Why it’s time to diversify UK healthcare
At talkhealth, we believe that everyone has the right to have access to great healthcare. Your race, income, age or gender shouldn’t influence the level of care or service that you’re able to enjoy. Unfortunately, however, we know that like many sectors of society, health care isn’t diverse enough.
That’s why we asked our members about their experiences. We wanted to know how their identity impacted on their access to healthcare.
A word on representation
According to the last nationwide survey, 9.1 million Brits were non-white in England and Wales – nearly 17% of the population. Our membership is a little under that national average, with 14% identifying Black, Asian, mixed or ‘other’.
Given the demographic of people who visit our kind of health site (largely female, middle-aged, situated in and around the South East), we believe that our membership is pretty representative of the bigger picture in the UK.
With that in mind, here are the results of our diversity in healthcare survey:
- 70% believe that not enough time and money is put into health and medical research for BAME communities
- 64% believe that BAME people haven’t been properly catered for during the pandemic
- 62% of people say they’ve not received adequate support for a condition that they believe to be more prevalent in BAME communities
- 93% of BAME people have never been tested for moles or skin cancer
- 10% of people from mixed backgrounds have had to explain their heritage during HCP appointments
Race versus treatment
We asked if our participants believed that their race had had an impact on their medical conditions and just over 4% said it had, with many complaining of racial bias from HCPs.
It’s well documented, for example, that Black women are routinely dismissed and let down during pregnancy. Indeed, they’re five times more likely to die in childbirth than other new mums in the UK.
One person told us: ’During my first labour, I visited the hospital with severe contractions. The midwife said, ‘I can tell by the look on your face, you are not having this baby right now’. She sent me home. 45 mins later, I almost gave birth in the car.
Another described having Hodgkin lymphoma aged 10. After months of not having her symptoms taken seriously, they were finally rushed to Great Ormond Street Hospital where, due to supposed racial bias, they mistook them for signs of TB.
‘For months and months, every medical staff member failed me by dismissing my symptoms because I was too young to get it, and because they fell back on racial stereotypes that I and my parents were being an angry brown family.’
It’s no longer socially acceptable to demand that people of mixed heritage dissect their racial makeup for the benefit of others. Asking where racially ambiguous people are from has become a taboo that many are rightly weary to contravene.
Within the healthcare system, however, it seems that HCPs are slow to catch up.
Over 10% of our mixed heritage members said their racial background was brought up during medical assessments, with HCPs asking where their surnames hailed from, asking their heritage to ‘determine what blood tests were needed’ and having their white British identity overlooked in favour of HCPs concentrating on their ‘other’ ethnicity.
If it really is necessary to know where someone’s family originates from, surely HCPs have to be able to produce solid reasoning? Natural curiosity isn’t good enough.
Perhaps it’d be different if there was real representation in the kinds of doctors and experts patients were seeing but we know that’s simply not the case; over 60% of our BAME members have seen an HCP of their ethnicity fewer than five times in their lives. That potentially leaves patients feeling alienated and ‘othered’.
When gender and race inequality collide
When we asked whether gender had played a role in not getting adequate healthcare, 43 participants answered with variations of the same theme: that women’s health and pain aren’t taken seriously.
Below are just a few examples of how five women feel they’ve been let down by the medical profession:
‘When I see a doctor, the first way they try to solve my problem is by giving me contraception – despite it not being really related to the issue.’
‘I was a serving soldier and believe that if I had been male, my injuries would have been treated differently. In the ’80s and ’90s, it was a very male-orientated environment and some people were still very anti-women in the forces.’
‘I feel that as a woman, there has been a tendency to give me medication and send me away rather than actually look into the causes of my lower back issues or be interested in fixing them. It took me five years to convince someone to send me for an MRI. If I was a man doing manual work rather than a female doing manual work, I would have been treated differently.’
‘Being a woman has made the process to get diagnosed as autistic longer and harder as a lot of the research on autism is on men and autism is still stereotyped as a medical condition that only men have.’
‘My gynae problems were dismissed as period pains. At 25, after being given loads of different contraceptive pills but not the one that had worked for me previously, I was told that the only treatments left were to have a baby or have a hysterectomy.’
Skin cancer risks
We know that anyone can develop skin cancer and issues arising from overexposure to sun rays. 65% of BAME members said that they’d received no information at all regarding skincare or skin cancer-directed at non-white communities. 93% had never been tested for moles or skin cancer either.
While they’re less at risk, Black and non-white people can still get skin cancer. However, they tend to be diagnosed later and as a result, the prognosis tends to be worse; the average 5-year melanoma survival rate is only 65% in Black people versus 91% in white.
70% of our respondents believe that not enough time and money is put into health and medical research for BAME people, with almost all saying that they weren’t aware of any BAME-specific services or clinical trials within the sector. That’s despite 60% believing that BAME people have specific health needs that require attention independent from mainstream NHS services.
Coronavirus v the Black community
The coronavirus pandemic has shown just how big a problem BAME communities face within the healthcare field. Black people are four times more likely to die from Covid-19 than white.
It’s not enough to simply write off that risk as ‘genetic’ or ‘lifestyle-induced’. We have to assess why non-white communities are dying at such disproportionate rates. Our members agree; 64% believe that BAME people haven’t been properly catered for during the pandemic.
Time for change
Finally, we asked what changes our members would like to see implemented in order to make healthcare in this country more fair and diverse.
Here are a few of the opinions submitted:
‘There needs to be more separate services available for BAME – especially now with coronavirus. They need to be all over the country. As far as I’m aware, in Scotland, there are no facilities that BAME can use separately if required.’
‘There needs to be more cultural understanding by the healthcare world about the way in which poor health is considered within the Asian community. The stigma attached to poor health can affect decision making, lifestyle choices and quality of life. Plus, there is a lack of research about many conditions and their effect specifically on BAME communities, even when it seems that they may be worse affected e.g. the Black community and Multiple Sclerosis.’
‘People should be made aware in a sensitive and professional way of genetic differences within certain populations (sickle cell disease among Black people, heart attacks among Asians) and not accuse researchers of racism. Attitude change due to education and promotional materials would make it easier for scientists to apply for funds and carry out vital research that would save lives.’
We want to see real and systemic change across society, and that has to involve the healthcare sector. talkhealth is a space for open dialogue and exchanges of ideas. If you’d like to be part of the change and think that you have something that our members should know about your commitment to diversity, let us know!