a difference.
References:
Evandrou, M., Falkingham J., Feng, Z. (2016) ‘Ethnic inequalities in limiting health and self-reported health in later life revisited’, Journal of Epidemiology and Community Health, 70(7), pp. 653-662.
MBRRACE-UK (2023) ‘Maternal Mortality 2019-2021’, MBRRACE-UK, available at: https://www.npeu.ox.ac.uk/mbrrace-uk/data-brief/maternal-mortality-2019-2021#:~:text=The%20risk%20of%20maternal%20death,%2D20%20(Figure%203). (Accessed 29 July 2023)
Nazroo, J., Falaschetti, E., Pierce, M. (2009) ‘Ethnic inequalities in access to and outcomes of healthcare: analysis of the Health Survey for England, Journal of Epidemiology and Community Health, 63, pp. 1022-1027.
Rudat, K. (1994) ‘Black and Minority Ethnic Groups in England: Health and Lifestyles’, London: Health Education Authority.
Salway S., Ghazala, M., Turner, D., Ellison, G., Carter, L., Gerrish, K. (2016) ‘Obstacles to “race equality” in the English National Health Service: Insights from the healthcare commissioning arena’, Social Science and Medicine, 152, pp. 102-110.
Tonkin, T. (2022) ‘Racism an issue in the NHS, finds survey’, British Medical Association, available at: https://www.bma.org.uk/news-and-opinion/racism-an-issue-in-nhs-finds-survey (Accessed 29 July 2023).
Women and Equalities Committee (2023) ‘Black maternal health’, UK Parliament, available at: https://publications.parliament.uk/pa/cm5803/cmselect/cmwomeq/94/report.html (Accessed 29 July 2023).
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