Health Inequities for the BAME Community During the Pandemic Case Study

Structural Inequities and the Exacerbation of Health Impacts on Marginalized Groups During the Pandemic

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Introduction Of The Case Study Response

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Rationale

According to the case study, the severity of the pandemic's effects on people of colour and other marginalized groups increased as a result of several structural inequities that had existed before the outbreak. However, the issue of comorbidity is the key that might influence the severity of the such epidemic in future as well (Guardian News & Media Limited, 2022). Thus, this report will prioritize the impact of national support for the Black, Asian and minority ethnic (BAME) community to manage their existing health conditions with an equal approach and make a difference in their health outcomes.

Scope

Employment, health services and hereditary issues all are major causes of the severity of the pandemic on the BAME population. Among these, the issue of having comorbidities is one of the significant issues that often get neglected and require precise emphasis by both the community and the health administration (Guardian News & Media Limited, 2022). Before the COVID-19 pandemic, minority groups had inferior health results and experiences than the total population. Poor access to services and increased prevalence of mental illness and metabolic diseases like type 2 diabetes, obesity and cardiovascular disease are instances. However, increasing data suggest that hereditary factors alone cannot explain the rise in diabetes and cardiovascular disease (Zhou and Kan, 2021).

Structure

Since the importance of identifying and addressing the issue of comorbidities such as diabetes and obesity is rising, the present report will be focused on the practices and role of the national stakeholders to address these issues with more investment in policies and initiatives.

Description Of COVID-19 has highlighted health inequities.

Main Issue

COVID-19 has highlighted health inequities. COVID-19 disproportionately affects BAME populations. PHE report revealed greater transmission and fatality rates for BAME groups than for non-BAME clusters. Before the COVID-19 epidemic, minority groups had inferior health outcomes and experiences than the total population (Smith and Mohan, 2022). Poor access to services and increased prevalence of mental illness and metabolic diseases like type 2 diabetes and coronary illness are instances. The issue is not proliferated by genetics or poor individual socio-economic circumstances, but also because of unequal access to health services which should be recognized at the core of understanding the extent of pandemic fatality among the BAME population (Naqvi, Gabriel and Adebowale, 2022). Minority groups, especially Asian communities, had a disproportionately high number of patients who had negative experiences at the doctor's office. When contrasted to whites, they were also significantly inclined to say they lacked the confidence to manage their own health and to report receiving insufficient support from other relevant councils in dealing with their illness (Warner et al., 2022). Thus, the lack of efficiency in managing their pre-existing diseases has directly impacted their capacity to hedge against the deadly virus. This highlights the inequality and expands the gap in healthcare access for the BAME population.

Key Stakeholders

General Medical Council (GMC), The National Health Service (NHS), and Public Health England (PHE) are some of the national organizations that are responsible for making equal healthcare opportunities and alternatives for the BAME community.

Discussion

The BAME population is being disadvantaged in the aspect of their healthcare needs and experience due to some major structural racism which still exists in the healthcare system. Although many researchers suggest that the BAME population is socio-economically weak and often faces a lack of services for their healthcare (Heaslip et al., 2022). The care approach for the population is often inconsistent. Thus, the people of this community face higher health issues and therefore they become more susceptible to major viruses such as the Covid-19 pandemic. This impacts the mortality ratio of this specific community. Although multiple organizations have tried to address this issue, structural discrimination has been affecting the possibility of better and enhanced healthcare alternatives for the BAME population (Razai et al., 2022). Ethnic health inequities are likely caused by the disproportionately low socioeconomic status of certain ethnic groups. Some government initiatives have attempted to address health disparities, but they have not always paid particular attention to racial or ethnic differences. By better focusing resources like screening programs, information, and distribution of resources, knowing a population's ethnic makeup helps enhance healthcare delivery. There is evidence of discrimination in-hospital treatment for ethnic minority groups, such as the decreased availability of care for coronary heart disease among South Asians. Blacks and other minorities have historically had poorer rates of quitting smoking than Whites (Out et al., 2020). Some members of the Black community and other ethnic minorities in Britain are more likely to express discontent with NHS services. Language hurdles, cultural differences, economic disparities, etc. all play a role. However, both clinical and social interventions are necessary to effectively treat these problems. Public Health England (PHE) released a national resource in 2018 that actually proves the trends and induces of ethnic health inequalities in England. This resource is meant to promote an interconnected strategy for reducing health disparities, as well as apprise local and national intervention by PHE and other authorities. NHS is also responsible for making acute judgements according to the minority groups' socioeconomic standing and ethnic inclinations and curating strategies accordingly (Out et al., 2020).

