Tackling racial health inequalities – what can we do?
What does it mean to be unequal?
Inequality is the state of not being equal, especially in status, rights, and opportunities[i]. Inequalities exist throughout our society and are often systemic, leading to unfair and unequal opportunities. Defining moments in time can help to highlight certain inequalities, increasing awareness of the problem, and rallying people around a just cause. We have seen this recently with the conviction of Derek Chauvin for the murder of African American, George Floyd. This may be a small step in hopefully supporting a move away from racial inequalities, but there is still a lot of work to be done. The same can be said for health inequalities. We recently watched Tortoise’s ThinkIn ‘Can Covid cure healthcare of its race bias?’ in which speaker Dr. Mohammad Razai, Academic Clinical Fellow in Primary Care at St George’s University of London, said, “We have known about ethnic inequalities in health, sometimes known as health disparities for a very long time.” It’s important to note at this point that health inequalities stretch far beyond race, and discrimination affects all parts of our society, from gender to sexual orientation. However, in this blog, we will focus on the role we play in addressing racial health inequalities. Whilst COVID-19 has brought racial health disparities to the forefront of conversation, for example, data published in January this year revealed that black African males are 2.7 times more likely to die from COVID-19 than white males,[ii] these inequalities are not something new. We know that ethnic minorities have poorer access to healthcare and poor experiences of care and treatment[iii] related to racial discrimination and marginalisation.[iv] This contributes to mistrust between ethnic minorities and the NHS, making them less likely to seek medical help / advice. Ultimately, this results in poorer health outcomes. For example, black women are four times more likely to die during pregnancy or childbirth than white women.[v]
What can we do?
It can be difficult to look at such a complex problem and understand what we can do to evoke positive change. That said, we believe that our role as communicators is to build and establish trust with ethnic minority communities. For example, it’s often easier to recruit patients that are highly engaged with their health for co-creation projects. These patients are usually white, British and from higher socioeconomic backgrounds, which can result in under representation of minority ethnic groups in the end product. By aiming to include patients from diverse backgrounds in our communications programmes, we can build a more holistic picture of the patient experience. This will ultimately help us to create materials, messaging and campaigns that benefit a larger proportion of the patient population. Reaching out and interacting with minority communities also builds trust, as their experiences are not only heard, but acted upon to improve outcomes. We must act to drive change in our industry, first and foremost by educating ourselves about the inequalities that exist (see further reading at end of this post), and then by acting to address them. Tackling health inequalities is understandably no simple task. There is not a simple answer, and it is hard to look at healthcare in isolation when systemic racism exists across society. The impact is felt in employment, education, and criminal justice. But we need to start somewhere, and COVID-19 has put the spotlight on healthcare, providing impetus to bring about long-awaited change.
Knowledge is power
If you want to know more about health inequalities, the reasons behind them, and what can be done to address them, here are some great resources:
- Tortoise ThinkIn – Can Covid cure healthcare of its race bias?
- Health Equity in England: The Marmot Review 10 Years On
- Build back fairer: The COVID-19 Marmot Review
- Sway – Unravelling unconscious bias. Dr Pragya Agarwal
Please get in touch if you would like to learn more about how we at Aurora ensure that minority communities are not only reached, but actively engaged in our campaigns. We’d love to hear from you.
[i] Alkire, S., Foster, J., Seth, S., Santos, M. E., Roche, J. M., and Ballon, P. (2015). ‘Multidimensional Poverty Measurement and Analysis’, Oxford: Oxford University Press. Retrieved on 2 October 2015 from Oxford Scholarship Online: August 2015 [ii] Office for National Statistics. Updating ethnic contrasts in deaths involving the coronavirus (COVID-19), England and Wales: deaths occurring 2 March to 28 July 2020. October 2020. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/updatingethniccontrastsindeathsinvolvingthecoronaviruscovid19englandandwales/deathsoccurring2marchto28july2020 Last accessed: May 2021 [iii] Stead M, Angus K, Langley T, et al. Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence. NIHR Journals Library, 2019. Public Health Research No 7.8. Available at: https://www.ncbi.nlm.nih.gov/books/NBK540706/[iv] Paradies Y, Ben J, Denson N, et al. Racism as a determinant of health: a systematic review and meta-analysis. PLoS One2015;10:e0138511. doi:10.1371/journal.pone.0138511 pmid:26398658 [v] MBRRACE-UK. Saving lives, improving mothers’ care. December 2020. https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2020/MBRRACE-UK_Maternal_Report_Dec_2020_v10.pdf.