Health and Social Care - Comparative healthcare for factors contributing to the Health and Social Inequalities

Critical analysis of the factors contributing to the health  and social Inequalities in Black Ethnic Minorities

Research Aims:

• To critically explore rationales why black minority ethnic (BME) communities have been disproportionately affected by COVID-19.
• To issue recommendations to reduce the health inequality between black minority ethnic and other communities.

Introduction

• A review determined that the UK Health inequalities have widened within the last decade (Iacobucci, 2020b).
• reduction in life expectancy among 10% of the UK's most deprived neighbourhoods.
• The current evidence shows that people from Black minority ethnic are disproportionately being treated for covid-19 in intensive care units in the UK compared to White British(Iacobucci, 2020a).

Race and Inequality

• COVID-19 has exposed pre-existing inequalities resulting from race, gender, poverty, age, and health.
• Race is a biologically predetermined attribute based on their ancestry and physical features (such as skin colour), country of origin.
• race is also a social construct, which exposes an individual to a range of social factors such as language, culture, diet, religion, ancestry

Factors contributing to the health  and social Inequalities

Having a different rate of exposure

• working in jobs that potentially increase exposure to the virus, such as healthcare, social work, and transport services (Katikireddi et al., 2021).
• Another aspect that increases exposure is living in crowded houses with potentially infected persons, potentially resulting in a higher viral load (Mutambudzi et al., 2021).

Increased vulnerability to covid-19

• due to underlying health differences such as comorbidities, nutritional status, and immune systems compromise (Katikireddi et al., 2021).
• It could also be driven by poor environmental conditions such as air pollution and overcrowding, which increase their chances of developing a considerably severe infection (Niedzwiedz et al., 2020).

The interventions designed to minimise exposure to the virus may disproportionately fail to adequately be protective for black ethnic communities (Katikireddi et al., 2021)

• The lockdown allowed only jobs that disproportionate representation of ethnic minorities such as health and social workers, which exposed minority communities to COVID-19. (Katikireddi et al., 2021)
• the lockdown and other containment measures reduced family income, damaging employment prospects, particularly for ethnic minorities, widening the social inequalities between them and other communities (Griffin, 2020).
• Limited economic means due to poor financial circumstances increase their chances of poor nutrition, which subsequently increases their vulnerability, making them more susceptible to COVID-19 (Katikireddi et al., 2021)
• most government interventions have been a one-size-fits-all approach, which may have created greater inequality between black ethnic minorities and the white British population (Katikireddi et al., 2021)

Recommendations to improving  Health & Social Outcomes

• develop culturally sensitive interventions for the black ethnic minorities. interventions needed to be tailored in terms of language sensitivity to the cultural nuances and understanding what aspects in the black ethnic minority make them disproportionately more susceptible.
• Communication is tailored to the needs and reach of the BME communities.
• to reduce health inequalities by developing solutions to the housing projects Iacobucci (2020b) and Griffin (2020).

• radicating "structural racism," which refers to an array of dynamics in the historical-cultural interpersonal and institutional settings that are normal and legitimate but routinely offer advantage two white individuals while resulting in adverse and chronic outcomes in people of ethnic minority (Churchwell et al., 2020).
• to intervene against structural racism, it requires for the government to invest in ensuring that black minority ethnic groups offer incentives to access the same opportunities and services from childhood to adulthood,
• The government should develop effective strategies for monitoring and evaluating various forms of inequalities between the races in health and healthcare to design specific interventions that limit disadvantages in the black ethnic communities

Conclusion

• The COVID-19 revealed structural inequalities between the races, particularly among black minority ethnic communities who had a disproportionately higher chance of being admitted to the intensive care unit than their white population, who had considerably higher infection rates. There is a need to develop structural changes at multiple levels to ensure that people from ethnic minorities are recorded similar opportunities to build their resilience and provide that they are not disadvantaged by advanced events such as the occurrence of a pandemic.

References

Baciu, A., Negussie, Y., Geller, A., Weinstein, J. N., and National Academies of Sciences, Engineering, and Medicine. (2017). The root causes of health inequity. In Communities in action: Pathways to health equity. National Academies Press (US).

Bhopal, R. S. (2014). Migration, ethnicity, race, and health in multicultural societies. Oxford: Oxford University Press.

Churchwell, K., Elkind, M. S., Benjamin, R. M., Carson, A. P., Chang, E. K., Lawrence, W., ... and American Heart Association. (2020). Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation, 142(24), e454-e468.

Griffin, S. (2020). Covid-19: Failure to control pandemic and inequalities made England worst affected in Europe, says a report.

Haynes, K. (2020). Structural inequalities exposed by COVID-19 in the UK: the need for accounting for care. Journal of Accounting and Organizational Change.

Iacobucci, G. (2020 a). Covid-19: Increased risk among ethnic minorities is largely due to poverty and social disparities, review finds. BMJ: British Medical Journal (Online), 371.

Iacobucci, G. (2020 b). Marmot 10 years on austerity has damaged the nation's health, say experts. BMJ: British Medical Journal (Online), 368.

Johnson, J., Stoskopf, C. and Shi, L. (2017) Comparative Health Systems Burlington: MA Jones and Bartlett Learning (Kortext).

Katikireddi, S. V., Lal, S., Carrol, E. D., Niedzwiedz, C. L., Khunti, K., Dundas, R., ... and Barr, B. (2021). The unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities. Journal Epidemiol Community Health. 75(10). 970-974.

Mutambudzi, M., Niedwiedz, C., Macdonald, E. B., Leyland, A., Mair, F., Anderson, J., ... and Demou, E. (2021). Occupation and risk of severe COVID-19: a prospective cohort study of 120 075 UK Biobank participants. Occupational and Environmental Medicine, 78(5), 307-314.

Niedzwiedz, C. L., O’Donnell, C. A., Jani, B. D., Demou, E., Ho, F. K., Celis-Morales, C., ... and Katikireddi, S. V. (2020). Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank. BMC medicine, 18, 1-14.