In the BAME population, the health concerns are usually higher than the white people. This is attributed to different reasons (Bambra et al., 2020). These people are supposed to work for longer hours, get unequal benefits, and primarily reside in a poor environment which impacts their health, these people often belong to economically poor backgrounds which influences their eating habits and physical activities. According to social cognitive theory (SCT), elements such as personal experience, social interaction, and context all have a role in shaping an individual's approach to health (Dace, Stibe and Timma, 2020). SCT promotes social support via the use of expectancies, self-efficacy, observational learning, and other stimuli to bring about desired behaviour change.

Key SCT elements for behaviour modification involve:

  • Self-efficacy is the idea that a person can accomplish an activity.
  • Knowing and performing a behaviour is behavioural capacity.
  • Expectations suggest the factors that determine the outcome.
  • Expectancies indicate valuing the results of behavioural change.
  • Self-control means observing and controlling behaviour.
  • Observational learning suggests seeing others execute or practice desirable actions.
  • Facilitate behavioural change via rewards and incentives.

Already the BAME community mostly rely on their traditional eating and lifestyle habits. Therefore, it is important to see how these people are motivated in their healthcare approach and what aspects need to be recognized by the national healthcare system and associated stakeholders to take appropriate initiatives to influence their tendencies and create a sustainable path for health issue mitigation while introducing proper preventive intervention (Bambra et al., 2020). The national healthcare systems are an attempt to make significant changes in their approach to healthcare assistance and preventive approach.

PHE Screening sponsored a session on screening inequities in 2015. The seminar was motivated by resolving screening inequities. It suggested a number of measures and advocated that they be expanded into an overall plan to address what PHE Screening could do to enable local stakeholders (including NHS England, local authorities, Clinical commissioning groups, primary care, providers, and the third sector) to eliminate screening inequities. Local and nationwide efforts to reduce screening inequities are advancing, but there are still obstacles (Keys et al., 2021). The emphasis is on the development of a cohesive plan to decrease screening inequities and provide empowered individual preference and fair access for everyone.

Solutions are also curated according to the changing policy interventions to assure that proper healthcare facilities can be provided while eliminating the disparities. For instance, the Secretary of State for Health has legal responsibilities regarding health disparities that PHE is responsible for carrying out on his behalf, under the Health and Social Care Act of 2012. For public agencies to fulfil their responsibility, they must give serious consideration to the pressing issue of reducing healthcare access disparities in England. It covers all PHE's public health operations, not only those directly related to healthcare (Keys et al., 2021). In alignment with this pledge, other recommendations can be made towards a better approach to the BAME population for equitable healthcare opportunity.

Health inequalities, such as racial and ethnic health disparities, are a serious problem in the United Kingdom, and the NHS needs to be held more accountable for improving patient care to eliminate these disparities (Bambra, Lynch and Smith, 2021). The Department of Health and Social Care, NHS England, and NHS Improvement would do well to make this an area of focus. The following are necessary components of this:

  • To ensure that reducing health inequalities is not viewed as a "nice to have," but rather as a "core purpose" for the NHS, the Department of Health and Social Care must start making it a key focus of every component of the new "triple aim" duty for the NHS suggested in the Innovation and Integration White Paper.
  • Facilities, preventive services, and health promotion activities tailored to Black and minority ethnic groups should be developed, delivered, evaluated, and improved in collaboration with societies, so the NHS must invest in tactical, government initiatives of interaction that construct maintained, trust-based relationships with these organizations. It can be done with the account of the social cognition theory as the BAME population’s approach and behavioural practices can be influenced by the interventions adopted by the communal engagement practices (Ganguli?Mitra et al., 2022). Through these interventions, a strong support approach can be made to modify the existing lifestyle behaviour, healthcare and eating habits that are often motivated by their ethnic roots which might negatively impact the overall well-being of the BAME population.

For the largest portion of the community, the impact of socioeconomic circumstances cannot be ignored. It is stated in most of the studies that even though health issues can be genetically inherited yet the influence of one's social and economic standing impacts the health standard to a significant extent. However, the cultural impact is also evident and often motivates the lifestyle and diet preferences of the people of the BAME community (Bambra, Lynch and Smith, 2021). Therefore, the healthcare administrative departments should take the initiative to influence their pattern of lifestyle and apply strategies that can motivate them to change the way they live and take positive suggestions for a better health outcome. The healthcare authorities should identify the demographic clusters on a communal basis to initiate strategies for healthy lifestyle discussions, seminars and social programs and campaigns that encourage the participation of the community members. It should be bifurcated on the basis of age, sex, ethnic differences etc. to make the initiative precise and specific. Especially the solution needs to be aimed at the young population to make the changes sustainable (Beauchamp et al., 2019). Discussions, monthly checkup campaigns in the BAME community, and health marketing strategies can lead to positive engagement and encouragement among young people which might boost awareness of healthy eating habits, weight management, treatment initiative and access to healthcare. This is a prospective solution that can be supported by the key idea of the social cognitive theory as these approaches have the capacity of influencing the pre-existing concepts regarding my own behaviour and actions. According to social cognitive theory, some of what people learn can be traced back to what they see other people doing in their everyday social encounters, experiences, and exposure to the medium (Beauchamp et al., 2019). Thus, creating a larger exposure to knowledge and awareness can influence the behaviour of these people which can positively impact their healthcare practices.

