How is ethnicity relevant to health and wellbeing?
The economic and health impact of the Covid 19 pandemic has affected those in poverty the hardest. Higher poverty rates among black, Asian and minority ethnic (BAME) groups have persisted despite various anti-poverty commitments and policies. Factors such as changes to the labour market, the recession and UK wide austerity policies have contributed to the continuation of poverty, alongside the presence of racism and discrimination which continues to limit the opportunities of many BAME people in Scotland. There is a further danger that the Covid-19 crisis will cause a rising tide of poverty amongst those on low incomes, including a disproportionate number of BAME people.
Although BAME people are more likely to be in poverty than white people, anti-poverty policies and strategies have so far had little focus on race. Despite evidence of higher poverty rates amongst BAME children, even child poverty campaigners often fail to mention race in relation to these issues. In addition, communication breakdown and cultural factors often create barriers to black and minority ethnic groups accessing mental health services. BAME groups generally have worse health than the overall population across the UK, although the patterns of ethnic health inequalities are very diverse. Ethnic health inequalities result from many interlinking factors, of which the relative poverty of BAME groups is probably the most important. This has had a significant impact on specific BAME groups particularly those in Bangladeshi and Pakistani groups who are more likely to be over represented in lower paid positions in low paid sectors.
Local action to tackle health inequalities Public health data in Scotland, shows that the health of minority ethnic communities is in some respects better than that of the majority white Scottish population. These differences can vary by disease and ethnic group. However, it also points to significant health inequalities that are evident in the high rates of coronary artery disease and diabetes in South Asians, the low uptake of breast and bowel cancer screening, the disparate patterns of psychiatric hospitalisation by ethnic group in Scotland and the late diagnosis of HIV. There is also scope for ethnically targeted obesity and diabetes prevention strategies, and for better treatment in Scotland for genetically influenced conditions experienced by certain ethnic groups, for example sickle cell disease in African origin groups. As such, local action to promote health and wellbeing for ethnicity should focus on:
- key indicators of health status by ethnic group, including mental ill-health, cancer incidence, obesity and tuberculosis
- ethnic inequalities in the social determinants of health, including education, employment, income and housing
- health-related practices including smoking, alcohol consumption, physical activity and healthy eating
- access to services and interventions including health promotion and preventive interventions, and primary care and community health services
- ways to incorporate ethnicity within action on health inequalities
- Improve information about services and access pathways for mental health services
For more information:
Joseph Rowntree Foundation - We must loosen poverty's grip on Black, Asian and ethnic minority people
The National Counselling Society - Raft of barriers face BME people with mental health problems
UK Health Security Agency - Local action on health inequalities amongst ethnic minorities
Top tips for communicating with diverse groups for NHS staff