Helping health practitioners to meet the challenges in race equality

Published by traceybignall for Race Equality Foundation in Health and also in Housing

Two recently published briefing papers highlight the challenges for health practitioners in addressing the health and social care needs of black and minority ethnic communities.

With the projected growth in the black and minority ethnic population and an expected rise in the number of adults with learning disabilities by 2021, Fulton and Richardson in their Better Health briefing paper, stress the pressing need to work towards race equality in advocacy services and call on heath and social care practitioners to act.

The discrimination and disadvantage experienced by black and minority ethnic communities is well researched. For those who also are learning disabled, they experience multiple discrimination. Research evidence shows that only a small percentage receive health and social care support, despite advocacy services which exist to facilitate access support for many vulnerable groups. The authors argue that advocacy services themselves have work to do to ensure there is effective race equality in the support they give to learning disabled people from African, Asian and Caribbean services.

In the Towards race equality in advocacy services: people with learning disabled from black and minority ethnic communities briefing paper, Fulton and Richardson highlight some of the urgent challenges for advocacy services including: examinging the concept of advocacy which may not be fully understood or translatable for many black and minority ethnic communities. This may lead to redefining services to be more ‘culturally tailored. Improving the cultural knowledge of practitioners so that negative stereotyping and perceptions do not lead to discriminatory practices. For example, the assumption of an extended network within Asian families deminishing the need for respite care for Asian carers. To promote full access to health and social care services, appropriate action is necessary to meet the language needs of those BME people who need to use advocacy services. Such action reaches beyond translated materials but considerations as to the mediums used to inform these communities.

We are aware of the health inequalities in relation to various health conditions. Reducing the numbers of people affected by cardiovascular disease is a priority for many primary care trusts. Cardiovascular disease (CVD) includes a number of conditions, such as coronary heart disease (CHD), and there are a number of complex and interrelated risk factors associated with this disease, of which ethnicity is one.

South Asians are the main minority ethnic group at risk of cardiovascular disease. But the evidence as to why is confusing. Behavioural factors, the link between diabetes and CHD (where Asian people have a high prevalence of diabetes), as well as social economic disadvantage, are inter-related contributors. Moreover, the evidence does show that changes in lifestyle can improve the quality of life for people with coronary heart disease. But where there are suggested changes in healthcare practice, black and minority ethnic people are still found to be disadvantaged. For example, minority ethnic people are less likely to receive cardiac rehabilitation which is the expected aftercare for all those admitted to hospital with coronary heart disease.

Importantly, Astin and Atkin in the ethnicity and coronary heart disease briefing paper acknowledge the difficulties for healthcare practitioners in treating those with, or likely to develop CVD, because of the challenge in determining when ethnicity makes a ‘difference and mediates a person’s experience, and when it does not’. Nevertheless, ensuring staff are culturally competent, working in partnership with third sector organisations and engaging with black and minority ethnic communities are some of the ways in which ethnicity as a risk factor for cardiovascular disease can be addressed.

Both papers are available on the Better-Health practice site developed by the Race Equality Foundation. The Better Health website provides health practitioners with free information and guidance on race equality through a quickly expanding collection of evidence-based briefing papers, resources and weblinks. The site also enables practitioners to share ideas and get involved with our good practice forums.

Notes
1. Towards race equality in advocacy services: people with learning disabilities from black and minority ethnic communities by Rorie Fulton and Kate Richardson, Better Health briefing paper 15, Race Equality Foundation
2. Ethnicity and coronary heart disease: making sense of risk and improving care by Felicity Astin and Karl Atkin, Better Health briefing 16, Race Equality Foundation
3. www.better-health.org.uk
4. The Race Equality Foundation is a national agency that promotes race equality across public services.