Conclusion and Recommendation

Differences in social and political contexts, race, tradition, religion, and citizenship all contribute to the formation of ethnic groups. While many individuals may feel a connection to more than one ethnic group, data collection and analysis demand that ethnicity be considered a constant. The UK is a place of ethnic diversity. The BAME population is one such example of an ethnic community that has been a centre of health research for several years. These people often face healthcare inequality and therefore have multiple comorbidities which have made them more vulnerable to the Covid-19 pandemic. The report has addressed the key reasons behind this increased susceptibility and how the national healthcare departments can curtail this threat through active strategic approaches.

In a nutshell, it can be suggested that to eliminate pre-existing health issues such as obesity, coronary issues and diabetes, healthcare stakeholders should focus on communitywide programs and awareness campaigns. These would increase the knowledge among young people belonging to the community and will widen their possibility for enhanced accessibility to advanced healthcare services.

Although there were some relevant sources which helped to strengthen the argument of this report, the identification of the sources was challenging as there are some complex research findings exist that often counter the desired outcome. Thus, future reports will be viable to enhance the subjective capacity of the topic.

References

Bambra, C., Lynch, J. and Smith, K.E., 2021. The unequal pandemic: COVID-19 and health inequalities. Policy Press.

Bambra, C., Riordan, R., Ford, J. and Matthews, F., 2020. The COVID-19 pandemic and health inequalities. J Epidemiol Community Health, 74(11), pp.964-968.

Beauchamp, M.R., Crawford, K.L. and Jackson, B., 2019. Social cognitive theory and physical activity: Mechanisms of behaviour change, critique, and legacy. Psychology of Sport and Exercise, 42, pp.110-117.

Dace, E., Stibe, A. and Timma, L., 2020. A holistic approach to manage environmental quality by using the Kano model and social cognitive theory. Corporate Social Responsibility and Environmental Management, 27(2), pp.430-443.

Ganguli?Mitra, A., Qureshi, K., Curry, G.D. and Meer, N., 2022. Justice and the racial dimensions of health inequalities: A view from COVID?19. Bioethics, 36(3), pp.252-259.

Guardian News & Media Limited, 2022. Health inequalities in UK are major factor in high BAME Covid cases. [Online]. Available at: https://www.theguardian.com/society/2021/jan/28/health-inequalities-in-uk-are-major-factor-in-high-bame-covid-cases [Accessed on 9th October 2022].

Heaslip, V., Thompson, R., Tauringana, M., Holland, S. and Glendening, N., 2022. Health inequity in the UK: exploring health inequality and inequity. Practice Nursing, 33(2), pp.72-76.

Keys, C., Nanayakkara, G., Onyejekwe, C., Sah, R.K. and Wright, T., 2021. Health inequalities and ethnic vulnerabilities during COVID-19 in the UK: a reflection on the PHE Reports. Feminist legal studies, 29(1), pp.107-118.

Naqvi, H., Gabriel, M. and Adebowale, V., 2022. The critical role of the NHS Race and Health Observatory. BMJ leader, 6(2).

Otu, A., Ahinkorah, B.O., Ameyaw, E.K., Seidu, A.A. and Yaya, S., 2020. One country, two crises: what Covid-19 reveals about health inequalities among BAME communities in the United Kingdom and the sustainability of its health system?. International journal for Equity in Health, 19(1), pp.1-6.

Razai, M.S., McKechnie, D., Rao, M. and Majeed, A., 2022. Now is the time for radical action on racial health inequalities. bmj, 376.

Smith, S. and Mohan, R., 2022. The NHS is not an island—tackling racial disparities in healthcare. bmj, 377.

Warner, M., Burn, S., Stoye, G., Aylin, P.P., Bottle, A. and Propper, C., 2022. Socioeconomic deprivation and ethnicity inequalities in disruption to NHS hospital admissions during the COVID-19 pandemic: a national observational study. BMJ quality & safety, 31(8), pp.590-598.

Zhou, M. and Kan, M.Y., 2021. The varying impacts of COVID-19 and its related measures in the UK: a year in review. PloS one, 16(9), p.e0257286.

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